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Year 2 EMS MoD > Repair and Regeneration > Flashcards

Repair and Regeneration Flashcards

1
Q

What is healing by repair?

A

Damaged cells replaced by fibrosis and scarring&raquo_space; loss of specialised function.

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2
Q

What is healing by regeneration?

A

Damaged cells replaced by like tissue&raquo_space; restores specialised function.

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3
Q

Which type of healing involves loss of specialised function?

A

Healing by repair.

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4
Q

Which type of healing involves restoration of specialised function?

A

Healing by regeneration.

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5
Q

What are the different types of cell populations? (3)

A
  • Labile
  • Stable
  • Permanent
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6
Q

What are the main features of a labile cell population? (4)

A
  • Easily altered
  • High normal turnover
  • Active stem cell population
  • Constantly goes round cell cycle
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7
Q

What is the regenerative capacity of a labile cell population?

A

Excellent regenerative capacity.

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8
Q

Give an example of a labile cell population.

A

Epithelium.

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9
Q

What are the main features of a stable (quiescent) cell population? (2)

A
  • Low turnover, but can massively increase if needed

- Stuck in G0, but&raquo_space; G1 when needed (cell cycle)

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10
Q

What is the regenerative capacity of a stable cell population?

A

Good regenerative capacity.

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11
Q

Give an example of a stable cell population.

A

Liver - renal tubules.

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12
Q

What are the main features of a permanent cell population? (4)

A
  • No physiological turnover
  • Long life cells
  • Removed from cell cycle
  • Often due to specialised structure
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13
Q

What is the regenerative capacity of a permanent cell population?

A

No regenerative capacity.

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14
Q

Give 2 examples of permanent cell populations.

A
  • Neurons

- Muscle cells

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15
Q

What is cirrhosis?

A

Chronic degenerative disease in which normal liver cells are damaged and are then replaced by scar tissue.

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16
Q

What is a stem cell?

A

An undifferentiated cell of a multicellular organism which is capable of giving rise to indefinitely more cells of the same type.

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17
Q

What are the main features of stem cells? (3)

A
  • Self-renewal
  • Asymmetrical replication
  • Reservoirs present in many tissues (‘niches’)
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18
Q

What is a stem cell niche?

A

A microenvironment, within the specific anatomic location where stem cells are found.
-location is crucial for survival and regeneration

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19
Q

What effect can a full thickness burn have on stem cells?

A

Destroys all layers&raquo_space; no stem cells left&raquo_space; cannot regenerate.

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20
Q

How is regeneration of stem cells controlled? (2)

A
  • Contact inhibition (proliferate until they touch)

- Complex control by growth factors and cell-matrix interactions

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21
Q

What does regeneration depend on? (2)

A
  • Structure of the damaged tissue

- Stem cell survival

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22
Q

What are the consequences of healing a MI by repair (scar)? (2)

A
  • MECHANICAL - loss of pumping capacity

- ELECTRICAL - abnormal electrical activity&raquo_space; arrhythmia

23
Q

What is organisation?

A

Pathological process - repair of specialised tissue by formation of fibrous scar (granulation tissue).

24
Q

What are the 3 main components of granulation tissue?

A
  • New capillary loops
  • Phagocytic cells (neutrophils, macrophages)
  • Myofibroblasts
25
Q

What is the function of myofibroblasts in granulation tissue? (2)

A
  • Synthesise collagen

- Wound contraction

26
Q

What are possible problems related to wound contraction?

A

Skin constriction and functional limitations.

-e.g. severe burns can prevent joint extension

27
Q

What are the changes that occur as granulation tissue matures (~3 months)? (3)

A
  • Decreased vascularity
  • Decreased cellularity
  • Increased collagen, ECM and wound strength
28
Q

What is the main effect of maturation of granulation tissue?

A

Wound strength increases with little metabolic demands.

29
Q

Why are sutures taken out before 3 months?

A

Foreign bodies can lead to infection.

30
Q

Why are myocytes replaced by fibrous tissue in ischaemic heart disease?

A

Acellular (not consisting of cells)&raquo_space; low metabolic requirements.

31
Q

What are the main types of factors that inhibit healing?

A
  • Local

- Systemic

32
Q

What are the main local factors that inhibit healing? (5)

A
  • Infection
  • Haematoma
  • Blood supply
  • Foreign bodies
  • Mechanical stress
33
Q

What are the main systemic factors that inhibit healing? (8)

A
  • Age
  • Drugs (e.g. steroids)
  • Anaemia
  • Diabetes
  • Malnutrition
  • Catabolic states
  • Vitamin C deficiency
  • Trace metal deficiency
34
Q

What is a haematoma?

A

Collection of clotted blood within tissues; hold tissue apart and prevents healing.

35
Q

What is healing by 1st intention?

A

Restoration by fibrous adhesion, without formation of granulation tissue; results in a thin scar.

36
Q

Give an example of a wound that heals by 1st intention.

A

Clean, uninfected surgical wound.

  • good haemostasis
  • edges held together (e.g. sutures)
37
Q

What are the stages of healing by 1st intention? (3)

A

Heals by organisation:
Fibrinous clot around edges
» granulation tissue grows into it
» neat fibrous scar

38
Q

What effect do haematoma and infection have on wound healing?

A

Lead to a bigger scar.

39
Q

What is healing by 2nd intention?

A

Healing by adhesion of granulating surfaces, when the edges of the wound are far apart. Granulations form from the base and sides of the wound toward the surface.

40
Q

When does healing by 2nd intention occur?

A
  • Extensive tissue loss
  • Wound edges not together
  • Large haematoma
  • Infection
  • Foreign body
41
Q

What does healing by 2nd intention lead to?

A

More granulation tissue and more extensive scarring.

42
Q

Give an example healing by 2nd intention suffered by many diabetics?

A

Chronic foot ulcer.

-base of ulcer = granulation tissue

43
Q

How strong is a wound at ~day 7?

A

10%.

-sutures taken out

44
Q

When does a wound reach 70-80% strength?

A

Week 4-12.

45
Q

What is the general process of fracture healing?

A 
Haematoma is organised
>> removal of necrotic fragments
>> osteoblasts lay down woven bone (CALLUS)
>>remodelling
>> replacement by lamellar bone
46
Q

What is an osteoblast?

A

A cell which secretes the substance of bone.

47
Q

What is a callus?

A

Thickened/hardened area of skin/soft tissue.

-bony healing around the end of broken bones

48
Q

What causes non-union of fractures?

A
  • Misalignment
  • Movement
  • Infection
  • Pre-existing bone pathology
49
Q

Why does brain tissue not heal by scarring?

A

Contains glial cells, rather than collagen and fibroblasts.

50
Q

What occurs instead of scarring in the brain?

A

Gliosis.

51
Q

What happens to damaged brain tissue?

A

Damaged tissue is broken down by macrophages and removed.

Cyst may form.

52
Q

What is gliosis?

A

Process leading to scars in the CNS that involves the production of a dense fibrous network of neuroglia (supporting cells) in areas of damage.

53
Q

How does an intracerebral haemorrhage resolve?

A

Lysis and removal of blood components&raquo_space; cyst surrounded by reactive gliosis.

54
Q

What is healing tightly controlled by?

A

Cytokines.

Year 2 EMS MoD (20 decks)

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