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Pathology Midterm > Repair, Regeneration, and Fibrosis (part 2) > Flashcards

Repair, Regeneration, and Fibrosis (part 2) Flashcards

1
Q

what is the very first thing that happens in the healing process?
how long does it take?

A

formation of fibrin clot
0-4 hours

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2
Q

inflammatory cell migration occurs from days ___ to ___ of wound healing

how are the cells migrating to the site of infection? what kind of cells migrate?

A

days 2-4

migrate through chemoattractants like fibronectin, chemokines, cell debris, bacterial products

many cells are recruited – macrophages, fibroblasts, etc

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3
Q

explain how a fibrin clot is formed (1st step of wound healing)

A

fibronectin binds fibrin, collagen, etc. fibrin strands are crosslinked by the action of TRANSGLUTAMINASE (factor 12)

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4
Q

transglutaminase is ___ derived

A

plasma

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5
Q

what is happening within 1-3 days of wound healing

what is the function?

A

recruitment of macrpohages

clean and remove debris and pathogens through phagocytosis of oposonized debris and cells

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6
Q

how are new collage fibers formed?

A

fibroblasts deposit new ECM rich in collagen TYPE 3 which is a good railroad for newcoming cells

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7
Q

formation of fibrin clot is the first step of wound healing

how and when is it removed

A

removed during the formation of collagen fibers by proteolysis and phagocytosis

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8
Q

what is the temprary matrix composed of? is it made before or after the formation of collagen fibers?

A

after the formation of collagen fibers

made of proteoglycans, fibers rich in type 3 collagen

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9
Q

______ receptors aid in the assembly of fibronectin complexes

A

integrin

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10
Q

explain what is happening in the final phase of the repair reaction

A

m1 macrophages are now m2

lasts 5 days-weeks

fibroblasts produce type 1 collagen (stiffer and thicker) to replace type 3 leading to a stronger matrix

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11
Q

what cells are producing type 1 collagen to replace with type 3

A

fibroblasts

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12
Q

_________ are very important in wound healing and inflammation

A

macrophages

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13
Q

differentiate between m1 macrophages and m2 macrophages

A

m1 are proinflammatory and present in the early stages of wound healing. they perform phagocytosis, release chemokines and growth factors

m2 are anti inflammatory and are present during wound healing. they recruit fibroblasts to create type 1 collagen and replace with type 3

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14
Q

what are the 2 major components of granulation tissue

A

stromal cells
proliferating capillaries

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15
Q

microscopically, granulation tissue is formed by what 3 things

A

fibroblasts
leukocytes (macrophgaes)
new capillaires

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16
Q

granulation tissue is a ____, specialized tissue that replaces what?

A

transient, specialized tissue that replaces the PROVISIONAL MATRIX

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17
Q

explain the process of angiogenesis in granulation tissue after an injury

A

endothelial cells form extensions called PSEUDOPODIA that grow toward the wound site. cytoplasmic flow enlarges and it eventually divides to form new cell.

vacuoles formed in these daughter cells fuse to form the lumen.

pericytes surround and stabilize

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18
Q

true or false

at its peak, granulation tissue is the most richly vascularized tissue in the body

A

TRUE

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19
Q

Once repair has been achieved, what happens to most of the newly formed capillaries in the granulation tissue

A

they undergo apoptosis and leave behind a pale, avascular scar – rich in collagen

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20
Q

what are the 4 main categories of anchoring junctions in animal cells

A

adherens (cadherins)
desmosomes (cadherins)
hemidesmosomes (integrins)
focal adhesions (integrins)

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21
Q

what are the connections in adherens junctions?

A

cadherins connect cells to each other and to actin filaments

22
Q

what are the connections in desmosomes

A

cadherins connect cells to each other and to INTERMEDIATE filaments

23
Q

what are the connections in hemidesmosomes

A

integrins connect basement to intermediate filaments

24
Q

what are the connections in focal adhesions

A

integrins connect ECM to actin filamanets

25
Q

_______ are calcium dependent, integral membrane proteins

A

cadherins

26
Q

name 3 types of cell migration and give their definitions

A

chemotaxis - migration along soluble chemical gradients

haptotaxis - due to matrix concentrations or adhesion

durotaxis - matrix pliability or stiffness

27
Q

all 3 types of cell migration require what

A

reorganization of the cytoskeleton

28
Q

_____ is a component of the basement membrane

A

laminin

29
Q

explain what wound contraction is

A

a healing response that functions to reduce the size of the tissue defect and decrease the amount of damaged tissue that needs repair

30
Q

true or false

skin healing is different than bone healing

A

true.

when a fracture is fully healed that area of bone is stronger than the rest

whereas with skin its strength and identifiability are not the same

31
Q

3 things that occur in early wound repair

2 things that occur mid repair

2 things that occur late repair

A

thrombosis (clotting)
inflammation
reepithelialization

granulation tissue formation
contraction

final tensile strength, collagen cross linking (type I replaces type 3)
remodeling and devascularization

32
Q

define regeneration

A

the growth of cells to replace lost tissues

33
Q

regeneration is a type of _______

A

repair

34
Q

differentiate between totipotent pluripotent multipotent and unipotent

A

unipotent - daughter cells become only one cell type

multipotent - can differentiate into few types of cells

pluripotent - can differentiate into almost any cell BUT a single cell has lost the ability to produce an entire individual

totipotent - can produce all adult cell types. ultimate stem cell is FERTILIZED EGG

35
Q

What are labile cells

A

the cells that are constantly turned over – best examples are epithelial cells. die via apoptosis and are rapidly replaced

36
Q

what are stable cells

A

population of cells that are normally replaced very slowly BUT are capable of rapid renewal after tissue loss

hepatocytes and kidney cells

37
Q

where are permanent cells located

A

CNS and heart

once destroyed they can’t regenerate

38
Q

what do glucocorticoids do and how?

A

they decrease inflammation by inhibiting lipid mediators (phospholipase A2 - no release of arachidonic acid)

39
Q

what is the difference between healing by primary intention and healing by secondary intention

A

skin–

healing by primary intention for wounds with closely apposed wound edges, minimal tissue loss and granulation tissue decreased. wound only requires minimal cell proliferation and vascularization to heal. narrow, linear scar

healing by secondary intention for a gouged wound. substantial tissue loss. extensive cell proliferation, matrix accumulation, and neovascularization

40
Q

what part of the kidney does not regenerate

A

the glomeruli

41
Q

how is myocardial damage repaired

A

by fibrosis and scar formation

42
Q

true or false

the CNS regenerates well after it has been damaged

A

FALSE - regenerates poorly

43
Q

_____ is the CNS equivalent of scar formation

A

gliosis

44
Q

can the PERIPHERAL nervous system regenerate?

A

can regenerate axons and if the ends align it may result in complete functional recovery – schwaan cell

45
Q

name 2 complications of wound healing

A

-defective scar formation
-excessive scar formation

46
Q

give some examples of defective scar formation

A

dehiscence (wound splitting open) or ulcerization

47
Q

what are keloids

A

hypertrophic scars that are the result of excessive scar formation due to deficient collagenase activity

48
Q

scar tissue vs granulation tissue

which has cross linked collagen

A

scar tissue

49
Q

heart healing

A

myofibroblasts

50
Q
A

Pathology Midterm (10 decks)

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