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Physiology > Responses to Cell and Tissue Injury > Flashcards

Responses to Cell and Tissue Injury Flashcards

1
Q

What is sublethal injury?

A

Reversible cell injury

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2
Q

What are the causes of sublethal injury?

A

1- Oncosis: hydropic change

2- Steatosis: fatty change

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3
Q

What can sublethal injury lead to over a longer amount of time

A

1- Autophagy

2- Atrophy

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4
Q

What is autophagy?

A

1- Intracellular degradation system
2- ‘Self-eating’
3- If the contents of the cell are too much in comparison the the energy provided, cell down-sizes

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5
Q

What is atrophy?

A

Wasting away of cells or tissue

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6
Q

What is necrosis?

A

The death of tissues following bioenergetic failure and loss of plasma membrane integrity

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7
Q

What kind of response can necrosis evoke?

A

Inflammatory response

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8
Q

What are the six different types of necrosis?

A 
1- Coagulative
2- Colliquative
3- Caseous
4- Gangrenous
5- Fibrinoid
6- Fat necrosis
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9
Q

What are the three main causes of necrosis?

A

1- Ischaemia
2- Metabolic disorders
3- Trauma

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10
Q

What is coagulative necrosis?

A

1- Most common, can happen in most tissues
2- Involves coagulation of cellular proteins
3- Firm pale area with ghost outlines on microscopy, appearance develops over time
4- Initially firm but later soft
5- Leads to an inflammatory response

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11
Q

What is colliquative necrosis?

A

1- Liquefaction with formation of cystic spaces

2- Proteolysis dominates over coagulation

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12
Q

What is caseous necrosis?

A

1- Characteristic of TB

2- Soft and white cheese-like dead tissue

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13
Q

What is gangrenous necrosis?

A

1- Necrosis with putrefaction
2- Wet and dry forms
3- Gas gangrene due to C perfringens

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14
Q

What is fibrinoid necrosis?

A

1- Histological observation/phenomenon

2- Most commonly associated with malignant hypertension

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15
Q

What is fat necrosis?

A

1- As a result of trauma
2- May cause a mass
3- May come after or due to pancreatitis and appear as multiple white spots

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16
Q

What is lethal injury?

A

1- Cell’s complete loss of ability to release sodium or water due to loss of plasma membrane integrity, leading to cell bursting
2- Irreversible, permanent death

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17
Q

What is apoptosis?

A

1- Programmed cell death
2- Removes a cell discreetly
3- Removes individual cells rather than groups of tissues
4- Preserve function as best as possible

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18
Q

What are indications of reduced apoptosis?

A

1- Neoplasia
2- Autoimmune disease
3- Virus infection

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19
Q

What are indications of increased apoptosis?

A

1- Neurodegenerative disorders

2- HIV infection of T lymphocytes

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20
Q

Compare the induction of apoptosis and necrosis.

A

1- Apoptosis: physiological or pathological

2- Necrosis: pathological

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21
Q

Compare the extent of the effect of apoptosis and necrosis.

A

1- Apoptosis: single cells

2- Necrosis: cell groups/tissue

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22
Q

Compare the biological events of apoptosis and necrosis.

A

1- Apoptosis: energy-dependent fragmentation of DNA

2- Necrosis: abnormal ion homeostasis

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23
Q

Compare the cell membrane integrity during apoptosis and necrosis.

A

1- Apoptosis: maintained

2- Necrosis: lost

24
Q

Compare cell morphology in apoptosis and necrosis.

A

1- Apoptosis: shrinkage and fragmentation

2- Necrosis: swelling and lysis

25
Q

Compare the inflammatory response in apoptosis and necrosis.

A

1- Apoptisis: none/never

2- Necrosis: normally present/usual

26
Q

Compare the fate of dead cells in apoptosis and necrosis.

A

1- Apoptosis: phagocytosed by neighbouring cells

2- Necrosis: phagocytosed by inflammatory cells

27
Q

What is pyroptosis?

A

1- Part apoptosis but then necrosis

2- Associated with salmonella infection

28
Q

What is pyroptosis usually associated with?

A

Salmonella infection

29
Q

What three options may happen after injury?

A

1- Death
2- Healing
3- Repair

30
Q

In regards to cell repair, what are the three types of cells?

A

1- Labile
2- Stable
3- Permanent

31
Q

What is labile tissue?

A

Tissue which is able to carry out a lot of cell proliferation, leading to quick cell regeneration

32
Q

Give three examples of labile tissue.

A

1- Blood
2- Skin
3- Gut

33
Q

What is stable tissue?

A

Cells which do not carry out constant proliferation, but rather remain at rest and only regenerate when needed.

34
Q

Give two examples of stable tissue.

A

1- Liver

2- Kidney

35
Q

What is permanent tissue?

A

Tissue which does not regenerate under any circumstances.

36
Q

Give two examples of permanent tissue.

A

1- Neurons

2- Skeletal muscle

37
Q

What factors favour resolution?

A

1- Minimal cell death and tissue damage
2- Occurence in tissue or organ with regenerative capacity
3- Rapid destruction of causal agent
4- Rapid removal of fluid and debris by good local vascular drainage

38
Q

What is organisation?

A

Repair of specialised tissue by formation of a scar

39
Q

What three steps are involved in organisation?

A
  • Formation of granulation tissues
    2- Removal of dead tissue by phagocytosis
    3- Wound contraction and scarring
40
Q

What factors favour organisation?

A

1- Large amounts of fibrin
2- Substantial necrosis
3- Exudate and debris cannot be removed or discharged

41
Q

Describe the structure of granulation tissues.

A

1- An intermediate substance
2- Contains loops of capillaries, myofibroblasts, collagen and inflammatory cells
3- Organised by the deposition of collagen and contraction

42
Q

What is healing by first intention?

A

1- Healing of a clean wound without cell death or tissue loss
2- Basement membrane may be disrupted

43
Q

What are the steps of healing by first intention?

A

1- Incisional space fills with blood
2- Scab forms
3- Neutrophils move towards clot
4- Epidermis thickens at its cut edges
5- Epidermal cells migrate along cut lines of dermis
6- Epithelial cells fuse in the midline beneath the surface scab
7- On day 3, neutrophils are largely replaced by macrophages
8- On day 5, granulation tissue invades incision space
9- Collagen fibres bridge the incision
10- Epidermis recovers to normal thickness

44
Q

What happens on day three of healing by first intention?

A

Neutrophils are replaced by macrophages

45
Q

What happens on day five of healing by first intention?

A

Granulation tissue invades incision space

46
Q

What happens during the second week of healing by first intention?

A

1- Proliferation of fibroblasts
2- Collagen accumulation
3- Leucocytes infiltrate, oedema reduced
4- Vascularity virtually disappears

47
Q

What happens after the first month of healing by first intention?

A

1- Scar consists of cellular connective tissue

2- Tensile strength increased

48
Q

What is healing by second intention?

A

1- Healing of wounds with separate edges
2- Extensive cell loss
3- Usually present when there is a large tissue defect
4- Much larger amounts of granulation tissue

49
Q

What factors favour healing by second intention?

A

1- Large amounts of fibrin
2- A lot of necrotic tissue
3- If the inflammatory reaction was more intense

50
Q

With regards to healing by second intention, what plays an important role in reducing the size of defect?

A

Wound contraction

51
Q

What is wound contraction?

A

When a normal healing process leads to physical deformity and functional limitations.

52
Q

What are the three steps of bone healing?

A

1- Repair
2- Remodelling
3- Resolution

53
Q

What systemic factors influence wound healing?

A 
1- Age
2- Nutrition
3- Metabolic status e.g. diabetes
4- Circulatory status
5- Hormones
54
Q

What local factors influence wound healing?

A

1- Infection
2- Mechanical factors (e.g. early movement of wounds delay healing)
3- Foreign bodies
4- Size, location and type of wound

55
Q

What three things may happen which exhibit abnormal wound repair?

A

1- Deficient scar formation
2- Excessive formation of repair components
3- Formation of contractures

56
Q

What are two examples of deficient scar formation?

A

1- Dehiscence (wound rupture)

2- Ulceration

57
Q

What is a keloid scar?

A

1- A type of scar which stands proud of the skin

2- Due to excessive fibroblast proliferation and overproduction of collagen

Physiology (6 decks)

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