Stiner - Wound Healing Flashcards
Step 1 of hemostasis
Vasoconstriction
__________ is the process of stopping bleeding and occurs in 3 steps
hemostasis
Step 2 of hemostasis
Temporary blockage by platelet plug
Step 3 of hemostasis
Blood coagulation/clot formation
Hemorrhaging is reduced by the constriction of ____ _____
blood vessels
______ adhere to damaged vessel endothelium to plug the wound
platelets
_____ form upon conversion of fibrinogen to ____ and its addition to the platelet plug
clots
fibrin
Damaged membranes release ______ and ______ which signal vasoconstriction
thromboxanes and prostaglandins
Upon activation, platelets release ______ which signal additional vasoconstriction and recruit additional platelets
cytokines
After hemostasis and coagulation ________ occurs as a result of _______ release
vasodilation
histamine
Coagulation is almost ______ following a blood vessel injury, it can either be activated via an ________ or ________ pathway
instantaneous
intrinsic or extrinsic
Expose of blood to sub endothelial collagen activates the _______ pathway
intrinsic
Exposure of blood to sub endothelial tissue factor activates ________ pathway
extrinsic
________ pathway begins on collagen surface and its final state activates ____
intrinsic
X
Intrinsic pathway beings with ________ converted to _______
prekallikrein
kallikrein
Intrinsic Pathway: XII —> ______
XIIa
Intrinsic Pathway: XIIa converts to _____
XI and XIa
Intrinsic Pathway: XIa activates _____
IX
Intrinsic Pathway: IXa along with VIIIa activates _____
X –> Xa
Extrinsic Pathway begins with VII leaving circulation and is converted to ____ via interaction with tissue factor (III) on fibroblasts
VIIa
Extrinsic Pathway: activates ___ and ___
IX and X
Extrinsic Pathway: Xa converts ________ to ________
prothrombin to thrombin
Extrinsic Pathway: Thrombin: activates XI which activates ______
IX
Extrinsic Pathway: Thrombin: activates and releases ____ from being bound to vWF
VIII
Extrinsic Pathway: Thrombin: VIIIa is the co-factor of ___ and together they activate ___
IXa
X
________ is a major endogenous anticoagulant, it is vitamin K dependent, activated by thrombin, degrades Va and VIIIa, deficiencies can lead to thrombosis
Protein C
___________, is a regulator of coagulation; thrombin, IXa, Xa, XIa, and XIIa
adhesiob to these factors is increased by heparin
deficiencies lead to thrombosis
antithrombin
______ _____ _____ pathway restricts the action of tissue factor
Tissue factor inhibitor
_______, a plasma protein produced and secreted by endothelium degrades fibrin
plasmin
_______ leads to activation of cAMP inhibits platelet activation by decreasing cytoplasmic Ca; thereby inhibiting activation of more platelets and clotting cascade
prostacyclin
True or False
Would healing has 3 phases
True
The first phase of inflammation involves the _____ injury and _______ response
initial
vascular
The second phase of inflammation is _______ ______
blood coagulation
The third phase of inflammation is _________; via ______ and _______
inflammation/inflammatory response
Macrophages
Neutrophils
The proliferative phase consists of 3 phases; ________, _________, and __________
angiogenesis
epitheliazation
granulation and tissue formation
New vasculature phase; begins with endothelial cells migrating to site and repairing damaged vessels; deposition of immature matrix and cellular elements
angiogenesis
New epithelialization phase; formation of epithelialization through cell division
epithelialization
Collagen deposition phase; via fibroblasts and endothelial cells
granulation and tissue formation phase
Remodeling and Maturation Phase involves ____ deposition, and cell _____ and _____; this begins a _____ after wounding and can last for up to a _____
collagen
migration and growth
week
year
keratinocytes secrete ____ and ____ which stimulate cell division and repair of damaged epithelium
TGF-β
KGF
Macrophages and neutrophils are both phagocytes and activate bactericidal mechanisms but macrophages also are involved with _____ _______
antigen presentation
In macrophages, _______ stimulates fibroblasts and mediates angiogenesis; ultimately attracting cells to the area to promote new cell/ECM growth
IGF-1
True or False
Macrophages arrive to the wound area before neutrophils
False; neutrophils arrive first and begin to clean the wound and are then degraded by macrophages which promote new cell growth
Endothelial growth and proliferation (angiogenesis) is directly stimulated by lack of _______ and presence of ______ ______
oxygen
lactic acid
VEGF, FGF, and PDGF (growth factors) are secreted by ________ cells
endothelial
When does the recruitment of neutrophils into the wound occur?
A. After the proliferation phase has begun
B. After epithelialization occurs
C. During angiogenesis
D. During the inflammation phase
D. During the inflammation phase
neutrophils are the first to arrive and begin to clean the wound
Fibrinogen is converted to fibrin by which enzyme and during which process
A. Fibrinogen activation enzyme; final pathway
B. Thrombin; intrinsic pathway
C. Plasminogen activator; fibrinolysis
D. Thrombin; final pathway
D. Thrombin; final pathway
The first phase of wound healing is the __________ phase
Inflammation
The second phase of wound healing is the _________ phase
Proliferative
The third page of wound healing is the __________ and __________ phase
Remodeling and Maturation
