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Patho > Tissue Injury > Flashcards

Tissue Injury Flashcards

1
Q

what are the two main processes that resolve cell injury

A

regeneration
repair

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2
Q

what are the mechanisms of cell injury

A

ischemia
infectious agents
immune reactions
genetic alterations

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3
Q

what are the two infectious agents

A

bacteria
viruses

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4
Q

what is ischemia

A

blood flow below the minimum necessary to maintain cell homeostasis and cell homeostasis
and metabolic function

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5
Q

what can ischemia result in

A

hypoxia or anoxia in tissue
decreased nutritional delivery
decreased removal of waste

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6
Q

how do bacterial agents affect cells

A

invade tissue
release exotoxins and endotoxins
cause cell lysis and degradation of ECM that aids in the spread of infection

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7
Q

what are two ways a virus may get into a host

A

indirect or direct

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8
Q

what is direct virus effect

A

usually found with RNA
kill by disturbing various cellular processes or disrupting the integrity of the cell nucleus/plasma membrane

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9
Q

what is indirect virus effect

A

integrate themselves into the cellular genome
encode production of foreign proteins that are not recognized by body’s immune system

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10
Q

what are the inflammatory cells

A

neutrophils
macrophages
T/B lymphocytes
mast cells
basophils

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11
Q

hallmarks of irreversible cell injury

A

alternations in the cell nucleus
mitochondria
lysosomes
rupture of cell membrane

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12
Q

2 mechanisms of tissue healing

A

regeneration and repair

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13
Q

what are regeneration / repair

A

regeneration - regrowth of original tissue

repair - formation of a connective tissue scar

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14
Q

what cells are involved in tissue healing

A

fibronectin
proteoglycans
elastin
collagen

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15
Q

function of fibronectin

A

“glue” for substances and cells
attracts fibroblasts and macrophages

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16
Q

what do proteoglycans and elastin do

A

bind to fibronectin and collagen to stabilize tissue undergoing repair

water retention

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17
Q

function of collagen

A

most important protein to provide structural support and tensile strength

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18
Q

how does collagen change during the maturation process

A

moves from type 3 to 1
3 being most immature, 1 being most mature

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19
Q

tell me about type 1 collagen

A

main component of mature scars
predominant in strong tissues such as tendons and bones

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20
Q

tell me about type 2 collagen

A

assembled thin supporting filaments
predominant type of collagen found in cartilage

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21
Q

tell me about type 3 collagen

A

assembled into thin filaments
makes tissue strong but supple and elastic
prevalent in newborns

22
Q

what are two current theories proposed to explain collagen realignment

A

tension vs induction

23
Q

what is the tension theory

A

as collagen gets laid, stress on the tissue will regulate how much collagen is laid down

24
Q

what is the induction theory of scar formation

A

the body knows what to do/has its own blueprint and lays down collagen according to that

25
Q

4 phases of healing

A

hemostasis and degeneration
inflammation
proliferation and migration
remodeling and maturation

26
Q

when does hemostasis and degeneration occur?

A

immediately after an acute injury to help the body try to stop bleeding and initiate coagulation

27
Q

characteristics of degeneration/hemostasis

A

formation of hematoma
necrosis of dead cell
start of inflammatory cell response

28
Q

when does inflammatory phase begin

A

once blood clot forms

29
Q

what occurs in the inflammation stage

A

vasodilation and increased capillary permeability to activate movement of cells to the wound site

30
Q

what coordinated reaction of body tissues involved in inflammation

A

vascular
humoral
neurologic
cellular responses

31
Q

functions of the inflammatory reactions

A

inactivate the injurious agent
break down and remove dead cells
initiate the healing of tissue

32
Q

tell me about the clinical manifestations of acute inflammation

A

redness, swelling, increased temperature, pain, decreased function

33
Q

primary outcomes of acute inflammation

A

complete resolution of normal tissue structure
healing of scar formation
chronic fibrosis

34
Q

vascular changes of acute inflammation

A

leakage of protein poor fluid (transudate) into interstitial spaces

leakage vessels become engorged with blood cells causing a slowing of blood flow

leukocytes accumulate and adhere to endothelial cells

adhesion of glycoproteins

35
Q

what are the predominant leukocytes present in acute inflammation

A

neutorphils

36
Q

chemical mediators of inflammation

A

histamine
platelet-activating factor
prostaglandins
leukotrienes
cytokines

37
Q

what is the purpose phagocytosis

A

inactivation and remove inflammatory stimulus in order to begin healing

38
Q

explain phagocytosis
what are the most important phagocytes

A

ingestion of microorganisms, other foreign substances, necrotic cells and connective tissue

monocytes and macrophages

39
Q

what are the hallmark signs of acute inflammation

A

pallor - pain
calor - heat
rumbor - redness
tumor - swelling
loss of function

40
Q

what is proliferation and migration

A

revascularization and rebuilding of tissue

fibroblasts drawn to the matrix and synthesis of new collagen/elastin/and proteogylcans

41
Q

what is the time frame of proliferation and migration

A

within 2 days of wound or injury

42
Q

what is neovascularization / angiogenesis? when does it occur?

A

establishment of a network that can transport oxygen and nutrients to support metabolism and healing

proliferation and migration

43
Q

tell me about remodeling and maturation

A

balance between tissue synthesis and degradation

44
Q

how long can remodeling and maturation take

A

years as initial collagen strands are broken down and rearranged due to stress

45
Q

tell me about the scar tissue changes during maturation phase

A

reduced and remodeled - smoother and stronger

less red due to decreased concentrations of blood vessels

46
Q

what are myofibroblasts

A

abundant contractile proteins to contribute to shrinkage of healing tissue

47
Q

scar formation process

A

initial collagen (type3)
remodeling (3 to 1)
consolidation
maturation

48
Q

hypertrophic scars

A

elevated collagen that is laid down within the borders

49
Q

keloid scars

A

outside of OG borders, laid in circular fashion

50
Q

what is the expected regeneration of peripheral nerves

A

undergoes myelin degeneration and axonal fragmentation

within 24 hours axonal sprouts occur

regeneration of 1 inch per month

Patho (15 decks)

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