Tissue Repair Flashcards

1
Q

First step in tissue repair

A

inflammation

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2
Q

What is tissue repair and what does it attempt to do?

A
  • response to cellular injury
  • attempts to maintain normal body structure (homeostasis) and function
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3
Q

2 forms of Tissue Repair

A
  1. regeneration
  2. replacement
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4
Q

What occurs during Regeneration?

A

injured cells are replaced with cells of the SAME tissue type

no scars

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5
Q

What occurs during Replacement?

A
  • buildup of connective tissue
  • replaced with different cells of CT
  • cause scars
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6
Q

What are the 2 primary structures of tissue Regeneration? What do they do?

A

parenchymal
- cells that perform the function of the targeted organ
- ex: liver’s purpose is to metabolize. Hepatocytes do that job

stromal
- structural cell: support CT, blood vessels, nerve fragments, and extracellular matrix

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7
Q

What determines the cell’s ability to regenerate?
What are the different regenerative cell types?

A

the cell’s ability to divide - mitosis

  1. Labile cells
  2. Stable cells
  3. Permanent/fixed cells
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8
Q

Labile cell characteristics and examples

A
  • can divide QUICKLY
  • skin cells
  • uterus
  • GI tract
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9
Q

Stable cell characteristics and examples

A
  • cells stop dividing after organ stops growing
  • stimulation is required for continued growth
  • liver cells
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10
Q

Permanent/fixed cell characteristics and examples

A
  • do not undergo division
  • cannot regenerate
  • nerve, heart, or brain cells
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11
Q

When does Fibrous tissue repair occur?

A
  • replacement tissue repair
  • occurs after a severe injury: deep laceration
  • tissue is replaced with CT
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12
Q

What is Granulation and what is the process?

A

Process of “filling” a deep wound

  1. angiogenesis - growth of new blood vessels from preexisting blood vessels
  2. fibrogenesis
  3. formation of scar tissue
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13
Q

What occurs during fibrogenesis?

A
  1. activation of fibroblasts - proliferation/build up of fibroblasts
  2. formation of extracellular matrix- when activated, release the components that become extracellular matrix - helps make skin tough and durable
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14
Q

Steps to formation of scar tissue

A
  1. emigration and proliferation of fibroblasts
  2. deposits of extracellular matrix components
    - deposit into wound area
    - no more blood flow, but continuous build up of collagen
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15
Q

What are 2 components that regulate the healing process?

A
  1. chemical mediators
  2. growth factors
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16
Q

Chemical mediators include…

A

components that participate in the inflammatory response

17
Q

Growth factors interact with ____ to control _____

A

interact with cell surface receptors to control processes involved with tissue repair and wound healing

18
Q

Growth factors control…

A

proliferation, differentiation, and metabolism of cell

19
Q

How do growth factors help regulate inflammatory process?

A

use chemoattractants to:
- stimulate accumulate angiogenesis
- contribute to generation of ECM
- chemotaxis

20
Q

3 basic components of ECM

A

Components
1. fibrous structural proteins
2. water-hydrated gels
3. adhesive glycoproteins

21
Q

2 basic forms of ECM

A

Forms
1. basement membrane
2. interstitial matrix

22
Q

What are the 2 Fibrous structural proteins of the ECM?

A
  1. collagen
  2. elastin
23
Q

What are the 2 water-hydrated gels of the ECM?

A
  1. proteoglycans
  2. hyaluronic acid
24
Q

What are the 2 adhesive glycoproteins of the ECM?

A
  1. fibropectin
  2. lamin
25
Basement membrane of ECM function
- foundation of wound healing process - if not intact, everything falls apart - helps with regeneration + stability - surrounds all cell fragments
26
Interstitial matrix of ECM function
- scaffolding: the supportive material between cells - supports epithelium blood vessel
27
4 roles of the ECM in regulating the healing process
1. add turgor to soft tissue + rigidity to bone 2. supply underlying layers for cell adhesion 3. regulation growth, movement, and differentiation of cells 4. provide storage + presentation of molecules controlling repair process
28
Wound healing depends on....
severity of wound
29
Primary Intention Wound Healing
- superficial - very little tissue loss - closed with stitches
30
Secondary Intention Wound Healing
- deep wound: multiple layers - replacement - extensive cell and tissue loss - new tissue required to fill gap: can't regenerate - leads to scar formation
31
3 Phases of Wound Healing
1. Inflammatory 2. Proliferative 3. Remodeling
32
Phase 1 of Wound Healing: Inflammatory (timeline, function, cells involved)
- begins at time of injury - prepares wound environment for healing cells: - neutrophils are first to arrive - macrophages join 24 hours after: release growth factor that stimulates proliferation
33
Phase 2 of Wound Healing: Proliferative (timeline, function, cells involved)
- begins within 2-3 days of injury - focus on building new tissue FIBROBLASTS play a key role in building up tissue epithelialization - final component - epithelial cells build up to close surface
34
Phase 3 of Wound Healing: Remodeling (timeline, function, cells involved)
- begins 3 weeks after injury and continue for 6 months or longer synthesis and lysis of fibroblasts: scarring - collagen breaks down and builds up stronger - decreased blood flow
35
5 Factors Impacting Wound Healing (and examples) (MBIIN)
1. Malnutrition: major block (protein intake, carbs, vitamins A and C, electrolytes) 2. Blood flow and O2 delivery (arterial disease, hypoxia) 3. Impaired inflammatory + immune responses (phagocytic disorders, diabetes, steroids) 4. Infection, poor wound healing, presence of foreign bodies 5. Nature of the tissue damage (superficial vs. deep)
36
Abnormal Wound Healing - Keloids (when does it occur, what happens, who does it impact)
- occurs in remodeling phase - excess production of scar tissue - primarily impacts African Americans
37
Abnormal Wound Healing - Contracture (what happens + what does it cause)
- over migration of wound margins over a joint - causes painful and stiff joints - no flexibility - "burn"
38
Abnormal Wound Healing - Dehiscence (what happens, cause, effect)
- reopening of previously closed wound - cause: poorly formed collagen framework - effect: increased drainage, decrease in adhesive protein
39
Abnormal Wound Healing - Adhesions (what happens, cause, effect)
- scar tissue binds to adjacent surfaces - common cause: inflamed membranes loops of bowel is common site of impact - effect: bowel obstruction