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Pathophysiology > Tissue Repair > Flashcards

Tissue Repair Flashcards

1
Q

hypoxia

A
  • decreased ability to obtain or use oxygen
  • most common cause of cell injury
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2
Q

hypoxemia

A

reduced transfer of oxygen from lungs to blood

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3
Q

ischemia

A

decreased blood flow to tissues

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4
Q

physical agents include

A

mechanical trauma (hit, cut, punctured), temperature extremes 9hot or cold), radiation (external or medical), and electric shock

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5
Q

potential causes of a hypoxic event

A
  • lack of air to breath in
  • no hemoglobin available to carry oxygen
  • hemoglobin lack the ability to carry oxygen
  • lack of blood flow to tissue
  • hypothermia (vasoconstriction of vessel)
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6
Q

free radicals

A
  • missing an electron
  • electrically uncharged atom or group of atoms with an unpaired electron
  • will attack a healthy atom to get an extra electron
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7
Q

Endogenous antioxidant system

A
  • come from within our own body
  • production decreases with age
  • contributes to premature aging and degenerative diseases
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8
Q

Exogenous antioxidents

A
  • come for outside our body
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9
Q

are endo/exo antioxidants more potent

A

endogenous antioxidants are far more potent

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10
Q

what foods should you avoid

A
  • nutrient poor foods and deficient in antioxidants
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11
Q

oxidative stress

A
  • over production of free radicals
  • plays a major part in the development of chronic and degenerative ailments such as cancer, arthritis, aging, autoimmmune disorders, cardiovascular and neurodegenerative diseases
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12
Q

free radical have a _____ role

A

dual (toxic and beneficial compounds)

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13
Q

how does the body counteract oxidative stress

A

antioxidants
- naturally (much more potent) or consuming foods and supplements

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14
Q

what are antioxidants

A

healthy atoms that will share an electron with the free radical atom preventing it from attacking another health atom, preventing cell damage

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15
Q

what is the best sources of antioxidants

A

vitamin C
- fruits and vegtables

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16
Q

foods to avoid

A
  • processed food
  • high glycemic food, limit processed meats (bacon, sausage, salami), limit red meat, dont reuse cooking fats and oils, limit alcohol
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17
Q

Asphyxiation

A

failure of cells to recieve or use oxygen

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18
Q

Suffocation

A
  • systemic hypoxia
  • no air is exchanged in the lungs
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19
Q

strangulation

A
  • causes of cerebral hypoxia
  • compression and closure of airway
  • external pressure on neck
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20
Q

types of strangualtion

A
  • hanging
  • ligature
  • manual
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21
Q

hanging

A

“V” inverted on neck

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22
Q

ligature

A
  • horizontal mark
  • petechia more common, internal injury rare
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23
Q

manual strangulation

A
  • severe internal damage, bruising and fractures of hyoid
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24
Q

drowning

A
  • no oxygen exchange in the lungs due to being filled with fluid
  • prevents the delivery of oxygen to tissues
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25
Q

carbon monoxide

A
  • binds to hemoglobin
  • unable to transport oxygen in the blood
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26
Q

carbon monoxide build up symptoms

A
  • headache, nausea, weakness, tinnitus, vomiting
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27
Q

treatment of carbon monoxide build up

A
  • fresh air
  • hyperbaric chamber (high pressure oxygen; forces the carbon monoxide off the hemoglobin)
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28
Q

Chemical asphyxiation

A
  • cyanide blocks the intercellular use of oxygen
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29
Q

Chemical asphyxiation symptoms

A

weakness, nausea, confusion, difficulty breathing, seizure, cardiac arrest

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30
Q

Chemical asphyxiation treatment

A
  • identify source
  • activated charcoal orally if ingestion has occurred
  • oxygen
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31
Q

Chemical asphyxiation occurs

A

in building fires

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32
Q

types of asphyxiation

A
  • suffocation
  • strangulation
  • drowning
  • chemical
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33
Q

Contusion

A

bruise
- bleeding into the skin or underlying tissues

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34
Q

Laceration

A
  • tear or rip resulting when tensile strength of skin or tissue is exceeded
  • ragged and irregular
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35
Q

Abrasion

A
  • superficial laceration
  • EXAMPLE: scrape on the knee
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36
Q

Avulsion

A
  • wide area of tissue is pulled away
  • only skin (either loose or torn)
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37
Q

Fracture

A
  • blunt force blows or impacts can cause bone to break or shatter
  • multiple types
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38
Q

Incised wound

A
  • wound that is longer than it is deep
  • can be straight or jagged
  • not always surgical
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39
Q

stab wound

A
  • deeper than it is long
  • can be surgical
  • EXAMPLE; stabbed with a knife
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40
Q

puncture wound

A
  • weapon has a sharp point but not sharp edges
  • EXAMPLE: punctured with a needle
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41
Q

reverse injury

A
  • cell recovery
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42
Q

cell death

A

necrosis

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43
Q

programmed cell removal

A

cell apoptosis
- controlled cell death

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44
Q

Autophagy

A
  • controlled process
  • cell recycles part of itself (eliminates nonfunctioning parts of the cell)
  • consumption of cells own contents as metabolic process occcurs in starvation and certain diseases (use nutrients to feed itself)
  • can prevent apoptosis
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45
Q

Apoptosis

A
  • dealth of cells which occurs as a normal and controlled part of an organisms growth or development
  • orderly process
  • controlled cellular fragmentation (phagocytosis occurs as phagocyte envelopes the cell and fragments)
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46
Q

necrosis

A
  • swelling and bursting of the cell membrane
  • death of most or all of the cells in an organ or tissue due to disease, injury, or failure of blood supply
  • rupture of the cell and damage to the area
47
Q

Coagulative necrosis

A
  • Kidney, heart, and adrenal glands
  • loss of nucleus with cellular outline preserved
  • caused by ischemia or infraction
  • cellular degeneration is delayed
  • architecture is maintained
48
Q

ischemia

A

inadequate blood supply to an organ

49
Q

infraction

A

obstruction of the blood supply to an organ or region of tissue

50
Q

Liquefactive necrosis

A
  • Neurons, brain
  • transforms tissue into liquid (brain has high content of lipid and water
  • caused by infraction or abcess
51
Q

Caseous necrosis

A
  • lungs
  • caused by tuberculous
  • dead tissue appears as a soft and white proteinaceous dead cell mass
52
Q

Fatty necrosis

A
  • breast, pancrease, and other abdominal organs
  • usually harmless
  • can be surgically removed in bothersome, but can go away on its own
53
Q

gangrenous necrosis

A
  • severe hypoxic injury
  • interrupted blood supply
  • medium for bacteria growth and it is impending health wound healing
54
Q

dry gangreen

A
  • result of coagulative necrosis
  • bllod supply is slowly reduced
  • skin becomes dry, wrinkled, skin changes to dark brown or black
55
Q

wet gangreen

A
  • blood supply is suddenly reduced
  • pus is release, very painful
56
Q

Gas gangreen

A
  • infection of the injured tissue by Clostridium (bacteria)
  • blood supply is reduced
  • produce hydrolytic enzymes and toxins that destroy connective tissues and cause gas bubbles
57
Q

Innate immunity

A
  • what we are born with
  • includes physical, chemical and cellular defenses against pathogens
58
Q

what is the most common cause of cellular death

A

hypoxia

59
Q

what happens in inflammation to cause hypoxia

A
  • increase in the metabolic demands of cells and reduction in metabolic substrates (energy producers) caused by thrombosis, trauma, compression, or atelectasis
60
Q

What happens in hypoxia to cause inflammation

A
  • mainly oxidative stress, acidosis, and apoptosis
61
Q

What leads to the visible inflammation

A
  • rapid leakage of K+
62
Q

who are the first responders

A
  • inflammatory cells and cytokines
  • begin inflammatory response and trap bacteria and other offending agents or start healing of injured tissue
63
Q

Major events in local inflammatory response

A

macrophages are activated, capillaries dialate and become more permeable, fluid clooting agents move into tissues, clotting begins, chemokines release phagocytic cells, attracts netrophils/macrophages to engulf pathogens/debris, healing begins

64
Q

what are sings of infection

A
  • redness
  • swelling
  • pus
65
Q

review inflammation process

A
66
Q

Hallmark signs

A

heat, pain, redness, swelling, and loss of function

67
Q

pain is caused by

A
  • systemic response
  • fever and proliferation of leukocytes
  • increased fluid at site triggers nerves
68
Q

redness and swelling is caused by

A
  • increased permeability
  • fluid released into tissues
69
Q

heat is caused by

A
  • capillary widening which increases blood flow
70
Q

tenderness is caused by

A
  • attraction of leukocytes
  • extravasation of leukocytes to the site of injury
71
Q

Adaptive immune response (acquired immune system)

A
  • has memory
  • can develop due to an antigen or vaccination
72
Q

inflammation is the ___ line of defense

A

2nd `

73
Q

release of cytokines in Acute phase causes:

A
  • fever caused by affect on hypothalmus
  • increased neutrophil production cause by effect on bone marrow
  • lethargy caused by effect on the CNS
  • increased erythrocyte sedimentation rate (ESR) and increased C-reactive protein caused by affect on liver
74
Q

Fever

A
  • local activity
  • caused by direct activity of cytokines or through local activity of prostaglandins
75
Q

Lethargy

A
  • stress induced
  • cytokines increase energy within the cells
  • taxing on the body
76
Q

ESR

A

rate at which red blood cells settle in saline solution

77
Q

ESR in someone with inflammation

A
  • protein in plasma is increased in inflammation
  • RBC’s stack and become heavier
  • settle out of solution faster
78
Q

C - reactive protein

A
  • made in the liver
  • increases in response to inflammation
79
Q

increased Sed rate and C reactive protein

A

inflammation

80
Q

acute inflammation is caused by

A
  • chemical irritants
  • frostbite
  • cuts, laceration, stabbing
  • trauma
  • allergic reactions
  • burns
  • infection
81
Q

chronic inflammation is caused by

A
  • cardiovascular disease
  • autism
  • rheumatoid arthritis
  • autoimmune disease
  • depression
  • neurological disease
  • alzheimers
  • cancer
82
Q

Acute inflammation

A
  • less than 2 weeks, short term
  • visible (easy to see, localized, quick to diagnose, responds to treatment)
  • in response to physical and chemical damages, pathogen invasion, tissue necrosis..
  • redness, increased blood flow and edema
  • 5 cardinal signs: pain, heat, swelling, and limited movement
83
Q

chronic inflammation

A
  • not visible
  • long term (years or months)
  • related to unsuccessful acute inflammatory response
  • no cardinal signs
  • fibrosis and angiogenesis
84
Q

fibrosis

A

permanent scar tissue

85
Q

angiogensis

A

formation of new blood cells

86
Q

in chronic inflammation, when macrophages are unable to protect the body, the body will form

A

granuloma cells
- attemt to wall of infected area

87
Q

systemic signs of chronic inflammation

A
  • fever
  • lethargy
  • increased ESR and C-reactive protein
  • granuloma
  • hyperplasia of spleen or lymph nodes
  • fluid exudation and edema
  • depression
  • insomnia
  • weight loss/weight gain
88
Q

purulent (suppurative exudate

A
  • consists of plasma with both active and dead neutrophils, fibrogen, and necrotic parenchymal cells
  • commonly referred to as pus
89
Q

necrotic parenchymal cells are commonly referred to as

A

pus

90
Q

fibrinous exudate is composed mainly of

A

fibrogen and fibrin

91
Q

what are the 3 stages of wound healing

A
  1. inflammation stage
  2. proliferation phase
  3. remodelling phase
92
Q

Inflammation stage

A
  • platelets, neutrophils, and macrophages bring wound healing mediators, recruit fibroblasts which promote angiogenesis
93
Q

proliferation stage

A
  • fibroblast proliferation = collagen synthesis
  • epithelization
94
Q

remodelling and Maturation Phase

A
  • cellular differentiation
  • scar tissue formation
  • scar remodelling (several weeks to 2 years)
  • contraction (myofibroblasts)
95
Q

primary intention

A
  • clean incision, early suture, fine scar
96
Q

Secondary Intention

A
  • gaping wound
  • granulation
  • epithelium grows over scar
  • loss of tissue
  • wound is extensive and edges cant be brought together
  • pressure ulcer
  • good for contaminated/infected wounds
97
Q

Tertiary intention

A
  • open wound
  • increased granulation
  • late suturing
  • allows for observation of wound
  • delayed primary closure
98
Q

complications of wound healing

A
  • adhesions
  • strictures and contractures
  • infection
  • dehiscence and evisceration
  • excess scar formation
99
Q

adhesions

A

abnormal union of membranous surfaces due to inflammation or injury

100
Q

Strictures and Contractures

A
  • excess of wound contraction
  • burn victims
  • luzo gloves
101
Q

infection

A
  • wound re-infects with initial pathogen or is contact with an external pathogen
102
Q

dishescence and evisceration

A
  • seperation of wound edges or intraabdominal contents come out of the surgical wound
103
Q

excess scar formation

A
  • hypertonic scare are confined with the original wound bed
  • keloid scars extend beyond
  • caused by excess tension/movement
104
Q

dysfunctional wound healing can be caused by

A
  • blood supply
  • obesity
  • excessive fibrin
  • diabetes
  • wound infection
  • nutrition
  • medications
105
Q

ischemic tissue (dysfunctional wound healing)

A
  • suceptiable to cellular death
  • prolongs inflammation and delays healing
106
Q

excessive bleeding (dysfunctional wound healing)

A
  • large clots increase space granulation must fill
107
Q

decreased blood volume (dysfunctional wound healing)

A

inhibits inflammatory process

108
Q

obesity (dysfunctional wound healing)

A
  • impaired leukocyte function
  • predisposes to infection
109
Q

excessive fibrin (dysfunctional wound healing)

A
  • fibrin released needs to be reabsorbed to prevent formation of fibrous adhesions
110
Q

Diabetes (dysfunctional wound healing)

A
  • prolonged wound healing
  • potential for small vessel disease
  • hyperglycemia
  • suppression of macrophages
  • risk for infection
111
Q

medications (dysfunctional wound healing)

A
  • Antineoplastic (slow cell divsion and inhibit angiogenesis
  • NSAIDS (delayed wound healing)
112
Q

steriods (dysfunctional wound healing)

A

prevent macrophages form migrating to site

113
Q

NSAIDS

A
  • work against inflammatory process
  • decreased permeability
  • delays healing

Pathophysiology (9 decks)

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