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CMBM exam 3 > Tissue repair > Flashcards

Tissue repair Flashcards

1
Q

What does it mean to repair a tissue?

A

Both restoration of tissue architecture and function after an injury
Complete recovery rarely achieved

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2
Q

What are the two mechanisms of tissue repair?

A

Regeneration of injured tissue

Replacement of lost tissue

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3
Q

Which mechanism of tissue repair require cell proliferation of intact or altered cellular matrix?

A

Both

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4
Q

Stem cells produce a baseline cell population which do ____ or ____.

A

Proliferate, die via apoptosis

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5
Q

What are the types of continuously dividing (labile) cells?

A

Skin basal, hematopoietic, hair follicles and GI cells

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6
Q

What does the G0 phase look like for the continuously dividing cells?

A

Short

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7
Q

What are the stable cells and what does it mean to be stable?

A

Liver, kidney, lung alveoli, bone, breast, endocrine, adipose, vessels
Only need to proliferate when necessary

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8
Q

What does the G0 phase look like for stable cells?

A

Long

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9
Q

What are the permanent tissues and what does that mean?

A

Neurons in CNS, ganglia in PNS, cardiac, skeletal muscle

Cannot divide functionally

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10
Q

What are some characteristics of continuously generating cells?

A

Can easily regenerate after injury with a infinite life span
Dependent on age and health
Contains pools of stem cells
Immune positive for CD34, CD117, Ki67

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11
Q

What are the three locations for skin stem cells?

A

Epidermis, sebaceous gland, hair follicle bulge

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12
Q

What are the actions of growth factor?

A

Stimulate cell division and proliferation

Promote cell differentiation and survival

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13
Q

What some examples of growth factors?

A

Epithelial growth factor (skin, fibroblasts)
Transforming growth factor (hepatocytes, epithelials)
Platelet derived growth factor (s muscle, cytokines)
Erythropoietin
Granulocyte growth factor

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14
Q

What does each growth factor have on its target cell?

A

A specific receptor

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15
Q

When cells are injured and proliferate what is released?

A

Cytokines

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16
Q

Where do the cell injury responsive cytokines come from?

A

Damaged tissue, inflammatory cells, macrophages and vascular endothelial cells and fibroblasts

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17
Q

What are the two forms of the extracellular matrix?

A

Interstital matrix and basement membrane

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18
Q

What does the extracellular matrix do?

A

Sequesters water and mineral from circulation
Stores presynthesized growth factors
Gives cells a scaffolding upon which to adhere and do their assigned tasks

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19
Q

What does the ECM regulate overall?

A

Proliferation, movement, and differentiation of cells living in or on it

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20
Q

If the ECM is completely destroyed what happens?

A

It cannot regenerate and a scar forms

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21
Q

When does regeneration occur in labile tissues?

A

All the time, can make as much as needed

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22
Q

When does regeneration occur in stable tissue?

A

A limited extent, only some can come back or compensate for lost tissue
Only occurs if the residual tissue is healthy and intact

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23
Q

When does regeneration occur in permanent tissue?

A

Pretty much never and will always form scar tissue

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24
Q

What are the steps to injury healing?

A
  1. Cut
  2. Inflammation
  3. Blood clotting
  4. Granulation tissue - scab,eschar
  5. Wound contraction
  6. Wound recovery
  7. Scar tissue
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25
If an injury is too severe...
regeneration can't happen
26
What are the four components used in regeneration mediated by growth factor?
New vessel formation VEGF Fibroblast proliferation FGF, TGF Fibroblast synthesis of immature scar - type 3 collagen Fibroblast remodeling with mature scar - type 1 collagen
27
What is an eschar?
A scab
28
Granulation tissue does not contain....
Cross linked collagen
29
What are the three examples of wound healing?
First intention - sew shut Second intention - leave open Third degree burn
30
What does it mean when a wound is healed by first intention?
Occurs in small wounds that close easily Suturing or butterfly tape possible to use Epithelial regeneration predominates over fibrosis Healing is fast, minimal scarring well vascularized, no dead tissue
31
What is the time line to see changes for first intention healing?
Immediately By 24 hours By 3-7 days Weeks later
32
During the phase of immediate healing for first intention, what is seen?
``` Vasoconstriction - platelet activation Vasodilation - fills with blood Blood clots release of mediators - PDGF Fibrinogen in blood converted to Fibrin by platelets Temporary scaffold ```
33
What happens in 24 hours in first intention wound healing?
``` Platelets aggregate Release PDGF's and firm clot formation Migration of cells first of neutrophils and then macrophages In Cut edges, stem cells wake up Chemotaxasis ```
34
By 3-7 days what has happened in first intention wound healing?
``` More macrophages with few PMN Granulation tissue formed - new blood vessels, fibroblasts (acted on by TGF) & myofibroblasts Collagen type 1 begins to bridge ECM starts to be made Newly made epithelium thickens ```
35
What happens after a few weeks in first intention wound healing?
Granulation tissue gone; ECM back Collagen type IV Epidermis full thickness Little scar forms
36
What happens in healing by second intention?
Large wound gap occurs and fibrosis predominates over epithelial regeneration Healing is slower, more inflammation, granulation of tissue formations and scaring (less wound contraction)
37
Why can good wounds (that could heal well) go bad?
Trauma, acute or chronic infection, diabetes, steroids, ischemia, radiation
38
What is a keloid scar?
Hypertrophic fibroblast response (more collagen) | too much type 1 leads to too much type 4 collagen
39
What is a proud flesh scar?
Hypertrophic granulation tissue (more vessels present) also called Pyogenic granuloma
40
When is a scar good and when is it bad?
Good - forms well and is resilient | Bad - permanent contraction dysfunction
41
How does HBV lead to scarring but HAV not?
HBV injures the matrix as well which leads to scarring | HAV only damages the cells
42
what can store cytokines?
extracellular matrix
43
what does basement membrane consist of?
Type IV collagen Laminin Proteoglycan
44
what does interstitial matrix consist of?
fibrillar collagens Elastin Proteoglycan Hyaluronan
45
what mediates the process of Scarring?
Growth factors 1. New vessel formation (angiogenesis) by VEGF 2. Fibroblast proliferation elaborating FGF, TGF 3. Fibroblast synthesis of immature scar - Type 1 collagen 4. Fibroblast remodeling with mature scar - Type 4 collagen
46
After a cut, a clot forms and within seconds
heeling begins with PDGF
47
Fibrinogen is converted to Fibrin for
temporary scaffolding for WBCs
48
By 24 hrs after an injury,
PMNs, platelets, Macs take over Endothelial cells begin to proliferate Fibroblasts emigrate - become myofibroblasts and wound contraction begins
49
By 3-5 days after an injury,
granulation tissue is present -scab, eschar New firm scaffolding is present that repair cells can work
50
Weeks after an injury
there is dense fibrosis - scar | scar remodeled in months from pink to white then wrinkled
51
Granulation tissue has
no crosslinked collagen mainly blood vessels and fibirin no PMNs
52
Examples of some injuries that heal by second intention?
Ischemic necrosis - infarction large burns Ulcers
53
Ulcer caused by
some ischemia and pressure
54
cirrhosis is
fibrosis and regenerative nodules
55
Trichrome
stains collagen blue
56
Proper Repair occurs
with architecture and function
57
what collagen change is seen in breast cancer?
Collagen type 5 is seen
58
Nephrosclerossi
scarring of glomeruli from hypertension induced damage
59
contraction of scars in the brain leads to
seizures
60
Lung infarctions are
hemorrhagic

CMBM exam 3 (24 decks)

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