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Concepts in Pathology and Tissue Morphology > tissue repair > Flashcards

tissue repair Flashcards

1
Q

what is the purpose of an inflammatory response

A

eliminate injurious agent and set in motion repair process

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2
Q

what are the cell types that proliferate during tissue repair

A
  • remnants of injured tissue
  • endothelial cells
  • fibroblasts
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3
Q

labile tissues are characterized by

A

continuous division

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4
Q

stable tissues are characterized by

A

quiescent (in G0), only divide if necessary

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5
Q

permanent tissues are characterized by

A

they are terminally differentiated

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6
Q

cell proliferation in tissue repair is driven by signals from

A

growth factors (GFs) and within the ECM

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7
Q

what is the most important source of growth factors in tissue repair

A

macrophages

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8
Q

all growth factors activated signaling pathways that induce production of proteins involved in

A

•driving cells through cell cycle
or
•release block on cell cycle (checkpoints)

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9
Q

what is a scar

A

replacement of parenchymal cells by collagen

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10
Q

in angiogenesis, newly formed vessels are leaky because

A

•incomplete intraendothelial junctions and because VEGF increases permeability

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11
Q

the leakiness of newly formed vessels leads to

A

edema

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12
Q

granulation tissue is formed by

A

migration/proliferation of fibroblasts, deposition of loose CT, together with vessels and interspersed leukocytes

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13
Q

the amount of granulation tissue formed depends on

A
  • size of tissue deficit

* intensity of inflammation

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14
Q

steps of connective tissue deposition (scarring)

A
  • angiogenesis
  • formation of granulation tissue
  • remodeling of CT
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15
Q

in angiogenesis during the formation of scar, what do matrix metalloproteinases (MMPs) do

A

degrade ECM to permit remodeling and extension of vascular tube

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16
Q

what is the most important cytokine for the synthesis and deposition of connective tissue proteins

A

TGF-β

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17
Q

what does TGF-β do

A

•anti-inflammatory -> limit/terminate inflammatory response by inhibiting lymphocyte activation and activity of other leukocytes

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18
Q

what are myofibroblasts

A
  • fibroblasts that have acquired some feature of smooth muscle
  • contribute to contraction of scar over time
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19
Q

what do MMPs do in remodeling of CT

A
  • degrade collagen and other ECM components

* depend on zinc (or other metal ion)

20
Q

what cells produce MMPs

A

fibroblasts, macrophages, neutrophils, synovial cells, and some endothelial cells

21
Q

how can infection influence tissue repair

A

prolongs inflammation and potentially increase local tissue injury

22
Q

examples of nutritional deficits that might inhibit healing

A

vitamin c or copper deficit, which are needed for collagen synthesis

23
Q

how can glucocorticoids influence tissue repair

A

they are anti-inflammatory, but may result in scar weakness due to inhibition of TGF-β

24
Q

mechanical stress during tissue repair may result in

A

dehiscence

25
Q

important examples of poor perfusion that could inhibit tissue repair

A
  • atherosclerosis
  • DM
  • obstructed venous drainage
26
Q

other factors that influence tissue repair

A
  • foreign bodies
  • diabetes (important!)
  • type/extent of injury
  • location
27
Q

when does first intention healing/primary union occur

A

when injury involves only the epithelial layer

28
Q

what is the primary mechanism of repair in first intention/primary union

A

epithelial regeneration

29
Q

when cell loss is more extensive, second intention healing or secondary union occur. what does this process involve

A

combination of regeneration and scar formation

30
Q

what are examples of extensive cell loss that would result in second intention/ secondary union

A

large wounds, abscess, ulcer, and ischemic necrosis

31
Q

what differentiates second intention from first intention

A
  • inflammation is more intense
  • fibrin clot is larger
  • more granulation tissue -> more scar tissue
  • type III collagen first, then type I replaces it
  • lots of wound contraction (myofibroblasts)
32
Q

strength in sutured wounds

A
  • 70% of normal skin with sutures
  • when sutures removed (~1 wk) about 10% but rapidly increases over 4 wks
  • ~70-80% by 3 mos, usually no substantial improvement from there
33
Q

when is dehiscence of a wound most common

A

after abdominal surgery

34
Q

when would ulceration occur in tissue repair

A

inadequate vascularization

35
Q

what is a hypertrophic scar

A

raised scar from excessive collagen deposition; type I collagen dominates

36
Q

what is keloid

A

scar grows beyond the wound; type III collagen is dominates

37
Q

what is contracture

A

exaggeration of contraction of wound

38
Q

scar formation is directly proportional to ___ and indirectly proportional to ___

A

amount of stromal damage; replicative ability of damage tissue

39
Q

what does EGF do

A

epidermal growth factor

stimulates keratinocytes

40
Q

what does KGF do

A

keratinocyte growth factor

stimulate keratinocytes

41
Q

what does FGF do

A

fibroblast growth factor

stimulate fibroblasts AND promote angiogenesis

42
Q

what does VEGF do

A

vascular endothelial growth factor

promote angiogenesis

43
Q

what does PDGF do

A

platelet derived growth factor

promote granulation tissue formation (endothelium, smooth muscle, and fibroblasts)

44
Q

what does TGF-α do

A

transforming growth factor alpha

similar to EGF- stimulate keratinocytes

45
Q

what does TGF-β do

A

transforming growth factor beta

stimulates fibroblasts AND is anti-inflammatory (unique characteristic)

Concepts in Pathology and Tissue Morphology (10 decks)

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