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Pathology > Tissue Repair, Regeneration, and Healing > Flashcards

Tissue Repair, Regeneration, and Healing Flashcards

1
Q

After injury, what two cell types are able to replace the injured cells?

A

Uninjured surrounding cells and stem cell division –> differentiation.

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2
Q

What is a labile tissue? Name an example.

A

Constantly dividing. Ex. epithelium, hematopoietic cells

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3
Q

What is a stable tissue? Name an example.

A

Minimal replicative activity. Ex. liver, kidney, smooth muscle, fibroblasts, mesenchymal tissues, glia

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4
Q

What is a permanent tissue? Name an example?

A

Terminally-differentiated and non-proliferative. Ex. neurons, cardiac muscle, skeletal muscle.

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5
Q

Can polypeptide growth factors act in an autocrine, paracrine, or endocrine manner?

A

Yeah

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6
Q

What are the three main functions of the extracellular matrix?

A
  1. Mechanical support
  2. Substrate for cell growth
  3. Regulation of cell proliferation and differentiation
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7
Q

What are the two main divisions of the ECM?

A

Interstitial (between cells) and basement membrane

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8
Q

If the ECM is damaged what is the only method of repair?

A

Scar formation

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9
Q

In the process of scar formation, _________ tissue is first laid down, then fibrous tissue is laid down, forming the scar.

A

granulation

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10
Q

TGF-beta is a potent _______ agent.

A

fibrogenic

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11
Q

Excessive production of ECM collagen in wound healing can lead to formation of ______ scars.

A

keloid

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12
Q

Dr. Kwan likens scars to ______ tape.

A

duct

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13
Q

Is duct tape hard to get off once its on?

A

Yeah

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14
Q

Fibrosis is characterized by the excessive deposition of _______ in tissues/organs.

A

collagen

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15
Q

Cell populations are regulated by a balance of cell division and ________.

A

apoptosis

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16
Q

Cell proliferation can be either physiologic or _______.

A

pathologic

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17
Q

What are the three major types of polypeptide growth factor receptors?

A
  1. Intrinsic tyrosine kinase activity
  2. Without intrinsic enzyme activity
  3. G-protein coupled
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18
Q

GF receptors that trigger phosophorylating events through MAP kinases or phosphatidylinositol-3 kinases to activate transcription factors fall into which category of GF receptor?

A

Ones with intrinsic tyrosine kinase activity

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19
Q

How do GF receptors without intrinsic kinase activity work?

A

They activate intracellular protein kinases like Janus kinases (JAKs), which activate cytoplasmic TFs –> nucleus.

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20
Q

Name the six major molecules that bind G-protein coupled receptors.

A
  1. Epinephrine
  2. ADH
  3. Serotonin
  4. Histamine
  5. Glucagon
  6. Chemokines

Mnemonic: Histamine CAGES

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21
Q

Do mesenchymal cells or parynchymal cells synthesize the interstitial matrix?

A

Mesenchymal

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22
Q

Which cells are involved in synthesizing the basement membrane?

A

Overlying epithelial cells and underlying mesenchymal cells.

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23
Q

How does the ECM regulate cell proliferation and differentiation?

A

By storage and presentation of regulatory molecules like growth factors.

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24
Q

Name two fibrous structural proteins.

A
  1. Collagen

2. Elastin

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25
Q

Name the two water-hydrated gels that are found in the ECM. What do these serve as reservoirs for that play a role in cell differentiation and proliferation?

A
  1. Proteoglycans
  2. Hyaluronan

They house GFs

26
Q

Fibronectin and laminin are types of _________ _________.

A

adhesive glycoproteins

27
Q

Fibronectin is a major component of the _______ ___ that forms fibrillar aggregates at wound healing sites.

A

interstitial ECM

28
Q

Integrins are major cellular receptors for the ____ and their binding leads to a signaling cascade that can affect _______, ______, and _______.

A

cellular receptors for the ECM. Binding affects locomotion, differentiation, and proliferation.

29
Q

Are regenerated tissues functionally and structurally identical to the original?

A

Yeah

30
Q

Which organ has good regenerative capability?

A

Liver

31
Q

Other than the liver, what tissues can regenerate well?

A

Bone, epithelium.

32
Q

What four organs have minor regenerative capacity?

A

Pancreas, adrenal, thyroid, lungs.

33
Q

If you donate one kidney, what is likely to happen to your remaining one?

A

It will undergo compensatory hypertrophy and hyperplasia

34
Q

Can successful regeneration occur if there is significant CT damage?

A

Nope

35
Q

How much of a person’s liver can safely be donated?

A

40-60%

36
Q

Dr. Kwan used uncomplicated bacterial pneumonia infection as an example of healing by ________. In this example, the alveoli filled with polymorphonuclear leukocyte-rich ______. Later, macrophages removed the debris in the alveoli and the epithelial cells underwent ________ —> normality.

A

resolution. Alveoli filled with poly-rich exudate. Epithelial cells underwent regeneration and things returned to normal.

37
Q

In a wound that includes CT damage, inflammatory cytokines recruit _______ cells that eventually lay down collagen, forming _______ tissue.

A

fibroblast, granulation

38
Q

How long does it take for granulation tissue to form after the CT is damaged?

A

3-5 days

39
Q

Name the seven steps in scar formation.

A
  1. Inflammatory response
  2. Proliferation and migration of parynchymal and CT cells
  3. Angiogenesis
  4. Fibroblast migration and proliferation
  5. Granulation tissue formed
  6. Remodeling
  7. Wound contraction and acquisition of strength
40
Q

After three to five months following healing via scar formation, the scar has approx. ____% the strength of the original tissue.

A

80

41
Q

What are the three most important growth factors for angiogenesis?

A

Vascular endothelial growth factor (VEGF), Fibroblast growth factor 2 (FGF-2), and Angiopoietins.

42
Q

During angiogenesis, EGF-VEGFR-2 interaction mobilizes _______ _______ _______ from the bone marrow so they can proliferate and differentiate at sites of angiogenesis.

A

endothelial progenitor cells (EPCs)

43
Q

Are FGF-2 receptors G-protein linked, have tyr. kinase activity, or interact with cytoplasmic kinases?

A

They have tyrosine kinase activity.

44
Q

FGF-2 enhances endothelial cell ___________, _________ and ________.

A

motility, proliferation and differentiation

45
Q

Angiopoietins 1 and 2 are involved in _____ing newly formed vessels by recruiting ______ and ______ cells. They also mediate vessel maturation from simple tubes into _______.

A

stabilizing by recruiting pericytes and smooth muscle cells. Turns simple tubes into networks.

46
Q

Which Angiopoietin helps maintain endothelial cell quiescence?

A

Ang1

47
Q

Name three GFs that stimulate fibroblasts to lay down ECM molecules in the process of wound healing via scar formation.

A
  1. TGF-beta
  2. PDGF
  3. FGF
48
Q

Which class of enzymes is important in degrading the ECM during the process of scar remodeling?

A

Matrix metalloproteases (MMPs)

49
Q

MMPs can be inactivated by binding to protease inhibitors such as _____ ________.

A

alpha-2 macroglobulin

50
Q

In healing by 1st intention, ______ regeneration predominates over fibrosis.

A

epithelial

51
Q

A deep wound with separated edges is most likely to undergo healing by ____ intention.

A

2nd

52
Q

Wound repair tensile strength plateaus at __ months following injury.

A

3

53
Q

Fibrosis is associated with ______ inflammation.

A

chronic

54
Q

Keloid scars are due to excessive _______ deposition.

A

collagen

55
Q

What is wound dehiscence?

A

Re-rupture

56
Q

_________ can cause joint immobility.

A

Contractures

57
Q

Can nutrition status, metabolic status, vascular adequacy, and anti-inflammatory meds influence wound healing?

A

Yeah.

58
Q

What do myofibroblasts do?

A

They use smooth muscle-like actin-myosin complexes to pull edges of a wound together as in healing by 2nd intention.

59
Q

What are the eight steps in angiogenesis?

A
  1. Vasodilation.
  2. Increased vascular permeability (VEGF).
  3. MMPs break down basement membrane.
  4. Endothelial cells secrete plasminogen activating factor (PAF), which cleaves plasminogen to plasmin for fibrinolysis.
  5. Endothelial cell proliferation and migration.
  6. Endothelial cells mature and remodel into capillary tubes.
  7. Peri-endothelial cells and smooth muscle cells are recruited.
  8. Endothelial cell migration and proliferation stops and the basement membrane is made.
60
Q

Name six GFs that bind receptors with intrinsic tyrosine kinase activity.

A
  1. PDGF
  2. HGF (hepatocyte GF)
  3. VEGF
  4. TGF-alpha
  5. FGF
  6. EGF

anything that ends in GF

61
Q

Name five types of molecules that bind receptors without intrinsic kinase activity.

A
  1. Cytokines
  2. Interferons
  3. Growth hormones
  4. EPO
  5. Colony-stimulating factors

Pathology (6 decks)

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