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Optometry Class OP4103 > Wound healing > Flashcards

Wound healing Flashcards

1
Q

what are the three tissue responses to injury?

A

-regeneration
-repair
-chronic inflammation

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2
Q

what is wound healing dependent on?

A

-capacity of tissue to regenerate
-type of wound and the degree of damage

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3
Q

what are the 6 types of wound?

A

-abrasion
-avulsion
-incision
-laceration
-puncture
-amputation

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4
Q

what are the three types of cells in terms of their renewal

A

-liable: constant cell renewal
-stable: slow renewal
-permenant: post mitotic

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5
Q

what are the two major components that undergo repair?

A

cells and the extracellular matrix

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6
Q

what does the extracellular matrix consist of?

A

-collagen
-basement membrane
-glycoproteins
-proteoglycans
-elastin

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7
Q

what are the steps of healing?

A
  1. haemostasis
    2.inflammation
  2. demolition
  3. proliferation
  4. maturation
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8
Q

what are the steps of haemostasis?

A
  1. reaction to injury
  2. truggeres platelet aggregation and activation of coagulation cascade
  3. haemostatic plug/ clot
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9
Q

what is the aims of inflammation?

A

-trigger phagocytosis
-to trigger plasma proteins and cause clotting factors, complement components and kininogens
-isolate, des

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10
Q

what are the steps leading up to inflammation?

A
  1. vasodilation and increased vascular permeability of the blood vessels
  2. plasma proteins of fibrinogen and fibronectin are released
  3. phagocytes are released
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11
Q

what are the symptoms of inflammation?

A

-rubor/ redness
-calor/ heat
-tumor/ swelling
-dolor/ pain

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12
Q

what cells are triggered in inflammation?

A

-neutrophils
-macrophages
-lymphocytes
-plasma proteins

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13
Q

what chemicals are triggered in haemostasis?

A

-platelets
-fibrin
-fibronectin
-transglutaminases

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14
Q

what cells are triggered in demolition

A

-mainly macrophages
-collagenases

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15
Q

what processes are triggered in proliferation?

A

-granulation
-anglogenisis
-extracellular matrix synthesis
-wound contraction
-epithelial proliferation

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16
Q

what processes are triggered in maturation?

A

-collagen cross linking
-remodelling
-capillary resorption

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17
Q

what are the steps of inflammation?

A
  1. vasodilation and vascular permeability
  2. plasma proteins of fibrinogen and fibronectin
  3. phagocytes are recruited
18
Q

what does proliferation do?

A

replaces the wound by cells and scar tissue

19
Q

what happens in the formation of granulation tissue?

A

-angiogenesis to form richly vascularised tissue
-deposition of non-collagenous ECM
-collagen synthesis
-scar tissue deposition

20
Q

what are the growth factors in proliferation?

A

-EGF
-FGF
-PDGF
-TGFB
-NGF

21
Q

what hormones are involved in proliferation?

A

insulin, glucagon and thyroid hormones

22
Q

how long does cell regeneration in epithelial wound healing take?

A

3-7 days

23
Q

what are the steps of granulation?

A

-endothelial cells spout
-new capillary bed is formed
-cell recruitment where inflammatory cells are triggered
-myofibroblasts released
-wound contraction occurs
-inward migration of myofibroblasts

24
Q

what happens in wound maturation?

A

-maximum collagen accumulation that takes 2-3 months
-continuous remodelling so continual ECM syntehsis and degredation organisation
-organisation
-collagen cross linking causes increase in tensile strength

25
Q

what causes a keloid scar?

A

excessive collagen deposition at wound site

26
Q

what are the local wound healing factors?

A

-type, size and location
-vascular supply
-oxygen supply
-infection
-necrosis
-foreign material
-movement

27
Q

what are the systemic wound healing factors?

A

-cardiovascular status
-nutritional status, vitamin A is essential for epithelial regeneration
-diseases such as diabetes or cancer
-drugs

28
Q

Give 5 procedures where the eye would have to undergo wound healing

A

after:
-laser surgery such as PKP or LASIK
-cataract surgery
-glaucoma filtration surgery
-proliferative vitreoretinopathy
-laser photocoagulation

29
Q

when would the cornea specifically have to undergo wound healing?

A

-infection
-trauma
-keratoplasty
-refractive surgery

30
Q

What does the nature and extent of the wound healing response depend on?

A

chemical or mechanical cause.
-chemical triggers a superficial response
-mechanical triggers a penetrating response

31
Q

What are the 5 refractive and transplant surgeries?

A

-photorefractive keratectomy (PRK)
-Laser-assisted in situ keratomileusis (LASIK)
-Laser-assisted sub-epithelial keratectomy (LASEK)
-Penetrating keratoplasty (PKP)
-Anterior lamellar keratoplasty (ALK)

32
Q

what is PKP?

A

a full thickness transplant that replaces diseased cornea and is especially useful in cases of endothelial dysfunction

33
Q

What is ALK?

A

a partial thickness graft of the epithelium and stroma and is for stromal pathologies without epithelial dysfunction

34
Q

what is the process of epithelial wound healing? how long does the process take?

A
  1. rounding off of wound edge, epithelial differentiation disappears
  2. stem cells and TACs proliferate
  3. loss of cell attachments: hemidesmosomes
  4. migration as a sheet along a temporary matrix
  5. re-epithelial differentiation/ stratification
35
Q

what is the process of stromal wound healing? What are the symptoms during the healing phase? how long is the healing phase?

A
  1. keratocyte apoptosis at wound site
  2. activation and proliferation of fibroblasts
  3. migration to wound site
  4. differentiation to myofibroblasts
  5. ECM remodelling as there is new synthesis of GAGs and collagen and degradation

symptoms:
-fibrosis and haze
-vision loss

takes 1-3 years

36
Q

Give the steps to endothelial wound healing

A

1.cells migrate across Descemet’s membrane to compensate regions of loss
2. cells enlarge to fill in gaps in polymegathism and pleomorphism

37
Q

when does endothelial healing need to occur?

A

if damaged human corneal endothelial cells are unable to regenerate

38
Q

What are the regulators of corneal wound healing?

A

-tear fluid
-growth factors
-adhesion molecules
-proteolytic enzymes

39
Q

what cell is responsible for wound contraction and why is wound contraction important?

A

myofibroblast, reduces wound size so faster healing

40
Q

Which cells undergo cell division to generate cells for the process of epithelial regeneration in the cornea and skin?

A

-cornea: limbal epithelial stem cells; TACs on the basal corneal epithelium
-skin: epithelial stem cells in the basal layer; TACs in the basal layer

41
Q

what are the steps of angiogenesis?

A

1.nearby capillary endothelial cell duplicates
2. this forms a tube of cells
3. this joins up with another tube of cells
4. this forms a new capillary bed at the wound site

42
Q

what are the 3 categories that describe a cells proliferative potential?

A

-liable
-stabile
-permanent

Optometry Class OP4103 (20 decks)

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