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RUSVM Pathology I > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

Embryonic Stem Cells

A

Pluripotent; isolated from blastocysts

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2
Q

PDGF, FGF, VEGF-A bind GF-R’s on endothelial cells to induce vascular formation by

A

Endothelial proliferation

Recruitment of pericytes

Deposition of ECM proteins

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3
Q

What occurs during the hemostasis phase of wound healing

A

Vasospasm → relaxation

Platelets aggregate to expose collagen and a network of fibrin forms

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4
Q

Repair

A

Replacement of injured tissue

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5
Q

Describe the arrangement of blood vessels in granulation tissue

A

Arranged perpendicular to fibrosis

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6
Q

Growth factors and cytokines involved in angiogenesis

A

VEGF, angiopoietin, FGF

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7
Q

Permanent Cell - Non-Dividing Cell

A

Have left the cell cycle and cannot undergo mitotic division in postnatal life

_________________________

Neurons, Cardiac and Skeletal Muscle

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8
Q

Mechanism of wound healing by primary intention

A
  • Simple Incision
  • Sutured incision with acute inflammatory response (2-7 days)
    • Redness and swelling
    • Zone of acute inflammation; formulation of granulation tissue
  • Healing Incison
    • Epithelial proliferation and repair
    • Maturing fibrous granulation tissue
  • Linear fibrous scar (6-12 months)
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9
Q

Mechanism of wound healing by second intention

A
  • Ragged, dirty or infected wound (2-3 days)
    • Necrotic slough
    • Acute inflammation
  • Phase of rapid proliferation of vascular granulation tissue (1-2 weeks)
    • Slough and scab
    • Epithelial proliferation
    • Vascular granulation tissue
    • Zone of hyperemia
  • Phase of granulation tissue maturation and wound contraction (3-6 weeks)
    • Fibrous granulation tissue beginning to contract, pull wound edges closer
    • Hyperemia
  • Healed wound
    • Pale depressed scar with puckering
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10
Q

The proliferation phase of wound healing occurs when? And can last for how long?

A

3-7 days

3-4 weeks

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11
Q

Quiescent - Stable Cells

A

Low level of replication; undergo rapid division in response to stimuli. Capable of reconstructing the tissue of orgin

_________________________

Smooth muscle, fibrocytes, vascular endothelial cells, chondrocytes, osteocytes

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12
Q

Collagen

A

Triple helices with lots of cross linkage providing tensile strength

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13
Q

Characteristics of epithelialization

A

Proliferate at denuded surfaces

Must disassemble connections to basement membrane and neighboring cells

Must express surface receptors that bind ECM

Regulated by contact inhibition

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14
Q

Tissues ability to return to normal depends on

A

Retention of ECM structural framework

Regenerative capacity of cells

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15
Q

Myofibroblasts

A

Form within wounds in response to TGF-beta

Increase with time and severity

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16
Q

Proud Flesh

A

Hypertrophic scar - excessive granulation tissue

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17
Q

T/F- Capillaries in granulation tissue are sturdy.

A

False

________________

Capillaries are fragile and bleed easily

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18
Q

When does healing begin?

A

Immediately after a wound develops

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19
Q

Process of degradation during inflammation phase of wound healing

A

Leukocytes clean up cell debris from the injury

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20
Q

Wound

A

Injured tissue

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21
Q

Tensile strength is diminished in what type of wound healing?

A

Secondary intention

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22
Q

Growth factors and cytokines involved in collagenase secretion

A

PDGF

FGF

TNF

TGF-beta inhibits

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23
Q

Growth factors are required for cellular

A

Proliferation

Differentiation

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24
Q

Angiogenesis

A

Formation of new blood vessels from existing ones

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25
T/F: Proliferation phase of wound healing increases with age and disease.
False \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ decreases
26
Growth factors and Cytokines involved in fibroblast migration/ replication
PDGF EGF FGF TGF-beta TNF IL-1
27
Fibroplasia
Migration and proliferation of fibroblasts
28
Extracellular Matrix consists of
Collagen Elastin Fibronectin Laminin
29
What phase of wound healing is required for return of tensile strength
Maturation
30
TGF-Beta
Produced by platelets and leukocytes Important for fibroblast migration and proliferation, and collagen/ECM protein synthesis
31
Epithelialization
Regeneration of epithelium
32
Fibrosis
Scar formation by connective tissue remodeling
33
Microscopically, what is found at the center of the wound during degradation
Dead cells Leukocytes Cytokines Serum/clotting proteins ECM substances
34
Conditions that may cause impaired wound healing
Tension on a tissue Prolonged inflammation Disorders in collagen synthesis Poor blood supply Impaired ability of cellular regeneration
35
Factors that favor fibrosis
Severe and prolonged tissue injury Loss of tissue framework Large amounts of exudate/inflammation Lack of renewable cell populations
36
Wound contraction is mediated by
Myofibroblasts
37
Fibrous Connective Tissue
Dense accumulation of fibroblasts and collagen With time, collagen becomes more densely packed Persists for years
38
What occurs during the proliferation phase of wound healing?
Regeneration of tissue Granulation tissue formation Stem cells influced by cytokines/growth factors Fibroblasts proliferate to fortify the wound → collagen deposition
39
Wounds that can be healed by second intention
Gaping wounds Septic wounds Foreign bodies Wound with delayed healing processes
40
Granulation Tissue
Distinctive arrangement of connective tissue fibers, fibroblasts and blood vessels
41
What occurs during the inflammation phase of wound healing?
Cardinal signs seen ECM components are chemotactic Degradation Leukocytes secrete chemotactic and growth factors → proliferation phase
42
Growth factors and cytokines involved in monocyte chemotaxis
Chemokines TNF PDGF FGF TGF-beta
43
Mechanism of angiogenesis
1. Proteolysis of ECM 2. Migration and chemotaxis 3. Proliferation 4. Lumen formation, maturation and inhibition of growth 5. Increased permeability through gaps and transcytosis
44
Phases of cutaneous wound healing
Hemostasis Inflammation Proliferation Maturation
45
Proliferation phase of wound healing is limited by
Proliferative potential of cell types involved
46
Consequences of fibrosis
Loss of functional parenchymal tissue Alteration of physical properties of tissue
47
What occurs during the maturation phase of wound healing?
Remodeling of granulation tissue, maturation of fibrosis and wound contraction Re-establishment of cell interactions Vascular regression
48
Labile - Continuously Dividing Cells
Proliferate throughout life, replacing those cells that are destroyed \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Epithelial cells of liver, kidney, lung, pancreas, skin, mucous membranes
49
T/F: If inflammation is excessive, it can reduce healing.
True
50
Wounds that can be healed by primary intention
Wounds with opposed edges
51
Role of extracellular matrix in regeneration and repair
Liver regeneration with restoration of normal tissue after injury requires intact cellular matrix If matrix is damaged the injury is repaired by fibrous tissue deposition and scar formation
52
Wound Contraction
Normal part of maturation phase Can be bad when connective tissue contracts and place tension on surrounding tissues May immobilize or deform tissue
53
Growth factors and cytokines involved in collagen synthesis
TGF-beta PDGF
54
What induces fibroblasts to synthesize collagen?
Growth factors
55
Important source for epithelial regeneration
Stem Cells
56
The inflammation phase of wound healing occurs in what time frame
24-96 hours
57
Growth factor mechanism
EGF binds receptors on epithelial cells → activates MAPK → induces G0 phase cell cycle
58
Growth factors and cytokines involved in keratinocyte replication
HB-EGF FGF-7 HGF
59
Maturation phase of wound healing occurs when and can last for how long?
Begins 3-4 weeks after injury Can last for years
60
Results of the hemostasis phase of wound healing
Reduced blood loss Binds edges of wound together Initiate angiogenesis - PDGF, TGF-Beta
61
Describe the arrangement of fibroblasts and connective tissue in granulation tissue
Grow parallel to the wound surface
62
Tissue Stem Cells
Not pluripotent - restricted lineage specific differentiation capacity Bone marrow - hematopoietic and mesenchymal cells Skeletal muscle "satellite cells"
63
Matrix Metalloproteinases
Important for degrading the ECM

RUSVM Pathology I (18 decks)

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