Wound Healing Flashcards

1
Q

regeneration v healing

A

requires intact tissue scaffolding. new cells tissues derived from stabile/stem cells restore tissues to normal state

occurs when scaffolding has been altered or destroyed. involves collagen deposition and results in scarring

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2
Q

cell proliferation regulated by

A

1 hormones
2 growth stimuli
3 pathology stimuli

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3
Q

cell division in stable cell populations governed by

A

1 soluble stimulatory and inhibitory factors

2 cell-to-cell contact

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4
Q

mechanisms for increasing proliferation

A

shortening cell cycle

pushing stable cells into cell cycle

stimulating stem cells to differentiate

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5
Q

soluble factors that interact w/ cells

A

growth factors- PI3 kinase/MAP kinase, IP3 kinase pathways

g-protein (chemokines)- cAMP pathways, Ca

Cytokine- JAK/STAT pathway

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6
Q

what are the broad processes that occur following injury

A

clotting and inflammation

removal of dead tissue

proliferation and migration of fibroblasts

angiogenesis and granulation tissue

ECM synthesis/collagen
tissue remodeling

wound contraction

wound strength

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7
Q

how does the ECM communicate w/ the cell

A

integrin proteins are attached to the ECM, and actin/cytoskeletal elements are attached to the integrin

disruption of the ECM causes changes in the cell via these anchors

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8
Q

ECM contents

A

collagen, elastin, fibrillin, elastic fibers

adhesive glycoproteins- fibronectin, laminin “glue”

matricellular proteins

proteoglycans- substances get anchored or use these to move

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9
Q

why doesnt collagen associate inside cells?

A

the subunits are capped- doesnt allow them to associate until they are removed extracellularly

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10
Q

what type of collagen is found in scar tissue? in basement membrane?

A

type 1, type 4

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11
Q

basement membrane components

A

laminin, collagen type 4, proteoglycans, intactin

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12
Q

laminin

A

cross structure- domain that binds cells, collagen type 4

gives cell polarity

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13
Q

fibronectin

A

has collagen 1, fibrin, integrin and heparan binding domains

important for beginning wound healing

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14
Q

in tissues that can regenerate, what determines whether the tissue fully recovers

A

if the basement membrane is preserved, the tissue will scar

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15
Q

mechanisms of wound healing

A

starts w/ hemostasis - causes clotting.

fibronectin, fibrin, and collagen start forming loose cross linked lattice. provides structure leukocytes can use to migrate and the initial tensile strength

platelets from initial injury release TGF-b and PDGF- causing proliferation of endothelium, fibroblasts and smooth muscle.

these generate granulation tissue and the beginning of a scar

PDGF also recruits PMNs and macrophages. produce collegenases and proteases to remove dead tissue

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16
Q

granulation tissue

A

earliest form of a scar. have new capillaries and collagen

17
Q

cicatrix

A

scars, specifically after burns

18
Q

what are the coagulation factors active in wound repair and what do they do?

A

hageman factor- permeability

bradykinin- dilation, permeability, pain

complement- leukocyte recruitment, permeability

fibrin- plug, growth factors, provisional matrix

19
Q

role of platets in wound healing

A

plug vessels

vasoconstriction

growth factors- PDGF, TGF-b, FGF (fibroblast proliferation, angiogenesis)

20
Q

macorphages in wound repair

A

decontamination via phagocytosis,

debridement (cleaning dead host tissue),

growth factor release

21
Q

fibroblast functions in wound repair

A

growth factor production

proliferation- granulation tissue formation

ECM production

ECM contraction

22
Q

epithelial cells in wound repair

A

growth factor production

migration and proliferation to reepithelialize

ECM production

23
Q

endothelial cell in wound repair

A

thrombomodulin, prostacyclin, and plasminogen prevent thrombosis

metalloproteases-make hole in nearby blood vessel to form new branch to area of damage

growth factor

leukocyte diapedesis

ECM production

angiogenesis

24
Q

healing by first intention/second intention

A

bring tissue close together to minimize the amount of scar tissue

second intention is lots of scar tissue

25
Q

factors affecting the success of tissue repair

A
SYSTEMIC
nutrition
metabolic status
circulation (ischemia)
hormones
genetics
medical treatment
LOCAL
infection
foreign bodies
mechanical factors
type of wound
26
Q

keloid

A

excessive collagen deposition

27
Q

desmoid

A

collagen get dirstributed into muscle and makes them nonfunctional

28
Q

wound dehiscence

A

separation occurs- not contraction and stability of scar tissue

29
Q

complications d/t healing

A
non functional scar
keloid
desmoid
ulcer
wound dehiscence
scar contraction across a joint