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Pathology > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

What is wound healing

It’s 2 major processes

A

-body’s response to injury to try and restore normal structure and functioning

  • regenerative
  • repair / resolution
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2
Q

What is regeneration

A

/proliferation of parenchymal cells to replace damaged area with exact same type to cell

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3
Q

What does functional and structural repair mean

A
  • restoration of organ function ( most common ) compensatory repair
  • restoration of complete organ structure
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4
Q

What is repair

A

-healing occurring by proliferation of CT tissue ( myofibroblasts , fibroblasts ) and laying down of collagen at injured area forming a fibrocystic scar

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5
Q

What does repair depend on

A

1 type of tissue damaged
2 Extent of damage
3 nature of damage

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6
Q

List the steps of repair

A

1 hemostasis
2 inflammation
3 proliferation

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7
Q

What is granulation tissue ( describe it )

Differentiate from granuloma

A
  • hallmark of wound healing. Pink and has granular appearance on surface
  • foci for granulamatous inflammation
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8
Q

List the 3 phases of granulation tissue formation

A

1 inflammatory phase
2 clearance phase
3 in growth of granulation tissue ( Angiogenesis and fibrosis )

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9
Q

What is
Angioblast
Hemongioblast
Vasculogenesis

A
  • stem cell which differentiates into embryonic blood vessels
  • stem cells which develop into embryonic blood vessels and hemapoietic cells
  • development is of embryonic blood vessels and blood from angioblast and hemongioblast
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10
Q

What is angiogenesis and 2 ways it comes about

A

-development of adult blood vessels through
1 from existing blood vessels
2 from stem cells from endothelial precursor cell ( EPC )

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11
Q

How does angiogenesis from stem cells come about

A
  • Endothelial precursor cells migrate to site of angiogenesis from bone marrow
  • proliferate and mature into vessels
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12
Q

How does vessels dilation and increased permeability come about in angiogenesis

How is the basement membrane degraded

A
  • vessels dilation mediated by nitric oxide
  • VEGF increased permeability

-matrix metalloproteinase degrade endothelial

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13
Q

How does angiogenesis by pre-existing vessels come about

A

/vessels increase width and permeability

  • basement membrane degraded
  • endothelial cells migrate to site of angiogenesis and proliferate , mature and reshape into vessels
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14
Q

What happens to pericytes during angiogenesis

What are they the pericytes

A

/they accumulate as vascular smooth muscles

-peri endothelial cells

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15
Q

What is fibrogenesis

A

-accumulation of blood vessels and fibroblasts and myeoblasts at site of injury surround by collagen 3 and ground substance

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16
Q

What 2 processes make granulation tissue

A

1 angiogenesis

2 fibrogenesis

17
Q

What is wound contraction

When does it occur

How does it occur

A
  • reduction of size of injured area
  • 2-3 days after injury and ends after 2 weeks
  • myofibroblasts have contractile apparatus which contract and reduce the size of wound
18
Q

3 types of cutaneous skin repair

A

1 1st intension
2 2nd intension : secondary union
3 tertiary

19
Q

List the steps of cutaneous wound healing

A

1 blood clotting / homeostasis
2 inflammation
3 proliferation : granulation tissue formed
4 maturation : tissue remodeling , wound contraction,

20
Q

Criteria for 1• union , 2• union and 3• union

A
  • clean wound ,uninfected
  • minimal tissue loss ,cut margins close to each other
  • infected wound , extensive tissue loss , cut margins greatly distanced , no clean cut wound
  • clean cut wound intentionally left open due to risk of enclosing infection
21
Q

Describe homeostasis and its function during wound healing

A
  • this is when the wound is filled with blood wc clots
  • seal wound from dehydration
  • top part of clot dries up forming seal Called scab to prevent infection
  • scaffold for inflammation cells and other healing cells
22
Q

Describe inflammation phase of wound healing

A

/WBC’s migrate to site of inflammation ( neutrophils later replaced by macrophages by day 3 )
-in 1st 24 hours neutrophils degrade debit and bacteria

23
Q

Describe proliferation phase of wound healing

A

-fibrosis and angiogenesis and granulation tissue formed ( 24-72 hours )
/epithelium at edge proliferates ( after 24 hours) , deposit basal membrane and fuse at middle
-wound now has deep single layer of epi
-by 5th day layer stratified and wound re-epithelized

24
Q

How are fibroblasts recruited to site of injury

A

-some are local and others migrate to site after stimulated by chemoattractants

25
Q

2 types of matrix secreted by fibroblasts

A

1 provisional - collagen 3 , fibronectin , fibrin

2 collagen 1

26
Q

Describe maturation phase of wound healing

A
  • no inflammation cells
  • angiogenesis ceases
  • granulation replaced by collagen 1
  • wound contraction occurs ( to reduce gap between cut margins )
27
Q

What provides wound strength and list various wound strengths at various times

A

-collagen 1

  • 1st week 10% of original
  • 4th week , exponential increase
  • 3rd month , 70-80% plateau reached
28
Q

2 categories of factors affecting wound healing

A

1 systematic

2 local

29
Q

List systematic factors affecting wound healing

A
  • nutrition ( malnutrition of protein and vitamin C decrease rate of healing )
  • diabetes mellitus
  • vascular condition ( atherosclerosis causes ischemia)
  • hormones ( some have anti inflammatory effect )
30
Q

Describe local factors affecting wound healing

A
  • presence of infection
  • presence of foreign body
  • size of wound
  • ischemia
  • location and vasculature of wound
31
Q

Complications of wound healing

A

1 wound rupture ( dehiscence ) - inadequate granulation formation
2 hypertrophic scar. Excess granulation ( wound has raised appearance
3 keloid - wound raised beyond wound area
4 Proud flesh - wound healed area way above scar area
5 wound contracture. - excess contraction
6

32
Q

How does the brain heal and why

A

/gliosis- glial cells proliferate and fill injured area ( small defects )

-large defects have cavitatory lesions filled with CSF

33
Q

Factors contributing to wound healing

A
  • antibiotics
  • skin graft : removal of skin from one part of body and place it on another part
  • suturing : closing the wound shut
  • removal of foreign body
34
Q

Function of VEGF , angiopoitein and TGF/beta

A
  • endothelial proliferation , endothelial maturation, endothelial precursor mobilized from bone marrow
  • stabilize newly formed bone marrow
  • induce fibroblast migration and proliferation
  • reduce ECM breakdown by metalloproteins
35
Q

Function of PDGF, IL-1 and TNF-alpha

A

Increases collagen synthesis

36
Q

What is scar remodeling

A

-production of proper amounts of collagen and ecm aided by metalloproteinase degradation

Pathology (13 decks)

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