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PP > Regeneration and Repair > Flashcards

Regeneration and Repair Flashcards

1
Q

What is the process of wound healing

A
  1. Haemostasis
  2. Inflammation
  3. Regeneration or Repair
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2
Q

What is Regeneration

A

Regrowth of cell (minimal evidence of injury)

-only possible with minor injuries
e.g. superficial skin incision/abrasion
-only possible with intact connective tissue architecture

-can be physiological
e.g. production of blood cells in bone marrow

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3
Q

What are stem cells

A

Cells that can differentiate into other cell types and self-renew

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4
Q

What are the 3 types of stem cells

A

Totipotent (produce all cell types)
e.g. embryonic stem cels

Multitpotent (produce several cell types)
e.g. haematopoietic stem cells

Unipotent (produce one cell type)
e.g. epithelial stem cells

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5
Q

Where are stem cells located

A

Epidermis (basal layer)
Intestinal mucosa (bottom of crypts)
Liver (between hepatocytes)

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6
Q

Which tissue types can generate

A

Lability tissue (continuous replication
Stable tissue (low level of replication, left cell cycle but can re-enter)

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7
Q

Process of formation of scar

A
  1. Bleeding & Haemostasis (prevention of blood loss)
  2. Inflammation (digestion of blood clot)
  3. Proliferation
    (capillaries, fibroblasts, myofibroblast, extracellular matrix) forming granulation tissue
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8
Q

Functions of granulation tissue

A

Fills the gap
Capillaries supply oxygen and nutrients
Contracts and closes the defect

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9
Q

Cells involved in fibrous repair

A

-Neutrophil, macrophage (phagocytosis, release of mediators)
-Lymphocyte (eliminate pathogens, co-ordinate other cells)
-Endothelial cell (proliferation then angiogenesis)

-Fibroblast
-Myofibroblast

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10
Q

Appearance & Function of Fibroblast

A

Appearance:
Spindle shaped nucleus, cytoplasmic extension

Function:
Secrete collagen and elastin, form extracellular matrix

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11
Q

Appearance & Function of Myofibroblast

A

Appearance:
Similar appearance to fibroblast
Between a fibroblast and smooth muscle

Function:
Express intracellular acting
Wound contraction

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12
Q

Features and examples of collagen

A

-provides extracellular framework
-29 different types
E.g.)
type 1 (bones,tendons,skin,sclera,cornea,vessel)
type 4
(basement membranes,lens,glomerular filtration)

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13
Q

Describe the steps of collagen synthesis

A

Intracellular
1. Pre-pro collagen (polypeptide α chain synthesised in ER of myofibroblast)

  1. Undergoes Vitamin C dependent hydroxylation
  2. Pro collagen (α chains cross-linked formation of triple helix in cytoplasm of myofibroblast)

Extracellular
4. C and N terminals of pro collagen cleaved, forming tropocollagen in extracellular space

  1. Tropocollagen crosslinked forming microfibrils ➡️fibrils ➡️ collagen fibres
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14
Q

Diseases of defective collagen

A

Acquired:
Scurvy

Inherited:
Ehlers-Danlos Syndrome
Osteogenesis Imperfecta
Alport Syndrome

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15
Q

Features of scurvy

A

Inadequate hydroxylation of pre-pro collagen

-defective triple helix = defective collagen
-unable to heal wound, tendency to bleed, tooth loss

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16
Q

Factors that induce regeneration

A

Cell-to-cell communication
Growth factors in the micro environment
Electric current & nervous stimuli

17
Q

How do cells communicate with each other to stimulate/inhibit proliferation

A

-direct cell-cell contact
-local mediators e.g.) growth factors
-hormone

18
Q

How do cell-cell contact enable communication

A

Via contact inhibition

-isolated cells replicate until they encounter other cells
-cadherin bind between cells and inhabit further proliferation

19
Q

How do growth factors enable communication

A

-Triggers polypeptides to act on cell surface
-Causes cell to enter cell cycle and proliferate

20
Q

Examples of growth factors

A

Epidermal GF
Vascular Endothelial GF
Platelet Derived GF
Tumour Necrosis Factor

21
Q

Features of primary intention

A

Incited wound with Apposed edges
(Sutured)

-minimal clot and granulation tissue
-epidermis regenerates
-dermis undergoes fibrous repair

22
Q

Features of secondary intention

A

Significant tissue loss with Unapposed edges
(Infection/ulcer/abscess)

-abundant clot, inflammation, granulation tissue
-wound contraction required (Myofibroblast)

-epidermis regenerates from edges
-dermis required fibrous requires

23
Q

Describe the process for fracture healing

A
  1. Haematoma surrounds the injury (granulation tissue)
  2. Soft Callus (fibrous tissue&cartilage),
    WOVEN bone
  3. Hard Callus
    Woven bone gradually organised into LAMERLLAR bone
  4. Remodelling
    Lamellar bone remodels to original outline of original bone
24
Q

Local factors influencing wound healing

A

Size
Location
Blood supply
Local infection
Foreign bodies

25
Q

Systemic factors influencing wound healing

A

Age
Anaemia, hypoxia, hypovolaemia
Obesity
Diabetes
Drugs
Vitamin deficiencies
Malnutrition

26
Q

List the complications of fibrous repair

A

Insufficient fibrosis
Excessive fibrosis
Adhesions
Loss of function
Disruption of architecture
Excessive scar contraction

27
Q

Features of insufficient an excessive fibrosis

A

Insufficient:
-wound dehiscence
-occurs in elderly, obesity, malnutrition, steroid use.

Excessive:
-Keloid scar (extending beyond the original scar)

28
Q

Features of adhesions as part of complications of fibres repair

A

Adhesions:
Fibrous band form (collage)
Can cause obstruction of tubes

29
Q

Features & example of loss of function as a complication of fibrous repair

A

Loss of function:
Replacement of specialised tissue by fibrous tissue

e.g.) myocardial infraction ➡️ ischemic damage leads to collagen deposition ➡️ arrhythmia (due to electrical signal not being conducted properly)

30
Q

Features of excessive scar contraction

A

Constriction of tubes
-fixed flexion deformities (contractures)
-excessive wound contraction (Myofibroblast)

31
Q

Examples of label tissue

A

Epithelium
Haemaopoietic

32
Q

Examples of stable tissue

A

Liver, kidney, pancreas, bone, endothelium, smooth muscle

33
Q

Examples of permanent tissue

A

Neurons, skeletal muscle, cardiac muscle

34
Q

Granulation is when…

A

Increased no. of
-capillaries
-myoblast/myofibroblast

PP (15 decks)

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