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Foundations of health and disease > How the body recovers from injury > Flashcards

How the body recovers from injury Flashcards

1
Q

What is resolution in the context of inflammation?

A

Resolution refers to the restoration of tissue back to its normal state.

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2
Q

What are the conditions that must be satisfied for resolution to occur?

A

The conditions for resolution include minimal cell death and tissue damage during the inflammatory phase, regenerative capacity of the tissue or organ, quick destruction of infectious pathogens through macrophage/neutrophil phagocytosis, quick removal of cell debris through macrophage phagocytosis and good vascular drainage, and the end of vascular dilation.

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3
Q

What are monocytes?

A

Monocytes are macrophage precursors that circulate in the blood.

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4
Q

What happens to monocytes after they migrate to tissues?

A

Monocytes differentiate into mature macrophages after migrating to tissues.

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5
Q

What role do resident macrophages play in tissues?

A

Resident macrophages in many tissues can clear infectious pathogens and also clear cell debris after cell death.

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6
Q

What is chemotaxis in the context of macrophage activities?

A

Chemotaxis refers to the migration of macrophages towards a damaged or infected area.

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7
Q

What is the process of phagocytosis?

A

Phagocytosis is the process by which macrophages ingest cell debris.

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8
Q

What is pinocytosis?

A

Pinocytosis is the process by which macrophages ingest fluids

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9
Q

How do macrophages remove debris?

A

Macrophages remove debris through phagocytosis.

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10
Q

What is the role of phosphatidylserine in macrophage activities?

A

: Phosphatidylserine serves as a “Don’t eat me” signaling molecule, recognized by phosphatidylserine receptors on macrophages.

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11
Q

How do tissue resident macrophages eliminate apoptotic cells?

A

Tissue resident macrophages recognize apoptotic cells or apoptotic bodies and eliminate them through phagocytosis.

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12
Q

What determines whether tissues repair or regenerate following an injury?

A

The extent of the damage determines whether tissues repair or regenerate following an injury.

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13
Q

What happens when small injuries occur in tissues?

A

For small injuries, some tissues can fully regenerate, regaining complete functionality.

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14
Q

How does tissue repair occur in more severe injuries?

A

In more severe injuries, the tissue repairs with some functionality restored, although it may not be the same as before the injury.

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15
Q

What are the key cells involved in tissue regeneration?

A

Stem cells play a crucial role in tissue regeneration.

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16
Q

Where are epithelial stem cells found?

A

Epithelial stem cells are found in the intestinal epithelium and the skin.

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17
Q

What type of cells divide in the basal layer of the skin?

A

Basal cells divide in the basal layer of the skin.

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18
Q

Where are stem cells found in the red bone marrow?

A

Stem cells are found in the red bone marrow of spongy bones.

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19
Q

What is required for tissue regeneration?

A

Tissue regeneration relies on the presence of cells with regenerative capacity, such as adult stem cells. However, regenerative capacity may vary between different tissues, with some having a greater capacity for regeneration (e.g., intestinal epithelium, skin, bone marrow) compared to others (e.g., heart muscle, neural system).

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20
Q

What happens to tissues with regenerative capacity in the event of severe or prolonged injury?

A

Even tissues with regenerative capacity undergo repair in the event of very severe or prolonged injury, particularly in cases of chronic inflammation.

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21
Q

What occurs in cases of severe injury or chronic inflammation that favors tissue repair over tissue regeneration?

A

In severe injury or chronic inflammation, there is extended destruction of epithelial or endothelial cells/tissue, which favors tissue repair instead of tissue regeneration.

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22
Q

What is an example of tissue repair in the skin?

A

Skin wound healing by first intention is an example of tissue repair in the skin, which occurs in the event of minor injuries, such as an incision with a scalpel.

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23
Q

How does skin wound healing by first intention proceed?

A

If the two sides of the wound are aligned close together, healing can proceed quickly and easily. Fibrin is deposited during blood coagulation and joins the two sides of the wound. It will be replaced by collagen.

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24
Q

What happens in the event of a bone fracture during tissue repair?

A

A hematoma (coagulated blood) provides the initial structure for tissue repair in a bone fracture.

25
Q

: How is necrotic tissue handled during bone repair?

A

Necrotic tissue is removed during the bone repair process.

26
Q

What is the first type of new bone formed during bone repair?

A

The first type of new bone formed is called callus, which initially contains bone with no structure and cartilage.

27
Q

How does the callus change during bone repair?

A

More structural bone progressively replaces the callus during the bone repair process.

28
Q

What factors influence the remodeling of the new bone during bone repair?

A

The new bone will be remodeled (reorganized) depending on the mechanical pressures of motion.

29
Q

What is an example of tissue repair in the liver?

A

Following liver injury, hepatocytes (liver cells) have good regenerative capacity but the tissue architecture cannot be fully restored.

30
Q

What condition can arise when the damage destroys liver architecture and full regeneration is not possible?

A

Liver cirrhosis is a condition that can arise when the liver’s architecture is destroyed and full regeneration is not possible.

31
Q

What are examples of permanent cells that do not have regenerative capacity?

A

Examples of permanent cells without regenerative capacity include neurons, cardiac muscle cells (cardiomyocytes), and smooth muscle cells.

32
Q

What is angiogenesis in the context of tissue repair?

A

Angiogenesis refers to the process of new vessel formation after tissue injury.

33
Q

How do new vessels form during angiogenesis?

A

New vessels form from existing vessels during angiogenesis.

34
Q

What is the role of vascular endothelial cells in angiogenesis?

A

Vascular endothelial cells receive signaling molecules and drive the formation of new vessels through proliferation.

35
Q

What factors are involved in the process of angiogenesis during tissue repair?

A

The process of angiogenesis during tissue repair involves several signaling pathways and cell-cell interactions.

36
Q

: What is the role of extracellular matrix proteins in angiogenesis?

A

Extracellular matrix proteins provide a scaffold for the proliferation of endothelial cells and the formation of new vessels, contributing to vascular remodeling.

37
Q

What is scar formation in the context of tissue repair?

A

Scar formation is a repair process that involves the deposition of connective tissue.

38
Q

What are the key steps that occur before scar formation?

A

Before scar formation, there is the resolution of inflammation and the removal of immune cell debris.

39
Q

What happens during scar formation?

A

During scar formation, there is cell proliferation and angiogenesis, along with the recruitment of fibroblasts, leading to the formation of a scar.

40
Q

When does wound healing by second intention occur?

A

Wound healing by second intention occurs in the event of large injuries, such as continuous blood loss or infection, where a portion of tissue is lost and the two sides cannot align close together.

41
Q

What are the steps involved in the mechanism of scar formation during wound healing by second intention?

A

The steps involved include phagocytosis, granulation (angiogenesis and migration of fibroblasts), migration and proliferation of fibroblasts, deposition of extracellular matrix (collagen fibers), and proliferation of epithelial cells. Eventually, the wound undergoes remodeling.

42
Q

What changes occur during scar remodeling?

A

During scar remodeling, the originally deposited collagen is degraded, and it changes to type I collagen. The blood vessels in the scar tissue disappear, and the scar tissue contracts. The final scar consists of collagen and the remaining fibroblasts.

43
Q

What is the composition of the final scar tissue?

A

The final scar tissue primarily consists of collagen and the remaining fibroblasts.

44
Q

What is the expected outcome of scar tissue in terms of tissue functionality?

A

The tissue regains functionality during scar remodeling, but it typically reaches a maximum strength of around 80% of normal skin strength.

45
Q

What characterizes the formation of granulation tissue during scar formation?

A

The formation of granulation tissue is characterized by angiogenesis (new blood vessels), the proliferation of fibroblasts, and the presence of inflammatory cells, usually neutrophils. The newly formed vessels in the granulation tissue are leaky and can contribute to edema and swelling.

46
Q

What does granulation tissue look like?

A

Granulation tissue appears with very few collagen fibers and is often stained blue. It is rich in blood vessels and is part of the initial scar formation process.

47
Q

What are skin ulcers commonly associated with?

A

Skin ulcers commonly affect the extremities, particularly the feet.

48
Q

How are skin ulcers characterized?

A

Skin ulcers are characterized by ulceration of the epithelium and granulation in the dermis.

49
Q

What are some causes of skin ulcers?

A

Skin ulcers can be caused by restricted blood flow and vascular disease, systemic metabolic disorders, or persistent or secondary infection.

50
Q

What is excessive scar formation?

A

Excessive scar formation refers to the abnormal deposition of collagen in the process of scar formation.

51
Q

What is a hypertrophic scar?

A

A hypertrophic scar is characterized by excessive deposition of collagen, resulting in a raised and thickened scar.

52
Q

What is a keloid?

A

A keloid is a type of excessive scar formation where the scar tissue grows beyond the scar boundaries and does not regress. It may have a genetic predisposition.

53
Q

What happens in the dermis in a keloid?

A

In a keloid, there is excessive collagen deposition in the dermis.

54
Q

What are some examples of excessive tissue fibrosis disorders?

A

Excessive tissue fibrosis disorders include conditions like liver cirrhosis and lung fibrosis, which can cause organ loss of function and potentially lead to death.

55
Q

What are some causes of localized impairment of wound healing?

A

Localized impairment of wound healing can be caused by various factors, including the cause and site of injury (e.g., burns vs. cuts, lip vs. foot), local infection, foreign body presence, hematoma, denervation, poor blood supply or perfusion, mechanical stress, iatrogenic stress, and necrotic tissue.

56
Q

What are some systemic complications that can affect wound healing?

A

Systemic complications of wound healing can be influenced by factors such as age, certain drugs (e.g., steroids, antibiotics), soft tissue genetic disorders (e.g., Ehlers-Danlos syndrome, Marfan syndrome), diabetes mellitus, malnutrition, obesity, vitamin C deficiency, and trace mineral deficiencies.

57
Q

What is the composition of the mucosal layer in chronic ulcers?

A

The mucosal layer is primarily composed of epithelial cells.

58
Q

What is the composition of the submucosal layer?

A

The submucosal layer consists of collagen fibers.

59
Q

What is progressively damaged in a chronic ulcer?

A

In a chronic ulcer, the mucosal epithelium is progressively damaged, and the injury can extend to the muscular (muscle) layer.

Foundations of health and disease (45 decks)

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