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HOS Unit 1 > A 7 Wound healing > Flashcards

A 7 Wound healing Flashcards

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1
Q

how long does it take for vasoconstriction to occur after a wound has occurred?

A

10-15 minutes post wounding.

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2
Q

what activates both the intrinsic and extrinsic clotting cascade?

A

collagen exposure

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3
Q

What do thromboxane A2 and Prostaglandin 2A do?

A

they are 2 important vasoconstrictors in wound healing that are released from damaged cell membranes.

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4
Q

do platelets help with vasoconstriction or vasodilatation?

A

vasoconstriction.

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5
Q

Platelets release?

A

epidermal growth factor (EGF)
fibronectin
histamine
PDGF

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6
Q

what is fibrin?

A

the primary component in the matrix of the early wound which creates a stable plug/clot.(thrombin–>fibrinogen–>fibrin)

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7
Q

besides leading to the fibrin clot, what else does thrombin do?

A

increases vascular permeability, and facilitates the migration of inflammatory cells.

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8
Q

what does histamine, prostaglandins (E1 &E2), kinins, C3a, C5a, and leukotrienes have in common?

A

they all increase vessel permeability so that cells can move out during inflammation and infection.

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9
Q

which white blood cells are the first to migrate to the wound area?

A

PMN’s or neutrophils.

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10
Q

What helps signal the white blood cell to leave the blood vessel and move into the tissue?

A

TGF-beta

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11
Q

what are the 3 stages of wound healing?

A

1) hemostasis and inflammation
2) granulation and proliferation
3) remodeling and maturation

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12
Q

lymphokines and interleukens are considered classes of?

A

cytokines

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13
Q

How do growth factors work?

A

1) GF cellular receptor
2) phosphorylation of a kinase
3) second messenger
4) nuclear transcription
5) cell proliferation

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14
Q

How long does the hemostasis/inflammatory phase generally last?

A

2-5 days post accident

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15
Q

What is the first response cell to the damaged tissue?

A

platelets

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16
Q

What is considered to be the first leukocyte (second cell type) to arrive on scene?

A

the neutrophil because the platelet releases C5a which is a chemoattractant for neutrophils.

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17
Q

What is the result when ADP leaks out from the damages tissues?

A

platelet aggragation

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18
Q

prothrombin–> thrombin, fibrinogen–> fibrin.

what do thrombin and fibrin do?

A

1) thrombin increases vascular permeability/extravascular migration
2) fibrin is the primary component of the matrix in the early wound as it strengthens the platelet aggregate.

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19
Q

which factors contribute to vessel permeability?

A 
thrombin
histamine
prostaglandins
C3a
C5a
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20
Q

what do neutrophils do?

A

phagocytosis

oxidative burst mechanisms

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21
Q

what are the third type of cells that migrate to the wound site?

A

macrophage

platelet–>neutrophil–>macrophage

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22
Q

what do macrophages release?

A

collagenases [debride the wound]
TNF [stimulate fibroblast and angiogenesis]
TGF [stimulates keratinocytes]

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23
Q

What time frame does the proliferative/granulation phase occur?

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A

2 days to 3 weeks

24
Q

_________are the most important mesenchymal cells in wound healing?

25
In order to fill in a gap produced by a wound, the cells migrate into the wound and lay down a sticky bed of proteins that consists of what?
laminin 5
26
T/F Fibroblast migrate across fibrils in the early wound.
False, they migrate ALONG and not ACCROSS. | for some reason she put an emphasis on this
27
What is the function of TIMP?
TIMP = tissue inhibitors of Metalloproteinases. | Recall that metalloproteinases break down the old matrix such as a scab to make new area)
28
which type of collagen predominates in early wound healing? | which type of collagen predominates in late wound healing?
``` early = type 3 collagen late = type 1 collagen ```
29
high lactate levels, low Ph, and hypoxia all stimulate what?
angiogenesis
30
what is considered the most potent angiogenic agent?
VEGF
31
List the order of cells that move to the wound area?
1) platelets 2) neutrophils 3) macrophages 4) fibroblasts
32
In what time frame does remodeling/maturation phase occur?
3 weeks to 2 years
33
collagen deposition reaches its peak in the wound by what time? however, it is only ________% as strong?
1) 3 weeks | 2) 15 percent
34
what is considered the most potent stimulant for collagen synthesis?
TGF beta
35
after complete renewal of the wound, the scar is only _____% as strong as the original?
80%
36
what percentage of normal skin is made up of collagen type 1?
80-90 %
37
T/F elastin is a major part of the wound healing process as it helps keep tension to prevent splitting?
False, recall that elastin is not a part of the new scar even though it is a part of normal skin.
38
Name 3 enzymes used for collagen breakdown?
1) Matrixmetalloproteins 2) collagenase 3) gelatinase
39
when does the scar reach maximum tensile strength?
at about 12 weeks. However, this is still only about 80% of normal.
40
What is first intention surgical repair of the skin?
wound healing by direct approximation such as with suturing.
41
what is second intention surgical repair of the skin?
wound left open to heal spontaneously
42
what is third intention surgical repair of the skin?
delayed wound closure.
43
Name vitamins/minerals (stuff) that affect wound healing?
vitamin K,A,C, zinc, protein deficiency, copper, cobalt, iron-->just trace elements.....
44
how does vitamin A affect wound healing?
decreased collagen and increased infection rate
45
how does vitamin C affect wound healing?
capillary fragility, unstable collagen
46
how does vitamin K affect wound healing?
clotting cascade
47
how does zinc affect wound healing?
decreased immune system
48
what is a Keloid scar?
excessive accumulation of collagen on the wound and beyond.
49
what is Hypertrophic scarring?
excessive accumulation of collagen on the wound only...
50
what is hypotrophic scarring?
insufficient accumulation of collagen of the wound
51
PDGF does what?
Chemotaxis angiogenesis wound contraction
52
TGF alpha & EGF (epidermal growth factor) do what?
keratinocyte migration | mitogenic fibroblasts
53
TGF beta does what?
angiogenesis | Promote collagen synthesis
54
FGF's do what?
fibroblast and keratinocyte migration | angiogenesis
55
TNF does what?
activates Macrophages | angiogenesis
56
T/F IL's 1 &2 are pyrogens?
True
57
Interferons (all)
activate macrophages | inhibit fibroblasts

HOS Unit 1 (13 decks)

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