Flashcards in B2.050 Chronic Complications of Diabetes Mellitus Deck (20)
how is it that diabetics are in a proinflammatory state but are also more prone to infection?
the proinflammatory state is due to release of cytokines and a nonspecific rise in inflammation throughout the body
this state reduces the efficacy of first responders to actual infections, leading to the increased risk of infection
what is the difference between tissue regeneration and tissue repair?
regeneration has a superior functional outcome- don't easily in epithelium due to epithelial stem cells, but difficult in infrastructure wounds
repair of tissues usually comes with scarring and structural and functional consequences
what are the 3 primary steps to repair by connective tissue deposition
why does angiogenesis produce leaky vessels?
partially by default and the virtue of the formation process- they're being developed piece by piece so can't be immediately structurally sound
also allows inflammatory cells easier passage between intra/extracellular compartments
what are the components of granulation tissue?
loose connective tissue
what is remodeling?
reorganization of college and increased cross linking as wound healing progresses
why is there contraction in scar remodeling?
1. as collagen cross links, collagen pulls tissue together
2. fibroblasts have contractile properties due to presence of actin (myofibroblasts)
what are the 3 components of angiogenesis?
growth factors (VEGF, FGF, angioprotein)
ECM proteins and enzymes
what is the function of growth factors in angiogenesis?
migration and proliferation of endothelial cells
what is the function of notch signaling?
regulates sprouting and branching of vessels
what is the function of ECM proteins and enzymes in angiogenesis?
interact with integrin receptors on endothelial cells
enzymatic remodeling allows growth
how is extracellular matrix degradation controlled in remodeling?
inactive zymogens, activated by proteases like plasmin
inactivated by tissue inhibitors of metalloproteinases
how does wound strength change over time?
how does new collagen appear different from old collagen on a slide?
appears lighter due to increased fluid and edema
how do the leading edges of benign and malignant neoplasms differ?
malignant- always has young collagen deposits due to constant tissue injury due to invasion and the resulting inflammation in host tissue
benign- capsule of well developed collagen at edge due to lack of invasion
characterize healing by first intention
minimizes time of healing
limited connective tissue
limited scarring, but limited strength
what is wound dehiscence?
edges of a wound come apart
what is ulceration?
wound heal from the bottom up; some may never epithelialize
what is fibromatosis?
semiautonomous proliferation of fibroblasts beyond what is required
difficult to control