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Chapter 3 Part 4 Flashcards

1
Q

What are the mediators of vasodilation?

A

histamine and prostaglandins

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2
Q

What are the mediators of increased vascular permiability?

A

histamine, serotonin, C3a and C5a, leukotrienes (C, D, and E)

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3
Q

What are the mediators of chemotaxis?

A

TNF, IL-1, chemokines, C3a, C5a, leukotriene B

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4
Q

What are the mediators of a fever?

A

IL-1, TNF, prostaglandins

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5
Q

What are the mediators of pain?

A

prostaglandins and bradykinin

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6
Q

What are the mediators of tissue damage?

A

lysosomal enzymes of leukocytes and ROS

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7
Q

Definition of repair

A

restoration of tissue architecture and function after an injury

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8
Q

What two reactions must occur to repair damaged tissues?

A

regeneration/proliferation by residual cells and maturation of tissue stem cells; formation of a connective tissue scar

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9
Q

What is tissue regeneration dependent on?

A

The ability of tissues to intrinsically proliferate, a process driven by growth factors

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10
Q

What cell types proliferate during tissue repair?

A

remnants of injured tissue, vascular endothelial cells, fibroblasts

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11
Q

Define labile cells

A

Cells that continuously divide, are lost and replaced by maturation of stem cells; examples include surface epithelia, hematopoietic cells, cuboidal epithelia of exocrine glands, columnar epithelium of GI,etc.

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12
Q

Define stable tissues

A

Quiescent cells in G0 that have minimally proliferative activity; examples include liver, kidney, pancreas

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13
Q

Define permanent tissues

A

cells that are terminally differentiated and nonproliferative; examples include neurons and cardiac muscle cells

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14
Q

What is the mechanism of tissue regeneration in labile tissues?

A

Injured cells are rapidly replaced by proliferation of residual cells and differentiation of stem cells on an intact basement membrane

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15
Q

What are the two cell types responsible for liver regeneration?

A

proliferation of hepatocytes and repopulation from progenitor cells

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16
Q

What is the first stage of hepatocyte proliferation in liver regeneration?

A

Priming; Kupffer cells release IL-6 to make hepatocytes competent to respond to growth factor

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17
Q

What is the second stage of hepatocyte proliferation in liver regeneration?

A

Growth factor; HGF and TGF-alpha stimulate hepatocyte metabolism, triggering the differentiation of almost all parenchymal and nonparenchymal hepatocytes

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18
Q

What is the third stage of hepatocyte proliferation in liver regeneration?

A

Termination; hepatocytes return to quiescence, mechanism unknown (possibly TGF-B)

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19
Q

Where do liver progenitor cells reside?

A

Canals of Hering

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20
Q

What are the steps of scar formation?

A

Angiogenesis, formation of granulation tissue, remodeling of connective tissue

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21
Q

What role do macrophages play in scar formation?

A

Clear dead tissue and offending agent, provide growth factors for cell proliferation, secrete cytokines that stimulate fibroblast proliferation and connective tissue synthesis

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22
Q

Definition of angiogenesis

A

Process of new blood vessel development from existing blood vessels

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23
Q

What is the first step of angiogenesis?

A

Vasodilation in response to nitric oxide and increased permeability by VEGF

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24
Q

What is the second step of angiogenesis?

A

Separation of pericytes from albuminal surface and breakdown of basement membrane to allow for vessel sprouting

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25
What is the third step of angiogenesis?
Migration of endothelial cells toward area of tissue injury
26
What is the fourth step of angiogenesis?
Proliferation of endothelial cells just behind the tip of migrating cells
27
What is the fifth step of angiogenesis?
Remodeling capillary tubes
28
What is the sixth step of angiogenesis?
Recruitment of pericytes to form mature vessel
29
What is the seventh step of angiogenesis?
Suppression of endothelial proliferation and migration and deposition of basement membrane
30
What are the prominent growth factors involved in angiogenesis?
VEGF-A, FGF-2, Angiopoietins 1 and 2, PDGF, TGF-B
31
What is the function of VEGF in angiogenesis?
Stimulates endothelial cell proliferation and migration, promotes vasodilation and formation of vascular lumen
32
What is the function of FGF-2 in angiogenesis?
stimulates proliferation of endothelial cells and promotes migration of macrophages and fibroblasts
33
What is the function of angiopoietins in angiogenesis?
Structural maturation of blood vessels by the recruitment of pericytes and smooth muscle
34
What is the function of PDGF in angiogenesis?
recruitment of smooth muscle cells
35
What is the function of TGF-B inangiogenesis?
suppresses endothelial proliferation and migration
36
What is the notch signaling pathway?
regulates the sprouting and branching of new vessels
37
What role do ECM proteins play in angiogenesis?
Form interactions with integrin receptors on endothelial cells and provide a scaffold for vessel growth
38
What is the role of metalloproteinases in angiogenesis?
ECM degradation to permit remodeling and extension of vascular tube
39
What two steps are involved in the deposition of connective tissue during scar formation?
migration and proliferation of fibroblasts to injury, deposition of ECM proteins produced by cells
40
What are the main cell types involved in deposition of connective tissue?
M2 macrophages, mast cells, lymphocytes
41
What is the most important cytokine for deposition of connective tissue in scar formation?
TGF-B
42
What is the role of TGF-B in tissue deposition?
stimulates fibroblast migration and proliferation, increases synthesis of collagen and fibronectin, and decreases degradation of ECM by inhibiting metalloproteinases
43
What are the levels of TGF-B regulated by?
Activation of latent TGF-B, rate of secretion of active molecule and ECM factors that enhance or diminish activity of TGF
44
What components does scar tissue consist of?
fibroblasts, dense collagen, fragments of elastic tisue and other ECM components
45
What cells contribute to scar contraction?
myofibroblasts
46
What enzymes are primarily responsible for the remodeling of connective tissue?
matrix metalloproteinases
47
What are the functions of matrix metalloproteinases?
cleavage of fibrillar collagen, amorphous collagen and fibronectin, degradation of proteoglycans and laminin
48
What factors regulate matrix metalloproteinase functions?
Proteases activate, TIMPs inhibit
49
What are key factors that can alter tissue repair?
infection, diabetes, nutritional status, glucocorticoids, mechanical factors, poor perfusion, foreign bodies, type and extent of injury, location of injury
50
What defines healing by first intention?
injury involves only epithelial layer and requires epithelial regeneration
51
What are the three steps of healing by first intention?
inflammation, proliferation, and maturation
52
What initially happens when a wound occurs?
rapid activation of coagulation pathways and formation of a blood clot on the surface, acts as a scaffold for migrating cells
53
What happens within the first 24 hours of a wound during healing by first intention?
Neutrophils migrate towards the fibrin clot and clear debris, basal cells at the edge of the debris begin to undergo mitosis and deposit components of basement membrane
54
What should occur by day three during healing by first intention?
Neutrophils are replaced by macrophages and granulation tissue begins to invade the wound, collagen fibers begin to form
55
What should occur by day five of healing by first intention?
Neovascularization and migration of fibroblasts (driven by TNF, TGF-B and FGF from macrophages)
56
What occurs during the second week of healing by first intention>
Continued collagen accumulation and fibroblast proliferation, regression of vascular channels
57
What defines healing by second intention?
extensive tissue loss involving a combination of regeneration and scarring
58
What are some key differences between primary and secondary healing?
Secondary healing involves larger clot layers, exudate, and necrotic debris and larger amounts of granulation tissue, involves wound contraction
59
What is the initial provisional matrix formed from in healing by second intention?
fibrin, plasma, fibronectin, type III collagen
60
What is the second provisional matrix formed from in healing by second intention?
Type I collagen
61
What is primarily responsible for the recovery of tensile strength after a wound?
excess collagen synthesis
62
Define fibrosis
excessive deposition of collagen and other ECM components, often refers to abnormal development of collagen in damaged organs
63
What are two complications of inadequate formation of granulation tissue?
wound dehiscence (wound rupture) and ulceration
64
What causes keloid and hypertrophic scar formation?
Excessive formation of components of the repair process
65
What is the difference between a keloid and a hypertrophic scar?
Hypertrophic scars occur due to excessive amounts of collagen within the boundary of the wound, Keloid formation occurs when the scar tissue grows beyond boundaries of the wound
66
What is exuberant granulation?
Formation of excessive amounts of granulation tissue
67
What is a desmoid or aggressive fibromatoses?
neoplasms that occur due to exuberant fibroblast proliferation and other connective tissue elements
68
What is the result of abnormal wound contraction?
Contracture leading to wound deformities, commonly seen after serious burns and most commonly occur on palms, soles and anterior thorax

MOD (34 decks)

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