How many phases of wound healing are there?
3 or 4 phase process depending on if you include hemostasis
What are the 3 phases of wound healing
Inflammation --*Hemostatis is included here
What is the goal of hemostasis
ensure the formation of the fibrin clot
What are the 2 steps of hemostasis
1. Vascular Constriction
2. Platelet aggregation
What happens in the inflammation stage
1. neutrophil inflammation
2. monocyte infiltration and differentiation to macrophage
What are the 4 steps to the proliferation stage
3. collagen synthesis
What happens during the remodeling stage
1. collagen remodeling
2. Vascular maturation and regression
How does the inflammatory phase begin
formation of the fibrin clot
What does hemostasis refer to
the cessation of blood flow through a blood vessel or body tissue via a stable fibrin hemostatic plug
What are the important blood clotting factors
In order for thrombin to be converted to prothrombin what must occur
protrombin (factor 2) must bind to calcium
What do factor 2,7,9,10 all have in common
they all have glutamic residues in the first 35 residues
gamma glutamyl carboxylase is dependent on what
vitamin K dependent
What enzyme is needed to change glutamic acid to gamma glutamyl glutamic acid? What is also needed
gamma glutamyl carboxylase. Needs factor K
If a person has a vitamin k deficieny what will happen to blood clotting factors
you will have lower than normal levels of blood clotting factors
what kind of drug is known as a vitamin k antagonist
How does warfarin work?
it inhibits the regeneration of vitamin K by inhibiting the reductase
How long does the inflammatory phase last
Which phase is this : associated with edema , erythema, heat, pain
list 3 cells involved in inflammatory phase
platelets, neutrophiles, macrophages
What phase is this:
1. clot formation
2. increased vessel permiability
3. Neutrophil migration in tissue
4. Macrophages release growth factors
What the function of the growth factors that macrophages release in inflammation?
They release growth factors that stimulate fibroblast proliferation, and collagen synthesis
What occurs during the first stage of the proliferation stage
granulation - connective tissue cells called fibroblasts proliferate under the growth factors that were secreted by macrophages (FGF-2)
What kind of collegen is found in the granulation phase
What does angiogeneiss refer to
the sprouting of new blood vessels (stage 2 of phase 2)
What does contraction refer to?
What is the process mediated by?
What stage of wound healing is this?
When the wound heals, the edges pull towards each other towards the center. This process is mediated by myofibroblasts.
This happens during the proliferation phase
The process leading to the formation of the fibrin clot is called
What is an important vitamin needed in the hemostasis stage
vitamin k- it activates factors 2,7,9,10
Describe the residues look like on factors 2,7.9,10
the have glutamate residues that must be gamma carboxylated so they can interact with calcium so that they can interact with phospholipids.
what is needed to activate factors 2,7, 9 ,10