Exam 1: Healing and Repair

Question 1

What is the definition of healing?

Answer 1

The process of restoration to normal structure and function

Question 2

What is the definition of repair?

Answer 2

To remedy, replace or heal as in a wound or a fracture

Question 3

In what two ways does the healing and repair process progress?

Answer 3

1. Total reconstruction
2. Partial reconstruction

Question 4

What important structure is the universal repair tissue?

Answer 4

Fiber our connective tissue scar

Question 5

What is the most abundant type of regenerative cell

Answer 5

labile

Question 6

Which type of cell has the poorest regenerative capacity

Answer 6

permenant

Question 7

What are the 4 phases of repair by connective tissue

Answer 7

1. angiogenesis
2. fibroblast activity
3. deposition
4. remodeling

Question 8

What occurs during angiogenesis

Answer 8

endothelial cell from damaged blood vessels migrate and proliferate

Question 9

What occurs during fibroblast activity

Answer 9

fibroblasts migrate to damaged area and proliferate

Question 10

What occurs during deposition

Answer 10

deposition of the extra cellular matrix in the damaged area

Question 11

What occurs during remodeling

Answer 11

remodeling of connective tissue results in shrinkage of the damaged area

Question 12

What is granulation tissue made of

Answer 12

proliferation of small capillaries, fibroblasts, extracellular fluid and macrophage infiltration

Question 13

Without ___ tissue, healing cannot occur

Answer 13

granulation

Question 14

What are the phases of tissue healing

Answer 14

Phase 1: homeostasis
Phase 2: inflammation
Phase 3: proliferation or granulation
Phase 4: remodeling or maturation

Question 15

What occurs during Phase 1= homeostasis

Answer 15

day 1-3, stop bleeding

Question 16

What occurs during Phase 2 = inflammation

Answer 16

day 3-20, new framework for blood vessel growth

Question 17

What occurs during Phase 3 = proliferation/granulation

Answer 17

week 1-6, pulls the wound close

Question 18

What occurs during Phase 4 = remodeling/maturation

Answer 18

week 6-2 years, final proper tissue

Question 19

What are the characteristics of first degree intention healing

Answer 19

small defect size, small granulation tissue, rapid healing, small scar, and rarely has complications

Question 20

What are the characteristics of second degree intention healing

Answer 20

large defect size, large granulation tissue, slow healing, large scar, can have keloid or proud flesh complications

Question 21

True or False
Diabetes mellitus is a local factor to wound healing

Answer 21

False, it is a systematic factor causing damage to the microvascular circulation

Question 22

What vitamin is needed for healing and collagen synthesis

Answer 22

vitamin C
- needed for hydroxylation of protein and lysine in collagen synthesis

Question 23

What are the 4 complications in wound healing

Answer 23

1. proud flesh
2. keloid formation
3. wound dehiscence
4. contracture

Question 24

What is proud flesh

Answer 24

excessive granulation tissue, bleeds easily

Question 25

What is keloid formation

Answer 25

genetic, more common in dark skinned people

Question 26

What is wound dehiscence

Answer 26

mechanical stress, postoperative coughing

Question 27

What is contracture

Answer 27

excessive wound contracture, 3rd degree burns

Question 28

What type of complication occurs when a wound has burst open due to sneezing

Answer 28

wound deshiscence

Question 29

What type of complication of wound healing occurs with a severe burn

Answer 29

contracture

Question 30

Open/ compound fracture

Answer 30

bone breaks and bony fragments have pierced the overlying skin or a wound exposes the bone

Question 31

Closed/simple fracture

Answer 31

bone breaks, but skin over fractured bone is still intact

Question 32

Complete fracture

Answer 32

bone breaks all the way through, skin penetration

Question 33

Incomplete fracture

Answer 33

bone is fractured but not fully separated

Question 34

Transverse fracture

Answer 34

break is straight across or runs directly across the short axis of the bone

Question 35

Oblique fracture

Answer 35

fracture line passes obliquely through the long axis of the bone at an angle

Question 36

Spiral fracture

Answer 36

a rotational force is applied through the long axis of the bone

Question 37

Comminuted fracture

Answer 37

bone breaks in more than 2 pieces

Question 38

Impacted fracture

Answer 38

ends are driven into each other

Question 39

Avulsion fracture

Answer 39

bony fragments pulled off by a tendon or ligament

Question 40

Pathological fracture

Answer 40

caused by disease

Question 41

What are the 4 phases of bone healing

Answer 41

1. reactive 2. reparative 1 3. reparative 2 4. remodeling

Question 42

What is phase1= Reactive

Answer 42

hematoma is formed and thus is replaced by granulation tissue

Question 43

What is phase 2=Reparative1

Answer 43

deposition of cartilaginous tissue by migrating chondroblasts, which form hyaline cartilage

Question 44

What is phase 3= Reparative2

Answer 44

the cartilaginous callus is infiltrated by osteoblasts and bony callus is formed

Question 45

What is phase 4= Remodeling

Answer 45

remodeling by osteoblasts, removal of excess bony tissue in the bony callus by phagocytic multi-nucleated giant osteoblasts

Question 46

In which stage of fracture healing is a cartilaginous callus formed

Answer 46

reparative2

Question 47

Which specific cells are involved in the remodeling phase of bone fracture healing

Answer 47

osteoblasts

Question 48

What are local factors of bone healing

Answer 48

blood supply, type of fracture, infection and immobilization

Question 49

What are systemic factors of bone healing

Answer 49

age, nutrition, hormones, diseases

Question 50

True or False A highly vascularized bone has a better chance at healing than a poorly vascularized one

Answer 50

True - a well vascularized bone heals more effectively

Question 51

True or False An 81 year old diabetic who has a fracture at the femoral head of the hip has a good chance of fracture healing within a reasonable time

Answer 51

False - age and diabetics will make the healing process longer

Question 52

How does a malfunction of a fracture occur

Answer 52

when a fracture heals in an abnormal position leading to misalignment

Question 53

What is the normal healing time for most fractures

Answer 53

6-8 weeks but the time can vary depending on the bone and individual health

Question 54

Which type of fracture complication may result in cystic degeneration

Answer 54

avascular necrosis - leads to cystic degeneration - particularly in fractures with poor blood supply such as those of the femoral head