Healing Flashcards
(173 cards)
1
Q
Define healing
A
Body tissue replacement
2
Q
Describe this tissue (2 points)
A
Destroyed
Lost
3
Q
What is the destroyed lost tissue replaced by?
A
Living tissue
4
Q
What are the 2 processes of healing?
A
Regeneration
Repair
5
Q
Which tissues replace the destroyed lost tissue in Regeneration?
A
Similar
6
Q
What are these tissues similar in?
A
Type
7
Q
Which tissue replaces the destroyed lost tissue in Repair?
A
Granulation
8
Q
What happens to this Granulation tissue?
A
Matures
9
Q
What tissue does this Granuloma tissue mature into?
A
Scar
10
Q
What is this process known as?
A
Scarring
11
Q
What is healing done by in regeneration?
A
Fibrosis
12
Q
When is healing by Fibrosis becomes inevitable?
A
When cells lack proliferative capacity
13
Q
Which cells do not have the capacity to proliferate?
A
Surrounding cells
14
Q
Describe these cells
A
Specialized
15
Q
What are the 2 factors that determine which healing process of the destroyed lost tissue is used?
A
Cell type
Destruction/Intactness
16
Q
Which organ’s cell type determines the healing process of the destroyed lost tissue used?
A
Damaged
17
Q
The destruction/intactness of which organ’s structure determines the healing process of the destroyed lost tissue used?
A
Stromal frame work
18
Q
According to what are cells classified?
A
Proliferative capacity
19
Q
What are the 3 types of cells?
A
Liable
Stable
Permanent
20
Q
Describe the chances of Regeneration of Liable cells
A
Excellent
21
Q
What are Liable cells characterized by?
A
Continuous turn over
22
Q
Describe the division of Liable cells
A
Programmed
23
Q
Where are the liable cells found in? (3 points)
A
GIT
Urinary tract
Skin
24
Q
What are the liable cells which are found in these 3 sites?
A
Surface epithelium
25
What are other 2 examples of Liable cells?
Lymphoid system
| Haemopoietic system
26
Which cell that divide is an example of liable cells?
Stem
27
Describe the chances of Regeneration of Stable cells
Good
28
Describe the level of replication of Stable cells compared to Liable cells
Lower
29
Describe the division of Stable cells
Rapid
30
What do these Stable cells respond to in order to divide rapidly?
Injury
31
Describe the number of stem cells which are an example of Stable cells
Few
32
What is an example of a stable cell which can proliferate?
Mesenchymal cell
33
What are the 4 examples of Mesenchymal cell?
Smooth muscle cells
Endothelial cells
Fibroblasts
Osteoblasts
34
What are examples of organs in which their stable cells can regenerate? (3 points)
Liver
Endocrine glands
Renal tubular epithelium
35
Describe Permanent cells
Non-dividing
36
What cannot happen to Permanent cells if they are lost?
Replacement
37
What do Permanent cells lack so that they cannot be replaced if lost?
Proliferative capacity
38
What are examples of Permanent cells?
| 3 points
Adult neurons
Striated muscle cells
Lens cells
39
What is Angiogenesis known as?
Neovascularization
40
Define Angiogenesis
New blood vessels formation
41
Where are these new blood vessels formed in?
Adult
42
What are the new blood vessels formed from? (2 points)
Pre-existing ones
| Endothelial precursor cells
43
What is the type of these blood vessels?
Capillaries
44
When does Angiogenesis occur in?
| 6 points
```
Wound healing
Infarction healing
Chronic inflammation
Serofibrinous inflammation
Thrombus
Abscess
```
45
Describe the capillary surface
Granular
46
What is the color of the capillary surface?
Red
47
What happens to the capillary when touched?
Bleeds easily
48
How does the capillary feels like when touched?
Moist
49
What will also be newly formed alongside the capillaries?
Fibroblasts
50
What are the functions of Fibroblasts?
| 4 points
Migration
Proliferation
Deposition of extracellular matrix
Tissue remolding
51
What are the 2 fates of Angiogenesis?
Fibrosis
| Scar
52
What are used to control Angiogenesis? (4 points)
Growth factors
Receptors
ECM proteins
Inhibitors
53
What are the ECM proteins considered as for Angiogenesis?
Regulators
54
What is skin wound healing an example of?
Regeneration and Repair Combination
55
What are the 2 types of skin wound healing?
First Intention
| Second Intention
56
What is the First Intention known as?
Primary Union
57
Describe the wound in First Intention type?
| 3 points
Clean
Uninfected
Surgically incised
58
What are the edges/margins of the wound approximated by?
Surgical sutures
59
What are lost in the wound of the First Intention type? (2 points)
Cells
| Tissues
60
Describe this loss in the First Intention type
Not much
61
What are the sequence of events of skin wound healing of the First type?
(4 points)
Initial Hemorrhage
Acute Inflammatory response
Epithelial changes
Organization
62
Describe the healing in the First Intention type
Rapid
63
What does this healing result in?
Scar
64
Describe this Scar (2 points)
Neat
| Linear
65
What is the healing in the form of?
Granulation Tissue
66
Describe this Granulation tissue
Scanty
67
Describe the wound where this scanty granulation tissue is formed at
Incised
68
What is the wound filled with in initial hemorrhage?
Blood
69
What happens to the blood?
Clots
70
What do the blood clots do to the wound?
Seal it
71
What do the blood clots prevent when sealing the wound? (2 points)
Dehydration
| Infection
72
Which cells are firstly involved in the Acute Inflammatory Response?
Polymorphs
73
Which cells replace the Polymorphs?
Macrophages
74
Which day do the Macrophages replace the Polymorphs in?
3rd
75
What also happens to the wound area in the 3rd day?
Invaded
76
Which cells invade the wound area?
Fibroblasts
77
What is the wound covered by?
Epithelium layer
78
Which day is when the wound become covered by Epithelium layer?
2nd
79
Which epithelium layer is where epithelial changes occur in?
Epidermis
80
Which epidermal cells are where epithelial changes occur in?
Basal cells
81
What are the changes of the epidermal basal cells? (3 points)
Proliferation
Migration
Separation
82
Where do the epidermal basal cells migrate towards?
Incisional space
83
What do the Epidermal cells separate?
Underlaying viable dermis
84
What do the Epidermal cells separate the underlaying viable dermis from?
Overlaying necrotic material
85
What does this separation results in forming?
Scab
86
What will then start to form?
New Collagen Fibrils
87
Which day are the new collagen fibrils formed in?
5th
88
Until when will the new collagen fibrils dominate?
Healing completion
89
What will then be formed later on?
Scar tissue
90
What will be formed with the scar tissue?
Elements
91
Which 2 elements will be formed later on?
Cellular
| Vascular
92
Describe the cellular element
Scanty
93
When will the scanty cellular and vascular elements be formed in?
4 weeks
94
What are the complications of the First Intention type?
Epidermal inclusion cyst formation
95
Describe the formation of the Epidermal inclusion cyst
Infrequent
96
What is the Second Intention known as?
Secondary union
97
Describe the wound in Second Intention type?
| 5 points
```
Unclean
Sometimes Infected
Open
Contracted
Irregular
```
98
What is involved in this wound compared to the wound of the primary intention?
Larger tissue defect
99
What has to be done with this large tissue defect?
Bridging
100
What are the edges/margins of the wound not approximated by?
Surgical sutures
101
Describe the edges/margins of the wound
Irregular
102
What are lost in the wound of the First Intention type? (2 points)
Cells
| Tissues
103
Describe this loss in the Second Intention type
Extensive
104
What does this healing result in?
Scar
105
Describe this scar (2 points)
Large
| Ugly
106
What happens to this scar with time?
Mature
107
Describe the color of this Scar on maturation
Pale
108
What is the color of this Scar on maturation?
White
109
Describe the 2 factors that made this Scar pale and white on maturation
Increased collagen
| Decreased vascularity
110
What are the sequence of events of skin wound healing of the First type?
(3 points)
Initial Hemorrhage
Acute Inflammatory Response
Epithelial changes
111
Describe the healing in the Second Intention type
Slow
112
What is the healing in the form of? (2 points)
Granulation tissue
| Suture tracks
113
Describe the Granulation tissue
Exuberant
114
Where exactly does the healing occur from the Granulation tissue?
In its gap
115
Where exactly does the healing occur from the Suture tracks?
Along them
116
What do the granulation tissue and the suture tracks do?
Fill the gap
117
What will occur more in the Second Intention type? (3 points)
Inflammation
Granulation tissue formation
Scarring
118
What is the main bulk of the secondary healing by?
Granulation
119
What will not be replaced in the Second Infection type?
Specialized skin structures
120
What are the 2 specialized skin structures that are not replaced in the Second Infection type?
Hair follicles
| Sweat glands
121
What is absent in the First Intention type but present in the Second Intention type?
Wound contraction
122
What causes wound contraction?
Myofibroblasts action
123
What size does the wound contract into?
One-third to One-fourth
124
Which size does the wound contract into One-third to One-fourth of it?
Original
125
What delays the healing process?
Bacterial contamination
126
What is released by the bacteria in case of bacterial contamination delaying the healing process?
Toxins
127
What do the bacterial toxins provoke?
| 3 points
Necrosis
Suppuration
Thrombosis
128
What does the release of bacterial toxins indicate?
Infection
129
What helps in healing?
Debridement
130
Define Debridement
Surgical removal of dead and necrotic tissue
131
Where does wound strengthened occur in?
Extracellular matrix
132
What is the wound strengthened by?
| 2 points
Proliferation of:
| Fibroblasts and Myofibroblasts
133
What are the Fibroblasts and Myofibroblasts provided with?
Structural support
134
What provides structural support to the Fibroblasts and Myofibroblasts?
ECM
135
What does ECM directs? (4 points)
Cell migration
Attachment
Differentiation
Organization
136
What are the 5 main components of the ECM?
```
Collagen
Adhesive glycoproteins
Basement membrane
Elastic fibers
Proteoglycans
```
137
What is the complication of healing in the Second Intention type?
Suppuration
138
What may the suppuration require?
Debridement
139
What are the 2 types of factors that affect wound healing?
Systemic
| Local
140
What features of healing are altered due to these factors?
| 2 points
Rate
| Efficiency
141
What are the systemic factors that affect wound healing? (7 points)
```
Age
Anemia
Nutritional deficiency
Glucocorticoid therapy
Cytotoxic drugs
Diabetes mellitus
Malignancy
Uremia
```
142
What nutrients ,if deficient, affect the wound healing? (3 points)
Protein
Vitamins
Minerals
143
What features of Diabetes mellitus affect wound healing? (2 points)
Infection
| Bad Vascularity
144
What are the local factors that affect wound healing? (6 points)
```
Infection
Cell type damage
Tissue damage
Blood supply
Venous drainage
Mechanical factors
Foreign body
```
145
What are the 3 type of cell in which the damaged cell could be classified as?
Liable
Stable
Permanent
146
Describe the 2 forms of tissue damage which affect the wound healing
Sever
| Mild
147
What is an example of a mechanical factor which affect the wound healing?
Blood vessels compression
148
What are the complications of wound healing? (8 points)
```
Wound Infection
Implantation cyst
Ulceration
Pigmentation
Incisional hernia
Keloid
Excessive contraction
Neoplasia
```
149
What does wound infection does to the healing?
Delays it
150
Describe the implantation cyst
Epidermal
151
Which cells flow into the healing wound?
Epithelial cells
152
What do these Epithelial cells sometimes do later on? (2 points)
Persist
| Proliferate
153
What do these Epithelial cells form after their proliferation?
Epidermoid cyst
154
What color does the pigment looks like?
Rust
155
What gives the rust-like color of the pigment?
Hemosiderin
156
Describe Incisional hernia
A Defect
157
What is this defect caused by?
Poor wound healing following surgery
158
Which organ will be affected by this poor wound healing?
Intestine
159
What happens to the intestine?
Protrude
160
Where does the Incisional hernia usually occur in?
Abdominal wall
161
Describe Keloid
Scar tissue area
162
Describe the area of this Scar tissue
Raised
163
Describe the Scar (3 points)
Excessive
Ugly
Painful
164
What results in a Keloid?
Collagenous tissue formation
165
Describe the formation of this Collagenous tissue
Excessive
166
What does the Excessive contraction result in?
Decrease in wound size
167
What does the decrease in wound size depend on? (3 points)
Myofibroblasts
Cell-cell contacts development
Sustained cell contraction
168
What are the 3 processes together known as?
Cicatrisation
169
What is the exaggeration of these 3 processes known as?
Contracture
170
What does the contracture result in?
Severe deformity
171
Which cell becomes neoplastic?
Squamous cell
172
What does this Squamous cell form?
Carcinoma
173
Where is this Carcinoma formed in?
Marjolin's Ulcer
