Inflammation, Healing and Repair

Question 1

_____________ includes hemostasis and degeneration; formation of a blood clot and necrosis of injured cells; acute inflammation or inflammatory reaction (acute stage: 1-3 days or longer); proliferation and migration (subacute stage: lasts 2-3 weeks); maturation and remodelling (post-acute state: up to months)

Answer 1

Phases of Healing

Question 2

________1_____ is inflammation is the immediate local response to injury and tissue damage; it is the first step in the process of tissue healing; the ultimate goal is replacement of injured tissue with healthy regenerated tissue or scar tissue; sudden onset and short duration - few minutes to a few days involving the _______2______ - heat, redness or erythema, pain, swelling or edema, loss of function

Answer 2

1 - Acute Inflammation

2 - five cardinal signs

Question 3

a large number of _______1____ are are responsible for the vascular and leucocyte response in an acute inflammatory response; ______2____ such as histamine, prostaglandins, leukotriens, cytokines, platelet activating factors and others; _____3_____ such as enzymes of the coagulation cascade, of the fibrinolytic system, kinin enzymatic system and complement system that have been broken down by the help of proteases from plasma cells

Answer 3

1 - chemical mediatorys
2 - cell-derived
3 - plasma derived

Question 4

Components of the Inflammatory Reaction: ______1_________ and _______2________

Answer 4

1 - Vascular stage

2 - Cellular Stage

Question 5

_____________ is vasodialation of arterioles and increased permeability of capillaries; occurs mostly immediately after tissue damage - preceding is a short neurally mediated constriction of arterioles; mediated by histamine that is released from damaged mast cells, basophils and platelets; the release is stimulated by phagocytes attreacted to the site and by activated complement proteins; enhanced by kinins, prostagglandins and leukotrienes

Answer 5

Vascular stage

Question 6

_______1______ occurs approximately 1 hour after the inflammatory response begins (varies); leukocytes (neutrophils at first) are attracted to the site of damage by microbes or injured cells themselves by kinins, complement and other neutrophils and they phagocytize the microbes; attraction of phagocytes to microbes or injured cells is called _______2______

Answer 6

1 - cellular stage

2 - chemotaxis

Question 7

_____1________ process starts already when phagocyctes remove necrotic tissue soon after tissue injury; once injurious agent is removed either ______2____ [regrowth of original tissue] or ____3___ [formation of a connective tissue scar] occur

Answer 7

1 - tissue healing
2 - regeneration
3 - repair

Question 8

___________ is inflammation that does not resolve but persists over time (up to years); can contribute to healing but usually does not lead to full return of function; ie. injurious agent persists, repeated episodes of acute inflammation in the same tissue, persistent immune reactions; hallmark is accumulation of macrophages, lymphocytes and plasma cells

Answer 8

Chronic Inflammation

Question 9

____________ leads to the formation of connective tissue scar or fibrosis and is associated with a loss of function

Answer 9

granulation tissue

Question 10

What are the local signs of chronic inflammation?

Answer 10

cicatrisation, contracture, granulomas, endarteritis obliterans, endophlebitis, ulceration

Question 11

____________ is a scar with considerate contraction (=shrinkage)

Answer 11

cicatrisation

Question 12

___________ is fibrosis of connective tissue in skin, fascia, muscle or joint with excessive shrinkages that prevents normal mobility

Answer 12

contracture

Question 13

___________ macrophages surround target and enclose it; they in turn are surrounded by leucocytes and fibroblasts; i.e. in tuberculosis or foreign body persistance

Answer 13

granulomas

Question 14

_____________ chronic progressive thickening of the tunica interna of arteries leading to stenosis/obstruction of the lumen

Answer 14

endarteritis obliterans

Question 15

______________ inflammation of the inner layer of a vein

Answer 15

endophlebitis

Question 16

__________ a suppurative or non healing lesion on a surface such as skin, mucous membrane or cornea

Answer 16

ulceration

Question 17

_______________ involves multiple organs and is usually associated with autoimmune disorders; examples include: vasculitic syndromes; rheumatoid arthritis (RA); systemic lupus erytematosus (SLE), progressive systemic sclerosis (PSS), tuberculosis (TB), sarcoidosis

Answer 17

Systemic inflammation

Question 18

______________ is inflammation of blood vessel walls

Answer 18

vasculitic syndromes

Question 19

____________ is affecting the synovial tissue, extraarticular rheumatoid nodules, serositis, chronic immune stimulation

Answer 19

rheumatoid arthritis (RA)

Question 20

_____________________ is affecting prevalently cardiovascular, renal or neurologic systems

Answer 20

systemic lupus erythematosus (SLE)

Question 21

_____________________ is fibrotic, degenerative and inflammatory changes throughout the body

Answer 21

progressive systemic sclerosis (PSS)

Question 22

____________ is caused by mycobacterium tuberculosis, formation of granulomas, primary site: lungs

Answer 22

tuberculosis (TB)

Question 23

____________ is formation of granulomas in lungs, liver, bones, eyes, or skin

Answer 23

sarcoidosis

Question 24

____________________ proliferation of endothelial cells to establish a vascular network; parenchymal cells can only regenerate when they can undergo mitosis; cells that are able to regenerate are labile cells and stable cells; TISSUE REGENERATION is the MOST DESIRABLE OUTCOME, it is the REPLACEMENT of dead parenchymal cells by new cells

Answer 24

proliferation and migration of cells

Question 25

____________________ is most cases healing is achieved by both regeneration and repair although regeneration is a very desirable healing process because it restores normal tissue structure and function; granulation tissue transforms into scare tissue; non functional vessels are degraded though apoptosis leaving few blood vessels in mature scar tissue

Answer 25

remodelling and maturation phase

Question 26

it is possible to minimize scarring by surgical union of the wound edges - healing by __________

Answer 26

healing by primary intention

Question 27

wound closure in which the edges are separated and filled by granulation tissue is called healing by ____________

Answer 27

healing by secondary intention (heals from the bottom up)

Question 28

What can influence wound healing?

Answer 28

growth factors, age, general health/presence of other medical conditions, tobacco/alcohol/perscription drugs, nutritional status, presence of infection, type of tissue, foreign bodies or irritants, stress, temperature [fever or hypothermia], adhesion, wound direction, vascular supply, movement

Question 29

Epithelium, dermal connective tissue, tendons and ligaments, peripheral nerve and bone all regenerate or repair for tissue healing?

Answer 29

regenerate

Question 30

____________ and ____________ both regenerate and repair for tissue healing.

Answer 30

skeletal mm and smooth mm

Question 31

The brain, cardiac mm, and cartilage all regenerate or repair for tissue healing?

Answer 31

repair

Question 32

What are some complications to wound healing?

Answer 32

permanent loss of ROM or usage, excessive scar tissue formation; chronic inflammation- may result from the presence of foreign bodies; dehiscence, evisceration, non-union, malunion,

Question 33

termed _______ when scar tissue exceeds the borders of the wound

Answer 33

keloid

Question 34

termed ______ when tissue remains within boarders

Answer 34

hypertrophic scar