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BDS2.5 Applied Biomedical Sciences > Pathology of wound healing > Flashcards

Pathology of wound healing Flashcards

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1
Q

What are the 2 categories of wound healing?

A

regeneration

repair

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2
Q

What is required for tissue regeneration to occur?

A

tissue requires ongoing mitotic activity

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3
Q

What is repair aspect of wound healing?

A

replaces damaged cells with fibrous connective tissue

leaves permanent scar

occurs in non-mitotic tissue and with more severe injuries

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4
Q

What type of repair occurs if the injury is extreme?

A

fibrous repair

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5
Q

What 2 structural components are tissues and organs divided into?

A

parenchymal tissue

stromal regions

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6
Q

What are parenchymal cells of tissues and organs?

A

functional cells of the organ

highly specialised

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7
Q

What are the stromal regions of tissues and organs

A

support tissue

connective tissue, ECM, blood vessles, nerves

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8
Q

What are examples of parenchymal tissues?

A

hepatocytes, kidney, tubular cells

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9
Q

What is regeneration?

A

injured cells replaced by identical new cells

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10
Q

What is repair?

A

damaged cells replaced by stromal/fibrous scar tissue

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11
Q

What are the 3 categories of tissue according to cell types?

A
  1. labile cells
  2. stable cells
  3. fixed cells
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12
Q

What can dictate if regeneration or repair will occur?

A

mitotic activity of teh cell/tissue

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13
Q

What are labile cells?

A

continuous division

continuously divide

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14
Q

Where would you find labile cells?

A

surface epithelium (skin, oral cavity, GI tract, uterus)

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15
Q

When does division of stable cells stop?

A

when growth is complete

still gave potential for division

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16
Q

What are examples f stable cells?

A

hepatocytes

kidney tubular cells

smooth muscle

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17
Q

Are mitotic cells capable of mitotic diivision?

A

no

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18
Q

What are damaged fixed cells replaced by?

A

fibrous scar tissue

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19
Q

Are wound healings by regeneration and fibrous tissue repair controlled by similar regulatory mechanisms?

A

yes

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20
Q

What does would healing by regeneration And repair involve?

A

inflammatory mediators

growth factors

ECM

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21
Q

What WBC release inflammatory mediators?

A

monocytes

macrophages

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22
Q

What are examples of inflammatory mediators?

A

TNF-a
interleukins
interferons
arachnoid acid
leukotrienes
prostaglandins

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23
Q

What isthe effect of inflammatory mediators?

A

blood clotting (initial vasodilation)

immune cell infiltration (delayed vasodilation)

phagocytosis of debris and bacteria

new cell growth/fibroblast infiltration

angiogenesis

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24
Q

What cells release growthfactors?

A

fibroblasts and macrophaes and endothelial cells

neutrophils

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25
What are examples of growth factors?
FGF EGF TGF
26
What is the effect of growth factors?
inflammatory response (cross-talk) chemotaxis proliferation and differentiation generation of ECM angiogenesis
27
What is the overall goal of growth factors?
moves process onwards to regeneration/repair damaged region mature scar
28
What do endothelial cells, immune cells, fibroblasts secrete?
ECM
29
What are the different types of ECM?
collagen and elastin proteoglycans and hyaluronic acid fibronectin and laminin
30
What are the fibrous/structural proteins (ECM)?
COLLAGEN AND ELASTON
31
What is the role of collagen and elastin ECM?
Scaffolding of ECM, provides framework and tensile strength
32
What is the water-hydrated gels (ECM)
proteoglycans and hyaluronic acid
33
What is the role of proteoglycans and hyaluronic acid in the ECM?
provides lubrication, resilience and flexibility
34
What are the adhesive glycoproteins (ECM)?
Fibronectin and laminin
35
What is the role of fibronectin and laminin in the ECM?
Provide cohesion between matrix components and cells
36
What are the 2 forms of ECM?
BASEMENT membrane Interstitial matrix
37
What is the most common type pf ECM?
interstitial matrix
38
What is the basement membrane?
ECM 'sheet' that epithelial, endothelial and smooth muscle cells lie on physical/chemical barrier, structural support, strength
39
Where is the interstitial tissue found?
found between cells within a tissue
40
Where is the interstitial matrix sparse?
nerves
41
Where is the interstitial matrix dense/abundant?
bone/cartilage
42
What is the role of the interstitial matrix?
provides adherence, structure - 'glue' holding cells together protects against tissue compression
43
What does the ECM help regulate?
proliferation, differentiation, movement
44
What is the primary objective of wound healing?
fill the area of destroyed tissue
45
Is regeneration limited?
yes, can often form scar tissue
46
What are the 3 phases of wound healing?
inflammatory phase proliferative remodelling
47
What stage of wound healing is platelet activation occur?
first stage - inflammatory phase clot
48
How log does the inflammatory phase last?
0-48hr
49
What WBC clear oput wound?
phagocytes and neutrophils ingest debris and fibrin
50
What else do macrophages do in inflammatory phase?
stimulate angiogenesis secrete growth factors that attract other cells
51
When does the proliferative phase occur?
48-3 weeks
52
What stage of wound healing do fibroblasts playa role?
proliferative phase (phase 2)
53
what recruits fibroblasts?
macrophages
54
What is the effect of fibroblasts secreting GF at wound?
angiogenesis further fibroblast recruitment/ECM production
55
What is the pre-cursor to scar tissue?
granulation tissue
56
What phase of wound healing does granulation tissue form?
phase 2 proliferation phase
57
Describe granulation tissue?
moist, red connective tissue
58
What 2 processes are in involved in granulation tissue formation?
angiogenesis fibrogenesis
59
What phase is inflammation no longer apparent?
late proliferative phase phase 2 (few macrophages, no oedema)
60
When does late proliferative phase occur?
3 weeks
61
What cells persist at late proliferative phase?
fibroblasts
62
What are fibroblasts secreting in LPP?
collagen strengthens ECM
63
What happens to granulation tissue in late proliferative phase?
migrates upward, leaving fibrous scar behind less angiogenesis, vasculature degenerates, scar largely avascular
64
What is epithelialization?
upper epithelial layer proliferates uses granulation tissue as matrix seals wound with new epithelium
65
when does remodelling phase occur?
3-6 weeks
66
in remodelling phase, what do the fibroblasts secrete?
collagenase
67
what is the role of collagenase secreted by the fibroblasts?
break down collagen fibres but not collapse the scaffold remodel scar and shrink scar
68
in the remodelling phase, how does the scar shrink inwards?
myofibroblasts contractile fibroblasts helps remodelling shrinks visible area
69
does the mature scar tissue have more of less collagen?
more
70
How long can the remodelling phase last?
up to 6 months
71
What has more ECM, repair or regeneration?
repair has more
72
What does regeneration have a higher emphasis on?
division of regenerating cells
73
What factors are required for wound healing?
nutrition O2 and blood flow immune and inflammatory function
74
What are factor which disrupt wound healing?
infection separation (large loss of ECM) foreign bodies
75
What are the 2 types of injury
primary and secondary intention
76
What controls proliferative phase?
growth factors
77
What is remodelling phase controlled by?
ECM

BDS2.5 Applied Biomedical Sciences (48 decks)

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