POM 04 - Cell healing and repair

Question 1

what is chronic inflammation and when does this happen

Answer 1

chronic inflammation is initiated if the cause of inflammation is not removed

other leukocyte types like macrophages and lymphocytes enter the tissue

Question 2

why are other leukocyte cells types attracted in chronic inflammation

Answer 2

neutrophils and other cells like endothelial cells in area of inflammation are pumping out growth factors and chemokine molecules attracting other cell types

Question 3

put in order the following processes in chronic inflammation

monocyte/macrophage, edema, neutrophils

Answer 3

1. edema (leakiness etc)
2. neutrophils
3. monocytes/macrophages (chronic inflammation)

Question 4

what happens to monocytes after they enter the injured tissue

Answer 4

activate and differentiate into macrophages

Question 5

do macrophages or neutrophils have greater phagocytic potential

Answer 5

marcophages

Question 6

what are two cell types involved in adaptive immunity

Answer 6

macrophages

lymphocytes

Question 7

what is a cell involved in innate immunity

Answer 7

neutrophils

Question 8

what are the clinical manifestations of inflammation - 5 things

Answer 8

redness
swelling
heat
pain
loss of function

Question 9

what kind of inflammation does granuloma formation pattern occur in

Answer 9

chronic

Question 10

what is the structure and layers of granuloma formation

Answer 10

necrosis core

microscopic aggregations of macrophages that transform into epithelioid macrophages around the necrosis

collar of lymphocytes around the epithelioid macrophages

Question 11

what cells do macrophages turn into once in granuloma formation

what do they fuse together to form

Answer 11

epithelioid macrophages

macrophages fuse into giant cells

Question 12

what are the two things that mediate the pyrexia systemic effect

Answer 12

IL-1 and TNF-a

Question 13

what are the 4 systemic effects of inflammation

Answer 13

pyrexia

leucocytosis

acute phase proteins from liver

endocrine changes

Question 14

what is the inflammatory endocrine changes seen

Answer 14

increase in glucocorticoid steroid hormones

Question 14

what produces IL-1 and TNF

Answer 14

macrophages

Question 14

what is leucocytosis

Answer 14

increased production and release of leukocytes from bone marrow

Question 14

what are the 6 acute phase reactions caused by IL-1 and TNF

Answer 14

fever

increase sleep

decrease appetite

increase acute phase proteins

haemodynamic effects (shock)

neutrophilia

Question 14

what are the 4 effects caused by IL-1 and TNF

Answer 14

acute phase changes

endothelial effects

fibroblast effects

leukocyte effects

Question 15

what are the 5 endothelial reactions caused by TNF and IL-1

Answer 15

increase leukocyte adherence

increase PGI synthesis

increase procoagulant activity

decrease anticoagulant activity

increase IL-1/8/6 and PDGF

Question 16

what are the 5 fibroblast reactions caused by IL-1 and TNF

Answer 16

increase proliferation

increase collagen synthesis

increase collagenase

increase protease

increase PGE synthesis

Question 17

what is the leukocyte effect caused by IL-1 and TNF

Answer 17

increased cytokine secretion (IL-1 and IL-6)

Question 18

what are the 2 downsides to inflammation

Answer 18

harmful if occur inappropriately or not adequately controlled

Question 19

what happens after chronic inflammation

Answer 19

healing attempts to restore as close as possible the original structure and function of injured/inflammed tissue

Question 20

what are the 2 components of healing

Answer 20

cleaning up the mess

rebuilding original structure and function through mix of regeneration and repair

Question 21

what is the cell mainly responsible for cleaning up the mess in healing

Answer 21

macrophages

Question 22

what is the cell mainly responsible for rebuilding the original structure and function in healing

Answer 22

stem cells

Question 24

what are the 3 options for healing

Answer 24

resolution

regeneration

repair

Question 25

what is the resolution pathway of healing

in terms of what type of injury it responds to, what cells are involved, and what the final outcome is for the cells

Answer 25

healing after minor injury

macrophage might be involved to aid process and clean up

tissue returns to normal

Question 26

what is the resolution pathway of repair

what are the 2 phases

Answer 26

stem cells are not available in area (quiescent)

1. organisation
2. granulation tissue

Question 27

what cells are involved in organisation phase of repair and what happens before this phase

Answer 27

fibroblasts

organisation happens after the mess is cleaned up by macrophages

Question 28

what is granulation tissue and is it the same as the granuloma

Answer 28

appearance in microscope of the organisation process

not the same as granuloma

Question 29

what is the final product formed in the repair pathway of healing

Answer 29

non functional fibrous scar

Question 30

what cells are involved in the regeneration pathway of healing

Answer 30

stem cells

Question 31

what happens in the regeneration pathway of healing and what is the outcome

Answer 31

tissue structure and function rebuilt

results in return of some/all previous function

Question 32

what are the 3 steps in the timecourse of healing

Answer 32

1. inflammation
2. granulation tissue
3. wound contraction

Question 33

what happens in wound contraction step in the timecourse of healing

Answer 33

fibroblasts depart or die leaving collagen scan which contracts and forms dense fibrous scars

Question 34

what direction are the collagen fibres aligned in in relation to stress

Answer 34

aligned in planes of stress