Session 3 - Wound Healing

Question 1

this is the process by which the cells in the body regenerate and repair to reduce the size of a damaged or necrotic area

Answer 1

healing

Question 2

what are the two processes involved in healing?

Answer 2

removal of necrotic tissue (demolition) and the replacement of this tissue; remove and replace

Question 3

what is defined as the process by which necrotic cells are replaced by the same tissue as was originally there?

Answer 3

regeneration

Question 4

what is the process by which injured tissue is replaced with scar tissue?

Answer 4

repair

Question 5

T or F: most often.healing proceeds through collagen deposition or scarring (fibrosis).

Answer 5

TRUE

Question 6

T or F: tissue regeneration is favored when the matrix composition and architecture are unaltered

Answer 6

TRUE

Question 7

T or F: wounds that do NOT heal may relfect damage to the tissue architecture by reduced protease activity, decreased matrix accumulation, or altered matrix assembly.

Answer 7

FALSE: all are true except that it’s EXCESS protease activity; remember, when you have fibrosis or scarring is when there is reduced protease activity and increased matrix accumulation

Question 8

what is released by platelets that help to facilitate repair?

Answer 8

platelet derived growth factor (PDGF)

Question 9

what is released from mast cells which help to promote BV formation?

Answer 9

heparin

Question 10

what are the 3 phases of wound healing?

Answer 10

1. inflammatory phase 2. proliferative phase 3. remodeling phase

Question 11

what happens to platelets after they are exposed to endothelial damage? (think of the steps taken to limit blood loss)

Answer 11

aggregate, add fibrin, form a thrombus.

Question 12

in which stage of wound healing is there a release of chemical factors such as growth hormones?

Answer 12

inflammatory phase

Question 13

the permeability of post-capillary venules increases due to ____ cells contracting while the ____ junctions retract. these factors allow for “inflammatory edema”

Answer 13

endothelial; inter-cells

Question 14

at first, the fluid in “inflammatory edema” is considered transudate or exudate? as time proceed does the characterization change or stay the same?

Answer 14

transudate; becomes exudate

Question 15

neutrophils or macrophages - these are responsible for cytokine release.

Answer 15

macrophages

Question 16

lymphocytes or macrophages - these have a role in cell-mediated immunity.

Answer 16

lymphocytes

Question 17

these specialized cells are responsible for the formation of granulation tissue, synthesis of collage and contraction of wounds

Answer 17

fibroblasts

Question 18

in acute inflammation which cells appear first, followed by which?

Answer 18

neutrophils followed by macrophages

Question 19

in simple chronic inflammation, which cells type is present most in numbers? followed by?

Answer 19

lymphocytes, followed by plasma cells and macrophages

Question 20

in granulomatous chronic inflammation, which cells are more numerous?

Answer 20

macrophage clusters, followed by peripheral lymphocytes

Question 21

as a mediator of acute inflammation, histamine is responsible for v/d or v/c?

Answer 21

v/d.

Question 22

what is IL-1 responsible for activating?

Answer 22

macrophages and fever

Question 23

what is IL-8 responsible for in the mediation of acute inflammation?

Answer 23

chemotaxin for polys

Question 24

locomotion of the rapidly migrating leukocytes is powered by what? slower moving cells such as fibroblasts move via what?

Answer 24

lamelipodia; filopodia

Question 25

what is a prominent early feature in injured tissue that serves to replace damaged cells?

Answer 25

cellularity (cell proliferation)

Question 26

what is the name of a specialized vascular tissue that is formed transiently during repair?

Answer 26

granulation tissue

Question 27

T or F: cells that are terminally differentiated do NOT contribute to repair or regeneration.

Answer 27

TRUE - such as myocytes, neurons.

Question 28

healing by primary or secondary intention: a wound with minimal tissue loss

Answer 28

primary

Question 29

healing by primary or secondary intention: wound requires contraction and extensive cell prolideration

Answer 29

secondary

Question 30

healing by primary or secondary intention: result is small scar

Answer 30

primary

Question 31

during the maturation phase of wounding healing, what happens to unnecessary vessels formed in granulation tissue?

Answer 31

removed by apoptosis

Question 32

T o F: the maturation phase of wound healing can last as long as a year.

Answer 32

TRUE

Question 33

what is the initial phase of wound healing? (following v/c and involves platelets adhering to damaged endothelium and discharging ADP)

Answer 33

hemostasis

Question 34

what is the second phase in the evens of wound healing?

Answer 34

inflammation

Question 35

there is an early, mid, and late phase involved in the repair of skin - in which phase will you find the following: thrombosis, inflammation, and re-epithelialization.

Answer 35

early

Question 36

in which phase of the repair of skin will you find granulation tissue formation and contraction?

Answer 36

mid

Question 37

in which phase in the repair of skin will you find the following: remodeling, and accretion of final tensile strength?

Answer 37

late

Question 38

this is the transient, specialized tissue of repair which replaces the provisional matrix.

Answer 38

granulation tissue

Question 39

T or F: a key step in the development of granulation tissue is the recruitment of monocytes to the site of injury by chemokines.

Answer 39

TRUE

Question 40

granulation tissue eventually transitions to what? (this is the balance between collagen synthesisi and collagen breakdown)

Answer 40

scar tissue

Question 41

what is it that remains active at the site of a wound increasing the density of a scar over time?

Answer 41

fibroblasts

Question 42

this is the physiological process involving the growth of new blood vessels from pre-esiting vessels.

Answer 42

angiogenesis

Question 43

what is the term for when there is spontaneous blood vessel formation?

Answer 43

vasculogenesis

Question 44

what is the term for new blood vessel formation by splitting off existing ones?

Answer 44

intussusception

Question 45

T or F: angiogenesis is a NORMAL process in growth and development as well as in wound healing.

Answer 45

True

Question 46

T or F: granulation tissue has more capillaries per unit volume than any other tissue

Answer 46

True

Question 47

when new blood vessels form de novo from angioblasts, what is this process called?

Answer 47

vasculogenesis

Question 48

how does the epidermis constantly renew itself? (via mitosis of what cells in which layer of skin)

Answer 48

kerinocytes of the basal layer

Question 49

T or F: in terms of re-epithialization, maturation requires an intact layer of basal cells that are in direct contact with another and the basement membrane

Answer 49

TRUE

Question 50

in terms of wound contraction, which cell is it that reacts like a smooth muscle?

Answer 50

fibroblasts - the myofibroblast is the cells response for wound contraction.

Question 51

which cells are responsible for the deforming pathological process termed would contracture?

Answer 51

myofibroblasts

Question 52

what is the renewal of a damaged tissue or a lst appendage that is identical to the original one?

Answer 52

regeneration

Question 53

the power to regenerate tissue is derived from a small number of unspecialized cells known as what?

Answer 53

stem cells

Question 54

in terms of complications of wound healing, if the injury sections or destroys the ______ layer of the stratum corneum, a scar will ALWAYS form.

Answer 54

papillary layer

Question 55

keloid or hypertrophic scare: continues to enlarge beyond the original size and shape of the wound.

Answer 55

keloid - a hypertrophic scar enlarge within the confines of the original wound

Question 56

T or R: keloids and hypertrophic scars are both raised above the skin level

Answer 56

TRUE

Question 57

T or F: hypertrophic scars are self-limited.

Answer 57

true

Question 58

what eventually happens to the general appearance of hypertrophic scars?

Answer 58

they become pale and flat over time

Question 59

what is the main difference btwn keloids, hypertrophic scars and widened scars?

Answer 59

widened scars are flat and sometimes depressed

Question 60

what is it called when the normally elastic connective tissues are replaces by inelastic fiber like tissue

Answer 60

contracture

Question 61

what is the most common cause of contracture?

Answer 61

scarring and lack of use (due to immobilization or inactivity)

Question 62

what is the best tx option for contracture?

Answer 62

PT

Question 63

what is contracture a serious complication of?

Answer 63

bruns

Question 64

what is the term that describes a rupture or splitting open, as of a surgical wound or of an organ or structure to discharge its contents?

Answer 64

dehiscence

Question 65

what type of surgeries are most commonly associated with a higher incidence of wound dehiscence?

Answer 65

abdominaal

Question 66

what is the appearance of the dermis when a keloid is present? (under the microscope)

Answer 66

thickened by the presence of collagen bundles