Topic 11 (Wound Healing) Flashcards
(133 cards)
1
Q
It is a process by which the tissues are restored to an anatomic and physiologic arrangement after they have been injured, to prevent irritants from entering into the underlying tissues which may cause infection.
A
Healing
2
Q
is the process of repair that follows injury to the skin and other soft tissues.
A
Wound healing
3
Q
It is the interaction of a complex cascade of cellular events that generates resurfacing, reconstitution, and restoration of the tensile strength of injured tissue.
A
Healing
4
Q
Under the most ideal circumstances, healing is a systematic process, traditionally explained in terms of 3 classic phases:
A
- Inflammation
- Proliferation
- Maturation
5
Q
Damaged cells release histamine
A
Inflammatory Exudative 1-3 Days Approx
6
Q
Histamine causes vasodilatation of the surrounding capillaries
A
Inflammatory Exudative 1-3 Days Approx
7
Q
Increased blood supply brings about oedema & engorgement resulting in the inflammatory
appearance.
A
Inflammatory Exudative 1-3 Days Approx
8
Q
The exudate assists in dilution and flushing out of microbes and toxins.
A
Inflammatory Exudative 1-3 Days Approx
9
Q
This a natural response to injury and does not indicate infection.
A
Inflammatory Exudative 1-3 Days Approx
10
Q
Signs & symptoms: heat, redness, pain, swelling, loss of function.
A
Inflammatory Exudative 1-3 Days Approx
11
Q
What does the damage cells release?
A
Histamine
12
Q
What causes vasodilation of the surrounding capillaries?
A
Histamine
13
Q
Histamine causes ____ of the surrounding capillaries.
A
Vasodilation
14
Q
What are the signs and symptoms during inflammatory exudative?
A
- Heat
- Redness
- Pain
- Swelling
- Loss of function
15
Q
Stage 2-3 days after injury (can last for weeks)
A
Proliferative Regeneration Stage
16
Q
A process includes:
- Granulation
- Contraction
- Epithealisation
A
Proliferative Regeneration Stage
17
Q
In this phase of normal healing, the wound remains red and raised
A
Proliferative Regeneration Stage
18
Q
In this stage, new blood vessels are formed.
A
Proliferative Regeneration Stage
19
Q
In this stage, wound contraction begins.
A
Proliferative Regeneration Stage
20
Q
Later stages proliferation occurs.
A
Proliferative Regeneration Stage
21
Q
In this stage, Epithealisation occurs.
A
Proliferative Regeneration Stage
22
Q
What is the other term for Maturation?
A
Reparative
23
Q
In this phase tensile strength increases.
A
Maturation/Reparative
24
Q
This can take considerable time - 12 months or longer.
A
Maturation/Reparative
25
The maximum tensile strength (following wound breakdown and repair) that can be obtained is 80% of previous skin strength.
Maturation/Reparative
26
At first the wound is pink, but gradually contracts to become a pale scar.
Maturation/Reparative
27
Hair follicles and sweat glands that are lost in open wounds are usually not replaced.
Maturation/Reparative
28
These wounds cannot be thought of as completely healed and can breakdown again.
Maturation/Reparative
29
The maximum tensile strength that can be obtained is ____ of previous skin strength.
80%
30
During this stage, what are lost in open wounds and are usually not replaced?
Hair follicles and sweat glands
31
What are the 2 Major Ways of Healing:
Regeneration and Repair
32
It is the restoration of destroyed tissue by the same kind of cells.
Regeneration
33
It is the restoration of function and tissue continuity but distortion of the normal architecture.
Repair
34
Repair by dense connective tissue is a formation of ____.
Scar Tissue
35
It is a formation of scar tissue.
Repair by dense CT
36
What are the 2 types of Wound Healing:
- Primary Union
- Secondary Union
37
Healing by first intention
Primary Union
38
Healing by secondary intention
Secondary Union
39
Narrow space between 2 cut surfaces of a wound undergo bleeding.
Primary Union/First Intention
40
Margins of the wound undergo mild acute inflammation releasing plasma and PMNL into the space.
Primary Union/First Intention
41
After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts.
Primary Union/First Intention
42
Macrophages phagocytose wound debris and hemosiderin from hemoglobin breakdown
Primary Union/First Intention
43
Fibroblasts begin to form ground substance
Primary Union/First Intention
44
Cells from the wound margin undergo mitosis and
move toward the center of the wound forming a
complete but thin epithelial covering
Primary Union/First Intention
45
The epithelium undergo maturation to regain full thickness.
Primary Union/First Intention
46
The underlying C.T. scar becomes fibrous and
avascular.
Primary Union/First Intention
47
Healing is complete in 2-3 weeks.
Primary Union/First Intention
48
After 24 hours, ____ begin to grow into the wound space, followed by macrophages and fibroblasts.
After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts
49
After 24 hours, caplliaries begin to grow into the wound space, followed by ____ and ____.
After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts
50
____ begin to form ground substance.
Fibroblasts
51
Cells from the wound margin undergo ____ and
move toward the center of the wound forming a
complete but thin epithelial covering
mitosis
52
The epithelium undergo ____ to regain full
thickness
maturation
53
The underlying C.T. scar becomes ____ and ____.
fibrous and avascular
54
In Primary Union, healing is complete in ____.
2-3 weeks
55
The 2 cut surfaces cannot be approximated so there is a large gap.
Secondary Union/Secondary Intention
56
There is bleeding, followed by blood clot formation Mild short-lived acute inflammatory reaction occur in the wound margins.
Secondary Union/Secondary Intention
57
Granulation tissue begins to move into the wound base and sides.
Secondary Union/Secondary Intention
58
Granulation tissue is made of:
- Capillary buds
- Fibroblasts
- Macrophages
- Plasma cells
- Lymphocytes
59
The macrophages fibroblasts, PMNL remove tissue debris.
Secondary Union/Secondary Intention
60
As the fibrous tissue is laid down in the deeper layers of the wound, this granulation tissue heals the wound from the base then going up to the layers above.
Secondary Union/Secondary Intention
61
As more collagen layers are formed in the granulation tissue, the wound undergoes contraction, showing fibroblastic activity.
Secondary Union/Secondary Intention
62
The space between the 2 edges of the wound is closed by granulation tissue and wound contraction thus closing the wound by epithelial migration and mitosis
Secondary Union/Secondary Intention
63
What are the Stages of Wound Healing:
- Coagulation/Inflammation
- Tissue Formation
- Remodeling
64
Wound Healing:
- Mins
- Hrs
- Days
Coagulation/Inflamation
65
Wound Healing:
Weeks
Tissue Formation
66
Wound Healing:
Months
Remodeling
67
- Hemostasis
- Neutrophils
- Monocyte
Coagulation/Inflammation
68
- Keratinocytes
- (Myo)Fibroblasts
- Endothelial cells
Tissue Formation
69
- Collagen
- Scar Appearance
Remodeling
70
Re-epithelialization
Keratinocytes
71
MMP Production
Keratinocytes
72
ECM Formation
(Myo)Fibroblasts
73
MMP Production
(Myo)Fibroblasts & Endothelial Cells
74
Angiogenesis
Endothelial Cells
75
Small, parallel bundles
Collagen
76
Thin Fibers
Collagen
77
Thin Fiber
Collagen
78
Increased Synthesis and Crosslinks
Thin Fibers and Thick Fibers
79
Flat and Discolored
Normal Scars
80
Scar raised
Hypertrophic Scars
81
Scar raised and Spread beyond wound boundaries
Keloid Scars
82
- Blood clot
- Blood Vessel
Bleeding/Hemostasis
83
- Scab
- Fibroblast
- Macrophage
- Blood Vessel
Inflammation
84
- Fibroblast proliferating
- Subcutaneous fat
Proliferation/Proliferative
85
- Freshly healed epidermis
- Freshly healed dermis
Remodeling
86
Give the 4 stages of Wound Healing:
- Hemostasis
- Inflammatory
- Proliferative
- Remodeling
87
Cut blood vessels bleed into the wound.
Hemostasis Phase
88
Blood clot forms, and leukocytes clean wound.
Inflammatory Phase
89
Blood vessels regrow, and granulation tissue forms.
Proliferation Phase
90
Epithelium regenerates, and connective tissue fibrosis occurs.
Maturation/Remodeling Phase
91
cells stick together to form a blood clot to stop the bleeding, and inflammatory molecules move into the wound to start the process of healing.
Blood Clotting
92
Initial response to wound healing
Hemostasis
93
network of fibrin thread in which varying amounts of platelets and blood cells are enmeshed; formed within 5 to 10 minutes after injury.
Clot
94
Clot formed within ____ after injury.
5 to 10 minutes
94
formed by a meshwork of fibers, red blood cells and platelets.
Clot
95
beginning of inflammatory process.
Next 24 to 48 hrs
96
Infiltration of ____ and ____.
Neutrophils and Macrophages
97
Other name for Neutrophils
polymorphonuclear leukocytes
98
It is the first inflammatory cell to invade the wound.
Neutrophils (polymorphonuclear leukocytes)
99
to remove bacteria
Nautrophil/PMNL
100
What is the main function of PMNL
to remove bacteria
101
Cells reach a maximum concentration at about ____ before they die.
24 hrs
102
Convert to macrophages which initiate tissue repair.
Monocytes
103
Their accumulation at the wound site is considered to be histologic sign of acute inflammation.
Neutrophils (polymorphonuclear leukocytes)
104
Wound fluid that contains dead neutrophils, wound debris and other factors.
Pus
105
predominant cell type in damaged tissue at 5 days.
Macrophage and Mononuclear Leukocytes
106
Participate in connective tissue formation by providing nutrients & oxygen.
Blood Vessels
107
Secrete bioactive substances (endothelial cells) and allowing inflammatory cell migration to the site of injury.
Blood Vessels
108
Blood vessels participate in connective tissue formation by providing ____ and ____.
Nutrients and Oxygen
109
Blood vessels secrete ____ and allowing inflammatory cell migration to the site of injury.
Bioactive Substances (Endothelial Cells)
110
is a mark left in the tissue after the wound heals
Scar
111
Represents an area that has a slightly higher than normal ratio of collagen fibers
Scar Tissue
112
Gingival tissues will heal with practically no scar formation.
Scar Tissue
113
What tissue will heal with practically no scar formation?
Gingival Tissues
114
- Matrix formation
- Remodelling
Final Stage of Wound Healing
115
The wound finishes closing over and becomes strong enough to allow for complete healing
Stage 4 (Remodeling)
116
Superficial wounds that only affect the top layer of skin do not scar.
Stage 4 (Remodeling)
117
Deeper wounds may cause some degree of scarring.
Stage 4 (Remodeling)
118
Wounds that only affect the top layer of skin do not scar.
Superficial wounds
119
Wounds may cause some degree of scarring.
Deeper wounds
120
Give the factors which influence wound healing in the mouth:
- Blood Supply
- Size of the wound
- Foreign Material
- Early Movement
- Infection
- Alveolar Osteitis
121
The most important factor in proper wound healing.
Blood Supply
122
The larger the wound, the more time needed for repair.
Size of the wound
123
The most common causes of Complication in post extraction healing
Foreign Material
124
Give the examples of Foreign Material:
- Suture
- Enamel
- Amalgam
- Bone
- Fragments
- Calculus
- Food debris
125
This is a particular cause of delay in bone fracture healing.
Early Movement
126
The most important post extraction complication.
Infection
127
The most common cause of delayed post operative pain
Alveolar Osteitis
128
The loss of blood clot from the socket, foul odor, severe radiating pain
Alveolar Osteitis
129
Symptoms: start on the 3% to 5th day after extraction
Alveolar Osteitis
130
Treatment: relief of pain and irrigation of the socket
Alveolar Osteitis
131
Alveolar Osteitis symptoms start on the ____ after extraction
3% to 5th day
132
Alveolar Osteitis treatment ____ and ____.
relief of pain and irrigation of the socket
