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ORAL PHYSIOLOGY > Topic 11 (Wound Healing) > Flashcards

Topic 11 (Wound Healing) Flashcards

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

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2
Q

is the process of repair that follows injury to the skin and other soft tissues.

A

Wound healing

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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

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4
Q

Under the most ideal circumstances, healing is a systematic process, traditionally explained in terms of 3 classic phases:

A
  • Inflammation
  • Proliferation
  • Maturation
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5
Q

Damaged cells release histamine

A

Inflammatory Exudative 1-3 Days Approx

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6
Q

Histamine causes vasodilatation of the surrounding capillaries

A

Inflammatory Exudative 1-3 Days Approx

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7
Q

Increased blood supply brings about oedema & engorgement resulting in the inflammatory
appearance.

A

Inflammatory Exudative 1-3 Days Approx

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8
Q

The exudate assists in dilution and flushing out of microbes and toxins.

A

Inflammatory Exudative 1-3 Days Approx

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9
Q

This a natural response to injury and does not indicate infection.

A

Inflammatory Exudative 1-3 Days Approx

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10
Q

Signs & symptoms: heat, redness, pain, swelling, loss of function.

A

Inflammatory Exudative 1-3 Days Approx

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11
Q

What does the damage cells release?

A

Histamine

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12
Q

What causes vasodilation of the surrounding capillaries?

A

Histamine

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13
Q

Histamine causes ____ of the surrounding capillaries.

A

Vasodilation

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14
Q

What are the signs and symptoms during inflammatory exudative?

A
  • Heat
  • Redness
  • Pain
  • Swelling
  • Loss of function
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15
Q

Stage 2-3 days after injury (can last for weeks)

A

Proliferative Regeneration Stage

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16
Q

A process includes:

  • Granulation
  • Contraction
  • Epithealisation
A

Proliferative Regeneration Stage

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17
Q

In this phase of normal healing, the wound remains red and raised

A

Proliferative Regeneration Stage

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18
Q

In this stage, new blood vessels are formed.

A

Proliferative Regeneration Stage

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19
Q

In this stage, wound contraction begins.

A

Proliferative Regeneration Stage

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20
Q

Later stages proliferation occurs.

A

Proliferative Regeneration Stage

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21
Q

In this stage, Epithealisation occurs.

A

Proliferative Regeneration Stage

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22
Q

What is the other term for Maturation?

A

Reparative

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23
Q

In this phase tensile strength increases.

A

Maturation/Reparative

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24
Q

This can take considerable time - 12 months or longer.

A

Maturation/Reparative

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25
Q

The maximum tensile strength (following wound breakdown and repair) that can be obtained is 80% of previous skin strength.

A

Maturation/Reparative

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26
Q

At first the wound is pink, but gradually contracts to become a pale scar.

A

Maturation/Reparative

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27
Q

Hair follicles and sweat glands that are lost in open wounds are usually not replaced.

A

Maturation/Reparative

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28
Q

These wounds cannot be thought of as completely healed and can breakdown again.

A

Maturation/Reparative

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29
Q

The maximum tensile strength that can be obtained is ____ of previous skin strength.

A

80%

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30
Q

During this stage, what are lost in open wounds and are usually not replaced?

A

Hair follicles and sweat glands

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31
Q

What are the 2 Major Ways of Healing:

A

Regeneration and Repair

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32
Q

It is the restoration of destroyed tissue by the same kind of cells.

A

Regeneration

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33
Q

It is the restoration of function and tissue continuity but distortion of the normal architecture.

A

Repair

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34
Q

Repair by dense connective tissue is a formation of ____.

A

Scar Tissue

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35
Q

It is a formation of scar tissue.

A

Repair by dense CT

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36
Q

What are the 2 types of Wound Healing:

A
  • Primary Union
  • Secondary Union
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37
Q

Healing by first intention

A

Primary Union

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38
Q

Healing by secondary intention

A

Secondary Union

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39
Q

Narrow space between 2 cut surfaces of a wound undergo bleeding.

A

Primary Union/First Intention

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40
Q

Margins of the wound undergo mild acute inflammation releasing plasma and PMNL into the space.

A

Primary Union/First Intention

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41
Q

After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts.

A

Primary Union/First Intention

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42
Q

Macrophages phagocytose wound debris and hemosiderin from hemoglobin breakdown

A

Primary Union/First Intention

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43
Q

Fibroblasts begin to form ground substance

A

Primary Union/First Intention

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44
Q

Cells from the wound margin undergo mitosis and
move toward the center of the wound forming a
complete but thin epithelial covering

A

Primary Union/First Intention

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45
Q

The epithelium undergo maturation to regain full thickness.

A

Primary Union/First Intention

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46
Q

The underlying C.T. scar becomes fibrous and
avascular.

A

Primary Union/First Intention

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47
Q

Healing is complete in 2-3 weeks.

A

Primary Union/First Intention

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48
Q

After 24 hours, ____ begin to grow into the wound space, followed by macrophages and fibroblasts.

A

After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts

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49
Q

After 24 hours, caplliaries begin to grow into the wound space, followed by ____ and ____.

A

After 24 hours, caplliaries begin to grow into the wound space, followed by macrophages and fibroblasts

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50
Q

____ begin to form ground substance.

A

Fibroblasts

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51
Q

Cells from the wound margin undergo ____ and
move toward the center of the wound forming a
complete but thin epithelial covering

A

mitosis

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52
Q

The epithelium undergo ____ to regain full
thickness

A

maturation

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53
Q

The underlying C.T. scar becomes ____ and ____.

A

fibrous and avascular

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54
Q

In Primary Union, healing is complete in ____.

A

2-3 weeks

55
Q

The 2 cut surfaces cannot be approximated so there is a large gap.

A

Secondary Union/Secondary Intention

56
Q

There is bleeding, followed by blood clot formation Mild short-lived acute inflammatory reaction occur in the wound margins.

A

Secondary Union/Secondary Intention

57
Q

Granulation tissue begins to move into the wound base and sides.

A

Secondary Union/Secondary Intention

58
Q

Granulation tissue is made of:

A
  • Capillary buds
  • Fibroblasts
  • Macrophages
  • Plasma cells
  • Lymphocytes
59
Q

The macrophages fibroblasts, PMNL remove tissue debris.

A

Secondary Union/Secondary Intention

60
Q

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.

A

Secondary Union/Secondary Intention

61
Q

As more collagen layers are formed in the granulation tissue, the wound undergoes contraction, showing fibroblastic activity.

A

Secondary Union/Secondary Intention

62
Q

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

A

Secondary Union/Secondary Intention

63
Q

What are the Stages of Wound Healing:

A
  • Coagulation/Inflammation
  • Tissue Formation
  • Remodeling
64
Q

Wound Healing:
- Mins
- Hrs
- Days

A

Coagulation/Inflamation

65
Q

Wound Healing:
Weeks

A

Tissue Formation

66
Q

Wound Healing:
Months

A

Remodeling

67
Q
  • Hemostasis
  • Neutrophils
  • Monocyte
A

Coagulation/Inflammation

68
Q
  • Keratinocytes
  • (Myo)Fibroblasts
  • Endothelial cells
A

Tissue Formation

69
Q
  • Collagen
  • Scar Appearance
A

Remodeling

70
Q

Re-epithelialization

A

Keratinocytes

71
Q

MMP Production

A

Keratinocytes

72
Q

ECM Formation

A

(Myo)Fibroblasts

73
Q

MMP Production

A

(Myo)Fibroblasts & Endothelial Cells

74
Q

Angiogenesis

A

Endothelial Cells

75
Q

Small, parallel bundles

A

Collagen

76
Q

Thin Fibers

A

Collagen

77
Q

Thin Fiber

A

Collagen

78
Q

Increased Synthesis and Crosslinks

A

Thin Fibers and Thick Fibers

79
Q

Flat and Discolored

A

Normal Scars

80
Q

Scar raised

A

Hypertrophic Scars

81
Q

Scar raised and Spread beyond wound boundaries

A

Keloid Scars

82
Q
  • Blood clot
  • Blood Vessel
A

Bleeding/Hemostasis

83
Q
  • Scab
  • Fibroblast
  • Macrophage
  • Blood Vessel
A

Inflammation

84
Q
  • Fibroblast proliferating
  • Subcutaneous fat
A

Proliferation/Proliferative

85
Q
  • Freshly healed epidermis
  • Freshly healed dermis
A

Remodeling

86
Q

Give the 4 stages of Wound Healing:

A
  • Hemostasis
  • Inflammatory
  • Proliferative
  • Remodeling
87
Q

Cut blood vessels bleed into the wound.

A

Hemostasis Phase

88
Q

Blood clot forms, and leukocytes clean wound.

A

Inflammatory Phase

89
Q

Blood vessels regrow, and granulation tissue forms.

A

Proliferation Phase

90
Q

Epithelium regenerates, and connective tissue fibrosis occurs.

A

Maturation/Remodeling Phase

91
Q

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.

A

Blood Clotting

92
Q

Initial response to wound healing

A

Hemostasis

93
Q

network of fibrin thread in which varying amounts of platelets and blood cells are enmeshed; formed within 5 to 10 minutes after injury.

A

Clot

94
Q

Clot formed within ____ after injury.

A

5 to 10 minutes

94
Q

formed by a meshwork of fibers, red blood cells and platelets.

A

Clot

95
Q

beginning of inflammatory process.

A

Next 24 to 48 hrs

96
Q

Infiltration of ____ and ____.

A

Neutrophils and Macrophages

97
Q

Other name for Neutrophils

A

polymorphonuclear leukocytes

98
Q

It is the first inflammatory cell to invade the wound.

A

Neutrophils (polymorphonuclear leukocytes)

99
Q

to remove bacteria

A

Nautrophil/PMNL

100
Q

What is the main function of PMNL

A

to remove bacteria

101
Q

Cells reach a maximum concentration at about ____ before they die.

A

24 hrs

102
Q

Convert to macrophages which initiate tissue repair.

A

Monocytes

103
Q

Their accumulation at the wound site is considered to be histologic sign of acute inflammation.

A

Neutrophils (polymorphonuclear leukocytes)

104
Q

Wound fluid that contains dead neutrophils, wound debris and other factors.

A

Pus

105
Q

predominant cell type in damaged tissue at 5 days.

A

Macrophage and Mononuclear Leukocytes

106
Q

Participate in connective tissue formation by providing nutrients & oxygen.

A

Blood Vessels

107
Q

Secrete bioactive substances (endothelial cells) and allowing inflammatory cell migration to the site of injury.

A

Blood Vessels

108
Q

Blood vessels participate in connective tissue formation by providing ____ and ____.

A

Nutrients and Oxygen

109
Q

Blood vessels secrete ____ and allowing inflammatory cell migration to the site of injury.

A

Bioactive Substances (Endothelial Cells)

110
Q

is a mark left in the tissue after the wound heals

A

Scar

111
Q

Represents an area that has a slightly higher than normal ratio of collagen fibers

A

Scar Tissue

112
Q

Gingival tissues will heal with practically no scar formation.

A

Scar Tissue

113
Q

What tissue will heal with practically no scar formation?

A

Gingival Tissues

114
Q
  • Matrix formation
  • Remodelling
A

Final Stage of Wound Healing

115
Q

The wound finishes closing over and becomes strong enough to allow for complete healing

A

Stage 4 (Remodeling)

116
Q

Superficial wounds that only affect the top layer of skin do not scar.

A

Stage 4 (Remodeling)

117
Q

Deeper wounds may cause some degree of scarring.

A

Stage 4 (Remodeling)

118
Q

Wounds that only affect the top layer of skin do not scar.

A

Superficial wounds

119
Q

Wounds may cause some degree of scarring.

A

Deeper wounds

120
Q

Give the factors which influence wound healing in the mouth:

A
  • Blood Supply
  • Size of the wound
  • Foreign Material
  • Early Movement
  • Infection
  • Alveolar Osteitis
121
Q

The most important factor in proper wound healing.

A

Blood Supply

122
Q

The larger the wound, the more time needed for repair.

A

Size of the wound

123
Q

The most common causes of Complication in post extraction healing

A

Foreign Material

124
Q

Give the examples of Foreign Material:

A
  • Suture
  • Enamel
  • Amalgam
  • Bone
  • Fragments
  • Calculus
  • Food debris
125
Q

This is a particular cause of delay in bone fracture healing.

A

Early Movement

126
Q

The most important post extraction complication.

A

Infection

127
Q

The most common cause of delayed post operative pain

A

Alveolar Osteitis

128
Q

The loss of blood clot from the socket, foul odor, severe radiating pain

A

Alveolar Osteitis

129
Q

Symptoms: start on the 3% to 5th day after extraction

A

Alveolar Osteitis

130
Q

Treatment: relief of pain and irrigation of the socket

A

Alveolar Osteitis

131
Q

Alveolar Osteitis symptoms start on the ____ after extraction

A

3% to 5th day

132
Q

Alveolar Osteitis treatment ____ and ____.

A

relief of pain and irrigation of the socket

ORAL PHYSIOLOGY (10 decks)

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