Wound Healing

Question 1

What are the 3 phases of Healing?

Answer 1

1. Inflammatory Stage (0-2 wks)
2. Proliferation/Repair (days to 6 weeks)
3. Maturation/Remodeling (6 weeks to 2 years)

Question 2

Five things we must know about Inflammatory Phase:

Answer 2

1. understand pathogenic mechanisms
2. amplification of initial response is key
3. inflammation persists until stimulus is removed
4. inflammation is potentially dangerous
5. therapeutic strategies target critical control points in cycle

Question 3

What is the key to responding to inflammation?

Answer 3

amplification

Question 4

What are the cardinal signs? (5)

Answer 4

• redness
• edema
• head
• pain
• loss of function

Question 5

what type of inflammation contains plasma cells, lymphocytes, and macrophages?

Answer 5

Chronic inflammation

Question 6

what are three outcomes of acute inflammation? (healing factors)

Answer 6

• resolution
• abscess
• scar

Question 7

the hydrostatic pressure of blood is normally nearly balanced by oncotic pressure of plasma proteins

Answer 7

Starling’s Law

Question 8

What are the three phases of inflammation?

Answer 8

Initiation
Amplification
Termination

Question 9

What phase of inflammation consists of changes in microvasculature, structural changes leading to extravasation and emigration of WBCs to site?

Answer 9

Initiation Phase

Question 10

Describe amplification? Phase 2 of inflammation

Answer 10

when both soluble mediators and cellular inflammatory systems are activated and amplified

Question 11

what phase is accomplished by specific inhibition or dissipation of mediators

Answer 11

Termination phase of inflammation

Question 12

What are some primary effects of inflammation?

Answer 12

vasodialation/vasoconstriction
activation of inflammatory cells
chemotaxis
cytotoxicityy (kills cells)
tissue degradation
pain 
fever

Question 13

What are the sources of inflammatory mediators?

Answer 13

cell derived ( proteins, phospholipids, mast cells, platelets)
inactive precursors in plasma

Question 14

What are:

• Vasoactive amines
• Plasma Proteins
• Kinin System ( powerful vasodialators)
• Coagulation pathway
• Fibrinolytic pathway (dissolves clots)
• Arachidonic acid metabolites
• Platelet activating factor
• Cytokines
• nitric oxide (peroxide)

Answer 14

Chemical mediators of inflammation

Question 15

what is a vasoactive amine that is abundant in mast cells that increases permeability around blood vessels?

Answer 15

Histamine

Question 16

what is a vasoactive amine that is similiar to histamine, and released after platet aggreation

Answer 16

Serotonin

Question 17

What is the most important product of the kinin system in inflammation? what does it do?

Answer 17

Bradykinin and vascular dilation and pain

Question 18

What is the vascular Reaction in inflammation

Answer 18

• immediate vasoconstriction
• clotting
• margination and diapedesis
• neutrophils and Macrophages
• vasodilation

Question 19

What stage of inflammation is when PMNs and macrophages are recruited to the site of injury by blood?

Answer 19

Apmlification

Question 20

how long is recruitement of macrophages in inflammation?

Answer 20

6- 48 hours

Question 21

what is the process of directed cell migration which is a dynamic and energy dependent?

Answer 21

chemotaxis

Question 22

what is a pivotal cell that secretes many diff molecules under various influences

Answer 22

macrophage

Question 23

what activates macrophages?

Answer 23

platelets
cytokines
fibronectin

Question 24

What can damage the host?

Answer 24

extracellular release of enzymes and activated oxygen species

Question 25

What is present in chronic inflammation?

Answer 25

``` mononuclear cells (macrophages, lymphocytes and plasma cells) ongoing inflammation causes tissue destruction ```

Question 26

What is not present in chronic inflammation?

Answer 26

neutrophils only macrophages and monocytes

Question 27

What is the clinical hallmark of inflammtion?

Answer 27

fever

Question 28

most common gram negative septicemia (bacteria in blood)

Answer 28

shock

Question 29

Types of drainage:

Answer 29

- Serous - Serosanguineous - Purulent - Dessication (scab) - Slough - Eschar - Maceration

Question 30

clear/clear yellow

Answer 30

serous

Question 31

blood tinged

Answer 31

serosanguneous

Question 32

creamy yellow, presence of neutrophiles, macrophages , pus

Answer 32

purulent

Question 33

yellow or yellow whitish

Answer 33

slough

Question 34

brown, black dead or damaged

Answer 34

eschar

Question 35

white colored healthy tissue, over hydrated

Answer 35

maceration

Question 36

What is the second stage of wound healing?

Answer 36

proliferation

Question 37

how long does proliferation usually last?

Answer 37

20 days

Question 38

what is the purpose of proliferation?

Answer 38

cover the wound and provide strength to the injury site

Question 39

What cells are involved in the proliferation stage?

Answer 39

fibroblasts, myofibroblasts and monocytes/macrophages

Question 40

Four stages of simultaneous process

Answer 40

1. Re-epitheliazation 2. collagen protection 3. wound contraction 4. neovascularization

Question 41

what provides a barrier and prevents fluid and electrolyte loss an decreases the risk of infection?

Answer 41

re-epitheliazation

Question 42

What slows down moist healing (re-epitheliazation)?

Answer 42

scars

Question 43

What occurs during the fibroblastic phase of wound healing?

Answer 43

collagen production

Question 44

What type of collagen is present in fibroblastic phase of wound healing?

Answer 44

Type III and Type I

Question 45

Compared to normal tissue how strong is the new scar?

Answer 45

70-80%

Question 46

What is the third PHASE OF HEALING?

Answer 46

Maturation/remodeling

Question 47

What type of scar is excess tissue outside the perimeter of original wound?

Answer 47

keloid

Question 48

excessive remains within perimeter of orginal wound?

Answer 48

hypertrophic