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Spicer Ex1 Repair

Repair and recovery for Exam 1, Pathology, Spicer, Bastyr

Define Repair: body’s collective attempt to restore homeostasis (normal A & P)
What are the general processes of Repair? Regeneration, Healing
Describe Regeneration: REGENERATION: regrowth of parenchyma (function) & stroma (structure); not much scarring; usually follows mild injury.
Describe Healing: HEALING: broad term which implies regeneration is partial/not possible; fibrous repair = scarring
In which repair process is repair partial, and comes with scarring? Healing
What are the three types of cells that need to be repaired Labile, Stable, Permanent
Describe the repair process of LABILE cells: LABILE: capable of regeneration; short life span; replaced from stem* cells Ex: bone marrow, intestinal/bronchial/skin epithelium
Describe the repair process of STABLE cells: STABLE: capable of regeneration but longer life span with slower reproductive cycle; in protected areas & very metabolically active. Ex: liver, kidney cells
Describe the repair process of PERMANENT cells: PERMANENT: cannot regenerate; terminally differentiated & cannot reproduce. Ex: cardiac & skeletal muscle, neurons (note: loss of permanent cells is usually a big deficit for the body)
What are Tissue structures are necessary for the internal support of for repair? Basement Membrane and Extracellular Matrix
Define Basement Membrane? Basement membrane: provides surface for epithelial cells to regrow
Define Extracellular Matrix? Extracellular matrix (ECM): Collagen elastic fibers create structural support, Use growth factors to enhance healing. Ex: Epidermal GF. Vascular endothelial GF.
What happens if you damage Basement Membrane or Extracellular Matrix? Basement membrane and ECM provide scaffold for regrowth and remodel to redevelop normal anatomy and function. If they are not functioning correctly, tissue may not return to normal function.
How do Cells regenerate? GENES code for growth factors; cells respond by mitotic activity. Ex: epidermal growth factor, vascular endothelial growth factor. ECM influences action of growth factors and related hormones.
If the basement membrane and ECM are damaged, Are cells receiving signal to grow? No. The Basement Membrane and ECM have to be repaired, or the signal has to come from somewhere else, (Scarring) for there to be regeneration.
Define Wound: Wound = injury resulting from short term injury at a discrete site Ex: surgical incision (major) –vs- scratch on skin (minor)
Define Fibrous repair: Scars form when damage is extensive.
What are the fundamentals of Wound Healing? 1. Cell migration into wound: neutrophils, fibroblasts, macrophages, clotting factors, exudate, 2. Growth of new blood vessels: angioneogenesis 3. Scar development a. Fibroblasts: GRANULATION TISSUE b. ECM deposition c. Maturation phase
Describe Angionegenesis: Growth of new blod vessels, capillaries, into the wound.
What are the four steps of Angioneogenesis? 1) Normal 2) Dissolution of Basement Membrane 3) Migration and proliferation of angioneoblastic endothelial cells 4) organization of new capillary branch
Describe Similarities and differences of First intention and second intention.: Healing by 1st intention: ex: straight, clean surgical incision Healing by 2nd intention: ex: lots of necrotic tissue, wider wound, as in ulcers, infarcts, abscesses, jagged wound margins due to trauma
Describe Abnormal wound healing: Abnormal wound healing is impaired healing due to local/systemic factors, or an abnormal (pathologic) repair process (diabetics are notoriously slow at healing, which is why even minor wounds can be very serious.)
What are Host factors interfering with wound healing? Infection: Most frequent Poor nutrition Steroids: Make fibroblast sluggish. Poor blood supply (diabetics) Foreign bodies, metal fragments and debris. Mechanical factors
What is a wound rupture? DEHISCENCE. wound rupture occurs most often in abdominal wounds which are under tension due to normal movements.
What is ulceration? Ulceration: wound surfaces not covered by epithelium will not heal properly.
Describe Pathologic wound healing: wound repair creates a problem, rather than solves it.
Describe KELOID? Pathologic wound healing. A KELOID is hyperplasia of epithelial tissue, creating a large “lump” of excess collagen. They look cancerous, but are not.
Describe Excess granulation tissue: localized, highly vascular area of persistent granulation tissue – looks worse than it is. Indicates a repair process which is “stuck” in the vascular stage.
Created by: Bastyr40



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