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HealingPart1
| Question | Answer |
|---|---|
| response to injury is a phylogenetically primitive, yet essential innate host response for restoration of _____ | tissue integrity |
| the body's ability to replace injured/dead cells and repair tissue after injury is critical to ______ | survival |
| ______are critical for the maintenance of normal structure and function | repair processes |
| _______(regeneration or repair) occurs after any insult that causes tissue destruction | healing |
| healing occurs via ______and ______ | regeneration and repair |
| complete restoration | regeneration |
| only some of the normal issue is restored and is a combo of regeneration and scar tissue formation | repair |
| proliferation of cells and tissues to replace lost structures | regeneration |
| true regeneration in _____and ____ such as tails and limbs | amphibians and reptiles |
| hyperplasia and or hypertrophy in some organs following resection | compensatory growth (seen in liver and kidney) |
| these cell types can regenerate | bones, skin, hematopoetic stem cells |
| is a proliferative response that "patches" a tissue injury site/is a tissue respounse to a wound/is a tissue response to aninflammatory process in an internal organ/is a tissue response to cell necrosis in organs incapable of regerneration | healing by repair |
| disruption of normal anatomical structure and function | wound |
| some tissues can regain near normal strength and function following an injury | broken bone and minor skin wounds |
| while parenchymal cells will divide to replace those that were lost, repair is ultimately accomplished by replacing some parenchymal cells with connective tissue or scar formation | tendon injury |
| dense fibrous connective tissue holding bowls together, consequence of inflammation in a body cavity | adhesion |
| fibrous connective tissue reconstruction | fibrosis-deposition of collagen |
| growth of new blood vessels | angiogenesis |
| hyperplastic regeneration of epithelium | epithelialization/re-epithelialization |
| in adult tissues, the ____of cell populations is determined by rates of cell proliferation, differentiation and death by apoptosis | size |
| mature cells in the body have differing abilities to re-initiate cell division->_____moves cell from quiescent phase back into cell division | gene transcription |
| _______is maintained between proliferation of stem cells, cell differentiation and cell dath | homeostatic equilibrium |
| ____contain cells that divide continually thoughout life | labile cell populations |
| skin epithelium/lining epithelium of mucosal ducts and glands/columnar epthilelium-GIT and uterus/hematopoetic and bone marrow cells | examples of labile cell populations |
| ______normally have a low level of replication of cells | stable cell populations or quiescent cells |
| parenchymal cells of most organs, endothelial cells, fibroblasts, smooth muscle, osteoblasts, chondrocytes, lymphocytes | retain ability to undergo rapid division in response to stimuli-stable cell examples |
| ________cell populations contain cells that cannot undergo mitotic division in postnatal life | non-dividing, permanent |
| neurons, cardiac myocytes, skeletal muscle myocytes | pemanent cells |
| _____are genes present in normal cells that regulate cell growth | proto-oncogenes |
| mutation in a proto-oncogene that prevents unrestricted growth or loss of control of growth | oncogene |
| replication of cells is stimulated by growth factors or by signaling from ECM components via | integrins |
| the ______has multiple controls and redundancies, including activators, inhibitors, and checkpoint mutations | cell cycle |
| resting phase, presynthetic | G1 |
| DNA synthesis phase | S |
| premitotic phase | G2 |
| mitosis | M |
| quiescent cells that have not entered the cell cycle | G0 |
| important enyzmes in regulation | cyclins and cyclin-dependent kinases |
| to enter the cycle, quiescent cell must go from ___ to ___ | G0, G1 |
| gateway to cell cycle, requires transcription of many genes, especially proto-oncogenes | G0 to G1 |
| if cell passes this point, it is irreversibly committed to DNA replication | G1/S restriction poin |
| DNA is checked before replicaiton | G1/S checkpoint |
| checks DNA after replication and monitors whether cell can safely enter mitosis/checkpoint activation triggers DNA repair mechanisms | G2/M checkpoint |
| activated if DNA is defective and cannot be repaired | P53 gene |
| triggers apoptosis in cell, cell enters non-replicative state called senesence | P53 gene |
| The injured tissue can only return to a normal functional status if the ______of the basement membranes and _____remains intact | architecture, ECM |
| The newly generated parenchymal cells must be able to _____, ______, and ____with other cells in a normal manner in order to establish normal function | migrate, orient themselves, establish connections |
| polypeptides that act as ligands that bind to specific cellular receptors | growth factors |
| growth factors deliver _____to target cells to turn on genes to initiate cell cycle entry and progression | signals |
| advances in knowledge of cell biology have ushered in a new field of science | regenerative medicine |
| pluripotent, can become any cell (ectoderm, mesoderm, endoderm) | embryonic stem cells |
| multipotent, can differentiate into a limited number of cell types, exist in niches | adult stem cells, mesenchymal cells |
| when stem cells divides into a new stem cell and a differentiated cell | obligatory asymmetric replication |
| mesenchymal stem cells are located in niches and in the bone marrow | developmental plasticity |
| balance maintained between pools containing stem cells and cells that with differentiate | stochastic differentiation |
| ______contains stem cells with remarkable ability to differentiate into other types of cells | bone marrow |
| a change in lineage commitment of a stem cell is called _____ | transdifferentiation |
| in adult animals, the special microenvironments in which stem cells reside are called _____ | niches |
| the source of embryonic stem cells is the inner cell mass of the _____ | blastocyst |
| differentiated cells can become IPS cell | induced pluripotent stem cell |
| located in bulge of hair follicle, sebaceous glands and lower layer of epidermis | skin stem cells |
| located near the base of crypt above Paneth cells | small intestine stem cells |
| at the limbus | cornea |
| 1.place diploid nucleus of adult cell into an enucleated oocyte. ES cells are obtained from dissociation of the blastocyst 2.generate iPS cells from patient by transducing with genes encoding ES cell transcription factors | stem cell therapy with 2 routes |
| can generate all blood cells, chondrocytes, osteoblasts, adipocytes, endothelial cells, myoblasts | hematopoietic stem cells |
| can reconstitute bone marrow after irradiation | hematopoietic stem cells |
| multipotent adult progenitor cells | marrow stromal cells |
| can differentiate into many different cell types and are similar to tissue stem cells, may be their progenitors | marrow stromal cells |
| cell proliferation can be stimulated by physiologic conditions | pregnancy and hormones |
| cell proliferation can be stimulated by pathologic conditions | tissue injury, necrosis, excessive hormone production |
| ______is controlled by signals from the micro-environment (stimulatory or inhibitory) | cell proliferation |
| ______bind to specific receptors on target cells | growth factors |
| cell responds to signaling molecule that it secretes | autocrine |
| one cell produces a ligand that acts upon adjacent target cell | paracrine |
| hormones and cytokines synthesized by cells act on distant target cells | endocrine |
| forms the space between cells, secreted locally | ECM |
| sequesters water and minerals in tissues/reservoir for growth factors that stimulate cell proliferation/provides a substratum for cells where they can adhere, migrate and proliferate | extracellular matrixfunctions |
| composed of basement membrane and interstitial matrix fibrous structural proteins(collagen and elastins), adhesive glycoproteins, proteoglycans and hyaluronic acid | ECM |
| ______is synthesized by epithelial cell and mesenchymal cell | basement membrane |
| _____provides the extracellular framework for all organs and tissues | collagen |
| _____provide elasticity (blood vessels, tubular organs) | elastins |
| _____into interstitial matrix and basement membrane | assemble |
| most common protein in the animal world, forms a triple helix structure, synthesis of procollagen in cell requires vitamin C, procollagen->collagen | collagen |
| synthesis of procollagen in cell requires | vitamin C |
| cross-linking between chains of adjacent molecules gives collagen its _______ | tensile strength |
| produced by platelets and macrophages/induces activation and migration of fibroblasts and synthesis of collagen/induces synthesis of ECM components/promotes angiogenesis | TGF-B |
| If TGF-B levels are too high in a wound | excessive scar tissue formation |
| injured/lost cell is capable of division/structural framework intact | requirements for regeneration |
| extracellular matrix framework is damaged;fibrosis disrupts architecture of tissue/permanent cells are damaged and they cannot divide to replace cells lost to injury | healing with collagen deposition (scar) |
| any abnormal deposition of connective tissue | fibrosis |
| frequently associated with chronic inflammation, in which tissue damage and repair are proceeding concurrently | fibrosis |
| fibroblasts secrete collagen and proteoglycans in response to TGF-B/fibroblasts align themselves parallel to tension stress lines in the tissue/myofibroblasts form within the wound/myofibroblasts contract, pulling the tissue edges back into appososition | fibrosis |
| formation of new blood vessels | neovascularization |
| proteolysis of ECM & basement membrane form capillary bud/migration of immature endothelial cells/endothelial cell proliferation form tubes/maturation of immature endothelial cells form capillaries lined w/ mature cells | angiogenesis |
| establishment of inter-endothelial cell gap junctions/recruitment of pericytes | angiogenesis |
| new blood vessels can form by ingrowth of surviving endothelial cells at the margin of the wound or by recruitment of endothelial progenitor cells from bone marrow | angiogenesis |
| chronic inflammation and fibrosis/tumor growth/ischemic tissue injury | importance of angiogenesis |
| Vascular endothelium growth factor | VEGF |
| VEGF, tissue hypoxia | growth factors for angiogenesis |
| mast cells and mesenchymal cells | VEGF source |
| _____is released during remodeling of collagen, and it inhibits angiogenesis | endostatin |
| specialized tissue that is the hallmark of healing | granulation tissue |
| characterized grossly by pink, soft, granular appearance on the surface of a wound | granulation tissue |
| characterized microscopically by formation of new capillaries (angiogenesis) and proliferation of fibroblasts | granulation tissue |
| stop blood loss and seals the opening | coagulation |
| get rid of cause of injury and necrotic debris | inflammation |
| reform the cutaneous barrier | re-epithelialization |
| form a temporary barrier to protect from hostile environment | granulation tissue and angiogenesis |
| replace injured/lost tissue with collagen | matrix production and scar formation |
| scar formed, collagen remodeled | remodeling phase |
| emigration of fibroblasts & proliferation at the site of injury/deposition of ECM/tissue remodeling | 3 processes involved in scar formation |
| ____from capillary sprouts also increases vascular permeability | VEGF |
| ____deposited locally from plasma | fibrinogen |
| _______secrete cytokines that promote fibroblast migration, especially TGF-B | macrophages, activated platelets, other leukocytes and endothelial cells |
| produced by most cells in granulation tissue including macrophages, endothelial cells, platelets, and lymphocytes | TGF-beta |
| causes fibroblast migration and proliferation, increased synthesis of collagen, and decreased degradation of ECM by MMPs(matrix metalloproteinase=degrades ECM)/chemotactic for monocytes | TGF-beta |
| fibroblasts deposit ECM & collagen/growth factors and cytokines(TGF-B & interleukins) increase collagen synthesis/net collagen accumulation is due to both increased synthesis & decreased degradation | ECM deposition and scar formation |
| As the scar matures, ____continues until a pale, avascular scar remains | vascular regression |
| granulation tissue is replaced with a ____ | scar |
| degradation of collagen and ECM proteins is accomplished primarily by ____which are Zn-dependent enzymes | matrix matallo-proteinases (MMPs) |
| hemostasis/acute inflammations/proliferation(granulation and epithelialization)/remodeling(maturation and contraction) | temporal phases of cutaneous wound healing |
| wounds have opposed edges/clean, un-infected surgical incision/limited amount of tissue damage/small amounts of granulation tissue formed, and limited amount of wound contractions occurs | healing by first intention/primary wound healing |
| rapid repair/24hrs-clot formed,PMNs@margin&mitotic activity in basal epithelial cells/Day3-macrophages dominate,granulation tissue&collagen synthesis,epithelial cells migrate over surface/Day5-granulation&angiogenesis peak,surface epithelium@normal thick | healing by 1st intention |
| Day14-fibroplasia and wound contraciton | healing by 1st intention |
| wound has separated edges, surface wound that creates a large defect | healing by 2nd intention |
| larger fibrin clot, more necrotic debris=more intense inflammatory reaction | larger defect |
| larger amounts of granulation tissue formed/extensive, permanent contraction of wound occurs | healing by 2nd intention, secondary wound healing |
| nutrition, metabolic status of patient, circulatory status, hormones | systemic factors that inhibit wound healing |
| infection, mechanical factors, lack of circulation, foreign bodies, size, location, and type of wound | local factors that inhibit wound healing |
| protein and vitamin C needed for collagen synthesis, Zn for MMPs | nutrition |
| diabetes mellitus delays healing | metabolic status of patient |
| inadequate blood supply delays healing | circulatory status |
| glucocorticoids inhibit both inflammation and collagen synthesis | hormones |
| causes persistent tissue injury and inflammation; most important cause of delayed healing | infection |
| excessive motion can separate wound edges and compress blood vessels; persistent trauma; pressure on wound surface | mechanical factors |
| decubitus ulcer, bed sore, pressure sore | lack of circulation |
| impede removal of debris from the tissue | foreign bodies |
| in-well vascularized areas, healing occurs quickly | size, location, and type of wound |
| ____heals faster than ____or ____caused by blunt trauma | small incision and large wound/wound |
| inadequate formation of granulation tissue or assembly of a scar/excessive formation of components of the repair process/excessive fibrosis | complications of cutaneous wound healing |
| wound bursts/opens/incusions ruptured | wound dehiscence |
| exuberant granulation | proud flesh |
| abdominal organ pertrusion thru incision | evisceration |
| excessive formation of fibrous connective tissue is called | schirrous reaction |
| contraction causes deformity (bands of contraction) | contracture |
| joint movement and organ function is compromised | contracture |
| in parenchymal organs, contraction of bands of fibrous connective tissue disrupts organ architecture which leads to | end stage organ failure |
Created by:
sniezek2