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PA: Healing

What is regeneration? Restoring tissue; new tissue is IDENTICAL to old tissue in structure and function
What is repair? Fibrous scar formation; normal structure, BUT function is altered
What is ideal healing? New tissue identical to old
What is acceptable healing? Almost normal structure, but less than optimal function
What is minimal healing? Minimal normal structure and partial function
What is failed healing? Abnormal structure and function
What is an example of failed healing? Articular cartilage (once it's gone, it's gone)
What are the four key successive phases of healing? Hemostasis Inflammatory Proliferative Remodeling/maturation
What is the hemostasis phase? Stopping of bleeding, body's emergency response to form blood clots, lasts seconds to minutes, may form hematoma
What is the inflammatory phase? Wound cleaned of debris
What are the 5 signs of inflammation? Redness Swelling Increased temperature Pain/tenderness LOF
What are the two categories of the proliferative phase? Fibroplasia Angiogenesis
What is fibroplasia? Formation of new scar tissue
What is angiogenesis? Formation of new blood vessels
What is the remodeling/maturation phase? Fibers align correctly and increase in strength (~300 days)
What is the initial response after injury? Vasoconstriction followed by vasodilation
What are some positive edema consequences? Dilute harmful substances Bring in O2 and other nutrients Lets clotting proteins in
What are some negative edema consequences? Compression in the vicinity, which then pushes on nerves eliciting pain Compression further disallow venous and lymphatic drainage
What is margination? Leukocytes come in contact with endothelium and adheres to it
What is diapedesis? Passage of leukocytes through capillary walls
What is chemotaxis? Calling neutrophils to the area
When do neutrophils arrive after an injury? Appear within one hour of injury, secondary to injured cells releasing leukocytosis inducing factors
When do monocytes appear? 2-4 days after injury
What do monocytes transform into? Dendritic cells and macrophages
What do macrophages do? Remove dead cells and debris
When do lymphocytes appear? ~5 days post injury
What is different about chronic inflammation compared to acute inflammation? Chronic inflammation does not present with the cardinal signs of inflammation
What are 4 important things regarding inflammatory chemicals Histamine Kinin Prostagladin Complement system
What does histamine do? Vasodilation Increases capillary permeability
What do kinins do? Vasodilation Major pain causing chemicals
What do prostagladins do? Sends danger message
What does the complement system do? Enhances defense
What are the components of repair phase of wound healing? Granulation Fibroplasia Angiogenesis Re-epithelialization
What does granulation tissue do? Reduced edema
What type of tissue is indicative of normal healing? Granulation tissue
How soon does type III collagen start forming after an injury? 2 days
What type of collagen (I or III) is unorganized and has poor strength? Collagen (Type III)
What are the three stages of the remodeling phase? Collagen conversion Wound contraction Scar formation
What is the tissue breaking strength when compared to pre-wound values? Never throught to exceed 80%
What is necessary for collagen cross-linking to occur? Oxygen
What is wound contraction? Process that closes wound after tissue loss
What are the main effector cells for wound contraction? Myofibroblasts
What is scar formation associated with? Wound contraction
How many stages make up scar formation? 4 stages
Characteristics of Stage I of scar formation 2-4 days post injury Type III collagen Prone to tear
Characteristics of Stage II of scar formation 5-21 days post injury Type III converted to type I collagen Less likely to tear MOST receptive to intervention
Characteristics of Stage III of scar formation 21-60 days post injury More fibrous and strong Decreased response to intervention
Characteristics of Stage IV of scar formation 60 days post injury Scar maturation Final appearance Unresponsive to treatment, surgical intervention considered
What is the difference between hypertrophic and keloid scars? Hypertrophic scars do not extend outside of the wound bed Keloid scars typically extend outside of the wound bed and are typically seen in Asian and African populations
Created by: 1185240090
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