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32 Cards in this Set
- Front
- Back
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1. What are some physical causes of tissue damage?
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Incision
-Crushing -Overheating -Overcooling -Desiccation -Irradiation -Compromised blood flow |
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2. What are some chemical causes of tissue damage?
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1. Agents w/ unphysiologic pH
2. Proteases agents -disrupt protein integrity 3. Vasoconstrictors -ischemia 4. Thrombogenic agents -ischemia |
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3. What are two characteristics of epithelialization?
What cells have regenerative ability? How does proliferation occur? |
1. Has regenerative ability
2. Re-establish integrity **proliferation Germinal epithelial cells 1. Via migration 2. Via contact inhibition *chemical meditations from epithelial cell |
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4. What happens during migration?
Where does migration occur? (two places) Upon epitheliazation what happens to the blood clot (scab)? |
Free edge of epithelium migrates toward another free edge
1. Occurs across whatever vascular bed that is available 2. Occurs under a blood clot Loosened and is dislodged |
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5. What are the three stages of wound healing?
What are the two phases of the inflammatory stage? |
1. Inflammatory stage
2. Fibroplastic stage 3. Remodeling stage 1. Vascular phase 2. Cellular phase |
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6. What is the first part of the inflammatory stage?
What occurs transiently during the inflammatory stage? What are the cardinal signs of inflammation? |
Vascular phase of inflammation
Vasoconstriction 1. Erythema (rubor) 2. Swelling/Edema (tumour) 3. Warmth (calore) 4. Pain (dolore) 5. Loss of function |
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7. What is the cause warmth and edema (calore and tumour)?
What causes swelling? What cause pain? (three things) What releases them? |
Vasodilation
Swelling by transudation of fluid 1. Histamine 2. Kinin 3. Prostaglandin Released by leukocytes **pressure from edema also causes pain |
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8. What causes loss of function?
What happens after the vascular phase of inflammation? What cells dominate? |
1. Edema
2. Histamine & prostaglandin released by leukocytes Cellular phase of inflammation 1. C3a and C5a 2. Monocytes 3. Lymphocytes (B and T group) |
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9. Summarize the inflammatory stage?
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1. Blood clot formation
2. Inflammatory cells and transudated plasma 3. Epithelial margination 4. Fibroblasts from undifferentiated mesenchymal cells 5. Lag phase |
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10. What is involved in the migratory phase of the fibroplastic stage?
What happens during the migratory phase of the fibroplastic stage? |
Fibroblasts and fibrin strands
1. Tropocollogen production 2. Lay down ground substance 3. Secrete fibronectin |
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11. What happens during the proliferative phase of the fibroplastic stage?
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1. Increase epithelial thickness
2. Collagen deposition 3. Budding capillaries |
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12. What happens in the remodeling stage?
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1. Changes in collagen
2. Decrease in vascularity 3. Wound contraction |
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13. What are four factors that impair wound healing?
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1. Foreign materials
2. Necrotic tissue 3. Ischemia 4. Tension |
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14. Why do foreign materials impair wound healing?
(three reasons) What does necrotic tissue impair wound healing? (three reasons) |
1. Bacterial proliferation
2. Bacterial haven and shelter 3. Antigenic 1. Barrier 2. Protected niche 3. Nutrient source |
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15. What is ischemia?
What does this result in? |
Decreased blood supply to a wound
1. Tissue necrosis 2. Increase risk of infection 3. Delayed wounding healing |
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16. Why can tension cause impaired wound healing?
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1. Sutures can result in ischemia
2. Loss of sutures and wound re-opening 3. Sutures left in too long can cause a scar |
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17. What is healing by primary intention?
What is healing by secondary intention? What is healing by tertiary intention? What type of healing occurs at extraction socket? What is the healing sequence? |
Close approximation of wound margins
Gap between wound edges Tissue grafts over large wounds Healing by secondary intention 1. Inflammation 2. Epitheliazation 3. Fibroplasia 4. Remodeling |
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18. What happens during the first week in the healing of an extraction socket?
(four things) |
1. Inflammatory stage
2. Fibroplasia 3. Epithelial migration 4. Osteoclasts accumulate at crestal bone |
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19. What happens during the second week in the healing of an extraction socket?
(two things) What happens during the third week in the healing of an extraction socket? (three things) |
1. Granulation tissue
2. Osteoid deposition 1. Continuation of epithelialization 2. Osteoclastic activity 3. Osteoblastic activity |
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20. What occurs during bone healing?
Three things... |
1. Inflammation
2. Fibroplasia 3. Remodeling -osteoblast -osteoclast |
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21. What three factors effect repair in bone healing?
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1. Compromised immobility
2. Compromised vascularity 3. Excessive torque and tension |
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22. What happens in the early phase of the fibroplastic stage of bone repair?
(two things) What happens during the late phase of the fibroplastic stage of bone healing? (four things) |
1. Differentiation of osteogenic cells
2. Capillary budding 1. Osteoclasts 2. Osteoblast 3. Capillary ingrowth 4. Callus formation |
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23. During the remodeling stage of bone repair what two cell types are seen?
What is developed? What decreases in size? |
Osteoclasts and osteoblasts
Development of new Haversian systems Decrease in callus size |
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24. What are the two phases of nerve injury and repair?
What are three types of peripheral nerve injury? |
1. Degeneration phase
2. Regeneration phase 1. Neuropraxia -loses no continuity of axon or endoneurium 2. Axontomesis -loss of axonal continuity but preserve endonerium 3. Neurotomesis -loss of both axonal continuity and endonerium |
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25. What are the types of degeneration seen during the degenerative phase of nerve healing?
What is segmental demyelination? What happens to conduction velocity? |
1. Segmental demyelination
2. Wallerian degeneration Dissolution of myelin sheath in isolated segment Slowing of conduction velocity **transmission of nerve impulses prevented |
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26. What are two causes of segmental demyelination?
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1. Neurapraxic injuries
2. Vascular or CT disorders |
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27. What are four symptoms of segmental demyelination?
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1. Paresthesia
2. Dysesthesia 3. Hyperesthesis 4. Hypoesthesia |
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28. What is paresthesia?
What is dysesthesia? What is hyperesthesia? What is hypoesthesia? |
Non painful subjective altered sensation
Painful subjective altered sensation Excessive sensitivity when nerve is stimulated Decrease sensitivity when nerve is stimulated |
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29. What happens in Wallerian degeneration?
Two things... Where is there no nerve conduction? When does Wallerian degeneration occur? |
1. Axons distal to nerve trunk undergo complete disintegration
2. Axons proximal to nerve trunk (CNS) undergo some degernation No nerve conduction distal to proximal stump Occurs upon transsection and other destructive processes that affect peripheral nerves |
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30. When can nerve regeneration begin?
During regeneration where are new fibers sent out from? How do new fibers grow? |
Almost immediately after injury
Proximal nerve stump sends out new fibers Growth cone grows down the remnant schwann cell tube |
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31. At what rate does nerve growth occur?
How far does growth continue for? |
Growth occurs at rate of 1 to 1.5 mm per day
Growth continues to nerve end or if there is blockage - random branching neuroma |
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32. When is microneurosurgery necessary?
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1. External or internal nerve compression
2. Intentional or accidental severance of a nerve 3. Appearance of traumatic neuroma and/or pain syndromes after nerve injury |
