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125 Cards in this Set
- Front
- Back
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Most important factor in determining whether or not a tissue will be repaired?
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Regenerative capacity of the tissue
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Replacement of dead or damaged tissues by new healthy tissues is called?
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Repair
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What is the best type of repair?
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Resolution
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Define Resolution
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Removal of tissue debris and inflammatory cells, drainage of fluid, and mild proliferation of intact parenchymal cells
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Regeneration is repair by (same/different) cell types as those destroyed
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Same
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Alcoholic develops cirrhosis and Myocardial infarction are examples of what?
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Organization
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Define Labile Cell
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Cells that are continually dividing (regenerating) to replace dying cells
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Where are Labile Cells derived from?
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Stem cells, which posses a high capacity to divide
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Where are some labile cells located?
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Hematopoietic cells, surface epithelia, epithelium of skin, oral cavity, cervix, vagina, endometrium, respiratory passages, GI tract, and urinary tract
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What phase are stable cells located in?
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G0 phase (do not show active proliferation but divide when actively stimulated)
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Stable cells are in?
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Parenchymal and Mesenchymal
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What are permanent cells?
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Nondividing cells that are unable to reproduce because they cannot undergo mitosis
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What cells are found in mature neurons and mm cells?
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Permanent cells
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What are glial cells an example of?
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Permanent cells
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What may happen if you have a severe enough insult (injury) that destroys the stromal framework and basal lamina?
What is an example? |
The regenerating cells grow in a haphazards fashion and the normal histoligic architecture is not maintained.
Ex: Cirrhosis |
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What are 2 things that are important in guiding the regenerating cells to reconstruct the same histologic architecture?
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The reticulin stromal framework and The basal lamina
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What phase is the DNA synthetic phase?
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S phase
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What phase is the resting or quiescent phase?
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G0 phase
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What phase is the premitotic phase and mitosis?
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G2 phase
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What phase is the presynthetic phase?
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G1 phase
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What cells leave the cycle and never divide again?
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Permanent Cells
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What are quiescent G0 cells that are NOT ACTIVE but that can be recruited into the cycle by certain stimuli
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Stable Cells
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Chemical substances, usually polypeptides, that stimulate cellular growth
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Growth Factors
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Where are Epidermal Growth Factors EGF's present?
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In Secretions and fluids
Ex: Saliva |
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Where are Platelet-derived growth factors present?
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In platelet alpha granules, endothelial cells, smooth mm, macrophages and some tumor cells
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What induces proliferation as well as migration of monocytes, fibroblasts, and smooth mm?
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Platelet-derived growth factor
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What do Transforming Growth Factor do?
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Growth factor for many epithelial cells that help repair by stimulating fibroblast, chemotaxis and production of collagen and fibronectin; also inhibits collagen breakdown
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Whats the deal with Fibroblast Growth Factors?
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Acidic type is found in neural tissues, basic type is found present in many organs and promotes angiogenesis
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What are cytokines?
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they are macrophage derived growth factors
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What are IL-1, TNF and integrins classified as?
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Cytokines
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What can promote the proliferation of fibroblasts?
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Cytokines (IL-1, TNF, and integrins)
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What stimulates bone marrow formation?
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Colony stimulating factors
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What are some examples of Colony Stimulating factors?
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Granulocyte and Macrophage CSF
Especially in leukemia and bone marrow transplantation regimens |
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Explain the process of Ligand-Receptor Binding and Activation
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The growth factor (ligand) unites with its specific receptor located on cell surface (intracellulary in steroid receptors) and creates a ligand-receptor complex
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What is the latter process after the creation of the ligand-receptor complex?
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The latter stimulates tryosine kinase, which in turn activates the protein phosphorylation cascade, ultimately moving the quiescent cell into the growth cycle
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What are the 2 functions of the allosteric protein receptor?
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Bind to ligand
Activate membrane cascade effect |
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What pathway does P13 Kinase go with?
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MAP-kinase pathway
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What pathway goes with JAK
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JAK/STAT pathway
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What pathway goes with G protein?
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cAMP pathway
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Collagen type found in the IVD
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Collagen type IX (9)
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What type of collagen is Strong mature collagen?
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Type I Collagen
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What type of collagen is cartilage, vitreous humor?
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Type II Collagen
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What type of collagen is thin, immature collagen?
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Type III Collagen
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What type of collagen is basement membranes?
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Type IV Collagen
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What type of collagen is fine fibrils?
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Type V Collagen
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What type of collagen is dermal-epidermal junctions?
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Type VII Collagen
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Collagens are composed of ?
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a triple helix of 3 polypeptide alpha chains
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What holds together the alpha chains?
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Hydroxyproline
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What type of collagen does hydroxyproline create?
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Creates procollagen
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How does hydroxyproline work in holding together of alpha chains?
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Proline hydroxylation needs vitamin C, procollagen is then released outside the fibroblast
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What leads to crosslinking of alpha chains and renders the collagen molecule structurally stable?
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Extracellular Lysyl hydroxylysyl Oxidation
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What is caused by an absence of Vitamin C?
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Scurvy
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Links components of the ECM together and to the cells?
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Glycoproteins
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What is a large glycoprotein formed by fibroblasts and endothelial cells?
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Fibronectin
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What is fibronectin involved in and where are they found?
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Involved in the attachment and migration of cells (inflammatory cell)
Present along cell surface and basement membrane |
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What is the most common glycoprotein in basement membranes?
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Laminin
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What does Laminin do?
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It binds ECM components (ex: collagen) to specific cell surface receptors and assists in capillary tube formation in angiogenesis
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What's bound to or with hydroxyapatite and calcium?
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Osteonectin
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What is Osteonectin?
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Type I collagen in the bone matrix and can initiate osteoid mineralization
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What has to do with transmembrane glycoproteins?
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Integrins
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What does integrins signal and how does it happen?
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With extracellular and intracellular domains, the intracellular domain adheres to cytoskeletal elements.
Signals the attachment and locomotion |
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What binds to chondrocytes to type II collagen
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Chondronectin
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Where is chondronectin located?
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In the cartilage matrix
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What is red, granular soft tissue that cover wound surfaces?
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Granulation Tissue
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Is granulation tissue highly resistant to infection?
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Yes, it bleeds easily and it is made up of newly formed capillaries, fibroblasts, and collagen bundles
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What is Angiogenesis?
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The process by which new capillaries are formed
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What are the 5 steps to angiogenesis?
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1) It starts by degradation of the basement membrane of the parent vessel (proteolysis of ECM)
2) Migration of endothelial cell and chemotaxis 3) Proliferation 4) Luman formation, maturation, and inhibition of growth 5) Increased permeability through gaps and transcytosis |
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What are the 2 factors that induce angiogenesis?
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FGF and VEGF
Fibroblast growth factor and Vascular endothelial growth factor |
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What does primary intention involve?
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Involves the healing of a clean incised surgical wound
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What does the secondary intention involve?
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Intention occurs in unclean, infected, or traumatic wounds
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How does secondary intention differ from primary intention?
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Differs from healing between first intention quantitatively but not qualitatively
Ex: same process occurs but with excessive scarring |
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What is an ulcer?
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Loss of surface epithelium
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What is a fistula?
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Tract is open at both ends
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What is it when a tract is open only at one end?
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Sinus
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Excessive collagen deposition forms?
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a Keloid
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What has excessive granulation tissue formation and creates a protruding red fleshy mass?
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Exuberant
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What is a painful nodule created by schwann cell hyperplasia and nerve fiber growth after nerve injury or amputation?
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Traumatic neuroma
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What is fibromatosis?
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The aggressive proliferation of fibrous tissue with characteristic local invasion
Ex: Desmoid tumor |
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What do Vit. C, drugs, mechanical factors, and infection affect?
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Affect tissue repair
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What delays healing?
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Infection
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What do corticosteroids affect?
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Affect collagen formation
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Within nutrition what does a deficiency in protein and vitamin C lead to?
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Inhibition of collagen synthesis
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What might cause a noninfective granuloma?
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Foreign bodies: Talcum powder or suture material may create a noninfective granuloma and delay healing
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Is thrombosis normal or pathogenesis?
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Pathogenesis
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Thrombosis is the pahogenesis hematological response to?
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To maintain blood in a vessel
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What is another name for a blood clot?
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Thrombus
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3 general components that regulate hemostasis and thrombosis?
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1) vascular wall
2) platelets 3) coagulation cascade |
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First thing to occur after injury to a blood vessel?
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Vasoconstriction
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Von Willebrand Factor activates?
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Activates platelets making them sticky
(They adhear to exposed ECM) |
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Local activation of the coagulation cascade leads to?
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Fibrin polymerization
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What is fibrin polymerization?
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"cementing" the platelets into a definitive secondary hemostatic plug
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2 counter-regulatory mechanisms that limit the formation of blood clots?
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1) Tissue type plasminogen activator (t-PA)(Fibrinolysic)
2) Thrombomodulin (interferons, with the coagulation cascade) Limit the hemostatic process to the site of injury |
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Platelets central role?
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Normal hemostasis
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How do platelets affect hemostasis?
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After vascular injury, they encounter ECM constituents that are normally sequestered beneath an intact endothelium;
Including collagen (most important), proteoglycans, fibronectin and other adhesive glycoproteins |
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3 general reactions that platelets undergo upon contact with ECM?
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1) Adhesion and Shape change
2) Secretion (release reaction) 3) Aggregation |
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The coagulation cascade is a series of?
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enzymatic conversions
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What does the enzymatic conversions do?
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Turns inactive proenzymes into activated enzymes and culminate in the formation of thrombin
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Once Thrombin is formed because of the enzymatic conversions what happens?
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Thrombin converts the soluble plasma protein fibrinogen precursor into the insoluble fibrous protein fibrin
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What converts fibrinogen into fibrin?
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Thrombin
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What factor is a link between the intrinsic and extrinsic pathways of the clotting cascade?
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Factor IX - linking
(Factor XII is for Hageman factor) |
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Which pathway involves tissue factor?
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Extrinsic
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Extrinsic pathway?
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A cellular lipoprotein exposed at sites of tissue injury
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Intrinsic Pathway?
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Pathway may be initiated in VITRO by the activation of Hageman factor (factor XII)
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What activates antithrombin III
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Binding to Heprin on endothelial cells
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3 natural anticoagulants the restrict the coagulation cascade to local areas?
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1) Antithrombin (III)
2) Proteins C and S 3) TFPI (Tissue Factor Pathway Inhibitor) |
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What is involved primarily in the fibrinolytic cascade?
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Plasmin
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What resulting product of the fibrinolytic system can also act as weak anticoagulants?
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FSP (fibrin split products)
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Clinical uses for FSP
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-Diagnostic help for abnormal thrombotic state (ex: Disseminated Intravascular Coagulation (DIC)
-Deep Venous Thrombosis -Pulmonary Thromboembolism |
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What is Hydrothorax?
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Fluid in thorax
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What is Hydropericardium?
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Fluid around the heart
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What are the Ascites (hydroperitoneum)
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Fluid in the abdomen
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What is Hematoma
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Blood in mm tissue
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What is Hemarthrosis?
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Blood in joints
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Anasarca is?
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Severe generalized edema
-with profound subcuatneous tissue swelling |
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IS Hyperemia and (active/Inactive) process?
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Active process from increased input into a tissue resulting in local increase in blood volume in a tissue
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Congestion is and (active/passive) process from decreased outflow from a tissue resulting in local increase in blood volume in a tissue
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Passive
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What pressure balances the blood hydrostatic pressure the most?
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Plasma Colloid pressure
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What law states the hydrostatic pressure of the blood is normally nearly balanced by the oncotic pressure of plasma proteins
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Starlings Law
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Edema is a result of what 2 things?
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1) Increase Hydrostatic pressure
2) Decrease osmotic pressure |
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Liver cirrhosis may manifest as?
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Reduced osmotic pressure, and lymphatic obstruction
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Disease that is most likely to cause lymphatic obstruction
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Filiarisis
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What is Filiarisis?
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Can cause extensive inguinal lymphatic and lymph node fibrosis.
Result can be elephantiasis |
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What do patients with CHF you check for
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Retain salt and water
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Decreased CO, Increased Capillary pressure, and Decreased Renal perfusion are all?
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Manifestations of CHF
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Non-inflammatory edema is normally not vascular and derives the oncotic pressure and can be associated with
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Nephrotic syndrome
(Ex: Capillary wall becomes leaky) |
