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125 Cards in this Set

  • Front
  • Back
Most important factor in determining whether or not a tissue will be repaired?
Regenerative capacity of the tissue
Replacement of dead or damaged tissues by new healthy tissues is called?
What is the best type of repair?
Define Resolution
Removal of tissue debris and inflammatory cells, drainage of fluid, and mild proliferation of intact parenchymal cells
Regeneration is repair by (same/different) cell types as those destroyed
Alcoholic develops cirrhosis and Myocardial infarction are examples of what?
Define Labile Cell
Cells that are continually dividing (regenerating) to replace dying cells
Where are Labile Cells derived from?
Stem cells, which posses a high capacity to divide
Where are some labile cells located?
Hematopoietic cells, surface epithelia, epithelium of skin, oral cavity, cervix, vagina, endometrium, respiratory passages, GI tract, and urinary tract
What phase are stable cells located in?
G0 phase (do not show active proliferation but divide when actively stimulated)
Stable cells are in?
Parenchymal and Mesenchymal
What are permanent cells?
Nondividing cells that are unable to reproduce because they cannot undergo mitosis
What cells are found in mature neurons and mm cells?
Permanent cells
What are glial cells an example of?
Permanent cells
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
What are 2 things that are important in guiding the regenerating cells to reconstruct the same histologic architecture?
The reticulin stromal framework and The basal lamina
What phase is the DNA synthetic phase?
S phase
What phase is the resting or quiescent phase?
G0 phase
What phase is the premitotic phase and mitosis?
G2 phase
What phase is the presynthetic phase?
G1 phase
What cells leave the cycle and never divide again?
Permanent Cells
What are quiescent G0 cells that are NOT ACTIVE but that can be recruited into the cycle by certain stimuli
Stable Cells
Chemical substances, usually polypeptides, that stimulate cellular growth
Growth Factors
Where are Epidermal Growth Factors EGF's present?
In Secretions and fluids
Ex: Saliva
Where are Platelet-derived growth factors present?
In platelet alpha granules, endothelial cells, smooth mm, macrophages and some tumor cells
What induces proliferation as well as migration of monocytes, fibroblasts, and smooth mm?
Platelet-derived growth factor
What do Transforming Growth Factor do?
Growth factor for many epithelial cells that help repair by stimulating fibroblast, chemotaxis and production of collagen and fibronectin; also inhibits collagen breakdown
Whats the deal with Fibroblast Growth Factors?
Acidic type is found in neural tissues, basic type is found present in many organs and promotes angiogenesis
What are cytokines?
they are macrophage derived growth factors
What are IL-1, TNF and integrins classified as?
What can promote the proliferation of fibroblasts?
Cytokines (IL-1, TNF, and integrins)
What stimulates bone marrow formation?
Colony stimulating factors
What are some examples of Colony Stimulating factors?
Granulocyte and Macrophage CSF
Especially in leukemia and bone marrow transplantation regimens
Explain the process of Ligand-Receptor Binding and Activation
The growth factor (ligand) unites with its specific receptor located on cell surface (intracellulary in steroid receptors) and creates a ligand-receptor complex
What is the latter process after the creation of the ligand-receptor complex?
The latter stimulates tryosine kinase, which in turn activates the protein phosphorylation cascade, ultimately moving the quiescent cell into the growth cycle
What are the 2 functions of the allosteric protein receptor?
Bind to ligand
Activate membrane cascade effect
What pathway does P13 Kinase go with?
MAP-kinase pathway
What pathway goes with JAK
JAK/STAT pathway
What pathway goes with G protein?
cAMP pathway
Collagen type found in the IVD
Collagen type IX (9)
What type of collagen is Strong mature collagen?
Type I Collagen
What type of collagen is cartilage, vitreous humor?
Type II Collagen
What type of collagen is thin, immature collagen?
Type III Collagen
What type of collagen is basement membranes?
Type IV Collagen
What type of collagen is fine fibrils?
Type V Collagen
What type of collagen is dermal-epidermal junctions?
Type VII Collagen
Collagens are composed of ?
a triple helix of 3 polypeptide alpha chains
What holds together the alpha chains?
What type of collagen does hydroxyproline create?
Creates procollagen
How does hydroxyproline work in holding together of alpha chains?
Proline hydroxylation needs vitamin C, procollagen is then released outside the fibroblast
What leads to crosslinking of alpha chains and renders the collagen molecule structurally stable?
Extracellular Lysyl hydroxylysyl Oxidation
What is caused by an absence of Vitamin C?
Links components of the ECM together and to the cells?
What is a large glycoprotein formed by fibroblasts and endothelial cells?
What is fibronectin involved in and where are they found?
Involved in the attachment and migration of cells (inflammatory cell)
Present along cell surface and basement membrane
What is the most common glycoprotein in basement membranes?
What does Laminin do?
It binds ECM components (ex: collagen) to specific cell surface receptors and assists in capillary tube formation in angiogenesis
What's bound to or with hydroxyapatite and calcium?
What is Osteonectin?
Type I collagen in the bone matrix and can initiate osteoid mineralization
What has to do with transmembrane glycoproteins?
What does integrins signal and how does it happen?
With extracellular and intracellular domains, the intracellular domain adheres to cytoskeletal elements.
Signals the attachment and locomotion
What binds to chondrocytes to type II collagen
Where is chondronectin located?
In the cartilage matrix
What is red, granular soft tissue that cover wound surfaces?
Granulation Tissue
Is granulation tissue highly resistant to infection?
Yes, it bleeds easily and it is made up of newly formed capillaries, fibroblasts, and collagen bundles
What is Angiogenesis?
The process by which new capillaries are formed
What are the 5 steps to angiogenesis?
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
What are the 2 factors that induce angiogenesis?
Fibroblast growth factor and Vascular endothelial growth factor
What does primary intention involve?
Involves the healing of a clean incised surgical wound
What does the secondary intention involve?
Intention occurs in unclean, infected, or traumatic wounds
How does secondary intention differ from primary intention?
Differs from healing between first intention quantitatively but not qualitatively
Ex: same process occurs but with excessive scarring
What is an ulcer?
Loss of surface epithelium
What is a fistula?
Tract is open at both ends
What is it when a tract is open only at one end?
Excessive collagen deposition forms?
a Keloid
What has excessive granulation tissue formation and creates a protruding red fleshy mass?
What is a painful nodule created by schwann cell hyperplasia and nerve fiber growth after nerve injury or amputation?
Traumatic neuroma
What is fibromatosis?
The aggressive proliferation of fibrous tissue with characteristic local invasion
Ex: Desmoid tumor
What do Vit. C, drugs, mechanical factors, and infection affect?
Affect tissue repair
What delays healing?
What do corticosteroids affect?
Affect collagen formation
Within nutrition what does a deficiency in protein and vitamin C lead to?
Inhibition of collagen synthesis
What might cause a noninfective granuloma?
Foreign bodies: Talcum powder or suture material may create a noninfective granuloma and delay healing
Is thrombosis normal or pathogenesis?
Thrombosis is the pahogenesis hematological response to?
To maintain blood in a vessel
What is another name for a blood clot?
3 general components that regulate hemostasis and thrombosis?
1) vascular wall
2) platelets
3) coagulation cascade
First thing to occur after injury to a blood vessel?
Von Willebrand Factor activates?
Activates platelets making them sticky
(They adhear to exposed ECM)
Local activation of the coagulation cascade leads to?
Fibrin polymerization
What is fibrin polymerization?
"cementing" the platelets into a definitive secondary hemostatic plug
2 counter-regulatory mechanisms that limit the formation of blood clots?
1) Tissue type plasminogen activator (t-PA)(Fibrinolysic)

2) Thrombomodulin (interferons, with the coagulation cascade) Limit the hemostatic process to the site of injury
Platelets central role?
Normal hemostasis
How do platelets affect hemostasis?
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
3 general reactions that platelets undergo upon contact with ECM?
1) Adhesion and Shape change
2) Secretion (release reaction)
3) Aggregation
The coagulation cascade is a series of?
enzymatic conversions
What does the enzymatic conversions do?
Turns inactive proenzymes into activated enzymes and culminate in the formation of thrombin
Once Thrombin is formed because of the enzymatic conversions what happens?
Thrombin converts the soluble plasma protein fibrinogen precursor into the insoluble fibrous protein fibrin
What converts fibrinogen into fibrin?
What factor is a link between the intrinsic and extrinsic pathways of the clotting cascade?
Factor IX - linking
(Factor XII is for Hageman factor)
Which pathway involves tissue factor?
Extrinsic pathway?
A cellular lipoprotein exposed at sites of tissue injury
Intrinsic Pathway?
Pathway may be initiated in VITRO by the activation of Hageman factor (factor XII)
What activates antithrombin III
Binding to Heprin on endothelial cells
3 natural anticoagulants the restrict the coagulation cascade to local areas?
1) Antithrombin (III)
2) Proteins C and S
3) TFPI (Tissue Factor Pathway Inhibitor)
What is involved primarily in the fibrinolytic cascade?
What resulting product of the fibrinolytic system can also act as weak anticoagulants?
FSP (fibrin split products)
Clinical uses for FSP
-Diagnostic help for abnormal thrombotic state (ex: Disseminated Intravascular Coagulation (DIC)
-Deep Venous Thrombosis
-Pulmonary Thromboembolism
What is Hydrothorax?
Fluid in thorax
What is Hydropericardium?
Fluid around the heart
What are the Ascites (hydroperitoneum)
Fluid in the abdomen
What is Hematoma
Blood in mm tissue
What is Hemarthrosis?
Blood in joints
Anasarca is?
Severe generalized edema
-with profound subcuatneous tissue swelling
IS Hyperemia and (active/Inactive) process?
Active process from increased input into a tissue resulting in local increase in blood volume in a tissue
Congestion is and (active/passive) process from decreased outflow from a tissue resulting in local increase in blood volume in a tissue
What pressure balances the blood hydrostatic pressure the most?
Plasma Colloid pressure
What law states the hydrostatic pressure of the blood is normally nearly balanced by the oncotic pressure of plasma proteins
Starlings Law
Edema is a result of what 2 things?
1) Increase Hydrostatic pressure
2) Decrease osmotic pressure
Liver cirrhosis may manifest as?
Reduced osmotic pressure, and lymphatic obstruction
Disease that is most likely to cause lymphatic obstruction
What is Filiarisis?
Can cause extensive inguinal lymphatic and lymph node fibrosis.
Result can be elephantiasis
What do patients with CHF you check for
Retain salt and water
Decreased CO, Increased Capillary pressure, and Decreased Renal perfusion are all?
Manifestations of CHF
Non-inflammatory edema is normally not vascular and derives the oncotic pressure and can be associated with
Nephrotic syndrome
(Ex: Capillary wall becomes leaky)