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56 Cards in this Set

  • Front
  • Back
define wound?

define regeneration?

define repair?
any disruption to anatomic and/or physiologic fxn tissue

replacement of lost cells with cells similar in fxn and structure

proliferation of connective tissue elements leading to formation of a collagenous scar
what type of cells have very good regenerative capacity?

what are examples of this cell type?
labile cells

ex. epithelium, bone marrow cells
what cells regenerate well as long as tissue outline is maintained during inflammatory process?

what are examples of this cell type?
stable cells

ex. glandular cells, liver parenchymal cells, MESENCHYMAL CELLS
what is another name for mesenchymal cells
supportive cells
what are types of mesenchymal cells?
-smooth muscle
-vascular endothelial cells
-bone cells and cartilage cells
what are the major components of the extracellular matrix
collagens, proteoglycans and adhesive glycopro's
why is the extracellular matrix so impt for wound healing?
provides the framework for cell migration

and also maintains the correct cell orientation for re-assemble of multilayer structures
what is an example of a regeneration of stabile cells?
increased growth of remaining liver tissue after hepatectomy
what cells have no regenerative capacity?

give examples of this cell type
permanent cells

ex skeletal muscle, cardiac muscle, some nerve cells in CNS
what is a new discovery of adult brain cells
can produce new neurons
what are the three major phases of wound healing?
what is inflammation phase characterized by?
1.clot formation
2.acute inflammation
3.macrophage infiltration
what is the proliferation phage characterized by?
1. development of granulation tissue
2.Fxn of granulation tissue
3.Regeneration of epidermis
what is the term granulation derived from?
what components develop in granulation tissue?
granular appearance of wound surfaces

new vessels and proliferating fibroblasts
what is the process of new vessel formation called?
what is the fxn of the new vessels formed in granulation tissue
provide nutrition for regerating tissues
what produces all of the wound collagen y the end of the proliferation phase?
what is the maturation phase?
remodeling of collagen and development of wound strength
what happens to the wound during the maturation phase?

what is maximal strength of the wound
it contracts toward center to decrease in size

70-80% of strength of original unwounded skin
what two layers make up the Skin?

what are the underlying layers of skin?
epidermis and dermis

subcutaneous tissue, then fascia, muscle and bone
which layer of skin is nonvascular?

what is the dermis composed of?

collagen and connective tissue
what appendages are present in the dermis?
sweat glands, sebaceous glands and hair follicles
what layer of skin has many blood vessels to provide oxygen and nutrients?
what is fxn of subcutaneous tissue?
shock absorber and heat insulator, also reseves calories
what are the 4 fxns of skin? from bacteria and environmental hazards
3.produce vit D
4.sensory transmitter
what is meant by "primary wound healing"?
clean, uninfected surgical incision
what are the temporal sequece of steps involved with primary wound healing?
same 3 as normal wound healing(inflammate,proliferate,maturate) but faster b.c only mild tissue destruction
what happens immediately in primary wound healing?
incision fills with clotted blood then scab
what happens within 24 hours of prim. wound?
neutrophils migrate to margins of incision and cut edges of epidermis thicken
hat happens within 24-48 hours of prim wound
thin continuous epithelial cell layer forms beneath scab
what happens by day 3 of prim wound
a. macrophages replace neutrophils
b. granulation tissue progressively invades incisional space
what happens day 5 of primary wound?
a. incisional space begin to bredge incision
b. epidermal layer becomes normal thickness with matrue differentiation
what happens during 2nd week of primary wound
a.fibroblasts proliferate and continue to produce collagen
b.blood vessels in granulation tissue disappear
c.scar begins to lighten
what happens after 1st month of prim wound healing
a. compact dermal scar covered by intact epidermis
b.dermal appendages destroyed in line of incision have been permanently lost
what happens in following months of prim wound healing
addition and remodeling of collagen to strenthen wound
what are examples of secondary wound healing
large, infected surface wound

inflammatory ulceration, infarction or very small laceration
what is the key difference between primary and secondary wound healing?

secondary wound healing is left to heal by itself

wound is too big to close, is infected, and/or is necrotic OR: wound is so small it can close on its own
what are other differences b/w primary and secondary if the wound is large?
large wounds have more:

-granulation tissue
-epithelial regeration
which type of healing results in a larger scar?

which healing takes more time

what are systemic factors impairing wound healing?
-nutritional deficiency
-inadequate blood supply
-diabitese mellitus DM
-steroid hormones
-immunocompromised patients(HIV)
what type of deficiency inhibits collagen synthesis?
what are three problems assoc with DM
1.impaired blood supply to wounds
2. decreased sensation in extremities
3.impaired immune fxn
what do steroid hormones inhibit?
inflammatory process and collagen synthesis
what blocks arachadonic acid?

what does this in turn block production of?
steroid hormones

prostaglandin and leukotriene
what are three possible complications of wound healing?
1.assembly of scar
2.excessive formation of components of repair process
3.formation of wound contractures
what is wound dehiscence?

why does this occur?
wound opens

increased abdominal pressure(cough, vomit, etc.)
most common after surgery
what are predisposing conditions to ulceration?
1.inadequate blood supply due to atherosclerosis
2.imparied sensation in extremities
what is an incisional herniation?

what is this due to?
bulging sac within healing or healed abdominal incision

abdominal pressure
what are possibilities from excessive formation of components of repair process?
1.hypertrophic scar
what is a raised scar?

what is it caused by?
hypertrophic scar

caused by excessive collagen
what causes a keloid?

what can this sometimes be?
excessive collagenous protrusion at scar site

disfiguring due to going beyond boundaries of original wound
what population has an increased occurence of keloids
African Americans
when are formation of wound contractures commonly seen?

what can they result in?
after burns

deformities of an areas as well as LIMITATION OF MOTION AT A JOINT
what happens with the formation of adhesions?

give examples.
inflamed serosal surfaces bind together
ex. collagenous adhesions b/w inflamed loops of bowel
what are sutue therapy complications?
1. sutures may be source of infection
2. premature suture removal prolongs healing process
what determines the pathway of repair (4)?
1. is stimulus promptly destroyed
2.presence and extent of cell necrosis
3.intactness of stroma
4.regenerative capacity of injured cells