Connective Tissue and Wound Healing Quiz
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Questions and Answers

What is the role of the fibroblast in connective tissue?

  • Provides structural support and elasticity to connective tissue
  • Forms the fibers of connective tissue and repairs injuries (correct)
  • Secretes heparin and histamine
  • Forms the matrix of connective tissue

Which type of connective tissue fiber is responsible for providing elasticity?

  • Collagenous fibers
  • Elastic fibers (correct)
  • Reticular fibers
  • All of the above

Which of the following is NOT a phase of wound healing?

  • Inflammatory
  • Fibroblastic
  • Hemostasis
  • Ossification (correct)

What is the primary function of heparin, a substance secreted by mast cells?

<p>Preventing blood clotting (A)</p> Signup and view all the answers

What is the role of platelets in the hemostasis phase of wound healing?

<p>They help to form a stable hemostatic plug (C)</p> Signup and view all the answers

What is the role of thrombin in the hemostasis phase of wound healing?

<p>It initiates fibrin formation from fibrinogen (C)</p> Signup and view all the answers

Which type of connective tissue is characterized by a rubbery matrix?

<p>Cartilage (A)</p> Signup and view all the answers

What is the primary function of the inflammatory phase of wound healing?

<p>To prepare the area for healing (C)</p> Signup and view all the answers

Which brain structure is involved in the descending pain inhibition pathway?

<p>Periaqueductal gray (B), Raphe nucleus (C)</p> Signup and view all the answers

What is the function of the substantia gelatinosa in the gate control theory?

<p>To inhibit the transmission of pain signals (B)</p> Signup and view all the answers

How does the activation of large-diameter afferent fibers (Aβ) affect pain perception?

<p>It reduces the pain signal (C)</p> Signup and view all the answers

What is the primary source of β-endorphin?

<p>Anterior pituitary gland (B)</p> Signup and view all the answers

Which of the following is NOT involved in the process of suppressing pain signals in the spinal cord?

<p>Activation of A-delta and C-fibers (A)</p> Signup and view all the answers

What is the primary cell involved in the remodeling phase of tissue healing?

<p>Fibroblast (C)</p> Signup and view all the answers

How long can the remodeling phase take after an injury?

<p>Up to 2 years (D)</p> Signup and view all the answers

Which process is dependent on oxygen during collagen formation and breakdown?

<p>Collagen formation (B)</p> Signup and view all the answers

What does the Induction Theory suggest about scar formation in dense tissues?

<p>It produces a dense, highly cross-linked scar. (D)</p> Signup and view all the answers

Which technique may be used to produce permanent changes in scar configuration?

<p>Dynamic splints (A)</p> Signup and view all the answers

Which type of pain is characterized as sharp, electric, and felt primarily at the point of injury?

<p>Fast pain (A)</p> Signup and view all the answers

What is true about slow pain as described in the content?

<p>It is typically felt in deeper tissues. (B)</p> Signup and view all the answers

What is a defining feature of pain as a protective mechanism?

<p>It causes individuals to react to remove the cause of pain. (D)</p> Signup and view all the answers

What type of pain is primarily transmitted by Type C fibers?

<p>Slow, chronic pain (C)</p> Signup and view all the answers

Where do fast pain signals typically terminate in the spinal cord?

<p>Lamina I and V (B)</p> Signup and view all the answers

What neurotransmitter is likely associated with Type C nerve endings?

<p>Substance P (D)</p> Signup and view all the answers

Which pathway is responsible for the localization of pain?

<p>Neospinothalamic pathway (D)</p> Signup and view all the answers

At what velocity do Type C fibers transmit pain signals?

<p>0.5-2 m/sec (A)</p> Signup and view all the answers

What occurs after a sudden painful stimulus based on the dual pain system?

<p>Both fast and slow pain sensations are experienced (B)</p> Signup and view all the answers

Where do the fibers from the second order neuron ascend after they decussate?

<p>Lateral spinothalamic tract (C)</p> Signup and view all the answers

Which area is primarily activated by chronic pain signals?

<p>Reticular area of the brain stem (D)</p> Signup and view all the answers

What is the primary role of neutrophils during the inflammatory phase of wound healing?

<p>To phagocytize debris and microorganisms (D)</p> Signup and view all the answers

Which cytokines are secreted by macrophages to promote healing?

<p>Epidermal growth factor (EGF) and transforming growth factor beta (TGF-B) (B)</p> Signup and view all the answers

What typically marks the clinical presentation of inflammation in wound healing?

<p>Redness, swelling, warmth, and pain (A)</p> Signup and view all the answers

What is a consequence of insufficient inflammation during wound healing?

<p>No healing at all (C)</p> Signup and view all the answers

When does the proliferative phase of wound healing typically begin?

<p>Around four days post-injury (C)</p> Signup and view all the answers

What is the main goal of the proliferative phase of wound healing?

<p>To repair the wound and regain strength (B)</p> Signup and view all the answers

Which of the following statements about inflammation and healing is correct?

<p>Balanced inflammation is crucial for proper healing. (B)</p> Signup and view all the answers

What contributes to increasing permeability and vasodilation during inflammation?

<p>Cytokines released by platelets (D)</p> Signup and view all the answers

What is the primary function of angiogenesis in the wound healing process?

<p>To supply oxygen and nutrients to the injured tissues (B)</p> Signup and view all the answers

Which phase of wound healing involves the proliferation of undamaged epithelial cells?

<p>Epithelization (A)</p> Signup and view all the answers

What role do fibroblasts play in collagen production during wound healing?

<p>They produce procollagen which is necessary for collagen formation (B)</p> Signup and view all the answers

What is the purpose of myofibroblasts during wound healing?

<p>To pull the wound edges together, facilitating contraction (D)</p> Signup and view all the answers

How does the number of cross links in collagen fibers affect wound healing?

<p>Increases the tensile strength of the wound (A)</p> Signup and view all the answers

What is the effect of immobilization during the angiogenesis phase of healing?

<p>It is essential to facilitate the growth of new blood vessels (D)</p> Signup and view all the answers

What distinguishes the remodeling phase of wound healing?

<p>It involves the replacement of type III collagen with type I collagen (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of epithelization?

<p>It enhances wound durability through collagen production (B)</p> Signup and view all the answers

Flashcards

Epithelial Tissue

A type of tissue that forms a protective layer on surfaces of the body and also lines cavities and tubes.

Types of Connective Tissue

Connective tissue is characterized by having cells embedded in a matrix, which can be soft, rubbery, or solid.

Fibroblast

Fibroblasts are the key cells responsible for building connective tissue fibers and repairing injuries.

Mast Cell

Mast cells release heparin, which prevents blood clotting, and histamine, which attracts immune cells to the site of injury.

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Collagenous Fiber

Collagen fibers are strong and flexible, providing structural support to tissues.

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Elastic Fiber

Elastic fibers are stretchy, allowing tissues to recoil to their original shape.

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Reticular Fiber

Reticular fibers form delicate networks, providing support for organs and cells.

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Hemostasis Phase

The first stage of wound healing that stops bleeding and seals off damaged blood vessels.

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Pain Receptors

Free nerve endings in the skin and internal tissues that detect painful stimuli.

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Fast Pain

The sharp, immediate pain felt after a sudden painful stimulus.

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Slow Pain

The dull, lingering pain that follows a painful stimulus.

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Glutamate (Fast Pain)

The neurotransmitter thought to be responsible for transmitting fast pain signals.

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Substance P (Slow Pain)

The neurotransmitter believed to transmit slow pain signals.

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First Order Neuron

The first relay station in the pain pathway, where nerve signals from the pain receptors enter the spinal cord.

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Second Order Neuron

The second relay station in the pain pathway, where nerve signals cross over to the opposite side of the spinal cord and ascend to the brain.

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Third Order Neuron

The final stage in the pain pathway, where nerve signals reach the thalamus and somatosensory cortex, allowing the brain to perceive and localize pain.

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Scar Remodeling

The process where the scar tissue changes and develops its final form.

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Synthesis-Lysis Balance

The balance between the formation of new collagen fibers and the breakdown of old collagen.

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Collagen Fiber Orientation

The process of aligning collagen fibers within the scar.

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Induction Theory

The idea that the type of tissue surrounding a scar influences its characteristics.

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Tension Theory

The theory suggesting that forces applied to a healing wound affect scar formation.

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Pain

The body's response to tissue damage, signaling a potential threat.

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Inflammation Phase

The stage of wound healing focusing on clearing debris, primarily by neutrophils (PMNs), which are attracted by inflammatory mediators.

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Neutrophils (PMNs)

Specialized white blood cells that engulf and destroy debris and microorganisms in the wound. They are the first line of defense against infection during the inflammation phase.

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Macrophages

A type of white blood cell that is attracted to the wound site after neutrophils and plays a role in phagocytizing debris and bacteria, contributing to the second line of defense. They also secrete factors for tissue repair.

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Histamine

A naturally occurring chemical released in the body during the inflammatory process. It dilates blood vessels and increases their permeability, allowing white blood cells and fluid to reach the wound site.

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Fibrin

A fibrous protein that forms a mesh-like structure at the wound site, helping to stop bleeding and provide a scaffold for cell migration and tissue repair. It is broken down during the inflammation phase.

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Proliferation Phase

The stage of wound healing where the focus shifts from clean-up to repairing and building new tissue. This includes activities like cell proliferation and collagen deposition.

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Fibroblast Growth Factor (FGF)

A type of growth factor secreted by cells like macrophages, promoting the growth and development of new blood vessels. This is crucial for tissue repair.

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Chemotactic Factors

Substances that guide the movement of specific cells towards the wound site. These factors help attract the necessary cells to the healing area.

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Angiogenesis (Vascular Sprouting)

The process of new blood vessels growing into a wound, providing oxygen and nutrients for healing. It involves sprouting from existing blood vessels and forming capillary loops.

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Epithelization

The wound surface closing with new epithelial cells, providing a barrier against infections.

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Collagen Production

The process of fibroblasts producing collagen fibers, providing strength and structure to the wound.

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Wound Contraction

The process of the wound shrinking as myofibroblasts pull the wound edges together.

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Remodeling Phase

The phase where the wound tissue is remodelled to increase strength and durability by replacing type III collagen with type I collagen, leading to a stronger scar.

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Oxygen Supply

A critical element in wound healing that supplies oxygen and nutrients to damaged tissues.

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Immobilization

The immobilization of the injured area during the early stages of wound healing, aiding in blood vessel formation and reducing stress on the wound.

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Heat Application

The application of heat to a wound, which is generally not recommended during the initial stages of healing as it can damage delicate new tissues.

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What are enkephalins?

The enkephalins are neurotransmitters primarily found in areas of the brain involved in pain control and the spinal cord's dorsal horn, where they help reduce pain signals.

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What are endorphins and where are they found?

Endorphins are another type of neurotransmitter, found mainly in the hypothalamus and pituitary gland. They are known for their strong pain-relieving effects.

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What is the Gate Control Theory?

This theory explains how the nervous system processes pain signals. It suggests that large-diameter nerve fibers (which carry non-painful signals) can block pain signals from reaching the brain by activating inhibitory circuits in the spinal cord.

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How does the brain play a role in pain suppression?

The brain can also suppress pain signals coming from the spinal cord using a descending pathway that releases enkephalins in the spinal cord. This pathway starts with the activation of the periaqueductal gray region in the midbrain.

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What are β-Endorphin and Dynorphin?

β-Endorphin and Dynorphin are powerful neuroactive peptides that play a role in pain relief. They are released in response to prolonged pain signals carried by small-diameter nerve fibers.

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Study Notes

Introduction to Response to Injury & Pain Management

  • This presentation covers response to injury and pain management.
  • The presenter is Dr. Walid Abouelnaga, an Associate Professor of Physical Therapy with a PhD, MSc, and PT qualifications.
  • The presentation is hosted at Aqaba University of Technology.

Types of Body Tissues

  • Epithelial tissue: Stratified squamous epithelium is found in the epidermis of the skin.
  • Connective tissue: There are three types:
    • Connective tissue proper with a soft matrix.
    • Cartilage with a rubbery matrix.
    • Bone with a solid matrix.
  • Muscular tissue
  • Nervous tissue

Connective Tissue Proper

  • Connective tissue proper is made up of three components:
    • Cells: Examples include fibroblasts and mast cells.
    • Fibers: Examples such as collagenous fibers, elastic fibers, and reticular fibers.
    • Matrix: The soft, jelly-like ground substance that embeds the cells and fibers.

Connective Tissue Cells

  • Fibroblasts: The most common connective tissue cell, responsible for forming and repairing connective tissue fibers.
  • Mast cells: Secrete heparin (anticoagulant) and histamine (chemotactic factor).

Connective Tissue Fibers

  • White collagenous fibers: Composed of collagen, a glue-like protein arranged in bundles.
  • Yellow elastic fibers: Elastic in nature, made of elastin protein.
  • Reticular fibers: Composed of reticulin protein, forming a fine network.

Phases of Wound Healing

  • There are four phases:
    • Hemostasis: Stops bleeding.
    • Inflammatory: Prepares the area for healing.
    • Fibroblastic: Rebuilds the structure.
    • Remodeling: The final form of healing.

Hemostasis

  • Hemostasis occurs within minutes of injury, unless there are clotting disorders.
  • Blood vessels constrict in response to injury, then relax.
  • Platelets aggregate and adhere to exposed collagen.
  • Platelets secrete factors that interact with the intrinsic clotting cascade, initiating fibrin formation from fibrinogen.
  • Fibrin strengthens the platelet aggregate into a stable hemostatic plug.
  • Platelets also secrete cytokines.

Inflammatory Phase

  • Clinically, inflammation is the second phase of wound healing.
  • It typically lasts up to four days post-injury.
  • Characteristics include erythema, swelling, warmth, and pain.
  • The inflammatory response makes the blood vessels leaky, allowing plasma and neutrophils (PMNs) to enter surrounding tissue.
  • Neutrophils phagocytize debris and microorganisms.
  • Mast cells release histamine, increasing vasodilation and permeability.
  • Macrophages phagocytize bacteria and debris to provide further defense.
  • This inflammation is needed for healing, but balance is crucial.

Proliferation Phase

  • The proliferation stage starts approximately four days after wounding, typically lasting until day 21 in acute wounds.
  • Once debris is cleared, the building process (proliferation) begins.
  • The repair and strengthening of the wound are the main objectives in this phase.
  • The process involves four key parts:
    • Angiogenesis: Formation of new blood vessels for O2 and nutrient delivery.
    • Epithelization: Epidermal regeneration (surface covering) via mitosis and cell migration
    • Collagen Production: Fibroblast production of collagen (tropocollagen, collagen filaments, fibrils), forming the irregular cross-links that improve structural integrity.
    • Wound Contraction: Myofibroblasts pull the edges of the wound together.

Remodeling Phase

  • This phase aims to produce greater tensile strength in dermal tissues by depositing the matrix and altering it progressively over time.
  • Type III collagen is replaced by type I.
  • The principle cell involved is the fibroblast.
  • Remodelings take up to two years, involving a synthesis-lysis balance (breaking down and building up) and collagen fiber orientation.
  • Balancing the formation and breakdown of collagen is essential for controlling hypertrophic scars.
  • Pressure therapy is often applied to control hypertrophic scars and their formation.

Pain Management - Definitions & Principles

  • Pain is characterized as an unpleasant sensation.
  • Pain protects individuals by triggering a reaction to eliminate the pain stimulus.

Types of Pain

  • Fast pain: Sharp, acute pain felt when a needle, knife, or burns are applied to the skin, often initially felt.
  • Slow pain: Also known as chronic pain (aching, throbbing, burning, dull pain), usually related to tissue damage, lingering and potentially debilitating.

Pain Receptors and Stimulation

  • Pain receptors are free nerve endings that are widespread in the skin and other tissues, such as the periosteum, arterial walls, and joints.

Pain Pathway

  • Fast pain signals are transmitted by small type Aδ fibers at high speeds (6-30 m/sec).
  • Slow pain signals are transmitted by type C fibers at slower speeds (0.5 - 2 m/sec)
  • Pain signals synapse at specific laminae in the spinal cord, before traveling to the brain via specific pathways.
  • Pain can be localized by the brain via specific areas in the cerebral cortex.

Pain Suppression

  • The enkephalins and endorphins are involved in pain control and are localized to brain areas involved in pain processing.

Gate Control Theory

  • Stimulation of large-diameter afferent fibers (Aβ) can inhibit pain signals by affecting the substantia gelatinosa (SG) interneurons.

Supra-spinal Inhibition

  • Stimulation of the periaqueductal grey region of the midbrain or the raphe nucleus in the pons and medulla affects the descending mechanism to influence second-order neuronal activity and potentially inhibit pain perception.

B-Endorphin and Dynorphin

  • β-Endorphin (BEP) and Dynorphin are neuroactive peptides that affect the body's response to pain and have analgesic effect.
  • BEP is mainly found in the anterior pituitary gland.

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Lecture 4. Response to Injury & Pain Management (Part 2) PDF

Description

Test your knowledge on the roles of fibroblasts, connective tissue fibers, and the phases of wound healing. This quiz covers key concepts related to pain perception and the physiological mechanisms involved in healing processes.

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