Pathology of Repair Overview
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Questions and Answers

What is the definition of repair?

Replacement of damaged tissue by new healthy one.

Which of the following are classical types of repair? (Select all that apply)

  • Regeneration (correct)
  • Fibrosis (correct)
  • Healing by organization
  • None of the above

What determines the type of repair?

  • The location of the injury
  • The age of the patient
  • Type of damaged cells (correct)
  • The time since the injury occurred

What are labile cells?

<p>Continuously dividing cells that heal by regeneration.</p> Signup and view all the answers

What are permanent cells?

<p>Cells that don't proliferate at all.</p> Signup and view all the answers

How do stable cells heal if damaged?

<p>By mixed regeneration and fibrosis (B)</p> Signup and view all the answers

What happens if the normal framework of an organ is destroyed?

<p>The proliferating cells may grow in a disorganized pattern.</p> Signup and view all the answers

What is the first phase of healing?

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

Match the following healing processes to their descriptions:

<p>Regeneration = Replacement of damaged tissue by healthy tissue of the same kind Fibrosis = Replacement of damaged tissue by granulation tissue that matures into fibrous tissue Healing in the Skin = Damage of epidermis results in regeneration Healing of Liver Damage = Severe damage leads to cirrhosis</p> Signup and view all the answers

Granulation tissue is a transient tissue formed during the repair by _____.

<p>fibrosis</p> Signup and view all the answers

What is the composition of granulation tissue?

<p>Capillaries and fibroblasts.</p> Signup and view all the answers

What essential process supplies nutrition to proliferating fibroblasts during granulation tissue formation?

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

Fibrosis in the CNS is referred to as gliosis.

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

Flashcards

Regeneration

Replacement of damaged tissue with identical healthy tissue

Fibrosis (Gliosis in CNS)

Damaged tissue replaced by fibrous scar tissue; in the brain/spinal cord (CNS) it is called gliosis.

Labile Cells

Cells that continually divide. If damaged, regenerate.

Permanent Cells

Cells that do not divide or regenerate. Damaged permanently.

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Stable Cells

Cells that normally don't divide, but can if damaged.

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Granulation Tissue

Transient tissue formed during repair by fibrosis.

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Healing Phase: Cleaning

Removal of necrotic tissue (dead cells) by immune cells (like macrophages).

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Healing Phase: Proliferation

New cells grow and replace damaged tissue.

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Healing Phase: Remodeling

Maturation of new tissue, trying to replicate original structure

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Bone Fracture Repair

Bone fracture repair process involving cleaning, proliferation (soft callus, hard callous) then remodeling phases with risk of non-union, fibrous union or mal-union.

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Study Notes

Pathology of Repair

  • Repair is the replacement of damaged tissue by new, healthy tissue.

Types of Repair

  • Classical types:
    • Regeneration: Replacing damaged tissue with the same type of tissue
    • Fibrosis (Gliosis in CNS): Formation of scar tissue, especially in the central nervous system.
  • Other types:
    • Organization: Healing of dead or non-living material by granulation tissue, which matures into fibrous tissue

Determinants of Repair Type

  • Type of damaged cells:
    • Permanent cells: Do not proliferate. Repair by fibrosis (e.g., muscle, nerve).
    • Stable cells: Can proliferate but have limited capacity. Repair by mixed regeneration and/or fibrosis (e.g., liver cells, kidney tubular cells, glands).
    • Labile cells: Continuously dividing. Repair by regeneration (e.g., epidermis, mucous membranes, blood and lymphoid tissue).
  • Supporting framework:
    • If the framework remains intact, healing by regeneration occurs.
    • If the framework is destroyed, the proliferating cells may display a disorganized pattern mixed with fibrosis.

Phases of Healing

  • Cleaning phase: Necrotic debris removal by phagocytic cells.
  • Proliferation phase: Repair cells proliferate to replace damaged ones.
  • Remodeling phase: The new tissue matures to resemble the original tissue.

Healing by Regeneration

  • Definition: Replacement of damaged tissue with healthy tissue of the same kind.
  • Cells healing by regeneration: Labile and stable cells (with intact framework).
  • Example in skin: Epidermis damage only—regeneration; epithelium & sub-epithelium damage—fibrosis.
  • Example in liver: Intact framework—regeneration; destroyed framework—cirrhosis.

Healing by Fibrosis (Gliosis in CNS)

  • Definition: Damaged tissue replaced by granulation tissue that matures into fibrous tissue.
  • Mechanism:
    • Capillaries (neo-vascularization).
    • Fibroblasts secrete collagen.
  • Fate:
    • Collagen fibers reorganization
    • Fibroblasts change into fibrocytes.
    • Formation of avascular, strong fibrous tissue (scar).
  • Examples: Muscle damage (e.g., myocardial infarction), nerve/neuron damage (CNS).

Healing by Organization

  • Definition: Healing of dead or non-living material by granulation tissue followed by fibrous tissue.
  • Examples: Thrombus, fibrin in sero-fibrinous inflammation.

Healing of Skin Wounds

  • Primary union (first intention): Clean incisional wounds; minimal tissue destruction and approximated edges. Characteristics: rapid healing, small scar, complications are rare.
  • Secondary union (second intention): Gaping wounds, septic wounds, or abscesses. Characteristics: slow healing, large scar, complications more frequent.

Complications of Repair

  • Too little repair: Ulcer, sinus, fistula, weak scar, incisional hernia, fibrous union of bone (pseudo-arthrosis).
  • Excessive repair: Excessive granulation tissue, excessive scar tissue, squamous cell carcinoma (rare).

Factors Affecting Repair

  • Local factors: Blood supply, foreign bodies, hematoma, infection, cell type, wound size.
  • Systemic factors: Age, nutritional status, presence of debilitating diseases, medication.

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Description

This quiz covers the pathology of repair, focusing on the types of tissue repair such as regeneration and fibrosis. It explores determinants of repair types based on the nature of the damaged cells and the supporting framework. Test your understanding of these critical concepts in tissue healing.

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