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Questions and Answers
What is the definition of repair?
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)
Which of the following are classical types of repair? (Select all that apply)
What determines the type of repair?
What determines the type of repair?
What are labile cells?
What are labile cells?
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What are permanent cells?
What are permanent cells?
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How do stable cells heal if damaged?
How do stable cells heal if damaged?
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What happens if the normal framework of an organ is destroyed?
What happens if the normal framework of an organ is destroyed?
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What is the first phase of healing?
What is the first phase of healing?
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Match the following healing processes to their descriptions:
Match the following healing processes to their descriptions:
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Granulation tissue is a transient tissue formed during the repair by _____.
Granulation tissue is a transient tissue formed during the repair by _____.
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What is the composition of granulation tissue?
What is the composition of granulation tissue?
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What essential process supplies nutrition to proliferating fibroblasts during granulation tissue formation?
What essential process supplies nutrition to proliferating fibroblasts during granulation tissue formation?
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Fibrosis in the CNS is referred to as gliosis.
Fibrosis in the CNS is referred to as gliosis.
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Study Notes
Pathology of Repair
- Repair is the replacement of damaged tissue by new, healthy tissue.
Types of Repair
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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.
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Other types:
- Organization: Healing of dead or non-living material by granulation tissue, which matures into fibrous tissue
Determinants of Repair Type
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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).
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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.
