Porth's Pathophysiology: Wound Healing and Nutrition

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Questions and Answers

What is a critical factor in successful wound healing in children?

Minimal energy stores

Adequate nutrition (correct)

Immature organ systems

High metabolic requirements

Which comorbidities increase the risk of wound complications in children?

Asthma and allergies

Diabetes and malabsorption (correct)

Cancer and autoimmune disorders

Cardiovascular disease and obesity

What changes occur in aging skin that affect wound healing?

Decrease in dermal thickness and collagen content (correct)

Increase in skin elasticity

Increase in dermal thickness

Increase in collagen content

How does sun exposure affect skin structure in older adults?

It exacerbates skin changes Signup and view all the answers

What is a common complication in children with certain comorbidities?

Skin breakdown or pressure sores Signup and view all the answers

Why are premature infants prone to impaired wound healing?

Immature organ systems and minimal energy stores Signup and view all the answers

What is a key factor in wound healing in adults?

Sun exposure and age Signup and view all the answers

Which of the following does NOT affect wound healing in children?

Immunization status Signup and view all the answers

What is the main reason for infarction to occur in an organ or part of the body?

Occlusion of an artery with no alternative blood supply Signup and view all the answers

What is the shape of an infarction typically?

Conical Signup and view all the answers

What can cause an artery to become occluded?

Embolus, thrombus, disease of the arterial wall, or pressure from outside the vessel Signup and view all the answers

What is caseous necrosis?

A type of coagulation necrosis in which dead cells persist indefinitely Signup and view all the answers

Where is caseous necrosis most commonly found?

In the center of tuberculous granulomas or tubercles Signup and view all the answers

What is age-related sarcopenia?

Loss of type II muscle fibers Signup and view all the answers

What is the main difference between age-related sarcopenia and cachexia?

Sarcopenia affects type II fibers, while cachexia affects type I fibers Signup and view all the answers

What is the main characteristic of caseous necrosis?

Dead cells persist indefinitely Signup and view all the answers

What is the result of chronically inflamed tissues signaling immune cells?

Destruction of healthy tissue and leading to maladaptive remodeling Signup and view all the answers

What characterizes nonspecific chronic inflammation?

Diffuse accumulation of macrophages and lymphocytes at the site of injury Signup and view all the answers

What is a characteristic feature of a granuloma?

A small, 1- to 2-mm lesion with a massing of macrophages surrounded by lymphocytes Signup and view all the answers

What is the result of ongoing chemotaxis in nonspecific chronic inflammation?

Macrophages infiltrate the inflamed site and accumulate Signup and view all the answers

What is a common feature of chronic inflammation?

Diffuse accumulation of immune cells at the site of injury Signup and view all the answers

What is a consequence of maladaptive remodeling?

Destruction of healthy tissue Signup and view all the answers

What is a characteristic of granulomatous inflammation?

Focal accumulation of macrophages and lymphocytes Signup and view all the answers

What is the outcome of immune cells being signaled by chronically inflamed tissues?

Amplified inflammatory response Signup and view all the answers

What is the normal range of pH in the extracellular fluid (ECF)?

7.35 to 7.45 Signup and view all the answers

What is the primary source of nonvolatile metabolic acids?

Protein metabolism Signup and view all the answers

What is the role of the lungs in acid-base regulation?

Eliminating dissolved CO2 Signup and view all the answers

What is the ratio of HCO3- concentration to dissolved CO2 concentration that determines a pH of 7.4?

20:1 Signup and view all the answers

What is the primary buffer system in the extracellular fluid (ECF)?

HCO3- buffer system Signup and view all the answers

What is the role of the kidneys in acid-base regulation?

Excreting nonvolatile metabolic acids Signup and view all the answers

What is the consequence of an imbalance in acid-base regulation?

Disruption of normal body function Signup and view all the answers

What is the relationship between the HCO3- concentration and dissolved CO2 concentration in the extracellular fluid (ECF)?

Their ratio determines the pH Signup and view all the answers

What is the primary function of the acute-phase protein CRP?

To bind to the surface of invading microorganisms and target them for destruction Signup and view all the answers

What is a characteristic of the systemic inflammatory response syndrome (SIRS)?

Increased production of inflammatory cytokines such as IL-1 and TNF-α Signup and view all the answers

What is a consequence of the acute-phase response?

Negative nitrogen balance Signup and view all the answers

What is the primary trigger for the acute-phase response?

Infection or inflammation Signup and view all the answers

What is the effect of inflammatory cytokines on the blood vessels?

Vasodilation Signup and view all the answers

What is the result of the release of large quantities of inflammatory cytokines in severe bacterial infections?

Systemic inflammatory response syndrome Signup and view all the answers

What is the significance of CRP in clinical conditions?

It is an important inflammatory biomarker Signup and view all the answers

What is a characteristic of the acute-phase response?

Elevated erythrocyte sedimentation rate (ESR) Signup and view all the answers

Study Notes

Wound Healing

Successful wound healing in children requires adequate nutrition, as they need sufficient calories to maintain growth and wound healing.
Premature infants are born with immature organ systems and minimal energy stores, making them prone to impaired wound healing.
Children with comorbidities like diabetes and malabsorption problems are at higher risk for wound complications.
Older adults experience impaired wound healing due to decreased dermal thickness, collagen content, and elasticity, exacerbated by sun exposure.

Geriatric Considerations

Aging skin undergoes structural and functional changes, leading to impaired wound healing.

Pediatric Considerations

Children require sufficient calories to maintain growth and wound healing.
Premature infants and children with comorbidities are at higher risk for impaired wound healing.

Infarction and Necrosis

Infarction occurs when an artery supplying an organ or part of the body becomes occluded, leading to tissue death.
Caseous necrosis is a distinctive form of coagulation necrosis characterized by dead cells persisting indefinitely, often found in tuberculous granulomas or tubercles.

Age-related sarcopenia is the loss of muscle mass due to the loss of type II fibers, differing from cachexia, which involves the loss of type I fibers.

Acid-Base Balance

Normal body function depends on maintaining a narrow pH range of 7.35 to 7.45 in the extracellular fluid (ECF).
The body regulates acid-base balance through respiratory and renal mechanisms, as well as chemical buffers in the intracellular fluid (ICF) and ECF.

Inflammation

Chronic inflammation involves a diffuse accumulation of macrophages and lymphocytes at the site of injury.
Granulomatous inflammation is a form of chronic inflammation characterized by a massing of macrophages surrounded by lymphocytes.
Systemic manifestations of inflammation include the acute-phase response, which involves changes in plasma proteins, skeletal muscle catabolism, and increased erythrocyte sedimentation rate.

Acute-Phase Response

The acute-phase response occurs in response to inflammation or infection, involving changes in plasma proteins, skeletal muscle catabolism, and systemic effects.

Sepsis and Systemic Inflammatory Response

Severe bacterial infections (sepsis) can lead to an uncontrolled inflammatory response, causing systemic inflammatory response syndrome (SIRS).
SIRS is characterized by the production and release of inflammatory cytokines, leading to generalized vasodilation, increased vascular permeability, and circulatory shock.

C-Reactive Protein (CRP)

CRP is an acute-phase protein and inflammatory biomarker in various clinical conditions.
CRP binds to the surface of invading microorganisms, targeting them for destruction by complement and phagocytosis.

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Description

Explore the importance of nutrition in wound healing, particularly in premature infants. Learn how adequate calories are essential for growth and recovery.