Tissue Repair and Regeneration

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Questions and Answers

In the context of tissue repair, what distinguishes regeneration from fibrosis?

  • Regeneration replaces damaged tissue with healthy, identical tissue, whereas fibrosis involves the formation of scar tissue by fibroblasts. (correct)
  • Regeneration is characterized by the proliferation of permanent cells, whereas fibrosis is associated with the activity of labile cells.
  • Regeneration involves the replacement of damaged tissue with non-functional scar tissue, while fibrosis restores original tissue structure and function.
  • Regeneration occurs primarily in tissues with a compromised supporting framework, while fibrosis is limited to tissues with an intact framework.

How does the condition of the supporting framework influence the type of tissue repair?

  • A damaged framework promotes regeneration by guiding cell growth, while an intact framework leads to fibrosis.
  • The supporting framework only influences the speed of tissue repair, not the type of repair that occurs.
  • The supporting framework determines the extent of inflammation during tissue repair; greater inflammation leads to fibrosis.
  • An intact framework supports organized regeneration, while a destroyed framework results in disorganized repair, potentially leading to fibrosis. (correct)

In the context of tissue repair, what is the primary role of labile cells, and where are they typically found?

  • Labile cells are involved in the repair of nerve tissue through gliosis and are found in the central nervous system.
  • Labile cells primarily secrete growth factors to stimulate repair and are typically found in connective tissues.
  • Labile cells, found in tissues like the epidermis, are continuously dividing and primarily involved in tissue repair by regeneration. (correct)
  • Labile cells are responsible for forming the initial scar tissue and are commonly found in areas of chronic inflammation.

How does the healing process of stable cells differ when comparing scenarios with intact versus damaged supporting frameworks?

<p>With an intact framework, stable cells can regenerate; however, if the framework is damaged, they resort to fibrosis or mixed repair. (D)</p> Signup and view all the answers

In the context of tissue repair, how does gliosis contribute to the healing of damaged nerve tissue involving permanent cells?

<p>Gliosis leads to the formation of a glial scar, which inhibits nerve regeneration and provides structural support. (A)</p> Signup and view all the answers

How do the roles of macrophages and osteoclasts differ in the cleaning phase of a simple bone fracture?

<p>Macrophages and osteoclasts both function in removing necrotic debris and blood from the fracture site. (B)</p> Signup and view all the answers

What roles do capillaries, fibroblasts, and osteoblasts play during the formation of provisional callus in bone healing?

<p>Capillaries provide oxygen and nutrients, fibroblasts deposit collagen, and osteoblasts form the bone matrix. (B)</p> Signup and view all the answers

How does the process of bone remodeling contribute to the final stage of healing a simple bone fracture?

<p>Bone remodeling removes the internal and external callus, allowing the intermediate callus to mature into lamellar bone, restoring bone marrow. (B)</p> Signup and view all the answers

What roles do osteoblasts play in the transition from soft to hard callus during bone fracture repair?

<p>Osteoblasts deposit minerals like calcium phosphate into the soft callus, forming the hard callus. (C)</p> Signup and view all the answers

What are the crucial differences between "osteoid (soft callus)" and "hard callus (osseous)"?

<p>Osteoid callus is soft and lacks mineralization, while osseous callus is mineralized and hard. (C)</p> Signup and view all the answers

How does the depth of skin damage influence the healing process, specifically distinguishing between regeneration and fibrosis?

<p>Damage limited to the epidermis or mucosa heals by regeneration, whereas damage extending into the sub-epithelium results in fibrosis. (C)</p> Signup and view all the answers

In liver damage, how does the state of the supporting framework differentiate between regeneration and cirrhosis?

<p>An intact supporting framework favors regeneration, while a destroyed framework results in disorganized regeneration and cirrhosis. (B)</p> Signup and view all the answers

Which of the following is the most accurate sequence of phases in the healing of any tissue?

<p>Cleaning phase, Proliferation phase, Re-modeling phase (B)</p> Signup and view all the answers

Which of the following situations will most likely cause 'Non-union' during bone fracture healing?

<p>Interposition of soft tissue (muscle or fascia) (B)</p> Signup and view all the answers

Which of the following factors will most likely cause 'Fibrous union' during bone fracture healing?

<p>Poor immobilization of the fractured ends (A)</p> Signup and view all the answers

Which quality of cells leads to tissue healing by regeneration?

<p>Continuously dividing cells (C)</p> Signup and view all the answers

Which of the following cells typically heals by fibrosis?

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

Which of the following cells can heal by both regeneration and mixed regeneration/fibrosis?

<p>Parenchymal cells (B)</p> Signup and view all the answers

After damage to nerve cells, they heal by gliosis. Which type of cells are nerve cells?

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

In which tissue type would scarring of organs be most likely?

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

Flashcards

Tissue Repair

Replacement of damaged tissue by new, healthy tissue.

Regeneration

Replacement of damaged tissue with the same tissue type.

Fibrosis (Gliosis)

Healing by replacement with connective tissue, especially in the CNS.

Cleaning Phase

Removal of necrotic debris by phagocytic cells.

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Proliferation Phase

Cells proliferate to replace the damaged ones.

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Re-modeling Phase

New tissue matures, simulating the original.

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Labile Cells

Continuously dividing cells that heal by regeneration. (e.g. Epidermis, Blood)

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Permanent Cells

Cells that do not proliferate and heal by fibrosis. (e.g. Muscle cells, Nerve cells)

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Stable Cells

Cells that can proliferate with limited capacity and heal by mixed regeneration or fibrosis. (e.g. Parenchymal cells, Mesenchymal cells)

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Granulation Tissue Formation

Fracture healing with capillaries, fibroblasts, and osteoblasts.

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Capillaries' Role in bone healing

Provides oxygen and nutrients to the active cells during bone fracture healing.

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Osteoblasts' Role in bone healing

Forms bone matrix during bone fracture healing.

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Osteoid (Soft Callus)

Soft tissue that unites the fracture ends early in bone healing.

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Hard Callus (Osseous)

Mineralized tissue that completely unites the fracture late in bone healing.

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Fibrous Union

Failure of fractured ends to unite with bone.

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Non-Union

Failure of fractured ends to unite at all.

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Mal-Union

Fractured ends unite in a deformed position.

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Delayed Union

Fracture healing is prolonged.

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Study Notes

  • Tissue repair is the replacement of damaged tissue with new, healthy tissue

Types of Repair

  • Classical types include regeneration and fibrosis (gliosis in the CNS)
  • Another type is organization

Factors determining type of repair

  • The type of damaged cells
  • The condition of the supporting framework

Types of Damaged Cells

  • Labile cells continuously divide, healing by regeneration if damaged; examples include epidermis, mucous membranes, and blood/lymphoid tissue
  • Permanent cells do not proliferate, include muscle cells which heal by fibrosis when damaged, and nerve cells which heal by gliosis
  • Stable cells proliferate with limited capacity, healing by mixed regeneration and/or fibrosis if damaged; examples include parenchymal cells (hepatocytes, renal tubules, endocrine/exocrine glands) and mesenchymal cells (fibroblasts, osteoblasts, chondroblasts)

Supporting Framework

  • Intact framework leads to healing by regeneration
  • Destroyed framework causes disorganized cell growth and improper regeneration mixed with fibrosis, such as in liver cirrhosis

Phases of Healing

  • Cleaning phase involves removing necrotic debris by phagocytic cells
  • Proliferation phase is when cells proliferate to replace the damaged ones
  • Re-modeling phase is the maturation of new tissue to simulate the original

Healing by Regeneration

  • Regeneration replaces damaged tissue with healthy tissue of the same kind

Cells that Heal by Regeneration

  • Labile cells
  • Stable cells with an intact framework

Healing in the Skin

  • Damage limited to the epidermis or mucosa results in regeneration
  • Damage to both the epithelium and sub-epithelium results in fibrosis, with loss of hair follicles, sweat, and sebaceous glands

Healing of Liver Damage

  • Intact supporting framework (mild damage) results in regeneration
  • Destroyed framework (severe damage) results in cirrhosis with disorganized regeneration, fibrosis, and loss of architecture

Healing of a Simple Bone Fracture

Cleaning Phase

  • Macrophages and osteoclasts clean blood and necrotic debris from fracture ends

Proliferation Phase

  • Granulation tissue formation develops between fracture ends, formed of capillaries, fibroblasts, and osteoblasts
  • Capillaries provide O2 and nutrients
  • Fibroblasts create collagen
  • Osteoblasts form bone matrix
  • Early stage sees formation of osteoid (soft callus), uniting the fracture ends, devoid of minerals
  • Osteoblasts secrete alkaline phosphatase, with mineral deposition transforming the soft callus into a hard callus (osseous)

Remodeling Phase

  • Osteoclasts remove unnecessary internal and external callus, leaving the permanent intermediate callus to become mature (lamellar) bone, allowing regeneration of bone marrow

Causes of Failure of Bony Union

  • Poor immobilization leads to fibrous union
  • Interposition of soft tissue like muscle or fascia leads to non-union
  • Lack of proper apposition leads to mal-union
  • Other factors contributing to failure: delayed union, pathological fractures due to bone disease, poor blood supply, infection, old age, and malnutrition

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