Notes in 04 Wound Healing

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Published	07/30/2024	At the wound site,PMNs peak at {{c1::1-2}} daysMacrophages peak at {{c1::2-4}} daysT Lymphocytes peak at {{c1::7}} days
Published	07/30/2024	Depletion of most wound T lymphocytes decreases wound {{c1::strength and collagen content}}
Published	07/30/2024	The strongest chemotactic factor for fibroblasts is {{c1::PDGF}}
Published	07/30/2024	PMNs secrete {{c1::TNF-α3}} which has a significant influence on subsequent angiogenesis and collagen synthesis
Published	07/30/2024	[VR]1. Neutrophils in the wound2. Time for epithelial closure{{c1::A}}
Published	07/30/2024	{{c1::Macrophages::Inflammatory cells}} are significant in regulating angiogenesis, matrix deposition, and remodeling
Published	07/30/2024	Selective depletion of the {{c1::CD8+ suppressor}} subset of T lymphocytes enhances wound healing
Published	07/30/2024	Selective depletion of the {{c1::CD4+ helper}} subset of T lymphocytes has no effect on wound healing
Published	07/30/2024	[VR]1. T Lymphocytes2. Fibroblast collagen synthesis{{c1::B}}
Published	07/30/2024	Fibroblasts and endothelial cells infiltrate the healing wound because of the chemotactic factor {{c1::PDGF}}
Published	07/30/2024	[QC] Collagen synthesis1. Wound fibroblasts2. Non-wound fibroblasts{{c1::A}}
Published	07/30/2024	[QC] Proliferation1. Wound fibroblasts2. Non-wound fibroblasts{{c1::B}}
Published	07/30/2024	[QC] Matrix Contraction1. Wound fibroblasts2. Non-wound fibroblasts{{c1::A}}
Published	07/30/2024	{{c1::Lactate}} accumulates in the wound environment over time and is a potent regulator of collagen synthesis through {{c2::ADP-ribosylation}}
Published	07/30/2024	The biggest component of ECM is Type {{c1::I}} collagen
Published	07/30/2024	Aside from Type I collagen, Type {{c1::III}} collagen becomes important in wound healing
Published	07/30/2024	Collagen is composed of a{{c1::Gly}} residue in every 3rd position, and{{c1::Pro or Lys}} residue in every 2nd position
Published	07/30/2024	Protocollagen needs to undergo {{c1::hydroxylation and glycosylation::2}} to become alpha-helical configuration
Published	07/30/2024	{{c1::Protocollagen}} → {{c1::Alpha-helical configuration}} → {{c1::Procollagen}} → Collagen
Published	07/30/2024	Although initially joined by weak, ionic bonds, the procollagen molecule becomes much stronger by the covalent cross-linking of {{c1::lysine}} residue…
Published	07/30/2024	Extracellularly, the {{c2::nonhelical registration peptides}} of procollagen are cleaved by {{c1::procollagen peptidase}}, and the procollagen strands…
Published	07/30/2024	Proteoglycan polysaccharide chains are made up of repeating disaccharide units composed of {{c1::glucuronic or iduronic acid and a hexosamine, which i…
Published	07/30/2024	The major glycosaminoglycans present in wounds are {{c1::dermatan and chondroitin sulfate::2}}
Published	07/30/2024	Assembly and configuration of collagen subunits into fibrils and fibers is dependent on {{c1::extent of sulfation of proteoglycans}}
Published	07/30/2024	In reorganization of previously synthesized Type III collagen, it is broken down by {{c1::matrix metalloproteinases (MMPs)}} and replaced by type…
Published	07/30/2024	The deposition of matrix at the wound site follows a characteristic pattern:Early Matrix Scaffolding Components: {{c1::Fibronectin, Type III Collagen}…
Published	07/30/2024	{{c1::Fibrillin}}, a glycoprotein secreted by fibroblasts, is essential for the formation of elastic fibers found in connective tissue
Published	07/30/2024	During the epithelialization phase of wound healing, {{c1::marginal basal}} cells lose their firm attachment to the underlying dermis, enlarge, and be…
Published	07/30/2024	[Importnat Stimulators of Reepithelialization]Loss of contact inhibitionECM component: {{c1::Fibronectin}}Cytokines: {{c1::EGF, TGF-β, bFGF, PGDF…
Published	07/30/2024	Wound contraction is performed by myofibroblasts as it contains {{c1::α-smooth muscle actin in thick bundles called stress fibers}} giving myofib…
Published	07/30/2024	When does wound contraction occur?{{c1::Almost immediately after injury. A lot of the stuff progress is done because of myofibroblasts on week 2 but i…
Published	07/30/2024	{{c1::Ehlers-Danlos syndrome (EDS)}} Clinical Findings:Thin, friable skin with prominent veins, easy bruising, poor wound healing, atrophic scar forma…
Published	07/30/2024	1/2 of patients with EDS have a genetic defect encoding α-chains of collagen type {{c1::V}}
Published	07/30/2024	Surgical Considerations when suturing a px with EDS:{{c1::Dermal wounds should be closed in two layers, approximated with the sutures under tension, a…
Published	07/30/2024	The genetic defect associated with Marfan’s syndrome is a mutation in the {{c1::FBN1}} gene, which encodes for {{c1::fibrillin}}
Published	07/30/2024	[VR]1. Marfan Syndrome2. {{c1::TGF-B::cytokine}}A
Published	07/30/2024	Osteogenesis Imperfecta (OI) is a result of a mutation in type {{c1::I}} collagen
Published	07/30/2024	{{c1::Osteogenesis Imperfecta (OI)}} Clinical Findings:brittle bones, osteopenia, low muscle mass, hernias, and ligament and joint laxity
Published	07/30/2024	Surgical Considerations when suturing a px with EB:{{c1::esophageal dilatation and gastrostomy tube placement. Dermal incisions must be meticulously p…
Published	07/30/2024	{{c1::Acrodermatitis enteropathica (AE)}} is an autosomal recessive disease of children that causes an inability to absorb sufficient zinc from breast…
Published	07/30/2024	The {{c1::submucosa}} is the layer of the GIT that imparts the greatest tensile strength and greatest suture-holding capacity
Published	07/30/2024	Healing of the {{c1::serosa}} layer of the GIT is required for achieving a watertight fibrin seal from the luminal side of the bowel
Published	07/30/2024	{{c1::Mesothelial (serosal) and mucosal::2}} layers of the GIT can heal can occur without scarring
Published	07/30/2024	[QC] 1st Week of Wound Healing in the GIT1. Collagenosynthesis2. Collagenolysis{{c1::B}}
Published	07/30/2024	{{c1::Pseudomonas aeruginosa}} is a strain of bacteria that shift GIT wound healing to collagenolysis
Published	07/30/2024	[QC] Collagen1. Colon fibroblasts2. Skin fibroblasts{{c1::A}}
Published	07/30/2024	[QC] Collagenase1. SI2. LI{{c1::B}}
Published	07/30/2024	Why should you be careful of fluid resuscitation after a GIT surgery?{{c1::Fluid third spacing, tissue edema, and increased intraabdominal pressure se…
Published	07/30/2024	4 Stages of Bone Healing: [In Order]{{c1::Hematoma FormationFibrocartilaginous/Soft Callus FormationBony Callus FormationBone Remodelling}}
Published	07/30/2024	the process of osseous union is mediated by {{c1::bone morphogenic proteins (BMPs)}}, which belong to the TGF-β superfamily
Published	07/30/2024	[QC] Cartilage Healing1. Superficial Wounds2. Deep Wounds{{c1::B}}
Published	07/30/2024	[QC] Scar Formation1. Hypervascular tendons2. Hypovascular tendons{{c1::B}}
Published	07/30/2024	{{c1::Tenocytes}} in tendons are metabolically very active and retain a large regenerative potential, even in the absence of vascularity
Published	07/30/2024	{{c1::Neurapraxia::Nerve Injury}} - focal demyelination
Published	07/30/2024	{{c1::Axonotmesis::Nerve Injury}} - interruption of axonal continuity but preservation of Schwann cell basal lamina
Published	07/30/2024	{{c1::Neurotmesis::Nerve Injury}} - complete transection
Published	07/30/2024	[QC] Scar Formation1. Adult wounds2. Fetal wounds{{c1::A}}
Published	07/30/2024	The fetus loses the ability to regenerate appendages by the {{c1::3rd}} trimester
Published	07/30/2024	Why is there no scar formation in fetuses?{{c1::Lack of TGF-Beta in fetal wounds}}
Published	07/30/2024	[VR]1. TGF-Beta32. Scar formation{{c1::B. TGF-B3 results in less scar formation because of downregulation of TGF-Beta1 and 2::aside from answer, also …
Published	07/30/2024	[QC] Collagen Synthesis1. Fetal fibroblasts2. Adult fibroblasts{{c1::A}}
Published	07/30/2024	[QC] Hyaluronic Acid Synthesis by Fibroblasts1. Fetus2. Adult{{c1::A. Lit rally Fetal urine sustains the synthesis of hyaluronic acid in fetuses in ut…
Published	07/30/2024	Why does collagen in fetal wound healing form reticular patterns while collagen in adult wound healing forms perpendicular to the surface?{{c1::Fetal …
Published	07/30/2024	an acute wound becomes chronic if healing is not achieved after {{c1::4 weeks::timeframe}} of treatment
Published	07/30/2024	An incised wound that is clean and closed by sutures is said to heal by {{c1::primary}} intention.
Published	07/30/2024	A wound that is left open to heal by granulation tissue formation and contraction is said to heal by {{c1::secondary}} intention.
Published	07/30/2024	A wound that is left open to heal for a few days then subsequently sutured is said to heal by {{c1::tertiary}} intention.
Published	07/30/2024	In what important cases would you let a wound heal by secondary intention?{{c1::Bacterial contamination or Tissue loss (Chronic Ulcers)}}
Published	07/30/2024	In regular wounds, the maximal wound strength is reached after about {{c1::6 weeks::timeframe}} of healing
Published	07/30/2024	[QC] Wound-breaking Strength1. Wounds with healing at normal rate2. Wounds with delayed healing{{c1::A}}
Published	07/30/2024	[QC] Maximal integrity and strength1. Wounds with healing at normal rate2. Wounds with delayed healing{{c1::C}}
Published	07/30/2024	Phases of Wound Healing:{{c1::Hemostasis and InflammationProliferationMatrix SynthesisMaturation and RemodellingEpitheliazation}}
Published	07/30/2024	Use corticosteroids {{c1::3-4 days::timeframe}} after an injury so that it does not affect wound healing as severely as when they are used immediately…
Published	07/30/2024	Administer topical {{c1::vitamin A}} to wounds treated with corticosteroid to stimulate epitheliazation and collagen synthesis
Published	07/30/2024	Use chemotherapeutic antimetabolite drugs {{c1::2 weeks::timeframe}} after an injury so that it does not affect wound healing as severely as when they…
Published	07/30/2024	Px with {{c1:: uncontrolled diabetes::metabolic disorder}} are all automatically special considerations when looking at wound healing because almost e…
Published	07/30/2024	{{c2::Uremic Gangrene Syndrome (Calciphylaxis)}} - Wounds of uremic px with with abnormal deposition of {{c1::calcium and phosphate::2}} in the tissue
Published	07/30/2024	Obesity itself (aka uncomplicated obesity with no comorbidities) does not cause any difference in wound healing w/ px with normal BMIs because it's th…
Published	07/30/2024	{{c1::Arginine::AA}} appears most active in terms of enhancing wound fibroplasia
Published	07/30/2024	a dietary supplemental regimen of {{c1::arginine, β-hydroxy-β-methyl butyrate, and glutamine::3 molecules (Hint: 2 AAs)}} was found to significantly a…
Published	07/30/2024	The vitamins most closely involved with wound healing are vitamin {{c1::C and A::2}}
Published	07/30/2024	{{c1::25-100K}} IU of Vitamin A is recommended for the restoration of wound healing that has been impaired by diabetes, tumor formation, cyclophospham…
Published	07/30/2024	The mineral most closely involved with wound healing is {{c1::Zinc. It increases fibroblast proliferation, and epitheliazation::aside from the mineral…
Published	07/30/2024	Dental Procedure Prophylaxis DOC: {{c1::broad-spectrum penicillins or amoxicillin}}
Published	07/30/2024	Urologic Instrumentation Prophylaxis DOC: {{c1::2nd-Gen Cephalosporin}}
Published	07/30/2024	Anatomical Wound Classification:{{c1::Superficial IncisionalDeep IncisionalOrgan/Space involving fascia, muscle, or the abdominal cavity}}
Published	07/30/2024	{{c1::Contamination::Contamination/Colonization/Infection}} - The presence of bacteria without multiplication
Published	07/30/2024	{{c1::Colonization::Contamination/Colonization/Infection}} - Multiplication without host response
Published	07/30/2024	{{c1::Infection::Contamination/Colonization/Infection}} - presence of host response in reaction to deposition and multiplication of bacteria
Published	07/30/2024	Chronic granulomatous disease (CGD) comprises a genetically heterogeneous group of diseases in which the {{c1::reduced nicotinamide adenine dinucleoti…
Published	07/30/2024	Chronic Granulomatous Disease (CGD) Diagnosis:{{c1::nitro blue tetrazolium (NBT) reduction test}}
Published	07/30/2024	The most common chronic wound is the {{c1::skin ulcer}}
Published	07/30/2024	{{c1::Malignant transformation of a chronic ulcer or Marjolin's Ulcer::Chronic Wound}} Clinical Findings:overturned wound edges of a long-standing wou…
Published	07/30/2024	Cancers arising de novo in chronic wounds include both {{c1::squamous and basal cell carcinomas::2}}
Published	07/30/2024	{{c1::Ischemic Arterial Ulcer::Chronic Wound}} Clinical Findings:Shallow with smooth margins, and a pale base w/ dry, scaling surrounding skin w/ pall…
Published	07/30/2024	Ischemic Arterial Ulcer Tx:{{c1::Revascularization}}Wound Care
Published	07/30/2024	{{c1::Venous Stasis Ulcer::Chronic Wound}} Clinical Findings:Shallow wound w/ irregular margins and pigmented periwound usually over the medial malleo…
Published	07/30/2024	Venous stasis ulcers usually occur in sites over {{c1::incompetent venous perforators (Crockett's perforator above the medial malleolus)}}
Published	07/30/2024	Chronic venous ulcers are commonly pain{{c1::less::less/ful}}
Published	07/30/2024	Venous Stasis Ulcers Pathophysio:{{c1::leakage of fibrinogen or neutrophils into the tissues; polymerization of fibrinogen into fibrin cuffs leads to …
Published	07/30/2024	Why is there lipodermatosclerosis (periwound pigmentation) in venous stasis ulcers?{{c1::Venous hypertension and capillary damage lead to extravasatio…
Published	07/30/2024	Venous Stasis Ulcer Tx:{{c1::Compression using rigid, zinc oxide–impregnated, nonelastic bandage or four-layered bandage approach as a more optimal me…
Published	07/30/2024	The biggest contributor to the formation of the diabetic foot is {{c1::diabetic neuropathy}}
Published	07/30/2024	{{c1::Decubitus/Pressure Ulcer::Chronic Wound}} Clinical Findings:Localized area of tissue necrosis that develops when soft tissue is compressed …
Published	07/30/2024	Stage {{c1::I}} of Decubitus/Pressure Ulcer Formation:No blanching erythema of intact skin
Published	07/30/2024	Stage {{c1::II}} of Decubitus/Pressure Ulcer Formation:Partial-thickness skin loss involving epidermis or dermis or both
Published	07/30/2024	Stage {{c1::III}} of Decubitus/Pressure Ulcer Formation:Full-thickness skin loss, but not through the fascia
Published	07/30/2024	Stage {{c1::IV}} of Decubitus/Pressure Ulcer Formation:Full-thickness skin loss with extensive involvement of muscle and bone.
Published	07/30/2024	[QC] Extension beyond the border of the wound1. Hypertrophic scars (HTSs)2. Keloids{{c1::B}}
Published	07/30/2024	[QC] Regression1. Hypertrophic scars (HTSs)2. Keloids{{c1::A}}
Published	07/30/2024	[VR]1. Occurence of Melanin2. Keloids{{c1::A}}
Published	07/30/2024	The risk of HTS increases if epithelialization takes longer than {{c1::21}} days
Published	07/30/2024	Where to HTS usually occur?{{c1::Areas of tension and flexor surfaces, which tend to be at right angles to joints or skin creases}}
Published	07/30/2024	HTS tend to occur {{c1::4 weeks::time frame}} after an injuryKeloids tend to occur {{c1::3 months to years}} after an injury
Published	07/30/2024	{{c1::skin of the earlobe, deltoid, presternal, and upper back::4}} regions have the highest incidences of forming keloids
Published	07/30/2024	{{c1::Increased thickness of the epidermis with the absence of rete ridges along with mast cells}} is a common histological finding of HTSs and Keloid…
Published	07/30/2024	HTSs collagen bundles are {{c1::parallel to the surface::orientation}}Keloid collagen bundles are {{c1::nonexistent and fibers have random orientation…
Published	07/30/2024	[QC] Collagen Fiber Thickness1. HTS2. Keloid{{c1::B}}
Published	07/30/2024	[QC] Myofibroblasts1. HTS2. Keloid{{c1::A}}
Published	07/30/2024	HTSs and Keloids have an increased response to {{c1::TGF-β::growth factor}}
Published	07/30/2024	HTSs have an increased expression of {{c1::IGF-1::growth factor}}
Published	07/30/2024	Keloids have an increased expression of {{c1::TGF-β1 and 2, VEGF, and plasminogen activator inhibitor-1 and an increased number of PDGF receptors::5 g…
Published	07/30/2024	Keratinocytes in HTSs and Keloids express {{c1::human leukocyte antigen (HLA)-2 and ICAM-1}} receptors, which are absent normal scar keratinocyte…
Published	07/30/2024	[QC] Antinuclear antibodies against fibroblasts, epithelial cells, and endothelial cells1. HTSs2. Keloids{{c1::B}}
Published	07/30/2024	Keloid formation is correlated with serum levels of Ig{{c1::E}}
Published	07/30/2024	HTSs have higher {{c1::T lymphocyte and Langerhans::2}} cell contents
Published	07/30/2024	When treating excision of keloids, add {{c1::silicone}} to prevent rebound hypertrophy in a relatively painless manner
Published	07/30/2024	Keloid Tx:ExcisionSilicone application for {{c1::3 months::time frame}}Intralesional Corticosteroid Injections decrease {{c2::TGF-Beta}} levelsRadiati…
Published	07/30/2024	{{c1::Peritoneal Adhesions}} - Fibrous bands of tissues formed between organs that are normally separated and/or between organs and the internal body …
Published	07/30/2024	[QC] Small bowel obstruction because of adhesion1. Proximal GIT2. Distal GIT{{c1::B}}
Published	07/30/2024	The leading cause of secondary infertility in women are {{c1::adhesions}}
Published	07/30/2024	Adhesion Pathophysio:{{c1::Peritoneal surface is damaged → Mesothelial layer is damaged → Inflammatory response → Fibrin deposition between damaged op…
Published	07/30/2024	Why is fibrinolytic activity reduced in adhesion formation?{{c1::Initial decreses in tPA and later increases of PAI-1 because of TNF-alpha, IL-1, and …
Published	07/30/2024	Anesthesia diluted with Epinephrine for local wound care is contraindicated for wound in {{c1::fingers, toes, ears, nose, or penis::5}} due to the ris…
Published	07/30/2024	Failure to remove the sutures or staples prior to {{c1::7 to 10}} days after repair will result in a cosmetically inferior wound
Published	07/30/2024	Read this entire freaking page. It's like really important but written is such a bad way that ur just going to have to read {{c1::it}}
Published	07/30/2024	{{c1::Absorbent Dressings::Type of Dressing}} - This type of dressing helps control exudate without soaking through the dressing, which can increase i…
Published	07/30/2024	{{c1::Nonadherent Dressings::Type of Dressing}} - impregnated with paraffin, petroleum jelly, or water-soluble jelly for use as nonadherent coverage. …
Published	07/30/2024	{{c1::Occlusive and Semiocclusive Dressings::Type of Dressing}} - Provide a good environment for clean, minimally exudative wounds. These film dressin…
Published	07/30/2024	{{c1::Hydrocolloid and Hydrogel Dressings::Type of Dressing}} - Form complex structures with water, and fluid absorption occurs with particle swelling…
Published	07/30/2024	{{c1::Alginates::Type of Dressing}} - Derived from brown algae and contain long chains of polysaccharides containing mannuronic and glucuronic acid th…
Published	07/30/2024	Reepitheliazation occur within {{c1::1}} days after injury and is seen as thickening of the epidermis at the wound edge and will be finished in a clea…
Published	07/30/2024	Use of chronic exogenous corticosteroids impairs the {{c1::inflammatory}} phase of wound healing
Published	07/30/2024	An important ancillary tx of diabetic wound care is {{c1::increased oxygen tension}}
Published	07/30/2024	{{c1::Epithelialization}} is a phase in wound healing that is not observed in tertiary intention
Published	07/30/2024	Why is there delayed wound healing in px with DM?{{c1::Defects in granulocyte function, capillary ingrowth, and fibroblast proliferation}}
Published	07/30/2024	Wound strength and mechanical integrity in the fresh wound are determined by {{c1::quantity and quality of new deposited collagen}}
Published	07/30/2024	What is the difference between wound healing in young vs old px?{{c1::Same amount of collagen synthesis, more protein accumulation in younger px}}
Published	07/30/2024	Which comes first for fibroblasts, activation or proliferation?{{c1::Proliferation}}
Published	07/30/2024	Profound anemia with {{c1::15}}% less hematocrit can interfere with wound healing
Status	Last Update	Fields