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Wound Healing :)

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Wound Healing :)

1. Vasospasm
- Reflex induced by the pain receptors
- Slows blood flow BUT arterial pressure maintained
  - 2. Vasoconstriction
    - Vasodilators inhibited
      - Nitrous Oxide
      - Prostacyclin
    - Increase in Endothelin
      - Vasoconstrictor
        helps prevent blood loss
        Need more stabilization
        3. Platelet Plug
        Requires platelets
        Myeloid Stem Cells
        Megakaryocytes
        1000x Thrombocytes
        Produced in Red Bone Marrow
        Stimulated by thrombopoietin
        Liver and Kidneys produce thrombopoietin
        Have no nuclei
        Lightest and smallest in the blood
        are granulocytes
        temporary blood clot via 3 steps
        1a. Adhesion
        Integrins bind to Collagen
        Integrins: on platelet surface
        Epithelium breaks
        Tunica Intima becomes exposed
        Collagen becomes exposed
        Von Willebrand Factor leaks in
        Von Willebrand Factor = glue of the platelet plug
        vWF from blood/plasma
        Binds to collagen and microfibrils
        Binds to glycoprotein 1-B
        on platelets surface
        hence vWF captures platelets
        1b) Platelet activation
        GP1-B conformational change
        Degranulation
        Alpha Granule
        Dense Granule
        Release
        ADP
        Increased Platelet Aggregation
        Calcium Ions
        Serotonin
        Increased Vascular Spasm
        Thromboxane (TXA2)
        Platelet Derived Growth Factor (PDGF)
        1c) Causes Platelet Aggregation
        Activated platelets latch onto other platelets and bring them together
        Further activation of platelets
        Temporary Clot formed
        Clot needs further stabilization
        4. Coagulation Cascade
        12
        12a
        11
        11a
        9
        9a
        10
        10a
        Prothrombin
        Thrombin (2)
        Fibrinogen
        Loose Fibrin
        Tight Fibrin
        CLOT
        5. Clot Stabilization
        Clot Contraction
        Clot Retraction
        Leads to serum being squeezed out of the clot
        Platelet Derived Growth Factor causes fibroblasts to form temporary connective tissue patch
        Smooth muscle cells restore musculature
        VEGF: Vascular Endothelial Growth Factor
        Endothelial lining restored
        Need to remove Clot
        6. Anticoagulation Systems
        Heparin
        Produced by Mast cells in peripheral connective tissues
        on endothelial cells
        on basophils
        Enhances Antithrombin III
        Binds to thrombin
        Inactivates Thrombin
        Prevents further formation of fibrin
        Tissue Plasminogen Activator
        Thrombin activates
        Factor 12 activates
        Plasminogen
        Plasmin
        main fibrinolytic enzyme
        directly degrades thrombus (clot)
        Removes deoxygenated blood within clot
        7. Bruising
        • Due to deoxygenated blood clot within skin/tissue
        7a. Breakdown of Hemoglobin
        Red-Blue color
        7b. Biliverdin
        Green color
        7c. Bilirubin
        Yellow
        7d. Hemosiderin
        Brown/Golden
        8. Immune Response
        Mast cell degranulation
        Release Histamine
        Vasodilation
        White blood cells arrive, etc. etc.
        Platelets affect neutrophils: bring over to site of interest
        Macrophages cause fibroblast proliferation/maturation
        Fibroblasts lay down collagen
        Lay down new tissue
        Tissue Repair
        9. Proliferation Phase
        Form granulation tissue
        Pink Tissue
        Highly resistant to infection
        Organizational Stage
        Very basic capillaries
        10. Angiogenesis
        need blood to heal
        New vessels branch off of pre-existing capillaries
        11. Epithelialization
        Macrophage stimulation of fibroblasts
        Release of FGF7 (fibroblast growth factor 7)
        Stimulates keratinocyte proliferation
        Keratinocyte migration upwards to build back tissue
        12. Tissue Maturation
        12a. Provisional Matrix
        moves a lot
        Original Collagen III
        Fibrin
        Plasmafibrinectin
        12b. remodels into Matrix
        sturdier
        Collagen I
        tougher skin
        13. Scarring may occur
        SCAR
        usually via Deep Injury
        usually lies underneath skin
        severe--> "tight white line" appearance
        HOW: myofibroblasts lining edge of the wound contract
        THE END!!!
        VEGF (Vascular Endothelial Growth Factor) promotes
        Endostatin (anti-VEG) inhibits
        Macrophages release 1L-6
        Proinflammation
        Release Bradykinin
        Increased vascular permeability
        Phagocytic cells also remove
        Thrombomodulin
        binds to thrombin
        Converts thrombin so that it doesn’t make fibrin anymore
        Fibrin
        Down regulates thrombin's positive feedback loop
        Protein C
        cleaves factor 5
        Protein S
        cleaves factor 8
        Factor 13
        Cleaves fibrinogen into fibrin
        5
        Calcium
        Platelet Factor 3 (PF3)
        3
        Tissue Thromboplastin
        released when tissue damaged
        7
        Calcium
        Limiting Factor
        8
        Calcium
        Platelet Factor 3 (PF3)
        4
        Calcium
        "Hemostasis"
        Minerals and Calcium needed to make factors
        factors are in blood
        Liver makes most factors
        Aggregation also attracts white blood cells to the site

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Description: Mind Map on Wound Healing :), created by Plymouth Med on 21/01/2018.
Created by: Plymouth Med
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Wound Healing :)

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