Wound Healing :)

Description

Mind Map on Wound Healing :), created by Plymouth Med on 21/01/2018.
Plymouth Med
Mind Map by Plymouth Med, updated more than 1 year ago
Plymouth Med
Created by Plymouth Med over 6 years ago
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Resource summary

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