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11953744
Wound Healing :)
Description
Mind Map on Wound Healing :), created by Plymouth Med on 21/01/2018.
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Mind Map by
Plymouth Med
, updated more than 1 year ago
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Created by
Plymouth Med
almost 7 years ago
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Resource summary
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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