《医科大学病理学英文课件CHAPTERITissuerepair》由会员分享，可在线阅读，更多相关《医科大学病理学英文课件CHAPTERITissuerepair（40页珍藏版）》请在金锄头文库上搜索。
1、医科大学病理学英文课件CHAPTER I Tissue repair1. RegenerationComplete regeneration:Incomplete regeneration: fibrous repair scarPhysiologic: cell renewingPathologic: cell injury regeneration一一. Cell cycle and proliferative potential1. Cell cycle Interphase G1 (presynthetic) S (DNA synthesis) G2 (premitotic) Mito
2、tic phase (M) Go : quiescent cells in a physiologic state 2.Types(1) Labile cells (continuously dividing C) Definition: continue to proliferate replacing destroyed cells aged cells Cell groups: Stratified squamous cell : epidermis, oral cavity, vagina and cervixThe lining mucosa of respiratory gastr
3、ointestinal tract Epithelium of the male and female tractMesothelium cellsHematopoietic and lymphoid cells(2) Stable (quiescent) cells: Definition: These cells not divide or at a very slow rate and undergo rapid division in response to injury. Cell groups: Parenchymal cells of glandular organ: liver
4、, kidneys tubuel epithelial. Mesenchymal cells: fibroblast, osteoblast(3) Permanent (nondividing) cells: Definition: no capacity of regeneration Cell groups: Nerve cells: Neurons destroyed are permanent lost replaced by the proliferation of glial C.Skeletal muscle cellsCardiac muscle cells二、二、Regene
5、ration process of various tissues(一一) Epithelial tissue1. Surface epithelium: Squamous cell basal layer cell proliferation Columnar cell adjacent gland recess cellsproliferation 2. Glandular epithelium:Base membrane intact restored cellBase membrane destroyed difficult Liver: Resected partly liver c
6、ell proliferation Necrosis of liver C, reticular framework intact : hepatocyte proliferation restore the structure Necrosis widely, framework collapsed hepatocyte nodular regeneration, FT(二二) Fibrous tissueFibroblast proliferation synthesis collagen derived from quiescent fibrocyte undifferentiated
7、mesenchymal C(三三) BV regeneration1. Capillary: EC budding proteolytic degradation of BM EC budding maturation of EC secrete collagen IV, laminin, fibronectin BM2. Large BV EC proliferation SMC CT proliferationRegeneration of capillary(四四) Cartilage and bone tissue1. Cartilage: proliferation capacity
8、 (chondroblast)2. Bone: proliferation capacity (osteoblast)(五五) muscle regeneration Muscle tissue: lower regenerative capacity Muscle fiber spilt completely FTscar(六六) Nervous tissue NC cant regenerate replaced by glial cell glial scarNevous fiber- schwann cell proliferationNevous fiber- schwann cel
9、l proliferation 3. Fibrous repair一、一、Form and Functions of Granulation Tissue(一一) Composition1.Granulation tissue: composed of numerous newly formed capillaries and fibroblast, accompanied with inflammatory cell infiltration2.Morphology:(1) Gross: red, soft, granular appearance(2) LM: cap + fibrobla
10、st + inflammatory cellsGranulation tissue Granulation tissue(二二) Functions and results1. Functions:(1)Anti-infection and protect wound surface from further injury.(2) Filling wound and the detect area(3) Replacing or encapsule necrosis thrombus, foreign bodies2. Results:GTcap, cell, fFT scar 二、二、Sca
11、r （一）（一）Concept granulation tissue CT（二）（二）MorphologyGross：contract, pallor, semitransparent tough less elasticity. LM： composed of collagen parallel fasciculi (hyaline change), less fibrous cells, and BVScarl（三）（三）effect and harm of scar l1benefits：lfilling the wound and ulcer, make tissue, organ i
12、ntact;stronger resist pull；if lack of elasticityhernia.l2disbenefit and harm:lcontractobstruction.obstruction.lconglutination.lexcess hyperplasia，hypertrophic scar (keloid). 三三 wound healing:l1.early change: an acute inflammatory process by the initial injury l2.contraction of woundl3. proliferation
13、 of granulation tissue and formation of scarl4. migration and regeneration of epithelium and other tissuesl2. types of wound healingl1) Healing by first intention (wounds with opposed edges) la clean, uninfected surgical incisionl2) Healing by second intention (wounds with separated edges) lmore ext
14、ensive loss of cells and tissue, as occurs in infarction, inflammatory ulceration, abscess formation, and surface wounds that create large defectsHealing under scar( (二二二二) ) bone fracture healingbone fracture healing 1. 1. basic processbasic process hematoma formationhematoma formation：1-21-2daysda
15、ys fibrous bone scab formationfibrous bone scab formation： 2-3 2-3days, granulation tissue formdays, granulation tissue form osteal bone scab:osteal bone scab: osblast osloid tissue calcium deposition osblast osloid tissue calcium deposition woven bone osteal bone scab.woven bone osteal bone scab. r
16、ebuild or remodelrebuild or remodel: : woven woven bone bone ply ply bone bone normal normal relationship relationship normal struture.normal struture. l 2. factors of affect fracture healingl correct reposition timely l firmly fixation timelyl take exercise early, keep local blood supply well.骨痂骨痂骨
17、痂骨痂 NearthrosisCPC病例3l王，男，12岁，因“车祸左小腿疼痛活动受限2小时“入院。患者2小时前被车撞倒在地，当时左小腿弯曲、疼痛，不能活动。入院检查：体温37。C，脉搏100次/分，血压90/60mmHg，左小腿肿胀，短缩，局部有压痛，可触及骨擦感，左小腿不能活动。l B超：腹内脏器未见异常。l 实验室检查：血常规、尿常规均正常。X线检查： 左左胫骨中下段骨中下段1/31/3斜形完全性骨折，左腓骨上斜形完全性骨折，左腓骨上1/31/3骨折骨折临临床床处处理：理：术术后后X X线报线报告告对对位、位、对线对线尚可。尚可。术术后一周后一周再次复再次复查查，结结果同前。一月后复果同
18、前。一月后复查查，对对位、位、对线对线良良好，好，见见少量骨痂形成。少量骨痂形成。牵牵引一月后改引一月后改为为石膏固定二石膏固定二月。月。术术后三月复后三月复查查：骨骨性性骨骨痂痂形形成成骨折愈合骨折愈合过过程程组织组织病理学改病理学改变变血血肿形成：骨折断端形成：骨折断端间形成血形成血肿 血血肿机化：幼稚机化：幼稚结缔组织含新含新生毛生毛细血管，包血管，包围并侵入血并侵入血肿纤维及及软骨性骨痂形成骨性骨痂形成 软骨性骨痂及骨性骨痂形成骨性骨痂及骨性骨痂形成 Masson染色染色 骨痂形成：骨痂形成：软骨骨细胞肥大，基胞肥大，基质钙化，以化，以软骨内化骨的方式成骨。骨内化骨的方式成骨。 骨痂形
19、成：骨痂形成：软骨性骨痂以骨性骨痂以软骨内骨内化骨化的方式形成幼稚的化骨化的方式形成幼稚的编织骨骨 massonmasson染色染色 骨痂形成：骨痂中新生骨骨痂形成：骨痂中新生骨为编织骨小梁表面骨小梁表面为成骨成骨 细胞，小梁胞，小梁间纤维组织富于血管。富于血管。l讨论：l 1. 该骨折愈合属于哪种类型的修复？l 2. 骨折愈合的基本过程如何？l 3. 哪些因素可影响骨折的愈合？病例三答案1.再生性修复2.(1)血肿形成 (2)纤维性骨痂 (3)骨性骨痂3.(1)复合因素：年龄、营养、内分泌(2)局部因素：感染与异物、局部血液循环、神经、电离辐射 (3)影响骨折愈合的因素：骨折断端的及时、正确的复位；及时、牢靠的固定；早日功能锻炼，保持良好血液供应。
