病理学英文ppt课件3Tissue-repair

,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,CHAPTER Tissue repair,CHAPTER Tissue rep,1,1. Regeneration,Complete regeneration:,Incomplete regeneration:,fibrous repair scar,Physiologic: cell renewing,Pathologic: cell injury regeneration,1. RegenerationComplete rege,2,一.,Cell cycle and proliferative potential,1. Cell cycle,Interphase G1 (presynthetic),S (DNA synthesis),G2 (premitotic),Mitotic phase (M),Go : quiescent cells in a physiologic state,一. Cell cycle and proliferativ,3,2.Types,(1),Labile cells,(continuously dividing C), Definition:,continue to proliferate,replacing destroyed cells,aged cells,2.Types(1) Labile cells (conti,4,Cell groups:,Stratified squamous cell : epidermis,oral cavity, vagina and cervix,The lining mucosa of respiratory,gastrointestinal tract,Epithelium of the male and female tract,Mesothelium cells,Hematopoietic and lymphoid cells, Cell groups: Stratified squa,5,(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, kidneys tubuel epithelial.,Mesenchymal cells: fibroblast, osteoblast,(2) Stable (quiescent) cells:,6,(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 cells,Cardiac muscle cells,(3) Permanent (nondividing) ce,7,二、,Regeneration process of various tissues,(,一,) Epithelial tissue,1. Surface epithelium:,Squamous cell basal layer cell,proliferation,Columnar cell adjacent gland recess,cellsproliferation,二、Regeneration process of,8,2. Glandular epithelium:,Base membrane intact restored cell,Base membrane destroyed difficult,Liver:, Resected partly liver cell proliferation, Necrosis of liver C, reticular framework,intact : hepatocyte proliferation ,restore the structure, Necrosis widely, framework collapsed hepatocyte nodular regeneration, FT,2. Glandular epithelium:Base m,9,(,二,) Fibrous tissue,Fibroblast proliferation,synthesis collagen,derived from,quiescent,fibrocyte,undifferentiated mesenchymal C,(二) Fibrous tissueFibroblast p,10,(,三,) BV regeneration,1. Capillary:,EC budding,proteolytic degradation of BM EC budding maturation of EC secrete collagen IV, laminin, fibronectin BM,2. Large BV EC proliferation,SMC CT proliferation,(三) BV regeneration1. Capillar,11,Regeneration of capillary,Regeneration of capillary,12,(,四,) Cartilage and bone tissue,1. Cartilage: proliferation capacity (chondroblast),2. Bone: proliferation capacity (osteoblast),(,五,) muscle regeneration,Muscle tissue: lower regenerative capacity,Muscle fiber spilt completely FTscar,(,六,) Nervous tissue,NC cant regenerate,replaced by glial cell glial scar,(四) Cartilage and bone tissue,13,Nevous fiber- schwann cell proliferation,Nevous fiber- schwann cell p,14,3. Fibrous repair,一、,Form and Functions of Granulation Tissue,(,一,) Composition,1.Granulation tissue:,composed of numerous newly formed capillaries and fibroblast, accompanied with inflammatory cell infiltration,2.Morphology:,(1) Gross: red, soft, granular appearance,(2) LM: cap + fibroblast + inflammatory cells,3. Fibrous repair一、Form and F,15,Granulation tissue,Granulation tissue,16,Granulation tissue,Granulation tissue,17,(,二,) Functions and results,1. 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 bodies,2. Results:,GTcap, cell, fFT scar,(二) Functions and results1. Fu,18,二、,Scar,（一）,Concept,granulation tissue CT,（二）,Morphology,Gross,：,contract, pallor, semitransparent,tough less elasticity.,LM,：,composed of collagen parallel,fasciculi (hyaline change),less fibrous cells, and BV,二、Scar,19,Scar,Scar,20,（三）,effect and harm of scar,1,benefits,：,filling the wound and ulcer, make tissue, organ intact;,stronger resist pull,；,if lack of elasticity,hernia.,2,disbenefit and harm:,contract,obstruction.,conglutination.,excess hyperplasia,，,hypertrophic scar (keloid).,（三）effect and harm of scar,21,三,wound healing:,1.early change: an acute inflammatory process by the initial injury,2.contraction of wound,3. proliferation of granulation tissue and formation of scar,4. migration and regeneration of epithelium and other tissues,三 wound healing:,22,2.,types of wound healing,1,) Healing by first intention (wounds with opposed edges),a clean, uninfected surgical incision,2) Healing by second intention (wounds with separated edges),more extensive loss of cells and tissue, as occurs in infarction, inflammatory ulceration, abscess formation, and surface wounds that create large defects,2. types of wound healing,23,病理学英文ppt课件3Tissue-repair,24,Healing under scar,Healing under scar,25,(二),bone fracture healing,1.,basic process,hematoma formation,：,1-2,days,fibrous bone scab formation,：,2-3,days, granulation tissue form,osteal bone scab:,osblast, osloid tissue calcium deposition woven bone ,osteal bone scab.,rebuild or remodel,:,woven bone,ply bone normal relationship normal struture.,(二) bone fracture healing,26,2.,factors of affect fracture healing,correct reposition timely,firmly fixation timely,take exercise early, keep local blood supply well.,2. factors of affect fracture,27,病理学英文ppt课件3Tissue-repair,28,病理学英文ppt课件3Tissue-repair,29,骨痂,骨痂,30,Nearthrosis,N,31,CPC,病例,3,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。,B,超：,腹内脏器未见异常。,实验室检查：,血常规、尿常规均正常。,CPC病例3王，男，12岁，因“车祸左小腿疼痛活动受限2,32,X,线检查：,左胫骨中下段,1/3,斜形完全性骨折，左腓骨上,1/3,骨折,X线检查： 左胫骨中下段1/3斜形完全性骨折，左腓骨上1/3,33,临床处理：,术后,X,线报告对位、对线尚可。术后一周再次复查，结果同前。一月后复查，对位、对线良好，见少量骨痂形成。牵引一月后改为石膏固定二月。术后三月复查：,骨性骨痂形成,临床处理：术后X线报告对位、对线尚可。术后一周再次复查，结果,34,骨折愈合过程组织病理学改变,血肿形成：骨折断端间形成血肿,血肿机化：幼稚结缔组织含新生毛细血管，包围并侵入血肿,骨折愈合过程组织病理学改变血肿形成：骨折断端间形成血肿 血肿,35,纤维及软骨性骨痂形成,软骨性骨痂及骨性骨痂形成,Masson,染色,纤维及软骨性骨痂形成 软骨性骨痂及骨性骨痂形成 Masson,36,骨痂形成：软骨细胞肥大，基质钙化，以软骨内化骨的方式成骨。,骨痂形成：软骨性骨痂以软骨内化骨化的方式形成幼稚的编织骨,masson,染色,骨痂形成：软骨细胞肥大，基质钙化，以软骨内化骨的方式成骨。,37,骨痂形成：骨痂中新生骨为编织骨小梁表面为成骨 细胞，小梁间纤维组织富于血管。,骨痂形成：骨痂中新生骨为编织骨小梁表面为成骨,38,讨论：,1.,该骨折愈合属于哪种类型的修复？,2.,骨折愈合的基本过程如何？,3.,哪些因素可影响骨折的愈合？,讨论：,39,病例三答案,再生性修复,(1)血肿形成 (2)纤维性骨痂 (3)骨性骨痂,(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。,病例三答案再生性修复,40,