HEALING
1. Wound healing:
a. Usually results in wounds achieving maximal strength by one month
b. Is characterized by neovascularisation becoming maximal by 48 hours
c. Is facilitated by steroids
d. By secondary intention is characterized by a more intense inflammatory response
e. Does not usually involve contraction in the size of the wound
2. Concerning the repair of a well opposed, clean surgical incision
a. Dermal appendages destroyed by the incision usually recover
b. New collagen begins to accumulate after the first week
c. Granulation tissue does not occur
d. There is an initial inflammatory response
e. 15% of original tissue strength is attained after 1 week
3. With respect to wound healing
a. ?
b. ?
c. neutrophils proliferate at the wound margins at the same time as epithelial proliferation occurs
d. ?
e. ?
4. In healing by primary intention
a. There is a large tissue defect
b. The tissue defect cannot be reconstituted
c. It involves excessive granulation tissue
d. An epithelial spur forms on the first day (24-48 hours)
e. ?
5. Wound healing
a. Is influenced by both cell-cell and cell-matrix interactions
b. Is characterized by neovascularisation within the first six hours
c. Is by secondary intention when a wound is created by a clean surgical incision
d. Leads to eventual scar formation within 24 hours
e. Is considered abnormal if granulation tissue appears by day 5
6. With respect to wound healing, by day 3
a. Neutrophils have been largely replaced by macrophages – 48 to 96 hours
b. Neovascularisation is maximal (5-7 days fills the wound)
c. Collagen bridges the incision
d. Fibroblasts begin proliferating (24-72hr)
e. The leukocyte infiltrate has largely disappeared
7. Removal of sutures from a wound at day 7 coincides with a wound strength of
a. 1% of unwounded skin strength
b. 10% of unwounded skin strength
c. 50% of unwounded skin strength
d. 75% of unwounded skin strength
e. 100% ie. Same as unwounded skin
8. Primary intention wound healing
a. Epithelial spurs at margins at 24 hours (24 - 48 hours, so could also be correct)
b. Marked wound contraction
c. Granulation tissue at…
d. Vitamin C deficiency and repair
e. Single most important factor in delayed wound healing is infection – definitely correct
9. Regarding wound healing, what occurs at the same time?
a. Neutrophils and basal epithelial mitoses
b. Tensile strength and granulation tissue
c. Neutrophils and granulation tissue
d. ?
e. ?
10. Which of the following is an accurate pairing of the steps involved in wound healing by
first intention?
a. Filling of incisional space with blood clot + neovascularisation
b. Appearance of neutrophils at wound margin + epithelial migration along cut margins of dermis
c. Vertical orientation of collagen fibres + blanching
d. Surface keratinisation + wound contraction
e. Loss of dermal appendages + appearance of granulation tissue – late + early
11. After the initial injury a surgical skin wound will usually reach 70% of th tensile strength of
unwounded skin at
a. Day 5
b. During the second week
c. By the end of the first month
d. By the end of the third month
e. A surgical wound cannot exceed a tensile strenth greater than 60% of unwounded skin
12. Wound healing
a. Occurs by secondary intention in surgical wounds
b. Is accelerated by glucocorticoids
c. Achieves maximal wound strength at two weeks
d. Does not depend on site or size of wound
e. Occurring by secondary intention involves abundant granulation tissue
13. Healing by first intention involves:
a. An initial infiltration of macrophages
b. The growth of abundant granulation tissue from the edge of the wound
c. The infiltrate of neutrophils into the clot within 24 hours
d. The formation of a scar within one week
e. The appearance of granulation tissue within 48 hours