Acute & Chronic Inflammation

Question 1

define inflammation

Answer 1

response to offending agents by vascularised tissue bringing to itself cells and molecules from circulation to eliminate the agents

Question 2

5 cardinal signs of inflammation

Answer 2

1. pain
2. redness
3. swelling [oedema]
4. heat/warmth
5. loss of function

Question 3

3 groups of inflammatory mediators secreted by mast cell degranulation

Answer 3

1. histamine
2. eicosanoids –> prostaglandins, thromboxanes, leukotrienes
3. cytokines [delayed because they are proteins take time to transcribe and translate]

Question 4

functions of tryptase and chymase

Answer 4

tryptase: cleaves fibrinogen + activate collagenase

chymase: cause degradation of epidermal basement membrane + stimulate mucus secretion

Question 5

pathogenesis of inflammation

Answer 5

mast cell/macrophage detect offending agent –> degranulation –> trigger vasodilation + bradyk/prosta trigger nociception + migration of neutrophils + increased vascular permeability

Question 6

5 systemic symptoms of inflammation

Answer 6

1. blood changes
   - anemia [bone marrow making inflammatory cells so can run out of resources to make RBCs],
   - leukocytosis: elevated wbcs
2. pyrexia –> TNFa –> PGE2 in hypothalmus
3. malaise
4. anorexia
5. nausea
6. swollen lymph nodes
7. leukocytosis

Question 7

infiltrate of chronic inflammation

Answer 7

lymphocytes, macrophages, plasma cells

Question 8

chronic inflammation definition

Answer 8

response of prolonged duration in which inflammation, tissue injuiry and attempts at repair coexists in varying combinations

Question 9

granuloma vs granulation

Answer 9

Granuloma is an aggregate of epithelioid histiocytes and a feature of some specific chronic inflammatory disorders.

Granulation tissue is an important component of healing and comprises small blood vessels in a connective tissue matrix with myofibroblasts.

Question 10

regeneration vs repair

Answer 10

rem cells regenerate vs rem cells cannot regenerate

restores orignal tissue vs connective tissue replaces lost cells [fibrosis]

no loss of fn vs some loss of fn

Question 11

5 steps of healing and repair

Answer 11

1. granulation tissue formation
2. hemostasis
3. angiogenesis
4. ECM deposition
5. re-epithelialisation
6. scar formation + remodelling

Question 12

healing

Answer 12

• cell proliferation –> rapid division and expansion
• migration –> cells move and cover exposed areas
• angiogensis –> cells involved in regeneration and fibrous repair need nutrients and oxygen
• inflammation –> immune cells clearing infectious/injurious stimuli
• ECM deposition –> collagen fibers form the glue which hold the final healing product together [remodelling]

Question 13

2 roles of macrophages in wound healing/repair

Answer 13

1. debridement [neutrophils]
2. secrete cytokines and growth factors for ECM deposition

Question 14

3 cell types involved in granulation tissue formation + roles

Answer 14

1. immune cells [macrophages –> debridement]
2. vascular connective tissue cells [endothelial cells, rbc –> angiogenesis]
3. (myo)fibroblasts –> ECM deposition

Question 15

Regenerative ability categories

Answer 15

labile [always regenerating as part of physio fn]
stable [can regenerate w appropriate signals]
permanent [never regenerates]

Question 16

4 labile tissues

Answer 16

1. bone marrow
2. skin
3. hair follicles
4. mucosae

Question 17

stable tissues

Answer 17

pancreas, liver

Question 18

permanent tissues

Answer 18

brain, heart

Question 19

transformation of granulation tissue to become scar

Answer 19

1. collagen iii provisional matrix
2. replacement with collagen i
3. rearrangement of collagen wrt new lines of stress
4. vascular resorption

Question 20

healing by 1st intention must have

Answer 20

apposed skin [skin that aligns/matches up