Acute Inflammation 1 Flashcards

1
Q

What is acute inflammation?

A

o Acute inflammation is a fundamental response maintaining integrity of an organism.
o It is a series or protective changes occurring in living tissue as a response to injury.
o It is a dynamic homeostatic response found in higher organisms.

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2
Q

What micro-organisms can cause acute inflammation?

A
  • bacteria
  • fungi
  • viruses
  • parasites
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3
Q

What are the mechanical causes of acute inflammation?

A
  • trauma
  • all injuries even sterile
  • surgery
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4
Q

What are the chemical causes of acute inflammation?

A
  • upset to pH

- irritation when bile and urine is in inappropriate place

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5
Q

What are the physical- extreme condition causes of acute inflammation?

A
  • heat=sunburn
  • cold=frostbite
  • ionising radiation
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6
Q

Why does dead tissue cause acute inflammation?

A

cell necrosis irritates adjacent tissue

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7
Q

What are the cardinal signs of inflammation?

A
  • tumour
  • dolor
  • rubor
  • calor
  • loss of function
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8
Q

What is the process of acute inflammation?

A

o Series of microscopic events
o Localised to affected tissue
o Take place in the microcirculation
o Result in the clinical symptoms and signs of acute inflammation- the cardinal signs.

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9
Q

What is involved in microcirculation?

A
  • capillary beds fed by arterioles and drained by venules
  • extracellular space and fluid and fluid and molecules within it
  • lymphatic channels and drainage
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10
Q

What do starling forces control?

A

flow (fluid flux) across membrane

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11
Q

What is involved in dynamic balance?

A

hydrostatic and colloid pressures, compartments and physical constants

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12
Q

What is pathogenesis in acute inflammation?

A

o Changes in vessel radius- flow
o Change in the permeability of the vessel wall- exudation
o Movement of neutrophils from the vessel to the extravascular space.

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13
Q

What are the 3 stages in the triple response?

A

flush, flare and wheal

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14
Q

Describe the process of the triple response.

A

o Transient arteriolar constriction (few movements, probably protective)
o Local arteriolar dilatation (active hyperaemia)
o Relaxation of vessel smooth muscle (autonomic NS or mediator derived?)

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15
Q

Why is there an increase in blood flow?

A

o Poiseuille’s law= flow is proportional to radius to the power of 4
o Increased arteriolar radius causes increased local tissue blood flow
o Results in observed redness and heat
o A minute increase in the radius of a vessel will majorly increase the flow if no other factor changes.

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16
Q

Why is there increased permeability of blood vessels?

A

o It is a localised vascular response that takes place at the microvascular bed.
o There is endothelial leakage, the fluid and proteins are not held in the vessel lumen which causes an imbalance in starling forces.
o Locally produced chemical mediators are involved.

17
Q

What are the effects of increased permeability?

A
  • Overall there is a net movement of plasma from the capillaries to the extravascular space.
  • The process is known as exudation and the fluid leaked is exudate.
  • Exudate is a fluid rich in protein, plasma and includes immunoglobulin and fibrinogen
  • Fluid loss increases the viscosity which in turn slow rate of flow causing a change in flow characteristic in the vessel
18
Q

What are the effects of exudation?

A
  • oedema is formed (accumulation of fluid in the extravascular space)
  • cause of swelling of tissue
  • the swelling causes pain and reduces function
19
Q

What is normal laminar flow?

A
  • WBC, neutrophils at centre of vessel
  • Surrounded by erythrocytes
  • Plasma at edge of vessel
20
Q

What is flow in inflammation?

A
  • loss of normal laminar flow
  • red cells aggregate in the centre of the lumen- rouleaux formation
  • neutrophils are found near endothelium- margination
21
Q

What are the phases of emigration of neutrophils?

A
  • margination= neutrophils move to endothelial aspect of lumen
  • pavementing= neutrophils adhere to endothelium
  • emigration- neutrophils squeeze between endothelial cells. Active process to extravascular tissues
22
Q

What are some examples of acute inflammation?

A
  • gingivitis
  • pleural inflammation
  • inflamed appendix
  • acute pyelonephritis
  • bacterial endocarditis
23
Q

What is the ideal outcome of acute inflammation?

A
  • inciting agent isolated and destroyed
  • macrophages move in from blood and phagocytose debris; the leave
  • epithelial surfaces regenerate
  • inflammatory exudate filters away
  • vascular changes return to normal
  • inflammation resolves
24
Q

What are the benefits of acute inflammation?

A
  • rapid response to non-specific insult
  • transient protection of inflamed area (cardinal signs)
  • neutrophils destroy organisms and denature antigen for macrophages
  • plasma proteins localise process
  • resolution and return to normal
25
Q

What are the outcomes of acute inflammation?

A
  • resolution
  • suppuration
  • organisation
  • chronic inflammation