Acute Inflammation 2 Flashcards
What is inflammation named according to?
The anatomical location if occurs at
How is inflammation named?
‘Structure’-itis
Such as:
Peritonitis (perioneal cavity)
Meningitis (meninges)
Appendicitis (appendix)
Except for:
Lungs
Pleural cavity
What is inflammation of the lungs known as?
Pneumonia
What is inflammation of the pleural cavity known as?
Pleurisy
What is the process of neutrophils destroying pathogens?
1) Recognise foreign anitgens
2) Move towards it
3) Adhere to it
4) Release oxidants (such as hydrogen peroxide) and enzymes (such as proteases) and destroy the pathogen
What is the consequence of neutrophil action?
Once they die they release their granules, producing pus which might extend to other tissues and cause further inflammation
What is pus?
A soup of fluids, containing bits of cells, organisms and endogenous proteins
What are the main plasma proteins in inflammation?
Fibinogen
Immunoglobulin
What is the role of fibrinogen?
Forms fibrin and clots exudate (localising the process)
What is the role of immunoglobulins?
Specific for antigen, humoral immune response
What are mediators of acute inflammation?
Molecules on endothelial cell surface
Molecules released from cells
Molecules in the plasma
Molecules inside cells
What are the collective effect of mediators?
Vasodilation
Increased permeability
Neutrophil adhesion
Chemotaxis (movement of motile cell)
Itch and pain
What is chemotaxis?
Movement of motile cell
What helps neutrophils stick?
Cell surface mediator ICAM-1 which appears on endothelial cells
What are mediators released from cells?
Histamine
Serotonin
Prostglandins
Cytokines
Nitric oxide
Oxygen free radicals
What cells release histamine?
Mast cells
Platelets
Basophils
What does histamine cause?
Vasodilation
Increased permeability
What releases serotonin?
Plateletes
What does serotonin do?
Causes vasoconstriction
What do prostgandlins do?
Promote histamine effect
Inhibit inflammatory cells
What produces cytokines?
Macrophages
Lymphocytes
Endothelium
What effects do cytokines have?
Both pro and anti-inflammatory
What do cytokines do?
Stimulate extracellular pathways and signilling
What does nitric acid do?
Smooth muscle relaxation
Anti-platelet
Regulate lymphocyte recruitment
What releases oxygen free radicals?
Neutrophils on phagocytosis
What do oxygen free radicals do?
Amplify other mediatory effects
What are molecules released inside cells for?
Signilling
What do are mediators released inside the cell?
Pathogen associated molecular pattern
Danger associated molecular pattern
What do mediators released inside the cell do?
Activate inflammatory response
What are the 4 purposes of plasma molecules?
Blood coagulation pathways
Fibrinolysis
Kinin system
Compliment cascade
What are blood coagulation pathways?
Ones which clots fibrinogen in exudate
What is fibrinolysis?
Break down of fibrin to help maintain blood supply
What are fibrin breakdown products?
Vasoactive
What does the kinin system do?
Bradykinin causes blood vessels to dilate
What does the compliment cascade do?
Ties inflammaiton with the immune system
Active components stimulate increased permeability, chemotaxis, phagocytosis and cell breakdown
What are the systematic effects of inflammation?
Pyrexia (raised temperature)
Feel unwell (malaise, anorexia, nausea, abdominal pain and vomiting)
Neutrophilia (raised white blood cellcount)
What is pyrexia?
Raised temperature
What could long term effects of inflammation be?
Lymphadenopathy (regional lymph node enlargement)
Weight loss
Anaemia
What is pus surrounded by and what does this do?
Pyogenic membrane which contains it
What is an abscess?
Collection of pus under pressure
What happens if pus breaks through the pyogenic membrane?
New cavities can be formed
What is an outcome of pus breaking through pyogenic membrane?
Formulation of granulation tissue which heals and leads to fibrosis and formation of a scar
What can granulation tissue be described as?
A universal patch, a repair kit for all damage
What does granulation tissue lead to the formation of?
New capillaries (angiogenesis)
Fibroblasts and collagen
Macrophages
What may occur after acute inflammation?
Dissemation
What are different kinds of dissemation after acute inflammation?
Patient septic (spreads to the bloodstream)
Bacteraemia (bacteria in blood)
Septicaemia (growth of bacteria in blood)
Toxaemia (toxic products in blood)
What are some basic cardiovascular terms?
Blood pressure (BP)
Cardiac output (CO)
Stroke volume (SV)
Heart rate (HR)
Systematic vascular resistance (SVR)
What is a formula that describes cardiac output?
CO = SV x HR
What is a formula that describes blood pressure?
BP = CO x SVR
What could systematic infection lead to?
Shock
What is shock?
The inability to perfuse tissues (passage of fluid through the circulatory system)
What are clinical symptoms of shock?
Peripheral vasodilation
Tachycardia (high heart rate)
Hypotension (low blood pressure)
Often pyrexia (raised body temperature)
What is tachycardia?
High heart rate
What is the pathogenesis of shock?
1) Systematic release of chemical mediators into plasma, causing vasodilation and loss of systematic vascular resistance
2) Increased heart rate to maintain cardiac output
3) Bacterial endotoxin is released which acts on hypthalamas and causes pyrexia
4) Activation of coagulation (liquid changes to solid state)
5) When increased heart rate cannot maintain cardiac output, blood pressure falls
6) Reduced perfusion of tissues which leads to loss of tissue and organ function
What are the outcomes of shock?
Quickly fatal
Tissue hypoxia (cell death)
Haemorrhage
What is a summary of acute inflammation outcomes?
Resolution
Suppuration
Organisation
Dissemation
Chronic inflammation
