Acute Inflammation Flashcards

1
Q

Define acute inflammation

A

Series of protective changes occurring in living tissue as a response to injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of inflammation

A

Redness
Heat
Swelling
Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of acute inflammation

A

Pathogenic organisms e.g. bacteria, fungi, viruses, parasites
Trauma and injury to tissue
Chemical upset to stable environment
Extreme physical condition e.g. radiation
Dead tissue
Hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is microcirculation

A

Capillary beds fed by arterioles and drained by venues
Extracellular space and fluid and molecules within it
Lymphatic channels and drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Steps in acute inflammation

A

Change in vessel radius
Change in permeability of vessel wall
Movement of neutrophils from vessel to extravascular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Local changes in vessel radius

A

Arteriolar constriction
Arteriolar dilation
Relaxation of vessel smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why increase radius+flow?

A

Increased local tissue blood flow
Results in observed redness and heat
Brings more white blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Effects of increased permeability

A

Rate of flow slows (stasis) which produces a change in flow characteristics
Fluid loss - increased viscosity
Exudation - net movement of plasma from capillaries to extravascular space
What is leaked is fluid rich protein which includes immunoglobulin ad fibrinogen, known as exudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Effects of exudation

A

Oedema forms - an accumulation of fluid in extravascular space.
Swelling of tissue in acute inflammation, swelling causes pain and reduces function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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 to extravascular tissues (active process)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ideal outcome of acute inflammation

A
Inciting agent isolated and destroyed
Macrophages move in from blood and phagocytose debris; then fuck off
Epithelial surfaces regenerate
Inflammatory exudate filters away
Vascular changes return to normal
Inflammation resolves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Benefits of acute inflammation

A
Rapid response to non specific insult
Transient protection of inflamed area
Neutrophils destroy organisms and denature antigen for macrophages
Plasma proteins localise process
Resolution and return to normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Outcomes of acute inflammation

A

Resolution
Suppuration
Organisation
Chronic Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do neutrophils do?

A

Mobile phagocytes recognise foreign antigen, move towards it by process of chemotaxis, adhere to organism
Granules possess oxidants and enzymes, the contents are released and they phagocytose and destroy foreign antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Consequences of neutrophil action

A

They die when granule contents are released and produce a soup of fluid, bits of cell, organisms and endogenous proteins i.e. pus
Might extend into other tissues, progressing the inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Role of plasma proteins in inflammation

A

Fibrinogen is a coagulation factor which forms fibrin an clots exudate.
Localises inflammatory process
Immunoglobulins in plasma specific for antigen, humour immune response

17
Q

Mediators of acute inflammation

A

Molecules on endothelial cell surface
Molecules released from cells
Molecules in the plasma

18
Q

Collective effects of mediators

A
Vasodilation
Increased permeability
Neutrophil adhesion
Chemotaxis
Itch and pain
19
Q

Immediate systemic effects of inflammation

A

Pyrexia (raised temperature)
Feel unwell: malaise, anoexia, nausea, abdominal pain and vomiting in kids because they vomit at everything
Neutrophilia - raised white cell count

20
Q

Longer term effects of acute inflammation

A

Lymphadenopathy (regional lymph node enlargement) as part of immune response
Anaemia
Weight loss

21
Q

Outcomes of acute inflammation: suppuration

A

Pus formations and pyogenic membrane surrounding pus

22
Q

Outcomes of acute inflammation: abscess

A

Collection of pus under pressure
Single local or multiloculated
Points and discharges
Collapses - healing and repair

23
Q

Where else can you find pus?

A

Empyema - in a hollow viscus e.g. gall bladder

Pyaemia - discharge into blood stream

24
Q

Outcomes of acute inflammation: organisation

A

Granulation tissue characteristic
Healing and repair
Leads to fibrosis and formation of a scar

25
Q

What is granulation tissue

A

Universal patch repair kit for all damage

26
Q

What is granulation tissue formed of

A

New capillaries
Fibroblasts
Collagen
Macrophages

27
Q

Outcomes of acute inflammation: dissemination

A

Spread to bloodstream - patient is septic

28
Q

What is bacteraemia

A

Bacteria in blood

29
Q

What is septicaemia

A

Growth of bacteria in blood

30
Q

What is toxaemia

A

Toxic products in blood

31
Q

What are the effects of systemic infection

A

Shock - inability to perfuse tissues

32
Q

Clinical picture of early septic shock

A
Tachycardia
Hypotension
Peripheral vasodilation
Often pyrexia
Sometimes haemorrhagic skin rash
33
Q

Pathogenesis of septic shock

A

Systemic release of chemical mediators from cells into plasma
Increased heart rate compensates
Activation of coagulation
Bacterial endotoxin released

34
Q

Outcome of septic shock

A

Rapidly fatal
Tissue hypoxia
Haemorrhage
Requires urgent intervention and support