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Yr1 -S1 - Principles of Disease > Acute Inflammation > Flashcards

Acute Inflammation Flashcards

1
Q

Acute Inflammation

A

Fundamental response maintaining the integrity of organism

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

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2
Q

Cardinal Signs of inflammation

A

Rubor (redness)
Calor (heat)
Tumor (swelling)
Dolor (pain)

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3
Q

Aetiology of acute inflammation

A 
Mirco-organisms
Mechanical
Chemical
Physical
Dead tissue
Hypersensitivity
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4
Q

Where does acute inflammation take place?

A

Microcirculation

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5
Q

Microcirculation

A

Capillary beds. Fed by arterioles and drained by venules

Extracellular space and fluid and molecules within it

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6
Q

Starling Forces control…

A

flow (fluid flux) across the membrane

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7
Q

Pathogenesis of acute inflammation involves…

A

Changes in vessel radius (FLOW)

Changes in the permeability of the vessel wall (EXUDATION)

movement of neutrophils from the vessel to the extravascular space

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8
Q

3 effects from local changes in vessel radius and blood flow…
(the triple response)

A
  1. Transient arteriolar constriction
  2. Local arteriolar dilatation
  3. Relaxation of Vessel Smooth muscle
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9
Q

The triple response

A

Flush, Flare, Wheal

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10
Q

Increased Radius = increased flow…. why?

A

Poiseuille’s Law

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11
Q

Increased permeability gives a…

A

localised vascular response (microvascular bed) `

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12
Q

Permeability of vessel wall (EXCUDATION)

A

net movement of plasma from capillaries to extravascular space

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13
Q

Excudate

A

What is leaked

Fluid rich in protein - plasma - includes immunoglobulin and fibrinogen

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14
Q

Effects of Excudation

A

Oedema formed

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15
Q

Oedema

A

accumulation of fluid in the extravascular space (explains swelling of tissue in acute inflammation)

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16
Q

Fluid loss (due to increased permeability) leads to…

A

Increased viscosity (poiseuilles law)

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17
Q

Most important cell in inflammation

A

neutrophil (polymorphonuclear leukocyte) / polymorph/ NPL

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18
Q

Red cells aggregate in the…

A

centre of the lumen

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19
Q

Neutrophils are found…

A

near endothelium

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20
Q

Erythrocytes

A

Red Blood Cell

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21
Q

3 phases of emigration of neutrophils

A

Margination, pavementing, emigration

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22
Q

MIgration

A

neutrophils migrate to endothelium of lumen

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23
Q

Pavementing

A

Neutrophils adhere to enndothelium

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24
Q

Emigration

A

Neutrophils squeeze between endothelial cells to extravascular tissues

25
Q

Resolution of acute inflammation involves…

A

Macrophages moving in from the blood and phagocytosing debris (then leaving)

26
Q

what are neutrophils

A

WBC

Mobile phagocytes (recognise foreign material, move towards it (chemotaxis), adhere to organism))

27
Q

Neutrophils die when…

A

The granule contents are released

They then produce put(fluid with bits of cell, organisms, endogenous proteins etc)

Might extend into other tissues, progressing the inflammation

28
Q

Fibrinogen

A

Coagulation factor
Forms fibrin and clots exudate

localises the inflammatory process

29
Q

Mediators of acute inflammation

A

Molecules on endothelial cell surface membrane

Molecules released from cells

Molecules in the plasma

30
Q

Collective effects of mediators of acute inflammation

A

Vasodilation

Increased permeability

Neutrophil adhesion

Chemotaxis

Itch and pain

31
Q

Molecules released from cells….

A

Histamine

5-hydroxytryptamine (serotonin)

prostaglandins

Leukotrienes

Omega 3 polyunsaturated fatty acids

Platelet-activating factor (PAF)

Cytokines and chemokines (TNFalpha, IL-1)

Nitric Oxide

Oxygen Free radicals

32
Q

Histamine

A

Produced in mast cells beside vessels in response to local injury

causes vasodilatation and increased permeability (therefore allows fluid to cross capillaries etc and enter the respiratory tract)

Acts via H1 receptors on endothelial cells

33
Q

Seratonin

A

Released when platelets degranulate in coagulation

Cause vasoconstriction

34
Q

Prosglandins

A

Many cells (endothelial and leukocytes)

Many promote histamines effects and inhibit inflammatory cells

35
Q

Leukotrienes

A

Neutrophils especially

Vasoactive - dynamic effect on vessels to increase permeability and constrict smooth muscle

36
Q

Omega-3 polyunsaturated fatty acids

A

decrease synthesis of inflammatory mediators

37
Q

Platelet-activating factor (PAF)

A

from inflammatory cells

reduced permeability by enhancing platelet degranulation at site of the injury

38
Q

Cytokines and chemokines

TNFalpha, IL-1

A

Small molecules produced by macrophages lymphocytes, endothelium in response to inflammatory stimuli

attract inflammatory cells

39
Q

Nitric Oxide

A

Various cells

Smooth muscle relaxation, anti-platelet, regulate leukocyte recruitment to inflammatory focus

40
Q

Oxygen free radicals

A

Released by neutrophils on phagocytosis, amplify other mediators

41
Q

Coagulation

A

Also known as clotting

when blood changes from the fluid state - to more of a gel

42
Q

Interactions of 4 enzymes cascades

A

Blood coagulation pathways, fibrinolysis, Kinin system, complement cascade

43
Q

Chemotaxis

A

The movement of a cell in a direction of the concentration gradient of a substance

(can be increasing or decreasing concentration depending on the substance)

44
Q

Immediate systemic effects of inflammation

A

Pyrexia (raised temperature)

Feel unwell (anorexia/nausea/abdominal pain)

Neutrophilia (raised WBC count - bone marrow releases/ produces excess)

45
Q

Longer term effects of Inflammation

A

Lymphadenopathy (regional lymph node enlargement)

Weight loss

Anaemia

46
Q

Suppuration

A

pus forming

47
Q

Exudate

A

mass of cells and fluid that has seeped out of blood vessels

filters into lesions or areas of inflammation

48
Q

Fibrin

A

Protein involved in the clotting of blood

49
Q

Abscess

A

Collection of pus (suppuration) under pressure

50
Q

Multi-loculated abscess

A

Pus bursts through pyogenic membrane and forms new cavities

51
Q

Pus in other places….

Empyema

Pyaemia

A

in hollow viscus (eg gall bladder)

discharge into bloodstream

52
Q

what is Granulation tissue?

A

‘universal patch’ - a repair kit for all damage

Formed of: 
New capillaries (angiogenesis)

Fibroblasts and collagen

Macrophages

53
Q

Dissemination

A

The act of spreading something…. AKA Spread to bloodstream

Bacteraemia (bacteria in blood)

Septicaemia (bacteria GROWS in blood)

Toxaemia (toxic in blood)

54
Q

Main effect of systemic infection

A

septic shock (inability to perfuse tissues)

55
Q

Septic shock

A

Peripheral vasodilatation

Tachycardia (high HR)

Hypotension (low BP)

Pyrexia (high temperature)

Skin rash (sometimes)

56
Q

Pathogenesis of septic shock

A

systemic release of chemical mediators form cells into plasma

cause vasodilatation (loss of SVR)

catecholamine release

tachycardia

Septic shock also releases IL-1 which acts on the hypothalamus to give pyrexia

Also activates coagulation

57
Q

BP =

A

CO x SVR

58
Q

Outcome of Septic Shock

A

Rapidly Fatal

Tissue Hypoxia (cell death)

Haemorrhage

Requires urgent intervention and support

Yr1 -S1 - Principles of Disease (25 decks)

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