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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
Resolution of acute inflammation involves...
Macrophages moving in from the blood and phagocytosing debris (then leaving)
26
what are neutrophils
WBC Mobile phagocytes (recognise foreign material, move towards it (chemotaxis), adhere to organism))
27
Neutrophils die when...
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
Fibrinogen
Coagulation factor Forms fibrin and clots exudate localises the inflammatory process
29
Mediators of acute inflammation
Molecules on endothelial cell surface membrane Molecules released from cells Molecules in the plasma
30
Collective effects of mediators of acute inflammation
Vasodilation Increased permeability Neutrophil adhesion Chemotaxis Itch and pain
31
Molecules released from cells....
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
Histamine
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
Seratonin
Released when platelets degranulate in coagulation Cause vasoconstriction
34
Prosglandins
Many cells (endothelial and leukocytes) Many promote histamines effects and inhibit inflammatory cells
35
Leukotrienes
Neutrophils especially Vasoactive - dynamic effect on vessels to increase permeability and constrict smooth muscle
36
Omega-3 polyunsaturated fatty acids
decrease synthesis of inflammatory mediators
37
Platelet-activating factor (PAF)
from inflammatory cells reduced permeability by enhancing platelet degranulation at site of the injury
38
Cytokines and chemokines | TNFalpha, IL-1
Small molecules produced by macrophages lymphocytes, endothelium in response to inflammatory stimuli attract inflammatory cells
39
Nitric Oxide
Various cells Smooth muscle relaxation, anti-platelet, regulate leukocyte recruitment to inflammatory focus
40
Oxygen free radicals
Released by neutrophils on phagocytosis, amplify other mediators
41
Coagulation
Also known as clotting when blood changes from the fluid state - to more of a gel
42
Interactions of 4 enzymes cascades
Blood coagulation pathways, fibrinolysis, Kinin system, complement cascade
43
Chemotaxis
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
Immediate systemic effects of inflammation
Pyrexia (raised temperature) Feel unwell (anorexia/nausea/abdominal pain) Neutrophilia (raised WBC count - bone marrow releases/ produces excess)
45
Longer term effects of Inflammation
Lymphadenopathy (regional lymph node enlargement) Weight loss Anaemia
46
Suppuration
pus forming
47
Exudate
mass of cells and fluid that has seeped out of blood vessels filters into lesions or areas of inflammation
48
Fibrin
Protein involved in the clotting of blood
49
Abscess
Collection of pus (suppuration) under pressure
50
Multi-loculated abscess
Pus bursts through pyogenic membrane and forms new cavities
51
Pus in other places.... Empyema Pyaemia
in hollow viscus (eg gall bladder) discharge into bloodstream
52
what is Granulation tissue?
'universal patch' - a repair kit for all damage ``` Formed of: New capillaries (angiogenesis) ``` Fibroblasts and collagen Macrophages
53
Dissemination
The act of spreading something.... AKA Spread to bloodstream Bacteraemia (bacteria in blood) Septicaemia (bacteria GROWS in blood) Toxaemia (toxic in blood)
54
Main effect of systemic infection
septic shock (inability to perfuse tissues)
55
Septic shock
Peripheral vasodilatation Tachycardia (high HR) Hypotension (low BP) Pyrexia (high temperature) Skin rash (sometimes)
56
Pathogenesis of septic shock
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
BP =
CO x SVR
58
Outcome of Septic Shock
Rapidly Fatal Tissue Hypoxia (cell death) Haemorrhage Requires urgent intervention and support

Yr1 -S1 - Principles of Disease (25 decks)

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