Chapter 12: Inflammation and Wound Healing [Practice Test] Flashcards
This is the directional migration of white blood cells to the site of injury resulting in an accumulation of neutrophils and monocytes at the site. What is this defined as?
Chemotaxis
Causes a change in pH.
Caused by Nerve stimulation by chemicals
ex. histamine and prostaglandins.
Caused by pressure from fluid exudate.
Pain
Description:
found in tissues were cells produce mucus.
Mucus production is accelerated by inflammatory response.
Example:
runny nose associated with upper respiratory tract infection.
What type of inflammatory exudate is this?
Catarrhal
_____ is a powerful vasoconstrictor and platelet ______ agent. It causes brief ______ and skin pallor at the injury site and promotes _________. It has a _____ half-life and the pallor soon gives way to _____ and _____ which are caused by _________ and _______.
Thromboxane aggregating vasoconstriction clot formation short vasodilation and redness prostaglandins and histamine
Source:
Stored in platelets, mast cells, enterochromaffin cells of the G.I. tract.
Mechanisms of action:
vasodilation
increased capillary permeability. Stimulates smooth muscle contraction.
Serotonin
Caused by increased metabolism at inflammatory site.
What local clinical manifestation of inflammation is this?
Heat
this is a sequential reaction to cell injury. It neutralizes and dilutes the inflammatory agent, remove necrotic materials, and establishes an environment for healing and repair.
The inflammatory process
Description: results from rupture or necrosis of blood vessel walls. Example: hematoma bleeding after surgery or tissue trauma
What type of inflammatory exudate is this?
Hemorrhagic
This consists of fluid and leukocytes that move from the circulation to the site of injury. The nature and quantity of this depends on the type and severity of the injury in the tissues involved.
Exudate
Inflammation ____ always present with infection but infection ____ always present with inflammation.
Is
Is not
The inflammatory response can be divided into four parts what are they?
Vascular response.
Cellular response.
Formation of exudate.
Healing.
Description:
consists of white blood cells, Microorganisms (dead and alive), liquefied dead cells, and other debris.
Example:
furuncle (boil),
abscess,
cellulitis (diffuse inflammation in connective tissue).
What type of inflammatory exudate is this?
Purulent (Pus)
Source:
Stored in granules of basophils, mast cells, and platelets.
Mechanism of action:
Causes vasodilation.
Causes increased capillary permeability.
What mediator of inflammation is this?
Histamine
An infection involves what three microorganisms?
bacteria
fungi
viruses
Description:
occurs with increasing vascular permeability and fibrinogen leakage into interstitial spaces.
Excessive amounts of fibrin that coats tissue surfaces may cause them to adhere.
Example:
Adhesions.
Gelatinous ribbons seen in surgical drain tubing.
Frequently covers fluid exuding wounds such as venous ulcers.
What type of inflammatory exudate is this?
Fibrinous
This is caused by swelling and pain.
What local clinical manifestation of inflammation is this?
Loss of function
Source:
Produced from precursor factor kininogen as a result of activation of Hagemann factor (XII) of clotting system.
Mechanism of action:
contraction of smooth muscle vasodilation
results in stimulation of pain.
What mediator of inflammation is this?
Kinin ex. bradykinin
A patient who is neutropenic or has a decreased immune response may not be able to mount an _______.
inflammatory response
Heat, radiation, trauma, chemicals, allergens, and an autoimmune reaction all cause what complication?
Inflammation
After cell injury local arterials briefly undergo transient vasoconstriction. After release of histamine and other chemicals by the injured cells, the vessels dilate. Chemical mediators cause increased capillary permeability and facilitate fluid movement from capillaries into tissue spaces. initially composed of serous fluid, this inflammatory exudate later contains plasma proteins, primarily albumin. These proteins exert oncotic pressure that further draws fluid out of the blood vessels into the tissues. Both vasodilation and increased capillary permeability are responsible for redness heat and swelling at the site of injury. As the plasma protein fibrinogen leaves the blood it is activated to fibrin by the products of the injured cells. Fibrin strengthens a blood clot formed by platelets. the clots function is to trap bacteria, prevent their spread, and serve as a framework for the healing process. Platelets then release growth factors that start the healing process. Which inflammatory response pathway is this?
Vascular Response
neutrophils and monocytes move from circulation to the site of injury. What is this action called? Which inflammatory response pathway is this?
Chemotaxis
Cellular Response
Description:
Found during the midpoint in healing after surgery or tissue injury. Composed of red blood cells and serous fluid which is semi-clear pink and may have red streaks.
Example:
Surgical drain fluid
What type of inflammatory exudate is this?
Serosanguineous
This occurs when the final component create holes in the cell membranes and cause targeted cell death by membrane rupture. This occurs commonly in what autoimmune disorders?
Cellular Lysis
Ex. rheumatoid arthritis
systemic lupus arythematosus
In cases where particles are too large for a single macrophage the macrophages accumulate in fuse to form a _______. The giant cell is then encapsulated by _______ leading to the formation of a granuloma. What disease process is this common in?
multi-nucleate a giant cell
Collagen
Tuberculosis
These are the first leukocytes to arrive at the site of injury usually within ___to ___ hours? They phagocytize or engulf the bacteria, other for material, damage cells. With their short lifespan ___ to ___ hours, dead _______ soon accumulate.
6-12
24-48
Neutrophils
In time a mixture of dead neutrophils, digested bacteria, and other cell debris accumulate as a creamy substance defined as?
pus
Source:
Anaphylatoxic agents generated from complement pathway activation.
Mechanism of action:
Stimulate histamine release and chemotaxis.
What mediator of inflammation is this?
Complement components
Ex. C3A C4A C5A
To keep up with the demand for neutrophils the _______releases more neutrophils into circulation this results in an elevated white blood cell count especially the _________ count. Sometimes the demand for neutrophils increases to the extent that the bone marrow releases immature forms of neutrophils called ______ into circulation. Mature neutrophils are called __________.
Bone marrow
Neutrophil
Bands
Segmented neutrophils
The finding of increased numbers of band neutrophils in circulation is called ________. This is commonly found in patients with ___________.
Shift to the left
acute bacterial infections
_________ are the second type of phagocytic cells that migrate from circulating blood. They usually arrive on the site within ___ to ___ days after the onset of inflammation. On entering the tissue spaces monocytes transform into __________. Together with the tissue macrophages these newly arrived macrophages assist in phagocytosis of the inflammatory debris. The macrophage role is important in _____ the area before healing can occur. Macrophages have a long lifespan they can multiply and may stay in damaged tissues for _____. These cells are important in orchestrating the healing process.
Monocyte 3 to 7 days macrophages cleaning weeks
Caused by fluid shift to interstitial spaces.
Caused by fluid exudate accumulation.
What local clinical manifestation of inflammation is this?
Swelling
______ arrive later at the site of injury. Their primary role is related to ______ and ________ immunity.
Lymphocytes
humoral
cell-mediated
Source:
Produced from arachidonic acid.
Mechanism of action:
vasodilation.
stimulate chemotaxis
What mediator of inflammation is this?
Prostaglandins PGs cause vasodilation.
Leukotrienes LTs stimulate chemotaxis
Enhanced phagocytosis, increased vascular permeability, chemotaxis, and cellular lysis are major functions of what chemical mediators?
Complement System
When cells are activated by injury arachidonic acid in the cell membrane is rapidly converted to produce prostaglandins, thromboxane, and leukotrienes.
What chemical mediator is this ?
Prostaglandins
Leukotrienes
________ form the slow reacting substance of anaphylaxis (SRS-A) which ______ smooth muscle of bronchi, causing _______ of the airway, _____ capillary permeability, leading to airway ______.
Leukotrienes constricts narrowing increases edema
Caused by hyperemia from vasodilation.
What local clinical manifestation of inflammation is this?
Redness
Description: results from outpouring of fluid. Seen in early stages of inflammation or when injury is mild. Example: Skin blisters. Pleural effusion.
What type of inflammatory exudate is this?
Serous