Chapter 3- Book Flashcards
Complex, nonspecific response to tissue injury intended to minimize the effects of infection, remove the damaged tissue, generate new tissue, and facilitate healing.
Inflammation
The reaction of vascularized tissue to cell injury or death
Inflammation
Small, membrane bound disks circulating in the blood that play an active role in normal hemostasis
Platelets
Vascular changes folllow 1 of these 3 responses
Immediate Transient Response
Immediate Sustained Response
Delayed Response
Cardinal signs of inflammation
Heat, redness, pain, swelling, loss of function
Small proteins that cells release as a messenger when their is a pathogen invasion
Chemokines
(Mine) means movement
_____ manifestations may occur as chemical mediators produced at the site of inflammation
Systemic
Acute inflammation involves two major components: the ______ and _______ stages
Vascular and cellular
Leukocytes known as ________ produce prostaglandins and leukotrienes, platelet-activating factor, inflammatory cytokines, and worth factors that promise regeneration of tissues.
Monocytes and macrophages
Pyogenic means
Pus forming
Local manifestations of acute reactions are determined by? (3)
Severity of reaction
It’s specific cause
Site of involvement
Types of local manifestations (5)
Serous exudate Fibrinous exudate Hemorrhagic exudate Membranous exudate Purulent (pus) exudate
A site of inflammation where an epithelial surface has become necrotic or eroded, often with sub Epithelial inflammation
Ulcer
Acute inflammation can result in 1 of 3 outcomes:
Resolution
Progression to chronic inflammation
Substantial scarring or fibrosis
Scarring and fibrosis occurs when
Their is significant tissue injury or when inflammation occurs in tissue that don’t regenerate
Chronic inflammation is result of: (2)
- )Recurrent or progressive acute inflammatory response
2. ) low grade, smoldering responses that fail to evoke an acute response
Chronic inflammation is characterized by having:
Infiltration with mononuclear cells (macrophages, lymphocytes, plasma cells)
Attempted connective tissue repair involving angiogenesis and fibrosis
Agents that evoke chronic inflammation are typically:
Low grade, persistent infections or irritants that are unable to penetrate deeply or spread rapidly.
Ex of foreign substances: (talk, asbestos, surgical materials, etc.)
Typically a small, 1-2 mm lesion in which there is a massing of macrophages surrounded by lymphocytes
Granuloma
The most prominent systemic manifestations of inflammation: (3)
- ) acute phase response
- ) alterations to # of WBC’s
- ) Fever
Acute-phase response to inflammation includes changes the concentration of: (5)
- ) plasma proteins
- )skeletal muscles catabolism
- ) negative nitrogen balance
- )elevated erythrocyte sedimentation rate
- )increased # of leukocytes
Normal value of WBC’s
Vs
Infection response
Normal: 4,000 to 10,000 cells/ul
Infection: 15,000 to 20,000 cells/ul
A decrease in WBC’s
Leukopenia
A severe bacterial infection
Sepsis
Normal body temp
36-37.5 degrees C
Or
97-99.5 degrees F
Internal core temperatures reach their highest point in the _________ and their lowest point in the _______
Late afternoon/evening
Early morning hours
Body temperature is regulated by the ______ located in the _____
Thermoregulatory center in the hypothalamus
The level at which body temperature is regulated so that core temperature is maintained within the normal range.
Thermostatic set point
Act at the cellular level to shift body metabolism to heat production rather than energy generation
Epinephrine and Norepinephrine
What raises the skin hair and produces goose bumps on skin to help reduce the surface area available for heat loss?
Pilomotor muscles
Under the surface of the skin to allow blood to move directly from the arterial to the venous system
Arteriovenous (AV) shunts
The transfer of heat through the air or a vacuum
Radiation
What percent of body heat is lost through radiation?
60%
Fever is caused by _____ M
Pyrogens
There are two types of pyrogens (microorganisms that cause fever)
What are they?
Endogenous- increase the set point of the hypothalamic thermoregulatory center through (PGE2)
Exogenous- act indirectly and may require several hours to produce their effect
4 Patterns of fever
- ) intermittent- temp returns to normal at least once every 24 hours
- ) remittent- temp doesn’t return to normal and it varies in either direction (sepsis, abscesses, acute bacterial endocarditis)
- ) sustained- remains above normal. (Drug-induced)
- ) relapsing- one or more episodes, each as long as several days. (TB, fungal infections, Lymes, malaria)
Physiologic behaviors that occur during a fever (4)
- ) Prodrome- * temp is rising- mild complaints of headache and fatigue
- ) Chill- temp is still rising, shaking and feeling cold
- ) Flush- cutaneous vasodilation occurs and skin is warm and red
- ) Defervesence- sweating
Common manifestations of fever
- anorexia- don’t want to eat
- myalgia
- arthralgia
- fatigue
What is often given to someone who has a fever?
Antipyretic drugs such as: aspirin, ibuprofen, acetaminophen
The vascular stage of acute inflammation is characterized by
Increased blood flow (vasodilation) Structural changes (increased vascular permeability)
The cellular stage of acute inflammation is characterized by
Emigration of leukocytes (mainly neutrophils) to the site of injury
Depending on the severity of injury, vascular changes that occur with inflammation follow 1 of 3 responses
- ) immediate transient response- occurs with minor injury. Occurs rapidly and is reversible (15-30 mins)
- ) Immediate sustained response- more serious types of injury’s and continues for several days (burns and bacterial infections)
- ) Delayed response- increased permeability begins in 2 to 12 hours and lasts for several hours or days. (Radiation such as sunburn)
Cellular stage of acute inflammation is characterized by changes in:
The endothelial cells lining the vasculature and movement of phagocytic leukocytes into the are of infection
The sequence of events in the cellular response to inflammation include:
- ) margination and adhesion
- ) transmigration
- ) Chemotaxis
- ) activation and phagocytosis
The release of ____ causes the endothelial cells lining the vessel to experts cell margination and adhesion molecules bind to carbohydrates on the leukocytes
Cytokines
The interaction where cytokines cause endothelial cells to attach to carbohydrates on the leukocytes is called what?
Tethering
_____ slows leukocyte flow through the blood and causes them to roll along the endothelial cell surface, finally coming to rest and adhering to the intracellular adhesion molecules on the endothelium
Tethering
_____ is the dynamic and energy-directed process of cell migration
Chemotaxis
Small proteins that direct the trafficking of leukocytes during the early stages of inflammation to the site of injury or infection
Chemokines
The enhanced binding of an antigen to a coated microbe or particle is called _____
Opsonization
Plasma derived mediators include: (3)
Acute-phase proteins
Coagulation factors
Complement proteins
The plasma is the source of inflammatory mediators that are products of 3 major protein cascade systems:
- ) Kallikrein-Kininogen system- generate kinins
- ) Coagulation system- fibbing and RBCs together to form clot
- ) Complement system- complement proteins
_____ are products of the liver and factors in the coagulation system
Kinins
Causes increase capillary permeability and pain
Bradykinin
Found primarily within platelet granules and is released during platelet aggregation
Serotonin
The development is new blood vessels is called?
Angiogenesis
What does nitric oxide do?
Expands the blood vessels, increasing the blood flow and decreasing plaque growth and blood clotting
What two things happen in the vascular stage of acute inflammation?
- ) vasodilation- histamine and NO
2. ) capillaries become more permeable- Histamine, bradykinine, and leukotrienes
What two things happen in the cellular stage of acute inflammation?
- ) WBC’s enter the injured tissue- margination and adhesion, transmigration, Chemotaxis
- ) Leukocyte activation and phagocytosis
During the cellular stage of acute inflammation what does arachidonic acid make?
Prostaglandins- vasodilate smooth muscle … induce bronchoconstriction
Inhibit inflammatory cell function
Leukotrienes- bronchoconstriction. Released by mast cells along with histamine
Increase vascular permeability
- both of these are important in blood clotting during a major injury. Vasoconstrict and dilate vessels
TNF-a and IL-1 are released by_____ and do what?
(Tumor necrosis factor)
(Inter leukin 1)
Macrophages
Activate epithelial cells to grab leukocytes from blood.
They also trigger other immune cells
What do corticosteroids do?
Prevent arachadonic acid so it helps manage the inflammatory response
What does aspirin do?
Deactivate the 1st enzyme (prostaglandin) of the cycloxygenase pathway
Decreases inflammation
The hallmark of acute phase response to inflammation is :
The liver secretes proteins: fibrinogen (clot formation), C-reactive protein, serum Amyloid A protein (defense proteins)
Fever happens when ____ are released, go to hypothalamus, and raise bodies ______.
Cytokines
Thermostatic set point
Intermittent fever is usually seen with _____
Bacterial infection
Sustained fever is usually seen with ____
Drug induced
Remitted Fever is characterized by:
The fact it never goes back to normal
Relapsing fever is seen with ___
TB, infectious disease, malaria, limes disease
