Chapter 3 Inflammation and Tissue Repair Flashcards
What is the first line of defense ?
skin and mucous membrane
involves surface and chemical barriers.
What is the second line of defense
inflammatory response
waging an inflammatory response is identical regardless of the cause of injury
phagocytes move in to engulf and destroy harmful substances
What is the third line of defense
immune response
a specific defense depending on the type of invader
immune cells recognize and destroy harmful substances
What is inflammation ?
the intensity of the inflammatory reaction is usually proportional to the extent of tissue injury
What is acute inflammation triggered by?
tissue injury and is essential for healing
What is injury?
tissue injury and is essential for healing
What is a vascular response?
To increase blood flow to the site of an injury
What is a cellular response ?
To alert the products of healing to attend to the site of injury
What is acute inflammation
occurs rapidly in reaction to cell injury, rids the body of the offending agent, enhances healing, and terminates after a short period, either hours or a few days
What is chronic inflammation?
occurs when the inflammatory reaction persists, inhibits, and causes continual cellular damage and organ dysfunction
How long can a vascular response happen
vasoconstriction from seconds to 10 minutes and the blood vessels follow vasoconstriction
What does plasma derived involve?
Complement System
Kinin System
Clotting System
What is the complement system?
Several proteins that comprise 10% - 15% of plasma; produce in liver.
Triggered by the presence of microorganisms.
Once triggered, activates a cascade of inflammatory mediators.
What is the kinin system?
Source of highly potent vasoactive inflammatory mediators.
Amplify the inflammatory response by triggering other inflammatory mediators.
What is the clotting system?
Promote coagulation through a cascade of clotting factors
Suppresses coagulation when clotting is complete
Various clotting factors produce and release inflammatory mediators.
What are the types of white blood cells in inflammation that are granulocytes?
eosinophils
mast cells
basophils
neutrophils
Why are neutrophils, basophils, and eosinophils are referred to as granulocytes
they contain cytoplasmic granules that contain important enzymes and inflammatory mediators to fight infection.
What are the types of white blood cells in inflammation that are agranulocytes
monocytes-> macrophages
T- lymphocytes
B- lymphocytes -> plasma cells
What are the three steps needed for a successful cellular response?
Chemotaxis
cellular adherence
cellular migration
What is histamine?
an inflammatory mediator released from basophils, platelets, and mast cells.
What is Histamine Receptor 1
smooth muscle cells of the bronchi
What is histamine 2 receptor
parietal cell of the stomach mucosa
What is chemotaxis ?
process of moving certain cells to the injury site.
Moving certain cells to the injury site
What is cellular adherence regulated by:
Inflammatory mediators, specifically, chemotactic factors released by endothelial cells
Receptors that bind leukocytes to the surface of endothelial cells near the site of injury
Attraction & binding
What is Cellular migration
allows leukocytes, erythrocytes, and platelets to go through endothelial to the exact site of injury
What are the local manifestations of acute inflammation (cardinal signs)
erythema, heat, edema, pain, loss of function
these manifestations are related to vasodilation and fluid accumulation in the tissues as a result of activating inflammatory mediators.
What is pyrexia
a fever
What are systemic manifestations related to the inflammatory response
pyrexia, and increased circulating leukocytes and plasma proteins.
What two test will signify inflammation is present but neither will identify the exact source or location of the inflammation?
CRP or ESR test
CRP is often the preferred test for acute inflammation
ESR deals with the clotting factor, fibrinogen.
What are inflammatory mediators?
vasoactive inflammatory mediators, facilitate the process of widening and loosening the blood vessels at the site of injury
Mast cells can release what kind of inflammatory mediators?
Histamine- locally released when injury to cell membrane occurs, vasodilator, alters capillary permeability, stimulates pain perception
Leukotrienes- Potent chemotactic agents (leukocytes)
Increase vascular permeability
Prostaglandins- controls inflammation, blood flow, formation of blood clots
What are the three phases of wound healing?
Inflammation
Proliferation
Remodeling
What is primary intention
Wound close & heals with no skin loss
What is secondary intention
Some loss of skin at the wound site
What is tertiary intention
A wound with a large gap of missing tissue that has been contaminated and needs a drainage tube while healing
What are the possible complications of a wound healing
Keloid- hyperplasia of scar tissue
Contractures- inflexible shrinkage of wound tissue that pulls the edges toward the center of the wound
Evisceration- opening of a wound with extrusion of tissues and organs
Dehiscence- opening of a wounds suture line (increases risk of infection)
What causes impaired healing?
Malnutrition
Impaired blood flow and oxygen delivery
Age effects
Foreign bodies
Infection
Impaired inflammatory and immune responses
What is a first degree burn?
thickness burns
damage the epidermis
This radiation-induced injury triggers vasodilation of the dermal blood vessels and increased capillary permeability, causing erythema, pain, and swelling of affected areas
DO NOT RESULT IN CELL NECROSIS OR SCARRING.
What is a second degree burn?
deep partial thickness burns
damage the epidermis and penetrate into the dermis
What is a third degree burn?
Full thickness burns
damage the epidermis and dermis and can penetrate subcutaneous layers as well
When do you increase your risk for malignant melanoma?
intermittent sun exposure
You get a paper cut and experience pain at the site. This response is related to:
a. increased perfusion at the site.
b. increased exudate and chemical mediators at the site.
c. bacteria that have entered the wound.
d. vasoconstriction at the site.
b. increased exudate and chemical mediators at the site.
Inflammation is ultimately needed to:
a. increase inflammatory mediators at the site to vasoconstrict the area.
b. increase platelets at the site for clotting.
c. restore functional cells.
d. prepare the site for healing.
d. prepare the site for healing.
A wound is 6 cm × 6 cm × 4 cm. A wound with these dimensions needs to heal through:
a. secondary intention.
b. primary intention.
c. tertiary intention.
d. scar tissue formation.
a. secondary intention.
A major difference between the acute and chronic inflammatory response is that in chronic inflammation:
a. inflammatory mediators are released.
b. neutrophils are much more prominent.
c. granulomas form around certain invaders.
d. granulation tissue is present.
c. granulomas form around certain invaders.
Which is not a local manifestation of acute inflammation?
a. Edema
b. Redness
c. Loss of function
d. Leukocytosis
d. Leukocytosis
With burn injuries, it is important to determine the depth of injury. You are in the sun too long without sunscreen and develop redness and blistering on your face, chest, and back. What depth of burn did you experience?
a. Superficial partial-thickness burn
b. Deep partial-thickness burn
c. Full-thickness burn
d. Dermal thickness burn
b. Deep partial-thickness burn
The hospitalized burn patient wants to know why you need to remove his dressings every day. It is painful and he wants to avoid uncovering his burn injury. You explain that removing the dressings promotes:
a. debridement.
b. Infection.
c. skin function.
d. drying the exudate.
a. debridement.
What is the one definitive test to diagnose rheumatoid arthritis (RA)?
a. A positive rheumatoid factor (RF).
b. An elevated erythrocyte sedimentation rate (ESR).
c. A positive antinuclear antibody (ANA)
d. One test is not definitive.
d. One test is not definitive.
Which of the following is the most common cause of acute gastritis?
a. Poor gastric perfusion
b. Too much stomach acid
c. Ingestion of aspirin, alcohol, or other chemicals
d.H. pylori infection
c. Ingestion of aspirin, alcohol, or other chemicals
Why is Crohn disease more likely to cause intestinal obstruction than ulcerative colitis?
a. Crohn disease is located in the small intestine.
b. Crohn disease causes granulomas to form in the submucosal layer.
c. Crohn disease causes abdominal pain and watery diarrhea.
d. Crohn disease is exacerbated by certain foods, such as spicy foods.
b. Crohn disease causes granulomas to form in the submucosal layer.
A patient is taking an anti-inflammatory drug for rheumatoid arthritis. What is the most likely action for this drug?
a. Blocks the chemical mediators of inflammation
b. Enhances the body’s immune system
c. Increases blood flow to the tissues
d. Decreases scar formation
a. Blocks the chemical mediators of inflammation
Which of the following is the most common cause of acute pancreatitis?
a. Cancer
b. Autoimmunity
c. Excess alcohol intake
d. Cystic fibrosis
c. Excess alcohol intake
Rheumatoid arthritis results in joint immobility as a result of:
a. synovial fluid loss.
b. pannus formation.
c. rheumatoid factor.
d. joint deviation.
b. pannus formation.
Which of the following meals would you recommend to a patient who has a wound injury to promote healing?
a. Eggs and orange juice
b. Spaghetti and garlic toast
c. Steak and potatoes
d. Tomato soup and grilled cheese
a. Eggs and orange juice
