Chapter 3: inflammation response and fever Flashcards
What do neutrophils respond to?
bacteria
What do eosinophils respond to?
parasites, allergens, and neoplasia
What do basophils respond to?
allergens and stress
What do mast cells respond to?
allergens
What do lymphocytes respond to?
viral and fungal infections
What is neoplasia?
abnormal new tissue growth that is a precursor for cancer
Explain the difference between acute and chronic inflammation.
ACUTE INFLAMMATION:
short duration, exudation of fluid and plasma proteins
CHRONIC INFLAMMATION:
proliferation of blood vessels, tissue necrosis, and fibrosis
What are some things that could cause acute inflammation?
trauma, infection, chemicals
What are a few things that are examples of chronic inflammation?
atherosclerosis, rheumatoid arthritis
What are the 5 cardinal signs of inflammation
S welling H eat L oss of function R edness P ain
may also have fever
What is the role of leukocytes role in inflammation?
Release interleukins and tumor necrosis factor that….
affect the thermoregulatory center to inc temp (fever)
the increase heat affects CNS resulting in lethargy
What role does the liver play in inflammation?
to provide fibrinogen and C-reactive protein to…
1) facilitate clotting
2) bind to pathogens
3) moderate inflammatory responses
Describe the 3 parts of the vascular stage of inflammation.
1) vasodilation
2) inc vascular permeability
3) plasma proteins exit and pull water
result in the cardinal signs
List and describe the 4 steps of the cellular stage of inflammation.
1) MARGINATION and ADHESION: leukocytes (neutrophils) accumulate at site and release cytokines
2) TRANSMIGRATION: leukocytes move through vessel wall to tissue
3) CHEMOTAXIS: leukocytes follow chemical trail of inflammatory chems
4) ACTIVATION and PHAGOCYTOSIS
List the three steps of phagocytosis.
1) RECOGNITION and ADHESION
2) ENGULFMENT
3) INTRACELLULAR KILLING
What are the 5 types of exudates and descriptions
SEROUS: clear
HEMORRHAGIC: red, severe dmg that affects vessels
FIBRINOUS: made of fibrin, less clear (cloudy). thick and sticky
MEMBRANOUS: necrotic cells in fibropurulent exudate. on mucous membranes
PURULENT: coloured (pus)
Describe the process of chronic inflammation
Macrophages accumulate and release inflammatory mediators
fibroblasts proliferate and create scar tissue
macrophages mass around foreign bodies
CT surrounds and isolates mass
List four causes of chronic inflammation.
1) FOREIGN BODIES: asbestos, talc, surgical sutures
2) MICROORGANISMS: viruses, bacteria, fungi, parasites
3) INJURY: tissue around healing fracture
4) OBESITY: adipose tissue is a source of inflammatory mediators therefore inc risk of inflammation
What is the core body temperature?
36 - 37.5 degrees
What are the core tissues that produce heat?
Muscles and viscera
What are the ways to obtain a core temp?
1) rectal
2) oral
3) tympanic
4) esophageal
5) pulmonary artery
6) urinary catheter
What part of the brain acts as the thermal control center?
hypothalamus
What are the two ways that the body produces heat?
SHIVERING: hypothalamus impulse (SNS) resulting in inc in muscle tone and oscillating rhythmic tremor
PHYISCAL EXERTION
What is the difference in cellular response to acute vs chronic inflammation?
ACUTE: abundant in neutrophils
CHRONIC: abundant in lymphocytes and macrophages
What are the two ways that the body attempts to retain heat?
VASOCONSTRICTION: closing of the arteriovenous shunts
PILOMOTOR muscle contraction: raises skin hair to trap air and dec surface area avail for heat loss
What are the 8 ways that the body loses heat?
radiation conduction convection evaporation exhalation urine/feces heat edema increasing HR
With one degree rise in temp, how much is the HR expected to rise?
15bpm
If the HR does not rise with an increase in temp, what might it be a sign of?
medication interference
neurological disease
aging
If the HR rises greater than expected, what might it be a sign of?
hyperthyroidism
pulmonary emboli
what is a pyrogen?
any substance that induces or mediates fever
Explain the two types of pyrogens
EXOGENOUS:
from outside body; bacterial products, toxins, or whole microorganisms
ENDOGENOUS:
released by cells like phagocytes (interleukens and TNF)
list and describe the 4 patterns of pyrexia.
INTERMITTANT: normal temp at least once q24hrs
REMITTANT: never returns to norm, but fluctuates
SUSTAINED/CONTINUOUS: never returns to norm and fluctuates minimally
RECURRANT/RELAPSING: episodes of fever and norm each lasting days
What are the 4 stages of pyrexia?
PRODROMAL stage
CHILL stage
FLUSH stage
DEFERVESCENCE stage
Describe the symptoms of the prodromal stage of pyrexia
headache fatigue aches pain malaise
Describe the symptoms of the chill stage of pyrexia.
chilled vasoconstriction AV shunts close piloerection pale skin rigor
Describe the symptoms of the flush stage of pyrexia.
vasodilation
AV shunts open
Describe the defervescence stage of pyrexia.
Temp dec to norm
sweating
What are the 4 manifestations of pyrexia?
Fatigue
Anorexia
Arthralgia
Myalgia
What is unique about inflammation and fever in the elderly?
they have an atypical afebrile or blunted response 20-30 per cent of the time
What contributes to the unique fever reaction to inflammation in the elderly?
1) dec hypothalamus ability to recognize change in body state
2) altered release of endogenous pyrogens
3) inability to respond to set point change (dec ability to v/c, shiver, etc)
