Chapter 5- Inflammation and Healing Flashcards
First line defense
Mechanical barrier such as skin or mucous membrane that blocks entry of bacteria or harmful substances into the tissues
Second line of defense
Phagocytosis and inflammation
Phagocytosis
Engulf bacteria, cell debris, or foreign matter
Interferons
non-specific agents that produce uninfected cells against viruses
Third line of defense
Stimulate production of unique antibodies or sensitized lymphocytes following exposure to specific substances
Inflammation
Normal defense mechanism in the body to localize and remove an injurious agent. Not the same as infection. The body’s response to tissue injury, resulting in redness, swelling, warmth, pain, and sometimes a loss of function. Suffix “itis” means inflammation
Causes of inflammation
Physical damage, caustic chemicals, allergic reactions, extreme heat or cold, foreign bodies, or infection
Acute inflammation
May develop immediately and last a short time, or may be more severe and prolonged
Local effects
cardinal signs are redness, heat, swelling, and pain
Redness and warmth
Caused by increased blood flow into the damaged area
Swelling and edema
Due to shift of protein and fluid into the interstitial space
Pain
Caused by increased pressure of fluid on the nerves and local irritation of nerves by chemical mediators such as bradykinin
Loss of function
Occurs if cells lack nutrients or swelling interferes mechanically with function such as joint movement
Exudate
Collection of interstitial fluid in the inflamed area
Serous
Watery exudates found in allergic reactions and burns
Fibrinous
Thick and sticky exudates with high cell and fibrin content; increases the risk of scar tissue in the area
Purulent
Thick, yellow-green; indicates bacterial infection; “pus”
Abscess
Localized pocket of purulent exudate in a solid tissue
Systemic effects of inflammation
Mild fever, malaise, fatigue, headache, anorexia, or fever
Diagnostic tests for inflammation
Leukocytosis, serum C-reactive protein elevated, erythrocyte sedimentation rate elevated, plasma proteins (fibrinogen and prothrombin), and differential count shows altered category of type of WBC
Complications of inflammation
Local inflammation and infection, and skeletal muscle spasms or strong muscle contraction
Chronic inflammation
Less swelling and exudate, more lymphocytes, macrophages, and fibroblasts, more tissue destruction, more collagen is produced in the area, more fibrous scar tissue forms
Complications of chronic inflammation
Rheumatoid arthritis and deep ulcers
Rheumatoid arthritis
Chronic inflammation with periodic exacerbations of acute inflammation
Deep ulcers
Caused by severe or prolonged inflammation caused by cell necrosis and lack of cell regeneration
Aspirin or acetylsalicylic acid
Reduced inflammatory response, reduced pain and fever. Always discontinue 7-14 days before surgery to prevent excessive bleeding
Acetaminophen
Decreases fever and pain but does not decrease inflammation
NSAIDS
Ibuprofen, piroxicam. Have anti-inflammatory, analgesic, and antipyretic properties. Reduced the production of prostaglandins. Treats acute injuries and used in dental procedures
Corticosteroids
Oral, topicl, joint, IM, IV, inhalers. Don’t stop suddenly
First-aid measures
RICE Rest Ice Compression Elevation
Other treatments
Physical therapy, occupational therapy, rest, nutrition, and hydration
Resolution
Minimal tissue damage. Damages cells recover, tissue returns to normal in short time
Regeneration
Occurs in damaged tissue and cells capable of mitosis
Replacement
By connective tissue when there is extensive damage
First intention
Wound is clean, free of foreign material and necrotic tissue, and edges are close together with minimal gap.. Surgical incisions
Second intention
Large break in the tissue, more inflammation, longer healing time, more scar tissue
Factors that promote healing
Youth, nutrition (vitamins A, C, and protein), good hemoglobin, effective circulation, clean wound, and no infection or further trauma to the site
Factors that delay healing
Advanced age, poor nutrition, dehydration, anemia, circulatory problems, certain chronic diseases, diabetes and cancer, irritation, infection, chemotherapy treatment, prolonged use of glucocorticoids, foreign material, radiation exposure, and bleeding
Complications from scar formation
Loss of function, contractures and obstruction, adhesions, hypertrophic scar tissue, and ulceration
Burns
Caused by thermal (heat), non-thermal (electrical or chemical)
First degree burn
Superficial; damage the epidermis and maybe upper dermis. Red and painful but heal quickly without scar tissue
Second degree burn
Partial thickness; destruction of epidermis and part of the dermis. Red, edematous, blistered, hypersensitive, painful in inflammatory stage. Dead skin sloughs off and healing occurs by regeneration from the edges of blistered areas. Grafts may be needed to cover large areas
Third degree burns
Full thickness; destruction of all layers. Burn area is charred and is hard and dry on the surface. Initially burn area is painless because of the destruction of nerves. Requires skin grafts for healing because there are no cells for production of new skin
