Chapter 9: Inflammation & Tissue Repair

Question 1

Cardinal Signs of Inflammation (5)

Answer 1

rubor - redness
tumor - swelling
calor - heat
dolor - pain
functio laesa - loss of function

Question 2

Goals of Inflammation

Answer 2

localize and eliminate microbes, foreign particles and abnormal cells
limit extent of tissue damage
repair of injured tissue
nonspecific, second line of defense

Question 3

Cells of Inflammation

Answer 3

endothelial cells
platelets (thrombocytes)
neutrophils & macrophages
mast cells

Question 4

Endothelial Cells

Answer 4

selectively-permeable barrier
maintain vessel patency (produce antiplatelet/antithrombin)
regulate blood flow (vasodilators/vasoconstrictors)
release inflammatory mediators
production of GF for angiogenesis

Question 5

Platelets (Thrombocytes)

Answer 5

involved in primary hemostasis
activated platelets release potent inflammatory mediators
increase vascular permeability (edema)
can cause vasodilation (redness, heat and pain)

Question 6

Neutrophils

Answer 6

primary phagocyte that arrives early

short-lived and must replaced constantly to maintain numbers

Question 7

Monocytes/Macrophages

Answer 7

arrive shortly after neutrophils and perform functions longer
engulf larger and greater quantities of foreign material
produce potent vasoactive mediators
pal an important role in chronic inflammation

Question 8

Vasoactive Mediators

Answer 8

prostaglandins
leukotrienes (LT)
platelet-activating factor (PAF)
inflammatory cytokines
growth factors

Question 9

Mast Cells

Answer 9

contain granules (histamine, proteoglycans, proteases)
and cytokines (TNF-α and IL-16)
released at activation (degranulation)
involved in IgE-triggered reactions and helminth infections

Question 10

Vascular Stage of Inflammation

Answer 10

involves the arterioles, capillaries, and venules
brief vasoconstriction
vasodilation (redness and warmth)
changes in blood flow
increased vascular permeability and leakage of fluid into the extra vascular tissues (edema, pain, impaired function)

Question 11

The Cellular Stage of Inflammation

Answer 11

includes leukocyte:
1 margination and adhesion to the endothelium
2 transmigration across the endothelium
3 chemotaxis
4 activation and phagocytosis

Question 12

Margination

Answer 12

leukocyte accumulation

Question 13

Adhesion

Answer 13

leukocytes adhere to the endothelium via intracellular adhesion molecules (ICAMSs)

Question 14

Transmigration

Answer 14

leukocytes move through the vessel wall and migrate to tissue spaces

Question 15

Chemotaxis

Answer 15

the dynamic and energy-directed process of DIRECTED cell migration
chemokines that direct the trafficking of leukocytes

Question 16

Phagocytosis

Answer 16

the ingestion of other cells
engulf and degrade bacteria and cellular debris
initiated by the recognition and binding particles

Question 17

Binding

Answer 17

trapping the agent, which triggers engulfment and activate the killing potential of the cell

Question 18

Opsonization

Answer 18

the coating of an antigen with antibody or complement to enhance binding (to help the antibody recognize it)
enhances phagocytosis

Question 19

Histamines

Answer 19

found in mast cell granules

released in response to trauma and immune reactions involving binding of IgE antibodies

Question 20

Location and Roles of Histamine

Answer 20

widely distributed in tissues
causes vasodilation
increased vascular permeability by H1 receptors on endothelial cells

Question 21

Arachidonic Acid Metabolites

Answer 21

eicosanoid inflammatory mediators:
prostaglandins
leukotrienes (LT)
thromboxane A2

Question 22

Cyclooxygenase Pathyway

Answer 22

produces prostaglandins and thromboxane A

Question 23

Lipoxygenase Pathway

Answer 23

produces leukotrienes

Question 24

Prostaglandins

Answer 24

induce inflammation and potentiate the effects of histamine and other inflammatory mediators

Question 25

Prostaglandins and Thromboxane A (TXA)

Answer 25

promote platelet aggregation and vasoconstriction

Question 26

Leukotrienes

Answer 26

similar in function to histamines but are more potent and longer-lasting important inflammatory mediators in BRONCHIAL ASTHMA AND ANAPHYLAXIS

Question 27

Bradykinin

Answer 27

plasma protein that increases vascular permeability and causes contraction of smooth muscle and vasodilation

Question 28

Cytokines

Answer 28

proteins produced by may cell types that modulate the function of other cells TNF-α and IL-1 are two of the major cytokines that mediate inflammation

Question 29

Chemokines

Answer 29

family of small proteins that act primarily as chemoattractants to recruit and direct the migration of immune and inflammatory cells inflammatory and homing chemokines

Question 30

Nitric Oxide (NO)

Answer 30

smooth muscle relaxation antagonism of platelet adhesion, aggregation and degranulation regulator of leukocyte recruitment (decreases) reduces the cellular phase of inflammation have antimicrobial actions

Question 31

Serous Exudates

Answer 31

watery fluids, low in protein content, that result form plasma entering the inflammatory site

Question 32

Hemorrhagic Exudates

Answer 32

occur when there is sever tissue injury that damages blood vessels significant leakage of RBCs from the capillaries

Question 33

Fibrinous Exudates

Answer 33

contain large amounts of fibrinogen and form a thick, sticky meshwork

Question 34

Membranous Exudates

Answer 34

develop on mucous membrane surfaces and are composed of necrotic cells enmeshed in fibropurulent exudates

Question 35

Purulent Exudates

Answer 35

contains pus, which is composed of degraded WBCs, protein and tissue debris also known as suppurative exudates

Question 36

Abscess

Answer 36

localized area of inflammation containing a purulent exudate that may be surrounded by a neutrophil layer fibroblasts may eventually enter the area and wall off the abscess

Question 37

Acute-Phase Response of Inflammation

Answer 37

begins within hours or days of onset of inflammation or infection release of cytokines (IL-1, IL-6, and TNF-α) fever, anorexia, fatigue, malaise acute phase proteins: CRP

Question 38

C-Reactive Protein (CRP)

Answer 38

``` biomarker in acute MI, malignancies, and autoimmune disorders function is protective - binds to surfaces of antigens to target for destruction synthesis is up-regulated by IL-6 during acute phase ```

Question 39

Labile Cells

Answer 39

continue to divide and replicate throughout life, replacing cells that are constantly being destroyed (apoptosis) epithelial cells, columnar epithelium, transitional epithelium skin, oral cavity, vagina, GI tract, uterus, urinary tract bone marrow cells

Question 40

Stabile Cells

Answer 40

normally stop dividing when growth ceases capable of regeneration if needed parenchymal cells of the liver and kidney smooth muscle cells and vascular endothelial cells

Question 41

Permanent Cells

Answer 41

cannot undergo mitotic division and do not normally regenerate replaced by scar tissue that lacks the function of destroyed tissue nerve cells, skeletal muscle cells, cardiac muscle cells

Question 42

Fibrous Tissue Repair

Answer 42

replacement with connective tissue | process that involves generation of granulation tissue and formation of scar tissue

Question 43

Angiogenesis

Answer 43

generation of new blood vessels from preexisting blood vessels gives red appearance of granulation tissue

Question 44

Fibrinogenesis

Answer 44

influx of activated fibroblasts | initiation of collagen synthesis

Question 45

Scar Formation

Answer 45

formation of pale, largely avascular tissue (scar)

Question 46

Primary Intention

Answer 46

no tissue loss heals more quickly Example: sutured surgical incision Primary intention wounds can become infected and need to heal by secondary intention

Question 47

Secondary Intention

Answer 47

larger wounds that have a greater loss of tissue and contamination heal more slowly - may leave open for a time results in larger amounts of scar tissues Examples: burns, large surface wounds

Question 48

Phases of Wound Healing

Answer 48

1 inflammatory phase 2 proliferative phase 3 remodeling phase

Question 49

1 Inflammatory Phase of Wound Healing

Answer 49

begins at the time of injury prepares wound environment for healing brief constriction then vasodilation and increased permeability involves neutrophils and macrophages

Question 50

2 Proliferative Phase of Wound Healing

Answer 50

usually begins within 2 to 3 days of injury and may last up to 3 weeks Focus: build new tissue to fill the wound space Key cells: fibroblasts and endothelial cells granulation tissue forms within 48 hours

Question 51

Epithelization

Answer 51

final component of proliferative phase that involves migration, proliferation, and differentiation of the epithelial cells at the wound edges to form a new surface layer similar to the one that was destroyed

Question 52

3 Remodeling Phase of Wound Healing

Answer 52

begins approximately 3 weeks after injury and continues for 6 months or longer continued production of scar tissue through collagen synthesis most wounds only gain 70-80% of the tensile strength of unwounded skin