Chronic Inflammation 2 Flashcards
Granulomatous inflammation is characterised how?
By the presence of granulomas in tissue and organs
What type of hypersensitivity are responsible for may granulomas?
Type IV
What antigens do granulomas respond to?
Indigestible antigens
What leukocytes do granulomas contain?
Neutrophils and eosinophils
Name the four types of granuloma
Langhans type, Foreign body type, Silicone associated and Warthog-Finkeldy type
What are Langhans granulomas?
Classically found in TB cases, characterised by peripheral ring of nuclei and large eosinophilic cytoplasm
What are foreign body type granulomas?
Often associated with pyogenic (pus) granulation tissue e.g. pilonidal abscess
What are silicone associated granulomas?
Due to ruptured silicone implants - usually but not always in breast - vacuoles contain silicone
What are Warthog-Finkeldy type granulomas?
Seen rarely in measles - characterised by a central cluster of nuclei
What is healing by primary intention?
Minimal gap with a small amount of granulation tissue with small linear scar
Outline the sequence of events of surgical wound healing by primary intention
Injury, blood clot and acute inflammation followed by granulation tissue formation and angiogenesis - phagocytosis of fibrin and myofibroblasts lay down collagen. Finally contraction of scar and re-epithelialisation
What is healing by secondary intention?
Lots of granulation tissue and contraction leading to large non-linear scar
What factors favour wound healing?
- Cleanliness
- Apposition of edges (no haematoma)
- Sound nutrition
- Metabolic stability and coagulation
What factors lead to impaired wound healing?
- Dirty, gaping, large haematoma
- Poorly nourished in vit A and C
- Abnormal CHO metabolism, diabetes and corticosteroid therapy
- Inhibition of angiogenesis
What occurs during fracture healing?
Same principles as at any site, modified situation due in bone- granulation tissue also contains osteoblasts
