Chronic Inflammation 2 Flashcards
What is granulomatous inflammation?
Defined by the presence of granulomas in tissues and organs.
Stimulated by indigestible antigen (type four hypersensitivity reaction)
Occurs in infectious and idiopathic diseases.
What are granulomas?
Aggregates of epitheloid macrophages in tissue.
May contain giant cells, surround dead material and be surrounded by lymphocytes.
Contains neutrophils and eosinophils.
What are giant cells?
Epitheloid histocytes which are active macrophages. It is possible that these fuse to form giant cells with large cytoplasm and multiple nuclei. Or could be proliferation of macrophages to make giant cells.
Don’t need granulomas to be present.
In what disease in Langhans typically found and what is it’s structure?
Found in Tuberculosis.
Has a peripheral rim of nuclei and a large eosinophilic cytoplasm.
What is foreign bodies usually associated with?
Pyogenic granulation tissue like a pilonidal abscess.
What are silicone associated giant cells?
Found in ruptured silicone implants and have vacuoles filled with leaked silicone.
Warthin Finkeldy type giant cells have what structure?
Central cluster of Nuclei rarely seen in measles.
What is the kind granulomatous inflammation seen in tuberculosis?
Caseous necrosis is dead tissue surrounded by macrophages, giant cells and lymphocytes.
What granulomatous inflammation is seen in syphilis?
Primary chancre and syphilitic gumma are granulomatous inflammation with plasma cells
What are some examples of non infective granulomas?
Rheumatoid disease which has degenerative collagen surrounded by macrophages.
Sarcoidosis is granulomas on the body.
Crohn’s disease causes ulcerations.
What two types of wound healing are there?
Surgical wounds heal by primary intention. There is a minimal gap for a blood clot and a small amount of granulation tissue to form a small linear scar.
Larger defects heal by secondary intention which causes lots of granulation tissue ingrowth and contraction and scarring.
What are the sequence of events for wound healing?
Injury followed by blood clotting and acute inflammation and fibrin.
Many growth factors and cytokines involved.
Granulation tissue growth and angiogenesis.
Phagocytosis of fibrin.
Myofibroblasts move in and lay down collagen.
Contraction of scar.
Re epithelialisation.
What aspects favour wound healing?
Cleanliness Apposition of edges No haemotomas Sound nutrition Metabolic stability and normality Normal inflammatory and coagulation mechanisms Note local mediators.
What are the sequence of events for a fracture healing?
Trauma results in a fracture and haematoma.
Bits of Dead bone and soft tissue collect
Acute inflammation, organisation, granulation tissue and macrophages clear debris.
Granulation tissue contains osteoblasts as well as fibroblasts
What is callus formation?
Osteoblasts lay down woven bone.
Nodules of cartilage present.
Bone remodelling involves osteoclasts removing dead bone. Lamellar bone progressively replacing woven bone.
Cortical and trabecular bone reformation.
