Chronic Inflammation 2

Question 1

Granuloma

Answer 1

Small area of inflammation in tissue - groups of epithelioid histiocytes (macrophages) in tissue

Question 2

Giant cells

Answer 2

Fusion of macrophages to form larger cells

Large cytoplasm, multiple nuclei

Question 3

Types of Giant Cells

Answer 3

Langhans - nuclei peripherally arranged around the edge
Foreign Body - made in response to a presence of a large foreign body
Warthin-Finkeldy - central cluster of nuclei

Question 4

Describe wound healing

Answer 4

Repair of tissue damage with granulation tissue formation -

Question 5

Describe surgical wound healing

Answer 5

Healing by primary intention (bring edges together)
Small amount of granulation tissue
Small linear scar

Question 6

Describe healing of larger defects

Answer 6

Healing by secondary intention (no offence to bring edges together)
Lots of granulation tissue ingrowth
Contraction and scarring

Question 7

Stages of healing

Answer 7

1. Injury, fibrin (blood clot)
2. Growth factors (proliferation) and cytokines activated
3. Granulation tissue growth - angiogenesis
4. phagocytosis of fibrin
5. Myofibrolasts move in and lay down collagen
6. Contraction of scar
7. Re-epithelialisation

Question 8

Favourable factors of wound healing

Answer 8

Cleanliness
Apposition of edges - no haematoma
Good nutrition

Question 9

Impaired wound healing factors

Answer 9

Dirty, gaping wound
Large haematoma
Poorly nourished - lack of vitamin C and A
Inhibition of angiogenesis

Question 10

Describe fracture healing

Answer 10

Have to repair bony structure as well as sort tissue

1. Trauma
2. Dead bone & soft tissue - blood supply leaves dead bone
3. Acute inflammation. and granulation tissue
4. Granulation tissue contains osteoblast and fibroblasts - lay down the bone

Question 11

Angiogenesis

Answer 11

New vessel formation - capillary buds
VEGF (growth factor) - released by hypoxic (lack of O2) cells stimulated proliferation of endothelial cells - stimulates blood vessel formation to deliver nutrients
Allows blood supply to enter damaged tissue

Question 12

Factors that impair healing

Answer 12

Angiogenesis and thrombosis - blood clot in circulatory system
Angiogenesis and malignant tumours - Ang. occurs at normal growth and supplies nutrients to tumour
Fibrosis and scarring in atherosclerosis