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Pathology > Class #4: Inflammation and Tissue Repair > Flashcards

Class #4: Inflammation and Tissue Repair Flashcards

1
Q

_____________ is a non-specific immune reaction that occurs in response to any kind of bodily injury. It is a response that is identical regardless of the injurious agent

A

Inflammation

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2
Q

______________ is a protective response intended to eliminate the initial cause of cell injury, remove the damaged tissue, and generate new tissue.

A

Inflammation

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3
Q

Inflammation works by 1), 2), or otherwise 3) the harmful agent.

A

diluting, destroying, neutralizing

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4
Q

Causes of ______________
 Immune response to pathogenic microorganisms
 Trauma (sprains/ligament, strain/muscle)
 Surgery
 Caustics (burning/corrosives), chemicals (poisons)
 Temperature extremes (burns)
 Ischemic tissue damage

A

Inflammation

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5
Q

Identify the Classic/Cardinal Signs of Inflammation

S- H- A- R- P-

A 
Swelling
Heat
Altered Function
Redness
Pain
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6
Q

The earliest (almost immediate) reaction of local tissue and blood vessels to injury

A

Acute inflammation

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7
Q

T/F: Acute inflammation typically lasts several weeks to a month

A

False: Is relatively short in duration, lasting from a few minutes to several days

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8
Q

Acute inflammation is characterized by the exudation of fluid and plasma components and emigration of leukocytes, predominately _______________, into the extravascular tissue

A

Neutrophils

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9
Q

Name some potential stimuli for acute inflammation

A

Infection, immune response, trauma, physical or chemical agents, and tissue necrosis from any cause.

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10
Q

When does acute inflammation become chronic?

A

When healing begins to occur at the same time as active inflammation.

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11
Q

Immediate vascular changes, vasodilation, and increased capillary permeability are part of __________

A

Acute inflammatory response (vascular)

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12
Q

Influx of white blood cells, e.g. neutrophils, monocytes and macrophages are part of ____________

A

Acute inflammatory response (cellular)

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13
Q

Word that describes things related to the physical aspects of blood circulation

A

Hemodynamic

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14
Q

T/F: The immediate vascular response to acute inflammation is a rapid vasodilation of the arterioles, and venules that supply the area with a resultant increase in capillary blood flow, causing heat and redness.

A

False: This comes after a momentary constriction of small blood vessels in the area

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15
Q

Accumulation of extrudates in the tissue spaces during acute inflammation produces 1), 2), and 3) of the affected part.

A

swelling, pain, and impaired function

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16
Q

As extrudates move out of the vessels during acute inflammation , 1) and 2) occur, which aids in preventing the spread of infectious microorganisms.

A

stagnation of flow and clotting of blood.

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17
Q

Vascular changes that may occur with inflammation include:
An 1) response occurs with minor injury
An 2) response occurs with more serious injury and
continues for several days and damages vessels in the area
A 3) response involves an increase in capillary
permeability that occurs for 4-24 hours after injury (e.g. sunburn)

A

1) immediate transient
2) immediate sustained
3) delayed hemodynamic

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18
Q

Cellular Response in Acute Inflammation is marked by movement of phagocytic leukocytes (aka_______________________) into the area of injury

A

White blood cells

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19
Q

Two types of leukocytes participate in the acute inflammatory response:

1) _____________ (neutrophils, eosinophils and basophils)
2) _____________ (the largest of the white blood cells)

A

1) Granulocytes

2) Monocytes

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20
Q

The sequence of events in the cellular response to inflammation includes:
They can only do this due to increased ______ and _______

A
  1. Margination
  2. Pavementing
  3. Trans-migration
    vasodilation and capillary permeability
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21
Q

Margination and adhesion of leukocytes to the endothelial lining: occurs in early stages of inflammation in which WBCs tend to occupy the periphery (______________)

A

Pavementing

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22
Q

_____________ movement of the WBC out of the capillary into the interstitial space.

A

Transmigration

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23
Q

Chemically stimulated movement of phagocytes to the site of inflammation:

A

Chemotaxis

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24
Q

The process of phagocytic cells (i.e. neutrophils, monocytes, tissue macrophages) engulfing and destroying bacteria

A

Phagocytosis

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25
Q

Phagocytosis involves three

distinct stages:

A
  1. Recognition and
    adherence
  2. Engulfment
  3. Intracellular killing
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26
Q

Although inflammation is precipitated by infection and injury, its signs and symptoms are produced by _________________

A

chemical mediators

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27
Q

Some chemical mediators have ________ and __________ properties (e.g. histamine, prostaglandins, and leukotrienes)

A

vasoactive and smooth-muscle constricting

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28
Q

Some chemical mediators act as chemotactic factors such as __________ liberated from leukocytes and complement fragments. These factors when released into the extracellular environment can damage the surrounding tissue.

A

cytokines

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29
Q

___________ may develop as the result of a recurrent or progressive acute inflammatory response or from low grade responses that failed to evoke an acute response.

A

Chronic Inflammation

30
Q

Chronic Inflammation is characterized by infiltration of ____________ and _____________, and by proliferation of fibroblasts (vs. acute: influx of neutrophils, exudate formation)

A

macrophages and lymphocytes

31
Q

Granulomatous formation leads to ________________

formation, a small lesion, which has a mass of macrophages surrounded by lymphocytes.

A

granuloma

32
Q

Type of inflammation associated with foreign bodies (splinters, sutures, silica, asbestos)

A

Granulomatous formation

33
Q

In non-specific chronic inflammation, there is a diffuse accumulation of macrophages and lymphocytes at the site of injury. Fibroblast proliferation occurs with subsequent scar formation that replaces
the normal connective tissue or the ___________(e.g. in the bowel this can cause narrowing of the bowel lumen).

A

parenchyma

34
Q

Watery fluids low in protein content, results from
plasma entering the inflammatory
site (e.g. blister)

A

Serous

35
Q

Occurs when there is severe tissue injury that causes damage to blood vessels, or when there is significant leakage of red blood cells from capillaries

A

Hemorrhagic

36
Q

develops on mucous membrane surfaces; composed of necrotic cells enmeshed in fibro-purulent exudates (e.g. tonsillitis)

A

Membranous or pseudomembranous

37
Q

contain pus: degraded WBCs,
proteins, tissue debris (necrotic
tissue), bacteria, edema; found in abscess or as pockets of pus

A

Purulent

38
Q

Usually from more severe injuries and from greater vascular permeability that allows larger molecules such as fibrinogens through the vascular barrier. Characteristic of inflammation in body cavities such as the pericardium and pleura. Resolves by scar formation between the parietal and visceral surfaces, with fibrous strands within the space.

A

Fibrinous

39
Q

A localized area of inflammation containing purulent exudates

A

Abcess

40
Q

A site of inflammation where an epithelial surface (e.g. skin or gastrointestinal epithelium) has become necrotic and eroded.

A

Ulceration

41
Q

In some cases, inflammatory mediators are released into the circulation resulting in prominent ________. These include:
 Acute phase response
 Alteration in the white blood cell count
 Fever
 Lymphadenitis (inflammation of the lymph nodes)
 Sepsis (infection in the blood) and septic shock

A

systemic manifestations

42
Q

Tissue repair that results when there is minimal tissue damage and cell necrosis (e.g. paper cut, small splinter)

A

Resolution

43
Q

Tissue repair that results in damaged tissue in which the cells are capable of mitosis

A

Regeneration

44
Q

Tissue repair that results when there is extensive tissue damage or the cells are incapable of mitosis. Injured cells are replaced by connective tissue which leaves a permanent scar, also known as fibrous tissue repair.

A

Replacement

45
Q

_______________ tissue: contains the functional cells of an organ or body part. Body cells are divided into three types according to their ability to undergo
regeneration: labile, stable, or permanent cells.

A

Parenchymal

46
Q

_______________ tissue: consists of the supporting connective tissues, blood vessels, extracellular matrix, and nerve fibers.

A

Stromal tissue

47
Q

There are three basic components of _____________:

  1. Fibrous structural proteins e.g. collagen and elastin fibers
  2. Water hydrated gels that permit resilience and lubrication e.g. proteoglycans and hyaluronic acid
  3. Adhesive glycoproteins that connect the matrix elements to one another and to cells e.g. fibronectin and laminin.
A

extracellular matrix (ECM)

48
Q

ECM exists in two forms:

A
  1. Basement membrane: (BM) surrounds epithelial, endothelial, and smooth muscle cells
  2. Interstitial matrix: present in the space between cells in connective tissue, and between the epithelium and supporting cells of blood vessels
49
Q

Regeneration is limited to tissues with cells that are able to undergo _________.

A

Mitosis

50
Q

Type of tissue repair seen in mild to moderate injury.

A

Tissue Regeneration

51
Q

Tissue ____________involves replacement of injured tissue with the cells of the same type, leaving little to no evidence of previous injury.

A

Regeneration

52
Q

Cells that continue to divide and replicate throughout life, replacing cells that are continually being destroyed.

A

Labile cells

53
Q

Cells that normally stop dividing when growth ceases. These cells are capable of undergoing regeneration when confronted with an appropriate stimulus and are capable of reconstituting the tissue of origin.

A

Stable cells

54
Q

Cells that cannot undergo mitotic division. These cells do not normally regenerate. Once destroyed, they are replaced by fibrous scar tissue that lacks the functional characteristics of the destroyed tissue.

A

Permanent or Fixed Cells

55
Q

This type of repair occurs with severe or persistent injury.

A

Replacement/Fibrous Tissue Repair

56
Q

This type of repair takes place when there is damage to both parenchymal cells and extracellular matrix.

A

Replacement/Fibrous Tissue Repair

57
Q

_____________ is a glistening red, moist, connective tissue. It contains newly formed capillaries, proliferating fibroblasts, and residual inflammatory cells.

A

Granulation tissue

58
Q

The development of granulation tissue involves the growth of new capillaries (_____________), _______________, and involution to the formation of scar tissue.

A

Angiogenesis

Fibroblasts

59
Q

________________ involves the generation and sprouting of new blood vessels from pre-existing blood vessels, present as minute red granules from the surface of wound (hence the name granulation tissue).

A

Angiogenesis

60
Q

_______________involves the influx of activated fibroblasts:

A

Fibrogenesis

61
Q

_________________ formation builds on the granulation tissue framework of new vessels and loose ECM.

A

Scar tissue

62
Q

The process of ______________ occurs in two phases:

  1. Emigration and proliferation of fibroblasts into site of injury, and
  2. Deposition of extracellular matrix by these cells
A

scar tissue

63
Q

Primary objective of ____________ is to fill the gap created by tissue destruction and to restore the
functional continuity of the injured part

A

wound healing

64
Q

Also known as healing by first intention. A sutured surgical incision is an example of healing by primary or first intention. It occurs at a faster rate and there is no loss of tissue. Example: C-Section scar

A

Primary intention

65
Q

Larger wounds (burns and surface wounds) have a greater loss of tissue and higher risk of infection. These heal via _______________.
 It occurs at a slower rate.
 There is loss of tissue.
 Large amount of scar tissue formation

A

Secondary intention

66
Q

Phase of wound healing that begins at the time of injury
 It includes hemostasis (activated immediately by platelet activation and aggregation), and vascular and cellular phases of inflammation.
 This phase can last from 3-4 days.

A

Inflammatory phase

67
Q 
Phase of wound healing that begins within 2-3 days of injury.
 It may last for 2-3 weeks.
 Primary focus is to build the new tissue to fill the wound space.
 This phase is characterized by:
 Angiogenesis
 Collagen synthesis
 Granulation tissue formation
 Epithelialisation
 Wound contracture
A

Proliferation phase

68
Q

Phase of wound healing that begins approximately 3 weeks after injury.
 It can continue for 6 months or longer depending upon extent of wound.
 Collagen is remodeled and realigned along lines of tension.
 Cells that are no longer needed are removed by apoptosis.

A

Maturation or Remodelling Phase

69
Q

In this process “drying up” cells become dehydrated and die. Healing is better in a somewhat moist environment (e.g. with a “moisture retention” dressing) as it enhances epidermal cell migration and encourages epithelization.

A

Desiccation

70
Q

Deterioration of tissue due to prolonged exposure to excessive moisture (e.g. due to urine and fecal incontinence)

A

Masceration

71
Q

One type of abnormality in healing by scar tissue is “___________” (tumor-like masses caused by the excessive production of collagen). DO NOT FRICTION or DO SPECIFIC/DEEP MASSAGE

A

keloid formation

Pathology (4 decks)

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