Exam 1: Inflammation 1 + 2 Flashcards
Define inflammation
The bodies innate response to injury; a complex reaction arising in vascularized tissue in response to an injury/ injurious agent
- results in fluid accumulation and leukocytes
- involved with repair process
Define inflammatory edema
Excess fluid in extravascular space that is a direct result of inflammation
Define Exudate
fluid with many cells and specific gravity more than 1.010
Define Transudate
fluid with few cells and specific gravity less than 1.010
Define Effusions
fluid in body cavities:
pleural, pericardial, ascites
What are the causes of inflammation?
physical, chemical, ischemic, hypoxia, anoxia, necrosis
What are the physical causes of inflammation?
blunt force trauma, hot or cold
What are the chemical causes of inflammation?
poisons, alcohol, endotoxins, and exotoxins
What are the infectious causes of inflammation?
viral, bacterial, fungal, protozoal, or prion
Define immunological
hypersensitivity reactions
Define ischemic
decreased blood supply
Define hypoxia
decreased O2 supply
Define anoxia
no O2
Define necrosis
cell death to injury or inflammation
what are the 5 cardinal signs of inflammation?
rubor, dolor, calor, tumor, functio laesa
Define rubor
redness:
vasodilation caused by histamine
Define dolor
Pain:
kallikrein and bradykinin
Define calor
Heat:
increased vascular due to histamine and serotonin
Define tumor
swelling:
increased vascularity permeable die to histamine and serotonin
Define functio laesa
loss of function:
decreased cell function
Define acute inflammation
neutrophils and macrophages:
= rapid onset and short lived
Define chronic inflammation
lymphocytes, macrophages and fibroblasts:
slow onset, long lived, symptoms appear late and pronounced tissue damage
What is the first step to hemodynamic change
a brief period of vasoconstriction
What follows vasoconstriction?
massive vasodilation of the arterioles mediated by histamine
What is histamine released from
basophils
Vasodilation results in hyperemia which results in
redness, heat, rubor and calor
Characteristics of exudates
cloudy, high protein, over 1.02, many calls, always inflammatory
What are the types of effusion
pleural, pericardial, joint and ascites
Where does pleural effusion take place
between the parietal and visceral pleura
Where does pericardial effusion take place
between the 2 layers of pericardium
What is joint effusion
fluid accumulates in the joint
Where are ascites
between the two layers of peritonium
What is margination
- white blood cells move to the edge of the blood vessel
- it is triggered by the reduction of blood flow
What is rolling
- roll on the endothelial cells
- triggered by the reduction of blood flow
What is adhesion
- stick to the endothelial cells
- triggered by immunoglobins, intergins and selectins
What is transmigration
- white blood cells move out of the blood vessel
- triggered by diapedesis
Which cells are the first line of defense in phagocytosis
neutrophils
Which cells are the second in line of defense in phagocytosis
monocytes
What is aggregation
- white blood cells gather around the damaged tissue,
- triggered by platelet released aggregins
What is phagocytosis
- ingestion of material to form a phagosome
- triggered by the adherence of material to the white blood cell surface
What is opsonization
- making the material more likely to stick
- triggered by release of immunoglobins
what is the role of chemical mediators in response to inflammation
- substances act to either initiate or enhance the response
- originates from either the plasma or cells
- redundancy provides amplification
- can have harmful effects on the host
What three systems are plasma derived from for inflammation response
kinin system, complement system, coagulation system
Kinin system helps
pain and swelling
compliment system helps
immune defense
coagulation system helps
blood clotting
what is the key plasma protein activating inflammatory response
Hegeman factor (factor XII)
Where is the hegman factor
- in the clotting cascade
- activated when blood vessels are damaged
Why is Bradykinin important
- it is the most potent chemical mediator in the kinin family
- responsible for pain, vasodilation and increased vascular permeability
- rapidly degraded
What are the three pathways the complement system activates
classical, alternative, mannose-lectin
What triggers the classical pathway
antibodies
What triggers the alternative pathway
microbes
What triggers the mannose-lectin pathway
sugar patterns on microbes
What is the source and effect of serotonin
platelets, vasodilation
What is the source and effect of thromboxanes
mast cells, vasoconstriction
What is the source and effect of leukotrines
mast cells, vasodilation and increased vascular permeability
what is the role of nitric oxide in inflammation
causes vasodilation and is cytoxic = has a free radical and a gaseous neurotransmitter
Fever
what is the chemical and mechanism
II-F
pyrogen acts on the hypothalamus
Anorexia
what is the chemical and mechanism
TNF
supreses appetite by acting on hypothalamus
Protein synthesis
what is the chemical and mechanism
II-6
acts on the liver to produce C-reactice protein
Leukocytes
what is the chemical and mechanism
II-2
acts on the bone marrow to stimulate cell lines
What are the outcomes of acute inflammation
resolution, fibrosis, abscess, sinue, fistula
Define resolution
natural outcomes of healing
- preferred outcome
Define Fibrosis
excess scar tissue
- keloid formation
Define sinue
blind end tract connecting one epithelial surface
- sinus between dental abscess and the skin
Define fistula
abnormal tract connecting two epithelial surfaces
- anorectal fistula in Crohn’s disease
what is an example of complete resolution of acute inflammation
Pneumonia
Disintegration of a nerve axon is what type of degeneration
wallerian degeneration
is skeletal muscle degeneration characterized histologically by waxy hyaline cartilage?
yes, called Zenker’s degeneration
what is the definition of chronic inflammation
inflammation of prolonged duration in which active inflammation, tissue destruction and attempts at healing are all progressing simultaneously
what are ways chronic inflammation can arise?
persistence of a stimulus, prolonged exposure to exogenous or endogenous toxic agent, immune mediated inflammatory diseases
What is an example of persistence of a stimulus
microbial, viral or fungal infection
What is an example of a prolonged exposure to exogenous or endogenous toxic agent
silicosis of the lung, artherosclerosis
what are an immune mediated inflammatory diseases
autoimmune diseases such as RA, MS and allergies
Chronic inflammation depends on what three things
- persistence of the injurious agent
- pathogenic mechanism
- presence of certian cell types
Examples of localized diseases and chronic inflammation
indigestible foreign material, suture material, talcum powder
Examples of generalized diseases and chronic inflammation
tuberculosis, leprosy, tertiary syphilis, sarcoidosis, some fungal infections
What are the 2 types of patterns of chronic inflammation
non-specific and specific
Macrophages are a feature of which pattern of chronic inflammation
non-specific
True or False
Causeous necrosis is associated with granulomatous inflammation
true
What cell nuclei is arranged in a haphazard pattern and involves encompassing undissolved material
osteoclasts
