ham Flashcards
exudate
fluid released from the body with a high concentration of protein, cells, or solid debris
exudation
pathological oozing of fluids, usually as a result of inflammation
transudate
fluid that passes through a membrane, ultrafiltrate of plasma
transudation
oozing of a fluid through pores or interstices
pus
protein rich fluid rich in leukocytes and parenchymal cell debris
edema
excess fluid in interstitial areas / body cavities from exudate and transudate
effusion
escape of fluid into a part of the body (pleural effusion)
sequence of vascular flow changes in acute inflammation
1) initial brief vasoconstriction to limit blood loss
2) vasodilation to increase blood flow, which results in calor, rubor, allows cells needed for repair to reach site more easily
3) increased vascular permeability due to increased capillary pressure, resulting in escape of exudate and ultimately, edema
signs of acute inflammation
Dolor, Calor, Rubor, Tumor, Functio Lasae
Cellular events leading to emigration of leukocytes to site of injury
Leuckocyte extravasion: Marge Rolls Along a Track Marginization Rolling Adhesion Transmigration
then chemotaxis - leukocytes move towards injury following chemical signals “chemoattractants”
phagocytosis - macrophage follows chemical gradient to source
Vasoactive Amines
Preformed Chemical Mediators of Inflammation, preformed and released quickly from mast cells (histamine) and platelets (serotonin)
Histamine
Vasoactive amine - chemical mediator preformed and released from mast cells that causes vasodilation and increases vascular permeability
Serotonin
Vasoactive amine - chemical mediator pre-formed and released from platelets that causes vasodilation and increases vascular permeability
Bradykinin
Chemical Mediator of inflammation, preformed in the plasma, increases vascular permeability, causes vasodilation, causes smooth muscle contraction, elicits pain
Complement System
Chemical Mediators of Inflammation; preformed in the plasma, includes C3a and C5a
C3a
Part of the complement system, promotes histamine release, mediates chemotaxis, promotes opsonization
C5a
Mediates chemotaxis, promotes histamine release
Arachidonic acid metabolites
Chemical Mediators of Inflammation located on the lipid membrane and formed via the cyclooxygenase and lipooxygenase pathways
Prostaglandins
Chemical Mediator of Inflammation, an arachidonic acid metabolite. Promotes vasodilation, increases vascular permeability, mediates chemotaxis.
Thromboxane
Chemical Mediator of Inflammation, an arachidonic acid metabolite. Promotes platelet aggregation
Prostacyclin
Inhibits platelet aggregation
Leukotrienes
Chemical Mediator of Inflammation, arachidonic acid metabolites. Mediates chemotaxis and increases vascular permeability.
Cytokines
Chemical Mediator of Inflammation General term for family of proteins produced by many cell types to mediate the function of other cell types.
IL1-mediates chemotaxis, induces fever, induces WBC release, promotes histamine release
IL6-induces fever
IL8-promotes histamine release
TNF-Induces fever, induces WBC release from marrow
p-Colony stimulating factors - increase WBC production
Platelet Activating Factor
PAF - Chemical Mediator of Inflammation. Released from mast cells, PMN (neutrophils)
PMNs
Neutrophils, polymononuclear cells
nitric oxide
Chemical Mediator of Inflammation, released from macrophages and endothelial cells. Involved in tissue destruction and vasodilation.
Chemical mediators of inflammation that increase vascular permeability
bradykinin, C3a, C5, histamine, serotonin, PAF, prostaglandins, leukotrienes
Chemical mediators of inflammation – Vascular dilators
bradykinin, histamine, serotonin, prostaglandin, NO
Chemical mediators of inflammation – Vascular constrictors
PAF
Chemical mediators of inflammation – Smooth Muscle Contractors
bradykinin
Chemical mediators of inflammation – pain elicitors
bradykinin and prostaglandin
Chemical mediators of inflammation – histamine release
C3, C5, IL1, IL8
Chemical mediators of inflammation – opsonization promotor
C3a
Chemical mediators of inflammation – Chemotaxis mediators
C5, C3, IL1, leukotriene B4, prostaglandins, PAF
Chemical mediators of inflammation – platelet aggregation promoters
thromboxane A2
Chemical mediators of inflammation – platlet aggregation inhibitors
prostacyclin
Chemical mediators of inflammation – Fever inducers
IL1, IL6, TNF
Chemical mediators of inflammation – Tissue destroyers
NO
Chemical mediators of inflammation – increased WBC releasors
IL1, TNF
Chemical mediators of inflammation – increased WBC production
CSFs
Acute Inflammation outcomes
complete resolution, suppuration/abscess formation, progression to chronic inflammation, repair
granulomatous inflammation
a conglomeration of macrophages cluster together to wall of infectious material from the rest of the body. Granulomas may form as a result of the inability of phagocytes to digest foreign material or continued irritant stimulus.
laboratory dx of inflammation
- Leukocytosis (more bands–immature leukocytes, seen in chronic inflammation)
- CRP– ACUTE phase reaction, increased WBCs
- ESR - acute inflammation, non specific marker for infection
primary intention wound healing
put it back together - cleanly incised and reapproximated
secondary intention
let it heal openly - granulates in
tertiary intention
delayed primary closure, avoids infection
Phases of wound healing
1) inflammation
2) epitheliazation
3) collagen synthesis
4) Scar Maturation
5) organization
Cell Injury
PGOCNIi physical genetic oxengation chemical nutrition infectious immunological
reversible cell injury
cell swells b/c NA/K pump is impaired, ER swells, mitochondria swells, chromatin clumps
irreversible cell injury
cell membrane integrity is lost, ER swells and lyses, ribosomes lost, lysosomes rupture, and nuclear changes occur
karolysis (dissolution of chromatin)
-pyknosis (nuclear shrinkage)
karyorrhexis (membrane rupture/fragmentation)
hypoxia vs. hypoxemia
hypoxia is decreased oxygen for body tissue, hypoxemia is decreased oxygen availability to blood
induction
one group of cells changes the behavior of another group of cells
Types of necrosis
"coagulation of liquid fat results in lawsuit cases" Coagulative liquefactive caseous fat
also: gummatous hemorrhagic fibrinoid fat saponification wet gangrene dry gangrene
coagulative necrosis
Cells are dead, but maintain outline/form, so the tissue maintains its architecture. Cell has no
nucleus and cytoplasm appears pink.
Cell death resulting from hypoxia (aside from brain cells) leads to coagulative necrosis.
Physical presentation: gangrene; skin appears firm, pale, as if “cooked.”
liquefactive necrosis
Cell loses its outline/shape and becomes “liquidy.” Bacterial and some fungal infections lead
to liquefactive necrosis. When brain cells become hypoxic, they suffer liquefactive necrosis.
Cell loses structure b/c lysosomal organisms are present & quickly break down necrotic cells.
Physical Presentation: Thick yellowish fluid/pus is present.
caseous necrosis
Cell loses its outline/form & tissue loses its architecture. Macrophages and lymphocytes
surround the cell (called granulomatous inflammatory border). Caseous Necrosis occurs in TB
infections.
Presentation: Soft, “cheesy,” yellow, whitish areas are present.
fat necrosis
Affects fat cells; cell maintains its outline/form and a blue layer of Calcium forms around the
cell. Neutrophils, lymphocytes, and macrophages surround the cell. Fat necrosis necrosis
occurs in the pancreas & in fatty tissue (breast, abd. subcutaneous adipose tissue).
Presentation: white, chalky areas are seen (these white/chalky areas are called “saponification”).
Gummatous necrosis, hemorrhagic necrosis, and fibrinoid necrosis
gummatous - firm, rubbery dead tissue, original archetecture not preserved, seen in only spirochete infections (syphillis)
hemorrhagic- occurs when drainage of a tissue is blocked & becomes backed up with blood and unable to perfuse (testicular torsion)
fibrinoid - necrosis that affects blood vessel walls
anaplasia
reversion of cells to an earlier state
wet/dry gangrene
dry - black, dry, shrivelled tissue with distinct difference between healthy and not
wet- swollen, red, dark, liquified tissue, foul odor from bacteria, border hard to discern