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AD1 > HBB - chronic inflammation > Flashcards

HBB - chronic inflammation Flashcards

1
Q

When does chronic inflammation occur?

A

If the stimulus is not removed.
Repeated acute inflammation.
Unique characteristic of stimulus.
Healing and tissue repair.

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2
Q

Why is a stimulus sometimes prolonged?

A

Hides from immune response
Resistant to destruction
Genetic dysfunction in host

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3
Q

What is the function of activated macrophages?

A 
Removal of injured tissue/debris
Antimicrobial activity
Proliferation of fibroblasts and keratinocytes
Angiogenesis
Deposition and remodelling of ECM
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4
Q

How does a caseative granuloma form?

A

Macrophages engulf organisms
Organism resists digestion and multiplies in macrophages
Macrophage dies and is engulfed by another macrophage
Central caseous necrosis may mineralise

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5
Q

What is a granuloma?

A

Aggregation of macrophages that forms in response to chronic inflammation.

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6
Q

How does an eosinophilic granuloma form?

A

Usually in response to parasites and hypersensitive reactions.
Eosinophils dominate along with macrophages, lymphocytes and plasma cells.
More common in cats. TH2 directed response to an unknown antigen.

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7
Q

How does an abscess form?

A

Pus is formed from the acute inflammatory phase.
Macrophages direct fibroblasts to produce collagen and ECM proteins.
Results in the formation of a slender CT wall, which matures to form a thick fibrous capsule, and is vascularised.

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8
Q

What products do fibroblasts produce?

A

ECM proteins
Collagen
Cytokines

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9
Q

What are the 4 stages of wound healing?

A

Haemostasis phase
Inflammatory response
Proliferative response
Connective tissue remodelling phase

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10
Q

Describe the haemostatic phase of wound healing.

A

Initially, the blood vessels vasoconstrict. Platelets adhere to the endothelium of the blood vessel. Fibrin mesh forms, when the platelets are stabilised and the blood clots, the blood vessels subsequently dilate.

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11
Q

Describe the inflammatory response of wound healing.

A

Removal of debris and bacteria.
Associated with cardinal signs
24-48 hours after the initial injury

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12
Q

Describe the proliferative phase of wound healing.

A

~4-24 days after the initial injury
Granulation tissue forms to fill the defect. This consists of immature CT and new blood vessels.
Re-epithelialization of the wound.

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13
Q

How is the connective tissue remodelled in wound healing?

A
  • MMP - matrix metalloproteinases
  • Stimulated by GF and cytokines, which stimulates collagen production, phagocytosis and physical stress.
  • Inhibited by steroids and tissue inhibitors.
  • Collagen fibres remodel the wound. The wound bed increases in tensile strength and flexibility.
  • Fibroblasts mature into myofibroblasts, which allows for contraction.
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14
Q

What is primary wound healing?

A

Wound edges are in close apposition

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15
Q

What is secondary wound healing?

A

Would edges are not in close apposition

More likely to involve scarring, contamination and long repair time

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16
Q

Why does fibrosis develop during chronic inflammation?

A

Persistent inflammation causes macrophages and lymphocytes to be activated
There is also a prolonged production of GF and cytokines. This increases the number of epithelial cells, fibroblasts and collagen molecules synthesised.
Collagen molecules synthesised also increases due to a low activity of MMPs.

17
Q

What is the composition and appearance of a serous exudate?

A
  • Low protein and inflammatory cell concentration.

- Appears watery, clear or slightly yellow.

18
Q

What is the composition and appearance of a catarrhal exudate?

A
  • Secretion of mucous mixed with inflammatory fluid. Common at sites of mucous production; GI tract and respiratory tract
  • Appears thick and gelatinous.
19
Q

What is the composition and causes of a fibrinous exudate?

A
  • High concentration of plasma proteins and low concentration of inflammatory cells.
  • Associated with severe endothelial damage, which allows the leakage of large plasma proteins, such as fibrinogen.
  • Common at the sites of serous membranes.
20
Q

What is the composition and appearance of a suppurative (purulent) exudate?

A
  • Accumulation of fluid with a high number of leukocytes, mainly neutrophils.
  • High plasma protein concentration
  • Appears as a thick milky liquid.
21
Q

What are the components of immature granulation tissue?

A

Macrophages and fibroblasts with emerging vessels.

22
Q

What are the components of mature granulation tissue?

A

Fibroblasts and sparse ECM proteins that from layers perpendicularly with running blood vessels.

23
Q

What are the components of fibrosis tissue?

A

Predominantly ECM proteins. Fewer fibroblasts and blood vessels.

AD1 (19 decks)

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