Inflammation Flashcards
Five Cardinal Signs of Acute Inflammation
- /2. Heat and Redness: due to increased blood flow through dilated blood vessels
- Swelling: result of increased passage of fluid from dilated and permeable blood vessels into the surrounding tissues.
- Pain: due to the direct effects of mediators, either from initial damage or that resulting from the inflammatory response itself, and the stretching of sensory nerves due to edema.
- Loss of Function: refers to either simple loss of mobility in a joint, due to edema and pain, or to the replacement of functional cells with scar tissue.
What role do Granulocytes play? Examples?
- Complicated nuclei 2-5 lobes
- Specialist cytoplasmic granules
- Activation of other immune cells
Types:
- Neutrophils
- Eosinophils
- Basophils
_________:Inflammatory fluid composed mainly of neutrophils, plasma proteins and cellular debris
Pus
___________:Any inflammatory process containing, consisting of or forming pus. Typical inflammations due to bacterial infections (e.g. purulent meningitis)
Purulent
____________: Any inflammatory process that contains, consists of or forms serum or a fluid having a watery consistency
Serous
Transudate versus Exudate?
•Transudate
Fluid low in protein and cellular content, which has passed through an intact membrane (as capillary wall) due to increased hydrostatic pressure or decreased osmotic forces. e.g. pleural fluid seen in heart failure (pleural effusion)
•Exudate
Fluid rich in protein and cellular content (white blood cells) which has leaked out of a tissue or its capillaries due to injury or inflammation. e.g. peritoneal pus seen in acute peritonitis
________________: Accumulation of fluid that has escaped from blood vessels or lymphatics. Can be ___________ (non inflammatory) or ____________ (inflammatory).
Effusion:
Accumulation of fluid that has escaped from blood vessels or lymphatics. Can be transudative (noninflammatory) or exudative (inflammatory).
What kind of Inflammation?
Serous Inflammation
What type of Inflammation?
What Type of Inflammation?
Suppurative Inflammation
Purulent meningitis is an example of_____________?
Acute inflammation
Acute Inflammation Outcome:
•________________
(Complete regeneration, repair)
•________________
(Healing by connective tissue replacement)
•________________
(Acute inflammation cannot be resolved)
Acute Inflammation Outcome:
•Resolution
(Complete regeneration, repair)
•Healing by Fibrosis (Scar)
(Healing by connective tissue replacement)
•Progression to Chronic Inflammation
(Acute inflammation cannot be resolved)
Threshold of different types of inflammation
Acute: Hours to Days
Subacute: 2-6 weeks
Chronic: Weeks to months
What is unique about a Granulomatous Inflammation
- Distinct type of chronic inflammation with specific clinical correlations
- Modified Macrophage: Epithelioid Histiocyte
- May Coalesce to form Multinucleated Giant Cells
__________________:
‒A compact collection of mature epithelioid histiocytes/multinucleated giant cells with peripherally palisaded histiocytes +/-collar of lymphocytes
‒May demonstrate central necrosis
Granuloma:
‒Compact collection of mature epithelioid histiocytes/multinucleated giant cells with peripherally palisaded histiocytes +/-collar of lymphocytes
‒May demonstrate central necrosis
What makes diagnosing Granulomatous Infections?
INFECTIOUS AGENTS: Difficult to stain, culture, diagnose and treat if you’re not expecting them
- •Tuberculosis*
- •Leprosy*
- •Syphilis*
- •Cat scratch disease*
- •Fungi –Histoplasma, Cryptococcus*
- •Parasites –schistosomiasis*
_________________
- Pale, white nodule
- Usually well circumscribed
- With caseous necrosis (e.g. Tuberculosis)
- Without necrosis (e.g. Sarcoidosis)
Granuloma
Phases of Wound Healing
Inflamatory
- Coagulation
- Inflammation
Proliferative
- Granulation tissue formation
a) Angiogenesis: capilaries to bring in more nutreients
b) Fibroblast proliferation: lay down collagen, scafolding for regeneration
c) Synthesis of Extracellular matrix
Remodeling
- Parenchymal proliferation (if possible)
- Contraction
- Remodelling
Describe the proliferative phase of healing? What tissue is created?
Proliferative Phase: Granulation Tissue
- Initial response to a wound (in terms of healing process)
- Consists of richly vascularised connective tissue containing new capillaries, proliferating (myo)fibroblasts, variable number of inflammatory cells (macrophages, plasma cells)
- Barrier to infection
- Provides scaffolding across which new tissue grows
- Infrastructure supplying nutrients
Difference between Granuloma and Granulation
Granuloma: specific type of chronic inflamtion for specific disease, consists of compact masses of epithelial macropahes
Granulation Tissue: lots of capiilaries, repair after inflamationduring proliferative phase
Healing by first versus second intention
First: well oposed edges, surgical insision. quicker healing
Second: Larger wounds, ulceration. Abundant granulation tissueHealing takes longer
What forms at the point of a stress fracture?
Callus
What ells are the prodemoniant players in chronic inflammation?
Macrophages
What roles do macrophages play?
- Destroy pathogens, foreign materials, degrade dead cells, debris
- Secrete cytokines, growth factors, activate other cells (especially T Cells)
- Promote tissue repair, angiogenesis, activate fibroblasts, collagen synthesis (M2 macrophage
Difference between M1 and M2 Macrophages
M1 (Classivally Activated): responds to triggers from microbes:
- proinflamatory role
- tries to destroy pathogens
- recruits muore leucocytes and cytokines
M2 (Alternatively Activated):
- More interested in repair process of inflammation
- Triggered by anti-inflamatory triggers
- Promotes tissue repair and myofibroblasts to repair damage from inflamatory response
Role and Activation of Lymphocytes? Effect on inflammation?
- Amplify and propagate chronic inflammation
- More severe and persistent inflammation when lymphocytes are activated
