Inflammation Flashcards
What kind of responses does inflammation use?
Physiologic and pathologic
Inflammation responses are intended to do what three things?
- Stop whatever caused the injury
- Remove the damaged tissue
- Generate new tissue
How to inflammatory responses do their jobs?
By destroying, digesting, walling off, of otherwise neutralizing harmful agents
Use whatever force is necessary -cool cop puts on shades and walks off screen-
What agents do inflammatory responses go after?
Toxins
Foreign agents
Infectious organisms
List the three steps of acute inflammation
- Vascular phase
- Cellular phase
»>Leukocyte activation and phagocytosis
The vascular phase of acute inflammation is characterized by
Changes in small blood vessels at the site of injury
What happens to the blood vessels near an injury when it first happens?
They briefly vasoconstrict (small) and then vasodilate (big)
What is the primary cause of the vasodilation that occurs with an injury?
Mast cells (immune cells that contribute to homeostasis of immune system)
Mast cells release ___ which causes ___
Histamine causes vasodilation
Histamine binds to ___ which cause ___
The cell receptors on the endothelial cells
The cells to become more permeable
The complement system forms a cascade which increases ___ and acts to ___
Increases vascular permeability and vasodilation
Acts to improve the process of phagocytosis
Explain what happens when a system “cascades”
One component is activated and the others are automatically activated in an orderly fashion
dominoes except they’re not falling over
What is released by the Kinin system?
Bradykinin
Bradykinin does what?
Increases vascular dilation of blood vessels
Acts as a mediator for pain
How long does the actions of bradykinin last?
Short lived
Increased blood flow to an injured area brings what?
Leukocytes
Clotting factors
The complement and Kinin systems
What is the purpose of leukocytes (phagocytes) in inflammator response?
They come in and destroy invading organisms
bouncer, ready to throw hands
List the five cardinal signs of inflammation
- Rubor (redness)
- Tumor (swelling)
- Calor (heat)
- Dolor (pain)
- Functio Laesa (loss of function)
Blood flows into the injured area, pressure is put on the vascular wall and this increases
Capillary permeability
Because of increased capillary permeability in inflammatory response, what happens to the exudate?
It goes out into the tissue and increases the osmotic pressure
With exudate in the tissue, fluid goes where? What happens in return?
Fluid goes into the interstitial spaces
This causes swelling, pain, and lack of function
What happens as fluid moves out of the capillary?
Blood flow slows and clotting occurs
Clotting and slowed blood flow helps to do what in inflammatory response?
helps to localize the inflammatory process and decrease infection
In the cellular stage of acute inflammation, leukocytes do what?
Margination - move towards the periphery of the vessel and accumulate
Explain adhesion
Blood flow slows, cytokine messenger ask endothelial cells to send out cell adhesion molecules - allow leukocytes to adhere to the endothelium cells
Once leukocytes adhere to endothelium cells in the cellular stage of acute inflammation, the endothelial cells separate why?
To create gaps for the leukocytes to migrate through to the injured tissues
Chemotaxis is the
Movement of an organism or entity in response to a chemical stimulus
for inflammation, cells can identify where an injury is because of the chemical stimulus The Marco-Polo of cells
Leukocytes use chemotaxis to
Find the site of the injury
Once leukocytes have found the injury site, what do happens?
They are activated to destroy the microbes (microorganisms; bacterium) through phagocytosis
The manifestations of inflammation may be produced by
They may be from __ or __
Chemical mediators
May be from the mast cells or the complement and kinin systems
Ulcerations refers to a site of inflammation where skin or lining has become
necrotic and eroded
essentially open wounds inside or outside the body
Describe serous exudate
Watery exudate
Low in protein content
think serous = serum = watery
Hemorrhagic exudate occurs when
There is severe tissue injury which damages BLOOD VESSELS or leakage from blood vessels
Hemorrhage = bleeding out
Fibrinous exudate contains
Form what?
Large amounts of fibrinogen
Thick and sticky meshwork (like a blood clot)
Membranous or pseudomembranous exudate develops
Composed of
A mucous membrane surface
Necrotic cells enmeshed in a fibrinopurulent exudate
Purulent exudate contains ___ which is composed of (3)
Pus
- Degraded WBCs
- Proteins
- Tissue debris
Acute inflammation is the body’s
Immediate protective response of local tissues and their blood vessels to injury
all hands on deck, emergency situation (acute)
Acute inflammation is critical for
Restoration of tissue homeostasis
Acute inflammation can be triggered by
Infections Spider bites Blunt injuries Burns Tissue necrosis
The goal of acute inflammation is to
Eliminate injurious agents and limit tissue damage
What is the timeline of acute inflammation and adaptive immunity?
Acute inflammation happens before adaptive immunity
Acute inflammation lasts for
A few minute to several days
Acute inflammation is characterized by
Plasma and cellular driven mediators
Which phagocyte is the most important in acute inflammation?
Leukocyte
> Specifically the neutrophil
Which type of inflammation is characterized by exudate and has the 5 cardinal signs?
Acute inflammation
Chronic inflammation may occur if
Acute inflammation is not successful in healing the injury
Chronic inflammation can last for
Years
Chronic inflammation is characterized by an infiltration by
This leads to what?
Macrophages, lymphocytes, and fibroblasts
- Inflammation
- Fibroblast proliferation
- Scarring and deformity
List the two types of chronic inflammation
Nonspecific inflammation
Granulomatous inflammation
In nonspecific chronic inflammation, there is an acute accumulation of
Macrophages and lymphocytes at the site of injury
In granulomatous chronic inflammation, a ___ seals off ___
Example:
Granulomatous lesion
The invading organism
Example: Tuberculosis
The most prominent systemic manifestations of inflammation are
Increased in WBCS (leukocytosis)
Fever
Elevated ESR (Erythrocyte Sedimentation Rate)
Enlargement of lymph nodes
ESR measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube
» High ESR means inflammation (clotting quickly because of an injury)
Would you expect to see mature or immature white blood cells coming into battle as the infection progresses?
Immature
> the body uses the WBCs already prepared (mature) so the bone marrow starts shooting our immature WBCs quickly to try to help
Like no one will notice children are fighting instead of adults, bone marrow!!
Most biochemical processes in the body are affected by
Changes in temp
How does body temperature affect biochemical processes?
It can slow it down or speed it up
Fever is the body’s response to
An endogenous pyrogen in response to infectious/noninfectious disorders
substances that originate in the body and can cause a fever
What is the body’s thermostat?
Hypothalamus
How does the hypothalamus control temperature?
It receives information from thermoreceptors (detect hot and cold), then compares that info with the set point (the temp within the body’s normal range)
A fever is an increase in body temp that results from
An increase in the set point of the thermostatic center in the hypothalamus
What are examples of non-infectious disease processes that can cause fevers?
Heart attack
Cancer
Autoimmune diseases
What are the stages of a fever?
Prodromal Period
Chill
Flush
Defervescence
During the prodromal (first) period of a fever a patient would make what kind of complaints? Examples?
Nonspecific complaints
Mild headache
Fatigue
General malaise
Fleeting aches and pains
During the chill (second) stage of a fever, you would expect
The patient would be chilled and have generalized shakes (rigors)/shivering
Vasoconstriction (remember, constrict first for a short time, then dilation)
Pallor
During the flush (third) stage of a fever there would be
Cutaneous vasodilation
Skin becomes warm and flushed
During the defervescence (fourth) stage of a fever, the patient would be
Sweating
Describe an elderly patient’s baseline temperature
How would this affect your judgement of a fever as a nurse?
Normally have a lower baseline temperature than younger patients
Even a small increase in an older patient might indicate a fever/serious infection
Older adults might have a ___ reaction to infection
Decreased or blunted
How might infections present in and elderly patient?
Confusion
Agitation
Weight loss
