Inflammation

Question 1

What kind of responses does inflammation use?

Answer 1

Physiologic and pathologic

Question 2

Inflammation responses are intended to do what three things?

Answer 2

1. Stop whatever caused the injury
2. Remove the damaged tissue
3. Generate new tissue

Question 3

How to inflammatory responses do their jobs?

Answer 3

By destroying, digesting, walling off, of otherwise neutralizing harmful agents

Use whatever force is necessary -cool cop puts on shades and walks off screen-

Question 4

What agents do inflammatory responses go after?

Answer 4

Toxins
Foreign agents
Infectious organisms

Question 5

List the three steps of acute inflammation

Answer 5

1. Vascular phase
2. Cellular phase
   »>Leukocyte activation and phagocytosis

Question 6

The vascular phase of acute inflammation is characterized by

Answer 6

Changes in small blood vessels at the site of injury

Question 7

What happens to the blood vessels near an injury when it first happens?

Answer 7

They briefly vasoconstrict (small) and then vasodilate (big)

Question 8

What is the primary cause of the vasodilation that occurs with an injury?

Answer 8

Mast cells (immune cells that contribute to homeostasis of immune system)

Question 9

Mast cells release ___ which causes ___

Answer 9

Histamine causes vasodilation

Question 10

Histamine binds to ___ which cause ___

Answer 10

The cell receptors on the endothelial cells

The cells to become more permeable

Question 11

The complement system forms a cascade which increases ___ and acts to ___

Answer 11

Increases vascular permeability and vasodilation

Acts to improve the process of phagocytosis

Question 12

Explain what happens when a system “cascades”

Answer 12

One component is activated and the others are automatically activated in an orderly fashion

dominoes except they’re not falling over

Question 13

What is released by the Kinin system?

Answer 13

Bradykinin

Question 14

Bradykinin does what?

Answer 14

Increases vascular dilation of blood vessels

Acts as a mediator for pain

Question 15

How long does the actions of bradykinin last?

Answer 15

Short lived

Question 16

Increased blood flow to an injured area brings what?

Answer 16

Leukocytes
Clotting factors
The complement and Kinin systems

Question 17

What is the purpose of leukocytes (phagocytes) in inflammator response?

Answer 17

They come in and destroy invading organisms

bouncer, ready to throw hands

Question 18

List the five cardinal signs of inflammation

Answer 18

1. Rubor (redness)
2. Tumor (swelling)
3. Calor (heat)
4. Dolor (pain)
5. Functio Laesa (loss of function)

Question 19

Blood flows into the injured area, pressure is put on the vascular wall and this increases

Answer 19

Capillary permeability

Question 20

Because of increased capillary permeability in inflammatory response, what happens to the exudate?

Answer 20

It goes out into the tissue and increases the osmotic pressure

Question 21

With exudate in the tissue, fluid goes where? What happens in return?

Answer 21

Fluid goes into the interstitial spaces

This causes swelling, pain, and lack of function

Question 22

What happens as fluid moves out of the capillary?

Answer 22

Blood flow slows and clotting occurs

Question 23

Clotting and slowed blood flow helps to do what in inflammatory response?

Answer 23

helps to localize the inflammatory process and decrease infection

Question 24

In the cellular stage of acute inflammation, leukocytes do what?

Answer 24

Margination - move towards the periphery of the vessel and accumulate

Question 25

Explain adhesion

Answer 25

Blood flow slows, cytokine messenger ask endothelial cells to send out cell adhesion molecules - allow leukocytes to adhere to the endothelium cells

Question 26

Once leukocytes adhere to endothelium cells in the cellular stage of acute inflammation, the endothelial cells separate why?

Answer 26

To create gaps for the leukocytes to migrate through to the injured tissues

Question 27

Chemotaxis is the

Answer 27

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

Question 28

Leukocytes use chemotaxis to

Answer 28

Find the site of the injury

Question 29

Once leukocytes have found the injury site, what do happens?

Answer 29

They are activated to destroy the microbes (microorganisms; bacterium) through phagocytosis

Question 30

The manifestations of inflammation may be produced by They may be from __ or __

Answer 30

Chemical mediators May be from the mast cells or the complement and kinin systems

Question 31

Ulcerations refers to a site of inflammation where skin or lining has become

Answer 31

necrotic and eroded *essentially open wounds inside or outside the body*

Question 32

Describe serous exudate

Answer 32

Watery exudate Low in protein content *think serous = serum = watery*

Question 33

Hemorrhagic exudate occurs when

Answer 33

There is severe tissue injury which damages BLOOD VESSELS or leakage from blood vessels **Hemorrhage = bleeding out**

Question 34

Fibrinous exudate contains Form what?

Answer 34

Large amounts of fibrinogen Thick and sticky meshwork (like a blood clot)

Question 35

Membranous or pseudomembranous exudate develops Composed of

Answer 35

A mucous membrane surface Necrotic cells enmeshed in a fibrinopurulent exudate

Question 36

Purulent exudate contains ___ which is composed of (3)

Answer 36

Pus 1. Degraded WBCs 2. Proteins 3. Tissue debris

Question 37

Acute inflammation is the body's

Answer 37

Immediate protective response of local tissues and their blood vessels to injury **all hands on deck, emergency situation (acute)**

Question 38

Acute inflammation is critical for

Answer 38

Restoration of tissue homeostasis

Question 39

Acute inflammation can be triggered by

Answer 39

``` Infections Spider bites Blunt injuries Burns Tissue necrosis ```

Question 40

The goal of acute inflammation is to

Answer 40

Eliminate injurious agents and limit tissue damage

Question 41

What is the timeline of acute inflammation and adaptive immunity?

Answer 41

Acute inflammation happens before adaptive immunity

Question 42

Acute inflammation lasts for

Answer 42

A few minute to several days

Question 43

Acute inflammation is characterized by

Answer 43

Plasma and cellular driven mediators

Question 44

Which phagocyte is the most important in acute inflammation?

Answer 44

Leukocyte | > Specifically the neutrophil

Question 45

Which type of inflammation is characterized by exudate and has the 5 cardinal signs?

Answer 45

Acute inflammation

Question 46

Chronic inflammation may occur if

Answer 46

Acute inflammation is not successful in healing the injury

Question 47

Chronic inflammation can last for

Answer 47

Years

Question 48

Chronic inflammation is characterized by an infiltration by This leads to what?

Answer 48

Macrophages, lymphocytes, and fibroblasts 1. Inflammation 2. Fibroblast proliferation 3. Scarring and deformity

Question 49

List the two types of chronic inflammation

Answer 49

Nonspecific inflammation Granulomatous inflammation

Question 50

In nonspecific chronic inflammation, there is an acute accumulation of

Answer 50

Macrophages and lymphocytes at the site of injury

Question 51

In granulomatous chronic inflammation, a ___ seals off ___ Example:

Answer 51

Granulomatous lesion The invading organism Example: Tuberculosis

Question 52

The most prominent systemic manifestations of inflammation are

Answer 52

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)

Question 53

Would you expect to see mature or immature white blood cells coming into battle as the infection progresses?

Answer 53

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!!**

Question 54

Most biochemical processes in the body are affected by

Answer 54

Changes in temp

Question 55

How does body temperature affect biochemical processes?

Answer 55

It can slow it down or speed it up

Question 56

Fever is the body's response to

Answer 56

An endogenous pyrogen in response to infectious/noninfectious disorders **substances that originate in the body and can cause a fever**

Question 57

What is the body's thermostat?

Answer 57

Hypothalamus

Question 58

How does the hypothalamus control temperature?

Answer 58

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)

Question 59

A fever is an increase in body temp that results from

Answer 59

An increase in the set point of the thermostatic center in the hypothalamus

Question 60

What are examples of non-infectious disease processes that can cause fevers?

Answer 60

Heart attack Cancer Autoimmune diseases

Question 61

What are the stages of a fever?

Answer 61

Prodromal Period Chill Flush Defervescence

Question 62

During the prodromal (first) period of a fever a patient would make what kind of complaints? Examples?

Answer 62

Nonspecific complaints Mild headache Fatigue General malaise Fleeting aches and pains

Question 63

During the chill (second) stage of a fever, you would expect

Answer 63

The patient would be chilled and have generalized shakes (rigors)/shivering Vasoconstriction (remember, constrict first for a short time, then dilation) Pallor

Question 64

During the flush (third) stage of a fever there would be

Answer 64

Cutaneous vasodilation | Skin becomes warm and flushed

Question 65

During the defervescence (fourth) stage of a fever, the patient would be

Answer 65

Sweating

Question 66

Describe an elderly patient's baseline temperature How would this affect your judgement of a fever as a nurse?

Answer 66

Normally have a lower baseline temperature than younger patients Even a small increase in an older patient might indicate a fever/serious infection

Question 67

Older adults might have a ___ reaction to infection

Answer 67

Decreased or blunted

Question 68

How might infections present in and elderly patient?

Answer 68

Confusion Agitation Weight loss