Inflammation Flashcards
What are our body’s lines of defense for inflammation?
Skin, mucous membranes, inflammation, specific immune response
What is inflammatory response?
Usually beneficial response to invasion of microorganisms or to tissue injury, Inflammation response removes stimulus and returns to non injured state
What is the Tissues reaction to Injury?
- vascular phase
- Cellular phase
- responses working together to destroy substances recognized as foreign body
What are the 8 steps in the Vascular System?
- complement
- Kinins(brady kinin)
- Histamine
- Seratonin and Leukotrienes
- Prostaglandins
- Hemostatic fibrinolystic systems
- Vascular changes from mediators
- Role of inflamatory substances
What is Complement process?
Major mediators released to tissue that is injured
- proteins, sequential activation (compliment cascade
- enhances chemotaxis, increases vascular permeability, and causes cell lysis
What is Kinins? Bradykinins
- Contribute to pain and fever
- vasodilation (more oxygen and nutrients)
what do Histamines do??
Vasodilation all over not just the site of injury
- major mediator of capillary permeability
- Role of mast cell/basophils cell = cells that release histamines
- degranulation of mass
What do serotonin and Leukotrienes do?
Similar to histamines, but slower but cause vasodilation and bronchoconstriction
What do Prostaglandins do?
= pain response
- Increase effect of histamine
- Promotes platelet aggregation (helping form clot)
What do hemostatic-fibrinolytic system do?
Activation
- clotting cascade, fibrin clot formation
- clot breaksdown to restore patency of vessel once clot is no longer needed
What are some vascular changes resulting from mediators?
- Brief vasoconstriction to minimize bleeding
- vasodialation leads to more blood flow and nutrients
- increased capilary permiability (move fluid into tissue)
- leakage of fluid
- EDEMA
- stimulation of pain receptors
What is the role of other inflammatory substances?
Cytokines (regulators) these effects other cells
- Interleukins = stimulates liver to produce plasma proteins
- Interferon = anti-viral effect @ receptor site = protects against invasion (does not destroy virus)
- Tissue Necrosis Factor (TNF) = increases phagocytosis of neutrophils, increasing fever.
TNF?
Tissue Necrosis Factor (TNF) = increases phagocytosis of neutrophils, increasing fever.
Interleukins
Interleukins = stimulates liver to produce plasma proteins
Interferon
Interferon = anti-viral effect @ receptor site = protects against invasion (does not destroy virus)
What are the 5 steps of the Cellular phase?
- margination
- Emigration
- Phagocytosis
- Formation of exudate
- Fibrin barrier formation
What is margination?
Pavementing = movement of phagocytes to outside of BV
- movement of phagocytes to periphery
- granulocytes neutrophils, eosinophils, basophils (early cells to respond
- Monocytes to macrophages present mean more chronic disease
What is emigration?
Diapedesis of leukocytes: chemotaxis (attraction of cell sto inflammation
= white blood cells pulled into tissue
Chemotaxis
attraction of WBC to area of inflammation
What is phagocytosis?
Begins with recognition of the target
- neutrophils and macrophages = both primary phagocytes that destroy the foreign body
- engulfment of foreign material
- ingestion through fusion with lysosomes within the phagocyte
- destruction by lysosomal enzymes
What is the formation of exudate?
drainage
- Initially plasma-like
- Prulrulent as cellular debris accumulate - thicker discolored, infection, discharge
What is fibrin barrier?
formation of activated at site of wals off area to limit spread
- framework for tissue formation = where healing begins
during chronic inflammation what is happening?
Inflammatory process persists, stimulus not clear
- more macrophages, less neutrophils
- lack of control of plasma protein synthesis
- natural inhibitors ineffective (mediators are not stopping it)
- may cause scar formation and organ dysfunction
What are the local responses due to inflammation?
Redness, heat, edema = vasodialation
pain = irritation of nerves
formation of exudate
bodys removal of exudate = depends on area
What are some systemic effects of inflammation on the body?
- Fever initiated by releasing pf pyrogens that act on hypothalamus and raise thermostat
- increase in circulating plasma proteins
what is CRP?
C-reactive protein
- normally not present
- Increases after acute inflammation or tissue destruction
- more common
what is ESR?
(Erythryocyte sedimentation rate)
- less specific
- elevated with inflamation
what is Leukocytosis?
Elevation in WBC count (neutrophils)
- left shift - increase in bands (bands are immature WBC)(come from bone marrow, they are releasing and sensing WBC but they are immature)
What is Lymphadenopathy?
Enlarged lyphm nodes (more severe)
- localized infection in attempt to drain exudate
What is the 3 parts of Resolution Inflammation?
Simple resolution
regeneration
repair by scar formation
What is simple resolution?
no destruction of tissue
- neutralization destruction of agent and vessels return to normal
What is regeneration?
replacement of lost or necrotic tissue by tissue of same type
- little to no evidence
In repair of scar formation what is happening?
- necrotic tissue and exudate by granulation tissue (vascular in nature) - enhanced angiogenesis
- Collagen formation to strengthen healing wound
- healing by primary and secondary intention?
What is primary Intention?
Healing by fist: minimal tissue loss nice cut
- sutured or stapled wounds
What is secondary intention?
Deep or large wounds that heal from the inside out
When there ia a large deep wound how does its healing look like?
- Proliferation phase (reconstruction) 3-4 days after injury
- remodeling phase
- contraction and fading of tissue
What are the factors that affect inflammatory response?
Poor nutrition
poor blood as well as oxygen
What are some of the abnormal wound healing poblems?
Dehiscence
Wound contractures
adhesions
what does Dehiscence mean?
reopening of a closed wound, coughing stretching, collagen is inadequate
What does wound contractures mean?
Physical abnormalities, limits movement, tissue becomes nonelastic
What does adhesions mean?
Scar tissues that bind to adjacent structures that should not be (excessive fibrin present)
