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NMSK1 - physio 1 > inflammation > Flashcards

inflammation Flashcards

1
Q

what is inflammation?

A

it is the **reaction **of vascularised living tissue to a local injury

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2
Q

what is the suffix associated with inflammation?

A

ITIS
eg appendicitis, bronchitis

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3
Q

what are examples of causes of inflammation?

A
  • infectious agents - eg viruses, bacteria, fungi
  • tissue necrosis
  • foreign bodies
  • immune reactions - hypersensitivity reactions - endogenous (autoimmune) or exogenous agents - eg allergy
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4
Q

what are 3 objectives of inflammation?

A
  • **localise and eliminate **the causative agent
  • limit tissue injury
  • begin the **process of repair **
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5
Q

what are 5 classic signs of acute inflammation?

A
  • heat
  • redness
  • swelling
  • pain
  • loss of function
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6
Q

define** acute vs chronic inflammation**

A
  1. acute - immediate and early response to injury, devekops rapidly and resolves rapidly
  2. **chronic **- longstanding inflammation, primary or following an acute inflammation
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7
Q

what is acute inflammation characteristed by?

A
  • accumulation of fluid, protein and acute inflammatory cells at the site of injury
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8
Q

what are the main cells involved in acute inflammation?

A

neutrophils

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9
Q

what are the ‘mediators’ of acute inflammation?

A
  • chemical products derived from the plasma or produced by cells
  • they initiate the inflammation process - & cause vasodilation of vessels
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10
Q

what are the** vascular events** that take place in acute inflammation?

A
  • vasodilatation of blood vessels - which leads to **increased blood flow and increased hydrostatic pressure** - redness and heat symptoms
  • vessels become more permeable or ‘leaky’ - exudate protein rich fluid - leads to swelling
  • both of the above lead to increased blood viscosity (intrinsic factor of blood)
  • wbc’s accumulate against the inner layer of vessel wall
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11
Q

what is oedema?

A

excess fluid in the interstitial tissue or body cavities

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12
Q

what is pus?

A

purulent inflammatory exudate rich in neutrophils and cell debris

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13
Q

what is exudate?

A

fluid that leaks out of blood vessels into nearby tissues

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14
Q

describe the **margination, rolling & transmigration ** in the cellular events that occur in acute inflammation

A
  • with** vasodilatation and increased vascular permeability,** fluid & plasma proteins will leak out of the vessel - which will lead to stasis and **wbc’s will accumulate **against the vessel wall
  • wbc’s will then** roll against the vessel wall** and** transmigrate** through the vessel and into the surrounding tissue
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15
Q

apart from migration, rolling, transmigration and migration to site of injury, what other cellular events occur in acute inflamation?

A
  • phagocytosis - cells engulf bacteria etc
  • cells release enzymes and other products if necessary
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16
Q

what are the main cells involved in acute inflammation & what to they do ?

A
  • white blood cells - esp **neutrophils and macrophages **are recruited to site of injury - they recognise pathogens and debris
  • they eliminate them and produce growth factors to allow for repair
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17
Q

what are the** beneficial effects** of inflammation?

A
  • toxins are diluted
  • fibrin is produced - which delays bacterial spread
  • antibodies arrive to site of injury
  • destruction of microbial agent
  • delivery of nutrients and o2 - due to vasodilation
  • removal of tissue debris
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18
Q

what are the **harmful effects **of inflammation?

A
  • can impair blood flow
  • can cause mechanical effects - eg swelling of epiglottis in throat
  • impaired function
  • can destruct tissue
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19
Q

what are the systemic effects of inflammation?

A
  • pyrexia - fever
  • increased tendency to sleep
  • pain
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20
Q

what can be seen in the laboratory about the systemic effects of inflammation?

A
  • leucocytosis - increased wbc’s
  • anaemia - if there is blood loss
  • acute reactive proteins - c reactive proteins
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21
Q

what are the main outcomes of acute inflammation?

A
  • complete resolution
  • absess formation - rare - occurs if there is not complete removal
  • healing by connective tissue replacement - fibrosis
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22
Q

what is chronic inflammation?

A
  • prolonged inflammation - for weeks or even months
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23
Q

why do people get chronic inflammation?

A
  • persistent or repeated bouts of acute inflammation
  • prolonged normal healing
24
Q

what are some examples of the causes of chronic inflammation?

A
  • persistent infection - eg bacilli bacteria or viruses
  • hypersensitivity - may be autoimmune, or abnormal response to normal host flora
  • exposure to potentially toxic substances - may be exogenous eg silica or endogenous eg lipids
25
Q

what are the main features of chronic inflammation?

A
  • infiltration or presence of inflammatory cells - macrophages, lymphocytes and plasma cells
  • tissue destruction - due to persistent injury
  • repair - attempt at healing by connective tissue replacement
26
Q

what are the main effector cells in chronic inflammation?

A

macrophages

27
Q

what is the function of macrophages?

A
  • sense and engulf particles
  • induce an inflammatory response
28
Q

what important cells do macrophages activate?

A

lymphocytes

29
Q

what is granulomatous inflammation?

A

* special type of chronic inflammation that is characterised by nodular aggregrates of macrophgaes and multinucleated giant cells

30
Q

what are examples of things that may lead to granulomatous inflammation?

A
  • infections - eg tb or fungal infections
  • foreign body - will trigger ongoing response
  • tumours
31
Q

define healing

A

the replacement of destroyed or lost tissue by a viable (usable) tissue

32
Q

what is the initial response of damaged tissue to injury?

A

acute inflammation

33
Q

what is complete resolution?

A

regeneration through proliferation of adjacent surving structures and tissue stem cells

34
Q

what is fibrosis ?

A
  • fibro proliterative response
  • scarring
35
Q

does the healing process usually involve regenration or scarring?

A
  • usually a combination of both
  • does depend on .. ability of body to remove cauative agent, ability to clear the inflammatory debris, ability of cells to regenerate and the degree of architectural damage
36
Q

what are liable cells?

A
  • they are continuously dividing cells
  • examples - epithelial cells such as skin, oral cavity and GIT
37
Q

what process occurs after injury to liable cells?

A

regeneration - if the supporting stroma is intact

38
Q

what are stable cells?

A
  • cells that have a low level of replication
  • example - liver
  • they can be stimulated to divide
39
Q

what process occurs after injury to stable cells?

A
  • healing by regeneration - if the supporting stroma is intact
40
Q

what are permanent cells?

A
  • non dividing cells
  • eg neurons and myocardial cells
41
Q

what process occurs after injury to permanent cells?

A
  • NO REGENERATION
  • replaced by connctive tissue - and healing by fibrosis
42
Q

Describe regeneration

A
  • replacement of lost cells by cells of the same type through cell division
  • however - the supporting framework must still be intact
  • tissue is returned to its pre injury state
  • controlled by stimulatory and inhibitory factors
43
Q

describe **fibrosis **

A
  • fibroproliferative response that patches rather than restores the tissue
  • occurs when there is destruction to both functional cells and stromal cells, death of permanent cells and long standing inflammation
44
Q

what are the 3 phases of healing?

A
  • inflammatory phase
  • proliferative phase
  • remodelling phase
45
Q

What does the inflammatory phase of healing involve?

A
  • haematoma formation - injury to blood vessel
  • presence of neutrophils
  • presence of macrophages
  • removal of tissue debris
46
Q

what does the proliferative phase of healing involve?

A
  • epithelial cell proliferation - granulation tissue forms
  • proliferation of fibroblasts and new vessel formation
47
Q

what does the remodelling phase of healing involve?

A
  • replacement of the granulation tissue by a fibrous stroma
  • degradation of excessive extra cellular matrix by metalloproteinase
  • increase in the strength of the wound
48
Q

what are the 2 types of wound healing on the skin?

A
  • primary intention
  • secondary intention
49
Q

describe primary intention

A
  • used in small wounds where the edges are close together
  • where there is minimal loss of tissue
  • eg after a surgical incision or clean wound
50
Q

describe secondary intention

A
  • for large gaping wounds
  • where there is an extensive loss of cells
51
Q

Describe the stages of wound healing by primary intention - day 1-7

A
  • day 1 - wound filled with blood clot and there is acute inflammation in surrounding tissue
  • day 2 - macrophages come and the epithelial cells start to close the wound by proliferating on the surface
  • day 3 - granulation tissue formation
  • day 5 - collagen deposition
  • day 7- sutures removed
52
Q

how is wound healing by secondary intention different to primary intention?

A
  • process is similar
  • slower - as there is a much larger wound
  • more intense inflammatory reaction
  • more scarring
53
Q

by what process does healing occur in skeletal muscle ?

A

regeneration

54
Q

what are examples of local factors that influence healing?

A
  • infections
  • forgein bodies
  • type of tissue
  • size and location
55
Q

what are systemic factors that can affect healing?

A
  • age and nutrition
  • hormones
  • chemotherapy etc
56
Q

what are the 4 stages of bone healing?

A
  • haematoma formation
  • external callus bridges the fracture site outside the bone
  • internal callus bridges the fracture in medullary cavity
  • remodelling

NMSK1 - physio 1 (36 decks)

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