Inflammation 2 Flashcards

(51 cards)

1
Q

What are the events of acute inflammation

A

Stimulus for inflammation
Vascular changes
Cellular events
Termination of acute inflammatory response

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2
Q

What can be the cause of acute inflammation

A

Infectious agents
Trauma
Necrotic tissue
Immune reactions

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3
Q

What are the inflammatory mediators of acute inflammation

A
Vasoactive amines 
Plasma proteases: complement 
Lipid mediators 
Platelet activating factor 
Cytokines 
Chemokines 
Nitric Oxide
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4
Q

What are the vascular changes in acute inflammation

A

Increased vascular flow (hyperemia) and blood vessels

Increased vascular permeability (capillaries and post-capillaries)

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5
Q

What are the cellular events of acute inflmmation

A

Extravasation- deliver of WBC to site of injury

Migration- cytokines
Rolling- selectin/integrin
Activation and Adhesion- integrin and chemokines
Transmigration - P-CAM

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6
Q

The process where WBC emigrate in tissues towards the site of injury

A

Chemotaxis

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7
Q

What are the 3 processes involved in phagocytosis

A

Recognition and attachment of particle

Engulfment with subsequent formation of phagocytic vacuole

Killing or degradation on ingested material

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8
Q

How is the acute inflammatory response terminated

A

Degrade inflammatory mediators
Stop signals
->pro-inflammatory leukotrienes to anti-inflammatory lipoxins from arachidonic acid
-> anti-inflammatory cytokines from macrophages
-> neural impulse inhibits TNF production in macrophages

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9
Q

What are the four outcomes of acute inflammation

A

Complete resolution

Healing by scarring

Abscess formation

Chronic inflammation

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10
Q

What is involved in inflammatory resolution

A

Neutralization of chemical mediators

Return to normal vascular permeability

Stop lymphocytic infiltration and removal of edema

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11
Q

Healing by scarring often occurs in what type of tissue

A

Tissues that do not have the ability to regenerate

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12
Q

How can chronic inflammation arise?

A

Following acute inflammation - persistent stimulus or interference in normal process

Repeated bouts of acute inflammation

Low grade response

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13
Q

Persistent infection by intracellular micro organisms which are low toxicity or prolonged exposure to non-degradable substances usually result in what kind of inflammation

A

Chronic

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14
Q

A small organized collection of modified macrophages (epithelioid cells) surrounded by a rim of lymphocytes

A

Granuloma

Granulomatous inflammation = Chronic!

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15
Q

What are some causes of granulomatous inflammation

A
Insert particles. Eg silica/asbestos 
Lipid resistant to metabolism 
Bacterial resistant to lysosomal degradation 
Systemic fungal agents 
Foreign bodies
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16
Q

What are the cells involved in granulomatous inflmmation

A

Epithelioid cells
Multinucleated giant cells
Lymphocytes

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17
Q

A large, pale-staining, eosinophilic macrophage with a ovoid nucleus, rich with ER, golgi, and vesicles

A

Epithelioid cells

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18
Q

Fusion of macrophages induced by cytokines causes formation of ______________________

A

Multinucleated giant cells

Nuclei are sometimes arranged around the periphery

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19
Q

What are the roles of T lymphocytes

A

To produce lymphokine and interferons
To attract ad activate macrophages
To induce formation of multinucleated giant cells

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20
Q

What are the two patterns of chronic inflammation?

A

Diffuse thickening of affected tissue (eg Johnes disease)

Solid, firm, nodular lesions ->may compress adjacent tissue

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21
Q

The term used when there are significant numbers of neutrophils present in the center of a granulomatous reaction

A

Pyogranulomatous

22
Q

Organized accumulation of machrophage so and epithelioid cells, often rimmed by lymphocytes

A

Simple granuloma

May be diffuse or local

23
Q

Granuloma with a central area of necrosis

A

Complex granuloma

-necrosis may lead to calcification/mineralization

24
Q

What is the sequelae of chronic inflammation ?

A

Persistence of stimuli-> progression of inflammatory rxn -> continuation of disease

25
Process by which lost or necrotic cells are replaced by vital cells
Repair
26
What are the two types of repair
Paraenchymal regeneration Fibrosis
27
Injured tissue replaced by identical types of tissue, leaves no residual trace of pervious injury
Parenchymal regeneration
28
Parenchymal regeneration can only occur if:
Tissue can regenerate framework of the tissue is maintained
29
Replacement of tissue by fibrous CT
Fibrosis
30
Fibrosis results in increased amount of ________ in tissue
Collagen
31
What are labile cells
AKA continuously dividing cells Follow the cell cycle from one mitosis to the next; proliferate throughout life Tissues composed of these cells regenerate after injury
32
What are examples of labile cells?
Surface epithelial Lining mucosa Columnar epithelium of GI tract, uterus, Fallopian tubes Transitional epithelium - urinary tract Spleen, lymphoid, and hematopoietic tissue
33
What are stable cells
Aka quiescent cells Low level of replication Can undergo rapid division in response to stimuli
34
What are examples of stable cells
Epithelium of liver, kidney, lung, pancreas Smooth muscle Fibroblast Vascular endothelium
35
What are permanent cells
Aka non-dividing cellls Cannot undergo mitotic division after postnatal life
36
What are examples of permanent cells?
Neurons | Cardiac muscle cells
37
What are the 4 components of fibrosis ?
Migrate and proliferation of fibroblasts Deposit ECM Form new blood vessel Maturation and organization of the scar (remodeling)
38
What factors favor fibrosis over regeneration
Severe/prolonged tissue injury Loss of framework (basement membranes) Large amount of exudate -> body able to eliminate Lack of renewable cell populations
39
What are the consequences of fibrosis
Loss of functional parenchymal tissue Alteration of physical properties of tissue -> skin scar prone to tearing -> pulmonary -> decreased compliance and vital capacity
40
When does granulation tissue form?
3-5 days after injury
41
What tissue is pink, soft, and granular on the surface of a wound.
Granulation tissue
42
Granulation tissue is composed of what 4 tissue zones?
Surface (young) -> deep tissue (old) Zone of necrotic debris Zone of macrophage and angiogenesis Zone of proliferating capillaries and fibroblast Zone of fibrous CT
43
What is the sequence of events of granulation tissue maturation
Bed of granulation tissue matures Deposits of collagen and ground substance Granulation bed contracts Specialization of some fibroblasts into contractile cells
44
What is the difference between and granuloma and granulation tissue
Granuloma = chronic inflammation Granulation tissue= repair process with large amount of fibrous CT and neovascularization
45
Process including CT replacement and regeneration by which restoration of tissue continuity achieved
Wound healing
46
Healing by first intention vs second intention
First intention: little exudate and tissue edges are close together (little scar) Second intention : edges of wounds are widely separated (mas scar)
47
What is the general process of skin healing ?
Blood clot Epithelial continuity is restored (24-48hrs) Epithelial cells lose contact with BM and other cells ->migrate to advancing edge ->mitosis to gradually cover epidermal defect Inflammatory reaction -> neutrophil infiltration followe by macrophage Neovascularization Fibroblast proliferation and laying down of collagen Devasculrization Regression of inflammatory cells and fibroblasts Scar
48
Remaining hepatocytes regenerate and some ECM framework is destroyed resulting in formation of irregular hepatocyte nodes separated by fibrous CT scars
Massive hepatic necrosis
49
_______ of the kidney has maximal regenerative capacity while the _____________ has minimal regenerative capacity
Renal cortical tubules; renal medullary tubules
50
____________ of the kidney has no regenerative capacity
Glomeruli
51
How does the kindey repair by regeneration
No rupture of cortical tubule BM | Surviving cells flatten, appear squamoid and migrate to necrotic area