Inflammation Flashcards
Nonspecific line of defense -Mast and dendritic cells
Triple response of Lewis -> mast cells release histamine
red, wheal, flare, urticaria
Natural epithelial barriers
keratinization
acidic surfaces
mucinous surfaces - binds bacteria
if breached then leads to inflammation
Specific Humoral and cellular immunity
Eczema
hyperemia
engorgment
excess blood flow
Diapedesis
passage of blood cells through intact walls of capillaries
emigration
diapedesis of leukocytes through small blood vessels walls
margination
adhesion of white blood cells to the walls of damaged blood vessels
pavementing
neutrophils line up along the endothelial surface of the blood vessel
transudation
escape of fluid by hydrostatic or osmotic pressure
Plasma ultrafiltrate
low protein content
from normal vascular permeability
exudation
fluid exiting through pore or wound
from increased vascular permeability
High protein and cell debris
cachecia
dramatic weight loss and muscle atrophy
wasting syndrome
purpura
purple or red discolorations on the skin that not do not blanch
extravasation
movement of white blood cells from capillaries to tissues
effusion
excess fluid in an area?
serosanguinous
composed of serum and blood
purulent
containing or discharging pus
supprative
formation or discharge of pus
Purposes of inflammation
To contain, neutralize and remove
urticaria
hives
in dermis
Eczema
surface rough
epithelia and dermal reaction
pt wears tight fitting shoes. Redness at base of nails. Pus developed then red streaks, skin sloughed off and ulcerated. Gangrene ensued and amputated leg. Stump got infected, developed septicemia and died. Bacteria responsible?
Strept - aerobic bacteria and releases alot of enzymes
red streaks meant bacteria in lymphatics
cardinal signs of inflammation
Calor - Heat - vasodilation Rubor - Redness - vasodilation Tumor - Edema - vascular permeability Dolor - Pain - mediator/release PMNs Functio - loss of function
Major components of Acute inflammation
vascular changes
cellular events
chemical mediators of inflammation
Paranechia
inflammation around nails
what vascular changes happens during acute inflammation
transient vasoconstriction - lasts seconds
vasodilation of precapillary arterioles - increased blood flow
“triple response of lewis” - Red line, flare and wheal
blood stasis
increased permeability of venules - mintues to days
Urticaria
redness and swelling seen when scratch skin
After vascular changes
there is movement of fluid and cells
Edema and Exudation
Vascular permeability
As protein exits vessels - intravascualar osmotic pressure drops and intravascular hydrostatic pressure increases
Endothelial gaps occur at intracellular junctions
Endothelial gaps are a _______ response induced by
immediate transient response
histamine, bradykinin, leukotrienes, substance P
what occurs to handle trauma?
Endothelial retraction
direct endothelial injury - immediate sustained response
leukocyte mediated endothelial injury
Vasculitis
delayed prolonged leakage - 2-12 hours: lasts hours to days
thermal, xray, UV - “sunburn” , bacterial toxin
During repair, these two events occur
Transcytosis - death of neutrophil and leukocytes?
Angiogenesis
Pt has pain from acute appendicitis. what is causing the pain?
Prostaglandins and bradykinins
Pt pain from acute appendicitis. What mediates the phagocytosis?
Complement C3b and IgG
There is erythemia of the appendix, what are the two chemical mediators?
Histamine and serotonin
these are vasodilators
Pt was acute appendicitis has a fever. What are the two chemical mediators?
IL-1 and TNF
What chemicals cause leukocyte infiltration?
Leukotrienes and HPETE
Pt has surgery. There is a small nodule under the skin at the incision site. What cell type is characteristic of this response?
Giant cells (multinucleated) this is from chronic inflammation
this is a foreign body granuloma
there is infiltration of a lot of Macrophages and these Macrophages fuse to create Giant multinucleated cells
What induces Macrophages to release ROS?
Lipoxins
What chemical would help clear organisms from lung parenchyma?
Hydrogen peroxide
Pt fractured femoral trochanter, 76 yo, lower leg is now swollen and painful with movement and tenderness to palpation. Strong pulse in arteries. What complication is most likely to occur after these events?
Pulmonary Thromboembolism - from stagnation of blood
Not disseminated intravascular coagulation - would need to see fever and chills
See lung cavitation in pt with chronic cough with fever and weight loss. What caused development of lung lesion?
Macrophage
Noncaseating granulomas lack central necrosis. Caused by
Reaction to foreign material Sarcoidosis Beryllium exposure Crohn disease Cat scratch disease
Chronic inflammation
inflammation of prolonged duration (weeks or months) in which active inflammation, tissue destruction, and attempts at repair are proceeding simultaneously
When does chronic inflammation occur?
Persistent infections - AFB, fungi, Treponemes
-low toxicity, delayed hypersensitivity, Granulomatous inflammation
Prolonged exposure to potentially toxic agents
-silica and toxic plasma lipids -> atherosclerosis
Autoimmunity - RA, Lupus
What is chronic inflammation characterized by?
Infiltration with mononuclear cells - Macs, lymphocytes and plasma cells
tissue destruction
repair involving angiogenesis and fibrosis
Macrophage is the prima donna of chronic inflammation
When do see caseating granulomas?
TB and fungal infections
use Acid fast stain or Silver stain
Key macrophage events
recruitment from circulation
local proliferation
immobilization
differentiation - microglia, kupffer, alveolar macrophage, osteoclasts
Pt has trouble breathing. Afebrile, diminished breath sounds and dullness to percussion bilaterally. 2+ pitting edema present on thighs and has bilateral pleural effusion. what may you see test wise?
Hypoalbuminemia
Low protein in blood allows fluid to escape into the tissue
Pt fevver and dry cough for 3 days and difficult breathing. Diffuse rales are auscultated over lower lung fields. Pleural effusion. Fluid removed is cloudy with cell count 15,500 leukocytes/ul, 98% are neutrophils. What describes the pleural process?
Purulent inflammation
empyema
pus in pleural space
Pt taking aspirin for arthritis for past 4 years. Continuing joint destruction with loss of articular cartilage and joint space narrowing. Pain reduction is most likely to be the result of diminishing what chemical mediator?
Prostaglandin
Expression of what on endothelial cells is most intstrumental in promoting inflammatory reaction and aiding neutrophils to migrate into injured tissue?
E-selectin
