Inflammation Flashcards
Inflammation
response to vascularized tissue injury
Acute Inflammation
quick, brief, after first moments after vasoconstriction
blood vessels dilate, leak proteins, neutrophil recruitment
Classic Signs of Inflammation
Red, warm, pain, swelling, loss of function
Chronic Inflammation
T-cell mediated, after duration
-macrophage mediated
Azurophil Granules
myeloperoxidase, elastase, cathepsins, lysozyme
Specific Granules
lactoferrin, alkaline phosphatase, collagenase, lysozyme
Granulation Tissue
fibrin meshwork made by endothelial cells and fibroblasts
Myeloperoxidase
H202 –> OCl- (bleach)
causes pus to turn a greenish tinge at air exposure
Hyperemia
increased blood flow from dilated arteries
Pus
liquid of neutrophils and liquefied body tissues
yellow from necrosis
Purulent
adjective for pus
Suppurate
verb to make pus
Abscess
pus surrounded by normal tissue
Empyema
pus filling a body cavity
pleural space
Pseudomonas infections
fluorescent-green pus (pyocyanin)
smells like grapes
Clostridial Infections
Thin (hydrolyzed), gray (lipolyzed) “dishwater” pus
Left-shifted neutrophil
immature neutrophils
seen in severe infections
Leukemoid Reaction vs. Leukemia
> 50,000 WBC in the absence of true leukemia
High leukocyte alkaline phosphatase, toxic granulation, lack chromosome markers
Systemic Inflammatory Response
multiple organ failure from infection
High levels of IL-1 and TNF-a
First line of defense
Neutrophils
Chediak-Higashi
organelle problems (lysosomes, melanocytes) -impaired neutrophil action
Chronic Granulomatous Disease
defects in neutrophil kill in staphylococci
Exudate
protein-rich fluid released from vessels
Transudate
low protein fluid (few cells)
Friction Blister
epidermis detached from dermis
Triple Response of Lewis
after scratched & vasoconstriction
- Local redness (capillaries dilate)
- Flare surrounding the scratch (capillaries dilate)
- Swelling/edema surrounds scratch
Histamine
released from mast cells
- dilates blood vessels
- contibute to pain/itching
Serotonin
released from platelets
-constricts vessels
Bradykinin
produced by kinin-kallikrein system
dilates vessels, PGI2 production, pain of inflammation
(bronchoconstrictor and inflames airway mucosa)
Cyclo-oxygenase
AA –> PG & TX
PGE2
causes fever, increased vessel permeability, vessel dilation
PGI2
inhibits platelet aggregation and dilates blood vessels
TXA2
promotes platelet aggregation and constricts blood vessels
Lipo-oxygenase Pathway
if COX is inhibited, AA –> lipo-oxygenase pathway –> LT, 5-HETE, Lipoxins
LTB4
promoter of neutrophil attachment and chemotaxis
LTC4, LTD4, LTE4
constricts vessels, increase permeability, constricts smooth m.
Lipoxins
produced by neutrophils and macrophages at end of inflammation
C3a
chemoattractant
C3b
binds microbes via antibodies promotes opsonization (phagocytosis)
C5a
inflammation promoter
- chemotaxis
- adhesion molecules
- vessel dilation
- leaky vessels
MAC
made at end of complement system, punches holes in membrane
IL-1
produced by macrophages
- fever
- increased neutrophil production
- increased adhesion molecules
- leukocyte recruitment
- causes fatigue and increased sensitivity to pain
Anakinra
blocks IL-1Ra to fight rheumatoid arthritis
IFN-gamma
made by T-cells, pro-inflammatory
- recruits neutrophils and macrophages
- production of IL1, IL12, IL23
IL-2
regulates T-cells response to Ag
IL-4 / IL-13
anti-inflammatory from M2
- produce IL-10, TGF-B
IL-5
from Th2 and mast cells
-eosinophil attractant
IL-6
acute phase reaction
some anti-inflammatory/some inflammatory
IL-12
from dendritic macrophages and stimulated B-cells
- T-cells –> Th1 –> IFN-g & TNF-a
IL-17
produced by Th17
-neutrophil and macrophage recruitment
TNF
from macrophages
- fever
- neutrophil production
- mediates acute phase reaction
- promotes thrombosis
- induces apoptosis
PDGF
produced by platelets and other mesenchymal cells
-growth of new vessels (scars)
TGF-B
activated in plasma
- collagen production in scar
- fibrosis in chronic inflamm
CRP & SAA-protein
produced by liver in response to acute phase reaction
Neutrophils
classic bacterial infections, candida, bad injury
Lymphocytes
AI, viruses, pertussis
Monocytes
mycobacteria, other fungi, typhoid
macrophage when it enters tissue
Eosinophils
worms, asthma, hodgkin’s, dermatitis, herpetiformis, dermatomyositis, IgE allergy
Plasma cells/B-cells
spirochetes (syphilis, Lyme disease)
No inflammatory cells
prions, gas gangrene (clostridia)
Stages of Inflammation
edema, neutrophils (24 hrs), macrophages (2-4 days)
Epithelioid
macrophages sticking together to form a granuloma (mimic epithelium)
Langhans Giant Cells
fused macrophages with nuclei in horseshoe formation
Fibrin
sealant for wounds, just fibers
“fibrinous”
Collagen
structural protein, triple helix
“fibrous”
Ulcer
epithelium and CT underneath have gone through necrosis
-covered with fibrin
Erosion
loss of epithelium w/out significant damage to CT
Pseudomembrane
broad, shallow ulcer
diptheria, C. difficile colitis
Factor XIII
crosslinks fibrin
Scar
new collagen at injury from damage to CT below lamina propria
Labile cells
continuously regenerating themselves
- epidermis, gut epithelium, bone marrow
Stable cells
will renew cell populations if members die
- liver, glands, fibroblasts
Permanent cells
limited ability to replace lost members
- brain, heart, skeletal m.
Steps of Wound Healing
- Fibrin
- Granulation tissue
- Scar formation
- Scar contracts
Exuberant granulation tissue
exaggeration of normal healing with granulation tissue above surface
VEGF-A
angiogenic, vessels sprout and grow into fibrin
Primary Intention wound healing
“perfect conditions” clean epithelial cut, stable patient
- little fibrin, small scar
Secondary Intention wound healing
compromised state, large wound
- lots of fibrin, large scar
Myofibroblasts
contract scar
growth from fibroblasts
Keloid
overly large scar, expands over time, thick/glassy collagen fibers
Hypertrophic scar
clean edges, stops expanding eventually
-tomy
cut something
-ectomy
cut something out
-ostomy
create a hole to outside/between two organs
-plasty
reshaped
-pexy
move something to right space
-rraphy
sewed something up
-desis
stick two things together
Aching pain
periosteum, tooth, dura, circuit in brain
Burning pain
mucosal injury, nerve injury
Crampy pain
hollow organ
Stabbing pain
serosal membrane
