inflammation Flashcards
2 causes of disease?
congenital; acquired
two types of congenital disease
inherited, intrauterine lesions
types of acquired
inflamation, neoplasia, immunologic, vascular, endocrine, degeneration, iatrogenic
illness caused by healthcare provider/treatment
iatrogenic disease
what is inflammation?
response of living tissues to irritation/injury
causes of inflammation?
infection, chem agents, phys agents, trauma, chronic irritation
cardinal signs of inflammation
calor (heat), rubor (redness), tumor (swelling), dolor (pain) , function laesa (disturbed function)
first response to injury :
hemodynamic (vascular) changes
what is vascular response?
mech stim–>nerves–>smooth muscle–>precapillary arterioles –>short vasoconstriction–>vasodilation (flooding of blood)
what is hyperemia?
^ blood flow to capillaries (vasodilate)–>congestion
RBC sludge is called
rouleaux
WBC attached to endothelium after ___ called
marginalization; pavementing
adhesion accomplished by:
surface adhesion molecules
why vessel wall changes?
^pressure, slowing of circulation, adhesion, soluble mediators released
2 classes of substances that mediate inflammation
plasma-derived, cell-derived
example of biogenic amine, preformed mediator
histamine
protein formed in plasma from Hageman activation
Bradykinin
mediator of inflam. that consists of several proteins that are activated in cascade
complement system
activation of complement cascade can occur thru 2 paths:
classical, alternate
classical path activated by :
antigen-antibody complex
alternate path activated by ___
bacterial endotoxins, fungi, etc
both paths converge to lead to form of ___
membrane attack complex
coat bacteria to be more susceptible to being engulfed by phagocytes
opsonins
derived from phospholipids of cell mem thru phospholipase
arachidonic acid derivatives
two metabol paths for arachidonic acid derivatives
lipoxygenase; cycloxygenase
lipoxygenase path–>?
leukotrienes
cycloxygenase path–>?
prostacyclin, thromboxanes
aspirin associated with __ path
cycloxygenase
leakage of fluid from vessel into interstitial spaces in emigration of leukocytes
transudation
transudate is __ in protein but has ___ cells
^ ; few
transudation causes ___
edema
what are PMNs?
polymorphonuclear leukocyte (acute–first to emigrate)
after PMN, see:
monocytes, eosinophils, macrophage, lymphocyte, plasma cells
emigration of leukocytes from BV occurs in these phases:
adhesion of PMN to endothelial; insertion of cyto pseudopods; passage thru basement mem; ameboid mvmt away from vessel to cause of inflamation
what is chemotaxis?
active mvmt of PMN along [ ] gradient
derived from bacteria or tissues destroyed by inflammation
chemoattractant
when PMNs reach bacteria/chemotactic substance, this happens
phagocytosis (scavenge, lose mobility)
attachment of PMN to bacteria wall facilitated by
immunoglobulin
most numerous WBC in circulating blood (60-70%)
PMNs
fever is involved with ___
interleukin 1 (endogenous pyrogen)
mononuclear cells derived from blood monocyte, larger than PMNs
macrophages
cells primarily involved w/ antibody production
lymphocytes
fragmentous cells without nucleus w/ granules
platelets
4 clinical parameters to classify inflammation
duration, etiology, location, morphology
inflammation that lasts for a few hours to a few days
acute
inflammation characterized by persistence of causative agents
chronic
4 classifications of infections:
bacteria, viral, protozoal, fungal
example of localized skin infection
boil (furuncle)
ex. of systemic inflammation
sepsis, systemic lupus
typical signs of inflammation found on:
skin, eyes, oral mucosa, genital organs
used to inspect the abdominal cavity
laparoscope
most terms are formed adding the suffix:
“itis”
type of inflammation typical of viral infections, mild, involving exudation of serum in early stage of most inflammation
serous
this type of inflammation may be organized and form scar tissue, indicating more severe inflammation, seen in lots of bacterial infections
fibrinous inflammation
ex. of fibrinous inflammation?
strep throat
this type of inflammation is characterized by pus, usually caused bacterially
purulent
closed pocket of purulent inflammatory exudate (pus) that must be drained
abscess
when abscesses rupture, form :
sinus or fistula
in chronic abscess, the wall of cavity is composed of a ____
capsule (fibrotic granulation tissue)
cavity usually occupied previously by abscess that drains thru tract to surface of body
sinus
channel formed tween 2 pre existing cavities or hollow organs and the surface of body
fistula
elevated body temp exceeds 37C, typical response to acute inflammation
fever
fever is caused by:
prostaglandins released by endogenous pyroens (IL-1 and TNF)
endogenous pyrogens are released by:
leukocytes or macrophages during inflammation
other non-specific symptoms of inflammation are called:
constitutional symptoms
constitutional symptoms include;
fatigue, weakness, depression, lack of appetite, general pain, exhaustion
3 classifications of cells according to ability to proliferate:
labile, stable, permanent
what are “labile” cells?
continuously dividing/mitotic cells throughout entire life
what are “stable” cells?
quiescent, facultative mitotic cells that need stim to div
what are “permanent” cells?
nondividing, post-mitotic cells that don’t have way to proliferate EVER
ex. of labile cells?
stem, basal layer of skin, mucosa of viscera
ex. of stable cells?
parenchymal organ (liver or kidney)
ex. of permanent cells?
neurons, myocardial cells
leukocytes and macrophages act on these connective tissue cells during healing:
epithelium, myofibroblasts, angioblasts, fibroblasts, collagen
these cells secrete matrix substances and are able to contract like muscle cells
myofibroblasts
these cells are precursors of BVs that provide a route for scavenger cells and influx of blood
angioblasts
these cells produce most of the xtracell matrix
fibroblasts
scars are formed by ___ + ____
fibronectin; collagen
ex of healing by first intention:
closed surgical wounds
ex of healing by secondary intention
unclosed wounds, large tissue defect, foreign bodies, infected wounds
complications of wound healing?
site, mech factor, size, infection, nutrition, circulatory status, age
nutr. and metabolic factors in healing
proteins, vitamin C (speeds up), excess cortisol (slows)
diabetes, example of ___wounds
ischemic (hypoxic)
this complication happens in diabetics and those taking steroids
deficient scar formation
decrease in tensile strength results in:
dehiscence
excess scar formation is called:
keloids (beyond boundaries, are discolored)
have segmented nuclei, usually composed of 3 lobes, also called neutrophils
PMN leukocytes
represent primary body defense system against bacteria
PMN leukocytes
also called histiocytes , typical of chronic inflammation
macrophages
these cells participate in forming granulomas
macrophages
essential for blood clot and are cyto fragments of megakaryocytes
platelets
hyperemia caused by :
dilation of arterioles
release of histamine at site of inflammation cause:
^ in permeability
aspirin inhibit:
prostaglandins
granulomas contain all cells except:
PMNs
most common cause of delayed healing of skin wound caused by traffic accident
infection
what transient event is an initial reaction to neurogenic and chem stim in area of inflammation?
constriction (followed by dilation)
where are the endothelial cells that react most prominently to mediators of inflammation?
venule
rich in proteins and not many cells
transudate
rich in proteins and many cells
exudate
