Inflammation and Phagocytosis Flashcards
1
Q
What is keratitis?
A
Inflammation of the CORNEA.
2
Q
Define Inflammation…
A
A reaction of vascularized living tissues to injury.
3
Q
What are characteristics of inflammation?
A
Inflammation involves Changes in vascular bed (epithelium), blood, and connective tissue. The intention of inflammation is to eliminate the irritant and repair the damaged tissue.
4
Q
What are the 5 signs of inflammation? (Mainly acute inflammation)
A
- Redness
- Swelling
- Pain
- Loss of Function
- Heat
5
Q
What are the roles of inflammation?
A
- Dilute, contain and isolate injury
- Destroy invading microorganisms and/or inactive toxins
- Achieve healing and repair
6
Q
What are the outcomes of inflammation in ideal, intense and failed conditions?
A
- Ideal conditions - return to normal
- Intense inflammatory response - attempt to separate injured tissue
- Failure to eliminate insult - sequel/consequences
7
Q
In intense inflammatory response, there is formation of WHAT?
A
Formation of a wall - like a capsule in an abscess - surrounded by fibrous connective tissue.
8
Q
If there is failure to eliminate the insult during inflammation, WHAT forms?
A
A scar forms! Ex: chronic dermatitis - thickening of the dermis.
9
Q
The inflammatory response requires WHAT in order to occur?
A
An initiating Stimulus (Etiology)!
10
Q
True/False: Inflammation occurs in living and dead tissues.
A
False - only in LIVING tissues
11
Q
True/False: Inflammation can be more harmful than the initial stimulus.
A
True.
12
Q
True/False: Inflammation is fairly stereotyped/predictable irrespective of etiology.
A
True.
13
Q
Through what components is Inflammation critically tied to the blood?
A
Through Plasma circulating cells, blood vessels, cellular and extracellular components.
14
Q
When does inflammation end?
A
When the stimulus is eliminated.
Mediators are broken down and dissipated.
WBCs have short half-lives.
15
Q
Define Exudation…(we need to know this!)
A
The escape of fluid, proteins and blood cells from the vascular system into the interstitial or body cavities.
16
Q
Define Transudate…(we need to know this!)
A
An ultra filtrate of blood plasma and results from hydrostatic imbalances across the vascular endothelium.
17
Q
Inflammatory extravascular fluid that has
high protein concentration, much cellular debris and a Specific Gravity above 1.020 is a…
A
EXUDATE!
18
Q
Fluid with a low protein content and a specific gravity LESS than 1.020 is a…
A
TRANSUDATE!
19
Q
Pyothorax is characterized by…exudate or transudate?
A
PUS..cloudy, whitish material within the thoracic cavity…this is an EXUDATE!
20
Q
Define Edema…
A
An excess of fluid in the interstitial tissues or serous cavities. Can be either an exudate or a transudate!
21
Q
When is Edema an exudate?
A
Inflammatory edema
22
Q
Define Pus…
A
Inflammatory exudate rich in leukocytes and parenchymal cell debris.
23
Q
What are the primary leukocytes in Pus?
A
Mainly neutrophils - viable and degenerated!
24
Q
How do you classify Exudate?
A
Serous
Fibrinous - fibrin is the main component
Suppurative
Granulomatous - has a lot of macrophages
Duration - acute or chronic
see the table in the Inflammation lecture from 5.15.15
25
What does EXTENT mean when classifying exudate?
Extent mean How Bad is it?
26
"Greasy Pig Disease" is an example of...
Severe Exudative Dermatitis in a Pig
27
Describe the characteristics of Peracute Inflammation?
ex: Anaphylactic Shock
Usually caused by a potent stimulus.
Usually the animal has no time to respond.
It is less common than acute disease processes.
28
What are General Features of Peracute Inflammation?
Time: 0-4 hrs
Vascular Involvement: Hyperemia, Slight edema, and Hemorrhage
Inflammatory Cells: Not usually numerous, few leukocytes
Clinical Signs: Shock and Sudden Death
29
Give an example of Peracute Inflammation...What do you see Grossly and Histologically?
Infectious canine hepatitis
Grossly - congestion and edema of abdominal viscera
Histologically - intranuclear inclusions within glomeruli
30
Acute Inflammation Characteristics are...
Time: begins within 4-6 hrs
Vascular Involvement: Active hyperemia, edema and occasional fibrin thrombi within vessels (will occlude the vessel).
Inflammatory Cells: leukocyte infiltration is variable, NO MACROPHAGES! Mainly neutrophils.
31
What causes Edema in Acute Inflammation?
Edema in Acute Inflammation is due to endothelial damage - lymphatics and small blood vessels.
32
What is the role of lymphatics in Acute Inflammation?
Moving away the Exudate!
33
What is Lymphadenitis?
It is reactive inflammation of lymph nodes that occurs in acute, subacute, and chronic inflammation.
34
What is Lymphangitis?
Inflammation of lymphatic vessels.
| ex: thickening of serial lymphatic vessels (chronic lymphangitis) due to Johne's disease
35
Define Subacute Inflammation...
The gradual change between acute and chronic inflammation
| Response DOES NOT include reparative responses like fibroplasia and angiogenesis.
36
What inflammatory cells do you see with Subacute Inflammation?
Inflammatory Cells will be "mixed" or "pleocellular" inflammatory infiltrate.
Primarily Neutrophils...may have lymphocytes macrophages and plasma cells.
37
Chronic Inflammation
result of a persistent inflammatory stimulus in which the host has failed to completely eliminate the causative agent.
38
Chronic Inflammation is characterized by evidence of 2 host tissue responses in terms of repair....What are they?
1. Scar tissue formation!
| 2. Parenchymal Regeneration!
39
What is the origin of Chronic Inflammation?
Follow an acute inflammatory phase
| May develop as an insidious, low-grade, subclinical process without history...
40
What is an example of Chronic Inflammation?
Multifocal ulcerative colitis, chronic in the feline
Chronic lymphangitis - Johne's disease in the goat
**See image from Lecture!**
41
What are the 5 Classifications for Distribution?
Focal, Multifocal, Coalescent, Locally extensive, Diffuse
42
Define Focal Inflammation...What is the Size of a Focal Inflammatory Lesion?
SINGLE abnormality or inflamed area within a tissue
| Size: varies from 1 mm to several centimeters in diameter
43
What is the #1 rule when making an "Interpretation"?
COVER YOUR @$$!!!
44
Define Multifocal...What is the Size of a Multifocal Inflammatory Lesion?
Arising from or pertaining to many foci
Size: Variable. Each focus of inflammation is separated from other inflamed foci by an intervening zone of relatively normal tissue.
45
What is Multifocal to Coalescent?
It is an indication of severity.
46
What is Locally Extensive classification?
Involves a considerable zone of tissue within an inflamed organ.
Origins: severe local runs that spread into adjacent normal tissue
Coalescence of foci in a multifocal rxn
Exxample: Cranioventral...
Locally extensive pneumonia in Pigs
47
What are the characteristics of Diffuse Classifications of Inflammation/Lesions?
The entire tissue is involved. Ex: Interstitial pneumonia
| Diffuse lesions are often viral or toxic in etiology.
48
What is Exudate? What are the 3 Common Types?
Classification according to the type of inflammatory cells and exudate/fluid.
Common types: Suppurative (more common)
Fibrinous and Serous (watery-type fluid)
49
What are the Classifications of Exudate? (7)
serous, supurative, fibrinous, serofibrinous, fibrino-purulent, purulent, granulomatous
50
Suppurative Exudation
consisting of, or containing pus; associated with the formation of pus
51
What is Pus? What is it composed of?
Pus is: A liquid inflammation product composed of...
accumulated dead cells
variable numbers of viable leukocytes (primarily neutrophils)
fluids added by the inflammatory edema-forming process
52
What are some examples of Suppurative Exudate?
Suppurative bronchopneumonia in a dog. Local Infection!
Ex: Pyometra in a dog
Ex: Chronic Suppurative Osteomyelitis - neutrophils came into the bone marrow and destroyed the bone marrow and the bone! - It took a while! "Focal Suppurative Osteomyelitis"
53
What is Suppuration?
The Process of Pus formation.
54
What is an Abscess?
Circumscribed (partially walled-off) collection of pus.
| Gross Appearance: yellow-to-white/gray and varies from watery to viscous depending on fluid content.
55
Is an Abscess Suppurative Inflammation?
Yes!
56
What is the Pathogenesis of Fibrinous Exudation?
Pathogenesis: severe injury to endothelium and basement membranes results in leakage of plasma proteins including fibrinogen, which polymerizes perivascularly as fibrin.
57
What does fibrinogen do?
Once out of the blood vessel, it polymerizes perivascularly and forms Fibrin - Fibrin is the first step of Adhesion!
58
What is the Gross Appearance of Fibrous Inflammation?
Gross Appearance: yellow-white, pale, tan stringy, shaggy meshwork - giving a rough irregular appearance to the tissue surfaces.
Fibrin Casts of friable materials may form in the lumen of tubular organs.
59
Is the process of Fibrous Inflammation Chronic or Acute?
Acute Process - can form in SECONDS!
60
Fibrinopurulent Exudate is a term...
used to classify an inflammatory process in which neutrophils and fibrin are abundant
ex: fibrinopurulent pericarditis in a foal
61
Presence of a fibrinous exudate involves what kind of process?
AN ACUTE PROCESS!
62
What kind of process is Fibrosis?
A CHRONIC PROCESS! - it is part of the scar tissue!
63
What are the Functions of Fibrin...
Provides support for the eventual ingrowth of fibroblasts and neocapillaries - a process known as ORGANIZATION of the Exudate.
* *the transformation of the fibrinous exudate (acute process) into well-vascularized C.T. (chronic process - known as the ORGANIZATION of the exudate)
64
How is Fibrin removed?
Enzymatic fibrinolysis or by phagocytosis by macrophages before organization can occur.
65
Fibrinous Vs. Fibrous
MAKE SURE YOU KNOW THE DIFFERENCE! LEARN IT NOW!
66
Serous Exudation
Inflammatory process in which the exudate occurs in tissues in the absence of a prominent cellular response.
May be a dominant pattern for a variety of mild injuries like Traumatic blisters, etc.
67
Gross Appearance of Serous Exudation:
Yellow, straw-like color, fluid commonly seen in early stages of inflammatory responses. - - Ulceration follows the rupture of the vesicle.
68
Granulomatous Inflammation is ALWAYS...
ALWAYS ALWAYS ALWAYS CHRONIC!
69
Characteristic cells of Granulomatous Inflammation...
-characterized by predominantly macrophages as well as lymphocytes and plasma cells
70
Large cells with abundant cytoplasm in a Granulomatous Inflammatory response are referred to as...
"multinucleate giant cells" or "epithelioid cells"
71
How are the macrophages arranged in a Granulomatous Inflammatory response?
Macrophages are clustered in a characteristic elliptical formation around the causative etiologic agent, or around a central necrotic area, or simply as organized nodules
72
Describe the Etiology of Granulomatous Inflammation...what Infectious Organisms are involved?
usually some non‐digestible organism or particle which serves as a chronic inflammatory stimulus, delayed‐type hypersensitivity is often required.
ORGANISMS:
• Mycobacterium, Actinomyces, Blastomyces,
Coccidioides, etc)
73
What are the Non-Infectious Agents that could cause the Etiology for Granulomatous Inflammation?
Noninfectious AGENTS: Mineral oil, Complex polysaccharides, Foreign bodies
74
What are other types of Inflammation modifiers? (3) What type of diagnosis are these used in?
Modifiers: Necrotizing, Hemorrhagic, Mucoid - - can be used in a morphologic diagnosis
75
What is necrotizing Inflammation?
Necrosis is the main feature and exudation is minimal. In general, the is interpreted as inflammatory (rather than purely ischemic) if an infectious etiology is suspected.
76
What is Hemorrhagic Inflammation?
Hemorrhage is the main feature of this type of inflammation. The presence of an etiologic agent will indicate that the process is inflammatory rather than a primary circulatory disturbance.
77
Describe the Inflammatory exudate in Mucopurulent or Catarrhal Inflammation?
The inflammatory exudate is composed of mucus and pus (neutrophils and cell debris).
78
List the Chemical Mediators of Inflammation...
```
• Vasoactive amines
• Plasma proteases: complement
• Lipid mediators such as arachidonic
acid
• Platelet activating factor (PAF)
• Cytokines
• Chemokines
• Nitric Oxide (NO)
```
79
What are the events of Acute Inflammation?
1. Stimuli for onset of acuteinflammation
2. Vascular changes
3. Cellular events
4. Termination of acute inflammatory response
80
Define Extravasation...
extravasation= delivery of white blood cells to the site of injury
81
What are the Events of Extravasation?
1. Margination (tethering)
2. Rolling
3. Activation and Adhesion
4. Transmigration
82
What bovine (and canine) disease is due to leucocyte adhesion's failure? Etiology?
Leucocyte Adhesion Deficiency (LAD)
| Etiology: Type 1 Mutation in Beta-1 Integrins CD18
83
What is the mechanism of LAD?
neutrophilia with impaired transmigration because neutrophils are unable to adhere
84
What are the Clinical Signs of LAD?
Clinical signs: gingivitis, tooth loss, ulcers in oral and enteric mucosa, cutaneous ulcers, pneumonia
85
Define Chemotaxis...
the process where white blood cells emigrate in tissues toward the site of injury
86
What are the 3 Interconnected Processes of Phagocytosis?
– Recognition and attachment of the particle to be ingested
– Engulfment with subsequent formation of phagocytic vacuole
– Killing or degradation of the ingested material
87
How do you terminate the acute inflammatory response?
Degradation of inflammatory mediators.
| Production of Stop Signals after the stimulus has been removed.
88
What do the Inflammatory Stop Signals do?
– Switch from pro‐inflammatory leukotrienes to anti‐
inflammatory lipoxins from arachidonic acid
– Liberation of anti‐inflammatory cytokines such as TGF‐ beta from macrophages and other cells.
– Neural impulses resulting in inhibition of TNF production in macrophages
