inflammation and repair 3 Flashcards
1
Q
what are the morphologic patterns for the classification of inflammation
A
serous
fibrinous (clots)
suppurative (pus)
ulcerative
2
Q
describe acute inflammation
A
-rapid onset, short duration (mins to days)
-emigration of leukocytes[mainly neutrophils]
-exudation of fluid and plasma proteins
3
Q
describe chronic inflammation
A
-longer duration
-mononuclear cells (macrophages, lymphocytes, plasma cells)
-proliferation of blood vessels and fibroblasts
4
Q
acute inflammation tends to be more (exudative/non-exudative)
A
exudative [fluid present]
5
Q
chronic inflammation is frequently (exudative/non-exudative) and is often associated with: _______and______
A
non-exudative
fibrosis and scarring
6
Q
what are the bodies 5 responses to injury:
A
known as inflammation
1. thermal
2. physical
3. chemical
4. allergic
5. immune mediated disease
7
Q
comes into play when inflammation is caused by a living organism (infection)
A
immunity
8
Q
T/F
inflammation and immunity are not the same thing
A
TRUE
9
Q
____may provoke inflammation and immunity
A
infection
10
Q
what exists without infection
A
inflammation
(inflammation does NOT imply infection)
11
Q
these may cause inflammation :
1. (allergic disease)
2.
A
- hypersensitivity
- autoimmune disease
12
Q
the body’s 3 lines of defense
A
- barriers (physical)
- inflammatory response
- immune response
13
Q
what are the physical barriers of the body
A
skin
mucous membranes
secretions
14
Q
what are the body’s inflammatory response (non-specific)
A
cells (leukocytes)
molecules (mediators)
15
Q
what are the body’s immune response (specific)
A
antibodies (humoral)
cytotoxic t cells (cellular)
16
Q
where are the components of the inflammatory responses found in:
1
2
3
A
- circulating blood cells and plasma proteins
- cells of the blood vessel walls
- cells and proteins of the ECM
17
Q
where are most of the defensive elements located in the body
A
in the blood
18
Q
process where defensive cells and chemicals leave the blood and enter the tissue
A
inflammation
19
Q
inflammation is a complex reaction to injury and 4 responses include:
A
- vascular responses
- cellular responses
- systemic reactions (fever)
- repair
20
Q
defensive cells:
A
leukocytes
WBC
21
Q
defensive proteins
A
plasma
22
Q
the inflammatory response 5 R’s:
A
- recognition of the injurious agent
- recruitment of leukocytes
- removal of the agent
- regulation (control) of the response
- resolution (repair)
23
Q
cardinal signs of inflammation
1
2
3
4
5
A
- calor-heat
- rubor-redness
- tumor-swelling
- dolor-pain
- loss of function
24
Q
list the cellular events in acute inflammation:
A
- margination (cells line up on peripheral)
- rolling
- adhesion
- diapedesis (squeeze between cells to get into connective tissue)
- chemotaxis
- phagocytosis
- killing
25
3 systemic manifestations of acute inflammation
fever- due to pyrogens
leukocytosis
acute phase response- cytokines stimulate hepatocytes to synthesize and secrete acute phase proteins
26
Fever [due to pyogenes], which is a systemic manifestation of acute inflammation, utilizes
cytokines [TNF, IL-1 released by leukocytes]
and
prostaglandins [from membrane phospholipids]
27
leukocytosis which is a systemic manifestation of acute inflammation, utilizes
-leukemoid reaction
-neutrophilia (shift to left)
-lymphocytosis
28
acute phase response[cytokines stimulate hepatocytes to synthesize and secrete phase proteins] which is a systemic manifestation of acute inflammation, utilizes
- c-reaction protein (CRP) :acts as an opsonin
- mannose-binding lectin: acts as an opsonin
29
lymphatics in inflammation:
lymphangitis
30
lymphatic spread of bacterial infection. painful red streaks and regional lymphadenopathy
lymphatics in inflammation: lymphangitis
31
what are the first mediators after inflammation, which are vasoactive amines
histamine and serotonin
32
this mediator is stored in granules of mast cells
histamine
33
this mediator is stored in the granules of platelets
serotonin
34
what do the mediators histamine and serotonin cause
cause vascular dilation and leakage
35
all acute inflammatory reactions may have one of three outcomes:
1. complete resolution
2. healing by connective tissue replacement (fibrosis)
3. progression of the response to chronic inflammation
36
localized collection of pus that has accumulated in a tissue cavity, producing fluctuance
abcess
37
diffuse spread of an acute inflammatory process through the fascial planes of soft tissue producing erythema, edema, warmth, and pain, without consolidation
cellulitis
38
type of inflammation where a clinical type of exudative inflammation occurs only on mucosal surfaces containing mucus-secreting cells, such as nasal or bronchial mucosa
caterrhal (seromucous) inflammation
39
an ulcer is a defect in epithelial continuity
ulcerative inflammation: recurrent aphthous stomatitis (like canker sores)
40
leukocyte adhesion deficiency-LAD is an example of
defects in neutrophil function
(basically severe periodontitis)
41
impaired chemotaxis- mutation of contractile proteins, is known as:
which is a defect in neutrophil function
lazy leukocyte syndrome
42
rare autosomal recessive condition associated with albinism
chediak-higashi syndrome
43
chediak-higashi syndrome defects:
1. giant lysosomal inclusions from fused primary granules
2. both chemotaxis and phagolysosome formation are defective
3. recurrent infections
4. platelet function is abnormal
44
deficient NADPH oxidase in the cell membranes of neutrophils and monocytes, resulting in an absent respiratory burst
chronic granulomatous
-disease of childhood
45
in chronic granulomatous (disease of childhood) what is not produced, which results in HOCL- not being synthesized because of the absence of this
no H2O2 produced
46
in chronic granulomatous (disease of childhood), what are the catalase-negative organism and what are the catalase-positive organisms
catalase-negative organisms: streptococcus species are killed
catalase-positive organisms: staphylococcus species are NOT killed
47
common autosomal recessive absence of myeloperoxidase enzyme in neutrophil and monocyte granules
myeloperoxidase (MPO) deficiency
48
autosomal disease where respiratory burst is normal and H2O2 is produced
(MPO) myeloperoxidase deficiency
49
the absence of MPO in (MPO) myeloperoxidase deficiency disease, prevents the synthesis of ______.
no great clinical consequences in most and diabetics may develop candidiasis
HOCL-
50
list the 5 immune deficiencies caused by defects in leukocyte function
1. too few neutrophils
2. failure in adhesion
3. slow chemotaxis
4. failure to phagocytose
5. failure to kill
51
examples of too few neutrophils which is caused by defects in leukocyte function
agranulocytosis and cyclic neutropenia
52
example of failure in adhesion which is caused by defects in leukocyte function
leukocyte adhesion deficiency (LAD)
53
example of slow chemotaxis which is caused by defects in leukocyte function
lazy leukocyte syndrome
54
examples of failure to phagocytose which is caused by defects in leukocyte function
1. bruton agammaglobulinemia
2. complement deficiency
55
examples of failure to kill which is caused by defects in leukocyte function
1. chronic granulomatous disease of childhood
2. chediak-higashi syndrome
3. myeloperoxidase deficiency
56
morphologic features of chronic inflammation
1. mononuclear cell infiltration (lymphocytes, plasma cells and macrophages)
2. tissue destruction (due to a persistent offending agent or by the inflammatory cells)
3. attempts at healing by connective tissue replacement (angiogenesis and fibrosis)
57
a pattern of chronic inflammation. aggregates of epitheliod macrophages (activated).
multinucleated giant cells
-mononulcear leukocytes, principally lymphocytes, and occasionally plasma cells peripherally
-fibrosis variable
granulomatous inflammation
58
2 classifications of granulomas
immune granulomas and foreign body granulomas
59
fungal infection inside giant cells; type of immune granuloma
coccidioides immitis
60
blocks fusion of phagosome with lysozome
intracellular pathogen
mycobacerium tuberculosis
61
granulation tissue vs granulomatous tissue
-reparative tissue
-endothelial cells and fibroblasts
-perliferation of blood vessels
granulation tissue
62
granulation tissue vs granulomatous tissue
-epitheliod macrophages
-giant cells
granulomatous tissue
63
pyogenic granuloma is a type of (granulation tissue/ granulomatous tissue)
granulation tissue
64
restoration of tissue architecture and function after an injury
repair
65
repair may occur by _____ or by _____(scar formation)
regeneration or healing
66
growth of cells and tissues to replace lost structures
regeneration
67
consists of variable proportions of two distinct processes:
healing
regeneration and scarring
68
regeneration cell classification:
1
2
3
1. continuously dividing tissues- labile
2. stable tissues- quiescent
3. permanent tissues- non-dividing
69
continuously dividing tissues -labile cells- are derived from the division of
stem cells
70
types of continuously dividing tissues (labile)
-hematopoietic cells
-surface epithelium
-stratified squamous epithelium of the skin, mouth, pharynx, esophagus, vagina and cervix
-gastrointestinal tract epithelium
71
____tissues can readily regenerate after injury as long as the pool of stem cells is preserved
labile tissues (continuously dividing tissues)
72
____ cells are quiescent and have a very low rate of turnover
stable cells
73
replacement of stable cells is carried out by
mitotic division of mature cells
74
types of stable tissues
-viscera (liver, kidney, pancreas)
-endothelial cells
-fibroblasts
-smooth muscle cells
75
___cells were generated during fetal life and never divide in postnatal life
permanent tissues (non-dividing)
76
these cells cannot be replaced if lost
-neurons; cardiac myocytes
permanent tissues (non-dividing)
77
in permanent tissues, repair is dominated by
scar formation
78
fibrosis (scarring) occurs if:
1. the tissue is intrinsically unable to regenerate (heart, brain)
2. the underlying connective tissue scaffolding is disrupted
3. following extensive exudates (organization)
79
two objectives of wound healing
epithelial regeneration
connective tissue repair
80
restore integrity of the epithelial surface
epithelial regeneration (wound healing)
81
restore the tensile strength of the sub-epithelial tissue
connective tissue repair (wound healing)
82
this healing occurs when the wound margins are pulled together
healing by primary intention
83
with healing by primary intention, all wound healing involves an ________even in the absence of infection
inflammatory reaction
84
healing by secondary intention, healing by secondary union occurs when
the wound margins are NOT pulled together
85
granulation tissue cells
endothelial cells
fibroblasts
myofibroblasts- contractile
86
excessive scar formation within the boundaries of the original wound producing a raised scar
hypertrophic scar
87
excessive scar formation that grows beyond the boundaries of the original wound
keloid
-common in african americans
88
this is required for the hydroxlyation of proline and lysine
vitamin C
