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HS 202 - Patho > Inflammation and Repair > Flashcards

Inflammation and Repair Flashcards

1
Q

inseparable and coexistent processes orchestrated
by leukocytes, chemical mediators, and GFs
present in tissue and blood

A

Inflammation and Repair

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2
Q

Follow a predictable sequence of events that includes:

  • tissue injury
  • vascular response
  • cellular response
  • resolution
A

Inflammation and Repair

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3
Q
  • Response of living vascularized tissue to injury

- ROLE: destroy/isolate injurious agents to achieve healing and repair

A

Inflammation

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4
Q

Factors determining pattern of inflammation

A
  • Inciting agent
  • Time of observation
  • Immune status of host
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5
Q

4 cardinal signs of inflammation

A

(D RCT = D Randomized Controlled Trials)

  • Dolor – pain
  • Rubor – redness
  • Calor – warmth/heat
  • Tumor – swelling
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6
Q

Fifth clinical sign of inflammation (later added by Virchow)

A

Functio laesa – loss of function

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7
Q

(iNIF)

Infections – bacterial, viral, fungal, parasitic and microbial toxins

Immune reactions/ hypersensitivity – autoimmune diseases, allergies

tissue Necrosis – ischemia, trauma, physical and chemical injury

Foreign bodies – splinters, dirt, sutures

A

Inciting agents/stimuli of inflammation

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8
Q

Typical Inflammatory Reactions: 5 Rs

A
  • RECOGNITION of the injurious agent by macrophages, other sentinel cells in tissues
  • RECRUITMENT of leukocytes and proteins – vasodilation, increased vascular permeability (edema)
  • REMOVAL/Elimination of the agent – WBCs and CHONs activation
  • REGULATION (control) of the response
  • RESOLUTION/REPAIR of damaged tissue – fibroblasts, ECM and cells
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9
Q

Acute Inflammation: Hallmarks

A

Redness and Warmth – result of vessel dilatation and increased blood flow to the inflamed part

Swelling – caused by accumulation of fluid, esp exudate

Pain – due to increased pressure on nerve endings from swelling, and a direct effect of certain chemical factors which are released to mediate the response

Loss of function – When swelling and pain are marked, there is partial or complete loss of function of the inflamed structure

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10
Q

Immediate and early response to an injurious agent

A

Acute Inflammation

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11
Q

3 major components of acute inflammation

A
  • Dilation of small vessels –> increase in blood flow
  • Increased permeability of the microvasculature –> plasma proteins and leukocytes to leave the circulation
  • Emigration of leukocytes from the microcirculation and their accumulation in the focus ofinjury, and their activation to eliminate the offending agent
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12
Q
  • high protein content, may be with RBCs/WBCs
  • formed in inflammation (vascular permeability
    increases due to increased inter-endothelial spaces)
A

Exudate

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13
Q
  • low protein content, few cells

- formed when fluid leaks out because of increased hydrostatic pressure or decreased oncotic pressure

A

Transudate

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14
Q

Vasodilation is induced by the action of several mediators, notably histamine on vascular smooth muscle

  • involves first arterioles and opening of capillary beds resulting in increased blood flow
  • redness (erythema) and warmth

Quickly followed by increased permeability of the microvasculature

Slowing of blood flow (stasis) - vascular congestion and localized redness

Leukocyte accumulation (principally neutrophils) along vascular endothelium

A

Vascular Changes (changes in blood flow and caliber) - Acute Inflammation

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15
Q

In inflammation, lymph flow is increased.
- secondarily inflamed lymphatics
- secondarily inflamed draining lymph nodes
¨ reactive or inflammatory lymphadenitis

A

Lymphangitis- secondarily inflamed lymphatics

Lymphadenitis- secondarily inflamed draining lymph nodes
*reactive or inflammatory lymphadenitis

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16
Q

Adhesion molecules and cytokines that mediate and control delivery of leukocytes to the site of injury

A

Chemokines

17
Q

1) Slowing of blood flow promotes margination, rolling and adhesion of leukocytes to swollen endothelial cells
2) Transmigration (diapedesis: passage of blood cells through the intact walls of the capillaries) across the endothelium into the interstitial tissues.

3) Chemotaxis or migration in interstitial tissues toward
a chemical stimulus

4) Phagocytosis of the offending agent, which may lead to the death of the microorganism

A

Leukocyte Recruitment to Sites of Inflammation

18
Q

Rolling – initial rapid and relatively loose adhesion involving the selectins

Stable (firm) adhesion – activation of leukocytes by chemical mediators resulting in increased avidity of integrins to bind to their ligands

Transmigration/ diapedesis – stable binding of integrins on activated leukocytes (LFA-1; MAC-1; VLA-4) to endothelial immunoglobulins (ICAM-1; VCAM-1); PECAM-1/CD31

A

Leukocyte Migration (Rolling, Adhesion, Transmigration)

19
Q

Leukocyte Migration (*Rolling, Adhesion, Transmigration)

A

Rolling – initial rapid and relatively loose adhesion involving the selectins

20
Q

Leukocyte Migration (Rolling, *Adhesion, Transmigration)

A

Stable (firm) adhesion – activation of leukocytes by chemical mediators resulting in increased avidity of integrins to bind to their ligands

21
Q

Leukocyte Migration (Rolling, Adhesion, *Transmigration)

A

Transmigration/ diapedesis – stable binding of integrins on activated leukocytes (LFA-1; MAC-1; VLA-4) to endothelial immunoglobulins (ICAM-1; VCAM-1); PECAM-1/CD31

22
Q

Directed migration of leukocytes towards chemical stimulus

- locomotion along a chemical gradient

A

Chemotaxis

23
Q

Chemotaxis

______________ emigrate first (1st 6 to 24 hrs), followed by ______________ (24 to 48 hrs).***

A

Neutrophils emigrate first (1st 6 to 24 hrs), followed by monocytes (24 to 48 hrs).***

24
Q

Chemotactic agents

¤ Bacterial derived N-Formyl peptides
¤ IL-8
¤ C5a
¤ Leukotriene B4
¤ Platelet Activating Factor
A

Chemotactic agents

¤ Bacterial derived N-Formyl peptides
¤ IL-8
¤ C5a
¤ Leukotriene B4
¤ Platelet Activating Factor
25
Q

Exceptions to Stereotypic Pattern of Cellular Infiltration

Pseudomonas infections
Viral infections
Allergic reactions
Hypersensitivity reactions

A

Exceptions to Stereotypic Pattern of Cellular Infiltration

Pseudomonas infections- dominated by continuously
recruited neutrophils in several days

Viral infections- lymphocytes may be the first cells to
arrive

Allergic reactions- eosinophils may be the main cell type

Hypersensitivity reactions- activated Lymphocytes,
macrophages and plasma cells

26
Q
  • Collection of activated epithelioid macrophages
  • May coalesce to form multinucleate giant cells
  • Often surrounded by lymphocytes, fibroblasts
A

Granuloma

27
Q

Causes transformation of macrophages to

epithelioid cells and multinucleate giant cells

A

IL-4 or IFN-gamma

Causes transformation of macrophages to
epithelioid cells and multinucleate giant cells

HS 202 - Patho (2 decks)

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