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241 Oral Pathology > Inflammation and Repair Part 1 > Flashcards

Inflammation and Repair Part 1 Flashcards

1
Q

What are the 5 innate defenses?

A

Physical barriers
Mechanical Defense
Antibacterial activity
Removal of foreign substances
Inflammation process

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2
Q

What are some physical barriers for defense?

A

Intact skin and/or mucosa

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3
Q

What are some mechanical defenses?

A

Respiratory systems cilia and mucus

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4
Q

Antibacterial activity as a means of defense

A

Enzymes in saliva

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5
Q

Removal of foreign substances as a means of defense

A

Flushing action of tears, saliva, urine and diarrhea

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6
Q

What is involved in the inflammation process as a means of innate defense?

A

White blood cells

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7
Q

Characteristics of inflammation

A

Nonspecific response
The extent and duration of the injury determines the extent and duration of the inflammatory response
Can be local or systemic
Can be acute, chronic or a combination

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8
Q

How long does the acute inflammatory response generally last?

A

Short, lasting only a few days

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9
Q

What are the 3 responses to injury?

A

Inflammation
Immunity
Repair

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10
Q

What is the difference between chronic and acute inflammation?

A

Acute lasts for only a short duration while chronic is ongoing and is a major component of the pathogenesis of common disorders

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11
Q

What are the cells involved in the inflammatory response?

A

Neutrophils
Monocytes
Lymphocytes
Eosinophil
Basophils

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12
Q

Where are monocytes located?

A

Circulate in blood

Macrophages once in tissue

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13
Q

When do we see lymphocytes and plasma cells?

A

CHRONIC inflammation and the immune response

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14
Q

What is the first type of WBC to arrive t the site of injury?

A

Neutrophils

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15
Q

What is the second type of WBC to arrive at the site of injury?

A

Monocytes, which will become macrophages when they enter the surrounding tissue

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16
Q

What is the function of polymorphoneukleocytes (PMNs)?

A

Phagocytosis

Derived from stem cells in bone marrow

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17
Q

What is the function of macrophages?

A

Phagocytosis

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18
Q

Of all WBCs which makes up the largest % of the population?

A

Neutrophils

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19
Q

What is the function of biochemical mediators?

A

Cause many of the events in the inflammatory response- can recruit other mediators and immune mechanisms

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20
Q

What are biochemical mediators derived from?

A

Blood
Endothelial cells
WBCs and platelets
Pathogenic organisms as they enter the tissue

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21
Q

What 3 systems are biochemical mediators responsible for?

A

Kinin system
Clotting mechanism
Complement system

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22
Q

What is the kinin system?

A

-Active in early phase of inflammation
-Activated by substances in plasma and injured tissue
-Increases dilation of blood vessels at site as well as permeability of BV
-Induces pain

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23
Q

What is clotting mechanism?

A

Clots blood and mediates inflammation

Helps stop bleeding at site of injury

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24
Q

What is the complement system composed of?

A

Series of plasma proteins that are activated in a cascade. They activate one protein that activates another and so on

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25
Q

What do complement components cause?

A

Cause mast cells to release histamine which increases vascular dilation and permeability

Can also cause cytolysis (cell death by creating holes)

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26
Q

What is opsonization?

A

When complement proteins attach themselves to the surface of bacteria stimulating WBCs to phagocytize?

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27
Q

Which system is responsible for blood clotting?

A

Clotting mechanism

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28
Q

3 activities the complement system is responsible for?

A

Release of histamine
Plasma protein cascade
Cytolysis

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29
Q

Which system is responsible for dilation of blood vessels?

A

Kinin system

Also the complement components

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30
Q

Sequence of events in the kinin system

A

After tissue injury:
Constriction of microcirculation
Dilation of microcirculation- erythema, and heat

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31
Q

Sequence of events in the clotting mechanism

A

Increased blood viscosity
Decreased blood flow

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32
Q

Sequence of event in the complement system

A

Chemotaxis
WBCs enter tissue
Phagocytosis

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33
Q

What is chemotaxis

A

Migration of many types to cell to a particular site

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34
Q

What are the cardinal localized signs of inflammation?

A

Redness
Heat
Swelling
Pain
Loss of normal tissue function

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35
Q

What are the cardinal systemic signs of inflammation?

A

Fever
Leukocytosis
Elevated C-reactive protein
Lymphadenopathy

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36
Q

What is fever controlled by?

A

The hypothalamus

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37
Q

What are the fever producing substances created by WBCs and pathogens?

A

Pyrogens

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38
Q

How does the hypothalamus induce fever?

A

Increases body temp by way of prostaglandins

39
Q

What are the systemic manifestation of leukocytosis?

A

Increase in circulating WBCs
The body’s attempt to provide more cells for phagocytosis
Type of WBC increasing can aid in a differential diagnosis

40
Q

What does an increase in lymphocytes signify?

A

A viral infection

41
Q

What does an increase in neutrophils signify?

A

Bacterial infection

42
Q

What does an increase in eosinophils signify?

A

Allergic reaction

43
Q

What lab test can be done to to evaluate a patient for infection or blood disorder?

A

Complete Blood Count (CBC)

44
Q

What is lymphadenopathy?

A

Enlarged and palpable superficial lymph nodes

45
Q

Why does lymphadenopathy occur?

A

Changes in lymphocytes found in the nodes which are the primary cells of the immune system
-Hyperplasia: Increase in # of cells
-Hypertrophy: Enlargement of individual cells

46
Q

Where is C-reactive protein produced? What does its presence signify?

A

Produced in the liver
Signifies serious, acute infection
Used to monitor tissue healing.
Possible marker for periodontal disease

47
Q

What is the purpose of anti-inflammatory drugs?

A

Tp bock or suppress the inflammatory response by blocking prostaglandins- reduces clinical signs

48
Q

What are the different types of drugs used to treat inflammation?

A

Non-steroidal anti-inflammatory drugs (NSAIDS- ibuprofen, aspirin)
Steroidal anti-inflammtory drugs (Prednisone)
Antihistamines

49
Q

What does inhibiting prostaglandins do?

A

Prevents the biochemical mediators of inflammation from being activated

50
Q

What part of the inflammation sequence is responsible for redness and heat?

A

Kinin system- dilation of microcirculation

51
Q

What part of the sequence is responsible for swelling and pain?

A

Kinin system

52
Q

What part of the body is responsible for initiating fevers? Why do we get them?

A

Hypothalamus
Fevers occur because the body is trying to kill off the virus or bacteria that is causing the infection

53
Q

What is the difference between hyperplasia and hypertrophy?

A

Hyperplasia is about and increase in NUMBER of cells while hypertrophy is about the increase in SIZEof cells

54
Q

What do we call when the lymph nodes are enlarged and what we call when the white blood cell count is elevated?

A

Enlarged= Lymphadenopathy
WBC elevated= Leukocytosis

55
Q

Why does hyperplasia occur?

A

In response to chronic irritation or abrasion
May or may not persist after removal of irritant

56
Q

Why does hypertrophy occur?

A

Can be seen as a response to hypertension in cardiac muscle

57
Q

What is atrophy?

A

Decrease in the size or function of a cell, tissue, organ or the entire body

58
Q

What is regeneration? Where is it seen?

A

Process by which tissue injured tissue is replaced with tissue identical to what was present before the injury

Seen in acute inflammation

59
Q

What is repair?

A

Restoration of damaged or diseased tissue that has undergone necrosis and need to be repaired w/ new cells and tissue components
Cannot be complete until source of injury is removed and agents are destroyed

60
Q

What happens microscopically on the day of the event?

A

Blood flows to injured tissue to form a clot

61
Q

What are blood clots composed of?

A

Fibrin, clumped RBCs and platelets

62
Q

What happens on day 2 after event?

A

Neutrophils emigrate from microcirculation into injured tissue in an acute inflammatory response

Phagocytosis occurs

63
Q

What happens on day 3?

A

Phagocytosis continues and angiogenesis occurs
Neutrophils reduce
Fibroplasia occurs
Granulation tissue forms
Epithelialization occurs
Blood clot acts as scaffold for new tissue
Lymphocytes and plasma cells migrate to site as chronic inflammation and immune response occur

64
Q

What is angiogenesis?

A

Stimulation and growth of new blood vessels

65
Q

What is fibroplasia?

A

Increase in number of fibroblasts, producing collagen fibers

66
Q

What is epithelialization?

A

Process by which new surface tissue is created

67
Q

What happens on day 7?

A

Inflammatory responses are complete
Source of injury has been removed
New tissue is relatively red
New epithelium is thin
New CT is highly vascularized
Immature collagen fibers present and fragile

68
Q

What happens on day 14?

A

Granulation tissue has been remodeled (tissue has full strength)
Mature, fibrous CT is called scar tissue (paler due to increase in collagen and decrease in vascularity)

69
Q

What does the amount of remaining scar tissue depend on?

A

Heredity
Strength and flexibility needed in the tissue
Tissue type

70
Q

Which is less prone to scar tissue, skin or mucosa?

A

Mucosa

71
Q

What are the three types of repair that can occur?

A

Primary, secondary and tertiary intention

72
Q

Do we see regeneration or repair in acute inflammation?

A

Regeneration

73
Q

Which day after injury will the neutrophils start to get reduced in the macrophages continue the phagocytosis?

A

Day 3

74
Q

What color does scar tissue clinically appear?

A

Whiter or pale

75
Q

What is healing by primary intention?

A

Healing of an injury w/ little loss of tissue
Margins are close together and little to no scarring forms

76
Q

What is healing by secondary intention?

A

Edges of injury cannot be joined during healing due to tissue loss
Large clot forms, formation of granulation tissue

Ex. extracted tooth, keloid

77
Q

What is a keloid?

A

Excessive scarring that mainly occurs in in skin and appears raised and extends beyond its original boundaries

78
Q

What is healing by tertiary intention?

A

Delayed surgican tissue repair until infection is resolved
-puncture wounds may become infected

79
Q

Which cells create new bone tissue?

A

Osteoblasts

80
Q

How does bone tissue repair occur?

A

Tissue damage leads to clot formation
Osteoblasts lay down immature bone (osteoid)
Calcifies over time and becomes replaced with w/viable bone trabeculae

81
Q

What factors influence bone repair?

A

Age
Nutrition
Tobacco use

82
Q

What are some injuries that may occur to the teeth?

A

Attrition- bruxism
Abrasion
Abfraction
Erosion- bulimia, meth abuse

83
Q

What is attrition?

A

Tooth to tooth wear

84
Q

What is bruxism?

A

Grinding and clenching teeth for non-functional purposes such as:
-Occlusal interferences
-Stress
-Tension
-Seizure disorders

85
Q

Signs and symptoms of bruxism?

A

Wear facets
Abnormal rate of attrition
Hypertrophy of masticatory muscles
Increased muscle tone
Muscle tenderness and fatigue
Cheek biting
TMJ pain
Tooth mobility
Sensitivity to cold

86
Q

How to manage bruxism

A

Occlusal adjustments to eliminate occlusal interferences and fabrication of an acrylic splint

87
Q

What is abrasion?

A

Pathologic wearing away of tooth structure that results from a repetitive mechanical movement

Most frequently seen on root surfaces with gingival recession- progression is slow and can be caused by toothbrushing

88
Q

What is abfraction?

A

Microfracture of tooth structure in areas of concentrated stress
Appears as wedge-shaped lesions at cervical areas

89
Q

What is erosion?

A

Loss of tooth structure as a result of chemicals, without bacterial involvement

90
Q

Potential causes of erosion

A

Industrial factors
Intraoral cocaine drug abuse
Overuse of soft drinks
Baby bottle caries
Sucking on lemons
Chronic vomitting

91
Q

What type of damage to teeth cannot be determined by location?

A

Erosion and abrasion

92
Q

What signs of bulimia can we look for?

A

Normal weight but secretive about eating habits
Electrolyte imbalance or malnutrition
Irritation of lips and oral mucosa
Traumatic lesions on the back of fingers

93
Q

How to manage oral health in someone with bulimia or chronic vomitting

A

Fluoride rinse and toothpaste
Rinse with water after purging
Avoid brushing immediately after
Use very soft toothbrush
May require full coverage restorative procedures

241 Oral Pathology (13 decks)

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