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NURS 2055 > Inflammation and Wound healing > Flashcards

Inflammation and Wound healing Flashcards

1
Q

What are the 3 types of cell injuries?

A

1) Sublethal injury
2) Lethal injury
3)Cell adaptation to sublethal injury

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2
Q

Define sublethal injury

A

Alters function without causing cell destruction. Potentially reversible if the harmful stimulus is removed

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3
Q

Define lethal injury

A

Irreversible process that causes cell death

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4
Q

Define cell adaptation to sublethal injury

A

1) Hypertrophy
2) Hyperplasia
3) Atrophy
4) Metaplasia
5) dysplasia

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5
Q

Define hypertrophy

A

An expansion in the size of cells which results in increase tissue mass without cell division. Basically surrounding tissue around the cell gets bigger

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6
Q

Define hyperplasia

A

Multiplication of cells as a result of increased cellular division. Basically cells multiply an example is endometriosis

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7
Q

Define atrophy

A

Decrease in the size of a tissue or organ as a result of a reduction in the number or size of individual cells. Usually caused by diseases, low blood supply and nutritional deficiency. Basically cells shrink

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8
Q

Define metaplasia

A

Transformation of once cell type into another in response to a change in physiologic condition or an external irritant. Basically the cell changes forms

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9
Q

Define dysplasia

A

Abnormal differential of dividing cells that results in changes in their size, shape and appearance

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10
Q

What causes lethal cell injury?

A
  • Hypoxia or ischemic injury
  • Chemical or physic injury
  • Viruses, bacteria
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11
Q

Define apoptosis

A

Programmed cell death

  • Anticipated event that occurs in some regenerating tissue to create homeostasis
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12
Q

Define necrosis

A

Tissue death that occurs as a result of traumatic injury, infection or exposure to toxic chemical

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13
Q

What are 4 defences against injury?

A

1) Skin and mucous membranes
2) Mononuclear phagocyte system
3) Inflammatory response
4) Immune system

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14
Q

Define mononuclear phagocyte system

A

Consist of monocytes and macrophages (phagocytes) and their precursor cells.

  • Monocytes and macrophages originate in the bone marrow
  • Monocytes spend a few days in blood then change into macrophages
  • Function include recognizing foreign material and replacing old or damaged cells
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15
Q

Define inflammatory response

A

Response to cell injury causes by pathogens, irritants or chronic health conditions

  • inflammation does NOT mean infection
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16
Q

What are the 4 phases of the inflammatory response?

A

1) Vascular response
2) Cellular response
3) Formation of exudate
4) Healing

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17
Q

Define the 1st phase inflammatory response

A

Vascular response:

1) the arterioles in the area undergo vasoconstriction which is stimulated by the SNS.

2) Then platelets adhere to vessels and make a seal on the injured area which forms a fibrin platelet clot

3) Release proinflammatory mediators such as histamine which causes vasodilation

4) Then increases blood flow to the area called hyperemia and filtration pressure increases = increase in capillary permeability

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18
Q

What is the purpose of fibrin in the vascular stage?

A

Functions to minimize blood loss and trap bacteria, prevent their spread and start the healing process

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19
Q

Define the 2nd phase of the inflammatory response

A

Phagocytes produce mediators to inhibit vascular smooth muscle contraction and growth platelet aggregation

  • Chemotaxis occurs: directional migration of WBC and ensures accumulation of neutrophils and monocytes at site of injury

Diapedesis: neutrophils, monocytes and macrophages collect along the capillary wall. Cells destroy and remove foreign material

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20
Q

Define neutrophils

A

First leukocyte at site of inflammation.
- They only last 24-48hours (short time)
They phagocyte bacteria aka engulf them

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21
Q

What is pus?

A

Dead neutrophils and digested bacteria

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22
Q

What else can release more neutrophils if needed?

A

Bone marrow. This will result in elevated WBC

23
Q

What if there’s not enough neutrophils?

A

Bone marrow releases immature for of neutrophils called bands. This makes the body “shift to the left” which makes this a Systemic response. Basically it is BAD to be in this stage like you will most likely die or need immediate medical intervention. Your body is releasing stuff from the bone marrow which is a big NO NO. this conditions is seen in pts with acute bacterial infection

24
Q

After the neutrophils what comes next?

A

Monocytes come in. arrive within 7 days after onset and can multiply if needed. They clean up anything the neutrophils weren’t able to do

25
Q

What comes after monocytes?

A
  • Lymphocytes: primary role is humoral and cell mediated immunity
  • Eosinophils: released in large quantities during allergic reaction
  • Basophils: carry histamine and heparin and release during inflammation
26
Q

What are clinical manifestation of exudate formation?

A

Redness (hyperemia from vasodilation), heat, pain, swelling

27
Q

What are some systemic manifestations to complement activation and release of cytokines?

A
  • Leukocytosis with a shift to the left
  • Increase pulse and heart rate
    Fever
28
Q

Describe fever for exudate formation

A

watch youtube

29
Q

What are 3 types of inflammation?

A

1) Acute: healing occurs in 2-3 weeks
- Neutrophil predominant cell type
- Elevated C-reactive protein

2) Subacute: features of acute process but lasts longer

3) Chronic: lasts for weeks, months or years.
Injurious agent persists, repeated tissue injuries and lymphocytes and macrophages predominant cell type

30
Q

What are the 2 types of healing process for cells?

A

1) Regeneration - replacement of lost cells and tissues with the same type

2) Repair - healing as a result of lost cells being replaced by connective tissues aka scar tissue
Usually occurs by primary, secondary or tertiary intention

31
Q

Which cells are stronger regeneration or repair?

A

regeneration

32
Q

What cells do not regenerate and occur with scar tissue?

A

Cardiac muscle cells do not regenerate

33
Q

What is primary intention?

A

Wound is closed with suture a

34
Q

What is secondary intention?

A

Wound is left open and allowed to heal with scar formation

35
Q

What is tertiary intention?

A

Wound is intentionally left open because if it is closed immediately, healing could be impaired by contamination, infection, edema or poor circulation. They leave it open then when its ready they will close it with a suture

36
Q

What are the 3 phases of primary intention healing?

A

1) Inflammatory phase - migration of epithelial cells and clots serving as meshwork for starting capillary growth

2) Granulation phase - secretion of collagen

3) Scar contracture - remodelling collagen and strengthening of scar

37
Q

What factors delay healing?

A

1) Nutrition
2) Inadequate blood supply
3) Smoking

38
Q

What is an important host defense?

A

fever

39
Q

What is an acute intervention for healing?

A

Rest
Ice/heat
Compression
Elevation

40
Q

what does histamine do for inflammation control?

A

causes vasodilation and stimulates contraction

41
Q

what does serotonin do?

A

causes vasodilation and stimulates smooth muscle contraction

42
Q

what does kinins do?

A

stimulation of pain

43
Q

what does complement components do?

A

stimulates histamine release, stimulates chemotaxis

44
Q

what does fibrinopeptides do?

A

stimulates chemotaxis for neutrophils and monocytes

45
Q

what does prostaglandins and leukotrienes do?

A

prostaglandin = vasodilation
leukotrienes = stimulates chemotaxis

46
Q

what do cytokines do?

A

act as a messenger between cells

47
Q

what are the 4 local manifestations of inflammation and their meaning?

A

1) redness : hyperaemia from vasodilation

2) heat : increased metabolism at inflammatory site

3) pain: change in pH; never stimulation

4) fluid shift to interstitial space; fluid exudate accumulation

48
Q

what is serous exudate?

A

thin watery clear - normal

49
Q

what is fibrinous exudate?

A

thin watery and cloudy. this is an indication of fibrin strands present - normal

50
Q

what is serosanguinous exudate?

A

pink blood and watery

51
Q

what is sanguineous exudate?

A

red blood, indication of fresh bleeding

52
Q

what is purulent exudate?

A

yellow thick and sticky pus

53
Q

what is haemorraghic exudate?

A

dark red. thick and sticky

54
Q

what is catarrhal exudate?

A

mucous. this exudate found in mucus membrane

NURS 2055 (18 decks)

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