Inflammation & Healing Flashcards
Inflammation
- vascular and cellular responses of living tissue to injury
- involves; blood, vessel, cell
- purpose is to eliminate offending irritant/stimulant
- reaction of living tissue to injury which comprises series of changes in the TERMINAL VASCULAR BED, and BLOOD, and TISSUE.
- remove and repair
- series of complex reactions by VASCULAR connective tissue elements in order to address injury
Causes of inflammation
° pathogenic microorganism
° chemical injuries
° mechanical and thermal injuries
° immune reactions
accumulation of fluid in the injured area (functions)
- to dilute
- to localize
- to destroy
- to remove
advantages of inflammation
- protect the surrounding tissue by localizing and isolating the injured tissues
- to neutralise and inactivate toxins
- destroys and inhibit the growth of pathogenic microorganisms
- prepares injured area for healing and repair.
disadvantages of inflammation
- excessive scar formation
- varying degrees of disabilities as a result of pain swelling
- tissue compression, vessel rupture, hemorrhage
- formation of cavities, sinus, fistula
- aggregates inflammation by destruction of surrounding intact tissue
- development of inflammatory diseases (hypersensitivity)
Cardinal Signs
° rubor (redness)
° tumor (swelling)
° calor (heat)
° dolor (pain)
° functio laesa
redness
rubor
swelling
tumor
heat
calor
pain
dolor
caused by vasodilation
rubor (redness)
fluid exudate, increase vascular permeability
tumor (swelling)
rapid inflow of warm blood thru dilated vessels
calor (heat)
vasoactive chemicals will be released
dolor (pain)
loss of function
functio laesa
vasoactive chemicals
histamine, serotonin
10 generalities of inflammatory response
- process
- living tissue
- series of events; overlapping into a continuum
- a response; requires initiation by some kind of stimulus
- response can be more harmful than the stimulus
- survival oriented
- fairly stereotype of any initiating stimuli
- always component of blood
- carefully coordinated defense mechanism essential to life
- complicated but understandable
escape of fluid and blood cells from the vascular system into the interstitial tissue
exudation
- fluid with high protein concentration
- high specific gravity increase 1.020
exudate
- fluid with low protein content
- specific gravity less than 1.012
- ultra filtrate of blood plasma
- result of hydrostatic imbalance across vascular endothelium
transudate
excess of fluid in the interstitial tissue/serous cavities
edema
purulent inflammatory exudate rich in leukocytes and parenchymal debris.
pus
cells involve in inflammation
° granulocytes
° agranulocytes
° plasma cells
example of granulocytes
✓ neutrophils
✓ eosinophils
✓ basophils
- first to arrive in the site of inflammation
- a phagocytic cells by releasing lytic lysosomal enzymes and some chemotactic factors
neutrophils
examples of lysosomal enzymes released by neutrophils
✓ myeloperoxidase
✓ acid hydrolysis
✓ lysosomes and muramidase
✓ cationic proteins
- prominent in allergic reactions, parasitic infections
- contains; lysosomal granules/enzymes, histamines
- also a phagocytic cells
eosinophils
-least numerous
- shared common properties of mast cells
- secrete and release vasoactive amines/chemicals
- non phagocytic cells
basophils
not found in circulation but in tissues
mast cells
example of agranulocytes
monocyte and lymphocytes
- peripheral blood phagocytes
- becomes part of the tissue, then become macrophage
- involved immune response as an antigen preventing cell
- phagocytic cells
monocytes
- found in tissues of all types of inflammation esp, after acute increase of neutrophils
- derived from bone marrow stem cells thru hematopoiesis
- both involved in cell mediated and humoral cell responses
lymphocytes
primary lymphoid organs
bone marrow
3 types of lymphocytes
- T-lymphocyte
- B-lymphocyte
- natural killer cells
70%. involved cell mediated lymphocytes
T-lymphocytes
derived from bursa
B-lymphocytes
- formed by a process of maturation and deviation of B-lymphocytes into 2 distinct cells
plasma cells
2 distinct cells
memory cells and plasma cells
surface contains immunoglobulins + antibodies
plasma cells
macrophages (important component of immune system)
a. histiocytes
b. skin
c. liver
d. lungs
e. kidney
f. brain
connective tissue
histiocytes
skin
langerhan cells
liver
von kupffer cell
lungs
alveolar macrophages
brain
microglial cells
responsible for hemodynamic + vascular changes
vasoactive amines
histamines
- stored in granules of mast cells
- found in basophils and platelets
- released by degranulation in response to various stimuli
- once released, can cause vasoconstriction and vasodilation
- cause increase vascular permeability of small veins and venules
mediators of inflammation
✓ protein
✓ peptides
✓ glycoproteins
✓ cytokines
✓ arachidonic acid metabolites
✓ nitric acid
✓ oxygen free radicals
✓ vasoactive amines
once activated, it will lead to formation BRADYKININ
kinin system
once plasma comes into contact with;
- collagen
- endotoxins
- basement membrane proteins
proteases secreted serine proteins
kallikrein
most important mediators of inflammation process
complement system
serotonin
- stored in GIT, CNS, dense granules of platelets
- regulates almost all immune cells in response to inflammation following the activation of platelets
leukocytes substances (activation of inflammation)
- hydrolytic enzymes
- proteases
- cationic proteins
lipid found in mast cells
Slow Reactive Substance of Anaphylaxis (SRSA)
biologically active substances produced by T-cells during immune reaction.
lymphokines
begins within 4-6 hours and can remain constant in appearance depending on the initiators for survival days
acute
may cover considerable time span between acute reaction and those in which evidence of chronicity apparent.
subacute
- prolonged inflammation
- caused by persistent agent
chronic
key features of chronicity
- caused by persistent inflammatory stimuli in which the host failed to completely rid in the tissue of invader
- inflammatory response is usually accompanied by an immune system due to persistence of invader
- highlighted by evidence of host tissue contribution in terms of reparative responses
- characterized histologically by both mononuclear cells infiltrates and by CT cells such as fibroblasts
Cellular Phase of Inflammation
° margination and pigmenting
° diapedesis
° chemotaxis
° phagocytosis
major event of inflammation
after injury
2 opposing forces in Inflammation
° hydrostatic pressure
° plasma colloid osmotic pressure
due to vasodilation
hydrostatic pressure
due to leakage of high protein fluid to interstitial resulting in marked net outflow and edema
plasma colloid osmotic pressure
3 patterns of increased in Inflammation
- immediate transient response
- immediate sustained reaction
- delayed prolonged leakage