Inflammation: Presentations, Players, Process Flashcards
What are the goals of inflammation?
Respond to injurious insult
Remove problem or injured cells
Restore/repair injured tissues
What are the six initiators or stimulators of inflammation?
Infections Trauma Physical or chemical agents Tissue necrosis Foreign bodies Hypersensitivity immune reactions
Which inflammation stimulators release inflammasomes?
Trauma
Physical or chemical agents
Tissue necrosis
Foreign bodies
What are the five signs of inflammation?
Heat Redness Swelling Pain Loss of function (chronic)
What is the sequence of events in inflammation?
Recognition Chemical mediator release Vascular permeability Migration and activation of cells Termination/resolution
What does vasodilation cause?
Heat and redness
What vascular changes occur in altered hemodynamics?
Brief constriction then vasodilation from histamine
What happens to vascular structure in inflammation?
Endothelial cells contract increasing the space between them
What causes redness at the site of inflammation?
Hemoconcentration due to loss of blood plasma leaving RBCs in circulation
What is exudate?
Fluid leaked contains protein and cells (inflammation)
What is transudate?
Not a lot of protein or cells are in the fluid leaked (non inflammatory)
Is exudate or transudate due to inflammation?
Exudate
What is effusion?
Excess fluid in cavities
What does serous mean?
Yellow, straw-like color, few cells
What does serosanguinous mean?
RBCs present, red tinge
What does fibrinous mean?
Large amounts of fibrin present due to activation of coagulation cascade
What does purulent mean?
Large number of polymorphonucleocytes (neutrophils) present
What are endogenous chemicals?
Chemicals that activate and amplify the inflammation process
What are the three types of endogenous chemicals?
Plasma-derived
Cell-derived
Extracellular matrix
What are the three functions of the complement system?
Phagocytosis/Destruction
Vascular inflammatory effects
Cellular inflammatory effects
What are cell derived chemical mediators of inflammation?
Vasoactive amines Arachidonic acid metabolites Platelet activating factor Lysosomal molecules Cytokines Chemokines Nitric oxide Interferon ROS Neuropeptides
What do lipoxins do?
Suppress inflammation by inhibiting WBC recruitment
What does alpha-1-antitrypsin do?
Inhibits neutrophil elastase
What happens if alpha-1-antitrypsin isn’t present?
Neutrophil elastase destroys the elastin leading to emphysema
What are the steps in WBC extravasation?
Margination (hemodynamics; slowing of blood movement)
Rolling (selectins)
Adhesion to endothelium (integrins)
WBC migration
What cells play a major role in acute inflammation?
Neutrophils
What cells play a major role in chronic inflammation?
Lymphocytes
Macrophages
Plasma cells
Fibroblasts (prominent fibrosis)
What are the outcomes of inflammation?
Resolution
Healing by fibrosis
Ongoing chronic inflammation
What are the causes of chronic inflammation?
Persistent infection or injurious stimulus
Prolonged exposure to injurious stimulus
Autoimmunity
What are histiocytes?
Longstanding resident macrophages in tissue (typical cause chronic inflammation)
What occurs in granulomatous inflammation?
Macrophages form a syncytium multinucleated giant cell
When do caseating granulomas form?
In necrosis
What occurs in TB?
Caseating granulomatous inflammation
What occurs in sarcoidosis?
Noncaseating granulomas
What are the systemic effects of inflammation?
Fever
Elevated plasma acute phase reactants
Complete blood count: Elevated WBCs, increased PMN (granulocytosis bacterial), increased lymphs (lymphocytosis viral)
What is ESR?
Erythrocyte sedimentation rate
What is the basis for the Rouleaux test?
Increased plasma proteins causes a decrease of charge on RBC membranes causing RBCs to stack higher and faster
