Inflammatory Response Flashcards
What are the cardinal signs of inflammation?
Rubor - redness Calor - heat Tumour - swelling Dolor - pain Loss of function
What is rubor?
Redness
What is calor?
Heat
What is a tumour?
Swelling
What is dolor?
Pain
What are some causes of acute inflammation?
Micro-organism invasion Chemical Upset Extreme physical conditions Dead tissue Hypersensitivity
How many classes of hypersensitivity are there?
4
What is accute inflammation
A series of microscopic events that are localised to the affected tissue
What is microcirculation?
The circulation of the blood in the smallest blood vessels
What is macrocirculation
The circulation of blood to and from the organs
What are capillary beds fed by?
Arterioles
What are capillary beds drained by?
Venules
What 3 things happen in accute inflammation?
Change in vessel radius- changing blood flow
Changes in the permeability of the vessel walls
Movement of neutrophils from the vessel to the extravascular space
Initially do changes in vessel radius constrict or relax and why?
Constrict - for protective reasons
Why is the arteriole radius increased?
as it increases local tissue blood flow
What is the effect of increased permeability in acute inflammation?
The net movement of plasma from the capillaries to the extravascular space
What is the process of movement of plasma from the capillaries to the extravascular space?
Exudation
What is oedema?
The accumulation of fluid in the extravascular space
Does blood viscosity increase or decrease with acute inflammation?
Increase
Why does blood viscosity increase with acute inflammation?
As the watery part of blood moves into the extravascular space making the blood thicker and slowing does its rate
The blood becoming thicker and the rate of blood flow slowing down is known as what?
Stasis
In normal blood flow where are WBC?
In the centre of the vessel
In normal blood flow where are RBC?
On the outer blood vessel
In inflammation blood flow where do neutrophils move to?
Closer to the surface of the vessel
In inflammation why do neutrophils move closer to the surface of blood vessels?
To facilitate their movement from the vessel to the tissue
What is the most important WBC in acute inflammation?
Neutrophils
What is margination?
When neutrophils move to the endothelial aspect of the lumen
What is pavementing?
When neutrophils adhere to the endothelium
What is emigration?
When the neutrophils squeeze between endothelial cells to the extravascular tissues
What is the ideal outcome of acute inflammation?
Resolution
Describe resolution
The initing agent is isolated and destroyed Macrophages move in and phagocytose Epithelial regenerates Vascular changes return to normal Inflammation resolves Its as if it never happened
Inflammation at the meninges is known as what?
Meningites
Inflammation at the appendix is what?
Appendicitis
Inflammation at the lungs is what?
Pneumonia
Inflammation at the pleural cavity is what?
Pleurisy
Inflammation at the peritoneal cavity is what?
Peritonitis
What do neutrophils contain?
Granules that posses oxidants and enzymes
When neutrophils release heir contents what happens to them?
They die
What do dead neutrophils produce?
a soup of fluid - PUS
What does fibrinogen polymerise to form?
Fibrin
The immunoglobulins in plasma are specific for what?
Antigens
What is the collective effect of the mediators of acute inflammation?
vasodilation Increased permeability Neutrophil adhesion Chemotaxis - Cells moving towards the site of infection Itching and pain
Where is histamine preformed?
Mast cells, platelets and basophils
What does histamine cause?
Vasodilation
Increased membrane permeability
What is histamine released as a result of?
Local injury
Where do adhesion molecules appear?
On endothelial cells
Why are adhesion molecules important?
For helping neutrophils stick together
Where is prostaglandins released from?
Many cells
What effect does prostaglandins have?
Promoting histamine effects and inhibiting inflammatory cells
What are cytokines and chemokines produced by?
Macrophages and lymphocytes
Where are leukortrienes released from?
Neutrophils
Do all mediators favour inflammation?
No some favour and some inhibit inflammation
What are the immediate effects of inflammation?
Pyrexia - raised temperature
Feeling generally unwell
Increased WBC count
What are the longer term effects of acute inflammation
Lymph node enlargement
Weight loss
Anaemia
In chronic inflammation what is the main cell population?
Lymphocytes
Plasma cells
Macrophages
In acute inflammation what is the main cell population?
Neutrophils
What does chronic inflammation feature?
Tissue or organ damage
Eventually what does tissue and organ damage lead to the loss of?
The loss of their function
What are the 2 ways in which chronic inflammation can occur?
May follow from acute inflammation
May arise as a primary pathology
Does chronic inflammation tend to be long or short term?
Long
What are the symptoms of chronic inflammation?
Are often vague - not very specific
Often get malaise
Can get weight loss
How does chronic inflammation arise from acute inflammation?
If there is alot of damage, the inability to remove debris and ultimately the failure of acute inflammation to resolve
How does chronic inflammation arise as a primary lesion?
This occurs if there is no preceding acute phase and only chronic changes are seen in the inflammation
What is organisation an outcome of?
Acute inflammation
What type of tissue is characteristic of organisation?
Granulation tissue
What does granulation tissue do?
Results in healing and repair - leading to fibrosis and the formation of a scar
Why do capillaries grow into inflammatory mass?
To allow the acess of plasma proteins
Macrophages from the blood and tissue
What does fibrous tissue form?
A scar
Give an example of when fibrosis can become a problem and lead to chronic inflammation
Adhesions between loops of the bowel following peritonitis
What are the 3 outcomes of acute inflammation?
Resolution
Fibrosis (scar)
Chronic inflammation
What occurs in an autoimmune disease?
Our immune system attacks our own antigens
What is the effect of an autoimmune disease?
Our own tissues and cells are targeted by our immune system and destroyed
What are the tissue components of chronic inflammation?
Granulation tissue
Collagen
What are the cell components of chronic inflammation?
Lymphocytes
Plasma cells
Macrophages
Fibrobasts
What are the main types of lymphocytes?
T cells and B cells
What is the main function of the lymphocytes?
Create an immune response and generate an immunological memory
What are plasma cells?
Differentiated B cells that are capable of antibody production
What organelle is visible in plasma cells and why?
The golgi apparatus because their main function is to package the Ab that are being expelled from the cell
What do activated B cells differentiate into?
Plasma cells
Do B cells create an immunological memory?
Yes
What other immune cell do B cells act with?
Macrophages
What do T cells produce?
Cytokines
What do T cells activate?
Macrophages and other cells
What mechanism do NK cells use to destroy cells and antigens?
Chemical mechanism involving the release of granule proteins
What do macrophages develop from?
Monocytes
Where are monocytes found?
In the bone marrow and bone tissue
What is suppuration?
An outcome of acute inflammation that involves pus formation
What is an abscess?
A collection of pus under pressure
What is a multiloculated abscess?
When the pus bursts through the pyogenic membrane and forms new cavities
What is organisation?
An outcome of acute inflammation that involves healing and repair of tissue - it leads to fibrosis and the formation of a scar
What is dissemination?
An outcome of acute inflammation that occurs when the inflammation spreads to the blood and becomes septic
What is bacteraemia?
When there is bacteria in the blood
What is septicaemia?
When there is the growth of bacteria in the blood
What is toxaemia?
When there are toxic products in the blood
What is SVR ( systemic vascular resistance)?
The resistance of the vessels
Why does SVR decrease in inflammation?
Because the blood vessels dilate
What is BP measured by?
CO x SVR
What is the outcome of septic shock?
Rapidly fatal
Cell death
Haemorrhage
