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Pathology > L4-7 Inflammation and healing > Flashcards

L4-7 Inflammation and healing Flashcards

1
Q

Cardinal signs of acute inflammation

A
  1. Rubor (redness)
  2. Tumor (swelling)
  3. Calor (warmth)
  4. Dolor (pain)
  5. Loss of function
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2
Q

3 tissue changes in acute inflammation (pathway)

A
  1. Alteration of vasculature leading to increased BF
    - Vascular dilatation
    - Increased membrane permeability
  2. Exudation of fluid and plasma
    - Edema
  3. Migration and activation of leukocytes
    - Margination, rolling and adhesions of leukocytes
    - Transmigration across endothelium
    - Movement towards chemotactic molecules
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3
Q

4 sequelae of acute inflammation

A
  1. Complete resolution
  2. Healing by scarring
  3. Suppuration
  4. Chronic inflammation
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4
Q

Difference between acute and chronic inflammation in terms of cells involved

A

Acute: neutrophils and macrophages

Chronic: lymphocytes, plasma cells and macrophages
Sometimes GRANULOMAS

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5
Q

5 characteristics of granulomatous inflammation

A
  1. Aggregates of macrophages (epithelioid histiocytes)
  2. Multinuclear giant cells
  3. Plasma cells
  4. Necrosis / no necrosis
  5. Rim of lymphocytes
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6
Q

Example of caseous and non-caseous granulomatous inflammation

A

Caseous: TB

Non-caseous: Crohn disease

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7
Q

3 stimuli of granulomatous inflammation

A
  1. Persistent T-cell response
  2. Immune-mediated (type IV)
  3. Foreign body
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8
Q

3 outcomes of healing and repair

A
  1. Resolution
  2. Regeneration
  3. Repair by fibrosis (scarring)
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9
Q

Examples of labile cells

A
  1. Epidermis
  2. Epithelium of GIT
  3. Bone marrow
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10
Q

Examples of stable cells

A
  1. Liver
  2. Renal tubules
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11
Q

Examples of permanent cells

A
  1. Neuronal cells
  2. Heart muscles
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12
Q

What are the 4 main components of repair by connective tissue fibrosis?

A
  1. Angiogenesis
  2. Migration of fibroblasts
  3. Deposition of ECM and collagen synthesis
  4. Maturation and organisation of fibrous tissue
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13
Q

5 steps of angiogenesis

A
  1. Degradation of basement membrane of parent vessel to allow formation of capillary sprout
  2. Migration of endothelial cells towards angiogenic stimulus
  3. Proliferation and maturation of endothelial cells + lumen formation

4.Recruitment of periendothelial cells for support and maintenance

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14
Q

What are the characteristics of a wound that undergoes healing by first intention

A
  1. Wounds with opposed edges
  2. Minimum tissue loss
  3. Rapid rate of healing
  4. Minimal granulation tissue
  5. Minimal scarring
  6. Low risk of infection
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15
Q

What happened within the first week of healing by first intention?

A
  1. Recruitment of neutrophils to the site of injury
  2. Formation of vascular granulation tissue
  3. Capillary proliferation
  4. Migration and proliferation of fibroblasts
  5. Re-epithelialization
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16
Q

What happened after the first week of healing by first intention?

A
  1. Retreat of capillaries
  2. Return of inflammatory cells into the circulation
  3. Remodelling of collagen network and maturation of fibrous scar
17
Q

What are the characteristics of a wound that undergoes healing by second intention

A
  1. Open wound edges
  2. Extensive tissue loss
  3. Slow rate of healing
  4. More granulomatous tissue
  5. More scarring
  6. High risk of infection
18
Q

What happens during the first 2 weeks of healing by 2nd intention

A

Rapid proliferation of vascular granulomatous tissue at the base of the ulcer, with an underlying zone of hyperaemia and overlying zone of necrotic debris

19
Q

What happens after the formation of granulomatous tissue in the healing of 2nd intention?

A
  1. Contraction of scar tissue, pulling opposing edge together
  2. Re-epithelialisation
  3. Sloughing off of the scab
20
Q

What are the 3 characteristics of the scab left behind by the healing of 2nd intention?

A
  1. No skin appendages
  2. Thin layer of overlying dermis
  3. Surface appearance of a puckered, pale and depressed scar
21
Q

5 local factors that retard wound healing

A
  1. Movement and tension of the wound
  2. Ischemia
  3. Infection
  4. Foreign body
  5. Radiation
22
Q

7 systemic factors that retard wound healing

A
  1. Blood disorders (anaemia. coagulation disorders)
  2. Collagen disorders (OI, EDS)
  3. Deficiency of vitamin C
  4. DM
  5. Cancer
  6. Old age
  7. Drugs

Pathology (13 decks)

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