Lecture 3 Study Guide (Inflammation & Repair) Flashcards
1
Q
The body’s response to injury (eliminate cell entry):
A
Inflammation
2
Q
Inflammation of the periotoneum:
A
Peritonitis
3
Q
Inflammation of the lymph node:
A
Lymphadenitis
4
Q
Inflammation of the Fallopian tube:
A
Salpingitis
5
Q
Inflammation of the cornea:
A
Keratitis
6
Q
Inflammation of the glans penis:
A
Balantitis (Reiters syndrome)
7
Q
Inflammation of the bladder:
A
Cystitis
8
Q
Comes into play when inflammation is caused by infection:
A
Immunity
9
Q
Infection may provoke ____ and _____
A
inflammation & immunity
10
Q
Inflammation may exist:
A
Without infection
11
Q
Inflammation may be caused by _____ or _____ (give examples)
A
Hypersensitivity (mucositis) or autoimmune disease (mucous membrane pemphigoid or RA)
12
Q
The body’s first and second line of defenses are considered:
A
Non-specific
13
Q
The body’s third line of defense is considered:
A
Specific
14
Q
Describe the body’s first line of defense:
A
BARRIERS- THE MOST IMPORTANT- skin, mucous membranes, secretions (nonspecific)
15
Q
Describe the body’s second line of defense:
A
Inflammatory response- innate- cells (leukocytes) and molecules (mediators) (nonspecific)
16
Q
Describe the body’s third line of defense:
A
Immune responses- acquired- antibodies (humoral) and cytotoxic T cells (cellular) (specific)
17
Q
Skins, mucous membranes & secretions =
A
body’s first line of defense
18
Q
Cells (leukocytes) & molecules (mediators) =
A
body’s second line of defense
19
Q
Antibodies (humoral) & cytotoxic T cells (cellular) =
A
body’s third line of defense
20
Q
List the three main components of inflammatory responses:
A
- circulating blood cells & plasma proteins
- cells of the blood vessel walls
- cells & proteins of the ECM
21
Q
What are the circulating blood cells and plasma proteins of inflammatory responses?
A
- PMNs/neutrophils
- lymphocytes
- monocytes
- eosinophils
- basophils
22
Q
The cells of the blood vessel walls that are components of inflammatory responses include:
A
- complement
- clotting factors (platelets)
23
Q
The cells and proteins of the ECM of the inflammatory responses include:
A
- mast cells
- macrophages
24
Q
What component of the inflammatory response is characterized by functioning to eliminate microbes and debris?
A
PMNs/neutrophils
25
What component of the inflammatory response is comprised of T cells, B cells, NK cells and function to produce antibodies?
Lymphocytes
26
What component of the inflammatory response are important for repair?
Eosinophils
27
Lymphocytes (circulating blood cells and plasma proteins of the inflammatory response) are specifically _____ cells and function to:
T cells, B cells & NK cells; produce antibodies
28
The complement & clotting factors (platelets) of the inflammatory response are the source of:
cytokines & NO
29
What cells of the ECM that are components of the inflammatory response produce histamine?
Mast cells
30
Mast cells produce:
Histamine
31
What cells of the ECM that are components of the inflammatory response eliminate debris and are a source of cytokines?
Macrophages
32
Inflammation is the bodies response to:
Injury
33
Most of the defensive elements of inflammation are located in the:
Blood
34
Inflammation is the means by which:
Defensive cells and chemicals leave the blood and enter tissue
35
Inflammation is a ______ to injury
Complex reaction
36
Inflammation is a complex reaction to injury including: (4)
1. vascular responses
2. cellular responses
3. systemic reactions
4. repair
37
Describe the vascular responses of inflammation:
MOST IMPORTANT
38
What is an example of a systemic reaction of inflammation?
Fever
39
Initially inflammation is _____ however if excessive or prolonged it may become _____
Beneficial; harmful
40
Inflammatory response 5 R's include:
1. recognition of the injurious agent
2. recruitment of leukocytes
3. removal of the agent
4. regulation (control) of the response
5. resolution (repair)
41
What are the cardinal signs of inflammation (5):
1. Color-heat
2. Rubor-redness
3. Tumor-swelling
4. Dolor-pain
5. Loss of function
42
inflammation that is characterized by a rapid onset, short duration and is intense:
acute
43
What cells are involved in acute inflammation?
Neutrophils
44
What type of inflammation involves the exudation of fluid and plasma proteins?
Acute inflammation
45
Acute inflammation involves ______ of fluid and plasma proteins
exudation
46
protein rich fluid that filters into a site (can cause swelling):
Exudate
47
Describe the composition of exudate:
protein rich
48
Describe the cellular events of acute inflammation: (7)
1. margination
2. rolling
3. adhesion
4. diapedesis
5. chemotaxis
6. phagocytosis
7. killing
49
inflammation characterized by a longer duration and considered low grade:
chronic inflammation
50
what cells are involved in chronic inflammation?
mononuclear cells- macrophages, lymphocytes, plasma cells
51
Mononuclear cells of chronic inflammation include: (3)
1. macrophages
2. lymphocytes
3. plasma cells
52
Proliferation of blood vessels and fibroblasts occurs in _____ inflammation
chronic
53
chronic inflammation is typically _____ and associated with fibrosis and scarring
non-exudative
54
chronic inflammation can be described as non-exudative meaning its associated with:
fibrosis and scarring
55
What are the causes of acute inflammation? (4)
1. mechanical, chemical, radiation, or thermal injury
2. infection
3. compromise of blood supply
4. immune injury
56
what are the morphological patterns of acute inflammation? (4)
1. serous inflammation
2. fibrinous inflammation
3. suppurative (purulent) inflammation
4. ulcerative inflammation
57
acute inflammation characterized by the accumulation of fluid right under the epithelium:
serous inflammation
58
serous inflammation produces _____ (describe it)
transudate (low protein fluid, more watery)
59
Give examples of conditions involving serous inflammation: (4)
1. friction blisters
2. poison ivy
3. thermal burn
4. herpes
60
acute inflammation characterized by large molecules (fibrinogen) moving into the extravascular space:
fibrinous inflammation
61
describe fibrinous inflammation:
acute inflammation, exudative; lines of mucosal fibrin and CT with inflammatory cells beneath
62
Fibrinous pericarditis in rheumatic fever is an example of:
Fibrinous inflammation
63
acute inflammation characterized by the production of pus:
suppurative (purulent) inflammation
64
Describe the contents of the pus produced in suppurative (purulent) inflammation:
Exudate, rich in neutrophils
65
Streptococcal meningitis, and submandibular gland abscess and abscess caused by infected tooth are all conditions associated with:
Suppurative (purulent) inflammation
66
acute inflammation characterized by a defect in epithelial continuity:
ulcerative inflammation
67
Describe ulcerative inflammation:
Clinically presents as a whiteish, yellowish area surrounded by red halo
68
Recurrent aphthous stomatitis is an example of:
Ulcerative inflammation
69
Other types acute inflammation (not the morphologic patterns) include:
1. Cellulitis
2. Catarrhal inflammatino
70
diffuse spread of acute inflammatory process through the fascial planes of soft tissues (not localized):
cellulitis
71
Describe the clinical manifestations of cellulitis:
produces erythema, edema, warmth, and pain WITHOUT consolidation (its diffuse)
72
Clinical type of exudative inflammation, presenting excess production of mucous:
Catarrhal inflammation
73
Catarrhal inflammation only occurs on ______ containing _____ cells such as _____ or _____
mucosal surfaces; mucous-secreting cells; nasal or bronchial mucosa
74
List all conditions classified as "defects in neutrophil function" (5)
1. Leukocyte adhesion deficiency (LAD)
2. Lazy leukocyte syndrome
3. Chediak-Higashi syndrome
4. Chronic granulomatous disease of childhood
5. Myeloperoxidase deficiency (MPO)
75
-defect in neutrophil function
-patients present with periodontal bone loss (exfoliating teeth)
-primary and secondary dentition is affected
-due to failure in adhesion of neutrophil to blood vessel wall
-nothing will stop the progression of this disease (greater risk of bacterial & fungal infections)
Leukocyte adhesion deficiency (LAD)
76
-defect in neutrophil function
-impaired chemotaxis due to mutation of contractile proteins
lazy leukocyte syndrome
77
-defect in neutrophil function
-rare autosomal recessive condition associated with albinism
-form giant lysosomal inclusions from fused primary granules
-both chemotaxis and phagolysosome formation are defective
-subjected to recurrent infections
-platelet function is abnormal
Chediak-higashi syndrome
78
-defect in neutrophil function
-X-linked (2/3) or autosomal recessive (1/3)
-deficient NADPH oxidase in cell membranes of neutrophils and monocytes
-absence of respiratory burst --> no H2O2 produced --> HOCl- (bleach) is NOT synthesized
-catalase negative organisms are killed
-catalase positive organisms are NOT killed
Chronic granulomatous disease of childhood
79
-defect in neutrophil function
-common autosomal recessive absence of MPO enzyme in neutrophil and monocyte granules
-respiratory burst is normal and H2O2 is produced
-absence of MPO prevents synthesis of HOCl-
-no great clinical consequences in most people
-diabetics may develop candidiasis (and additional problems)
Myeloperoxidase (MPO) deficiency
80
Immune deficiencies caused by defects in leukocyte function categories include:
1. too few neutrophils
2. failure in adhesion
3. slow chemotaxis
4. failure to phagocytose
5. failure to kill invader
81
What immune deficiency caused by defects in leukocyte function is due to too few neutrophils?
1. agranulocytosis
2. cyclic neutropenia
82
What immune deficiency caused by defects in leukocyte function is due to failure in adhesion?
1. leukocyte adhesion deficiency (LAD)
83
What immune deficiency caused by defects in leukocyte function is due to slow chemotaxis?
1. lazy leukocyte syndrome
84
What immune deficiency caused by defects in leukocyte function is due to failure to phagocytose?
1. bruton Agammaglobulinemia
2. complement deficiency
85
What immune deficiency caused by defects in leukocyte function is due to failure to kill invader?
1. chediak-higashi syndrome
2. chronic granulomatous disease of childhood
3. myeloperoxidase deficiency
86
The cell-derived preformed mediators of inflammation and where they come from:
1. histamine
2. serotonin
Come from secretory granules
87
The source of histamine:
1. mast cells
2. basophils
3. platelets
88
The source of serotonin:
platelets
89
The newly synthesized mediators of inflammation include:
1. prostaglandins
2. leukotrienes
90
The source of prostaglandins:
1. all leukocytes
2. platelets
3. EC
91
The source of leukotrienes:
all leukocytes
92
Both histamine and serotonin are both ____ chemical mediators of inflammation
Preformed (in secretory granules)
93
Both prostaglandins and leukotrienes are _____ chemical mediators of inflammation
Newly synthesized
94
Arachidonic acid metabolites=
eicosanoids
95
When take drugs for an inflammatory process this is where the drugs act:
Arachidonic acid metabolite (eicosanoids)
96
______ act on phospholipase preventing arachidonic acid
steroids
97
_____ act on cyclooxygenase preventing prostaglandins
aspirins/NSAIDs
98
What do steroids act on? What does this prevent?
Phospholipases; arachidonic acid
99
What do aspirins/NSAIDs act on? What does this prevent?
Cyclooxygenase; prostaglandind
100
Cell membranes phospholipids produce arachidonic acid, which forms (2):
1. leukotrienes
2. prostaglandins
101
Responsible for vasodilation/vasoconstriction, chemotaxis of neutrophils and bronchospasm:
Leukotrienes
102
Responsible for vasodilation/vasoconstriction, promotion/inhibitions of platelet aggregations and pain/fever in inflammation:
Prostaglandins
103
-persistent infection (example mycobacteria)
-prolonged exposure to toxic agents
-exogenous (example silicosis- exposure to foreign agent)
-endogenous (example atherosclerosis - plaque buildup within blood vessels)
-immune-mediated inflammatory disease
-autoimmune diseases (RA)
-unregulated responses against microbes (example IBS)
-immune responses against environmental substances- allergic disease (example bronchia asthma)
Causes of chronic inflammation
104
What are the morphological features of chronics inflammation? (3)
1. mononuclear cell infiltration
2. tissue destruction
3. angiogenesis & fibrosis
105
A pattern of chronic inflammation that is non-exudative; aggregates of epithelioid macrophages (activated; histiocytes)
Granulomatous inflammation
106
Describe the exudative pattern of granulomative inflammation:
Non-exudative
107
The macrophages involved in granulomatous inflammation are considered:
Epithelial histocytes
108
Discuss characteristic cells of granulomatous inflammation: (3)
1. aggregates epithelioid macrophages (epithelial histiocytes)
2. multinucleate giant cells (langhans giant cells)
3. mononuclear leukocytes (mainly lymphocytes & occasionally plasma cells on periphery)
109
Granulomatous inflammation is a type of _______ inflammation
chronic
110
There is a _____ variable in granulomatous inflammation
fibrosis
111
What are the two classifications of granulomas?
1. immune granulomas
2. foreign body granulomas
112
-Coccidioides immitis (fungal organisms inside giant cell) is an example of:
immune granuloma
113
-Tuberculosis (bacterial infection that contains necrotizing granulomas) is an example of:
immune granuloma
114
-Mycobacterium TB (intracellular pathogen, blocks fusion of phagosome with lysosome) is an example of:
immune granuloma
115
-Sarcoidosis (immune-mediated condition) is an example of:
immune granuloma
116
-Coccidioides immitis
-Tuberculosis
-Mycobacterium TB
-Sarcoidosis
These are all example of:
Immune granulomas
117
Forms when a foreign body (i.e., wood splinter) enters soft tissue and inflammation follows:
Foreign body granuloma
118
-reparative tissue (example- pyogenic granuloma)
-contains endothelial cells and fibroblasts
-formation of BVs
-body repairing from some type of injury
Granulation tissue
119
Granulation tissue may be considered _____ tissue
reparative
120
What type of cells are present in granulation tissue?
Endothelial cells and fibroblasts
121
The formation of BVs is characteristic of:
Granulation tissue
122
If the body is repairing from some type of injury, what tissue will be seen?
Granulation tissue
123
-contains granulomas (very specific type of chronic inflammation)
-the granulomas within consist of epithelial histiocytes, giant multinuclear cells, and mononuclear leukocytes
Granulomatous tissue
124
Granulomatous tissue contains _____ and is a very specific type of _____
granulomas; chronic inflammation
125
What is within the granulomas of granulomatous tissue?
Epithelial histiocytes, giant multinuclear cells, and mononuclear leukocytes
126
A pyogenic granuloma is ____ NOT _____
granulation tissue; granulomatous tissue
127
The neutrophilia seen in leukocytosis (a systemic manifestation of acute inflammation) represents a shift:
To the left
128
Restoration of tissue architecture and function after an injury:
Wound healing and repair
129
Repair of wound may occur by ____ or ____
regeneration or healing (scar formation)
130
Growth of cells and tissues to replace lost structures:
Regerneation
131
What are the three components of regeneration?
1. continuously dividing tissues (labile)
2. stabile tissues (quiescent)
3. permanent tissues (non-dividing)
132
Continuously dividing tissues of regeneration:
Labile tissues
133
Stable tissue of regeneration:
Quiescent tissues
134
Permanent tissues of regeneration:
Non-dividing tissues
135
Consists of variable proportions of two distinct processes- regeneration and scarring (fibrosis):
Healing
136
Healing consists of variable proportions of two distinct processes, including:
1. regeneration
2. scarring (fibrosis)
137
Scarring occurs if: (3)
1. tissue is intrinsically unable to regenerate (heart, brain)
2. underlying connective tissue scaffolding is disrupted
3. following extensive exudates (organization)
138
Scarring occurs in tissues that are intrinsically unable to regenerates such as:
Heart and brain
139
If the underlying connective tissue scaffolding is disrupted what may occur?
Scarring
140
Regeneration: Cell classification
-Labile cells are derived from the division of:
Stem cells
141
Regeneration: Cell classification
-Labile cells are derived from the division of stem cells: (4)
1. hematopoietic cells
2. surface epithelium
3. stratified squamous epithelium of skin, mouth, pharynx, esophagus, vagina & cervix
4. GI tract epithelium
142
Regeneration: Cell classification
-Labile tissue can readily regenerate after injury as long as:
the pool of stem cells is preserved
143
Regeneration: Cell classification
-the most common forms of cancer arise from:
Labile tissues
144
Regeneration: Cell classification
-The most common forms of cancer arise from labile tissues including: (5)
(list tissue and associated cancer)
1. epidermis- skin cancer
2. bronchial mucosa- lung cancer
3. oral mucosa- oral cancer
4. cervical mucosa- cervical cancer
5. hematopoietic tissue- leukemias
145
Regeneration: Cell classification
-stable tissues
Quiescent
146
Regeneration: Cell classification
-stable cells are quiescent and have a:
very low rate of turnover
147
Regeneration: Cell classification
-in stable tissues, replacement is carried out by:
mitotic division of mature cells
148
Regeneration: Cell classification
-in stable tissues, replacement is carried out by mitotic division of mature cells including: (4)
1. viscera (liver, kidney, pancreas)
2. endothelial cells
3. fibroblasts
4. smooth muscle cells
149
Regeneration: Cell classification
-with the exception of ____, stable tissue have limited capacity to regenerate
liver
150
Regeneration: Cell classification
-what tissues have a limited capacity to regenerate?
stable tissues
151
Regeneration: Cell classification
-malignant tumors of ____ tissues are among the rarer forms of cancer
stable tissues
152
Regeneration: Cell classification
-permanent tissues are considered
non-dividing
153
Regeneration: Cell classification
-permanent cells were generated during ____ and:
Fetal life; never divide in postnatal life
154
Regeneration: Cell classification
-describe the replacement of permanent tissues
Can NOT be replaced if lost
155
Regeneration: Cell classification
-permanent tissues cannot be replaced if lost, these include:
1. neurons
2. cardiac myocytes
156
Regeneration: Cell classification
-because permanent tissues cannot be replaced if lost, repair is dominated by:
Scar formation
157
The objectives of wound healing include: (2)
1. epithelial regeneration
2. connective tissue repair
158
Wound healing characterized by restoring the integrity of the epithelial surface:
epithelial regeneration
159
Wound healing characterized by restoring tensile strength of the sub-epithelial tissue:
connective tissue repair
160
Occurs when wound margins are pulled together- suture:
Healing by primary intention
161
Example- mucocele - surgeons make incision and remove sac of fluid
Healing occurs by:
Primary intention
162
All wound healing involves ______, even without an infection
Inflammatory reaction
163
Occurs when the wound margin are NOT pulled together:
Healing by secondary intention
164
Example- tumor on hard palate- not a lot of tissue here so can't close it after biopsy; let open wound fill in with granulation tissue- endothelial cells, fibroblasts, and myofibroblasts
Healing occurs by:
Secondary intention
165
Wound contraction by myofibroblasts of granulation tissue is characteristic of:
Healing by secondary intention
166
Excessive scar formation formed WITHIN the boundaries of original wound:
Hypertrophic scar
167
Excessive scar formation that grows BEYOND boundaries of original wound; common in African Americans:
Keloid
168
What may cause a deficiency in wound healing?
Vitamin C deficiency (Scruvy)
169
In wound healing, why is vitamin C important?
Vitamin C is required for the hydroxylation of proline and lysine (forms collagen)
170
