Lewis Ch 11 (inflammation) Flashcards
what are the three purposes of inflammation
- Neutralizes and dilutes inflammatory agent
- Removes necrotic materials
- Establishes an environment suitable for healing and repair
four steps of the inflammatory response
- vascular response
- cellular response
- formation of exudate
- healing
explain the vascular response during inflammation
- brief vasoconstriction
- release of chemical mediators (histamine, kinins, prostaglandins)
- vasodilation and increased capillary permeability
- fibrinogen converted to fibrin
- clot
what chemical mediators are released during vascular response (3)
histamine
kinins
prostaglandins
explain the cellular response during inflammation
- chemotaxis (WBCs to injury: neutrophils, monocytes, lymphocytes, macrophages)
- immune response
- phagocytosis
what is the first leukocyte to arrive at site of injury during cellular response
neutrophil
what leukocytes have a short life span, are phagocytic, accumulate as pus
neutrophil
mature neutrophils are called
segmented neutrophils
immature neutrophils are called
bands
increase in immature band neutrophils is called
shift to the left
Second type of phagocytic cells to migrate to site of injury during cellular response
monocytes
what cell transforms to macrophages, have a long life span, and are phagocytic
monocytes
chemical mediator that is proinflammatory, is a Potent vasodilators that contributes to increased blood flow and edema, and stimulates fever
prostaglandins
chemical mediator that is a Powerful vasoconstrictor that causes pallor at site
thromboxane
chemical mediator that is a slow reacting substance of anaphylaxis (SRS-A), Constricts smooth muscle of bronchi, causes Increased capillary permeability
leukotrienes
type of inflammatory exudate: accelerates mucus production (ex: runny nose with upper resp tract infection)
catarrhal
type of inflammatory exudate: occurs with increasing vascular permeability and fibrinogen leakage into interstitial spaces (ex: adhesions)
fibrinous
type of inflammatory exudate: results from rupture/necrosis of blood vessel walls (ex: hematoma)
hemorrhagic
type of inflammatory exudate: consists of WBCs, microorganisms, liquified dead cells, and other debris (ex: boil, abscess)
purulent (pus)
type of inflammatory exudate: composed of RBCs and serous fluid, occurs during healing after surgery or tissue injury
serosanguinous
type of inflammatory exudate: results from outpouring of fluid (ex: skin blister)
serous
what are five local manifestations of inflammation
- heat
- loss of function
- swelling
- redness
- pain
what are five systemic manifestations of inflammation
- WBC “shift to the left”
- malaise
- nausea
- increased pulse and respiratory rate
- fever
what part of the brain raises the thermostatic set point during fever
hypothalamus
what chemical mediator (cytokine) triggers fever
prostaglandins
4 beneficial defense mechanisms of fever
- increased killing microorganisms
- increased phagocytosis
- increased production T cells
- increased interferon activity
predominant cell type at site of acute inflammation
neutrophil
Predominant cell types during chronic inflammation
lymphocyte
macrophage
two major components of process of healing during inflammation
regeneration
repair
three types of wound healing
primary: approximated
secondary: nonapproximated
tertiary: delayed suturing
what depth of tissue loss is involved in superficial tissue injury
epidermis
what depth of tissue loss is involved in partial thickness tissue injury
extends to dermis
what depth of tissue loss is involved in full thickness tissue injury
can extend to bone
abnormal passage between organs or a hollow organ and skin
fistula
complication of healing: separation of previously joined edges
dehiscence
five complications of healing
infection fistula formation hemorrhage hypertrophic scars keloid scars
what is the first and second most common sites for pressure injuries
- sacrum
2. heels
pressure exerted on the skin when it adheres to the bed and skin layers slide in the direction of body movement (pulling patient up in bed)
shear
steps for production of fever
- cytokines released
- raised thermostatic set point
- increased muscle contraction
- shivering
- vasoconstriction
- decreased sweating
what drugs inhibit prostaglandin synthesis
- tylenol
- NSAIDs
- aspirin (salicylates)
replacement of lost cells and tissues with cells of the same type
regeneration
more common type of healing with connective tissue to replace lost cells;usually results in scar formation.
repair
3 phases in primary intention healing
- initial inflammatory phase
- granulation phase
- maturation and scar contraction
immature connective tissue cells that migrate into the healing site and secrete collagen
fibroblasts
