Modalities Ch. 5 Flashcards
inflammatory response
a local response to an irritant
purpose of inflammation
defending the body against outside substances
disposing of dead and dying tissue
preparing the body for tissue repair
5 cardinal signs of inflammation
redness - rubor heat - calor swelling - edema pain - dolor lack of function - funca leasa
phases of inflammation
primary injury ultrastructural changes chemical mediation hemodynamic changes metabolic changes permeability changes leukocyte migration phagocytosis
primary injury
any occurrence that causes cell damage
ultrastructural changes
- what is it?
- result
changes to the cell that occur as a result of injury
cell eventually dies
changes can be a result of primary or secondary injury
chemical mediation
chemical changes are activated by structural changes
chemicals signal to the rest of the body
chemicals are largely responsible for regulation the inflammatory stage
names of chemicals or necessary parts
mast cells chemotactin histamine, kinins serotonin heparin
mast cells
where the chemicals come from
chemotactin
regulates chemotaxis (attraction and process of chemical transport)
histamine, kinins
capillary permeability
vasodilation
serotonin
cap. permeability
heparin
prevents the blood from clotting
hemodynamic
changes in blood flow
what hemodynamic changes occur?
- immediately
- following
immediate vasoconstriction -hypoxia triggers inflammatory response followed by vasolilation -release of platelets increase in capillaries -leukocytes (white blood cells) arrive
leukocyte function
move through capillaries and bind to endothelium (vessel wall)
follows the wall until it finds an opening to get through
metabolic changes function
cause further structural damage hypoxic environment is produced cells become anaerobic -less efficient dysfunction of the sodium pump cell eventually dies
intracellular acidosis
increased acid levels within the cells
lysosomes are overtasked with trying to remove the increased foreign matter
lysosome membranes rupture leading to enzymatic chaos in the cell that increases the tissue damage
lysosomes
contain enzymes that digest foreign matter within the cells
permeability changes
histamine, kinins and serotonic increase permeability of small blood vessels via chemotaxis
endothelial cells contract
leukocytes move through the endothelium into the injured tissue
permeability is a two-way street - out and in
proteins enter the blood stream
-increased viscosity
-increased hematoma
leukocyte migration
the more damaged tissue, the more leukocytes migrate to the area
neutrophils and macrophages
neutrophils
small and numerous first line of defense against infection die fighting within about seven hours their battles with other organisms may produce damage to adjacent tissue their death signals macrophages
macrophages
larger leukocytes reproduce responsible for cleaning up injury sites breakdown cellular debris so that it can be picked up by the lymph vessels produce cytokines
phagocytosis
digestion of cellular debris and other foreign material into pieces small enough to be removed from the injury site
secondary injury
body’s response to tissue damaged by trauma (primary injury) leads to further tissue damage
secondary enzymatic injury
cell death
lysosomes release enzymes
enzymes break down the membranes of neighboring live cells
excessive neutrophils lead to excessive tissue breakdown (theory)
secondary metabolic injury
hypoxia
cells have insufficient fuel
inadequate waste removal
cell death
swelling vs. edema
swelling: increase in tissue volume
edema: accumulation of the fluid portion of blood in the tissue
fluid dynamics
the movement of fluid between capillaries and tissue
normally balanced
an imbalance results in edema
-more fluid coming in that going out
hydrostatic pressure
capillary filtration pressure: the pressure difference between the inside the outside of a vellel
hydrostatic pressure: the pressure induced by a column of water. PUSHES WATER OUT
capillary hydrostatic pressure (CHP): forces fluid out of the capillary
tissue hydrostatic pressure (THP): forces fluid into the capillary
oncotic pressure
pressure resulting from the attraction of fluid by free proteins
tissue oncotic pressure (TOP): pulls fluid out of the capillary
capillary oncotic pressure (COP): pulls fluid into the capillary
fluid filtration in healthy tissue
slightly more going out of capillary (free proteins)
lymphatic system removes it
fluid filtration in injured tissue
hematoma (tissue debris and hemorrhage) dumps large amounts of fluid into the capillary
increases tissue oncotic pressure
treating swelling
swelling cannot be reversed further swelling can be prevented cold application decreases secondary metabolic injury decrease in proteins decrease in TOP
