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NYCC Physiopathology > Outcomes of Inflammation > Flashcards

Outcomes of Inflammation Flashcards

1
Q

What is granulomatous inflammation? What cells are unique to a granuloma?

A

Morphological pattern of chronic inflammation with epitheloid cells (Macrophages), CD4+ lymphocytes, giant cells (fused macrophages), and fibroblasts

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2
Q

What unique macrophage is present in granulomas caused by tuberculosis?

A

Langhan’s giant cells

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3
Q

What is the name given to the initial “pre-scar” tissue seen in the early stages of healing by fibrosis?

A

Granulation tissue

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4
Q

What cell type is important in wound contraction?

A

Myofibroblasts

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5
Q

What is a primary wound healing response initiated in response to?

A

Stitches and surgical incisions

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6
Q

What is a secondary wound healing response initiated in response to?

A

Open wounds and abrasions

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7
Q

What are the four outcomes of acute inflammation?

A

Resolution, abcess/suppuration, fibrosis, becomes chronic inflammation

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8
Q

What is the usual outcome in an acute pattern of inflammation?

A

Resolution

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9
Q

What is an abscess made from?

A

Fibrin

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10
Q

What is the duration marker for chronic inflammation?

A

Three weeks or greater (anything shorter is acute)

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11
Q

What are the causes of chronic inflammation?

A

Persistent microbial infection, prolonged exposure to toxins, autoimmune diseases, cancers

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12
Q

What hypersensitivity reactions cause chronic inflammation?

A

Type II and III

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13
Q

What is the hallmark cell of granulomatous inflammation?

A

Epithelioid cell (activated macrophage)

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14
Q

What pathologies and foreign objects can cause granulomatous inflammation?

A

Tuberculosis, histoplasmosis, sutures, asbestos, silica gel, Crohn’s disease, sarcoidosis, leprosy, syphilis

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15
Q

What cells are present in a granuloma?

A

Epithelioid cells, giant cells, fibroblasts, CD4+ lymphocytes

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16
Q

What is the number one disease presenting with caseous necrosis? What other fungal pathology can cause it?

A

1 = Tuberculosis; #2 = Histoplasmosis

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17
Q

What are the outcomes involved in the wound healing repair process?

A

Total reconstruction by regeneration or resolution
Partial reconstruction
Universal repair tissue (fibrous scar)

18
Q

What are the four components of wound healing and repair?

A

Angiogenesis (proliferating endothelial cells)
Proliferating fibroblasts
Deposition of ECM
Remodeling of CT

19
Q

What is granulation tissue composed of?

A

Proliferating capillaries
Proliferating fibroblasts and myofibroblasts
Extracellular fluid
Macrophages

20
Q

What are the functions of granulation tissue?

A

Fill in tissue “gaps”
Remove dead cell debris
Aid in wound contraction
Formation of “pre-scar”

21
Q

What is universal repair tissue equivalent to?

A

Fibrous connective tissue scar

22
Q

What is the first type of collagen laid down in wound healing?

A

Type III collagen

23
Q

What is the function of a myofibroblast?

A

Wound contraction for primary and secondary union healing

24
Q

Granulation tissue is always (Acute/Chronic)?

A

Acute

25
Q

What immune response is granulation tissue associated with?

A

Innate immune response

26
Q

What are the steps of primary and secondary union and timeframes?

A

Blood clot fills incision (4-16 minutes)
Neutrophils infiltrate (less than 24 hrs)
Epithelium continuity is restored (less than 24 hrs)
Macrophages infiltrate (Day 3)
Granulation tissue fills incision (Days 5-7)
Progressive Collagenization (Day 7)
Remodeling (3 months)

27
Q

What is different about a secondary union wound healing process?

A

More granulation tissue
Prolonged inflammatory response
More debris and inflammatory exudate
More scar tissue formation
More myofibroblast activity

28
Q

What are local factors that influence wound healing?

A

Type, size, and location
Vascular supply
Infection
Movement

29
Q

What are systemic factors that influence wound healing?

A

Circulatory status
Infection
Malnutrition

30
Q

What are examples of complications of normal wound healing?

A

Proud flesh, keloid, wound dehiscence, contracture

31
Q

Where are the highest amount of continuous capillaries located in the body which can be implicated in faster wound healing?

A

Face

32
Q

What is proud flesh?

A

Excessive granulation tissue

33
Q

What is a keloid?

A

Hypertrophic scar with excessive collagen deposition

34
Q

What is one way that a keloid commonly forms?

A

Piercings

35
Q

In what population is a keloid most common?

A

African American

36
Q

Diabetics have (Better/Worse) wound healing characteristics?

A

Worse

37
Q

What is wound dehiscence?

A

Mechanical stress resulting in the reopening of a scar or wound

38
Q

What is contracture?

A

Excessive wound contraction by myofibroblasts resulting in shortening of tendons

39
Q

What traumatic injury can result in excessive wound contracture?

A

3rd degree burns, Achilles rupture repair

40
Q

What are important characteristics/mechanisms regarding cauliflower ear?

A
  • Inflammatory serous or purulent exudate due to traumatic injury resulting in injury to an arteriole
  • may also result in dystrophic calcification

NYCC Physiopathology (28 decks)

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