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General Pathology > Pathology inflammation 2 > Flashcards

Pathology inflammation 2 Flashcards

0
Q

Continually dividing cells

A

Undifferentiated stem cells divide by mitosis and then differentiate and replace cells that were lost due to tissue destruction
e.g. skin cells

Outcome: resolution- minimal tissue damage

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1
Q

Healing and repair of tissue loss

A
  1. Continuously dividing/mitotic/labile cells (skin)
  2. Quiescent/facultative mitotic/stable cells (liver)
  3. Non-dividing/post-mitotic permanent cells (neuron)
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2
Q

Quiescent, facultative mitotic cells

A

Cells do not divide regularly but can be stimulated to divide if necessary to replace cells lost by tissue damage e.g. liver cells

Outcome: Regeneration, can be limisted

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3
Q

Non Dividing cells post mitotic cells (permanent cells)

A

No capacity to divide and regenerate under any circumstances. E.g. Neurons
Outcome: replacement of parenchymal tissue with connective tissue leads to loss of functional capacity

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4
Q

Healing - by first intention

A

the process involved when the wound is clean, free of foreign material an necrotic tissue and the edges are close together

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5
Q

Healing by second intention

A

the situation where there is a large break in the tissue more inflammation a longer healing period and more scar tissue

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6
Q

cells participating in Healing wounds

A

Leukocytes (WBC)
-PMNs
Connective tissue cells
Epithelial cells - undergo mitosis and extend across the wound
-macrophages: stay longer at the site of healing and produce many cytokines, growth factors and mediators
-other connective tissue: Myofiboblast-hybrid properties of smooth muscle cells and fiboblasts
-Angioblast- precursors to blood vessesls
-Fibroblasts - produce most of the extracellular matrix

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7
Q

Healing process

A
  • Blood clots forms and seals the area
  • Inflammation develops
  • phagocytes, monocytes, macrophages remove cellular debris
  • Granulation tissue grows into the gap
  • tissue is fragile
  • Epithelial cells undergo mitosis and extend across the wound
  • fibrolasts enter the area and produce collagen (a protein that is the basic component of scar tissue and provides strength of repair)
  • Fibroblasts and macrophages produce cytokines to attract more fibroblasts
  • Fibroblasts stimulate epithelial cell proliferation and migration and promote development of new blood vessels
  • cross linking and shortening of collagen fibers promotes formation of tight strong scar
  • capillaries in the area decrease
  • scar tissue is not normal functional tissue
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8
Q

Factors promoting healing

A 
Youth
Good nutrition
Adequate hemogloblin
Effective circulation
clean wound
no foreign bodies
no complications
small wound
site of wound
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9
Q

Factors delaying healing

A 
advanced age
poor nutrition
anemia
poor circulation
presence of other disorders (diabetes)
Irritation or excessive mobility
infection, foreign materials 
large sized wound
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10
Q

Complications of healing

A
  1. loss of function
  2. deficient star formation
  3. excessive scar formation
  4. infection
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11
Q

Complication of healing -excess scar formation

A

Keloids-overgrowth of scar tissue with excessive collagen
Contracture-fixation and deformity of the joint
Adhesions-bands of scar tissue that join two normally separated surfaces, e.g. intestine

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12
Q

Complications of wound healing - Infection

A

May develop in an inflamed tissue because microorganisms can more easily penetrate when the barrier is damaged and the blood supply is impaired

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13
Q

Classification of inflammation

A
  1. Duration- How long is it?
  2. Etiology-What caused it?
  3. Location-where is it?
  4. Morphology (pathology) - what does it look like?
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14
Q

Classification of inflammation

A

Duration - how long is it
Etiology - what caused it?
Location - where is it?
Morphology (pathology) - what does it look like?

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15
Q

Acute inflammation

A

Process initiated by local vessels near injured tissue
Vessels alter permeability of walls to allow emigration of leukocytes into the area
Leaukocytes migrate along a chemotactic gradient to reach site of injury where they attempt to repair and remove stimulus
Cascade of biochemical events propagates the response involving vascular system, immune system, cells
self regulation of the inflammatory response concludes acute inflammation
removal of stimuli stops the response of the inflammatory process
inflammatory response requires constant stimuli to propagate the process
Outcomes - resolution, abscess formation, chronic inflammation

16
Q

Chronic Inflammation

A

May represent prolonged acute inflammation or persistence of causative agents
Not necessarily characterized by classic signs and symptoms of acute inflammation
onset - delayed
Duration-months, years
Outcomes - tissue destruction, fibrosis

17
Q

Etiology of inflammation

A

Infections - bacteria, viruses, protozoa, fungi, helminthis (worms)
Chemical - organic or inorganic, industrial, medicinal
Physical - foreign bodies, heat, irradiation, trauma
Immune
Often the etiology is multifactoral

18
Q

Location of Inflammation

A

Localized (e.g. sprain)

Systematic (widespread,e.g. sepsis often begins as localized)

19
Q

Morphology of Inflammation

A
  1. serous
  2. Fibrinous
  3. Purulent
  4. Ulcerative
  5. Pseudomembranous
  6. Chronic
  7. Granulomatous
20
Q

Serous Inflammation

A

Mildest form of inflammation
Characterized by clear fluid
Occurs in early stages of inflammation, typcal in viral infections, arthritis, burns
Generally self-limiting
Generally resolves easily and without consequence

21
Q

Fibrinous inflammation

A

Exudate is rich in fibrin (protein)
Indicative of a more severe inflammation
Seen in bacterial infections, strep throat, bacterial pneumonia, bacterial pericarditis
Does not resolve as easily
Leads to growth of fibrous tissue (scarring) in the parenchyma
Consequence loss of function

22
Q

Purulent inflammtion

A

Typically caused by pus-forming bacteria such as sraphylococci and streptococci
Pus can accumulate on the mucosa or skin or in internal organs
Abscess - localized collection of pus

23
Q

Ulcerative inflammation

A

Inflammation of body surfaces or mucosa
Leads to ulceration or necrosis of epithelial lining
Ulcer- defect involving the epithelium, can also extend into the connective tissue
E.g.peptic ulcer in stomach

24
Q

Pseudomembranous inflammation

A

Combination of ulcerative, fibrinous and purulent inflammation
exudate of fibrin, pus, cellular debris and mucous forms a pseudomembrane on the surface of ulcers
E.g. Diphteria - pseudemembranes form on the throat, can be scraped away to expose ulcerated defects that bleed

25
Q

Chronic inflammation

A

Exudate contains monocytes, lymphocytes, macrophages, plasma cells
Secretory products of chronic inflammatory cells stimulate proliferation of fibroblasts and perpetuate inflammation by constantly recruiting new inflammatory cells
Loss of parenchyma is accompanied by scarring
May lead to loss of function
E.g. scarring of Fallopian tubes associated with pelvic inlfammatory disease can lead to infertility
E.g. Fibrosis associated with chronic lung disease can impair passage of oxygen in to lungs
Functional consequences can lead to many serious symptoms

26
Q

Granulomatous inflammation

A

special form of chronic inflammation that is not preceded by acute inflammation
T-lymphocytes and macrophages accumulate at the site of injury
Lymphocytes release cytokines that transform macrophages into epithelioid cells
Epithelioid cells fuse with one another to form multinucleated giant cells
Multinucleated giant cells epithelioid cells and lymphocytes aggregate into nodules called granulomas
Granulomas destroy tissue and persist for a long time
E.g. syphilis, tuberculosis

27
Q

Granuloma consists of

A

Lymphocytes
Epithelioid cells (macrophages)
Multinucleated giant cells

28
Q

Clinical correlations of inflammation

A

Clinical findings of inflammation

  • fever-elevation in body temperature that exceeds 37 degrees celsius
  • caused by pyrogenic cytokines; interleukin 1 (IL-1) and tumour necrosis factor (TNF)
  • Leukocytosis - increase in circulating WBCs
  • Constitutional symptoms - non-specific, include fatigue, weakness, depression, malaise, lack of appetite, achiness etc.
29
Q

Inflammatory disorders

A 
Immune disorders
infections
injuries
arthritis
Cancer

General Pathology (12 decks)

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