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YR 3 - Illness and Wellbeing > Pathology - Inflammation and Repair Review > Flashcards

Pathology - Inflammation and Repair Review Flashcards

1
Q

what is inflammation?

A

a response from vascularised tissue to injury

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2
Q

4 purposes of inflammation

A
  • deliver necessary components to site
  • isolate injury
  • destroy microbes
  • remove debris
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3
Q

2 types of inflammation

A

acute
chronic

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4
Q

what is the dominant cell in acute inflammation?

A

neutrophil

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5
Q

what is the dominant cell in chronic inflammation

A

lymphocytes/macrophages

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6
Q

describe acute inflammation - onset, duration

A

early onset
short duration

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7
Q

describe chronic inflammation - onset, duration

A

later onset
longer duration

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8
Q

5 signs of inflammation

A

calor - heat
dolor - pain
rubor - redness
tumour - swelling
function laesa - loss of function

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9
Q

what are the 5 R’s?

A

recognition
recruitment
removal
regulation
repair

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10
Q

define acute inflammation

A

rapid host response that delivers:
- leukocytes
- plasma proteins - antibodies and fibrinogen
to sites of infection or tissue injury

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11
Q

what changes occur in acute inflammation?

A

vascular and cellular reactions:

  • increased vasodilation
  • increased vascular permeability
  • recruitment of leukocytes
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12
Q

what does increased vasodilation and vascular permeability lead to?

A

oedema

  • protein rich exudate releases into the extravascular tissues
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13
Q

what affect does oedema have on the blood flow?

A

the blood flow decreases and the viscosity increases as the concentration of RBC increase

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14
Q

what does slower blood flow lead to?

A

stasis

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15
Q

what are the 5 step cellular changes in acute inflammation?

A
  1. margination
  2. rolling
  3. adhesion
  4. migration
  5. chemotaxis
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16
Q

describe margination (2)

A

vascular stasis
neutrophils move out from central axis toward vessel wall

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17
Q

describe rolling.

A
  • cytokines activate endothelial selectins
  • neutrophil surface ligand interact with the selectins
  • roll along the surface
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18
Q

what is a selectin?

A

self-adhesion molecule

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19
Q

describe adhesion.

A
  • change in integrin
    = higher affinity binding site to selectins
  • neutrophil stops rolling
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20
Q

describe migration.

A

neutrophil moves across blood vessel wall via PECAM-1

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21
Q

describe chemotaxis

A

neutrophils exit
move to site of injury via chemokine gradient

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22
Q

what are 2 types of chemokine? give examples.

A

exogenous - bacterial products
endogenous - cytokines, complement, arachidonic acid metabolites

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23
Q

3 Roles of a Neutrophil

A

phagocytosis
engulfment
killing/degradation

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24
Q

6 Benefits of acute inflammation

A
  • dilute toxins
  • antibodies
  • drug delivery
  • nutrient and oxygen delivery
  • fibrin formaiton
  • stimulates immune response
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25
Q

3 Harmful Effects of Acute Inflammation

A
  • lysosomal enzymes can digest normal tissue
  • swelling
  • may be inappropriate response
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26
Q

4 ways in which acute inflammation may appear as a morphological pattern

A

SEROUS INFLAMMATION

FIBRINOUS INFLAMMATION

PURULENT/SUPPURATIVE INFLAMMATION

ULCERATION

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27
Q

How does Serous Inflammation Appear Morphologically?

A
  • exudation of cell-depleted fluid into body cavity
  • few microbes and cells
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28
Q

How does Fibrous Inflammation Appear Morphologically?

A

formation of fibrin

29
Q

How does Purulent Inflammation Appear Morphologically?

A
  • infection + neutrophils
  • lead to necrosis
  • lead to pus
30
Q

How does Ulceration Appear Morphologically?

A
  • loss of surface integrity due to shedding of necrotic tissue
31
Q

what is an abscess?

A

a localised collection of pus

32
Q

what is pus-producing bacteria called?

A

pyogenic

33
Q

what happens if acute inflammation persists, non-resolving or may be too prolonged?

A

chronic inflammation

34
Q

what inflammation is atheroscelerosis? how is it induced?

A

chronic
induced by tissue deposition of lipids/cholestrol

35
Q

4 Features of chronic inflammation

A
  • mononuclear cell infiltration
  • macrophages
  • tissue destruction
  • healing
36
Q

How does Healing Appear?

A

blood vessel proliferation - angiogenesis
granulation tissue

37
Q

Roles of a Macrophage

A

phagocytic
initiate tissue repair - scar or fibrosis
secrete inflammatory mediators
interact with lymphocytes - present antigen

38
Q

What Is Granulomatous Inflammation?

A

a distinctive pattern of chronic inflam
the bodies response to try contain agents which are difficult to eradicate

39
Q

Name 7 Conditions which can Lead to Granulomatous Tissue.

A

tuberculosis
leprosy
syphilis
cat-scratch disease
sarcoidosis
Crohn disease
industrial dust exposure

40
Q

How do granulomas appear microscopically?

A
  • aggregation of macrophages
  • collar of mononuclear leukocytes
  • giant cells
41
Q

what are the 2 types of giant cells and how do they present?

A

peripheral nuclei - look like horse shoe
= langerhans giant cell
- very common with tuberculosis

haphazard nuclei
= foreign body type

42
Q

Define Resolution

A

the complete restoration of normal tissue architecture without scarring through regeneration

43
Q

define regeneration

A

when existing cells or stem cells are proliferating to restore damaged tissues

44
Q

define organisation

A

replacing damaged tissues using granulation tissue

45
Q

define scar formation

A

form of tissue repair occurring in tissues unable to regenerate or too severely damaged to adequately support regeneration

46
Q

define fibrosis

A

the deposition of excessive collagen in response to chronic inflammation or tissue necrosis

47
Q

After inflammation, repair occurs in which two processes ?

A

regeneration or scar formation

48
Q

define tissue repair

A

restoration of tissue architecture and function

not resolution

49
Q

define regeneration

A

the proliferation of residual cells within a tissue to restore the damaged tissue

50
Q

what does the ability of a tissue to regenerate depend on? (3)

A
  • intrinsic proliferative capacity
  • presence of stem cells
  • integrity of supporting connective tissue framework
51
Q

regarding regeneration and scar formation, what are the differences in origin and end point?

A

regeneration
the process that results in resolution
- from mild injury

scar formation
connective tissue deposition
- from severe injury

52
Q

for an example, give two mechanism in which the liver regenerates.

A

proliferation of existing hepatocytes
replacing cells by progenitor stem cells

ONLY IF EXTRA-CELLULAR MATRIX IS INTACT

53
Q

what condition from alcohol use leads to scarring of the liver with impaired regeneration and nodules of tissue?

A

cirrhosis

54
Q

what condition includes scarring of the lungs?

A

fibrosis - damage to connective tissue

55
Q

what is a scar?

A

the end result of replacement of any tissue parenchyma by collagen

56
Q

define ischaemia

A

an inadequate blood supply to an organ or part of the body, especially the heart muscles

57
Q

3 steps in scar tissue formation

A

inflammation

cellular proliferation
- angiogenesis
- fibroblasts - deposit collagen

maturation
-granulation tissue formation (organisation)
- cellular migration - TGFb in granulation tissue
- deposition of connective tissue

maybe wound contraction if its a large surface

58
Q

what type of macrophage is involved in scar tissue formation?

A

M2 alternatively activated macrophage

59
Q

how is angiogenesis regulated?

A

the release of angiogenic factors
stimulate blood vessel growth

60
Q

how does granulation tissue form?

A

from fibroblast proliferation

61
Q

what is the process of wound contraction

A

fibroblasts convert into
- myofibroblasts like smooth muscle and contract

62
Q

what is the purpose of wound contraction

A

to reduce the wound size

63
Q

what are the two processes which come under cutaneous wound healing?

A

primary and secondary intention

64
Q

what is primary intention healing?

A

when the wound is thin, small and little fibrosis

65
Q

what is secondary intention healing?

A

when the wound is large, clot, more granulation tissue
wound contraction

66
Q

what if there is is inadequate granulation tissue formation?

A

leads to wound dehiscence and ulceration

67
Q

what does excessive formation of tissue repair lead to?

A

hypertrophic scars
keloids

68
Q

in acute inflammation, what does the serum exudate mainly consist of? (2)

A

fibrinogen
immunoglobulins

69
Q

what embolism can only occur in individuals with heart defects?

A

paradoxical embolisms

YR 3 - Illness and Wellbeing (31 decks)

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