Porth Chapter 14 Flashcards
Cardinal signs of inflammation
- rubor (redness)
- tumor (swelling)
- calor (heat)
- dolor (pain)
- functio laesa (loss of function)
Factors involved in protective responses and bodily repair
- inflammatory reaction
- immune response
- tissue repair and wound healing
Causes of Inflammation
- immune response to infectious organisms
- trauma
- surgery
- caustic chemicals
- extremes of heat and cold
- ischemic damage to body tissues
Granulomatous Inflammation
Associated with foreign bodies such as:
- splinters
- sutures
- silica, asbestos
Associated with microorganisms that cause:
- tuberculosis
- syphilis, sarcoidosis
- deep fungal infections
- brucellosis
Vascular changes that may occur with inflammation
- An immediate transient response - occurs with minor injury
- An immediate sustained response - occurs with more serious injury and continues for several days and damages the vessels in the area
- A delayed hemodynamic response - involves an increase capillary permeability that occurs 4 to 24 hours after injury
Cellular stage of acute inflammation
marked by movement of phagocytic white blood cells (leukocytes) into the area of injury; two types of leukocytes participate in the acute inflammatory response:
- granulocytes (neutrophils, eosinophils, and basophils)
- monocytes (the largest of the white blood cells)
Direction of cellular response
- margination, adhesion, transmigration
- cytokines - adhesion molecules
- selectins, integrins, and immunoglobulin
- initiation of adhesion
- aggregation of inflammatory cells
- movement into underlying tissue
Inflammatory mediators
- histamine
- cytokines
- arachidonic acid metabolites
- eicosanoids (prostaglandins, leukotrienes, Omega-3 polyunsaturated fatty acids) - platelet-activating factor
- plasma proteins
Classification of Inflammatory mediators by function
- those with vasoactive and smooth muscle-constricting properties
- chemotactic factors such as complement fragments and cytokines
- plasma proteases that can activate complement and components of the clotting system
- reactive molecules and cytokines liberated from leukocytes, which when released into the extracellular environment can damage the surrounding tissue
Serous exudates
watery fluids low in protein content, result from plasma entering the inflammatory site
hemorrhagic exudates
occur when there is severe tissue injury that causes damage to blood vessels or when there is significant leakage of red cells from the capillaries
membranous or pseudomembranous exudates
develop on mucous membrane surfaces, are composed of necrotic cells enmeshed in a fibropurulent exudate
purulent or suppurative exudates
contain pus; composed of degraded white blood cells, proteins, and tissue debris
fibrinous exudates
contain large amounts of fibrinogen and form a thick and sticky meshwork
acute inflammation
short duration; nonspecific early response to injury; aimed primarily at removing the injurious agent and limiting tissue damage; self limited; infiltration of neutrophils; exudate
chronic inflammation
longer duration lasting for days to years; a recurrent or progressive acute inflammatory process or a low-grade smoldering response that fails to evoke an acute response; self-perpetuating; infiltration by mononuclear cells (macrophages) and lymphocytes; proliferation of fibroblasts
Most prominent systemic manifestations of inflammation
acute-phase response; alterations in white blood cell count (leukocytosis and leukopenia)
Parenchymal
tissues contain the functioning cells of an organ or body part (hepatocytes, renal tubular cells)
Stromal tissues
consist of the supporting connective tissues, blood vessels, extracellular matrix, and nerve fibers
Labile
continue to divide and replicate throughout life, replacing cells that are continually being destroyed
Stable
normally stop dividing when growth ceases
Permanent cells
cannot undergo mitotic division
healing objective
to fill the gap created by tissue destruction and to restore the structural continuity
primary healing
small, clean wound
secondary healing
great loss of tissue with contamination
components of Extracellular matrix
- fibrous structural proteins
- collagen and elastin fibers - water-hydrated gels that permit resilience and lubrication
- proteoglycans and hyaluronic acid - adhesive glycoproteins that connect the matrix elements to each other and to cells
- fibronectin and laminin
basement membrane (ECM)
surrounds epithelial, endothelial, and smooth muscle cells
interstitial matrix (ECM)
present in the spaces between cells the connective tissue and between the epithelium and supporting cells of blood vessels
steps in development of a new capillary vessel
- proteolytic degradation of the parent vessel basement membrane, allowing for formation of a capillary sprout
- migration of endothelial cells from the original capillary toward an angiogenic stimuli
- proliferation of the endothelial cells behind the leading edge of the migrating cells
- maturation of the endothelial cells and proliferation of pericytes (for capillaries) and smooth muscle cells (for larger vessels)
factors regulating the healing process
action of chemical mediators and growth factors that mediate the healing process; interactions between the extracellular and cell matrix
two phases of scar formation
- emigration and proliferation of fibroblasts into the site of injury; deposition of the ECM by these cells
causes of impaired wound healing
malnutrition, impaired blood flow and oxygen delivery, impaired imflammatory and immu
causes of impaired wound healing
malnutrition, impaired blood flow and oxygen delivery, impaired inflammatory and immune responses, infection, wound separation, foreign bodies, age effects
