Proliferative inflamamiton and healing Flashcards
what is proliferaiton and how can it happen
-increased number of cells in inflammatory region
2 ways: cell divisiona nd by vessles
proliferaiton of vv ariesee in tissues how
- endothelial proliferaiton of vv
- development form mesenchymal stem cells
proloferaiton of soft tissue cells1
- fibroblasts(ECM–>fibrocytes(inactive)
-developmet fomr mesenchymal stem cells
prolierfartion of previous tissue by cells(by healing roocess
- from stem cells
-less common from remnant of cells in tissye: liver
proliferation of acute inflamamiton(steps of inflammaiton)
- accummulation of inflammaotry cells form inflammatory exsudate
2.proliferation of immune system cells - proliferation of vvessles and fibroblasts
- when removed–>non specific granulation tissue
formaiton of non-sppecific granulation tissue
- profliferation of capp and macrophages
- prolif of fibroblasts
- ENDOTHELIAL CELLS-MACROPHAGES AND FIBROBLASTS - decrease of macrophages +syntheiss of extracellular components
- decrease of capp netwrok and stabilizaiton of vv(prolif of pericytes, formaiton of vv wall) and formaiton of final vascular network
- decrease iof fibroblast–>fibrocytes and acc of extracellular matrix (fibers)
- scarificaiton and retraction of scar (myofibroblasts)
healing ad integrum
healing without dmaage of prevoius structure aka regernaation
helaing as defactam
healing with damaged tissue structrue aka repair
chronic inflamamiton-time critera depending of type of tissue and infectinous agents
- mucosa or skin-more than 7-10d
- parenchynmatous organs-weeks
heaptitis by heptotropic viruses-more than 6 moths and more
most distinct feature of chronic and acute
chronic-proliferation of cells:
- mononucelar pahgocytes: macrophages, monocytes and epitheloid cells
-multinucleated cells: cells of non-specific immune system
-cells of specific immuen system:lymphocytes and plasma cells
-eosinophils: in some type of chronic-autoimune, allergy and parasites
-fibrobalsts
- vessle proliferaiton
high virulace agents ec
mycobacteria(TB)
low virulence
HPV
primary proliferative inflammaiton ex
UNKOWN ETIOLOGY
1. palmar, plantar fibromatosis
2. sterile serositits/polyserosititis(curschmanns disease, concatos disease)
3. idiopathic retroperineal (ormond disease)
- palmar, plantar fibromatosis
general
-60-70 y: earldy-middle aged men
-risk fctros: epilepsi, DM, smoking, alcholcl, manual work
-bilateral
pathology
- prolif of fibroblast+fibrotic tissue in palmar/plantar tunnel–>ahesion of tendons and sheats–>demobilization and continual contracture of finger aka DUPUTRENS CONTRACTURE
- semi flexion-like claw
- sterile serositits/polyserosititis(curschmanns disease, concatos disease)
- abdominal organs
-when capsule gets very thick bc acc of fibrotic material-lievr and spleen–>abnormally thick and white
-sterile inflammaiton of serous membranes
- adhesions of intestine(when solitayr)–>ileus
- sticture of large vv –>portal hypertnesion
-constrictive pericarditis->diastolic heart failure
- idiopathic retroperineal (ormond disease)
-fibrois sof retroperitineum(only soft fat tissue)
pathology:
- fibroproductive inflammaiton–>stenotizarion of ureter(acc of urine in kidney)–>HYDRONEPHROSIS/PYELONEPHRITIS/rENAL FIALURE
secondary proliferative inflammation ex:
KNOWN ETIOLOGY:
- healing of acute inflammaiton
- every chronic inlammaiton when know wtiology
- granulomatous (specific inflamamiton)
healing
replacemnet of dead cells or necrotic tissue by proliferatin of parenchymal and mesenchymal cells of tissue
regualtion: hormonal, contact inhibition
per primam intentionem, primary union
healing by first intention aka healing without complications
per secundam intentionem, secondary union
healing by second intentions aka healing with complicaitons
per titiam intentionem, tertiary union
healing by third intention aka assisatnce of doctor by complicated gealing
factors influecnign healing-TYPE OF TISSUE
1.Tissue of labile cells
- more than 1,5 % of cells are in mitosis(skin, mucosa of resp, GI, urinary, genital tract, BM, lymphoid tissue)
- prolifeare
- tissue of stable cells
- less than 1,5% (parenchymatous orgns, glanfs, endothelial cells, smooth muscle of vv, skin adnexa)
- prolif is low but possible - tissye of permamnent cells
- no cell proflif(NEURONS , SKELETAL MUSCKE
-striated, cardiac m and most smooth(uterus)
healing of wounds
-always repair
-final epithelium or surface of skin will be restored back, the granulation tissue beneath the dermis IS ALWAYS PRESENT
- if extensive granualtion tissue->scarificaiton–>contraction
healin of foreign bodye
-usually indigestible material or very problamtic to digest
- enzymes and macrophges not able to resolve it and leads to following:
- acc of monocytes/histiocytes–>impossuble to digest
- transformaiton of macrophages into epitheloid cells-syntehsis of growth factors
- sti phages to be larger, stornger and aggressive–>duse together–>multinucleated giant cells - fusion of macro–>giant cells–>enguld the foreign body
- giant cells wiht multiple nuclei
4A. destruction of foregin body–>dissaperance of giant cells–>scar
4B: resistant foreing body–>persistance of giant cells–>formaiton of scar wound
healing of necrosis
- losign supportive framwork
- no regenration
- acc of monocytes/histiocytes
- resoption of necrotic material–>fomraiton of lipophages, siderophages, giant cells
- fibrotic capsuel - replacement of necrotic tissue by granulaiton tissye
- scar ffibrotic tissye - tranformaiton of granulaiton into scar
healing of permamnent tissues -peripheral nerve
- repair
- serious/extensive injury: whole neuron destroyed
- less serious: neurons tries to regenerate
- peripheral process is destroyed
- remaning pricess will persist up to ranvier node
- peripherla process trye to extend and find a new way to proliferae
- when schwann cell will be preseverd–>processes will find these and travek through then and spread to peripheral part and teh innevation partly restoted
pahntoma symoms
pain or itching in jured region, becuase fibers are still sensitvive, however they dont innervate normal structure
healing of permanent tissue-skeletal muscle
- prolifaeration of organelles of survinvin syncital cells
- spreafing of syncytial cells into saved endomysial tunnels
- partial restoration of muscle function
