Sequels To Acute Inflammatory Response- Resolution, Suppuration And Chronic Inflammation

Question 1

Suppuration

Answer 1

Process of forming pus, which consists of living, dying and dead polymorphs, large amount of protein and usually bacteria.
It is Suppurative or purulent exudate and generally signifies a bacterial infection, NOT viral infections.

Question 2

Abscess formation

Answer 2

Localised pus.
If acute inflammatory response is unable to get rid of bacteria quickly from our tissue, then a wall is formed around the infection to minimise the spread of bacteria.
The walking off of an infection is the abscess.

Question 3

Granulation tissue

Answer 3

New, vascularised collagenous tissue that is formed in response to injury. The collagen on granulation tissue that is formed initially by resident, proliferating fibroblasts is immature and temporary. Cytokines and growth factors released by cells and bacteria stimulate division of endothelial cells and cause them to link up and spawn new capillaries.

Question 4

Chronic inflammation

Answer 4

Implies inflammation has been ongoing for an extended period of time.
Signifies difficult to get rid of aetiological agent, eg trauma, non-degradable foreign body etc.
Main WBCs found are lymphocytes and macrophages.

Question 5

Chronic inflammation developing from acute inflammation

Answer 5

If an aetiological agent cannot be removed due to various reasons, lymphocytes and macrophages will take over from polymorphs as being the main WBCs within chronically inflamed tissue.

Can also occur due to trauma, resulting in misaligned healing and adhesion formation at the inflamed joint.

Question 6

Chronic inflammation developing from repeated bouts of acute inflammation

Answer 6

Acute inflammatory episodes remit and relapse until ultimately the tissue is chronically inflamed; laden with lymphocytes and macrophages and possessing varying degrees of scar tissue.

Inflammation reoccurs for example, every few months over many years.

Question 7

Resolution

Answer 7

After tissue is injured it reverts back, both structurally and functionally to its previous uninjured state.
Very few tissues have this ability, cells usually die.
Usually only happens when there are small amounts of damage.

Question 8

Chronic inflammation developing from onset

Answer 8

Where inflammation contains lymphocytes and macrophages from onset.

Question 9

Chronically inflamed tissue contains..

Answer 9

• Mononuclear cells (lymphocytes and macrophages)
• Initial increase in blood vessels due to migration of endothelial cells from surround blood vessels
• Increased cell div of local fibroblasts, which in turn increase their production of collagen to ultimately result in scar formation. Also referred to as fibrosis and is defined as the pathological formation of collagen.
• Low degree of ongoing cell death

Question 10

Chronic granulomatous inflammation

Answer 10

Lesion called a granuloma is formed.
Granulomas contain lymphocytes and macrophages as well as early granulation tissue and thus eventually scar.
The amount of necrosis occurring in a granuloma depends on aetiological agent.
Granulomatous inflammation contains altered, large macrophages called epithelioid cells, which fuse to form multinucleated giant cells.

Two types:
Langhan’s giant cells: found in granulomas or tubercles in tuberculosis, leprosy, sarcoidosis
Foreign body type giant cells: formed in response to foreign bodies such as metal, glass, wood.

Formation of giant cells signifies the aetiological agent is extremely difficult to eradicate.