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Surgical biology and methods > Surgical biology > Flashcards

Surgical biology Flashcards

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AP® Biology flashcards Biology 101 flashcards
1
Q

What are the macroscopic signs of inflammation?

A

Rubor, calor, dolor, tumor

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2
Q

What are the components of the acute vascular response in inflammation?

A
  1. Vasodilation
  2. Vascular permeability
  3. Vascular stasis
  4. Leukocyte extravasation
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3
Q

What mediators are involved in vascular smooth muscle changes during inflammation that result in vasodilation?

A

Histamine, nitric oxide, leukotrienes, prostaglandins, complement factors

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4
Q

An increase in the number and size of intracellular endothelial gaps during inflammation is caused by what mediators?

A

Histamine, serotonin.

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5
Q

Briefly describe the stages of leukocyte extravasation.

A
  1. Margination due to vascular stasis
  2. Weak transient interactions with selectins on endothelial cells 3. Eventual vascular adhesion via integrins on leukocyte surface (increased expression due to cytokines)
  3. Interendothelial diapedesis
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6
Q

What are the primary functions of the neutrophil?

A

Local killing via phagocytosis, release of superoxide radicals, and formation of neutrophil extracellular traps.

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7
Q

What proinflammatory mediators are produced by neutrophils?

A

IL-1, IL-alpha, IL-1beta, IL-6, TNF-alpha

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8
Q

What happens once neutrophils enter the tissue bed?

A

Neutrophils are primed by bacterial products, enter tissue bed where they undergo necrosis, apoptosis or are sloughed. Replaced by macrophages after 24-48 hours.

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9
Q

What are the two types of macrophage?

A
  1. Tissue resident macrophages
  2. Monocyte derived macrophages
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10
Q

What is macrophage polarization?

A

Ability of macrophages to assume two distinct functional phenotypes:
1) M1: Pro-inflammatory, produce IL-1Beta, IL-6, TNF-alpha
2) M2: Anti-inflammatory. Activated by IL-4, IL-13, IL-10. Produce PDGF and TGF-beta which simulate fibroblasts to produce collagen.

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11
Q

What is the role of lymphocytes in the inflammatory response?

A

Helper CD4+ T-cells and cytotoxic CD8+ T-cells are both involved in cell-mediated immunity. CD4+ cells further differentiate into Th-1 and Th-2 helper cells. Th-1 cells maximize the bacterial killing potential of macrophages.

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12
Q

What is the role of mast cells in the inflammatory reponse?

A

Primary source of histamine, and also release serotonin, leukotrienes, prostaglandin metabolites, heparin and cytokines.

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13
Q

What is the role of endothelial cells in the inflammatory response?

A

Expression of proinflammatory cytokines, chemoattractants and adhesion molecules that leads to extravasation, migration and accumulation of leukocytes and lymphocytes.

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14
Q

What is a PAMP?

A

A highly conserved microbial molecule recognized as foreign to the host.

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15
Q

What is a DAMP?

A

Endogenous molecules such as fibrinogen which alert the body to cellular damage initiated by infectious or non-infectious agents.

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16
Q

Describe the role of PAMPS/DAMPS in the inflammatory process

A
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17
Q

List the mediators of inflammation

A
  1. Vasoactive amines
  2. Cytokines
  3. Lipid/cell membrane derived mediators
  4. Reactive oxygen species
  5. Acute phase proteins
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18
Q

Describe the role of histamine in the inflammatory response

A

Predominantly interacts with histamine receptor on endothelial cells resulting in arteriolar vasodilation, increased venule permeability and constriction of large arteries. Rapid onset and short half-life.

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19
Q

What is a cytokine?

A

A diverse group of small, soluble proteins that act as intercellular messengers - including TNF, IL, TGF, interferons and others.

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20
Q

List the pro-inflammatory cytokines

A

TNF-alpha, IL-1-beta, IL-6, IL-8/CXCL8 (this is a chemokine, i.e. a chemotactic cytokine).

21
Q

List the anti-inflammatory cytokines

A

IL-4, IL-13, IL-10

22
Q

Describe the eicosanoid pathway

A
23
Q

What is the difference between COX-1 and COX-2?

A

COX-1 is considered constitutive and is involved in homeostasis. COX-2 expression is induced by trauma, growth factors, and proinflammatory cytokines.

24
Q

What are resolvins and protectins?

A

Lipid derived pro-resolution mediators generated from EHA and DHA (omega-3 polyunsaturated fatty acids).

25
Q

What are reactive oxygen species?

A

Unstable molecules that initiate chain reactions to perpetuate further reactive oxygen species.

26
Q

What are the effects of reactive oxygen species?

A

Antibacterial defense, wound debridement, intracellular signalling, pathologic tissue damage.

27
Q

What is the process by which phagocytic cells produce reactive oxygen species within phagocytic vesicles?

A

The respiratory or oxidative burst

28
Q

What is frustrated phagocytosis?

A

When a phagocyte encounters a large aggregate of foreign material or microbes and fails to engulf the target, resulting in the release of damaging agents into the extracellular inflammatory milieu.

29
Q

How do reactive oxygen species cause reperfusion injury?

A

Ischemia causes hypoxanthine production. Following reperfusion and reoxygenation xanthine oxidase converts hypoxanthine to xanthine and then hydrogen peroxide.

30
Q

What are the three forms of nitric oxide?

A
  1. Constitutive endothelial derived nitric oxide.
  2. Constitutive neuronal derived nitric oxide.
  3. Inducible nitric oxide.
31
Q

What is the function of nitric oxide in the inflammatory response?

A
32
Q

What is a negative acute phase reactive protein?

A

A protein that decreases in concentration by at least 25% during an inflammatory response.

33
Q

What is the primary negative acute phase protein?

A

Albumin

34
Q

What is a positive acute phase reactive protein?

A

A protein that increases in concentration by at least 25% during an inflammatory response.

35
Q

List examples of positive acute phase reactive proteins

A

C-reactive protein, serum amyloid A, serume amyloid P, complement proteins, coagulation factors, kallikrein-kinin system

36
Q

What is the role of C-reactive protein?

A

Both pro and anti-inflammatory effects: regulates leukocyte infiltration, inhibits the respiratory burst in neutrophils, activates macrophages to produce IL-1B, IL-6, TNF-alpha.

37
Q

What is the complement system?

A

More than 30 serum proteins and cell surface receptors that play an integral role in opsonization, phagocytosis, chemotaxis and active cell lysis.

38
Q

What are the three complement activation pathways?

A
  1. Classical
  2. Lectin
  3. Alternative
39
Q

Describe the complement pathway

A
40
Q

What is the kallikrein-kinin system?

A

The cleavage of kininogen (high molecular weight proteins produced by the liver) by kallikrein proteases to form vasoactive kinins.

41
Q

What is the primary kinin?

A

Bradykinin

42
Q

What are the two membrane receptors of bradykinin?

A
  1. B2: ubiquitous and constitutive
  2. B1: pathologic
43
Q

What are the effects of bradykinin?

A

Venous dilation, vascular permeability, pain.

44
Q

What are tachykinins?

A

Neuropeptides released from peripheral neurons after stimulation or direct trauma of sensory nerves.

45
Q

What is substance P?

A

A major tachykinin that is released by inflammatory leukocytes and prominent neurons in response to histamine. Causes inflammatory signal amplification and enhanced nociception.

46
Q

What is the definition of multiple organ dysfunction syndrome?

A

The progressive dysfunction of two or more organ systems not involved in the initial physiologic insult.

46
Q

What is the major mechanism suspected to be responsible for MODS?

A

Reperfusion mediated oxidative injury to the gut epithelium providing a major source of mediators driving distance organ damage.

47
Q

What characterizes prolonged or chronic inflammation?

A

Monocytic infiltrates, angiogenesis, and progressive tissue fibrosis. Fibroblasts play a significant role.

Surgical biology and methods (11 decks)

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