Test 2 Flashcards
what are the purposes of inflammation (3)?
- neutralize and destroy invading and harmful agents
- limit the spread of harmful agents to other tissue (localization)
- prepare damaged tissue for repair
during inflammation capillary permeability is increased. this results in _____, ____, and _____. The last of which allows for coagulation cascades to occur.
- redness
- increased viscosity (rbc and platelet accumulation)
- slowed blood flow
what are the 3 major components of acute inflammation?
- dilation of small vessels
- increase permeabiltity of the microvasculature
- emigration of leukocytes from the microcirculation
what is the site of acute inflammation?
postcapillary vasculature: thin walled vessels that allow for passage of fluid and proteins
during inflammation there is efflux of 3 things from the vasculature. the two main ones are ____ and ____. the minority one is _____
- proteins
- fluid
- rbcs
compare and contrast exudate and transudate. consider content and common times of occurrence.
exudate
* content: high protein, few cells
* time: inflammation, infection, injury
transudate
* content: low protein, few cells
* time: increased hydrostatic pressure and decreased colloid osmotic pressure - kidney and liver disease, protein malnutrition
what are the 5 cardinal signs of infection?
- redness (rubor)
- swelling (tumor)
- heat (calor)
- pain (dolor)
- loss of function (functio laesa)
what are the steps of inflammation?
- bradykinin release
- pain receptor activation via bradykinin
- histamine release from mast cells and basophils
- capillary dilation
- increased blood flow and capillary permeability
- bacteria enter tissue
- neutrophils and monocytes to injury site
- phagocytosis of bacteria by neutrophils
- macrophages leave bloodstream for phagocytosis
what is the process of inflammation from chemokines to extravasation?
- macrophage with microbes releases chemokines
- integrin on leukocyte goes from low to high affinity state
- selectins and integrin ligands allow for ‘rolling’ of the leukocyte
- leukocyte squeezes through endothelium
different interferons respond to different types of infection. ____ respond to bacterial infections, whereas ____ and respond to viral infections.
- gamma
- alpha
- beta
what occurs with leukocyte activation via GPCRs?
- cytoskeletal changes and signal transduction
- increased integrin activity -> endothelial adhesion
- chemotaxis -> migration into tissues
what occurs with leukocyte activation via TLRs OR cytokine receptors?
- production of mediators -> inflammation amplification
- ROS production -> microbicidial leukocyte activity -> killing of microbes
what occurs with leukocyte activation via phagocytic receptors?
- ROS production -> microbicidial leukocyte activity - killing of microbes
- phagocytosis of microbe -> microbicidial leukocyte activity -> killing of microbes
what are the 4 types of exudates?
- serous
- fibrinous
- purulent
- hemorrhagic
describe serous exudate:
* texture
* contents
* location
* derivation
* cause
- texture: water (serum like)
- contents: mostly fluid, some proteins and white blood cells, sterile
- location: within body cavities lined by the peritoneum, pleura, or pericardium
- derivation: from plasma (via vascular permeability) or mesothelial secretions (irritation)
- cause: tissue injury, irritation (friction), viral infection
describe fibrinous inflammation exudate:
* texture
* contents
* location
* cause
* resolution
* adverse outcomes
- texture: thick and sticky
- contents: lots of cells and fibrin
- location: lining of body cavities - pericardium, meninges, pleura
- cause: activation of coagulation cascade causing build-up of fibrin meshwork (increased vascular permeability)
- resolution: fibrinolysis and macrophage activity
- adverse outcome: scar tissue when sustained with vascularization
describe purulent inflammation exudate:
* texture
* colour
* contents
* cause
- texture: thick
- colour: yellow-green
- contents: leukocytes, cell debris, microorganisms, edema fluid
- cause: bacterial infection (staphylococcus, acute appendicitis)
the colour of a purulent exudate is indicative of different health levels. for example, white indicates —– , yellow-green indicates —–, and bright green indicates —–.
- white: no infection
- yellow-green: infection
- bright green: pseudomonas infection (i.e. burn)
describe what an ulcer is an how it is formed
- localized concave excavation of the surface of an organ or tissue
- caused by shedding of inflamed necrotic tissue - extensive leukocyte infiltration in combination with vasodilation
- late on it can inlcude scarring and chronic inflammation
what are the common sites of ulcers?
- mouth
- stomach
- intestines
- geniourinary tract
- skin
- subcutaneous tissues of lower extremities
describe abscess:
* what it is
* make-up
* cause
* type of exudate
- what: localized collections of pus
- make up: central mass (collection of neurotic leukocytes and tissue cells) with surrounding neutrophils
- cause: bacterial infection
- type of exudate: purulent
what are the 4 types of ulcers?
- venous leg ulcers
- arterial ulcers
- diabetic ulcers
- pressure sores
venous leg ulcers are common in elderly with —, but can also be caused by —— or ——-.
- chronic venous hypertension
- varicose veins
- congestive heart failure
aterial ulcers are common in those with what?
atherosclerosis of peripheral arteries
diabetic ulcers are of the —– extremeties and can be worsened by —–, —–, and —–.
- lower
- ichemia
- neuropathy
- secondary infections
what is the cause of pressure sores?
mechanical pressure and local ischemia
what are the 3 outcomes of acute inflammation?
- complete resolution
- tissue replacement
- chronic inflammation
in complete resolution there is complete removal of —–, —–, and —–. there is also the resorption of excess fluid through —-. this allows for regeneration of damaged host cells and regain of full and normal function.
- inflammatory cause
- offending/foreign agent
- cellular debris
- lymphatics
tissue replacement also includes healing of —– via —- or —–. this occurs due to what (3)?
- healing of: connective tissue
- via: scarring or fibrosis
1. more substantive tissue destruction
2. at sites where tissue cannot regenerate, or in serous cavities
3. extensive fibrin deposits exudation in tissue
what are the potential causes of chronic inflammation?
- acute inflammatory response is sustained
- assaulting cause is presistent or recurring
where is complete resolution the easiest? provide an example
at sites where cells routinely proliferate
* i.e. epithelial tissue
provide an example of chronic inflammation due to:
1. assualt persistence
2. assault recurring
- hepatitis - liver damage
- asthma and Kohl’s disease
what type of cells/tissues are inherently more proliferative?
- stem cells
- epithelial skin cells (squamous epithelia)
- epithelial cells lining GI tract (columnar epithelium)
cells in the G0 phase can regenerate in response to what?
injury
quiescent cells can be stimulated to regenerate in response to what? give some examples of thesse cells
stimulated to regenerate in response to growth factors
* i.e. endothelial cells, fibroblasts, smooth muscle cells
explain the role of epidermal growth factor and what it is secreted by
secreted by: macrophages, salivary glands, keratinocytes
role: mitosis in keratinocytes and fibroblasts, stimulate keratinocyte migration, stimulate formation of granular tissue
explain the role of vascular endothelial growth factor and what it is secreted by
secreted by: mesencymal cells
role: stimulate proliferation in endothelial cells, increase vascular permeability, angiogenesis
describe collagen as an ECM component in tissue repair
- main supportive protein of skin, tendons and scars
- fibrous materials
describe fibronectin as an ECM component in tissue repair
- fibrous glycoprotein
- binding component of tissues
- scaffold for ECM deposition, angiogenesis, re-epithelialization
- made by fibroblasts, monocytes, and endothelium
describe fibrinogen as an ECM component in tissue repair
- blood protein
- forms clots in damaged vessels
- key for blood clots and coagulation casacade
describe elastin as an ECM component in tissue repair
- provide ability of tissues to recoil
- important in cardiac valves and large blood vessels that have to accomodate recurrent pulsatile flow - also in uterus, skin, and ligaments
describe proteoglycans and hyaluronan as an ECM component in tissue repair
- hydrated gels that cofner resistance to compressive forces
- reservoirs for secreted growth factors
- provide a layer of lubrication between bony surfaces
describe laminin as an ECM component in tissue repair
- most abundant glycoprotein in the basement membrane
- mediates attachment to the basement membrane, cell proliferation, differentiation, and motility
what are some of the cell (4) and fiber (3) components of ECM?
cells
1. fibroblasts
2. macrophages
3. lymphocytes
4. neutrophils
fibers
1. collagen
2. elastin
3. reticular
what is the mechanism of connective tissue deposition?
- cytokines made by macrophages and leukocytes stimulate the migration and proliferation of fibroblasts and myofibroblasts
what are the stages of the tissue repair process?
- clot formation and inflammation
- cell proliferation - epithelial cells, vascularization, fibroblasts
- fibrous scar
what is the fundamental difference between healing by first intention and healing by second intention?
first intention : fibrous union where all edges fully close
second intention : concave nature of wound where there wasn’t full closure
abraisons occur when what layers of the skin is scraped off?
epidermis
what is a contusion?
skin wound when a blow that crushes the tissue occurs
the immune system from human physiological perspective is sometimes referred to as the ____ or ____ immune response
human OR host
what is the concept of immunity related to?
the ability of the human body to protect itself from foreign entities, invaders, pathogenic bacteria, viruses and disease causing agents
what are the 3 key functions of the immune system?
- protection against diseass causing agents
- removal of dead, dying or destroyed host cells
- recognition and removal of any abnormally functioning self cells
the immune system has three key functions. in order to perform these functions 2 things are needed:
- regular commmunication between immune cells via small chemical signaling molecules
- recruitment of additional immune cells
host defenses can be described in 3 lines. the first line of defense contains 3 things: ____. the second line of defense has four: ____. and the third line of defense has two subcomponents - ____ and ____ which lead to ____.
- first line: physical barriers, chemical barriers, genetic components
- second line: phagocytosis, inflammation, fever, antimicrobial proteins
- third line: active (infection) or passive (maternal antibodies) that leads to B/T cells and their effects
in innate immunity recognition can occur via multiple traits, such as PAMP which stands for ____ and is recognized by PRRs or ____.
- PAMP: pathogen associated molecular pattern
- PPR: pattern recognition receptor
what are some mechanisms of innate immunity?
- phagocytosis
- complement cascade
- inflammation and fever
what is innate immunity mediated by?
cells (whole cell response) and cytokines
what are the 5 types of receptors most utilized in innate immunity?
- TLRs: toll like receptors
- NLRs: NOD like receptors
- C-type lectin
- Kinase
- GPCRs
describe TLRs by their location and what they recognize
- location: on cell surface or on membrane of an endosomal compartment
- recognize: extracellular pathogens (i.e. pathogenic e. coli, cholera)
what are some examples of bacteria that are extracellular? intracellular?
- intracellular: salmonella, mycobacterium Tb
- extracellular: pathogenic e.coli, cholera
describe NLRs by their location and what they recognize
- location: intracellular
- recognize: internalized pathogens (i.e. viruses)
viruses are often recognized by NLRs (NOD-like receptors). why?
viruses are required to become internalized to replicate
kinases have what type of receptors?
type 1 IFN receptors
define antigen
any molecule that induces a specific immunity response
adaptive immunity is a specific response to target a given pathogen. this immunity is mediated by ____ and ____. it is composed of two branches - ____ and ____.
- mediated by: B cells and T cells
- branches: cell mediated (T cell), humoral (B cell)
t-lymphocytes are 60-70% of lymphocytes in peripheral blood. they mature in the thymus and respond to what?
respond to protein antigens on MHC
T helper cells have ____ protein markers and recognize antigens on ____ that are processed by APCs. they activate other cells via ____ and stimulate ____ and ____. have 3 subclasses, ____ that secrete pro-inflammatory cytokines
T helper cells have CD4+ protein markers and recognize antigens on MHC-II that are processed by APCs. they activate other cells via cytokine secretion and stimulate B cell proliferation and antibody production. have 3 subclasses, TH1, TH2, and TH17 that secrete pro-inflammatory cytokines
cytotoxic T cells have ____ protein markers and recognize antigen on ____ on viral-infected or cancer cells. they can also ____ these cells.
cytotoxic T cells have CD8+ protein markers and recognize antigen on MHC-I on viral-infected or cancer cells. they can also directly kill these cells.
what is the function of regulatory T lymphocytes?
supression of the immune/inflammatory response
what are the main classes of MHC?
- class 1: for CD8+ cells
- class II: for CD4+ cells
- class III: complement, cytokines, etc.
what is the broad function of MHC? (think in terms of it’s surface)
cell surface proteins display antigens on the surface of host cells
where is the human leukocyte antigen (HLA) encoded?
chromosome 6
what type of bonds are present in MHCs?
sulfide bonds (sulfur-sulfur)