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Perf Tech Exam 3 > Topic 12 Part 2 > Flashcards

Topic 12 Part 2 Flashcards

1
Q

4 signs of inflammation

A

redness, pain, heat, swelling

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2
Q

goal of inflammation

A 
dispose of microbes/ toxins / foreign materials
Occurs at the site of injury
Prevents the spread
Prepare for repair
Restore homeostasis
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3
Q

stages of inflammation

A
  1. Vasodilation- Increase permeability of blood vessels
  2. Emigration- Movement of phagocytes from blood to interstitial fluid
  3. Tissue repair
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4
Q

Increases permeability Allows

A

antibodies and clotting factors to leave the blood

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5
Q

Vasodilation Allows

A

more blood into an area

-Helps remove microbial toxins and dead cells

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6
Q

Factors that cause vasodilation and increased

permeability:

A

Histamine, Kinins, prostaglandins, leukotrienes, Complement

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7
Q

Histamine:

  • ____ cells in the tissues release
  • ______ and _____ stimulate the release of _____ in the blood
  • Causes increased _____ and _______
A
  • Mast cells in the tissues release
  • Basophils and platelets stimulate the release of histamine in the blood
  • Causes increased dilation and permeability
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8
Q 
Kinins:
Type of molecule: \_\_\_\_\_\_\_
Induce \_\_\_\_\_\_ and increase \_\_\_\_\_\_\_\_
Act as \_\_\_\_\_\_\_ agent phagocytes
Ex: \_\_\_\_\_\_\_\_
A

Type of molecule: Polypeptides
Induce vasodilation and increase permeability
Act as chemotaxic agent phagocytes
Ex: bradykinin

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9
Q

Prostaglandins:
Type of molecule: _____
Released by _________
Stimulate emigration of ________

A

Type of molecule: Lipid
Released by damaged cells
Stimulate emigration of phagocytes

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10
Q

Leukotrienes:
_______ and ____ cells produced
Increase ______

A

Basophils and mast cells produced

Increase permeability

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11
Q

Complement:
Stimulate _______ release
Attract _______
Promote _________

A

Stimulate histamine release
Attract neutrophils
Promote Phagocytosis

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12
Q

Clotting factors move into tissues

  • Initiate the _______
  • Fibrinogen converted to fibrin–>Forms ______= Localizes and traps invading organisms/ Blocks spread of organism
A
  • Initiate the clotting cascade

- Fibrinogen converted to fibrin–>Forms fibrin mesh= Localizes and traps invading organisms/ Blocks spread of organism

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13
Q

Within 1hour of start of inflammatory process: _____ appear

A

Phagocytes

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14
Q

Inflammation:

Neutrophils _____ to blood vessel wall with increased ______ and attempt to destroy via _______

A

Neutrophils stick to blood vessel wall with increased blood flow and attempt to destroy via phagocytosis

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15
Q

Inflammation:

  • _______ follow neutrophils–>Transform into ______ (More potent _______ than neutrophils)
  • Eventually macrophages _____
  • Leave collection of dead cells and fluid (____)
A
  • Monocytes follow neutrophils–>Transform into macrophages (More potent phagocytes than neutrophils)
  • Eventually macrophages die
  • Leave collection of dead cells and fluid (Pus)
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16
Q 
Inflammation: Redness
Large amount of blood in \_\_\_\_\_\_
Local temperatures \_\_\_\_\_
Metabolic reactions \_\_\_\_\_\_
More heat \_\_\_\_\_\_
A

Large amount of blood in damaged area
Local temperatures increase
Metabolic reactions speed up
More heat released

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17
Q

Inflammation: Swelling
Increased _______
More ____ in the area

A

Increased permeability

More fluid in the area

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18
Q

Inflammation: Pain

Symptom of inflammation–

A

neuron injury or increased pressure (edema)

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19
Q 
Fever:
\_\_\_\_\_\_\_ increase body temperature
Trigger release of \_\_\_\_\_\_\_ (cause fever)
Helps to inhibit the \_\_\_\_\_ of some microbes
Helps to speed up body \_\_\_\_\_\_
Aids in \_\_\_\_\_\_
A

Bacteria toxins increase body temperature
Trigger release of interleukin-1 (cause fever)
Helps to inhibit the growth of some microbes
Helps to speed up body reactions
Aids in repair

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20
Q

2 components of inflammation

A

vascular reaction

cellular reaction

21
Q

Acute inflammation=

A

rapid onset / short duration / emigration of

neutrophils

22
Q

Chronic Inflammation=

A

long duration / lymphocyte involvement /

proliferation of blood vessels / tissue necrosis

23
Q

Vascular changes purpose=

A

Maximize movement of plasma proteins and appropriate circulating cells into the site of injury or infection
HOW?? Vasodilation / Increased capillary permeability

24
Q

Vasodilation:
Early ________
_______ involved first, followed by opening of new ____
Induced by variety of mediators (_____ / _____)
RESULT:
Increased ______ which increases ______ and _____ of tissue

A

Early manifestation
Arterioles involved first, followed by opening of new capillary beds
Induced by variety of mediators (histamine / nitric oxide)
RESULT:
Increased blood flow which increases redness and warmth of tissue

25
Q

Increased Capillary Permeability:

  • Movement of protein rich fluid into ______ tissue and concentration of red blood cells (_____ change)
  • Physical changes in ______ structure of capillaries
A

-Movement of protein rich fluid into extravascular tissue
and concentration of red blood cells (viscosity change)
-Physical changes in endothelial structure of capillaries

26
Q

Increased Capillary Permeability: Result
_____ & ______ changes force fluid into interstitial space (results stasis) / _____ begin adhering to endothelium and moving into interstitial space / physical openings in ______ allow more fluid / protein / cells to migrate

A 
Osmotic & hemodynamic changes force fluid into
interstitial space (results stasis) / neutrophils begin
adhering to endothelium and moving into interstitial
space / physical openings in endothelium allow more
fluid / protein / cells to migrate
27
Q

Extravasation=

A

movement of leukocytes from vessel lumen to interstitial space

28
Q

Margination=

A

movement of leukocytes toward the wall of the capillary

29
Q

Rolling=

A

leukocytes tumble slowly along endothelium, adhere transiently, then are finally attached–endothelium completely lined with white cells

30
Q

Transmigration (diapedesis)=

A

insert pseudopods into junctions between endothelial cells–move through the junction

31
Q

Chemotaxis=

A

migrate thru interstitial fluid to source of problem

32
Q

Chemotaxix=
Locomotion along ______
Most common exogenous agents are _____ products
Common endogenous agents (3)

A

Locomotion along chemical gradient
Most common exogenous agents are bacterial products
Common endogenous agents (3)
–components of complement (C5a)
–products of lipoxygenase pathway (leukotriene B4)
–cytokines

33
Q

Leukocyte activation induced by:

A

microbes / products necrotic cells / antigen-antibody complexes / cytokines

34
Q

results of leukocyte activation (5)

A
  1. production of arachidonic acid metabolites
  2. degrannulation and secretion of lysosomal enzymes
  3. secretion of cytokines
  4. modulation of surface receptors
  5. phagocytosis
35
Q

Chemical mediators: originate from

A

plasma or cells

–plasma derived must be activated cell-derived usually stored in intracellular granules

36
Q

Chemical mediators: Production of active mediators triggered by

A

microbial products or host proteins (complement, etc.)

37
Q

Chemical mediators:

  • Usually bind to specific receptors on _______
  • One mediator may stimulate the release of other ____
  • Mediators can act on more than one _____
  • Once activated and released, most are ______
  • Most have the potential to cause ______
A

-Usually bind to specific receptors on target cells
-One mediator may stimulate the release of other
mediators
-Mediators can act on more than one target
-Once activated and released, most are short lived
-Most have the potential to cause GREAT HARM

38
Q

2 or more present for diagnosis of SIRS:

  1. Body temp
  2. HR
  3. Respiratory Rate
  4. Leukocyte count
A
  1. Body temp above 38C or below 36C
  2. HR >90 BPM
  3. Respiratory Rate >20/min Or PaCO2 12,000 cell/mm2 Or Or <10% immature neutrophils
39
Q

CPB produces “whole body” inflammatory response: Wide spectrum of injuries- All come within the “catch all” terms of SIRS

A 
Pulmonary
Renal
Gut
Central Nervous system
Myocardial dysfunction
Coagulopathy**
Hemolysis
Fever
Increase susceptibility to infection
Leukocytosis
40
Q

Widely accepted that SIRS is induced in all patients undergoing bypass:

  • -Incidence and severity is _____ (Most have a ___ clinical symptoms / Minority develop severe ____ changes or _____ after bypass.)
  • -Degree of response is _________ nor type of response.
  • -Risk factor: ______ (Frequently a risk factor, but not necessarily)
A

–Incidence and severity is variable (Most have a few clinical symptoms / Minority develop severe hemodynamic changes or organ failure after bypass.)
–Degree of response is not predictable nor type of
response.
–Risk factor: Length of CPB (Frequently a risk factor, but not necessarily)

41
Q

SIRAB: Set in motion _____ mediated events that activate vascular endothelium: Allow further ______ mediated inflammatory injury

A

Set in motion cytokine mediated events that

activate vascular endothelium: Allow further neutrophil mediated inflammatory injury

42
Q

SIRAB: most common culprit

A

contact with foreign surface
Other factor: Altered arterial blood flow patterns, Sheer stress (blood pumps), Cardiotomy suction, Tissue ischemia, Reperfusion, Hypothermia, Relative anemia, anticoagulants

43
Q

SIRAB: Contact activation=

A

Blood passes through non-physiologic ECC

44
Q

SIRAB: Activation of contact proteins…

A

Coagulation factors XII and XI
Prekallikrein
High molecular weight kininogen

45
Q

SIRAB end result

A

Formation of bradykinin
Conversion of plasminogen into plasmin
Initiates fibrinolysis
Triggers classical complement cascade

46
Q

Big Picture:
1-Multiple inflammatory mediators are released upon exposure to ECC- Disrupt _____
2-Generalized whole body inflammatory response: ____ mediated–>Activates _____–>Further _____ injury
3-None occur ____
4-Stimulate or catalyze other reactions in cycle of ____

A

1-Multiple inflammatory mediators are released upon exposure to ECC- Disrupt homeostasis
2-Generalized whole body inflammatory response: Chemokine mediated–>Activates vascular endothelium–>Further neutrophil-mediated injury
3-None occur alone
4-Stimulate or catalyze other reactions in cycle of SIRAB

47
Q

Immune System and Bypass: Part 1
1-Post operatively –Shown patients more _____
2-Noted _____ and ______ are decreased
3-_____ ability of _______ are decreased

A

1-Post operatively –Shown patients more susceptible to infections
2-Noted serum immunoglobulins and complement are decreased
3-Chemotaxic ability of granulocytes are decreased

48
Q

Immune System and Bypass: Part 2
4- _____ cells are decreased: Number and function
5-____ and _____ cells are decreased
6-____ cells are slightly increased
7-___ number remains low for about 1 week post bypass

A

4- NK cells are decreased: Number and function
5-CD3+ and CD4+ cells are decreased
6-CD8+ cells are slightly increased
7-Leukocyte number remains low for about 1 week post bypass

Perf Tech Exam 3 (4 decks)

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