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171 Cards in this Set

  • Front
  • Back
Purpose of Tissue Response to Injury
Destroy and remove substances recognized as foreign

prevent minor infections from becoming overwelming

prepare damaged tissue for repair
What is Acute Inflammation?
short term

completely resolves

mostly polymorphonuclear leukocytes/ neutrophils
What is Chronic Inflammation?
long term

may or may not be completely resolved
Etiology of Inflammation
Infection
Physical trauma
chemical trauma
irradiation
thermal injury
immunity
ischemia
nutrient deprivation
failure to recognize self
what is a wound
disruption of tissue integrity
what is mechanical injury
incision
what is physical injury
car wreck, burns, etc.
what is an incision
produced by a cutting instrument

wound edges are close together and aligned
what is a contusion
a bruise
what is an abrasion
rubbing or scraping off of epidermis or mucous membrane by friction
what is a laceration
tissue or organ tearing by blunt or irregular instrument

tissues not aligned and not close together

loose flaps of tissue
what is a puncture
piercing of tissue or organ with sharp instrument
projectile or penetrating wound
foreign object enters body at high velocity
Signs and Symptoms of Inflammation
Rubor (redness)
Calor (heat)
Tumor (edema)
Dolor (pain)
Functio laesa (alteration in functioning)
Signs of Lymphadenopathy
enlarged lymph node due to filtering
Signs of Lymphangitis
imflammation of lymphatic vessel
Sign of Lymphadentitis
inflammation and localized infection of lymph nodes
for every one degree F the heart rate increase ?
10
Systemic Lab Signs of Inflammation
elevated WBC
Elevated Erythrocyte Sedimentation Rate (ESR)
Neutrophils function
pyogenic bacteria
Eosinophils function
parasitic worms

allergy
lymphocyte function
viruses
what are the two types of inflammatory repsonses
cellular
vascular
what cell is the first to arrive at inflamed site
neutrophils
Neutrophils have a long or short lifespan?
short
when an increased need for neutrophils is occuring what does the bone marrow produce?
immature neutrophils (bands)
what cell's function is to respond to chemical messengers?
eosinophils
what cell is least abundant of the WBC's?
basophils
which cell functions similar to mast cells?
basophils
where are mast cells located?
mast cells
where are basophils located?
blood stream
what do mast cells and basophils release?
histamine and serotonin
what does basophils release that mast cells do not?
heparin
what does heparin do in inflammatory response?
makes blood thinner so fluid and cells can get to the site faster
where are histiocytes?
in connective tissue

a macrophage
where are microglials?
in the brain

a macrophage
where are Kupffer cells?
in the liver

a macrophage
what is the function of lymphocytes?
immunity
lymphocytes make up what percent of WBC's?
25%
what are lymphokines?
substances released from T lymphocytes
what attracts monocytes to the area of inflammation?
neutrophils
where are macrophages located?
tissue
what do monocytes/ macrophages do in chronic inflammation?
wall off area that can't be repaired, trap the antigens
what do polymorphonuclear neutrophils secrete?
powerful chemotactic chemicals
why does margination occur?
blood flow slows
blood thickness increases
electrical charge changes
chemical mediators
what is pavementing?
sticking of neutrophils to vascular endothelium

only in veins
what is diapedesis?
when neutrophils squeeze through or pass through the endothelial gaps into tissue
what are the chemotactic factors?
C5a
bacterial components
LTB4 (metabolite of arachidonic acid)
opsonisation
tagging antigen for phagocytosis
initial vascular response is
vasoconstriction
why does vasodialation occur in vascular response?
to increase blood flow and fluid
what does bradykinin do?
stimulates capillary and venule endothelial cels to retract

end result: creates space that allows leukocytes to squeeze through
where is receptor H1
lungs
where is receptor H2
gut
what cells release histamine
platelets
mast cells
basophils
histamine causes
widening of capillaries
decrease in BP
increase gastric juices
tightens smoot muscles of bronchi and uterus
where is serotonin released from?
platelets
GI tract

vasodilation
why are chemicals important in acute inflammation?
vasodilation
emigration
chemotaxis
increased vascular permeability
Where is arachidonic acid released from?
injured cells by phospholipase
two pathways of AA
leukotrienes
prostaglandins
leukotrienes are chemotaxis for
neutrophils and eosinophils
prostaglandins are chemotaxis for
neutrophil chemotaxis
Platelet activating factor is synthesized by what?
endothelial cells
injured tissue
cytokines are made by
lymphocytes
macrophages
what do cytokines do?
assist in inflammatory response
direct growth of bone marrow cells
what does nitric acid do?
relaxes vascular smooth muscle
reduces platelet aggregation
regulates WBC recruitment
aids phagocytic cells
what are complements?
inactive proteins circulating in the blood
what is the classic pathway?
C1- antigen-antibody complexes
what is the alternative pathway?
C3
what does the complement system do?
opsonization
chemotaxis
induce granulation of mast cells
produces cell lysis

HELPS KILL
fibrinogen converts to fibrin in what system?
clotting system
what is the purpose of clotting?
prevents spread of infection
keeps antigens at site of greatest phagocytosis
what factor is hageman factor?
seven
where is kallikrein located?
body fluids
what is the kinin system activated by?
decrease pH
temp change
contact with abnormal surfaces
hageman factor
what does bradykinin do?
powerful vasodilator
induces pain
what does the hageman factor do?
activates coagulation, kinin and fibrinogen systems
what are the good effects of inflammation?
dilute toxins
entry of antibodies
drug transport
fibrin formation
deliver of O2 and nutrients
stimulates immune system
harmful effects of inflammation
digest normal tissue
swelling
inappropriate inflammatory response
labile cells
undergo complete regeneration

epithelium
bone marrow
stable cells
regenerate if stimulated

hepatocytes
endothelium
permanent cells
no regeneration

neurons
cardiac
what is chronic inflammation?
lasts longer than 2 weeks
what happens during chronic inflammation?
foreign material walled off from healthy tissue but not destroyed or removed

scar tissue
what is lost by second intention healing?
tissue
hair follicles
melanocytes
sweat glands
what are keloids?
bulging tumorous scars from abnormalities in collagen synthesis and breakdown

*if removed returns*
exuberant granulation?
excessive scar tissue

*if removed no return*
contracture
migration of wound margins towards center
dehiscence
bursting open of previously closed wound

collagen not strong enough
evisceration
protrusion of abdominal organs
stenosis
narrowing or obstruction of opening by formation of scar tissue around a tubular area
adhesions
inflamed serous or mucous membrane
what is normal count for WBC's
5 to 10 thousand
Leukopenia
too few WBC
Leukocytosis
too many WBCs
what is the count in neutropenia?
less than 1500
what is the count in agranulocytosis?
less than 200
what is aplastic anemia?
all myleoid cells are low
what percent of WBCs are Neutrophils?
50 to 70
what percent of WBCs are eosinophils?
0-4
what percent of WBCs are basophils?
0-1
what percent of WBCs are Lymphocytes?
20-40
what percent of WBCs are monocytes?
1 to 6
in Neutrophilic Leukocytosis what does it mean to "shift to the left"
increase in bands (immature)
onset or progression of infection
in Neutrophilic Leukocytosis what does it mean to "shift to the right"
decrease in bands
resolution of infection
what is the lab CD 4+ testing for?
helper T cells
what is the lab CD 8+ testing for?
affector T cells
what are B lymphocytes?
humoral mediated immunity
antibodies
fight bacteria and viruses
what type of immunity are natural killer cells?
innate (born with)
what type of immunity are T cells?
cell mediated immunity
WBCs in Leukemia do not...
mature correctly
phagocytize
provide immunity
Signs and Symptoms for ALL and AML
fatigue
pallor
weight loss
repeated infections
easy bruising
nosebleeds
hemorrage
Signs and Symptoms of ALL
bone pain (bone marrow expansion)
infection (too few neutrophils)
CNS and Pulmonary involvement
Hyperuricemia
Treatment of ALL
chemotherapy
irradiation
bone marrow transplant
Massive necrosis of malignant cells during therapy of ALL can lead to
hyperkalemia
hyperphosphatemia
hyperuricemia
HYPOcalcemia
HYPOmagnesemia
acidosis
what happens in lymphoma
lymphocytes multiply
crowd out healthy cells
create tumors that enlarge lymph nodes or other parts of immune system
what is the distinguishing cell factor in Hodgkins Lymphoma?
Reed-Sternberg cell
sysns and symptoms of HL
painless increase in single node or multiple
dry cough
persistant fever
night sweats
weight loss
pain in node after drinking alcohol?
Clinical manifestations of HL?
impaired immunity
elevated neutrophils
mild anemia
eosinophilia
hypergammaglobulinemia (early)
hypogammaglobulinemia (late)
stageing of HL based on what?
number (how many nodes involved)
locations (on one or both sides)
has disease metastisized to bone marrow or liver or both
NHL
suspected to be caused by virus
in older adults and immunosupressed
most originate in B cell
spread slowly
NHL pathology
monocytes affected
painless enlarged nodes
may progress to extranodal involvement (nasopharynx, GI tract, abdomen, bone marrow)
Humoral immunity impaired (Hypogammaglobulinemia)
what is Multiple Myeloma?
disorder of plasma cells in which IgG and IgA produced
where do malignant plasma cells gather
in bone marrow to produce a tumor
why does MM affect the skeletal system?
it causes lysis of bone (cytokines) which leads to bone pain, fractures, hypercalcemia, and osteoporosis
how does MM affect the hematological system?
bone marrow infiltration
bone marrow replacement
anemia
thrombocytopenia
bleeding
hypogammaglobulinemia
how des MM affect the renal system?
hyperuricemia due to rapid turnover of cells
hypercalcemic nephropathy
renal infiltration by plasma cells
how does MM affect the nervous system?
cord suppression
intracranial plasma cell masses
neuropathy
what is Hyperviscosity Syndrome?
sludging in capillaries
purpura
retinal hemorrage
papilledema
coronary ischemia
CNS symptoms (vertigo,seizures)
a standard, average, or typical example of a set objects or values
normal
specific illness or disorder characterized by a recognizable set of signs and symptoms
disease
a state of complete physical, mental, and social well-being, not merely the absense of disease or infirmity
health
cause of a disease
etiology
the development or evolution of the disease
pathogenesis
changes in life proccess which can be observed
manifestations
abnormal outcome of a disease, treatment, or injury
sequelae
new or separate condition arising from existing condition, often alters prognosis
complication
vital functions of a cell
obtain nutrients and CO2
metabolism
elimination/ excretion
adaptation to enviornment
replication/ reproduction
controls cell division
holds all genes
nucleus
composed of pieces of RNA that are the instructions for making protein
ribosomes
reads ribosomes instructions to make protein

packages new protein and sends it to golgi body
rough ER
contains hormones and enzymes

help breakdown toxins
smooth ER
post office of the cell

packages items in the cell and sends them where they need to go
golgi apparatus
powerhouse of the cell

aerobic metabolism
mitochondria
breading down stored nutrients to produce energy
catabolism
building up more complex molecules out of simpler ones for energy
anabolism
proteins break down to
amino acids
fats break down to
fatty acids
carbohydrates break down to
glucose
waste products of aerobic metabolism
CO2 and water
if O2 is not present pyruvate becomes
lactic acid
process by which cells divide and reproduce
cell proliferation
the degree to which a gene or a particular group of genes is active
expression
decrease in cell size
atrophy
increase in cell size
hypertrophy
increase in the number of cells
hyperplasia
conversion of one type of cell to another
metaplasia
abnormal cell growth of specific tissue results in cells that vary in size, shape and appearance
dysplasia
critical lack of blood supply to an area
ischemia
death of tissue caused by lack of blood supply
infarction
localized tissue death that occurs in groups of cels in response to disease or injury
necrosis
an electrically uncharged atom or molecule having an unpaired electron
free radical
ex.
partial thickness burns
heat stroke
low intensity heat injury
ex.
electrical burns
full thickness burns
high intensity heat injury
complication of radiation therapy
radiation proctosigmoiditis
injured tissue infiltrated with calcium
dystrophic
normal tissue infiltrated with calcium
metastatic
area of coagulative necrosis
gangrene
rigor mortis
stiffness
algor mortis
temperature change
livor mortis
color change