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253 Cards in this Set
- Front
- Back
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Cell
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The basic structural unit of all plants and animals. A membrane enclosing a thick fluid and a nucleus. Cells are specialized to carry out all of the body's basic functions
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Cell membrane
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Also plasma membrane; the outercovering of a cell
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Semipermeable
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Able to allow some, but not all, substances to pass through. Cell membranes are semipermeable
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Cytoplasm
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The thick fluid, or protoplasm, that fills a cell
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Organelles
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Structures that perform specific functions within a cell
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Nucleus
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The organelle within a cell that contains the DNA, or genetic material; in the cells of higher organisms, the nucleus is surrounded by a membrane
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Adenosine triphosphate (ATP)
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A high-energy compound present in all cells, especially muscle cells; when split by enzyme action it yields energy. Energy is stored in ATP
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Structural Hierarchy of the Body
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Cells - Tissues - Organs - Organ Systems - Organism
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Tissue
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A group of cells that perform a simular function
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Epithelia tissue
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The protective tissue that lines internal and external body tissues. (Skin, mucous membranes, the lining of the intenstinal tract)
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Muscle Tissue
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Tissue that is capable of contraction when stiumlated. The 3 types are: Cardiac, Smooth and Skeletal
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Connective Tissue
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The most abundant body tissue; it provides support, connection, and insulation. (Bone, cartilage, fat, blood)
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Nerve Tissue
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Tissue that transmits electrical impulses throughout the body
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Organ
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A group of tissues functioning together (Examples; Heart, liver, brain, ovary, eye)
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Organ system
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A group of organs that work together
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Cardiovascular System
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The heart, blood vessels, and blood
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Respiratory System
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The lungs and associated structures
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Gastrointestinal System
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The mouth, salivary glands, esophagus, stomach, intestines, liver, pancreas, gallbladder, rectum and anus
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Genitourinary System
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The kidneys, ureters, bladder and urethra
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Reproductive System
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Female: ovaries, fallopian tubes, uterus, and vagina. Male: testes, prostate, seminal visicles, vas deferens, and penis
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Nervous System
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The brain, spinal cord, and all of the peripheral nerves
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Endocrine System
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The pituitary gland, pineal gland, pancreas, testes (male), ovaries (female), adrenal glands, thyroid gland, and parathyroid glands
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Lymphatic System
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The spleen, lymph nodes, lymphatic channels, thoracic duct, and the lymph fluid
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Muscular System
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Primarily the skeletal muscles
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Skeletal System
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The bones, cartilage and associated connective tissue
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Organism
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The sum of all the cells, tissues, organs, and organ systems of a living being
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Homeostasis
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The natural tendency of the body to maintain a steady and normal internal environment
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Anatomy
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The structure of an organism; body structure
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Physiology
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The functions of an organism; the physical and chemical processes of a living thing.
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Metabolism
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The total changes that take place during physiological processes
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Local Effects of Disease
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At the site of the illness or injury
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Systemic Effects of Disease
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Throughout the body
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Negative fedback loop
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Body mechanisms that work to reverse, or compensate for, a pathophysiological process (or to reverse any physiological process, whether pathological or nonpathological).
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Pathology
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The study of disease and its causes.
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Pathophysiology
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The physiology of disordered function
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Atrophy
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A decrease in cell size resulting from a decreased workload
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Hypertrophy
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An increase in cell size resulting from an increased workload
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Dilation
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Enlargement
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Hyperplasia
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An increase in the number of cells resulting from an increased workload
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Mitosis
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Cell division with division of the nucleus. The process by which the body grows
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Metaplasia
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Replacement of one type of cell by another type of cell that is not normal for that tissue
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Dysplasia
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A change in cell size, shape, or appearance caused by an external stressor
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Hypoxia
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Oxygen deficiency
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Ischemia
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A blockage in the delivery of oxygenated blood to the cells
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Pathogen
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A microorganism capable of producing infection or disease
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The 3 possible outcomes of Pathogens vs. the Body
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1. Pathogen wins
2. Pathogen and body battle to a draw. 3. Body defeats pathogen |
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Anabolism
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The constructive phase of metabolism in which cells convert nonliving substances into living cytoplasm
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Catabolism
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The destructive phase of metabolism in which cells break down complex substances into simpler substances with release of energy
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Cellular swelling
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Swelling of a cell caused by injury to or change in permeability of the cell membrane with resulting inability to maintian stable intra-and extracullular fluid and electrolyte levels
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Fatty change
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A result of cellular injury and swelling in which lipids (fat vesicles) invade the area of injury; occurs most commonly in the liver
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Apoptosis
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Response in which an injured cell releases enzymes that engulf and destroy itself; one way the body rids itself of damaged and dead cells
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Necrosis
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Cell death; a pathological cell change
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Total body water (TBW)
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The total amount of water in the body at a given time. Accounts for approximately 60% of the total body weight.
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Intracellular fluid (ICF)
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The fluid inside the body cells (75% of TBW)
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Extracellular fluid
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The fluid outside the body cells, comprised of intranvascular fluid and interstitial fluid (25% of TBW)
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Intravascular fluid
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The fluid within the circulatory system; blood plasma (7.5% of TBW)
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Interstitial fluid
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The fluid in the body tissues that is outside the cells and outside the vascular system (17.5% of TBW)
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Solvent
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A substance that dissolves other substances, forming a solution
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The universal solvent
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Water
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Dehydration
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Excessive loss of body fluid
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Turgor
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Normal tension in a cell; the resistance of the skin to deformation
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Overhydration
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The presence or retention of an abnormaly high amount of body fluid
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H (Chemical notation)
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Hydrogen
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O (Chemical notation)
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Oxygen
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C (Chemical notation)
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Carbon
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N (Chemical notation)
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Nitrogen
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Ca (Chemical notation)
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Calcium
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Cl (Chemical notation)
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Chlorine
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I (Chemical notation)
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Iodine
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Fe (Chemical notation)
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Iron
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Mg (Chemical notation)
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Magnesium
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P (Chemical notation)
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Phosphorus
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K (Chemical notation)
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Potassium
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Na (Chemical notation)
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Sodium
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S (Chemical notation)
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Sulfur
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Ion
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An atom that has lost one or more negatively charged electrons and now has a postive charge, or an atom that has gained one or more electrons and has a negative charge.
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Cation
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A positively charged ion. Indicated by a superscript plus (+)
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Anion
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A negatively charged ion. Indicatd by a superscript minus (-)
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Electrolyte
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A substance that, in water, seperates into electrically charged particles
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Dissociate
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Seperate; break down
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Buffer
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A substance that tends to preserve or restore a normal acid-base balance by increasing or decreasing the concentration of hydrogen ions
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Isotonic
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Equal in concentration of solute molecules
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Hypertonic
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Having a greater concentration of solute molecules
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Hypotonic
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Having a lesser concentration of solute molecules
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Osmotic gradient
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The difference in concentration between solutions on opposite sides of a semipermeable membrane
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Diffusion
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The movement of molecules through a membrane from an area of greater concentration to an area of lesser concentration
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Osmosis
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The passage of a solvent such as water thorugh a membrane
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Active transport
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Movement of a substance through a cell membrane against the osmotic gradient; that is from an area of lesser concentration to an area of greater concentration
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Facilitated diffusion
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Diffusion of a substance such as glucose through a cell membrane that requires the assistance of a "helper," or carrier protein
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Osmolality
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The concentration of solute per kilogram of water. (see also osmolarity)
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Osmolarity
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The concentration of solute per liter of water (often used synonymously with osmolality)
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Osmotic pressure
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The pressure exerted by the concentration of solutes on one side of a membrane that, if hypertonic, tends to "pull" water from the other side of the membrane
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Oncotic force
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A force of osmotic pressure exerted by the large protein particles, or colloids, present in the blood plasma. In the capillaries the plasma colloids tend to pull water from the interstitial space across the capillary membrane into the capillary. Also called colloid osmotic pressure
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Hydrostatic pressure
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Blood pressure or force against vessel walls created by the heartbeat. Tends to force water out of the capillaries into the interstitial space
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Filtration
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Movement of water out of the plasma across the capillary membrane into the interstitial space
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Net filtration
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The total loss of water from blood plasma across the capillary membrane into the interstitial space
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Edema
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Excess fluid in the interstitial space
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Plasma
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The liquid part of the blood (54% of blood)
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Erythrocytes
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Red blood cells, which contain hemoglobin, which transports oxygen to the cells
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Leukocytes
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White blood cells, which play a key role in the immune system and inflammatory (infection-fighting) responses (1% of blood)
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Thrombocytes
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Platelets, which are important in blood clotting
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Hemoglobin
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An iron-based compound that binds with oxygen and transports it to the cells
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Hematocrit
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The percentage of the blood occupied by erythrocytes (45%)
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Hemoglobin-based oxygen-carrying solutions (HBOCs)
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Intravenous fluids that have the capability to transport oxygen and are compatible with all blood types
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Colloids
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Substances, such as proteins or starches, consisting of large molecules or molecule aggregates that disperse evenly within a liquid without forming a true solution
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Albumin
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A protein commonly present in plant and animal tissues. In blood, it works to maintain blood volume and blood pressure and provides colloid osmotic pressure which prevents plasma loss from the capillaries
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Crystalloids
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Substances capable of crystallization. Unlike colloids, they can diffuse through a membrane, such as a capillary wall
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Tonicity
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Solute concentration or somotic pressure relative to the blood plasma or body cells
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Lactated Ringer's
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An isotonic electrolyte solution of sodium chloride, potassium chloride, calcium chloride, and sodium lactate in water
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Normal saline
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An electrolyte solution of sodium chloride in water. It is isotonic with extracellular fluid
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D5W
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A hypotonic glucose solution used to keep a vein open and to supply calories necessary for cell metabolism.
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pH (Potential of hydrogen)
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A measure of relative acidity or alkalinity. The lower the Ph the greater the acidity the higher the pH the greater the alkalinity
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Normal pH range
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7.35 - 7.45
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Acidosis
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A high concentration of hydrogen ions; a pH below 7.35
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Alkalosis
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A low concentration of hydrogen ions; pH above 7.45
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3 Mechanisms of Hydrogen ion removal
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1. Bicarbonate buffer system
2. Respiration 3. Kidney function |
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Resiratory acidosis
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Acidity caused by abnormal retention of carbon dioxide resulting from impaired ventilation
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Respiratory alkalosis
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Alkalinity caused by excessive eleimination of carbon dioxide resulting from increased respirations
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Metabolic acidosis
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Acidity caused by an increase in acid, often because of increased production of acids during metabolism or from causes such as vomiting, diarrhea, diabetes, or medication
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Metabolic alkalosis
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Alkalinity caused by an increase in plasma bicarbonate resulting from causes including diuresis, vomiting, or ingestion of too much sodium bicarbonate
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Diuretic
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An agent that increases urine secretion and elimination of body water
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How many chromosomes do every human somatic cell contain?
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46 (23 pairs) in a human somatic cell
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Perfusion
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The supplying of oxygen and nutrients to the body tissues as a result of the constant passage of blood through the capillaries
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Hypoperfusion
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Inadequate perfusion of the body tissues, resulting in an inadequate supply of oxygen and nutrients to the body tissues. Also called shock.
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Stroke volume
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The amount of blood ejected by the heart in one contraction. (Made up by preload, cardiac contractile force and afterload)
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Preload
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The amount of blood delivered to the heart during diastole
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Diastole
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When the heart fills with blood between contractions
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Cardiac contractile force
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The strength of a contraction of the heart
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Catecholamines
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Epinephrine and norepinephrine, hormones that strongly affect the nervous and cardiovascular systems, metabolic rate, temperature, and smooth muscle
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Afterload
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The resistance a contraction of the heart must overcome in order to eject blood
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Cardiac output
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The amount of blood pumped by the heart in 1 minute (stroke volume x heart rate)
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Peripheral vascular resistance
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The resistance of the vessels to the flow of blood: increased when vessels constrict, decreased when the vessels relax
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Natriuretic peptides (NPs)
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Peptide hormones synthesized by the heart, brain and other organs with effects that include excretion of large amounts of sodium in the urine and dilation of the blood vessels
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Major functions of Perfusion
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1. Oxygen transport
2. Waste removal |
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Aerobic metabolism
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The 2nd stage of metabolism, requiring the presence of oxygen Yields a high amount of energy.
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Anaerobic metabolism
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The 1st stage of metabolism, which does not require oxygen. Yields very little energy.
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The stages of shock
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1. Compensated
2. Decompensated (progressive) 3. Irreversible |
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Compensated shock
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Early stage of shock during which the body's compensatory mechanisms are able to maintain normal perfusion
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Decompensated shock
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Advanced stages of shock when the body's compensatory mechanisms are no longer able to maintain normal perfusion; also called progressive shock
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Irreversible shock
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Shock that has progressed so far thta no medical intervention can reverse the condition and death is inevitable
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Cardiogenic shock
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Shock caused by insufficient cardiac output; the inability of the heart to pump enough blood to perfuse all parts of the body
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Hypovolemic shock
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Shock caused by a loss of intravascular fluid volume
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Osmotic diuresis
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Greatly increased urination and dehydration due to high levels of glucose that cannot be reabsorbed into the blood from the kidney tubules, causing a loss of water into the urine
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Neurogenic shock
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Shock resulting from brain or spinal cord injury that causes an interruption of nerve impulses to the arteries with loss of arterial tone, dialation, and relative hypovolemia
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Anaphylaxis
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A life-threatening allergic reaction; also called anaphylactic shock
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Septic Shock
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Shock that develops as the result of infection carried by the bloodstream, eventually causing dysfunction of multiple organ systems
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Septicemia (sepsis)
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An infection that enters the bloodstream and is carried throughout the body.
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Multiple Organ Dysfunction Syndrome (MODS)
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Progressive impairment of two or more organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury
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Progression to MODS
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Infection - Sepsis - Septic shock - MODS - Death (if not corrected early)
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Virus
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An organism with no organized cellular structure that is much smaller than a bacterium, and visible only under an electron microsope. They invade and live inside the cells of the organism they infect.
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Bacteria (singular bacterium)
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Single-cell organisms with a cell membrane and cytoplasm but no organized nucleus. They bind to the cells of a host organism to obtain food and support
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Antibiotics
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Substances that destroy or inhibit microorganisms (tiny living bodies invisible to the naked eye)
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Exotoxins
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Toxic (poisonous) substances secreted by bacterial cells during their growth
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Endotoxins
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Molecules in the walls of certain Gram-negative bacteria that are released when the bacterium dies or is destroyed, causing toxic effects on the host body
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Three lines of defense against infection and injury
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1. Anatomic barriers
2. Inflammatory response 3. Immune response |
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Antigen
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A marker on the surface of a cell that identifies it as "self" or "nonself"
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Antibody
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A substance produced by B lymphocytes in response to the presence of a foreign antigen, thus preventing infection
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Immune response
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They body's reactions that inactivate or eliminate foreign antigens
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Immunity
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A long-term condition of protection from infection or disease
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Natural Immunity
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Inborn protection against infection or disease that is part of the person's or species' genetic makeup
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Acquiried immunity
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Protection from infection or disease that is (1) developed by the body after exposure to an antigen or (2) transferred to the person from an outside source such as from the mother through the placenta or as a serum
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Immunoglobulins
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Antibodies; proteins, produced in response to foreign antigens, that destroy or control the antigens
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Primary immune response
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The initial development of antibodies in response to the first exposure to an antigen in which the immune system becomes "primed" to produce a faster, stronger response to any future exposures
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Secondary immune response
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The swift, strong response of the immune system to repeated exposures to an antigen
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Lymphocyte
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A type of leukocyte, or white blood cell, that attacks foreign substances as part of the body's immune response
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B Lymphocytes
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The type of white blood cells that, in response to the presence of an antigen, produce antibodies that attack the antigen, develop a memory for the antigen, and confer long term immunity to the antigen
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Humoral immunity
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The long-term immunity to an antigen provided by antibodies produced by B lymphocytes
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T Lymphocytes
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The type of white blood cell that does not produce antibodies but, instead, attacks antigens directly
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Cell-mediated immunity
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The short-term immunity to an antigen provided by T lymphocytes, which directly attack the antigen but do not produce antibodies or memory for the antigen
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Immunogens
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Antigens that are able to trigger an immune response
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Haptens
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Molecules that do not trigger an immune response on their own but can become immunogenic when combined with larger molecules
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HLA antigens
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Antigens the body recognizes as self or non-self; present on all body cells exept the red blood cells
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Major histocompatibility comlex (MHC)
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A group of genes on chromosome 6 that provide the genetic code for HLA antigens
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Rh blood group
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A group of antigens discovered on the red blood cells of rhesus monkeys that is also present to some extent in humans
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Characteristics of Antigenic Immunogenicity
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1. Sufficient foreignness
2. Sufficient size 3. Sufficient complexity 4. Presence in sufficient amounts |
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Rh factor
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An antigen in the Rh blood group (antigen D) Rh+ and Rh- blood are incompatible
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ABO blood groups
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Four blood groups formed by the presence or absence of two antigens known as A and B. (O+, O- (Universal donor) A+, A-, B+, B-, AB+ (Universal recipient), AB-)
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Stem cells
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Undifferentiated cells in the bone marrow from which all blood cells develop. Also called hemocytoblasts
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Clonal diversity
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The development, by B lymphocyte precursors in the bone marror, of receptors for every possible type of antigen
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Clonal selection
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The process by which a specific antigen reacts with the appropriate receptors on the surface of immature B lymphocytes, thereby activating them to proliferate, differentiate, and produce antibodies to the activating antigen
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Memory cells
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Cells produced by mature B lymphocytes that "remember" the activating antigen and will trigger a stronger and swifter immune response if reexpsure to the antigen occurs
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Antigen-Antibody complex
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The substance formed when an antibody combines with an antigen to deactivate or destroy it; also called immune complex
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4 functions of antibodies
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1. Neutralization of bacterial toxins
2. Neutralization of viruses 3. Opsonization of bacteria 4. Activation of inflammatory processes |
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IgM
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Produced first and is the largest immunoglobulin
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IgG
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Has "memory" and recognizes repeated invasions of an antigen. Is the major class of immunoglobulin
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IgA
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Immunoglobulin involved in the secretory immune responses
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IgE
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Immunoglobulin involved in allergic reactions and prevention of parasitic infections
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IgD
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Immunoglobulin of which little is known and is present in very low concentrations, principally on the surfaces of developing B cells
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Monoclonal antibody
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An antibody that is very pure and specific to a single antigen
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Secretory immune system
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Lymphoid tissue beneath the mucosal endotherlium that secrete substances such as sweat, tears, saliva, mucus, and breast milk. (Also called the external or mucosal immune system)
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Delayed hypersensitivity
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An allergic response that takes place after the elapse of some time following reexposure to an antigen
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Cytotoxic
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Toxic, or poisonous, to cells
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Cytokines
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Proteins, produced by white blood cells, that regulate immune responses by binding with and affecting the function of the cells that produced them or of other, nearby cells
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Monokine
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A cytokine released by a macrophage
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Lymphokine
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A cytokine released by a lymphocyte
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Antigen processing
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The recognition, ingestion, and breakdown of a foreign antigen, culminating in production of an antibody to the antigen or in a direct cytotoxic response to the antigen
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Antigen-presenting cells (APCs)
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Cells, such as macrophages, that present (express onto their surfaces) portions of an antigens they have digested
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T cell receptor (TCR)
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A molecule on the surface of a helper T cell that responds to a specific antigen. There is a specific TCR for every antigen to which the human body may be exposed
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Inflammation
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The body's response to cellular injury. Develops swiftly, is nonspecific (attacks all unwanted substances in the same way) and is temporary, leading ot healing
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4 functions of inflamation
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1. Destroy and remove unwanted substances
2. Wall off the infected and inflamed area 3. Stimulate the immune response 4. Promote healing |
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Mast cells
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Large cells, resembling bags of granules, that reside near blood vessels. When stimulated by injury, chemicals, or allergic responses, they activate the inflammatory response by degranulation and synthesis of leukotrienes and prostaglandins.
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Degranulation
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The emptying of granules from the interior of a mast cell into the extracellular environment
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Histamine
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A substance released during the degranulation of mast cells and also released by basophils that, through constriction and dialation of blood vessels, increases blood flow to the injury site and also increases the permeability of vessel walls.
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Seratonin
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A substance released by platelets that, through constriction and dilation of blood vessels, affects blood flow to an injured or affected site
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Serotonin
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A substance released by platelets that, through constriction and dilation of blood vessels, affects blood flow to an injured or affected site
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Chemotactic factors
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Chemicals that attract white cells to the site of inflammation, a process called chemotaxis
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Leukotrienes
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Also called slow-reacting substances of anaphylaxis (SRS-A); substances synthesized by mast cells during inflammatory response that cause vasodilation, vascular permeability, and chemotaxis
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Prostaglandins
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Substances synthesized by mast cells during inflammatory response that cause vasodilation, vascular permeability, and chemotaxis and also cause pain
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Kinin system
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A plasma protein system that produces bradykinin, a substance that works with prostaglandins to cause pain
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Exudate
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Substances that panetrate vessel walls to move into the surrounding tissues
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Inflammation Sequence
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Vascular response - Increased permeability - Exudation of white cells
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Margination
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Adherence of white cells to vessel walls in the early stages of inflammation
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Diapedesis
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Movement of white cells out of blood vessels through gaps in the vessel walls that are created when inflammatory processes cause the vessel walls to constrict
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Granulocytes
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White cells with multiple nuclei that have the appearance of a bag of granules; also called polymorphonuclear cells.
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Monocytes
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White cells with a single nucleus; the largest normal blood cells. During inflammation, moncytes mature and grow to several times their original size, becoming macrophages
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Phagocytes
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Cells that have the ability to ingest other cells and substances, such as bacteria and cell debris. All granulocytes and monocytes are phagocytes
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Neutrophils
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Granular white blood cells (the most numerous of the white blood cells) that are readily attracted to the site of inflammation where they quickly attack and phagocytose bacteria and other undersirable substances
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Macrophages
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Large white blood cells (matured monocytes) that will ingest and destroy, or partially destroy invading organisms
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Eosinophils
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Granular white blood cells that attack parasites and also help to control and limit the inflammatory response
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Basophils
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Granular white blood cells that, similarly to mast cells, release histamine and other chemicals that control constriction and dilation of blood vessels during inflammation
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Platelets
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Fragments of cytoplasm that circulate in the blood and work with components of the goagulation system to promote blood clotting. Platelets also release serotonin, a vasoconstrictive substance
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Fibroblasts
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Cells that secrete collagen, a critical factor in wound healing
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Pus
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A liquid mixture of dead cells, bits of dead tissue, and tissue fluid that may accumulate in inflamed tissues
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Granuloma
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A tumor or growth that forms when foreign bodies that cannot be destroyed by macrophages are surrounded and walled off
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Resolution
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The complete healing of a wound and return of tissues to their normal structure and function; the ending of inflammation with no scar formation
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Regeneration
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Regrowth through cell proliferation
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Repair
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Healing of a wound with scar formation
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Debridement
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The cleaning up or removal of debris, dead cells, and scabs from a wound principally through phagocytosis
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Primary intention
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Simple healing of a minor wound without granulation or pus formation
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Secondary intention
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Complex healing of a larger wound involving sealing of the wound through scab formation, granulation or filling of the wound, and constriction of the wound
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Granulation
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Filling of a wound by the inward growth of healthy tissues from the wound edges
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Epithelialization
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Growth of epithelial cells under a scab, separating it from the wound and providing a protective covering for the healing wound
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Contraction
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Inward movement of wound edges during healing that eventually brings the wound edges together
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Maturation
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Continuing processes of wound reconstruction that may occur over a period of years after initial healing, as scar tissue is remodeled and strengthened
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Hypersensitivity
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An exaggerated and harmful immune response; an umbrella term for allergy, autoimmunity, and isommunity
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Allergy
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Exaggerated immune resonse to an environmental antigen
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Autoimmunity
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An immune response to self-antigens, which the body normally tolerates
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Isoimmunity
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An immune response to antigens from another member of the same species, for example Rh reactions between a mother and infant or transplant rejections; also called alloimmunity
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Immediate hypersensitivity reaction
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A swiftly occurring secondary hypersensitivity reaction (one that occurs after reexposure. Immediate hypersensitivity reactions are usually more sever than delayed reactions. The swiftest and most severe such reactions is anaphylaxis
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Delayed hypersensitivity reaction
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A hypersensitivity reaction that takes place after the elapse of some time following reexposure to an antigen. Delayed hypersensitivity reactions are usually less severe than immediate reactions
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Four types of hypersensitivity reactions
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Type I - IgE reactions
Type II - Tissue specific reactions Type III - Immune-complex-mediated reactions Type IV - Cell-mediated tissue reactions |
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Two types of immune deficiency
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1. Congenital (inborn)
2. Acquired (after birth) |
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AIDS (Acquired Immunodeficiency Syndrome)
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A group of signs, symptoms, and disorders that often develop as a consequence of HIV infection
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HIV (Human Immunodeficiency Virus)
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A virus that breaks down the immune defenses, making the body vulnerable to a variety of infections and disorders
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Stress
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A state of physical or psychological arousal to stimulus
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Stressor
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The stimulus or cause of stress
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General adaptation syndrome (GAS)
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A sequence of stress response stageI, alarm; stage II, resistance or adaptions; stage III, exhaustion
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Physiological stress
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A chemical or physical disturbance in the cells or tissue fluid produced by a change in the external environment or within the body
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Dynamic steady state
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Homeostasis; the tendency of the body to maintain a net constant composition although the components of the body's internal environment are always changing
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Turnover
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The continual synthesis and breakdown of body substancs that results in the dynamic steady state
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Psychoneuroimmunological regulation
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The interactions of psychological, neurological endocrine, and immunological factors that contribute to alteration of the immune system as an outcome of a stress respense that is not quickly resolved
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Stress response
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Changes within the body initiated by a stressor
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Cortisol
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A steroid hormone released by the adrenal cortex that regulates the metabolism of fats, carbohydrates, sodium, potassium, and proteins and also has an anti-inflammatory effect
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