Path 404 Sp 2008 Acute Inflamation

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acute inflamation

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the body's response to injury irrespective of the type of injury (stab wound, bacterial infection, burn, infarct); usually defined in terms of the vascular and cellular response

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vascular response

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increased blood flow to the injured area and increased vascular permeability that allows leakage of water, electrolytes and serum proteins into the tissue spaces

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cellular response

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movement of leukocytes, predominately neutrophils and monocytes, from the blood into the tissue

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exudate

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accumulation of watery fluid, proteins and leukocytes in the tissue during the acute inflammatory response

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margination

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dilation of blood vessel causes blood flow to slow down and moves leukocytes to periphery of vessel

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emigration

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after adhering to the endothelial wall, leukocytes slip between the endothelial cells into the tissue

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Which arrives first, neutrophils or macrophages?

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neutrophils

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neutrophil

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after arrival at the injured site, may die and liberate powerful digestive enzymes or they may phagocytize and digest cellular debris and foreign material before dying

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chemotaxis

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movement of white blood cells inresponse to a chemical gradient that may be positive or negative

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opsonins

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phagocytosis promoting antibodies

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marcophages (monocytes)

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arrive later than neutrophils and live in the area longer; clean up majority of inflammatory debris including neutrophils

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systemic effects of inflammation

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fever, sleepiness, loss of appetite, outpouring of neutrophils and macrophages from the bone marrow

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arachidonic acid system

What are the two degradation pathways?

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Cyclooxygenase pathway--leads to production of prostaglandins and prostacyclins

Lipoxygenase pathway--results in the production of chemotactic agents

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complement system

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initiated by antigen-antibody reaction and involves a complex cascade of chemical events leading to the production of C5-9, the membrane attack complex (MAC) which can kill cells; intermediates C3a and C5a are vasodilators

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bradykinin

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vasodilator, stimulates pain fibers

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cytokines

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regulate acute inflammation by increasing leukocyte adhesion to endothelium, increasing procoagulant activity, increasing prostacyclin synthesis, or attenuating (down-regulating) the acute inflammatory response

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transudate

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collection of fluid in tissue or in a body space due to increased hydrostatic or decreased osmotic pressure in the vascular system without loss of protein into the tissue (watery with low protein count)

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serous exudate

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contains fluid as well as small amounts of protein and often implies a lesser degree of damage

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fibrinous exudate

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exudate composed of large amounts of fibrinogen from the blood that is polymerized to form fibrin

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purulent exudate

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contains innumerable live and dead leukocytes, mostly neutrophils (pus)

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hemorrhagic exudate

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exudate in which the inury has been so severe as to damage capillary walls will be a mixture of all other types of exudate plus red blood cells

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abscess: What are they typically caused by? What are some specific examples?

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a localized, usually spherical lesion containing liquefied dead tissue and neutrophils; typically caused by bacteria; boil, furuncle, paronychia, empyema

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cellulitis

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a spreading acute inflammatory process

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ulcer

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locally excavated area of skin or mucous membrane secondary to an injury and the subsequent inflamation