Path - Inflammation & Healing

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abdcess

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A circumscribed collection of purulent exudate frequently associated with swelling and other signs of inflammation.

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abrasion

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An excoriation, or circumscribed removal of the superficial layers of skin or mucous membrane.

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arachidonic acid metabolites

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important chemical mediator from damaged cells or tissues

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carbuncle

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Deep-seated pyogenic infection of the skin and subcutaneous tissues, usually arising in several contiguous hair follicles, with formation of connecting sinuses.

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cardinal signs

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cardinal signs of inflammation are redness, swelling heat and pain (rubor, calor, dolor, tumor)

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cellulitis

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Inflammation of subcutaneous, loose connective tissue

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edema

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An accumulation of an excessive amount of watery fluid in cells or intercellular tissues.

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empyema

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Pus in a body cavity; when used without qualification, refers specifically to pyothorax.(in pleural cavity)

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eosinophilic

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Staining readily with eosin dyes; denoting such cell or tissue elements.-- stains pink

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epitheliold cell

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seen in granulomatous chronic inflammation. They are modified activated macrophages which resemble epithelium in having abundant plump cytoplasm which stains a pale pink in H & E sections. Their cytoplam is rich in endoplasmic reticulum, Golgi vesicles and vacuoles, and they apprear to be adapted more for secretion than for phagocytosis. Epitheliod cells are considered to be the defining cell type of the granuloma

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erysipelas

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A specific, acute, superficial cutaneous cellulitis caused by beta-hemolytic streptococci and characterized by hot, red, edematous, brawny, and sharply defined eruptions; usually accompanied by severe constitutional symptoms.

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exudate

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Any fluid that has exuded out of a tissue or its capillaries, more specifically because of injury or inflammation (e.g., peritoneal pus in peritonitis, or the exudate that forms a scab over a skin abrasion) in which case it is characteristically high in protein and white blood cells.

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catarrh

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Inflammation of a mucous membrane with increased flow of mucus or exudate.

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purulent

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Containing, consisting of, or forming pus.

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sanguineous

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Relating to blood; bloody.

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serous

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Relating to, containing, or producing serum or a substance having a watery consistency.

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fibrinous

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Pertaining to or composed of fibrin.

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folliculitis

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An inflammatory reaction in hair follicles; the lesions may be papules or pustules

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furuncle
syn. boil

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A localized pyogenic infection, most frequently by Staphylococcus aureus, originating deep in a hair follicle.

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sty

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inflammation of the sebaceous gland of an eyelash.

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Giant Cells-Langhans type

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multinucleated giant cells seen in tuberculosis and other granulomatous diseases; the nuclei are arranged in an arciform manner at the periphery of the cells;

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Giant Cell-Foreign body type

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a multinucleate “cell” or syncytium formed around particulate matter in chronic inflammatory reactions, formed by a fusion of macrophages.

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Asteroid Body in Giant Cell

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an eosinophilic inclusion resembling a star with delicate radiating lines, occurring in a vacuolated area of cytoplasm of a multinucleated giant cell; especially frequent in sarcoidosis, but also seen in other granulomas;

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Schaumann bodies

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concentrically laminated calcified bodies found in granulomas, particularly in sarcoidosis.

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gliosis

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Overgrowth of the astrocytes in an area of damage in the brain or spinal cord.

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granuloma

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Term applied to nodular inflammatory lesions, usually small or granular, firm, persistent, and containing compactly grouped modified phagocytes such as epithelioid cells, giant cells, and other macrophages.

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gummatous necrosis

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grossly yellowish-white, rubbery
- syphilis, etc

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healing

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replacement of destroyed or lost tissue by viable tissue either by
1)regeneration - replacement of lost parenchyma by cells of the same type
2) repair- replacement of lost cells by connective tissue(the scar)

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hemoconcentration

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Decrease in the volume of plasma in relation to the number of red blood cells; increase in the concentration of red blood cells in the circulating blood

Occurs in delayed prolonged acute inflammation after extravasation of intracellular fluid.

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hyperemia

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The presence of an increased amount of bloodflow in a part or organ.

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impetigo

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A contagious superficial pyoderma, caused by Staphylococcus aureus and/or group A streptococci, that begins with a superficial flaccid vesicle that ruptures and forms a thick yellowish crust, most commonly occurring in children.

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incision

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A cut; a surgical wound; a division of the soft parts usually made with a knife.

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inflammation

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A fundamental pathologic process consisting of a dynamic complex of cytologic and chemical reactions that occur in the affected blood vessels and adjacent tissues in response to an injury or abnormal stimulation caused by a physical, chemical, or biologic agent, including: 1) the local reactions and resulting morphologic changes, 2) the destruction or removal of the injurious material, 3) the responses that lead to repair and healing. The so-called “cardinal signs” of inflammation are: rubor, redness; calor, heat (or warmth); tumor, swelling; and dolor, pain; a fifth sign, functio laesa, inhibited or lost function, is sometimes added. All of the signs may be observed in certain instances, but no one of them is necessarily always present.

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acute inflammation

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any inflammation that has a fairly rapid onset, quickly becomes severe, and is usually manifested for only a few days, but which may persist for even a few weeks; characterized histologically by edema, hyperemia, and inflitrates of polymorphonuclear leukocytes.

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Subacute inflammation

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circumstance that occurs after repeated bouts of acute inflammation which progress to partial healing before another acute episode occurs.
-characterized by the presence of both acute anc chronic inflammatory cells

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chronic inflammation

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an inflammation that may begin with a relatively rapid onset or in a slow, insidious, and even unnoticed manner, and which tends to persist for several weeks, months, or years and has a vague and indefinite termination; occurs when the injuring agent (or products resulting from its presence) persists in the lesion, and the host's tissues respond in a manner (or to a degree) that is not sufficient to overcome completely the continuing effects of the injuring agent; characterized histopathologically by infiltrates of lymphocytes, plasma cells, and histiocytes; fibrosis; and granuloma formation

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granulomatous inflammation

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an inflammatory reaction in which the distinguishing feature is an actual increase in the number of tissue cells -- characterized by increase in epithelioid cells

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integrin

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A family of cell membrane glycoproteins that are heterodimers composed of alpha - and beta-chain subunits. They serve as extracellular matrix glycoprotein receptors involved in cell adhesion, e.g., the mediation of adhesion of neutrophils to endothelial cells.
many of them bind to a relitively small site consisting of 3 AA: arginine, glycine, & aspartate-RGD

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itis

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inflammation of

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lymphangitis

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inflammation of lymphatics

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lymphadenitis

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inflammation of lymph nodes

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keloid

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A nodular, firm, movable, nonencapsulated, often linear mass of hyperplastic scar tissue, tender and frequently painful, consisting of wide irregularly distributed bands of collagen; occurs in the dermis and adjacent subcutaneous tissue, usually after trauma, surgery, a burn, or severe cutaneous disease such as cystic acne, and is more common in blacks.

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kinin

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chemical mediator of aute inflammation. Activated directly or indirectly by Factor VII. result from action of kallikrein. Potent producers of pain and promote peripheral vasodilation through smooth muscle relaxation and contraction of endothelium

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labile cells

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Cells that undergo cell division throughout life. Their replacement is usually rapid and presise.
e.g., surface epithelia, mucosal lining of all excretory ducts of the body glands, transitional cells of urinary tract, hematopoietic cells, etc.

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stable cells

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Do not normally replicate, except at a very low rate, but can be stimulated to multiply rapidly. e.g., liver, kidney, vascular endothelium

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perminant cells

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cells that cannot undergo mitotic division to any significant extent in post-natal life. While their loss may result in some attempt at regenration particularly in neurons of the peripheral nervous system, success is minimal and the end result is commonly their replacenemt by scarring or gliosis. e.g, neurons, cardiac mm, etc

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leukocyte

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WBC
circulating may indicate inflammation

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adhesion

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damaged tissues release cytokines that activate the endothelium of nearby blood vessels to display molecules(P, E,ICAM, & VCAM) selectin) which stick to leukocyte causing them to bind and migrate into the extravascular space to reach injured tissues.

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chemotaxis

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Locomotion along a chemical gradient

once leukocytes are in the extravascular space they are guided towards the site of injury by factors such as C5, N-formyl peptides, leukotriene, B4, platelet activating factor, & IL-8

The result of chemotaxis is a local iaccumulation of leukocytes at the source of the inflammatory stimulus, where phagocytosis procedes

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emigration

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when misshapen adherent leukocytes find their way through wident intercellular junctions of vascular endothelium into extravascular space to reach damaged tissue

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margination

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A phenomenon that occurs during the relatively early phases of inflammation; as a result of dilation of capillaries and slowing of the bloodstream, leukocytes tend to occupy the periphery of the cross-sectional lumen and adhere to the endothelial cells that line the vessels.

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pavementing

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when integrins bind to VCAM &ICAMs the leukocytes undergo a drastic change in shape before they emigrate through the pores in the vascular endothelium.

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phagocytosis

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Attachment (opsonins)
Engulfment
Killing or degradation

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neutropenia

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The presence of abnormally small numbers of neutrophils in the circulating blood.

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neutrophilia

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An increase of neutrophilic leukocytes in blood or tissues; also frequently used synonymously with leukocytosis, inasmuch as the latter is generally the result of an increased number of neutrophilic granulocytes in the circulating blood (or in the tissues, or both). N. is usually absolute, i.e., there is an increase in the total number of leukocytes as well as an increased percentage of neutrophils; in some instances, neutrophilia may be relative (i.e., there is an increased percentage of neutrophils), but the total number of all types of leukocytes may be within the normal range.

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organization

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fibroblasts are attracted to the site of chronic inflammation by chemotactic factors and roliferate from those locally present. They are prominent when organization is taking place.

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phlegmon

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An inflammatory mass of the subcutaneous tissues that may progress to an abscess.

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primary union (healing by first intention)

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healing by fibrous adhesion, without suppuration or granulation tissue formation.

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purulent

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Containing, consisting of, or forming pus.

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pus

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A fluid product of inflammation, consisting of a liquid containing leukocytes and the debris of dead cells and tissue elements liquefied by the proteolytic and histolytic enzymes (e.g., leukoprotease) that are elaborated by polymorphonuclear leukocytes.

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regeneration

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Reproduction or reconstitution of a lost or injured part.

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repair

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Restoration of diseased or damaged tissues naturally by healing processes or artificially, as by surgical means.

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resolution

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The arrest of an inflammatory process without suppuration; the absorption or breaking down and removal of the products of inflammation or of a new growth.

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respiratory burst

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the marked increase in metabolic activity that occurs in phagocytes and certain other cells following binding of particles resulting in an increase in oxygen consumption, formation of superoxide anion, formation of hydrogen peroxide, and activation of the hexose monophosphate shunt.

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RGD

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arginine, glycine, & aspartate--three AA that make up an adhesion molecule that integrins on leukocites bind to before undergoing migration to damaged tissue

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scarring

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fibrous tissue replacing normal tissues destroyed by injury or disease.

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healing by second intention

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delayed closure of two granulating surfaces.

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selectin (E,L,P)

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A cell surface molecule involved in immune adhesion and cell trafficking.

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suppuration

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The formation of pus.

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transudate

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Any fluid (solvent and solute) that has passed through a presumably normal membrane, such as the capillary wall, as a result of imbalanced hydrostatic and osmotic forces; characteristically low in protein unless there has been secondary concentration.

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triple response

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the triphasic response to the firm stroking of the skin. Phase 1 is the sharply demarcated erythema that follows a momentary blanching of the skin and is the result of release of histamine from the mast cells. Phase 2 is the intense red flare extending beyond the margins of the line of pressure but in the same configuration, and is the result of arteriolar dilation; also called axon flare because it is mediated by axon reflex. Phase 3 is the appearance of a line wheal in the configuration of the original stroking.

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ulcer

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A lesion through the skin or a mucous membrane resulting from loss of tissue, usually with inflammation.

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vesicle

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A small (less than 1.0 cm in diameter), circumscribed elevation of the skin containing fluid.