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27 Cards in this Set

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What is inflammation?
• a protective response intended to eliminate the intial cause of cell injury as well as the necrotic cells and tissues resulting from that injury
• reaction of vascularized tissue to local injury
What are the two basic patterns of inflammation?
acute and chronic
What are the 5 cardinal signs of acute inflammation?
• redness (rubor)
• swelling (tumor)
• heat (calor)
• pain (dolor)
• loss of function (functio laesa)
What are the 2 major components of acute inflammation?
• Vasular stage
• Cellular Stage
What occurs during the vascular stage?
• almost immediately, there is a momentary constriction of small blood vessels in the area of injury
• then vasodilation of arterioles and venules causing redness and warmth
• then an increase in capillary permeability > fluid moves into the tissues > swelling, pain, & loss of function
• as fluid moves out of the capillaries, there is stagnation of blood flow and clotting of blood in the small capillaries, which helps in localizing the spread of infection
Describe what happens during the cellular stage of acute inflammation
• movement of phagocytic WBC (leukocytes) in the area of injury
• two types of leukocytes: granulocytes & monocytes
What is the primary phagocyte that arrives early at the site of inflammation?
Neutrophil
What are the names of immature neutrophil released from the bone marrow?
bands
Which granulocyte contains histamine?
Basophils
What are some characteristics of mast cells?
• widely distributed in the connective tissues throughout the body
• prevalent along mucosal surfaces of the lung, GI tract, and dermis of the skin
• when combined with IgE, play a central roll in allergic & hypersensitivity reactions
What is the sequence of events in the cellular response to inflammation of leukocytes?
1. margination: adhesion of WBC to the endothelial cells of blood vessels
2. emigration: leukocytes pass through the capillary walls, and move into the tissue spaces
3. chemotaxis: process by which leukocytes migrate due to a chemical signal (such as cytokines, bacterial or cellular debris, and complement)
4. phagocytosis: involves opsonization, engulfment & intracellular killing
What is opsonization?
the enhanced binding of an antigen due to antibody or complement
What are some characteristics of histamine?
• found in high concentrations in circulating platelets, mast cells, and basophils
• stimulated release by trauma and immune reactions involving binding of IgE antibodies
• causes dilation and increased permeability of capillaries
How do NSAIDS work?
NSAIDs reduce inflammation by inactivating the first enzyme in the cyclooxygenase pathway for prostaglandin synthesis
Which chemical mediator mediates swelling, redness, & tissue warmth?
histamine, prostaglandins, leukotrienes, bradykinin, & platelet-activating factor
Which chemical mediator mediates tissue damage?
lysosomal enzymes and products release from neutrophils, macrophages, and other inflammatory cells
Which chemical mediator mediates chemotaxis?
complement fragments
Which chemical mediator mediates pain?
prostaglandins & bradykinins
Which chemical mediator mediates fever?
IL-1, IL-6, & TNF
Which chemical mediator mediates leukocytosis?
IL-1 & other cytokines
What are some causes of chronic inflammation?
• recurrent or progressive acute inflammatory process
• low-grade smoldering responses that fail to evoke an acute response
What are the 2 patterns of chronic inflammation?
1. nonspecific chronic inflammation - involves diffuse accumulation of macrophages & lymphocytes; leads to scar formation

2. granulomatous inflammation - development of granulomas, a mass of macrophages surrounded by lymphocytes; seen with poorly digestible agents that are not easily controlled by other inflammatory mechanisms
What are the most prominent manifestations of inflammation?
1. acute-phase response
2. alterations in WBC count
3. fever
What changes occur during the acute-phase response?
• changes in the concentration of plasma proteins
• increased erythrocyte sedimentation rate (ESR)
• fever
• increase # of leukocytes
• skeletal muscle catabolism
• negative nitrogen balance
Name 2 proteins that exhibit increased synthesis by the liver during the acute-phase response.
1. fibrinogen
2. C-reactive protein (CRP)
What is the function of C-reactive protein (CRP)?
• protective in that it binds to the surface of invading microorganisms and targets them for destruction by complement and phagocytosis

• has antiinflammatory functions
What occurs during the inflammatory phase?
• hemostasis
• constriction of injured blood vessels
• initiation of platelet activation and aggregation
• then vessel dilation aloowing plasma and blood components to leak into the injured area
• migration of phagocytic WBC