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101 Cards in this Set

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  • Back
What are the components of an acute inflammatory response?
increased blood flow, changes in structure of microvasculature, loss of plasma proteins and blood cells from circulation
What is the Lewis Triple response?
1. transient vasoconstriction
2. arterioles dilate
3. fluid loss and stasis
What are 7 things that can cause acute inflammation?
1. infections
2. trauma
3. physical agents
4. chemical agents
5. necrosis
6. foreign bodies
7. hypersensitivity
rubor
red
color
heat
tumore
swelling
dolor
pain
vascular alterations in acute inflammation
vasodilation, increase permeability, stasis becuase of the dilated vessels, big cells move to the outside (WBC) to be able to go into tissue
What is the hallmark of acute inflammation?
arterioles dilate and increase vascular permeability, fluid into extracellular space
Why do we lose fluid?
increase in capillary hydrostatic pressure and increase in colloid osmotic pressure
What are the mechanisms for increased vascular permeability?
histamine and bradykinin
What factors are involved in a direct injury?
arterioles, capillaries and venules; there is immediate and sustained leakage
What are factors are involved in leukocyte dependent injury?
mostly venules, pulmonary capillaries and there is a late response
What is an immediate sustained?
occurs with burns, lytic bacteria infections; leakage starts with injury and lasts hours to days
What is a delayed prolonged injury?
mild to moderate thermal injury; sunburn, 2-12 hours post injury
What is are the factors involved in increased transcytosis?
venules and vascular endothelium-derived growth factor
margination
vessel dilates and heavy cells move to outside
diapedesis
active process; involves movement of cells through junctions in endothelial cells
migration
migration of cells to damaged areas
What are the adhesion molecule?
E-selectins, P-selectins and L-selectins
E-selectins
found on endothelial cells and induced by TNF and IL-1
P-selectins
found on endothelial cells and platelets; redistributed to cell surface from Weibel-Palade bodies by histamine, thrombin and PAF
What are the immunoglobin-like adhesion molecules?
ICAM-1 and VCAM-1
What are the integrins important in inflammation?
LFA-1 and Mac-1 and VLA-4; found on leukocytes and mediate binding to endothelial cells
What are the steps in leukocyte emigration?
1. blood flow slowed and WBC undergo margination
2. mediators stimulate changes in endothelium
3. rolling occurs
4. affinity of intergin increases keeping the cells at the site of injury
5. reorganization of cytoskeletons of leukocytes
What are the roles of TNF and IL-1 in response to injury?
act on endothelial cells to enhance adhesion molecules
What increases the avidity of integrins?
chemokines
What are the receptors for diapedesis?
PECAM-1 and CD99
chemotaxis?
unidirectional migration of leukocytes in response to a diffusion gradient of a chemical attractant
chemokinesis
increased frequency or velocity of leukocytes
What are exogenous chemoattractants?
bacterial products
endogenous chemoattractants
components of C' cascade, leukotrienes and cytokines
What is the process of chemoattractants?
bind to transmembrane G-protein receptors on leukocytes, signals polymerization of actin on the leading edge of the cells, filapodia pull cell forward
What is meant by leukocyte activation?
induction of defensive responses by a variety of substances such as necrotic tissue, Ag-Ab complexes and cytokines
What receptors act in leukocyte activation?
toll-like receptors
When is phagocytosis increased?
with opsonization
characteristics of cell derived chemical mediators of inflammation
preformed in granules or newly synthesized
what are plasma derived chemical mediators?
coagulation, complement and kinin
What are some preformed mediators?
histamine (mast cells, basophils and platelets), serotonin (platelets) and lysosomal enzymes (neutrophils and macrophages)
what are some newly synthesized chemical mediators?
prostaglandins, leukotrines, platelet-activatin factors, activated O2 species, NO and cytokines
What activates Hageman?
when it encounters collagen it doesn't like
What does Hageman factor activate?
kinin and coagulation systems
What is activated in the C' cascade?
C3a and C5a, and MAC complex
When is C4 measured at normal levels?
in the alternative state but it is decreased in the classical state
Histamine
found in mast cells, basophils and platelets, causes constriction of large arteries, dilation of arterioles and increased vascular permeability
Serotonin
found in platlets, same effects as histamine; release stimulated by collagen and thrombin
What activates the Hageman factor?
HMWK, collagen, basement membrane and activated platelets
What does the Hagemen factor activate?
clotting and kinin cascade
activator of bradykinin
HMWK
Clotting cascade
XII
XI
Prothrombin
Fibrogen
Fibrin
activator of plasmin
plasminogen cleaves C3 to C3a
what does plasmin activate?
C' cascade
product of fibrin
fibrin split products
C3a and C5a
anaphylatoxins that cause histamine release which causes vasodilation and increased vascular permeability
effector functions of complement pathway
inflammation C3a and C5a
phagocytosis C3a
lysis MAC complex
actions of bradykinin
increase vascular permeability, smooth muscle contraction and vasodilation and pain
activator of fibrinogen?
thrombin
functions of fibrinopeptides
increased vascular permeability and cheomtactic for leukocytes
function of fibrin split products?
increased vascular permeability
products of arachidonic acid?
lipoxygenase and cycloxygenase
product of cycloxygenase?
prostaglandins and then prostacyclins and TXA's
product of lipoxygenase
leukotrienes
constituents of specific granules in leukocytes
lactoferrin, lysozyme, plasminogen activator
constituents of azurophil granules of leukocytes
myeloperoxidase; larger and more detrimental
free radicals released from PMNs and macrophages, functions?
endothelial cell injury, generation of chemotactic lipids and inactivate important proteases
purpose of platelet activating factor?
activate platelets, causing their aggregation and the release of 5HT and histamine; can produce all the cardinal signs of inflammation
mechanims for platelet activating factor to produce the signs of inflammation
leukocyte adhesion, leukocyte degranulation
oxidative burst
increased vascular dilation
vasodilation
bronchoconstriction
2 important cytokines in inflammation
IL-1 and TNF; modulate function of other cells
chemokine function
recruitment of leukocytes and regulation of passage through tissue; ex. platelet factor 4 and eotaxin
3 isoforms of NO
1. endothelial
2. neuronal
3. inducible
function of endothelial and neuronal NO
relax smooth muscle, reduce platelet aggregation, inhibit leukocyte rolling, adhesion and tethering
diseases where NO is defective
diabetes, hypertension and athersclerosis
chemotactic factors for neutrophils
eosinophil chemotactic factor, LTB4
chemotactic factors for macrophages
monokines
chemotactic factors for lymphocytes
lymphokines
chemotactic factors for mast cells
histamine and eosinophil chemotactic factor
involved in vasodilation
prostaglandins, NO and histamine
involved in increased vascular permeability
vasoactive amines, C3a and C5a, bradykinin, leukotrienes, PAF
involved in chemotaxis, leukocyte recruitement and activation
C5a, leukotrienes, chemokines, IL-1 and TNF
involved in fever
Il-1 and TNF, prostaglandins
involved in pain
prostaglandins, bradykinin
involved in tissue damage
PMN and macrophage lysosomal enzymes, O2 metabolite and NO
morphologic patterns of exudate
1. purulent- pus
2. cellulitis
3. pseudomembranous- sits on surface
4. urticarial- hives
5. fibrinous- fibrin like; not gotten rid of easily
6. lymphangitic- inflammation of lymphocytes
7. fibrinoid
serous
watery fluid of low protein conent; derived from serum or secretions of mesothelial cells
fibinous
outpouring of fibrinogen and conversion to fibrin
catarrhal
discharge of mucoid material
suppurative
formation of pus
hemorrhagic
large amounts of blood
abscess
localized collection of pus
cellulitis
diffuse edematous spreading inflammation within solid tissues
ulcer
local defects in the surface of organ or tissue; takes off epithelium and goes down into tissue
erosion
just takes off epithelium layer
PMNs
phagocyotize bacteria; contain azurophil and specific granules
microbiocidal mechanisms
O2 dependent and O2 independent
imporant property of lymphocytes
recirculate
basophils
circulating leukocytes with large granules containing histamine and heparin
mast cells
distributed in connective tisse; receptors for Fc of IgE; degranulate and release histamine
alpha granules of platelets
fibrinogen, platelet factor 4, platelet derived growth factor
delta granules of platelets
ATP, histamine and serotonin
chronic granulomatous disease
decreased oxidative burst
chediak-higashi syndrome
mulitple defects including locomotino and lysosomal degranulation; phagosomes can't fuse with lysosomes