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