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114 Cards in this Set
- Front
- Back
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What causes the acute inflammatory response?
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Cell injury (trauna, hypoxia, genetics, immune response)
and the presence of dead cells (host's, microbe, parasie, or someone else's) |
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What are the cardinal signs of inflammation?
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redness
warmth pain selling loss of function |
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What do the arterioles do during the inflammation response?
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first constrict, then dilate increasing flow
to the site and making it appear congested or red |
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What causes the "warmth" in inflammation?
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closeness to the skin surface
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What causes the swelling in inflammation?
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increased pressure in the microcirculation
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Why is the edema necessary in inflammation?
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to dilute out the toxins or invading organism
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What causes pain during inflammation?
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pressure of the edema on the nerve ending
changes in pH electrical charges |
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What happens to the vessels on the venule end of the capillary system in inflammation?
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they become more permeable by the retraction of the epithelial cells in the vessels
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What does the permeability allow?
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leukocytes (WBC's) to leak out
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What are mast cells?
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bags of granules in the loose connective tissue
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What do mast cells do?
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activate the inflammatory response
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What do mast cells do?
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activate inflammatory response in two ways
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What is degranulation?
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the release of granular contents into the extracellular tissue
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What is degranulation caused by?
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physical injury
chemicals immunologic factors (IgE) |
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What is the purpose of degranulation?
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to activate the inflammatory response
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What are the two the inflammatory response is activated?
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degranulation
biochemical mediators |
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How do biochemical mediators affect the inflammatory response?
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they are released in the granules
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What are the biochemical mediators involved in the inflammatory response?
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histamine
serotonin |
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What is the prime mediator in allergic reactions?
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histamine
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What is the most important vasoactive amine?
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histamine
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How fast in histamine released?
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in seconds
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What is serotonin released by?
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platelets
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What temporary response do histamine and serotonin cause?
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constriction of large vessel walls
and dilation of postcapillary venules |
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What is the purpose of the constriction and dilation in an allergic reaction?
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increase blood flow into the microcirculation
and increase the permeability |
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What are the two chemotaxic factors that are released in the granules?
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Neutrophil Chemotactic factor
Eosinophil chemtactic factor of anaphylaxis |
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When do neutrophils react in an inflammatory response?
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early in acute inflammation
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What are eosinophols especially phagocytic with?
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parasites
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What do eosinophils havve that break down histamine?
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enzymes that break down histamine
that control the vascular responser |
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What are leukotrines?
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slow reacting substances similar to histamine
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When are leukotrienes seen?
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late in inflammatory process but have longer response
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What do prostaglandins do?
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cause vasodilation
capillary permeability pain and fever |
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What are the two types of leukocytes?
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Granulocutes
nongranulocytes |
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What are the three types of granulocytes?
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neutrophils
eosinophils basophils |
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Give the characteristics of neutrophils
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-60-70% of WBC's
-Seen early in acute inflammation -first to arrive in acute inflammation -short life span (10 hrs) -Sensitive to acid -inmature forms called hands or stabs -mature ones are phagocytes -Remove debris in sterile wound |
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Give the characteristics of eosinophils
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-1-3% of WBC's
-controls vascular effects of serotonin and histamine -in allergic reactions IgE mediate degranulation -defense against parasite by destroying membrane |
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Give the characteristics of basophils
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-03.-0.5% of WBC's
-act similar to tissue mast cells -contain histamine -increased in allergies and stress |
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What are the two types of agranulocytes
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Monocytes
Lymphocytes |
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Give the characteristics of Monocytes
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-3-8% of WBC's
-largest WBC -found in tissues (spleen, liver, lungs) -replaces neutrophil in 3-7 days -late or chronic inflammation -slower to arrive -drawn by chemotaxis --live 3-4X longer than neutrophils -acid environment -process Hb from old RBC/recycle iron |
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Give the characteristics of lymphocytes
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-humoral and cell mediated
immunity of B & T cells |
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What are the three functions of phagocytes
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chemotaxis
margination/pavementing diapedesis |
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What is chemotaxis?
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-attraction by chemical compounds
-leukocytes move to highest concentration of chemotaxic compounds |
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What is margination/pavementing
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movement of phagocytes to
outside wall of blood vessels in injured area |
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What happens during phagocytosis?
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-recognize target cell and adhere to it
-engulf or ingest target (phasosome) fuse with lysosomes to become phagolysosone |
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What happens during oxygen dependent phagocytosis?
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create hydrogen peroxide which is reactive and damaging to cells
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What happens during oxygen independent phagocytosis?
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-acid pH 3.5-4.0 due to lactic acid
-proteins bind to and damage target cell membrane -lysozymes attack cell wall |
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What is the end result of phagocytosis?
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-cell dies and lyses
-lysosomal enzymes released and digest tissue then trigger inflammation process |
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What are cytokines?
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cellular hormones that communicate with cell it is bound to
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What can cytokines cause?
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reaction in the brain resulting in fever
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Name the three cytokines
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Interleukins I & II (IL1, 2)
lymphokines interferon |
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What are interleukins produced by?
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macrophage or lymphocyte
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What does IL 1 do?
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activates other phatocytic cells like neutrophils
and increase lyusosomal activity |
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What is IL 2 produced by?
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Th
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What does IL 2 do?
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-T and NK cell growth factor
-increases antibody production |
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What are lymphokines produced by?
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T-cells after being stimualted by an antigen
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Are lymphokines specific or non specific in acute inflammation?
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non-specific
(specific |
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What five actions do lymphokines have?
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-prevent macrophage from leaving site
-increase phatocytic activity -promote chemotaxis -promote maturation of monocyte to macrophage -stimulate release of more lymphokines |
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What does interferon do?
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work against viruses by preventing
them from invading normal cells |
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What are the three plama protein systems?
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-complement
-clotting -kinin |
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What does the complement system play a part in?
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every inflammatory response
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What is the complemnent system activated by?
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-antigen/antibody complex (classic pathway)
-products from bacteria (alternative pathway) -components from kinin and clotting systems) |
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What does the classic pathway include/involve?
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-antigen/antibody complex
-Fc tails of antibodies are close together and C1 proteins binds them -this activates other complement proteins in the system |
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Describe the alternative pathway
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substances from bacteria cell wall interact with C3 protein of the cascade
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Where do both pathways meet?
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C5
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What occurs during the C5-C9 response?
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-opsinization of bacteria
-leukocyte chemotaxis -degranulation of mast cells |
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What do components C8/C9 do?
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create pores in bacterial cell wall letting in
water and ions that cause cell lysis |
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What is the clotting system activated by?
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-factor XII (hageman factor)
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When is factor XII activated?
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when there is an injury
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What do injured cells trigger?
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the clotting cascade
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What are the two pathways of the clotting system?
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intrinsic
extrinsic |
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Where do the two pathways converge at?
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Factor X leading to the formation of fibrin
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What is the function of the clotting system?
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-prevent spreading of organism
-keeps organisms at site of greatest phagocytosis -forms clot that stops bleeding and forms framework for repair -activates the kinin system |
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What is the primary kinin?
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bradykinin
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What is the kinin system activated by?
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Factor XII of the clotting system. Converts inactve
form in teh plasma to bradykinin |
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when does the kinin system function?
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later phases of inflammation
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What is the function of the kinin system?
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-dilate vessels of microcirculation
-increase permeability -longer acting then histamine -work with prostaglandins to cause pain -increased leukocyte chemotaxis |
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What happens if the products of inflammation are released into non-injured tissue?
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destroys normal cells
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What controls the inflammatory response?
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-components are destroyed by enzymes in plasma
-natural antagonists for histamines, kinins, and complement proteins -histamines controlled by receptors on host target cells |
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What is the redness and warmth of inflammation due to?
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increased blood flow in injured area
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What is the swelling of inflammation due to?
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increased permeability of microcirculation
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What does the increased permeability of microcirculation cause?
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exudate/drainage containing proteins, leukocytes and possibly bacteria
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What is the purpose of exudate?
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-dilute toxins
-carry plasma proteins, leukocytes and antibodies to injured site -stimulate increased lymph drainage to discard debris |
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Name the six types of exudate
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serous
mucinous fibrinous purulent hemorrhagic mixed |
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Describe serous exudate
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water fluid with few plamsa proteins and leukocytes
(blister) -seen early or in mild inflamm. |
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Describe mucinous exudate
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seen in increased secretion from mucous secreting membranes
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Describe fibrinous exudate?
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- in severe or advanced imflammation
-fibrin accumulation usually in cavities -shaggy appearance -may lead to adhesions |
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Describe purulent exudate
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-also called supprative (pus)
-combination of neutrophils and dead bacteris -walled off like abcess -hard to treat unless drained |
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Describe hemorrhagic exudate
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-aldo called sanguinous
-increased RBC's due to blood vessel drainage |
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Describe Mixed exudate
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serosanguinous, fibrinopurulent
and mucopurulent |
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What is the pain in acute inflammation caused by?
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pressure of exudate, prostaglandins
and bradykinin |
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What does the pain in inflammatin lead to?
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decreased function
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What are the systemic
manifestations of acute inflammation? |
-fever
-leukocytosis -increased plasma proteins |
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What occurs in the body to cause fever?
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pyrogen is released from neutrophil and macrophage
affecting regulatin center of the hypothalmus resetting thermostat |
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What is fever caused by?
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exposure to bacterial toxin antigen
antibody complex or after phagocytosis |
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What is leukocytosis?
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increased numbers of circulating leukocytes
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Where are leukocytes released from?
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bone marrow
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What does "left-shift" refer to?
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more inmature leukocytes than mature ones
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What is leukocytosis stimulated by?
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inflammation
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What is the normal leukocyte count?
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5-10K mm/3
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What is looked at to determine the cause of inflammation?
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the WBC differential
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What does increased plasma proteins show?
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inflammation
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What does increased plasma protein result in?
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increased SED rate? (erythrocyte sedimentation)
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Describe RBC sedimentation
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the more plasma proteins in the blood the faster
the RBC's settle to bottom and separate out from the plasma |
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What are the causes of chronic inflammation?
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-unsuccessful treatment of acute
-bacteria with touch cell walls resistant to phatocytosis -bacteria surviving macrophage (TB, leprosy) -some bacteria produce toxins damage tissue -prolonged irritation from non-biodegradable substances |
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What are the characteristics of chronic inflammation?
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dense infiltration of lymphocytes and
macrophages -granuloma caused by foreign body or bacteria that are poorly digested -single macrophages fuse into giant cells -decay of cells in granuloma |
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What causes a walled off area in chronic inflammation?
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fibrous deposits of calcified
collagen (caseous necrosis) |
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`Why do surgical gloves how use absorbable corn starch?
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gloves dusted with talc powder caused
granulomas in wound area |
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What is the delay of cells in granuloma due to?
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-release of acid and enzymes that lead to liquefaction necrosis
-fluid diffuses out and a hollow thick walld structure remains for life |
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What is resolution?
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-restoration to original structure
and function -damage is minor -no complications -occures in tissues that can regenerate |
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what is repair?
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-occurs in tissue that does not
regenerate or injury is extensive, infected or granuloma is formed |
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What is the tissur replaced by in repair?
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by scar tissue that restores tensile
strength but not function |
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What are the three types of repair?
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primary intention
secondary intention tertiary intention |
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Describe primary intention
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-minimal tissue loss
-wound edges held by clot -in days area bridged by granulation tissue and epithelium regenerates -usually sterile surgical wounds |
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Describe secondary intention
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-edges further apart
-edges not brought together easily -need more granulation and epithelium -scar is larger -may be infected surgical wound or pressure ulcer |
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Describe tertiary intention
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-allow beginning secondary healing
-when partially filled will surgically close wound to decrease healing time |
