Pathology Test 1 Lecture 3

Front 1

__ is an Organized response to various stressors to include hemodynamic responses, cellular responses, removal of damaged or dead tissue, & preparation for repair & regeneration.

Back 1

inflammation

Front 2

the Ultimate goal of __ is to replace injured tissue w/regenerated tissue, a fibrous scar or both.

Back 2

inflammation

Front 3

Inflammation __ is the same no matter what the cause is!
__ varies with the specific cause.
__ varies with specific cause & duration of exposure to the harmful substance (could think about a sunburn. Longer exposure causes more damage)

Back 3

process
Timing
Severity

Front 4

__- the area where the blood is flowing through the blood vessel. Fluid from the blood needs an opening to leak out and travel into the __. With inflammation we open up the wall and allow the cells in the blood to flow into the __. process known as__

Back 4

lumen
interstition x's 2
edema

Front 5

steps of inflammation:
1. __
2. initial __ (couple of seconds)
3. release of __(cells in the lumen detect problem)
4. __ —increased blood flow (hyperemia)- the area turns red
5. increased __
6. __ or __ move to site of injury by chemotaxis (sending the message). __- the cells leaving the blood vessel going to the intersition (opening of the epithelial cells)
7. __ —removal of debris in preparation for healing

Back 5

injury
vasoconstriction
chemical mediators
vasodilation
capillary permeability
WBC’s or leukocytes
Diapedesis
phagocytosis

Front 6

__ and __ - eat up the invader and then die (puss)

Back 6

PMN and macrophages

Front 7

arteries vs. veins
__ larger cross sectional area
__ thiker walls

Back 7

vein
arteries

Front 8

role of __:
Give rigidity to the vessels.
Allow contraction or relaxation of smaller vessels.
Shunt blood (send blood to an area) vasoconstriction or vasodilation.

Back 8

smooth muscles

Front 9

role of __:
Keeps blood moving
Stops a clot from forming by:
-Barrier to collagen
-Metabolize ADP

Back 9

endothelial cell

Front 10

__ cells Don’t allow anything out unless they open up.
They line the inside of the blood vessel

Back 10

endothelial cell

Front 11

behind endothelial cells there is __

Back 11

collagen

Front 12

if endothelial cells become sticky due to bad eating habits could lead to __ formation

Back 12

clot

Front 13

__- attract the good guys to the invaders
__ - either vaso dialtion or construction

Back 13

Chemotactic factors
Vasoactive mediators

Front 14

4 cardinal signs/ symptoms of inflammation:
_ _ _ _ may also see _ _

Back 14

1. Calor- heat
2. Rubor- red
3. Dolor- pain
4. Edema- swelling
Functio laeso
Pus formation—neutrophils that die after engulfing dead tissue

Front 15

__ —redness caused by increased blood flow

Back 15

Rubor

Front 16

__ —heat caused by increased blood flow

Back 16

Calor

Front 17

__ —caused by shift of proteins & fluid into the interstitial space (fluid and proteins)

Back 17

Edema

Front 18

__ —pain resulting from pressure of fluid

Back 18

Dolor

Front 19

__ —swelling causing restricted joint motion (loss of function) the body doesn’t want to have joint motion until it heals

Back 19

Functio laeso

Front 20

Consequences of inflammation:
1. Dilution of __
Why? Brings blood into the area (bring good things in and bad things out)
2. __ limits further damage by decreasing function
Example: SCI or Diabetic
3. Removal of __ and __
Why? STOP destruction caused by foreign invader
4. Sets up for __ or __of tissue
5. May lead to damage of only __ cells

Back 20

microorganisms
Pain
necrotic tissue & microorganisms
repair or regeneration
injured

Front 21

vasoactive mediators:
__ —released from mast cells & basophils, causes vasodilation & bronchoconstriction (hard to breath)

Back 21

Histamine

Front 22

vasoactive mediators:
__ –released from platelets. Increases Vasodilation

Back 22

Serontonin

Front 23

vasoactive mediators:
__ –increases vasodilation & increase perception of pain in that area

Back 23

Bradykinins

Front 24

vasoactive mediators:
__ —come from cell membranes being damaged. Arterioles open up & increase vascular permeability

Back 24

Prostaglandins/Leukotrienes

Front 25

vasoactive mediators:
__- platelets increase in size and become more sticky, much more likely to clump together and form clots

Back 25

Platelet activating factor

Front 26

chemotactic factors:
Example: C5a—__—engulf debris

Back 26

complement proteins

Front 27

Cell or cell types found in acute inflammation
1. __( ) –engulf as much tissue as it can then dies there. leave puss
2. __ —pieces of cells, rush to the area to plug up damaged capillary to limit loss of blood
3.__- in blood vessel and macrophages in the interstition,

Back 27

polymorphonuclear cells (PMN's)
Platelets
Monocyte/macrophage

Front 28

types of inflammatory mediators:
-__
-__ —both B & T cells depending on cause of chronic inflammation (body trying to limit damage and figure out what is causing the inflammation)
-__ —makes antibodies by B cells
-__ —these guys lay down collagen for repair.
-__- lining the lumen also found in the interstition

Back 28

Monocyte/macrophages
Lymphocytes
Plasma cells
Fibrocytes/fibroblasts
Endothelial cells

Front 29

Hemodynamic Changes, alterations in blood flow:
1. __ (stop cock)
__ –short lived-seconds to minutes. Controlled by sympathetic discharge
__ —hyperemia. Overriding effect is arterioles open wide. Bring in good guys

Back 29

Arteriole
Vasoconstriction
Vasodilation

Front 30

Hemodynamic Changes, alterations in blood flow:
2. Increased __
-Endothelial cells contract opening junctions between the cells known as__ (btw endothelial cells)
-Plasma proteins leak out thus resulting in a reduced __pressure, increased __pressure. Bc more fluid out there is (inflimation)
-This increases the __(bring in and blood does not more as fast) & __ of RBC’s & WBC’s

Back 30

vascular permeability
tight junctions
capillary osmotic
interstitial osmotic
stasis
congestion

Front 31

endothelial separation leads to..
1. __ —pure water coming across endothelial cells. Example is sunburn, blisters
2. __ —plasma proteins and water leaking out
Ex: ascites (water follows plasma proteins)
3. __—RBC’s, plasma proteins & water present in interstitium
Ex: Bandage after a surgery

Back 31

Transudate
Exudate
Serosanginous exudate

Front 32

Vasoactive substances:
__ —Hageman clotting factor 12 & complement usually float around in blood in an inactive form.
__ —Mast cells, basophils, platelets, PMN’s, monocytes/macrophages

Back 32

Plasma derived
Cell derived

Front 33

Other mediators of inflammation:
-__ —any time Hageman Factor gets exposed to a basement membrane, specifically collagen (bc endothelial cells have opened up)
- __
-__ phospholopid bilayer gets broken down
-__

Back 33

Hageman factor XII
Complement
Arachidonic Acid
Mast cells

Front 34

Destruction of the fatty tails leads to the formation of __. which is the precursor to prostaglandins & leukotrienes.
asprin works on this ptw to limit pain bc of inflammation

Back 34

arachidonic acid

Front 35

__ are slow acting substances of anaphylaxis.

Back 35

Leukotrienes

Front 36

are found in the blood and once they leave the blood and go into the tissue, they are called Mast cells.

Back 36

basophils

Front 37

__release causes vasodilation, endothelial contraction, BRONCHOconstriction & Mucus SECRETION.

Back 37

mast cell

Front 38

__ process begins soon after tissue injury & occurs either by R&R (regeneration—regrowth OR by repair—scar formation).

Back 38

tissue healing

Front 39

__ cells are recruited by chemotaxis & begin the healing process by breaking down & removing the necrotic tissue.

Back 39

Inflammatory

Front 40

This occurs primarily by __ that secrete degradative enzymes & also eat the cellular debris, conn tissue fragments & plasma proteins in the dead tissue

Back 40

phagocytes

Front 41

__ is complex & influenced by components such as fibronectin, proteoglycans & elastin, collagen, & parenchymal (tissue) & endothelial cells.

Back 41

healing

Front 42

Plasma proteins that leak from inflammed vessels are the 1st source of __ very early in the process of injury.

Back 42

fibronectin

Front 43

__ provides the formation of scaffolding, tensile strength & the ability to glue cells together. It stabilizes fibrin, a protein that makes up blood clots.

Back 43

fibronectin

Front 44

__ binds several proteins together such as DNA derived from necrotic cells, thereby acting as an __ (marks the foreign invader for future attacks) (molecule that acts as a binding enhancer to facilitate phagocytosis) during the breakdown of necrotic tissue.

Back 44

fibronectin
OPSONIN

Front 45

fibronectin attracts __ and __by chemotaxis to healing tissue.

Back 45

Fibroblasts & macrophages

Front 46

fibronectin attracts __ in turn, secrete more fibronectin. Fibronectin binds to proteoglycans & collagens & this binding further stabilizes the healing tissue. allows for repair to start

Back 46

fibroblasts

Front 47

__are secreted in abundance by fibroblasts early during the tissue repair rxn.
they bind to fibronectin & collagen to help stabilize tissue undergoing repair.

Back 47

Proteoglycans

Front 48

Once the tissue is healed, __ contribute to the organization & stability of collagen & create an electrical charge that gives basement membranes the property of functioning like molecular sieves.

Back 48

proteoglycans

Front 49

Fibroblasts also synthesize & secrete __, a protein that becomes cross-linked to form fibrils or long sheets that provide tissues with elasticity.

Back 49

elastin

Front 50

role of connective tissue:
_ _ _ _

Back 50

Support
Protection
Nourishment
Innervation

Front 51

__ The MOST abundant protein in the body.
Provides structural support & tensile strength for almost all tissues & organs of the body.
It is a fibrous protein molecule consisting of 3 chains of a. Acid coiled in a 3D-helix

Back 51

collagen

Front 52

Each collagen type (27) has a specialized __. The a. acid makeup of each molecule and the way it is assembled vary for each type & this determines the __ properties of each type. For example, unidirectional collagen or parallel bundles contributes to the strength of tendons.

Back 52

function
structural

Front 53

__= glue producer
and is the principal extracellular component of normal tendon.

Back 53

collagen

Front 54

most common form of collagen— very strong form and can be found in all body tissues. It is the main component of mature scars & abundant in strong tissues such as tendons & bones

Back 54

type 1

Front 55

predominant type of collagenfound in cartilaginous tissue. In the annulus of the disc, it has a ½ life of 3 months; allowing for maintenance of nutritive exchanges possibly delaying further degeneration

Back 55

type 2

Front 56

__ collagen accounts for plasticity of skin & blood vessels. Elastic; strong but supple. It contains interchain disulfide bonds not found in type I & II. It is the 1st type deposited in wound healing. More prevalent in newborns.

Back 56

type 3

Front 57

in wound healing Initially, type __ collagen is laid down in a wound providing support for angiogenesis. As time passes, type__ is degraded by enzymes secreted by fibroblasts & is replaced by type _ collagen.

Back 57

3 3 1

Front 58

Type _ collagen enhances wound tensile strength & is the main component of the scar tissue that remains after repair is completed.

Back 58

1

Front 59

Inflammation __ days
Proliferation __ days
Maturation __ days
__ inflammation the inflammation phase keeps going (B and T cells will be present)

Back 59

7-10
10-30
30-100
chronic

Front 60

__ in the genes for collagen Cause a multitude of diseases of bone, cartilage & blood vessels including osteogenesis imperfecta, Ehlers Danlos syndrome, some forms of osteoporosis, OA & familial aneurysms. (abdominal aortic aneurysm)

Back 60

mutations

Front 61

__ scavengers inhibit the rate of collagen formation

Back 61

free radical

Front 62

Differences in collagen fiber __ have been demonstrated in unidirectional GH instability vs. Multidirectional instability. Smaller collagen __ in the multidirectional instability patients suggest an underlying collagen abnormality.

Back 62

Diameter x's 2