PTAT 2530 Ch. 2 Inflammation

Circulatory Changes

-Arteriole constriction followed by vasodilation -Active hyperemia -increased hydrostatic pressure (edma) -Slowed circulation (congestion) -RBCs cluster (rouleaux) and WBCs margination

Classsification of Inflammation

-Duration -Etiology -Location -Pathologic Features

Serous

-Fluid/Drainage of the exudate -if the fluid is clear its serous -someone after a burn may produce alot of this -looks like bubbles on the skin **The least pathological form**

Mediators of Inflammation

1. Plasma Derived 2. Cell Derived

Contracture

A joint that is fixed at a certain degree of motion

Which of the following is NOT an activity neutrophils primarily participate in? A. Clot Formation B. Cytokine production C. Phagocytes D. Pus Formation

A. Clot Formation (Platelets form clots)

Activated Hageman Factor

Acts upon our plateletts top help clot

Duration

Acute: Condition that hasn't been present long, about 14 days or less Chronic: Generally a longer lasting condition for more than 14 days

Which of the following causes the redness and swelling associated with inflammation A. Arteriole constriction B. Arteriolar dilation C. Venule constriction D. Venule dilation

B. Arteriolar Dilation

Which of the following is NOT a cardinal sign of inflammation? A. Calor B. Palor C. Rubor D. Tumor

B. Palor (Pale)

A 41 year old male undergoes surgery and has part of a population of stable cells removed. Which of the following best describes how the body will heal this defect?

B. The remaining cells will enter mitosis to replace the lost tissue **Cardiac tissue is the only tissue cell that doesnt regenerate**

Which of the following effects does bradykinin have that histamine does not have? A. Activates the coagulation B. acts faster C. Incites Pain D. increases vessel permeability

C. Incites Pain

Which of the following is the common terminal pathway of the complement system? A. Anaphylaxis B. Lectin patheway C. Membrane attack complex formation D. Opsonification

C. Membrane attack complex formation (associate the 2 together)

Arachidonic acid is derived from which of the following sources? A. Cytoplasmic proteins B. Extracellular proteins C. Phospholipids D. Nucleic Acids

C. Phospholipids (fatty acids)

Which of the following is the mildest form of inflammation? A. Fibrinous B. Purulent C. Serous D. Ulcerative

C. Serous Inflammation (least pathological)

Mechanical Factors

Can the patient still bend or straighten their limb with the wound

Which of the following wounds will heal the quickest?

D. A small eye wound healing by primary intention in a 30 yr old female **Primary has quickest** **The younger you are the better**

Which of the following best describes phagocytosis? A. Migration of a PMN out of a blood vessel B. Migration of a PMN to the site of injury C. Release of interleukins by PMN D. Uptake of debris by PMN

D. Uptake of debris by PMN

Dehiscence

Deficient scar formation

Complications of wound healing

Dehiscence Keloids Contractures

Functio Laesa

Disturbed function

Systemic Symptoms

Fever leukocytes constitutional symptoms (how the patient feels) Psuedomembranous can be systemic

Calor

Heat

Plasma Inflammation

Histamine Bradykinin Activated Hageman Factor

Active Hyperemia

Increased blood flow

Bradykinin

Induces pain (we cannot tell when this or histamine will occur) Longer acting

Clinical Features of Inflammation

Localized symptoms Systemic Symptoms

Location

Localized: Pain and inflammation is generally in one confined are Widespread: Pain or inflammation is not confined to one general area but in multiple areas or radiates to different locations

Macrophages with wound healing

Myofibroblast Fibroblasts angioblast **words that end with Blast are healers** **opposite of that, words that end with clast breakdown**

Dolor

Pain

Cells that participate in wound healing

Polymophonucular Luekocytes Macrophages

Cells of Inflammation

Polymorphonucular neutrophils (WBC's) Eosinophils Basophils Macrophages Platelets Lymphocytes Plasma Cells **If you are lacking in any one of these, it affects the inflammation process**

PMN

Primary Monocyte Neutrophil (WBC's)

Mitotic Cell Cycle

Prophase Pro-metapahse Metaphase Anaphase Telephase

Rubor

Redness

Pathologic Forms of Inflammation

Serous Fibrinous Purulent Ulcerative Psuedomembraneous Chronic Granulmatous

Localized Symptoms

Serous is often localized

Determinants of Wound Healing

Site of wound Size of wound Mechanical factors Infection Circulatory status Nutritional and metabolic factors Age

Pathologic Featrures

Size Color How much Wet/dry Exudate?

Granuloma

Something that grows on the exterior or outside the skin on the epithelium. they are very LARGE!

Tumor

Swelling

Secondary Intention (Wound Healing)

The wound has to be irrigated and treated to destroy bacteria inside Like a surgical incision Be careful about disturbing wound healing with this one when treating

Emigration of Leukocytes

WBC's leaving the blood vessels carry exudate Exudate can cause swelling or seeping puss is an example and is white or yellow

Edema

WBC's move out of the blood vessels into the interstatial fluid

Phagocytosis

WBCs engulf bacteria that they find and release it

Etiology

What Caused it? Infectious Chemical Physical (injury or surgery) Immune Causes (Rheumatoid Arthritis)

Fibrinous Inflammation

When something is long term, it can affect the fibers of the muscles that prevents the muscle from functioning correctly

Scar Tissue

You can have internal or external scar tissue

Plasma Derived

a chemical has to cause the plasma inflammation

Keloids

excess scar formation **Can lead to joint contractures**

Histamine

fairly short acting or has a short action time (20-30 mins) released from platelets and mast cells

Fistula

found between 2 hollow organs like in the small intestines or the esophagus and the stomach (ulcer). It creates a loop that is not supposed to be there

Arachidonic Acid Derivatives

it is a fatty acid that also can cause inflammation and is found within our blood plasma

The Complement System

it is a series of several different proteins: They come from the liver and circulate in the bloodstream and also help our blood to clot (w/platelets)

Purulent Inflammation

like the serous fluid except is discolored like yellow or green. A strong sign of inflammation

Cardinal signs of inflammation

redness, swelling, heat, pain, loss of function

Hypothalamus

regulates our bodys temperature

Sinus

same as an abscess but it has an exit or an opening (like a pimple or a cyst)

Cell Derived

the WBCs are the cause

Primary Intention (Wound Healing)

the wound heals itself granulation tissue comes from the dermis

Psuedomembranous Inflammation

this is the linning of the intestines or anywhere else that has a mucosal membrane lining

Abscess

usually forms within a structure or an organ (confined: no opening or exit)