patho chapter 5

inflammation reaction purpose:

prevent the spread of damage agents to set the stage for repair

affects of inflammation:

• capillary dilation

• increases capillary permeability

• attraction of leukocytes

systemic effects of inflammation:

• fever

• feeling ill

• severe widespread of inflammatory process

characteristics of inflammation:

• heat and redness from dilated blood vessels

• swelling like edema

• tenderness and pain for irritation or never endings

• impairment of function die to any agent that causes cell injury

causes of inflammation:

a nonspecific response to any gent that causes cell injury

dominant cells of acute inflammation:

• monocyte

• polymorphonuclear leukocyte cell

Polymorphonuclear leukocyte cell

• most important cell in acute inflammatory response

• neutrophils arrive first

monocyte:

follow water to clean up tissue damage

exudate:

fluid mixture of protein, leukocyte, and tissue debris

benefits of exudate:

• dilutes toxins to reduce further damage

• Increase pain to prevent additional injury

• Brings antibodies into tissue to act against microorganisms

• Brings protein into tissues

types of exudates:

• Serous: primarily fluid, endothelial cells contract slightly so only fluid escapes like a blister

• Purulent: large inflammatory cells of living and dead WBS, like pus or abscess

mild inflammatory process:

self limiting, subsides with tissue resolution

severe inflammatory process:

tissue damage

goals of healing:

• restore structure

• strength

• some function

regeneration healing:

• when tissue is replaced from parenchyma

• lost cells are replaced by mitosis of adjacent uninjured cells

repair healing:

• when fibrous scar tissue fills the gap left by the loss of damage tissue

• restore the strength and structural integrity of tissues that can’t regenerate

inflammatory mediators:

chemical agents that intensity the inflammatory process

cell derived mediators:

• mast cells

• platelets

• arachidonic acid derivatives

mast cells:

specialized CT cells with granules filled with histamine and heparin

platelets:

release histamine and serotonin when activated

Arachidonic acid derivatives:

produced by all WBC's

mediators form blood plasma:

• Formed following a cascade of activation steps

• Bradykinins: activation is triggered by one of the proteins in the blood coagulation cascade

• Complement: consists of 20 blood proteins that circulate in inactive form

Roles of lysosomal enzymes with inflammation:

Released from the cytoplasm of phagocytic neutrophils and monocytes that are damaged or destroyed during an inflammatory reaction

Roles of antigen-antibody with inflammation:

• Activates complement, generating mediators

• Attracts leukocytes

Harmful effects of inflammation:

• Tissue injury results in part from the injurious agent and in part from the inflammatory reaction itself

• In most cases inflammation is self-limited and subsides when harmful agent has been eliminated

• Pain: signals tissue damage and limits use of injured tissue

• Swelling: sometime it is so great that it impairs function or blocks passages

• Tissue damage: sometimes can leads to damage of healthy tissue

Temperature:

• Application of cold or heat

• Cold: applied early to limit swelling since it causes vasoconstriction

• Heat: applied after to stimulate phagocytosis

Elevation:

limits swelling by slowing blood flow and promoting drainage

Compression:

limits welling by preventing exudate formation due to increased tissue pressure and promoting drainage

Drug therapy;

• Directed at chemical mediators that underlies inflammation

• Corticosteroids: used to suppress a persistent inflammatory

• NSAIDs: block production of prostaglandins

• Antihistamines: block the action of histamine at blood vessel receptors

When might chronic inflammation occur:

• Inflammation can become chronic when the acute inflammatory response is unable to remove or neutralize an injurious agent

• Relatively quiet, smoldering inflammation, associated with repeated attempts of the body healing

• Causes damage of normal tissue

Predominant cells:

lymphocytes, plasma cells, and monocytes