Acute inflammation

Question 1

What are the causes of acute inflammation

Answer 1

Micro-organisms (bacteria, fungi, viruses, parasites)
Mechanical (trauma, injury to tissue)
Chemical (Changes to pH, bile/ urine in the wrong places)
Physical (burn/ frostbite/ radiation)
Dead tissue (necrosis irritates hypersensitivity)

Question 2

List the cardinal signs of acute inflammation

Answer 2

Redness, Pain, Heat, Swelling, Loss of function

Question 3

Give the immediate effects of acute inflammation

Answer 3

Pyrexia - raised temperature
Unwell - nausea, lose appetite, abdominal pain
Neutrophilia - raised WBC count

Question 4

Give the three main microvascular changes that occur

Answer 4

Change to blood vessel radius and blood flow
Increased permeability
Movement of neutrophils

Question 5

Describe the sequence in which blood vessel radius increases

Answer 5

Short arterial constriction for protection
Local arterial dilation - excess blood in vessels
Relaxation of vessel smooth muscle
Increased radius > increased tissue blood flow . observed redness and heat

Question 6

Describe what happens to blood vessels as an outcome of changes in permeability

Answer 6

Endothelial leak - fluid and proteins not held in vessel lumen
Leads to exudation

Question 7

Describe what happens to neutrophils and RBC

Answer 7

WBC marginate to endothelium (pavement) and emigrate to the extravascular tissue
RBC aggregate in the centre of the lumen (rouleaux formation)

Question 8

Describe suppuration

Answer 8

Pus formation

Question 9

What surrounds the pus

Answer 9

Pyogenic membrane with ingrowth of granulation tissue

Question 10

What is contained in pus

Answer 10

dead tissue, organisms, neutrophils, RBC, debris

Question 11

Describe organistaion

Answer 11

Granulation tissue repairs wound

Leads to fibrosis and formation of a scar

Question 12

What does granulation tissue contain

Answer 12

New capillaries (angiogenesis)
fibroblasts and collagen
macrophages

Question 13

Describe exudation

Answer 13

Net movement of plasma from capillaries to extravascular space.
Fluid accumulates to form an oedema
Swelling > pain > reduce function

Question 14

Describe dissemination

Answer 14

Inflammation spreads to bloodstream so patient becomes septic

Question 15

What are the clinical symptoms of dissemination

Answer 15

Inability to supply tissue with blood
Peripheral vasodilation
High heart rate (tachycardia)
Low BP (hypotension)
Haemorrhagic skin rash - damaged vessels leak blood
Tissue hypoxia - FATAL

Question 16

List the outcomes of acute inflammation

Answer 16

Resolution (ideal)
Suppuration (pus)
Organisation
Dissemination
Exudation
Chronic inflammation

Question 17

List the long term effects of acute inflammation

Answer 17

Lymphadenopathy - enlargement of regional lymph nodes
Weight loss - catabolic process
Anaemia

Question 18

Summarise the mediators of inflammation

Answer 18

vasodialtion/ vasoconstriction
Altered permeability
Neutrophil adhesion
Chemotaxis - neutrophils move to damaged area
Itch and pain
DYNAMIC BALANCE TO FAVOUR/ INHIBIT INFLAMMATION

Question 19

Where can mediator molecules come from

Answer 19

on endothelial cells 
released from cells
In plasma (need activated)

Question 20

Recognise the benefits of acute inflammation

Answer 20

Rapid response to insult
Cardinal signs/ loss of function protect area
Neutrophils destroy organisms and denature antigen
Plasma proteins localise process
Resolution and return to normal