6 Inflammation

Question 1

inflammation

Answer 1

local response to injury or invasion by pathogenic organisms

Question 2

what may inflammation be involved in

Answer 2

allergic reactions

Question 3

what may inflammation be a prequel to

Answer 3

prequel to the body-wide immune response

Question 4

inflammation characteristics

Answer 4

rubor
calor
dolor
tumor

Question 5

rubor

Answer 5

red

Question 6

calor

Answer 6

hot

Question 7

dolor

Answer 7

painful

Question 8

tumor

Answer 8

swollen

Question 9

what does rubor and calor do

Answer 9

> Result of local vasodilation

> Increases blood flow to the affected area

Question 10

what does dolor do

Answer 10

> Result of stimulation of nociceptive terminals by chemicals released from damaged tissue
Leads to awareness and avoidance/protection

Question 11

what does tumor do

Answer 11

> Result of increased capillary permeability
Proteins move from blood into interstitial fluid: osmotic effect attracts water
White blood cells move into damaged tissue
Provides some physical protection

Question 12

what should inflammation results be

Answer 12

> repair of damaged tissue

> defeat of pathogens

Question 13

what are the inflammation results often

Answer 13

> Ineffective (infection occurs)
Extended beyond duration of cause
Inappropriate (allergy)
Chronic (e.g. arthritis)

Question 14

what can help inflammation

Answer 14

• Relieve symptoms

- Reduce pain

Question 15

what is the triple response

Answer 15

red reaction
flare
wheal

Question 16

Red reaction effect

Answer 16

• initial reddening (hyperaemia)

- due to local arteriolar vasodilation

Question 17

what is red reaction initiated by

Answer 17

> mechanical effects of injury

> histamine

Question 18

flare effect

Answer 18

• Spreading of red area

- Due to axon reflex, via spinal cord and local branching

Question 19

what is the flare response initiated by

Answer 19

mechanical stimulation of nociceptive C-fibres

Question 20

what does flare response lead to

Answer 20

powerful vasodilators in skin (Substance P, CGRP)

Question 21

wheal effect

Answer 21

Formation of raised area

Formation of exudate associated with vascular and cellular events – a very complex process…

Question 22

what causes wheal

Answer 22

Due to accumulation of fluid (exudate) in the tissue, after increase in capillary permeability (inter-endothelial junctions)

Question 23

where does exudate form

Answer 23

site of injury
> vascular events (factors from plasma)
> cellular events (factors from cells)

Question 24

characteristics of exudate

Answer 24

• High specific gravity (1.02)
• High protein levels
• Cells & cell fragments

Question 25

Vascular events

Answer 25

- Blood leaks into tissues and initiates enzyme cascades

Question 26

what initiates vascular events

Answer 26

Initiated by the increased blood flow of the red reaction

Question 27

what do vascular events cause

Answer 27

local haemoconcentration

Question 28

what do vascular events assist

Answer 28

haemostasis

Question 29

why does the capillary wall become leaky

Answer 29

- endothelial contraction - loss of junctions - direct injury - local hormones

Question 30

effect of leaky capillary

Answer 30

Plasma leaks out and is exposed to collagen, von-Willebrand factor, non-endothelial cells = enzyme cascade

Question 31

kinin cascade

Answer 31

kallikrein bradykinin = vasodilation and pain eicosanoids = vasodilation and pain

Question 32

fibrinolytic cascade

Answer 32

plasmin = fibrinolysis | aids complement cascade to form C9 which causes bacterial cell lysis

Question 33

coagulation cascade

Answer 33

thrombin aids complement cascade | haemostasis

Question 34

what does fibrinolysis aid

Answer 34

haemostasis to wound repair in coagulation cascade

Question 35

eicosanoids

Answer 35

slow acting, delayed response

Question 36

what does kininogen form

Answer 36

B1 and B2 receptors

Question 37

kininogen (alpha-globulin) effects

Answer 37

contraction of visceral smooth muscle relaxation of vascular smooth muscle increase capillary permeability stimulate pain receptors

Question 38

endothelial cells effects

Answer 38

vasodilation bronchospasm pain many other actions

Question 39

Cellular events: tissue cells | Endothelial cells

Answer 39

Represent the site of tissue damage. Penetration of endothelium allows blood proteins to contact tissues

Question 40

what do endothelial cells generate

Answer 40

prostaglandins

Question 41

where is endothelial cells active

Answer 41

wound repair and angiogenesis

Question 42

``` Cellular events: tissue cells Tissue macrophages (Histiocytes) ```

Answer 42

Consume invading bacteria, particulates, damaged tissue etc.

Question 43

where are tissue macrophages (Histiocytes) active

Answer 43

immune response (antigen presentation) and wound repair

Question 44

Cellular events: tissue cells - what do fibroblasts synthesise

Answer 44

extracellular matrix proteins (collagen, fibronectin, laminin etc.) and ECM-regulating enzymes during wound repair and tissue turnover

Question 45

what does histamine cause

Answer 45

``` vasodilation arteriolar permeability smooth muscle contraction pain and itch allergic responses ```

Question 46

what does IL-1 do

Answer 46

stimulates fibroblasts (wound repair)

Question 47

what does IL-2 do

Answer 47

promotes T-cell proliferation (immune response)

Question 48

what do polynuclear leukocytes

Answer 48

adhere to and migrate through endothelium (chemotactic response to complement cascade)

Question 49

Drug treatments for inflammation

Answer 49

Steroidal: Glucocorticoids Non-steroidal (NSAIDs) Anti-histamines