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Pathophysiology for PN > Ch3 - Inflammation And Tissue Repair > Flashcards

Ch3 - Inflammation And Tissue Repair Flashcards

1
Q

Inflammation is a non-specific response of body to local tissue injury. Part of the _________ of defense.

A

2nd line defense

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2
Q

Functions of inflammation?

A
  1. Increase blood flow to site (vascular response)
  2. Increase healing cells at site (cellular response)
  3. Prepare for tissue repair
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3
Q

Lines of defense:
▫️first:
▫️second:
▫️third:

A

1st: skin and mucous membranes
2nd: Inflammatory
3rd : immune response

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4
Q

Causes of inflammation?

A

▫️infection - microbial agent
▫️physical agents - trauma, electrical, temperature
▫️radiation - ionizing, nonionizing, UV
▫️chemicals - acid, alkali, toxins
🔹drugs, lead, ethanol, mercury
▫️nutritional - excesses or deficiencies
▫️ischemia/infarction- auto, allo, allergy
▫️Genetic and metabolic disorders

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5
Q

Advantages of inflammation?

A

▫️serves to isolate and localize injured area, protecting normal tissue
▫️can neutralize and inactivate toxic substances
▫️destroys and limits growth of microorganism
▫️prepares the area for wound healing and repair by cleaning debris

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6
Q

Disadvantages of inflammation:

A

▫️Infection: microorganisms ca more easily penetrate oedematous tissues
▫️deep ulcers: result of severe or prolonged inflammation
▫️scar tissue: due to excessive tissue damage
▫️local complications: depend on site of inflammation but may include obstruction, loss of sensation, and decreased cell function.
▫️Pain

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7
Q

Chemical mediators?

A

🔹Cell-derived

🔹plasma derived

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8
Q

Cell-derived?

A

🔺white blood cell
🔺platelets
🔺endothelial or damaged tissue cells

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9
Q

Plasma-derived:

A

🔺complement system
🔺kinin system
🔺clotting system

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10
Q

it’s primary role is to destroy and remove microorganisms to prevent infection through opsonization (making bacteria vulnerable to phagocytosis) and cell lysis (destruction)

*produced in the liver

A

Complement

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11
Q

promotes coagulation through a cascade of clotting factors

A

Clotting

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12
Q

Source of highly potent vasoactive inflammatory mediators. Amplifies the inflammatory response by triggering other inflammatory mediators.

A

Kinin

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13
Q

Vascular response?

A

▫️increased capillary membrane permeability
▫️vasodilation
▫️hyperaemia

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14
Q

Cellular response ?

A

▫️chemotaxis
▫️cellular adherence
▫️cellular migration

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15
Q

_______cells are housed in connective tissues of body and near all blood vessels - allows for immediate release of chemical mediators into blood stream

A

Mast cell

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16
Q

_________are released from WBC platelets and injured cells and signal to trigger, enhance or discontinue the inflammation response.

A

Cytokines

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17
Q

Cells Active in cellular response:

A 
▫️leukocytes
▫️neutrophils
▫️macrophages
▫️erythrocytes
▫️platelets
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18
Q

Role of these cell is phagocytosis; removal of dead tissue

A

Leukocytes

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19
Q

A type of WBC; earliest phagocytize responders

A

Neutrophils

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20
Q

A type of WBC; Large, king-lived phagocytes associated with a prolonged (chronic) inflammatory response; monocytes are immature macrophages

A

Macrophages

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21
Q

It’s a type of cell that carry oxygen to tissues

A

Erythrocyte

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22
Q

It’s a type of cell that trap harmful substances; stop bleeding; form structural origin of repair

A

Platelets

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23
Q

Healing undergoes:

A
  1. scar tissue
  2. Regeneration (replacement by same type of cell)
  3. Resolution (damaged cells recover)
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24
Q

Local Manifestation of acute inflammation:

5 cardinal clinical signs

A
  1. Redness (erythema)
  2. Heat
  3. Incapacitation
  4. Pain
  5. Exudate and edema
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25
Q

Other possible systemic manifestations:

A
  1. Malaise Headache
  2. Fatigue
  3. Anorexia
  4. Mild fever - due to pyrogens from macrophages
  5. Increased circulating leukocytes and plasma proteins
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26
Q

Benefits of fever

A

▫️stimulates phagocytosis
▫️decreases rate of multiplication of pathogens
▫️prevents release of Fe & Z from liver which bacteria feed on
▫️increased tissue repair process

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27
Q

Treatment of inflammation:

A

▫️reduced blood flow
▫️ decrease swelling
▫️block the action of chemical mediators
▫️decrease pain

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28
Q

type of inflammation, usually rapid onset w/ minimal damage and rapid resolution. It is characterized by the formation of exudates/edema.

A

Acute

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29
Q

A collection of interstitial fluid formed in the inflamed area.

A

Edema

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30
Q

Function of exudates:

A
  1. Carry plasma proteins and leukocytes to injured area
  2. Neutralize the inflammation reaction
  3. Dilute toxins
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31
Q

Type of exudates - watery, with low protein; usually seen w/ burns or allergic reactions (mild inflammation)

A

Serous exudate

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32
Q

Type of exudate, blood vessels damage with leakage of RBCs from capillaries

A

Hemorrhagic exudate

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33
Q

Type of exudate, contains large amounts of fibrin increasing the risk of scar tissue build-up in the area

A

Fibrinous exudate

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34
Q

Type of exudate, contains pus (degraded WBC, proteins and tissue debris); caused by certain microorganisms. Indicates bacterial infection.

A

Purulent exudate

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35
Q

Type of exudate, firms on mucous membranes and contains lots of mucous, ex. Rhintis, bronchitis

A

Catarrhal

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36
Q

It’s an inflammation that may last for weeks, months or years.

A

Chronic inflammation

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37
Q

Chronic inflammation may be the result of:

A

▫️an acute inflammation when the cause is not completely eradicated because the body is either:
🔺unable to remove the inflammatory agent
🔺 unable to destroy the inflammatory agent
🔺has an inadequate defense system
◽️an insidious dev’t due to chronic irritation
▫️when it involves certain type of bacteria (TB)

38
Q

In chronic inflammation, the major WBC moving to site?

A

Macrophages and lymphocytes

39
Q

Proliferation of fibroblasts also occurs, w/c can lead to:

A

▫️scarring and deformity

40
Q

What are the factors that inhibit repair?

A
  1. Old age
  2. Nutrition
  3. Immune depression
  4. Certain diseases (ex. Diabetes)
  5. Malignancy (ex. Leukaemia)
  6. Drugs
  7. Superimposed infection
41
Q

Increase blood flow to site

A

Vascular response

42
Q

Increase healing cells at site

A

Cellular response

43
Q

Inflammatory mediators

A

Mast cells and cytokines

44
Q

An inflammatory mediator released from WBC, platelets and injured cells and signal to trigger, enhance or discontinue the inflammation response

A

Cytokines

45
Q

An inflammatory mediator housed in connective tissues of body and near all blood vessels - allows for immediate release of chemical mediators into blood stream.

A

Mast Cells

46
Q

It’s a type of WBC that release bradykinin - produces histamine

A

Basophil

47
Q

What cell is activated by chemotaxis?

A

chemokines

48
Q

Local manifestation of acute inflammation

A
  1. Redness (erythema)
  2. Heat
  3. Incapacitation
  4. Pain
  5. Exudate and edema
49
Q

Other possible systemic manifestations:

A
  1. Malaise Headache
  2. Fatigue
  3. Anorexia
  4. Mild fever
  5. Increased circulating leukocytes and plasma proteins
50
Q

In chronic inflammation, _____ and ; _____ instead of neutrophils are the major WBC moving to site

A

▫️macrophages and lymphocytes

51
Q

Inflammatory cell in acute inflammation?

A

▫️neutrophil and macrophages

52
Q

Inflammatory cells in chronic inflammation?

A

Lymphocytes, plasma cells, macrophages, fibroblasts (for scarring)

53
Q

The body organs and structures contain 2 functional types of tissues:

A

▫️parenchyma (functioning cells)

▫️stroma (supporting connective tissue)

54
Q

The primary objective of healing process is to “fill the gap”

A

▫️restore the structural continuity of the injured part

55
Q

Secondary objective of healing process is _______ of the injured part.

A

restore the functional continuity

56
Q

Injured tissues heals by:

A
  1. Resolution (if tissue damage is minimal)
  2. Regeneration ofvparenchymal cells
  3. Replacement with connective tissue
57
Q

Chemical mediators are involved with healing process:

A

▫️chemotaxis; fibroblast recruitment

▫️proliferation of cells

58
Q

Ability to regenerate varies with cell type:

A

▫️labile Cells - skin and mucous membranes
▫️stable cells - undergo mitosis as necessary
▫️permanent cells - amitotic

59
Q

A cell that form lining of stomach and esophagus and are continuously being replaced.

A

▫️Labile Cells

60
Q

A bone cells divide only when necessary

A

▫️ Stable cells

61
Q

Is a type of cell once injured from ischemia, cardic Cells cannot be replaced.

A

Permanent cells

62
Q

Non-regenerated parenchymal Cells are replaced by a ________ (process also called fibrosis) when:
🔺extensive tissue damage occurred
🔺 cells are amitotic

A

▫️CT scar

63
Q

Wound healing and closure occur by _______ or _______ intention depending on the extent of tissue damage.

A

▫️primary

▫️secondary intention

64
Q

▫️ ________ intention - small wound e.g. sutured surgical incision or paper cut

▫️_________ intention - e.g. burns, large surface wounds - tissues have undergone greater loss of tissue and contamination

A

▫️primary intention

▫️secondary intention

65
Q

Tissue healing phases:

A
  1. Inflammation
  2. Proliferation (repair, regeneration, replacement)
  3. Remodelling
66
Q

Injury that heal by secondary intention undergo:

A

▫️wound contraction

67
Q

chemotactic mediators, or ________, stimulate a cellular response:

▫️chemotaxis
▫️adherence
▫️migration
▫️phagocytosis

A

Chemokines

68
Q

For chronic inflammation:
▫️macrophages
▫️lymphocytes

A

For acute inflammation
▫️PMNs
▫️Platelets
▫️Mast Cells

69
Q

Cell derived chemical mediators:

A

▫️WBC
▫️Platelets
▫️endothelial or damage tissue cells

70
Q

Plasma derived chemical mediators:

A

▫️complement system
▫️Kinin System
▫️clotting System

71
Q

it’s a plasma derived cell whose primary role is to destroy and remove microorganisms to prevent infection through opsonization (making bacteria vulnerable to phagocytosis) or cell lysis (destruction)

A

Complement

72
Q

Plasma derived cell that promotes coagulation through a cascade of clotting factors

A

Clotting

73
Q

Is a plasma derived cell which is a good source of highly potent vasoactive inflammatory mediators. It amplifies the inflammatory response by triggering other inflammatory mediators

A

Kinin

74
Q

What’s vascular response to these cell mediators?

A

▫️increased capillary membrane permeability
▫️vasodilation
▫️hyperaemia (excess blood in the body part)

75
Q

Cells active in the cellular response:

A 
▫️leukocyte (WBC)
▫️neutrophils 
▫️macrophages 
▫️erythrocytes 
▫️platelets
76
Q

Is a cell that trap harmful substances; stop bleeding; form structural origin of repair

A

Platelets

77
Q

A type of WBC; earliest phagocytic responder

A

Neutrophils

78
Q

In blood test, it is elevated during inflammation to promote coagulation
this is needed for scar formation

A

Fibrinogen

79
Q

In blood test, is increased above 10,000/mm3

reference value: 5,000 - 10,000 blood cells/mm3

A

WBC count

80
Q

Extra cellular fluid accumulation often in tissues because of increased vascular permeability

A

Exudate and edema

81
Q

Other manifestation of acute inflammation:

A

▫️malaise headache
▫️fatigue
▫️anorexia
▫️mild fever - due to pyrogens from macrophages
▫️increased circulating leukocytes and plasma proteins

82
Q

What are the benefits of fever?

A

▫️stimulates phagocytosis
▫️decrease rate of multiplication of Pathogens
▫️prevents release of Fe and Z from liver which bacteria feed on ( this happen w/ low fever only)
▫️increased tissue repair process

83
Q

Treatment for inflammation

A

▫️reduce blood flow
▫️decrease swelling
▫️block the action of chemical mediators
▫️decrease pain

84
Q

Functions of exudates:

A

▫️carry plasma proteins and leukocytes to injured area
▫️neutralize the inflammation reaction
▫️dilute toxins

85
Q

Body organs and structures contain two functional types of tissues:

A

▫️parenchyma (functioning cells)

▫️stroma (supporting connective tissue)

86
Q

Tissue healing phase, usually begins w/ 2 to 3 days of injury and may lasts as long as 3 wks

Fibroblast produce collagen

healing by 2ndary intention - more granulation tissue

A

Phase 2 - proliferative phase

87
Q

Healing phase where scar tissue remodels by breaking down old collagen (collagenase) and synthesizing new collagen (by fibroblasts)

Injury that heal by secondary intention undergo wound contraction

A

Phase 3 - remodeling phase

88
Q

complications of healing by scarring:

A
  1. Contractures / obstructions
  2. Adhesions ( connection of scar tissue between 2 separate tissues ex. Intestines)
  3. Ulceration
  4. Dehiscence (wound separation)
  5. Hypertrophic scar formation (keloids)

**dehiscence & ulceration can easily lead to infection

89
Q

A type of mediator such as histamine, leukotrenes, and prostaglandins

A

Aspactive mediators

90
Q

Also called chemokines. A type of mediators that stimulate cellular response

A

Chemotactic mediators

91
Q

Two cells with active vasoactive mediators. Both WBC, causes hyperaemia (⬆️of blood to area)

A

Mast cell and basophil cell

Pathophysiology for PN (14 decks)

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