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HLSC 222 - Pathophysiology Across the Lifespan > Chapter 6 - Innate Immunity: Inflammation & Wound Healing > Flashcards

Chapter 6 - Innate Immunity: Inflammation & Wound Healing Flashcards

1
Q

Innate immunity involves the ____ and ____ lines of defense

A

first and second

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2
Q

What is the first line of defense?

A

physical (skin), mechanical (mucous membrane), biochemical barriers

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3
Q

What is the second line of defense?

A

the firing squad - inflammation response, macrophages, and neutrophils

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4
Q

Adaptive immunity is the ____ line of defence.

A

third

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5
Q

What is the third line of defense?

A

acquired or specific immunity via B and T cells

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6
Q

Which type of T cell is involved in both innate and adaptive immunity?

A

Natural Killer T Cell

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7
Q

What do Mast cells release?

A

histamines (cytokines)

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8
Q

What does histamine do?

A

induce vasodilation

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9
Q

What do platelets do?

A

induce clotting to stop blood loss

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10
Q

What is the role of macrophages and neutrophils during the inflammatory response?

A

phagocytosis of the pathogen

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11
Q

What element do macrophages follow?

A

cytokines

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12
Q

What is pus accumulation?

A

the gathering of dead phagocytes and pathogens

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13
Q

What leaks out and is followed by fluid to induce swelling?

A

ions, followed by water

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14
Q

What is the role of prostaglandins in the inflammatory response?

A

Overseer/coordinator of events

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15
Q

What is another principal coordinator during inflammation?

A

vascular epithelium

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16
Q

What 2 cells are contained in the tissue close to vessels?

A

mast and dendritic cells

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17
Q

Which cells are an inflammation activator? What do they release?

A

mast cells release cytokines

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18
Q

Dendritic Cells

A

connect the innate and adaptive immune response

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19
Q

What recruits the innate and adaptive immune systems?

A

chemical molecules

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20
Q

Where are chemical molecules released from?

A

Damaged or destroyed cells

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21
Q

What are cytokines?

A

a general term for released chemical molecules (messengers) that regulate innate and adaptive immunity

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22
Q

Cytokines can be ___inflammatory or ___-inflammatory

A

pro or anti (shut down)

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23
Q

Lymphokines

A

cytokines released from lymphocytes

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24
Q

Monokines

A

cytokines released from monocytes

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25
Q

What do monocytes change into?

A

macrophages

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26
Q

What produces IL-1?

A

macrophages

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27
Q

What produces IL-6?

A

macrophages, lymphocytes, fibroblasts

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28
Q

What is different about interleukins than cytokines?

A

ILs have self-limiting abilities

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29
Q

What is the order of cells in the immune response?

A

mast cell, neutrophil, macrophage, basophil, eosinophil, natural killer cell

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30
Q

Cytokine Storm Syndrome

A

activated by Covid-19, a severe systemic immune response that can be damaging to the body

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31
Q

What is the cytokine released during CSS?

A

IL-6 (lymphokine) which plays a major role in the excessive recruitment of lymphocytes

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32
Q

What is the treatment for Covid-19?

A

IL-6 antibody production to counteract the effects

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33
Q

TNF-a is a _____ but not an _______

A

cytokine but not an interleukin

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34
Q

What releases TNF-a?

A

macrophages and mast cells

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35
Q

What are the pro-inflammatory effects of TNF-a?

A

fever, cachexia, fatal shock (gram- bacteria), granuloma

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36
Q

Cachexia

A

muscle wasting

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37
Q

What is a main anti-inflammatory cytokine?

A

IL-10 aka lymphokine

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38
Q

How do monocytes move out of blood vessels?

A

through interstitial spaces between cells

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39
Q

How does capillary permeability change during inflammation?

A

increased permeability

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40
Q

Capillary widening = ______ blood flow

A

increased

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41
Q

Increased permeability = _____ _____ into tissues

A

fluid release

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42
Q

Attraction of leukocytes = leaking of leukocytes to…

A

injury site

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43
Q

Systemic response = _____ and increase in _____

A

fever and increase in leukocytes

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44
Q

What are the signs and symptoms of inflammation?

A

heat, redness, swelling, tenderness, pain

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45
Q

What is the goal of the inflammatory response?

A

limit and control bleeding and infection

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46
Q

Interventions for Inflammation:

A

clean wound (saline), remove loose debris, treat with antibiotics

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47
Q

What does “itis” tell us?

A

Where the inflammation is (ie. tonsilitis)

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48
Q

What activates inflammation?

A

cell injury or death

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49
Q

What are 5 things that cause cell death?

A

infection, damage, ischemia, temperature, radiation

50
Q

Erythrocyte Sedimentation Rate (ESR)

A

determination of the rate of RBC settling in saline solution

51
Q

An increase in infection affects RBCs how?

A

RBCs bind to each other, making them heavier and settle in saline faster

52
Q

Increased ESR = ______ infection

A

increased

53
Q

Sed Rate

A

distance (in mm) the RBCs fall in 1 hour

54
Q

What causes the C-reactive protein?

A

the effect of acute inflammation on the liver

55
Q

C-reactive protein ____ in response to inflammation

A

increases

56
Q

Is CRP specific to the disease?

A

no

57
Q

What do CRP tests monitor?

A

disease progress and flares

58
Q

What does blood work for WBC count measure?

A

increase in neutrophils (bands)

59
Q

What does it mean if there is an increase of neutrophils in the blood?

A

we have not got a hold of the infection yet

60
Q

How long does acute inflammation last?

A

less than 2 weeks

61
Q

Symptoms of acute inflammation?

A

swelling, pain, heat, redness

62
Q

Is acute inflammation localized or systemic?

A

localized

63
Q

What are the 3 main systemic changes due to acute inflammation? (Hint: temp, WBC, protein)

A

fever, leukocytosis, increase in circulating proteins

64
Q

Leukocytosis

A

increase in circulating leukocytes

65
Q

When can acute inflammation become chronic?

A

if the response is unsuccessful

66
Q

How long does chronic inflammation last?

A

longer than two weeks, up to months or years

67
Q

Does chronic inflammation occur only after acute inflammation?

A

no, it can occur without previous inflammation

68
Q

What is 3 things cause of chronic inflammation?

A

microorganisms that resist phagocytosis, survive in a macrophage, and/or produce toxins

69
Q

How does chronic inflammation present?

A

as a dense infiltration of macrophages and lymphocytes

70
Q

When do granulomas form?

A

if macrophages are unable to stop damage, the body walls off the infected area

71
Q

Which cytokine drives granuloma formation?

A

TNF-a

72
Q

Granuloma

A

cluster of WBCs and other tissues

73
Q

If acute inflammation resolves, what is restored?

A

cellular and tissue homeostasis

74
Q

What is the first cell to arrive at the inflammation site, and the fastest to leave?

A

platelets

75
Q

What is the first white blood cell on scene?

A

neutrophils

76
Q

Which WBC arrives second to neutrophils?

A

macrophages

77
Q

Fibroblasts arrive after _______ and do what?

A

after macrophages and begin repairing the tissue

78
Q

Which WBC arrives last and what does it do?

A

lymphocytes (B and T cells) arrive if the problem isn’t under control and…

79
Q

The transition from acute inflammation to healing begins…

A

IMMEDIATELY

80
Q

What do platelets do in wound healing?

A

initiate clot formation and formation of undamaged cells

81
Q

What do neutrophils do in wound healing?

A

clean wound of debris and bacteria

82
Q

What do macrophages do in wound healing?

A

-release growth factors
-recruit fibroblasts
-promote angiogenesis

83
Q

Angiogenesis

A

development of new blood vessels

84
Q

What 3 cells are involved in the ‘inflammation’ phase of wound healing?

A

platelets, neutrophils, macrophages

85
Q

How long does the ‘proliferation and new tissue formation’ phase of wound healing last?

A

starts at 3 days and lasts 2 weeks

86
Q

What do fibroblasts do in the ‘proliferation and tissue formation’ stage of wound healing?

A

collagen synthesis

87
Q

What is “epithelialization”? When does it occur?

A

epithelial cells migrate to the wound during the proliferation and new tissue formation stage

88
Q

When does cellular differentiation and macrophage secretions occur?

A

proliferation and new tissue formation stage

89
Q

How long does the “remodelling and maturation” phase of wound healing last?

A

weeks to years

90
Q

Cellular differentiation during the remodelling and maturation phase:

A

unspecialized cells (stem cells) mature and perform important cellular functions

91
Q

When does scar tissue formation and remodelling occur?

A

during the remodelling and maturation phase of wound healing

92
Q

What is the major remodelling cell?

A

fibroblasts

93
Q

What is the primary intention of tissue repair?

A

-clean incision
-early suture

94
Q

Why is early suture the best choice?

A

leaves a fresh wound with sufficient vascularization

95
Q

What is the result if primary tissue repair intentions are successful?

A

fine scar

96
Q

Secondary intention of tissue repair involves g_________ for gaping wounds

A

granulation

97
Q

Why is granulation a secondary intention?

A

the wound is extensive and the edges can’t be brought together to suture

98
Q

Secondary intentions are ideal for c________ or i__________ wounds because the wound is left open to heal spontaneously.

A

contaminated or infected

99
Q

Tertiary tissue repair intentions are used when delayed ______ closure happens

A

primary closure

100
Q

Tertiary intentions are used on open but not ________ wounds

A

gaping

101
Q

Tertiary intentions for tissue repair allow for ________ and ________

A

granulation and observation

102
Q

Tertiary intentions: when the wound is clean…

A

it is sutured closed but has a wider scar than primary

103
Q

Adhesions

A

abnormal union of membranous surfaces

104
Q

When are adhesions common?

A

bowel surgery

105
Q

When are adhesions painful?

A

when they stop the normal movements of the intestinal system

106
Q

Wound Contraction

A

healing cells pull other cells together and contract the tissue

107
Q

Wound contractions are common with ____ injuries

A

burn

108
Q

Infections

A

wound is reinfected with the initial or new pathogen

109
Q

Dehiscence

A

incision separates following surgery – wound is “dehisced”

110
Q

Evisceration

A

surgical complication where the incision opens and abdominal organs protrude

111
Q

What is the result of dehiscence and/or evisceration?

A

excess scar formation caused by excess tension or movement

112
Q

Low blood supply during wound healing…

A

inhibits the recovery process

113
Q

High blood supply during wound healing…

A

increases risk for blood clots

114
Q

Being obese predisposes wound to possible _______

A

infections

115
Q

When fibrin (clotting factor) doesn’t get reabsorbed it causes…

A

fibrous adhesions

116
Q

Why does having diabetes prolong wound healing?

A

hyperglycaemia suppresses macrophages

117
Q

Hyperglycaemia

A

excess glucose in blood due to malfunction of insulin

118
Q

Why is nutrition important during wound healing?

A

to meet metabolic needs

119
Q

How can being on steroids impact wound healing?

A

steroids prevent macrophages from migrating to infection site

120
Q

Antineoplastic drugs used for cancer treatment to slow cell division impact wound healing by…

A

blocking neoplasm formation (new abnormal tissue growth)

HLSC 222 - Pathophysiology Across the Lifespan (16 decks)

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