What causes granulomata Inflammation
indigestible antigens causing a granulomas build up in tissue and organs
Also can be due to type IV hypersensitivity
What is granulomas
epithelioid macrophages in tissue
What is a giant cells and what is its structure
Macrophages fused together
Large cytoplasm and multiple nuclei
What are four examples of different types of giant cells
Langhans - tuberculosis
In the presence of a Foreign body
Leaked silicon implants
Warthin–Finkeldey cell - early case measles
What is idiopathic disease
Diseases that we don’t know how they happened
What may granulomas contain
Giant cells
What may surround granulomas
Lymphocytes and Dead tissue
Name some Infectious Granulomas diseases
Tuberculosis
Leprosy
Syphilis
What is caseous necrosis and what surrounds it
Dead tissue
macrophages, giant cells, lymphocytes
Name some noninfectious Granulomas diseases
Rheumatoid disease - autoimmune pain at joints
Sarcoidosis - small patches of red and swollen tissue usually present lungs or skin
Chrons disease - inflammation of the intestine
What conditions favour wound healing
cleanliness apposition of edges (no haematoma) sound nutrition metabolic stability and normality normal inflammatory and coagulation mechanisms note local mediators
Define an ulcer and ulceration
an open sore on the skin surface
eroding on the skin by an ulcer
What are the stages of wound healing
phase of acute inflammation
local angiogenesis – new vessels grow
granulation tissue formation
fibrosis and scar formation
How else can wounds heal
Surgically
How are small defects surgically healed
by primary intention
What is the outcome of primary intention
Minimal gap
Small amount of granulation tissue
Small (near invisible) linear scar
How are large defects surgically healed
by secondary intention
What are the outcomes of secondary intention
Greater granulation tissue growth
Contraction of skin to bring together
Forming greater and more visible scar
What are the sequence of events in scaring
Injury, Blood clot formed by platelets Acute inflammation Granulation tissue growth Phagocytosis of fibrin Fibroblasts lay down collagen Contraction of scar as skin pulled together re-epithelialisation
What is angiogenesis
New vessel formation
enabling blood supply to enter damaged tissue
What impairs wound healing
dirty, gaping wound, large haematoma
poorly nourished, lack of vitamins C, A
abnormal CHO metabolism, diabetes, corticosteroid therapy
inhibition of angiogenesis
What is the difference between fracture healing and normal healing
Granulation tissue contains OSTEOBLASTS as well as fibroblasts
What is formed formed originally in bone healing in a fracture
Fibrous tissue called Callus
What happens in callus formation
Osteoblasts randomly throw down fibrous tissue called callus, then angiogenesis occurs allowing reformation and trabecular and cortical bone replace callus
What stimulated proliferation of vessels
Vascular endothelial growth factor released by hypoxic cells
What is the difference between granulomas inflammation compared to other chronic inflammations
Is response to to antigen from an infectious pathogen, foreign body or unknown that is resistant to neutrophils,as the “first responder”
