Inflammation and Repair Flashcards
(124 cards)
1
Q
Name of the organ or tissue + “itis”
A
= inflammation in that organ or tissue
2
Q
Tonsil =
A
Tonsillitis
3
Q
Appendix =
A
Appendicitis
4
Q
Peritoneum =
A
Peritonitis
5
Q
Lymph Node =
A
Lymphadenitis
6
Q
Salpingitis –
A
fallopian tube
7
Q
Keratitis -
A
cornea
8
Q
Balanitis –
A
glans penis
– Reiter’s syndrome
9
Q
Cystitis -
A
bladder
10
Q
skin -
A
dermatitis
11
Q
nasal mucosa -
A
rhinitis
12
Q
renal glomerulus -
A
glomerulonephritis
13
Q
hair follicle or sebaceous gland -
A
folliculitis
14
Q
paranasal sinus -
A
sinusitis
15
Q
renal interstitium -
A
pyelonephritis
16
Q
lips -
A
chelitis
17
Q
ear -
A
otitis
18
Q
ureter -
A
urethritis, urethritis
19
Q
oral mucosa
A
stomatitis
20
Q
eyelid -
A
blepharitis
21
Q
urinary bladder -
A
cystitis
22
Q
gingiva -
A
gingivitis
23
Q
conjunctiva -
A
conjunctivitis
24
Q
prostate -
A
prostatitis
25
perdiodontium -
periodontitis
26
cornea -
keratitis
27
urethra -
urethritis
28
dental pulp -
pulpitis
29
Classification of Inflammation
| 3
* Acute or chronic inflammation
* Exudative or non-exudative inflammation
* Morphologic Patterns
30
Morphologic Patterns
| 4
– Serous
– Fibrinous
– Suppurative
– Ulcerative
31
Acute inflammation
| 3
– Rapid onset, short duration (minutes to days)
– Emigration of leukocytes, predominately neutrophils
– Exudation of fluid and plasma proteins
32
Chronic inflammation
| 3
– Longer duration
– Mononuclear cells –macrophages, lymphocytes, plasma cells
– Proliferation of blood vessels and fibroblasts
33
Exudative - --- inflammation tends to be
| more exudative
acute
34
Non-Exudative - --- inflammation is
frequently non-exudative and is often
associated with (2)
chronic
| fibrosis and scarring
35
Inflammation –
the body’s response to injury
36
inflammation (5)
```
– Thermal
– Physical
– Chemical
– Allergic
– Immune mediated disease
```
37
Immunity –
comes into play when inflammation
| is caused by a living organism (infection)
38
Infection may provoke
inflammation & immunity
39
--- may exist without infection
Inflammation
| –Inflammation DOES NOT imply infection
40
Hypersensitivity (allergic disease) may cause
inflammation
41
Autoimmune disease may cause
| ---
inflammation
42
The Body’s Defenses:
| 3 Lines of Defense
Barriers
Inflammatory Response
Immune Response
43
Barriers
| 3
– Skin
– Mucous membranes
– Secretions
44
Inflammatory Response
| 2
– Cells (leukocytes)
| – Molecules (mediators)
45
Immune Response
| 2
– Antibodies (humoral)
| – Cytotoxic T cells (cellular)
46
Components Of
Inflammatory Responses
(3)
* Circulating blood cells and plasma proteins
* Cells of the blood vessel walls
* Cells and proteins of the extracellular matrix
47
Inflammation Is The
| Body’s Response To ---
Injury
48
Most of the defensive elements are located in the ---
blood
49
Inflammation is the means by which defensive cells and chemicals leave the blood and enter the ---
tissue
50
Inflammation is a complex reaction to injury:
| 4
– Vascular responses
– Cellular responses
– Systemic reactions
– Repair
51
--- is beneficial. Excess or prolonged --- may be harmful.
Inflammation
52
Leukocytes –
defensive cells
53
Plasma –
defensive proteins
54
The Inflammatory Response:
| 5 R’s
* Recognition of the injurious agent
* Recruitment of leukocytes
* Removal of the agent
* Regulation (control) of the response
* Resolution (repair)
55
Causes of Acute Inflammation
| 7
* Mechanical injury
* Chemical injury
* Radiation injury
* Thermal injury
* Infection
* Compromise of blood supply
* Immune injury
56
Cardinal Signs of Acute Inflammation
| 5
* Calor –heat
* Rubor - redness
* Tumor - swelling
* Dolor - pain
* Loss of function
57
Cellular Events in Acute Inflammation
| 7
* Margination
* Rolling
* Adhesion
* Diapedesis
* Chemotaxis
* Phagocytosis
* Killing
58
Systemic Manifestations of Acute
| Inflammation (3)
fever
Leukocytosis
Acute phase response
59
Fever –due to ---
pyrogens
60
Fever (2)
– Cytokines - TNF, IL-1 released by leukocytes
| – Prostaglandins –from membrane phospholipids
61
Leukocytosis
| 3
– Leukemoid reaction
– Neutrophilia - shift-to-left
– Lymphocytosis
62
Acute phase response –
cytokines stimulate hepatocytes to synthesize and secrete acute phase proteins
63
Acute phase response (2)
– C-reactive protein (CRP) –acts as an opsonin
| – Mannose-binding lectin - acts as an opsonin
64
Lymphangitis
• Lymphatic spread of
| bacterial infection
65
Lymphangitis description
Painful red streaks and
regional
lymphadenopathy
66
Chemical Mediators Of Inflammation (2) derived
cell
| plasma protein
67
preformed mediators in secretory granules (3)
histamine
serotonin
lysosomal enzymes
68
mediator: histamine
source: (3)
mast cells
basophils
platelets
69
mediator: serotonin
source:
platelets
70
mediator: lysosomal enzymes
source: (2)
neutrophils
| macrophages
71
newly synthesized (6)
```
prostaglandins
leukotrienes
platelet activating factors
activated oxygen species
NO
cytokines
```
72
mediator: prostaglandins
source: (3)
all leukocytes
platelets
EC
73
mediator: leukotrienes
source:
all leukocytes
74
mediator: platelet activating factors
source: (2)
all leukocytes
| EC
75
mediator: activated oxygen species
source:
all lleukocytes
76
mediator: NO
source:
macrophages
77
mediator: cytokines
source: (3)
lymphocytes
macrophages
EC
78
factor 12 activation (2)
```
kinin system (bradykinin)
coaggulation/fibrinolysis system
```
79
complement activation (4)
C3A
C5A
C3B
C5b-9
80
Vasoactive Amines (2)
HISTAMINE AND SEROTONIN
81
Unlike most other mediators, histamine and serotonin are available in
preformed supplies
82
Histamine is stored in
granules of mast cells
83
Serotonin is stored in the
granules of platelets
84
The first mediators to be released after injury
Histamine and Serotonin
85
Histamine and Serotonin cause (2)
dilation and leakage
86
Antigen (Ag) -
A substance that can induce an immune response when introduced into an animal.
87
Antibody (Ab) -
A protein that is produced in response an antigen. The antibody binds the antigen that stimulated its production. All antibodies are immunoglobulins.
88
Immunoglobulin (Ig) -
A glycoprotein composed of heavy and light chains that functions as an antibody.
89
Schematic Structure of a Typical
Immunoglobulin (Antibody) Molecule
(4)
```
• Heavy chains (2)
• Light chains (2)
• Variable regions form
antigen-binding site (Fab)
• Constant end (Fc)
receptor for attachment
of phagocytic cells)
```
90
• IgM -
first immunoglobulin to appear in an immune response
91
• IgG -
principal immunoglobulin of the secondary immune response. Only immunoglobulin capable of crossing the placental barrier
92
• IgA -
principal immunoglobulin in external secretions of mucosal surfaces, tears, saliva, and colostrum
93
• IgE -
plays an important role in immediate hypersensitivity reactions and parasitic infections
94
• IgD -
thought to activate the B-lymphocyte
95
The Complement System
```
• C1 to C9
• Critical step activation of C3
–C3 convertase cleaves C3 –C3a, C3b
• C3b deposits to microbes surface, forms C5
convertase
• C5 convertase cleaves C5 –C5a, C5b
• Initiates assembly of MAC
```
96
Complement System is
Multifunctional
(4)
```
• Membrane attack complex (MAC) lysis
(C56789)
• Opsonization (C3b)
• Chemotaxis (C5a)
• Vasodilation and increased vessel
permeability via histamine release (C3a, C5a)
anaphylatoxins
```
97
All acute inflammatory reactions may have one of three outcomes:
(3)
1. Complete resolution
2. Healing by connective tissue replacement (fibrosis)
3. Progression of the response to chronic inflammation
98
Fibrinous Inflammation:
Fibrinous Pericarditis in Rheumatic Fever
99
Abscess
• A localized collection of pus that has accumulated in
| a tissue cavity, producing fluctuance
100
Cellulitis
```
• Diffuse spread of an
acute inflammatory
process through the
fascial planes of soft
tissue producing
erythema, edema,
warmth, and pain,
without consolidation
```
101
Catarrhal (Seromucous) Inflammation
```
• Catarrhal
inflammation, a clinical
type of exudative
inflammation, occurs
only on mucosal
surfaces containing
mucus-secreting cells,
such as nasal or
bronchial mucosa
```
102
Ulcerative Inflammation:
| Recurrent Aphthous Stomatitis
• An ulcer is a defect in epithelial continuity
103
Lazy Leukocyte Syndrome
Impaired Chemotaxis –Mutation of Contractile Proteins
104
Chediak-Higashi Syndrome
| 5
* A rare autosomal recessive condition associated with albinism
* Giant lysosomal inclusions from fused primary granules
* Both chemotaxis and phagolysosome formation are defective
* Recurrent infections
* Platelet function is abnormal
105
Chronic Granulomatous
Disease of Childhood
(5)
* X-linked (2/3) or autosomal (1/3) recessive
* Deficient NADPH oxidase in the cell membranes of neutrophils and monocytes, resulting in an absent respiratory burst
* No H2O2 produced - HOCl- is notsynthesized because of the absence of H2O2
* Catalase-negative organisms (e.g., Streptococcus species) are killed
* Catalase-positive organisms (e.g., Staphylococcus aureus) are not killed
106
Myeloperoxidase (MPO) Deficiency
| 5
* A common (1:2,000 individuals) autosomal recessive absence of myeloperoxidase enzyme in neutrophil and monocyte granules
* Respiratory burst is normal and H2O2 is produced
* Absence of MPO prevents synthesis of HOCl-
* No great clinical consequences in most people
* Diabetics may develop candidiasis
107
Too few neutrophils
| 2
– Agranulocytosis
| – Cyclic neutropenia
108
Failure in adhesion
| 1
– Leukocyte Adhesion Deficiency (LAD)
109
Slow chemotaxis
| 1
– “Lazy” leukocyte syndrome
110
Failure to phagocytose
| 2
– Bruton Agammaglobulinemia
| – Complement deficiency
111
Failure to kill
| 3
– Chronic Granulomatous Disease of Childhood
– Chediak-Higashi Syndrome
– Myeloperoxidase Deficiency
112
Causes of Chronic Inflammation
| 8
* Persistent infection - mycobacteria
* Prolonged exposure to toxic agents
* Exogenous - silicosis
* Endogenous - atherosclerosis
* Immune-mediated inflammatory disease
* Autoimmune diseases - rheumatoid arthritis
* Unregulated immune responses against microbes –inflammatory bowel disease
* Immune responses against environmental substances –(allergic disease) -bronchial asthma
113
Morphologic Features Of
Chronic Inflammation
(3)
• Mononuclear cell infiltration
• Tissue destruction
• Attempts at healing by connective tissue
replacement
114
• Mononuclear cell infiltration – (3)
lymphocytes,
| plasma cells and macrophages
115
• Tissue destruction –
due to a persistent
| offending agent or by the inflammatory cells
116
• Attempts at healing by connective tissue
| replacement - (2)
angiogenesis and fibrosis
117
Granulomatous Inflammation
| 5
```
• A pattern of chronic
inflammation
• Aggregates of epitheliod
macrophages (activated)
• Multinucleated giant cells
• Mononuclear leukocytes,
principally lymphocytes
and occasionally plasma
cells peripherally
• Fibrosis variable
```
118
Classification of Granulomas
| 2
* Immune granulomas
| * Foreign body granulomas
119
Immune Granuloma:
Coccidioides immitis
120
Caseation Necrosis in Tuberculosis:
Necrotizing Granulomatous
| Inflammation
121
Mycobacterium Tuberculosis:
| Intracellular Pathogen
• Blocks fusion of phagosome with lysozome
122
Granulation Tissue (2)
Reparative Tissue
| Endothelial Cells and Fibroblasts
123
Granulomatous Tissue (2)
Epitheliod Macrophages
| Giant Cells
124
Pyogenic Granuloma:
| Granulation Tissue NOT --- Tissue
Granulomatous
