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NUR 612 Advanced Pathophysiology > Module 2.3 Inflammation, Tissue Repair and Wound Healing. > Flashcards

Module 2.3 Inflammation, Tissue Repair and Wound Healing. Flashcards

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1
Q

Purpose of inflammation

A

Eliminate cause of injury

Generate new tissue

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2
Q

Acute Inflammation Summary

A
  1. Short duration
  2. Aim is removal of injuring agent and limiting tissue damage
  3. Infiltration of NEUTROPHILS
  4. Produces EXUDATE
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3
Q

Chronic Inflammation summary

A
  1. Lasts days to years.
  2. Infiltration of MACROPHAGES AND LYMPHOCYTES
  3. Proliferation of FIBROBLASTS - scarring
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4
Q

Types of chronic inflammation

A

Recurrent or progressive

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5
Q

How to differentiate between chronic and acute inflammation in a patient.

A

look at the WBC’s in the area. lymphocytes not seen in early stages, only in chronic.

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6
Q

Leukocytes of inflammation

A

Monocytes
Neutrophils
Basophils
Eosinophils

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7
Q

When an Eosinophil moves into the tissue it becomes a

A

Mast cell

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8
Q

When a Monocyte moves into the tissue it becomes a

A

Macrophage

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9
Q

Connective tissue cells of inflammation

A

Fibroblasts
Macrophages
Mast cells

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10
Q

Vascular phase of inflammation

A

Vasodilation (after very brief constriction).
causes Rubor and Calor
Increased vascular permeability > swelling (tumor)

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11
Q

Rubor

A

redness

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12
Q

Calor

A

Heat

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13
Q

Tumor (in inflammation)

A

swelling due to vascular permeability

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14
Q

Dolor

A

Pain

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15
Q

Functio Laesa

A

Loss of Function

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16
Q

5 Hallmark signs of inflammation

A
  1. Rubor
  2. Calor
  3. Tumor
  4. Dolor
  5. Functio Laesa
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17
Q

Immediate Transient response

A

Lasts 15-30 minutes.

Minor burns/bumps

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18
Q

Immediate Sustained response

A

May last several days.

Usually result of vascular injury

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19
Q

Delayed hemodynamic response

A

occurs 2-24 hours after exposure to radiation.

Sunburn, radiation therapy

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20
Q

Margination

A

Accumulation of leukocytes caused by cytokines (ie selections, integrins) which recruit WBC’s.

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21
Q

Adhesion

A

leukocytes slow down and role until they find site of high cytokine activity. (verify/read up on?)

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22
Q

Transmigration

A

Leukocytes extend foot and squeeze through vessel wall. into tissue spaces

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23
Q

What causes transmigration

A

Chemotactic factors

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24
Q

Why are chemokines important in early inflammation

A

They attract and direct leukocytes to needed areas

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25
What immune cell secretes chemokines
macrophages
26
Stages of Phagocytosis
Recognition and adherence (detection of cells covered in opsin) Engulfment (opsinization) Intracellular killing
27
LISTEN TO 13 MINUTE MARK
LISTEN TO 13 MINUTE MARK
28
Bacterial infections generally result in what WBC change?
Increased neutrophils
29
Parasitic infections and allergies generally result in what WBC change?
Increased Basophils
30
Effect of inflammation/infection on erythrocyte sedimentation rate
increased ESR
31
Overwhelming infection may cause
Leukopenia - decreased WBC's
32
What cell releases histamines?
Mast Cells
33
Role of histamines in inflammation
Vasodilation and increased permeability of venules
34
What are the 2 arachidonic acid metabolites and where do they come from
Prostaglandins Thromboxane From cell membranes
35
Effects of Prostaglandins
vasodilation Bronchconstriction potentiates Histamine (associated with anaphylaxis) Uterine contractions during menstruation
36
Effects of Thromboxane
Vasoconstriction Bronchoconstriction Promotes Platelet function
37
Effects of Platelet Activation Factor
Activates Neutrophils Attracts Eosinophils Activates Platelets
38
Plasma proteins as inflammatory mediators
Promotes blood clotting Activates compliment system. Vasoactive Peptides
39
Bradykinin (vasoactive peptide)
increased vascular permeability | Dilation of blood vessels, contraction of smooth muscle
40
Nitric Oxide as inflammatory mediator
Think free radicals!! Platelet Aggregation Causes increased tissue injury (can become never ending cycle)
41
STUDY FIGURE 9.3
STUDY FIGURE 9.3
42
Acute phase response of cell mediated response (TQ!)
``` Fever Anorexia Hypotension Tachycardia Corticosteroid and ACTH released ```
43
Serous Exudate
Watery Low in protein content Plasma entering the inflammatory site
44
Hemorrhagic exudates
Severe tissue damage involving vessels or severe leakage of red cells from capilaries
45
Membranous or Pseudomembranous exudates
Develop on mucous membrane surfaces. Composed of necrotic cells enmeshed in fibro-purulent-exudate. Seen in burns!
46
Purulent or Suppurative Exudates
contain pus (WBC's, proteins, tissue debris)
47
Fibrinous Exudates
Large amount of fibrinogen | Form thick sticky meshwork
48
READ INFO ON SLIDE 23! WILL BE ON TEST
READ INFO ON SLIDE 23! WILL BE ON TEST
49
What is an abscess
A walled off inflamed area filled with purulent exudate.
50
What are characteristics unique to chronic inflammation.
Granulomas Infiltration with Macrophages and LYMPHOCYTES proliferation of Fibroblasts
51
What is chronic gramulomatous inflammation associated with
Foreign Bodies Splinters, sutures, asbestos, silica Microbes TB, Syphilis, sarcoidosis, Deep fungal infections, brucellosis
52
Parenchymal Tissue
Tissue containing the functional cells of the organ (hepatocytes, renal tubular cells)
53
Stromal Tissue
Supporting tissue (Nerves, ECM, Blood Vessels, etc.)
54
Labile Cells
Replaceable cells (skin, mucosa, GI tract)
55
Stable Cells
Normally stop dividing when they reach maturity. May start again if damaged (partial liver removal)
56
Example of stable cells
Parenchymal cells of liver and kidneys. smooth muscle cells, vascular endothelium.
57
Permanent cells
Cannot undergo mitotic division. | Nerves, skeletal muscle, cardiac.
58
Stages of wound healing
Inflammatory phase Proliferative phase Maturational (remodeling) phase
59
inflammatory phase of healing
Injury Blood clots and WBC's migrate to site Neutrophils arrive first, then macrophages.
60
Proliferative phase
Fibroblasts are predominant cell. | Secrete reconstruction material (collagen, vascular growth factors for angiogenesis)
61
Maturational or remodeling phase
~3 weeks post injury. | Scar formation
62
Healing by primary intention
Small clean wound, well approximated, no tissue lost.
63
Healing by secondary intention
great tissue loss, contamination, left open to heal. Still minimal scarring if properly cared for
64
What may delay wound healing
``` DM Corticosteroid use Malnutrition Impaired circulation/perfusion Age Infection ```
65
Issues with healing in children
Electrolyte imbalances Temp Instability Immune insufficiency in very young kids Nutritional needs (Short gut syndrome, DM)

NUR 612 Advanced Pathophysiology (21 decks)

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