patho chapter 5

inflammation reaction purpose:

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prevent the spread of damage agents to set the stage for repair

affects of inflammation:

* capillary dilation
* increases capillary permeability
* attraction of leukocytes

systemic effects of inflammation:

* fever
* feeling ill
* severe widespread of inflammatory process

characteristics of inflammation:

* heat and redness from dilated blood vessels
* swelling like edema
* tenderness and pain for irritation or never endings
* impairment of function die to any agent that causes cell injury

causes of inflammation:

a nonspecific response to any gent that causes cell injury

dominant cells of acute inflammation:

* monocyte
* polymorphonuclear leukocyte cell

Polymorphonuclear leukocyte cell

* most important cell in acute inflammatory response
* neutrophils arrive first

monocyte:

follow water to clean up tissue damage

exudate:

fluid mixture of protein, leukocyte, and tissue debris

benefits of exudate:

* dilutes toxins to reduce further damage 
* Increase pain to prevent additional injury
* Brings antibodies into tissue to act against microorganisms 
* Brings protein into tissues

types of exudates:

* Serous: primarily fluid, endothelial cells contract slightly so only fluid escapes like a blister 
* Purulent: large inflammatory cells of living and dead WBS, like pus or abscess

mild inflammatory process:

self limiting, subsides with tissue resolution

severe inflammatory process:

tissue damage

goals of healing:

* restore structure
* strength
* some function

regeneration healing:

* when tissue is replaced from parenchyma
* lost cells are replaced by mitosis of adjacent uninjured cells

repair healing:

* when fibrous scar tissue fills the gap left by the loss of damage tissue
* restore the strength and structural integrity of tissues that can’t regenerate

inflammatory mediators:

chemical agents that intensity the inflammatory process

cell derived mediators:

* mast cells
* platelets
* arachidonic acid derivatives

mast cells:

specialized CT cells with granules filled with histamine and heparin

platelets:

release histamine and serotonin when activated

Arachidonic acid derivatives:

produced by all WBC's

mediators form blood plasma:

* Formed following a cascade of activation steps 
* Bradykinins: activation is triggered by one of the proteins in the blood coagulation cascade 
* Complement: consists of 20 blood proteins that circulate in inactive form

Roles of lysosomal enzymes with inflammation:

Released from the cytoplasm of phagocytic neutrophils and monocytes that are damaged or destroyed during an inflammatory reaction 

Roles of antigen-antibody with inflammation:

* Activates complement, generating mediators 
* Attracts leukocytes  

Harmful effects of inflammation:

* Tissue injury results in part from the injurious agent and in part from the inflammatory reaction itself 
* In most cases inflammation is self-limited and subsides when harmful agent has been eliminated 
* Pain: signals tissue damage and limits use of injured tissue 
* Swelling: sometime it is so great that it impairs function or blocks passages 
* Tissue damage: sometimes can leads to damage of healthy tissue

Temperature: 

* Application of cold or heat 
* Cold: applied early to limit swelling since it causes vasoconstriction 
* Heat: applied after to stimulate phagocytosis 

Elevation:

limits swelling by slowing blood flow and promoting drainage 

Compression:

limits welling by preventing exudate formation due to increased tissue pressure and promoting drainage 

Drug therapy;

* Directed at chemical mediators that underlies inflammation 
* Corticosteroids: used to suppress a persistent inflammatory 
* NSAIDs: block production of prostaglandins 
* Antihistamines: block the action of histamine at blood vessel receptors 

When might chronic inflammation occur:

* Inflammation can become chronic when the acute inflammatory response is unable to remove or neutralize an injurious agent 
* Relatively quiet, smoldering inflammation, associated with repeated attempts of the body healing 
* Causes damage of normal tissue 

Predominant cells:

lymphocytes, plasma cells, and monocytes