INFLAMMATION 3

SEROUS INFLAMMATION

SEROUS INFLAMMATION

characterized by an outpouring of a thin fluid that is derived from either the blood serum or secretion of mesothelial cells lining the peritoneal(abdomen), pleural(lungs), and pericardial(heart) cavities

SEROUS INFLAMMATION

resolves without reactions **kumabaga ay pag gumaling, parang walang nangyari

Effusion

- fluid in a serous cavity

- exudate na nasa serous cavity

FIBRINOUS INFLAMMATION

more severe injuries result in greater vascular permeability that ultimately leads to exudation of larger molecules such as fibrinogens through the vascular barrier

FIBRINOUS INFLAMMATION

- a characteristic of inflammation in serous body cavities such as the pericardium (butter and bread appearance) meninges and pleura

SUPPURATIVE (PURULENT) INFLAMMATION

characterized by the prod. of a large amount of pus

Pus

A thick creamy liquid, yellowish or blood stained in color

a large amount of living or dead leukocytes (pus cells)

Necrotic tissue debris

Living and dead bacteria

Edema fluid

Pus is composed of:

Abscess formation

a circumscribed accumulation of pus in a living tissue

Pyogenic membrane

Abscess formation is encapsulated by a so called

Pyogenic membrane

consists of layers of fibrin, inflammatory cells and granulation tissue

Acute diffuse (phlegmonous) inflammation

is characterized by the diffuse spread of the exudate through tissue spaces

Acute diffuse (phlegmonous) inflammation

is caused by virulent bacteria without either localization or marked pus formation

CATARRHAL INFLAMMATION

a mild and superficial inflammation of the mucous membrane

CATARRHAL INFLAMMATION

is commonly seen in the upper respiratory tract following viral infections where mucous secreting glands are present in large numbers

PSEUDOMEMBRANOUS INFLAMMATION

the basis elements are extensive confluent necrosis of the surface epithelium of an inflamed mucosa and severe inflammation of the underlying tissues

PSEUDOMEMBRANOUS INFLAMMATION

the fibrinogens in the inflamed tissue coagulate within the necrotic epithelium

Fibrinogen, the necrotic epithelium, the neutrophilic polymorphs, red blood cells, bacteria, and tissue debris

forms a false (pseudo) membrane which forms a white colored layer over the surface of inflamed mucosa

Clostridium difficile

ang nagbabalot sa swollen colon

CHRONIC INFLAMMATION

prolonged duration (weeks to years) in which continuing inflammation, tissue injury, and healing, often by fibrosis, proceed simultaneously

Angiogenesis

new blood supply

PERSISTENT INFECTIONS

- di mawala wala -

- certain microorganisms associated with intracellular

infection such as tuberculosis, leprosy, and certain

fungi

PERSISTENT INFECTIONS

- elicits a delayed type hypersensitivity

Delayed type hypersensitivity

a T lymphocyte mediated immune response

IMMUNE MEDIATED INFLAMMATORY DISEASE

HYPERSENSITIVITY DISEASES

IMMUNE MEDIATED INFLAMMATORY DISEASE

may show morphologic patterns of mixed acute and chronic inflammation

a. Endogenous lipid components which result in atherosclerosis

b. Exogenous substances such as silica

PROLONGED EXPOSURE TO POTENTIALLY TOXIC AGENTS

- is caused by either

Silica

results to silicosis

PROGRESSION FROM ACUTE INFLAMMATION

may abscess formation

MONOCYTES AND MACROPHAGES

primary cells in chronic inflammation

Macrophage

arise from the common precursor cells in bone marrow, which give rise to blood monocytes

Monocytes

precursor ng macrophage kasi ito pa yung cell na nasa labas ng bloodstream

Macrophage

- are scavenger cells of the body

- ingest and eliminate microbes and dead

tissues

Macrophage

- initiate the process of tissue repair and ar

involved in scar formation and fibrosis

- secretes mediators of inflammation

Macrophage

- displays antigens to T lymphocytes and

respond to signals from T cells, thus setting up a feedback loop that is essential for defense mechanism of many microbes by cell mediated immune response

T-LYMPHOCYTES

primarily involved in cellular immunity with lymphokine production

T-LYMPHOCYTES

the key regular and effector cells of the immune system

B-LYMPHOCYTES AND PLASMA CELLS

produce antibody directed either against persistent antigen in the inflammatory site or against altered tissue components

MAST CELLS AND EOSINOPHILS

appear predominantly in response to parasitic infestations and allergic reaction

NEUTROPHILS

the hallmarks of acute inflammatory reactions

NONSPECIFIC CHRONIC INFLAMMATION

involves a diffuse accumulation of macrophages and lymphocytes at site of injury that is usually productive with new fibrous tissue formations

NONSPECIFIC CHRONIC INFLAMMATION

walang nabubuong granuloma

- kalat kalat ang epithelioid cells

SPECIFIC INFLAMMATION

GRANULOMATOUS INFLAMMATION

SPECIFIC INFLAMMATION

may presence of granuloma

Granuloma

well organized/scattered ang epithelioid cell na hindi pus pero fluidy

Granuloma

a collection of epithelioid cells

Granuloma

usually contains multinucleated giant cells and is usually surrounded by a cuff of lymphocytes and occasional plasma cells

Granuloma

can fuse with each other and form multinucleated giant cells

Epithelioid cells

an activated macrophage with a modified epithelial cell like appearance

TYPES OF GIANT CELLS

formed by fusion of macrophage by a concerted attempt of two or more cells to engulf a single particle

Foreign body type giant cells

have irregularly scattered nuclei in presence of indigestible materials

Langhans giant cells

nuclei are arranged peripherally in a horse shaped pattern which is typically seen in tuberculosis, sarcoidosis, and etc

FEVER

most important systemic manifestations of inflammation

FEVER

coordinated by the hypothalamus and by cytokines (IL-1, IL-6, TNF-alpha) released from macrophages and other cells

Exogenous pyrogens

are lipopolysaccharides(LPS) that stimulate

leukocytes to release cytokines such as IL-1 and TNF which stimulate the production of prostaglandins in hypothalamus

IL-1 and TNF

called endogenous pyrogens

Prostaglandin

chemical mediators ng fever

ENDOCRINE AND METABOLIC RESPONSES

increase ini glucocorticoid; decrease in vasopressin

- C reactive proteins

- Serum amyloid A

- Complement and coagulation proteins

The liver secretes acute phase proteins such

as:

AUTONOMIC RESPONSES

redirection of blood flow from the cutaneous to the deep vascular bed

AUTONOMIC RESPONSES

- increase in pulse rate and blood pressure = increase in sweating

- di na siya naccontrol

BEHAVIORAL RESPONSES

ang mga usually nararamdaman pag may flu:rigor, chills anorexia, somnolence, and malaise

LEUKOCYTES

the common feature of inflammation, especially in bacterial infections

Neutrophilia

Most bacterial infections induce

lymphocytosis

• Some viral infections such as infectious mononucleosis, & mumps cause

WEIGHT LOSS

is due to the action of IL-1(mediator ng fever) and TNF-alpha which increases the catabolism in skeletal muscle, adipose tissue, and the liver with resultant negative nitrogen balance