Inflammation

the first line of defense is

the first line of defense is

innate immunity

Ex: skin epithelial layers

innate immunity

defenses against any pathogen

the second line of defense is

adaptive immunity

adaptive immunity

the ability to recognize and remember specific antigens and mount an attack on them.

Humoral or cell-mediated

humoral immunity

specific immunity produced by B cells that produce antibodies that circulate in body fluids

cell-mediated immunity

immunity against abnormal cells and pathogens inside living cells

-itis

inflammation

what is inflammation?

it is an automatic response to injury or illness

the goal of inflammation is to

eliminate the cause of cell injury
remove/repair damaged tissue
make new tissue

why is nutrition essential for inflammation healing?

Optimal wound healing requires adequate nutrition. Nutrition deficiencies impede the normal processes that allow progression through stages of wound healing. Malnutrition has also been related to decreased wound tensile strength and increased infection rates.

Basophils

A circulating WBC that produces histamine.

secretes cytokines

Eosinophils

increases in amount during parasitic infections

secretes cytokines

platelets

Platelets, or thrombocytes, are small, colorless cell fragments in our blood that form clots and stop or prevent bleeding. Platelets are made in our bone marrow, the sponge-like tissue inside our bones. Bone marrow contains stem cells that develop into red blood cells, white blood cells, and platelets.

releases inflammatory mediators to encourage permeability and vasodilation

Neutrophils

Most abundant white blood cell., The most abundant type of white blood cell. Phagocytic and tend to self-destruct as they destroy foreign invaders, limiting their life span to a few days.

First to appear at site of injury

Increases during inflammation and bacterial infections

Makes nitric oxide to help kill engulfed debris

Monocytes

They are the largest type of leukocyte in blood and can differentiate into macrophages and monocyte-derived dendritic cells. plays a role in both the inflammatory and anti-inflammatory processes that take place during an immune response.

mast cells

Cells that release chemicals (such as histamine) that promote inflammation.

attracts other leukocytes to site

binds to IgE to release histamine

Macrophages

Found within the lymph nodes, they are phagocytes that destroy bacteria, cancer cells, and other foreign matter in the lymphatic stream.

dendritic cells

capture antigens and deliver them to lymph nodes

endothelial cells

cells lining the blood vessels

controls blood flow

encourages adhesion of other, helps in WBC production, has a semi-permeable membrane

bands are

immature neutrophils

Histamine

A chemical that is responsible for the symptoms of an allergy

s/s of histamine

Itchy skin (pruritus).
Expanding of blood vessels (vasodilation).
Low blood pressure (hypotension).
Increased heart rate (tachycardia).
Flushing.
Narrowing of your airways (bronchoconstriction).
Pain.
Movement of fluids through blood vessel walls (vascular permeability).

mast cells and basophils bind to _______ to release histamine

IgE

Cytokines

Chemicals released by the immune system communicate with the brain.

binds to receptors on target cells to active their processes

basophils and eosinophils secrete

cytokines

platelet function is to

stop the bleeding via clotting

monocytes act as

macrophages for pathogen destruction (phagocytosis)

monocytes can differentiate into

macrophages and dendritic cells

macrophages participate in

pathogen destruction

macrophages release

cytokines and chemokines

Granulocytes

A type of immune cell that has granules (small particles) with enzymes that are released during infections, allergic reactions, and asthma.; neutrophils, eosinophils, basophils.

agranulocytes

those white blood cells that simply lack any granules within their cytoplasm

monocytes, macrophages, lymphocytes

NEVER LET MONKEYS EAT BANANAS stands for

neutrophils
lymphocytes
monocytes
eosinophils
basophils

T cells

Cells created in the thymus that produce substances that attack infected cells in the body.

B cells

produce antibodies

Chemokines

a subgroup of cytokines

accumulates at the site of injury

produced as a result of bacterial toxins

histamine binds to ________ receptors on the endothelial cells

H1 (histamine type 1)

histamine causes

swelling and inflammation

dilation of arterioles and increased permeability

what stops histamine by binding with H1 receptors

antihistamines like Benadryl

arachidonic acid

a type of omega 6 acid found in cell membranes

can be converted to prostaglandins to increase platelet aggregation and vasoconstriction

omega 3 datty acids help prevent

it helps prevent negative effects of inflammation by replacing omega-6 arachidonic acid in inflammatory cells

what kinds of food reduce inflammation?

flax-seed, canola oil, green leafy veggies, walnuts, soybeans, fish oil

platelet activating factor

activates neutrophils and attracts eosinophils and causes platelets to come together to form a clot

thrombotic cascade

The end result is a blood clot that creates a barrier over the injury site, protecting it until it heals.

free radicals (ROS)

are released from leukocytes after immune or inflammatory responses

vascular stage of inflammation

temporary vasoconstriction to prevent blood loss

rapid vasodilation (from histamine and Nitric Oxide) increases blood flow which causes heat and redness

cellular stage of inflammation

cell movement and activity

WBC move along vessels until they reach the site of injury/invader where they stick to the vessel wall then they squeeze between vessel wall cells and into tissue space

chemotaxis-chemoattractants (cytokines) call WBC to site

monocytes, neutrophils, macrophages are activated

leukocytes/neutrophils consume debris; damaged cells are repaired

Phagocytosis

A type of endocytosis in which a cell engulfs large particles or whole cells

Bacterium attaches to membrane and is ingested forming a phagosome which then fuses with he lysosome and the lysosomal enzymes digest the captured material and excretes the digested products out of the cell

what are the five cardinal signs of inflammation

pain
heat
redness
swelling
loss of function

what is exudate

fluid containing clotting factors and antibodies
also called pus or drainage

serous exudate

clear, like plasma

low protien

purulent exudate

Drainage which contains pus, usually yellow, green or brown; indicates infection

hemorrhagic exudate

Exudate contains blood: indicates bleeding

seen in tissue injury, RBC leaks from capillaries

fibrinous exudate

thick, clotted, sticky

indicates more advanced inflammation

membranous exudate

develop and occurs on mucous membrane surfaces and are composed of necrotic cells

+ fibrinopurulent exudate

Serosanguineous exudate

thin, watery, and pale red to pink in color

mix of serous and sanguineous

sanguineous exudate

bright red, bloody drainage

abscess

Collection of pus underneath the skin

localized area of inflammation with purulent exudate surrounded by neutrophils

chronic inflammation may develop as a result of

recurrent or progressive acute inflammation or from mild responses that do not progress into an actual acute response

is self perpetuating

lasts for weeks-years

chronic inflammation involves

macrophages
lymphocytes
fibroblasts

BUT NOT NEUTROPHILS

inflammation s/s include

fever
leukocyotsis
increase plasma protein synthesis

Primary intention wound healing

intentional wounds with minimal tissue loss and well approximated edges.

secondary intention wound healing

wounds that require a great deal more tissue replacement (open wound)

factors affecting wound healing include

malnutrition
blood flow
O2 delivery
impaired inflammation
immune responses
infection
bite wounds
age

Wound healing: inflammatory phase

the initial phase of wound healing in which bleeding is reduced as blood vessels in the affected area constrict

nursing interventions for inflammation include

medications like NSAIDS, steroids
heat
cold
elevate
education
diet

Tumor Necrosis Factor Alpha

regulates cytokine production, increases PAF

Wound healing: Proliferative phase

wound matrix formed during haemostasis is replaced by granulation tissue

Nitric Oxide (NO)

released by neutrophils

causes smooth muscle relaxation, stops platelet function and aggregation, signals for more leukocytes and helps with apoptosis regulation

acute inflammation

self limited

short duration

s/s: exudate, abscess, ulcer