Acute Inflammation - Session 3, L1

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Questions and Answers

Which selectin molecule is primarily expressed on platelets and endothelium?

  • M-selectin
  • L-selectin
  • P-selectin (correct)
  • E-selectin

What mechanism primarily describes the migration of leukocytes through the vessel wall?

  • Phagocytosis
  • Exocytosis
  • Transcytosis
  • Diapedesis (correct)

Which of the following substances can act as chemotactic factors for leukocytes?

  • Cytokines (correct)
  • Nucleotides
  • Cholesterols
  • Glucose

What is the main biological purpose of vasodilatation during acute inflammation?

<p>Increased delivery of immune cells (B)</p> Signup and view all the answers

How do leukocytes primarily detect changes in the endothelium for firm adhesion?

<p>Using integrins (D)</p> Signup and view all the answers

What role does fluid exudation play in acute inflammation?

<p>Neutralizes toxins (C)</p> Signup and view all the answers

What is a major characteristic of the infiltration of cells during acute inflammation?

<p>Removes pathogenic organisms (B)</p> Signup and view all the answers

What beneficial effect does pain have during acute inflammation?

<p>It enforces rest. (A)</p> Signup and view all the answers

What is the primary biological purpose of acute inflammation?

<p>To eliminate or limit the spread of injurious agents (A)</p> Signup and view all the answers

Which characteristic is NOT associated with acute inflammation?

<p>Chronic cell response (C)</p> Signup and view all the answers

Which of the following is a significant cause of acute inflammation?

<p>Microbial infections (D)</p> Signup and view all the answers

Which feature describes the vascular reaction in acute inflammation?

<p>Accumulation of fluid exudate and neutrophils (C)</p> Signup and view all the answers

What triggers the accumulation of neutrophils during acute inflammation?

<p>Inflammatory mediators derived from plasma or cells (D)</p> Signup and view all the answers

What occurs after the acute inflammatory response resolves?

<p>Repair of damaged tissues (B)</p> Signup and view all the answers

Which of the following is an example of a physical agent that can cause acute inflammation?

<p>Heat from burn injuries (C)</p> Signup and view all the answers

In acute inflammation, which type of cell is primarily involved in the early response?

<p>Neutrophils (A)</p> Signup and view all the answers

What defines a transudate in medical terms?

<p>Low protein content with specific gravity less than 1.012 (D)</p> Signup and view all the answers

What is the primary cause of increased vascular permeability during acute inflammation?

<p>Endothelial cell contraction leading to intercellular gaps (C)</p> Signup and view all the answers

Which sequence describes the recruitment of leukocytes to the site of injury?

<p>Margination, Rolling, Adhesion, Emigration, Migration (A)</p> Signup and view all the answers

What occurs during the rolling phase of leukocyte recruitment?

<p>Leukocytes detach and reattach to endothelial cells (A)</p> Signup and view all the answers

What is a consequence of increased lymphatic drainage due to oedema?

<p>Enhanced removal of fluid and debris (B)</p> Signup and view all the answers

What best describes pus in the context of exudates?

<p>A purulent exudate rich in neutrophils and debris (D)</p> Signup and view all the answers

During severe inflammatory reactions, what may the lymphatics transport that contributes to disease spread?

<p>Infectious agents (A)</p> Signup and view all the answers

What causes leakage from new blood vessels during tissue repair?

<p>Angiogenesis where vessels remain leaky (D)</p> Signup and view all the answers

What is the primary cause of redness in acute inflammation?

<p>Vasodilatation of arterioles and capillaries (D)</p> Signup and view all the answers

What does the term 'exudate' refer to in the context of inflammation?

<p>Protein-rich fluid with specific gravity above 1.02 (A)</p> Signup and view all the answers

Which of the following clinical features indicates pain during acute inflammation?

<p>DOLOR (B)</p> Signup and view all the answers

What happens to blood vessels during the initial stages of acute inflammation?

<p>Transient vasoconstriction followed by vasodilatation (B)</p> Signup and view all the answers

How does increased vascular permeability affect fluid movement during acute inflammation?

<p>Increases the osmotic pressure of the interstitial fluid (B)</p> Signup and view all the answers

What role does hydrostatic pressure play in fluid loss during inflammation?

<p>It promotes the outflow of fluid from the blood into tissues (A)</p> Signup and view all the answers

What is the significance of neutrophil margination during acute inflammation?

<p>Enhances the recruitment of immune cells to injured tissues (B)</p> Signup and view all the answers

How does Starling's Law relate to fluid exudation during acute inflammation?

<p>It requires an equal balance of hydrostatic and osmotic pressures (B)</p> Signup and view all the answers

Flashcards

Acute inflammation: What is it?

The body's immediate response to injury caused by various agents. It aims to eliminate or limit the spread of harmful substances, remove damaged cells, and initiate healing.

Key characteristic of acute inflammation

The accumulation of fluid exudate and neutrophils in tissues.

What controls acute inflammation?

Chemical messengers that regulate the inflammatory response, originating from plasma or cells.

What are the common causes of acute inflammation?

Microbial infections, hypersensitivity reactions, physical agents, and tissue necrosis.

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What is purulent inflammation?

A type of acute inflammation characterized by the presence of pus, usually caused by pyogenic bacteria.

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What is hypersensitivity inflammation?

Inflammation that occurs when the immune system overreacts to harmless substances or even the body's own tissues.

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What happens after acute inflammation?

The process of cells and tissues being repaired after injury.

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What are the classic signs of inflammation?

Redness, swelling, heat, pain, and loss of function.

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Rubor

Redness, a hallmark of inflammation, caused by increased blood flow to the affected area due to vasodilation.

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Tumor

Swelling that occurs at the site of inflammation due to the accumulation of fluid in the interstitial space.

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Calor

Heat experienced at the site of inflammation, a consequence of increased blood flow.

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Dolor

Pain felt at the site of inflammation. It is a complex response involving both inflammatory mediators and nerve stimulation.

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Loss of Function

The impairment of function of the inflamed tissue or organ. It is often a direct consequence of the other cardinal signs of inflammation.

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Exudation

The movement of protein-rich fluid from the blood vessels into the interstitial space due to increased vascular permeability. It contributes to the swelling (tumor) and the other cardinal signs of inflammation.

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Exudate

A fluid with a high protein content and specific gravity above 1.02, characteristically found in inflammatory conditions.

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Transudate

A fluid with a low protein content and specific gravity below 1.02, typically associated with non-inflammatory conditions like heart failure.

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What is edema?

A buildup of fluid in the interstitium, the space between cells, caused by increased vascular permeability and lymphatic dysfunction. It can be classified as transudate or exudate.

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What characterizes transudate?

A low-protein fluid that leaks out of blood vessels, primarily due to increased hydrostatic pressure, like in heart failure. It has a specific gravity less than 1.012.

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What characterizes exudate?

A fluid rich in protein and inflammatory cells, often seen in infections or tissue damage. It has a higher specific gravity than transudate and helps fight off pathogens.

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What is pus?

A specific type of exudate with high concentrations of neutrophils and cellular debris, typically found in infections caused by pyogenic bacteria.

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What is leukocyte recruitment?

The process by which white blood cells, primarily neutrophils, move from the bloodstream to the site of injury or infection, following chemical signals.

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What is margination?

The initial step in leukocyte recruitment where neutrophils align along the blood vessel wall.

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What is rolling?

The continuous adhesion and detachment of neutrophils to the vessel wall, rolling along the endothelium.

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What is adhesion?

The firm attachment of neutrophils to the endothelial surface, preparing for migration into the tissue.

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Selectins and Rolling

The weak and transient interactions involved in the rolling of leukocytes (WBCs) on endothelium, mediated by the selectin family of adhesion molecules. These molecules include E-selectin on endothelium, P-selectin on platelets and endothelium, and L-selectin on leukocytes.

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Integrins and Firm Adhesion

The firm adhesion of leukocytes to the endothelium, mediated by integrins on leukocytes binding to their ligands on endothelial cells. This is triggered by signals from the rolling process.

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Leukocyte Emigration (Diapedesis)

The process of leukocytes migrating through the vessel wall, typically occurring at intercellular junctions, mainly in venules.

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Chemotaxis

The movement of leukocytes toward sites of infection or injury along a chemical gradient. This is guided by chemoattractants like bacterial products, cytokines, complement components, and metabolites like those from arachidonic acid.

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Phagocytosis

The engulfment and destruction of microorganisms by phagocytes, primarily neutrophils. This process involves engulfing the microbe into a phagosome, followed by its destruction by enzymatic and reactive oxygen species.

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Exudation of Fluid

The process of delivering plasma proteins, like immunoglobulins, inflammatory mediators, and fibrinogen, to the area of injury. This dilutes toxins, increases lymphatic drainage, and delivers microbes to phagocytes and antigens to the immune system.

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Infiltration of Cells

The removal of pathogenic organisms and necrotic debris by cells like phagocytes. This is a key process in clearing the infection and initiating healing.

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Vasodilatation

Increased blood flow to the injured area, contributing to redness (rubor) and heat (calor). This delivers more nutrients and oxygen to the injured tissue.

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Study Notes

Acute Inflammation - Session 3, L1

  • Topic: Acute Inflammation

  • Definition: The body's local response to injury from a variety of agents. It's a defense mechanism to eliminate harmful agents and damaged cells.

  • Characteristics: Innate, immediate, and early response. Short-duration, typically minutes/hours/few days.

  • Objectives:

    • Identify the major causes and purposes of acute inflammation
    • Characterize macroscopic features
    • Characterize microscopic features: edema, vasodilation, neutrophil margination and migration
    • Understand the relationship between microscopic and macroscopic changes.
  • References: Robbins basic pathology, Muir's Textbook of pathology

Causes of Acute Inflammation

  • Microbial infections (bacterial, viral, fungal, parasitic)
  • Hypersensitivity reactions (against environmental substances or "self" tissues)
  • Physical and chemical agents (burns, frostbite, radiation, chemical injury)
  • Tissue necrosis (ischemia, injury)

Major Characteristics of Acute Inflammation

  • Vascular reaction:
    • Accumulation of fluid exudate and neutrophils in tissues
  • Controlled by chemical mediators derived from plasma or cells.
  • Protective but can lead to local and systemic complications, usually followed by repair.

Clinical Features of Acute Inflammation

  • Clinical signs:
    • Rubor (redness)
    • Tumor (swelling)
    • Calor (heat)
    • Dolor (pain)
    • Loss of function

Fluid Exudation

  • Acute inflammation leads to increased hydrostatic pressure (by arteriolar dilation) and increased permeability (leading to loss of proteins into tissues)

  • This results in a net flow of fluid out of blood vessels.

  • Exudate: High protein and specific gravity above 1.02, resulting from inflammation.

  • Transudate: Low protein and specific gravity below 1.012 from hydrostatic pressure imbalance.

Vascular Changes

  • Transient vasoconstriction of arterioles (few seconds).
  • Vasodilation of arterioles and capillaries (increased blood flow, heat, redness).
  • Increased permeability of blood vessels (exudation of protein-rich fluid into tissues, slowing of blood flow).
  • Concentration of red blood cells (RBCs) in small vessels (stasis).

Mechanisms of Increased Vascular Permeability

  • Endothelial cell contraction
  • Endothelial injury
  • Increased transcytosis (movement of proteins through channels)

Cellular Events

  • Leukocyte recruitment to injury site

    • Stasis
    • Margination
    • Rolling (intermittently sticking to endothelium)
    • Adhesion (strong adhesion to endothelium)
    • Emigration (moving through vessel wall)
    • Migration (movement in interstitial tissues towards a chemotactic stimulus).
  • Chemotaxis (movement of leukocytes towards chemical stimuli)

  • Phagocytosis (engulfment of microoganisms by neutrophils).

  • Additional roles of neutrophils:

    • May release toxic metabolites/enzymes damaging host tissue

Edema

  • Excess fluid in the interstitium (can be transudate or exudate).
  • Oedema leads to increased lymphatic drainage.
  • Pus is a purulent exudate containing neutrophils and cell debris.
  • Increased lymph flow is important for draining fluid, leukocytes, and debris from extravascular spaces.

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