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What is inflammation?
A complex biological response of vascular tissues to harmful stimuli.
Which of the following are types of inflammation? (Select all that apply)
The cardinal signs of inflammation are represented by the acronym ______.
PRISH
Chronic inflammation lasts for more than 2 weeks.
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What is the primary purpose of inflammation?
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What causes swelling during inflammation?
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Name two types of leukocytes that respond to inflammation.
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What triggers the release of vasodilators during inflammation?
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What is Crohn's disease?
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Steatorrhea refers to the presence of excessive fat in feces.
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Increased capillary permeability during inflammation leads to ______.
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Study Notes
Inflammation
- Complex biological response of vascular tissues triggered by stimuli like pathogens, damaged cells, or irritants.
- Purpose: removal of harmful stimuli and initiation of healing
- Non-specific response serving a protective function.
- Classified by the type of exudates produced
- Acute: Typically lasts less than 2 weeks
- Subacute Inflammation: Gradual onset, potential progression to chronic or severe reaction
- Chronic: Lasting for months or years
Cardinal Signs (PRISH)
- P ain: Resulting from chemical release by damaged cells.
- R edness: Caused by vasodilation
- I nflammation: Due to increased blood flow to the area
- S welling: Caused by an influx of fluid into the damaged region.
- H eat: Due to increased blood flow to the area
- L oss of function: Caused by increased swelling and pain
Characteristics of Inflammation
- Vascular Changes:
- Vasodilation: Occurs from arteriole level, progresses to capillaries leading to increased blood flow, resulting in redness and heat
- Increased permeability: Caused by movement of plasma into tissues resulting in stasis (slowed blood flow) and swelling
- Release of bradykinin: Vasoactive protein inducing vasodilation, increased vascular permeability, and pain.
Stages of Inflammation
- Initial tissue injury: Releases chemicals like bradykinins, serotonin, lymphokines, prostaglandins, and histamine, acting as chemical messengers
- Increased blood flow to the injured area
- Increased capillary permeability
- Leukocyte migration: Caused by chemotaxis (chemical messengers), leading to migration of white blood cells (leukocytes) to the damaged area.
- Two primary types of leukocytes involved:
- Neutrophils: First responders to neutralize bacteria
- Macrophages: Involved in the healing process by engulfing bacteria
- Two primary types of leukocytes involved:
- Tissue regeneration: Destroyed cells are replaced by identical or similar structural and functioning cells and/or fibrous tissues.
Treatment
- Minimize complications of edema
- Reduce inflammatory response
- Monitor systemic response
- Comfort measures: Rest, elevation, wrapping, analgesics
- Heat, cold, or both applications may be necessary with physician's order
Gastrointestinal Disorders
Inflammatory Bowel Disease (IBD)
- Group of chronic disorders:
- Crohn's disease (regional enteritis)
- Ulcerative colitis
- Inflammation and/or ulceration of the bowel
- Unknown cause but potential factors include:
- Environmental triggers (air pollutants)
- Food, tobacco
- Viral illness
- Genetic hereditary
Crohn's disease (regional enteritis)
- Subacute and chronic inflammation of the GI tract wall affecting all layers
- Commonly occurs in the distal ileum and ascending colon
- Characterized by periods of remission and exacerbation
- Regional enteritis/Skip lesions: Diseased bowel segments are sharply demarcated by adjoining areas of normal bowel tissue
Crohn's disease: Pathology
- Crypt inflammation and abscesses develop into small, focal ulcers.
- Ulcers deepen into longitudinal and transverse ulcers separated by edematous patches, giving a cobblestone appearance.
- Inflammation extends into the peritoneum, leading to the formation of fistulas, fissures, and abscesses.
- Interference with intestinal peristalsis due to constricted lumen leads to crampy abdominal pain, tenderness, and spasm.
- In advanced disease, the bowel wall thickens and becomes fibrotic (tissue dysfunction) leading to a narrowed intestinal lumen.
- Diseased bowel loops may adhere to surrounding loops
Crohn's disease: Clinical Manifestations
- Right lower quadrant pain and diarrhea not relieved by defecation
- Crampy abdominal pain after meals
- Anorexia, weight loss, and malnutrition due to limited food intake to prevent further abdominal pain
- Nutritional deficiencies (e.g., anemia)
- Chronic diarrhea
- Fever and leukocytosis: Possible if inflamed intestine perforates, leading to intra-abdominal and anal abscesses
- Steatorrhea (excess fat in feces)
Crohn's disease: Assessment and Diagnostic Findings
- Barium Study of the Upper GI Tract: String sign of the terminal ileum (traditional diagnostic test) .
- Improved diagnostic exams: CT scan and MRI, highlight bowel wall thickening, mesenteric edema, and identify obstructions, abscesses, and fistulae.
- CT scan has greater diagnostic sensitivity for Crohn's disease.
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Description
This quiz explores the complex biological response of inflammation, including its types, causes, and the cardinal signs associated with it. Participants will learn about acute, subacute, and chronic inflammation, as well as the physiological changes that occur during these processes.