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Questions and Answers
What is the primary type of cellular infiltrate found in acute inflammation?
What is the primary type of cellular infiltrate found in acute inflammation?
Which of the following correctly describes the onset of chronic inflammation?
Which of the following correctly describes the onset of chronic inflammation?
What is the main purpose of inflammatory fluid exudate?
What is the main purpose of inflammatory fluid exudate?
Which process describes the movement of neutrophils toward the site of inflammation?
Which process describes the movement of neutrophils toward the site of inflammation?
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Which of the following cells are primarily associated with chronic inflammation?
Which of the following cells are primarily associated with chronic inflammation?
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What is a primary benefit of phagocytosis?
What is a primary benefit of phagocytosis?
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Which sequence correctly describes the events of inflammation?
Which sequence correctly describes the events of inflammation?
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Which of the following is NOT a chemical mediator involved in inflammation?
Which of the following is NOT a chemical mediator involved in inflammation?
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What characterizes suppurative inflammation?
What characterizes suppurative inflammation?
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In which scenario is an abscess most likely to occur?
In which scenario is an abscess most likely to occur?
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Study Notes
Inflammation Overview
- Inflammation is a local vascular and cellular response of living tissue to an injurious agent.
- Aims of inflammation include fighting bacteria, localizing infection, and removing damaged tissue.
- Causes of inflammation include allergic reactions, chemical irritants, infections, trauma, injury, burns, lacerations, cuts, wounds, frostbite, and various diseases (e.g., cardiovascular disease, neurological disease, autoimmune diseases, cancer, lupus, and fibromyalgia).
- Types of inflammation include acute and chronic inflammation.
Acute Inflammation
- Onset is fast, typically within minutes to hours.
- Cellular infiltrate is primarily neutrophils.
- Tissue injury and fibrosis are usually mild and self-limited.
- Local and systemic signs are prominent.
Chronic Inflammation
- Onset is slow, often over days.
- Cellular infiltrate includes monocytes, macrophages, and lymphocytes.
- Tissue injury and fibrosis are often severe and progressive.
- Local and systemic signs are less prominent.
Cells in Acute and Chronic Inflammation
- Acute: neutrophils (phagocytosis, pus cells)
- Chronic: lymphocytes (chronic), plasma (chronic), histiocytes (chronic phagocytosis, monocytes), eosinophils (allergy, parasitic), mast cells (allergy - histamine, serotonin), and giant cells (phagocytosis, histiocytes).
Local Signs of Inflammation
- Heat
- Redness
- Swelling
- Pain
- Loss of function
Systemic Effects of Inflammation
- Fever
- Leukocytosis
- Malaise
- Nausea
- Anorexia
- Lymphoid hyperplasia
- CRP and ESR raised
Main Events of Inflammation
- Vascular response
- Inflammatory fluid exudate
- Inflammatory cellular exudate
Vascular Response
- Changes in vascular flow and caliber: vasodilation (histamine), stasis (increased viscosity, swollen ends, open capillaries).
- Increased permeability: histamine, kinins, endothelial "gaps", direct endothelial injury.
Inflammatory Fluid Exudate
- Formation: increased vascular dilation and permeability, interstitial osmotic pressure, and reduced hydrostatic pressure.
- Function: diluting toxins, bringing antibodies, supplying nutrition, supplying fibrinogen (for localization and movement of inflammatory cells and fibroblasts).
Composition of Exudate
- Appearance: turbid (like pus)
- Consistency: viscous
- Protein content: high (4-8 gm)
- Specific gravity: high (above 1018)
- Cell content: numerous neutrophils
- On standing: clots
Cellular Exudate
- Extravasation of neutrophils (Margination, Rolling, Adhesion, Transmigration - Diapedesis)
- Chemotaxis (directed movement of neutrophils and macrophages to the inflamed area)
- Activation of leukocytes: produce eicosanoids, undergo degranulation, secrete cytokines
- Phagocytosis (ingestion and destruction of bacteria, necrotic debris, and foreign particles)
Opsonization and Phagocytosis (Cellular Responses)
- Recognition (Opsonins - Immunoglobulins, complement)
- Engulfment
- Killing (oxidative and non-oxidative)
Chemical Mediators
- Cellular: histamine, serotonin, eicosanoids, nitric oxide, platelet activating factor (PAF)
- Plasma: complement, kinins, clotting factors, fibrinolytic
Outcomes of Acute Inflammation
- Resolution
- Regression & Healing
- Progression & spread
- Progression & Chronicity
Summary of Sequence of Events
- Vasodilation → Increased vascular permeability → Leakage of exudate, stasis → Extravasation, margination, rolling, adhesion, transmigration (diapedesis) → Chemotaxis → PMN activation → Phagocytosis: recognition, attachment, engulfment, killing → Termination → 100% resolution, scar, or chronic inflammation
Types of Acute Inflammation
- Suppurative
- Localized: Abscess, Furuncle, Carbuncle
- Diffuse: Cellulitis
- Non-Suppurative
Types of Acute Non-Suppurative Inflammation
- Catarrhal
- Serous
- Fibrinous
- Membranous
- Hemorrhagic
- Necrotizing
- Serofibrinous (various infections)
Chronic Inflammation
- Causes: persistence of infection, prolonged exposure to insult
- Types: non-specific, specific (granuloma)
Granulomas
- Definition: chronic, specific inflammation with nodular collection of epithelioid cells, lymphocytes, and giant cells
- Etiology:
- Infective (bacteria, parasites, fungi)
- Non-infective (selososis, foreign bodies)
- Unknown (Crohn's, sarcoidosis)
- Components: histiocytes, epithelioid cells, giant cells (Langhans), lymphocytes, fibroblasts
- Classification: with or without caseation, suppurative, foreign body
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Description
This quiz explores the fundamental concepts of inflammation, including its causes, aims, and the differences between acute and chronic inflammation. Test your knowledge on the cellular responses and pathological implications of inflammation in living tissues.
