Types of Acute Inflammation

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Questions and Answers

What primarily composes the central necrotic area of an abscess?

  • Granulation tissue
  • Toxins and inflammatory fluid
  • Polymorph nuclear leukocytes
  • Liquefied necrotic tissue (correct)

Which characteristic does NOT describe the composition of pus?

  • Thick and creamy
  • Does not clot on standing
  • Not absorbed rapidly by the body
  • Contains living polymorphs (correct)

What causes the increase in osmotic pressure inside an abscess?

  • Accumulation of granulation tissue
  • Release of bacterial toxins
  • Digestion and liquefaction of necrotic material (correct)
  • Inflammatory cell proliferation

What is one consequence if the pus in an abscess is not evacuated?

<p>The abscess may become chronic (B)</p> Signup and view all the answers

Which feature of pus is attributed to bacterial pigments?

<p>Yellow color (D)</p> Signup and view all the answers

What is the role of chemotactic substances in the inflammation process?

<p>They attract larger numbers of leukocytes (C)</p> Signup and view all the answers

What transformation occurs to the pyogenic membrane if pus is not evacuated from an abscess?

<p>It transforms into a chronic abscess structure (C)</p> Signup and view all the answers

The inflammatory fluid exudate found in pus primarily comprises what?

<p>Proteins and dead cell debris (C)</p> Signup and view all the answers

What type of inflammation features exudates rich in mucin?

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

Which inflammation is associated with exudates rich in fibrin and typically affects serous membranes and the alveoli of the lung?

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

What is the characteristic fluid in serous inflammation?

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

Which type of inflammation results in the formation of a pseudomembrane due to the presence of necrotic tissue and inflammatory cells?

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

Which inflammation involves the destruction of capillary walls leading to exudates rich in red blood cells?

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

Necrotizing inflammation is primarily characterized by which of the following?

<p>Marked tissue necrosis (A)</p> Signup and view all the answers

In allergic inflammation, which type of exudate is predominant?

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

What is a key feature of serofibrinous inflammation?

<p>Shaggy appearance resembling bread and butter (A)</p> Signup and view all the answers

What characterizes a carbuncle?

<p>Multiple communicating deep abscesses. (D)</p> Signup and view all the answers

Where is a carbuncle most likely to develop?

<p>Thick skin areas like the back of the neck. (C)</p> Signup and view all the answers

What is the primary cause of cellulitis?

<p>Streptococcus haemolyticus. (C)</p> Signup and view all the answers

What difference distinguishes abscesses from cellulitis?

<p>Abscesses contain localized pus whereas cellulitis has a diffuse distribution. (D)</p> Signup and view all the answers

What best describes the appearance of cellulitis?

<p>Hot, red, edematous, and shiny skin. (B)</p> Signup and view all the answers

What contributes to the rapid spread of infection in cellulitis?

<p>Secretion of streptokinase, hyaluronidase, and fibrinolysin. (A)</p> Signup and view all the answers

What type of pain is typically associated with an abscess?

<p>Localized and often throbbing pain. (B)</p> Signup and view all the answers

Which condition presents with increased red blood cell content?

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

What characterizes serofibrinous inflammation?

<p>Initial accumulation of fibrin followed by serous fluid (A)</p> Signup and view all the answers

What is a potential fate of serofibrinous inflammation?

<p>Formation of fibrous adhesions if fibrin is not cleared (A)</p> Signup and view all the answers

What defines pseudomembranous inflammation?

<p>Formation of a thick, adherent membrane over the inflamed area (C)</p> Signup and view all the answers

In pseudomembranous inflammation, what structure forms the pseudomembrane?

<p>Fibrin network combined with necrotic tissue and pathogens (B)</p> Signup and view all the answers

What is the main characteristic of hemorrhagic inflammation?

<p>Presence of red blood cells due to capillary wall destruction (C)</p> Signup and view all the answers

What type of inflammation is characterized by significant tissue necrosis?

<p>Necrotizing inflammation (D)</p> Signup and view all the answers

Allergic inflammation primarily involves which type of inflammatory cells?

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

What triggers allergic inflammation in the body?

<p>An antigen-antibody reaction specific to a sensitized individual (A)</p> Signup and view all the answers

What occurs if the pus from an abscess is not evacuated?

<p>The abscess becomes chronic (B)</p> Signup and view all the answers

Which of the following best describes a sinus?

<p>A blind ended tract between the abscess cavity and the skin surface (C)</p> Signup and view all the answers

What type of tissue is found in the pyogenic membrane of an abscess?

<p>Central area of necrosis and liquefaction (D)</p> Signup and view all the answers

Which of the following describes a keloid?

<p>A large scar projecting on the surface (D)</p> Signup and view all the answers

What type of inflammation is characterized by the presence of burn blisters?

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

What condition is associated with a fibrous tract connecting an abscess and another organ?

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

What is chronicity in relation to abscesses?

<p>An ongoing infection with thick pus (D)</p> Signup and view all the answers

Which type of inflammation is exemplified by diphtheria?

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

Which infection is caused primarily by Staphylococcus aureus?

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

What is a key characteristic of chronic inflammation compared to acute inflammation?

<p>Mild or prolonged irritant (D)</p> Signup and view all the answers

Which mechanism triggers chronic inflammation by prolonged exposure to toxic agents?

<p>Prolonged exposure to silica (C)</p> Signup and view all the answers

Which is a complication of healing related to abscesses?

<p>Formation of a sinus (D)</p> Signup and view all the answers

What cells are commonly found in chronic inflammation?

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

What is the primary difference in fluid exudates between acute and chronic inflammation?

<p>Chronic inflammation features scanty fluid exudates. (B)</p> Signup and view all the answers

Which of the following is NOT a mechanism of chronic inflammation?

<p>Acute inflammatory response (B)</p> Signup and view all the answers

What structural change is commonly observed in blood vessels during chronic inflammation?

<p>Endarteritis obliterans with thick walls (C)</p> Signup and view all the answers

Flashcards

Abscess Formation

An accumulation of pus in a localized area, resulting from a bacterial infection.

Pus Composition

Pus consists of bacteria, toxins, necrotic tissue, inflammatory fluid, and dead white blood cells.

Abscess Zones

An abscess has three zones: central necrosis (dead tissue), a middle zone of pus, and a peripheral zone of inflammation.

Pus Characteristics

Pus is thick, creamy, alkaline, yellow, and odorless (unless caused by certain bacteria).

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Abscess Enlargement

Abscesses grow by further liquefaction of necrotic tissue, increasing pressure inside.

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Abscess Healing

Abscess healing involves the replacement of pus with granulation tissue.

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Chronic Abscess

If pus is not drained, the inflammation persists, becoming chronic and thick.

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Abscess Complications

Complications include chronic infection, spread to other areas, and issues during healing.

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Carbuncle (definition)

Localized suppurative inflammation with multiple communicating deep abscesses, open on the surface by sinuses.

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Carbuncle (cause)

Usually Staphylococcus aureus, especially in diabetic patients.

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Cellulitis (definition)

Diffuse suppurative inflammation of loose subcutaneous tissues.

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Cellulitis (Cause)

Streptococcus haemolyticus, which breaks down tissue to spread infection.

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Abscess (definition)

Localized collection of pus within a tissue cavity.

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Abscess vs. Cellulitis (clinical appearance)

Abscess shows a well-defined swelling with redness and tenderness, while cellulitis has diffuse redness, swelling, warmth, and pain.

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Abscess vs. Cellulitis (pus formation)

Abscess has a clear collection of pus, while cellulitis has thin, slowly formed pus.

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Abscess vs. Cellulitis (borders)

Abscess has clear and localized borders, cellulitis has poorly defined, more diffuse borders.

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Pyogenic membrane

The membrane of an abscess, composed of a central necrosis area, a liquefaction area, and a peripheral inflammation zone.

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Sinus

A blind-ended tract of infected granulation tissue between an abscess and the skin surface.

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Fistula

An infected granulation tissue tract between an abscess cavity and a hollow organ, or between two hollow organs.

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Ulcer

A persistent loss of surface tissue continuity.

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Keloid

A large scar that projects from the skin surface, caused by excessive healing.

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Furuncle (boil)

A small abscess related to hair follicles or sebaceous glands, commonly caused by Staphylococcus aureus.

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Spread of infection

Complications arising from abscesses such as bacteremia, septicemia, and pyemia

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Serofibrinous Inflammation

A type of inflammation where fibrin and fluid accumulate in the affected area, starting dry with more fibrin and becoming wet as more fluid collects.

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Serofibrinous Inflammation Fate

Serofibrinous inflammation can either resolve (fibrin destroyed and fluid absorbed) or lead to fibrous adhesion (fibrin not removed).

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Membranous Inflammation

A severe type of acute inflammation where a thick, dirty, adherent pseudomembrabe forms on the inflamed surface.

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Membranous Inflammation Cause

Membranous inflammation occurs when the causative organism secretes toxins, causing necrosis of the mucosa, leading to fibrin and cell accumulation forming a pseudomembrane.

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Hemorrhagic Inflammation

Acute inflammation characterized by exudates rich in red blood cells due to damaged capillary walls.

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Necrotizing Inflammation

Acute inflammation with severe tissue necrosis, characterized by marked cell death.

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Allergic Inflammation

Inflammation triggered by an antigen-antibody reaction, causing excess fluid with high eosinophil count.

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Allergic Inflammation Examples

Examples of allergic inflammation include eczema (allergic dermatitis) and allergic rhinitis.

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Catarrhal Inflammation

Inflammation where the exudate is rich in mucus, often seen in mucous membranes. It's usually mild.

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Fibrinous Inflammation

Inflammation characterized by an exudate rich in fibrin. This is often seen in serous membranes like the pleura, pericardium, and peritoneum, as well as in the alveoli of the lungs.

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Serous Inflammation

Inflammation where the exudate is mainly watery fluid, seen in serous membranes and burns.

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Membranous (Pseudomembranous) Inflammation

Inflammation where a pseudomembrane forms over the inflamed area. This membrane is made of fibrin, dead cells, and inflammatory cells. It is often seen in diphtheria and dysentery.

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Burn Blister Example

Burn blisters are an example of serous inflammation, characterized by fluid exudation from blood vessels.

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Diphtheria Example

Diphtheria is an example of pseudomembranous inflammation, characterized by a thick, yellowish-gray membrane forming on mucous membranes.

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Chronic Inflammation

Chronic inflammation is a prolonged inflammatory process lasting for months or years, involving tissue destruction and healing attempts.

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Causes of Chronic Inflammation

Chronic inflammation can be caused by persistent infections, prolonged exposure to toxins, or autoimmune reactions.

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Chronic Inflammation vs. Acute

Chronic inflammation differs from acute inflammation by having a milder irritant, minimal tissue destruction, and scantly fluid exudates.

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Chronic Inflammation Cells

Chronic inflammation is characterized by lymphocytes, eosinophils, plasma cells, macrophages, fibroblasts, and foreign body giant cells.

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Endarteritis Obliterans

Endarteritis obliterans (EAO) is a characteristic of chronic inflammation, involving thickened blood vessel walls and narrowed lumens.

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Perivascular Cells

In chronic inflammation, cells are often found around blood vessels (perivascular) or diffusely spread, which are lymphocytes, eosinophils, plasma cells, macrophages, fibroblasts, and foreign body giant cells

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Study Notes

Types of Acute Inflammation

  • Suppurative inflammation is characterized by pus formation
  • Causes of suppurative inflammation include pyogenic organisms (staphylococci, streptococci, gonococci, and E. coli)
  • Localized suppurative inflammation can manifest as abscesses, furuncles, and carbuncles
  • Diffuse suppurative inflammation can manifest as cellulitis

Types of Suppurative Inflammation

  • Abscess: A localized collection of pus within a tissue cavity.
  • Cause: Staphylococci that secrete coagulase (enzyme converting fibrinogen into fibrin).
  • Site: Any body organ, including subcutaneous tissue, breast, and brain.

Pathogenesis and Pathological Picture of Abscess

  • Pyogenic bacteria and toxins cause necrosis in the central area.
  • Acute inflammatory cells (mainly polymorphs) surround the necrotic area.
  • The abscess is composed of three zones: central necrosis, a mid zone of pus, and a peripheral zone of acute inflammation (pyogenic membrane).

Characteristics of Pus

  • Pus is thick and creamy
  • Pus is alkaline
  • Pus is usually yellow due to bacterial pigments and hemosiderin.
  • Pus is often odorless, but may have an offensive odor if caused by E. coli.
  • Pus does not clot when standing because fibrinogen is destroyed by proteolytic enzymes.

Composition of Pus

  • Pus consists of the causative bacteria and their toxins
  • Necrotic tissue
  • Inflammatory fluid exudates
  • Inflammatory cellular exudates (pus cells)

Fate of Abscess

  • Pus is not readily absorbed by the body.
  • Abscesses require drainage to heal.
  • Healing is by granulation tissue.
  • If pus is not drained, the abscess becomes chronic, and the pyogenic membrane transforms into granulation tissue.

Complications of Abscess

  • Chronic abscess (chronicity): If pus isn't evacuated, the abscess becomes chronic, and pus thickens. The pyogenic membrane gradually replaces with granulation tissue.
  • Spread of infection: Bacteremia, septicemia, and pyemia can result from the spread of bacteria.
  • Complications of healing: Ulceration, fistula, sinus formation, and keloid formation are possible.

Non-Suppurative Inflammation

  • These are defined by the type of exudate, not the presence of pus
  • Types include catarrhal, fibrinous, serous, serofibrinous, membranous, necrotizing, allergic and hemorrhagic

Catarrhal Inflammation

  • Characterized by a mild, non-suppurative inflammation of mucous membranes
  • Rich in mucin
  • Found in the mucosa of the gastrointestinal tract, upper respiratory system, and urinary system

Serous Inflammation

  • Acute, non-suppurative inflammation with an exudate rich in serous fluid (watery).
  • Examples include burn blisters and inflammation of serous membranes like pleura, pericardium and peritoneum.

Fibrinous Inflammation

  • Acute, non-suppurative inflammation characterized by exudates rich in fibrin.
  • Found in serous membranes (pleura, pericardium, and peritoneum) and alveoli (lobar pneumonia).

Serofibrinous Inflammation

  • Acute, non-suppurative inflammation with exudates rich in serous fluid and fibrin.
  • Visceral and parietal layers thicken, become opaque, and lose luster.
  • Accumulation of serous fluid leads to an effusion, creating a "bread-and-butter" appearance.
  • microscopic examination: serosal cells are first swollen, then necrosed and desquamate (ulcer). Subserosal tissue shows dilated, congested blood vessels and edema.
  • Fate: resolution (fibrin destroyed, fluid absorbed) or organization (fibrous adhesions if fibrin not removed)

Membranous (Pseudomembranous) Inflammation

  • Severe, non-suppurative inflammation with a pseudomembrane over the inflamed area.
  • Examples: diphtheria and bacillary dysentery
  • Histological characteristics: membrane of fibrin, cell debris and bacteria

Hemorrhagic Inflammation

  • Acute, non-suppurative characterized by exudates rich in RBCs due to capillary wall destruction.
  • Examples: typhus, smallpox, and plague

Necrotizing Inflammation

  • Acute, non-suppurative featuring marked tissue necrosis.
  • Examples: Vincent angina and cancrum oris

Allergic Inflammation

  • Inflammation happens when the body reacts to a specific antigen.
  • Characterized by an excessively large amount of inflammatory exudate (edema) wealthy in eosinophils.
  • Examples: eczema, allergic dermatitis, and allergic rhinitis

Chronic Inflammation

  • Slow, prolonged inflammation lasting months or years.
  • Features: Minimal tissue destruction, blood vessels show endarteritis obliterans, scanty fluid exudates. Chronic inflammation involves perivascular infiltration with lymphocytes, macrophages, eosinophils, plasma cells, and foreign body giant cells. Fibroblasts proliferate rather than exudate.

Mechanisms of Chronic Inflammation

  • Persistent infections (low toxicity, evoking delayed type hypersensitivity, e.g., tubercle bacilli)
  • Prolonged exposure to potentially toxic agents (exogenous e.g. silica causing silicosis; endogenous, e.g., atherosclerosis).
  • Autoimmunity (autoantigens evoke immune reaction, tissue damage and inflammation).

Summary of Acute vs Chronic Inflammation

Feature Acute Inflammation Chronic Inflammation
Causes Severe irritant Persistent infections; toxic agents; autoimmunity
Onset Sudden Gradual
Duration Short Prolonged
Vascular Phenomenon Present Slight or absent
Fluid exudate Abundant Scanty
Cardinal signs Present Often absent
Toxemia Present Often absent
Cells Primarily neutrophils Lymphocytes, macrophages, plasma cells, fibroblasts
Blood vessels Dilated and congested Endarteritis obliterans (thickened walls)

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