Inflammation Study Guide PDF

Study Guide Inflammation A. Name the four signs of inflammation and relate them to the precipitating events (Table 6-3) 1. Erythema (redness) – Vasodilation and increased blood flow 2. Heat - Vasodilatio...

Study Guide Inflammation A. Name the four signs of inflammation and relate them to the precipitating events (Table 6-3) 1. Erythema (redness) – Vasodilation and increased blood flow 2. Heat - Vasodilation and increased blood flow 3. Edema – Increased vascular permeability and hydrostatic pressure, causing filtration into interstitial spaces 4. Pain – Multiple causes i. Direct trauma ii. Edema causing pressure iii. Nerve endings swelling iv. Chemical mediation B. Differentiate acute vs. chronic inflammation 1. Acute i. Chiefly edema (including fluid and plasma proteins) and neutrophilic migration 2. Chronic i. Includes lymphocytes, plasma cells, and macrophage infiltration (a) Attracted by chemotaxis from other cells (b) Promote growth of endothelial cells and fibroblasts (a) Granulation tissue forms ii. Angiogenesis / Neovascularization iii. Fibrosis iv. Tissue destruction C. Provide examples of conditions that would cause acute and chronic inflammation 1. Acute i. Infections ii. Tissue necrosis iii. Foreign bodies iv. Immune Reactions 2. Chronic i. Extensive necrosis ii. Sites where regeneration of tissue parenchyma is not possible (a) Heart (b) CNS (c) PNS iii. Underlying cause is not addressed (a) Persistent injurious agent iv. Repeated episodes of acute inflammation D. Briefly describe granulomatous inflammation 1. Aggregate of macrophages and lymphocytes E. Differentiate exudate, transudate, and effusion 1. Exudate is high protein fluid with high cellular content i. Dependent upon increased vascular permeability  2. Transudate is low protein fluid with minimal cellular content i. Dependent upon Starling’s forces causing filtration ii. No increase in vascular permeability 3. Effusion is the leakage of either of these into anatomic space (or potential space) i. Can be exudate or transudate F. Describe the role of vascular alterations in inflammation 1. Goal: increase movement of plasma proteins and circulating cells out of intravascular space to get to the site of injury i. Process of “exudation” (a) Increased capillary permeability (a) Increased inter-endothelial spaces (b) Fluid and protein leakage ii. Vasodilation (a) Increased blood flow to the area [initially] iii. Decreased blood flow to the area (a) After leakage of fluid out of the area (b) Increased viscosity of the blood iv. Clotting of fluid due to increased fibrinogen v. Migration and accumulation of leukocytes (a) Destroy pathogen G. Describe the role of leukocytes in inflammation and the process by which this occurs 1. Role i. Remove / eliminate injurious stimulus ii. Release toxic substances to kill, inactivate, and degrade pathogens iii. Clean up the area by phagocytosis iv. Release growth factors for healing/regeneration 2. Process i. Stasis = Engorgement of blood vessels causing a slowing of blood flow in the region ii. Margination = Accumulation of leukocytes to endothelial cells of blood vessel walls (a) Possible because of adhesion molecules (a) Bind leukocytes to other leukocytes (b) Bind leukocytes to capillaries / venules iii. Diapedesis = Leukocytes actively migrate out of blood vessel, by squeezing between endothelial cells, to reach the interstitial space iv. Chemotaxis = The use of chemotactic agents (chemokines) which attract other cells to move into the area H. Briefly describe the role of the lymphatic system in the inflammatory response 1. Lymphatic vessels drain exudate from the interstitium i. Reduce edema ii. Removal of inflammatory stimuli iii. Removal of leukocytes 2. Phagocytes present antigens to immunocompetent B and T cells in the lymph nodes i. Proliferation of lymphocytes ensues ii. Lymphadenopathy = enlargement of lymph nodes  iii. Further adaptive immune response as necessary I. Define lymphangitis 1. Inflammation of the lymphatic vessels i. Red streaks under the skin ii. Painful to palpation J. Describe the key inflammatory mediators 1. Histamine i. Synthesized and stored in granules within mast cells, basophils, and platelets ii. Effects (a) Endothelial contraction (a) Increased vascular permeability (b) Exudation (b) Vasodilation (c) Bronchoconstriction iii. Inactivated in