immune response
the third line of defense
vascular response
Response in which there is increased blood flow to the site of an injury
cellular response
Type of response that alerts the products of healing to attend to the site of injury
dilate
Part of vascular response to accommodate increased blood flow to the site of the injury
permeable
(vascular response) lining of the blood vessel loosens to allow cells to easily move from the vessel into the injured tissue
Inc blood flow, inc healing cells, prepare for tissue repare
Three goals of inflammation
Mast cells, basophils
Cell derived chemical mediators
Complement, kinin, clotting systems
Plasma derived chemical mediators
exudate
Watery fluid that accumulates at the site of injury
Mast cell
An important inflammatory mediator, a leukocyte that is responsible for the production and immediate inflammatory mediators through a response of degranulation. ("first responders")
Degranulation
When the mast cell breaks apart and releases inflammatory mediators in the form of extracellular granules
Basophil
A white blood cell that contains granules that acts in the same manner as mast cells
Mast cell
mediators released by ________ include histamine, leukotrienes, and prostaglandins
Histamine, leukotrienes, prostaglandins
Mediators released by mast cells include....
Prostaglandins, leukotrienes, thromboxane
Inflammatory mediators associated with arachidonic acid
Chemotaxis
A process of moving certain cells to the site of injury - attracts specific types of cells
Chemotaxis, cellular adherence, cellular migration
Three steps needed for a successful cellular response
Adherence
Attraction and binding, essential for effective phagocytosis
Diapedesis
Process in which cells can move between and through endothelial junctions
Interferons
Can cause nonspecific flu-like symptoms
Interferons
Small, antiviral proteins produced by virus infected cells; they prevent viruses from multiplying
Alpha, beta, gamma
Three types of interferons
Heat, redness, swelling, pain, incapacitation, edema
Local manifestations of inflammation
Fever, fatigue, weight loss, headache, lethargy, inc leukocytes
Systemic manifestations of inflammation
Cellulitis
Acute spreading infection at any site
Abscess
Infection associated with breakdown of tissues and formation of pus
Septicemia
overwhelming infection where pathogenic bacteria gain access to bloodstream
5,000 - 10,000
White blood cell count
45-75%
Neutrophils %
0-8%
Eosinophils %
0-3%
Basophils %
16-46%
Lymphocytes %
4-11%
Monocytes %
0-17 mm/hr
Men (Erythrocyte sedimentation rate)
1-25 mm/hr
Women (Erythrocyte sedimentation rate)
44-114 mm/hr
Pregnancy (Erythrocyte sedimentation rate)
1-13 mm/hr
Children (Erythrocyte sedimentation rate)
11.2-13.2 seconds
Prothrombin time (time to coagulate)
175-400 mg/dL
Fibrinogen (elevated during inflammation to promote coagulation)
<10 mg/L
C-reactive protein (>_____ indicates significant inflammatory disease)
The complement system
Stimulates inflammation, opsonization, and lysis of foreign cells
Opsonization, opsonins
Process by which phagocytosis is facilitated by the deposition of ________. (Allows phagocytes to easily "grab" particles)
Reduce blood flow, decrease swelling, block the action of chemical mediators
Three steps in treatment of inflammation
Inflammatory, proliferative, remodeling
Three steps of healing and tissue repair
Inflammatory phase
Covers the wound - first step of healing and tissue repair
Proliferative phase
Cleans the debris and restores structural integrity - second step of healing and tissue repair
Remodeling phase
Resolution, regeneration, replacement - third step of healing and tissue repair
Ulcers
Complication of wound healing. Open lesion of the skin prone to infection
Dehiscence
Complication of wound healing. Deficient scar formation, in which the wound splits open, often at a suture line
Keloids
Complication of wound healing. Hypertrophic scars that result from excessive collagen production at the site of injury
Chronic inflammation
Formation of granulomas and scarring often occur
Deep partial burn
Blistering occurs in this type of burn
Full thickness burn
Redness, eschar, edema, and exudate characterize this type of burn
Rule of nines
Diagnostic criteria used for burns
Sepsis
Bacterial infection of the blood
Debridement
A process of mechanically removing debris, including necrotic tissue, from the wound.
B
You get a paper cut and experience pain at the site. This response is related to:
A. Increased perfusion at the site
B. Increased exudate and chemical mediators at the site
C. Bacteria that have entered the wound
D. Vasoconstriction at the site
D
Inflammation is ultimately needed to:
A. Increase inflammatory mediators at the site to vasoconstrict the area
B. Increase platelets at the site for clotting
C. Restore functional cells
D. Prepare the site for healing
Primary intention
Type of healing where the wound is closed with all areas of the wound connecting and healing simultaneously (ex. paper cut)
Secondary intention
Type of healing where the wound heals from the bottom up. Slower and more involved process (ex. open crater-like wound)
A
A wound is 6cm x 6cm x 4cm. A wound with these dimensions needs to heal through:
A. Secondary intention
B. Primary intention
C. Tertiary intention
D. Scar tissue formation
D
A major difference between the acute and chronic inflammatory response is that in chronic inflammation:
A. Inflammatory mediators are released
B. Neutrophils are much more prominent
C. Granulomas form around certain invaders
D. Granulation tissue is prese
D
Which is not a local manifestation of acute inflammation:
A. Edema
B. Redness
C. Loss of function
D. Leukocytes
A
The hospitalized burn patient want to know why you need to remove his dressings every day. You explain that removing the dressings promotes:
A. Debridement
B. Infection
C. Skin function
D. Drying and exudate
D
Which of the following is the most common cause of acute gastritis?
A. Poor gastric perfusion
B. Too much stomach acid
C. Ingestion of aspirin, alcohol, or other chemicals
D. H. Pylori infection