What is the bodes response to injury?
inflammation, immunity, repair
Injury
-tissue damage
-severe injury may result in necrosis
-less severe injury may result in reversible cellular responses such as hypertrophy, atrophy, hyperplasia
What is necrosis?
the pathologic death of cell(s) or part of a tissue or an organ (irreversible damage to cells)
What is hypertrophy?
size increases
What is hyperplasia?
the number increases
Natural (innate) defense
inborn defenses
-physical barrier
-mechanical defense
-removal of foreign substances
-antibacterial activity
-gastric juice & vaginal fluid
-inflammation
Physical barrier
intact skin and mucosa
resident microflora on skin and mucosa
Mechanical defense
cilia and mucus in the respiratory tract
movement
Removal of foreign substances
tears, saliva, urine, diarrhea
Antibacterial activity
lysozyme (enzyme that is capable of breaking down) in rearm saliva, and nasal secretion
Inflammation
-a nonspecific response
-either local or systemic
-may be acute(a few days) or chronic (a few weeks, months, or even indefinitely) or combination
-repair occurs only if the sour of injury is removed
Classic (cardinal)signs (the local changes)
redness, heat, swelling, pain, loss of normal function
Systemic signs
fever, leukocytosis(# of WBC increase), elevated C-reactive protein, lymphadenopathy (large lymph nodes)
Reapair occurs only if?
the source of the injury is removed
What does emigration mean?
the passage of white blood cells through the endothelium and wall of the microcirculation into the injured tissue
What does migration mean?
a process during inflammation in which white blood cells tend to move to the periphery of the blood vessel wall
What does pavementing mean?
Adherence of white blood cells to the walls of a blood vessel during inflammation
What is a thin,clear fluid mainly plasma fluids and proteins, a few WBCs?
Serous (watery) exudate
What is a thick white to yellow pus that contains plasma fluids and proteins, tissue debris, and many WBCs?
Purulent exudate
What is accumulation of purulent in a cavity formed by the tissue?
Abscess
Excess exudate may drain out of the tissue through a channel called?
fistula
As a result of inserting pressure on sensory nerves by excess exudate is referred to as?
Pain
The direct movement of white blood cells to the area of injury by chemical mediators is called?
Chemotaxis
What is the first to arrive in the inflammatory response
Neutrophilis
2nd to arrive are?
monocytes
What is the process of ingestion and digestion by cells?
phagocytosis
In acute inflammation we find what kind of cells?
Neutrophils
In chronic inflammation we find?
Macrophages, lymphocytes, and plasma cells
There are still neutrophils just not as many
What are the three systems of plasma proteins that may be activated?
Kinin system
Clotting mechanism
Complement system
What directly affects the permeability of the blood vessels?
Histamine
Kinin system causes _______ and __________ of blood vessels
vasodilation and increased permeability
What does kinin system induce?
pain
The primary kinin is?
bradykinin
Whats the role of blood plasma proteins?
its role is limited to early stages of inflammation
Clotting mechanism helps?
helps stop bleeding at the site of the injury
What does the clotting mechanism form?
forms a fibrinous meshwork that keeps foreign substances corralled.
Clotting mechanism activates?
activates kinin system-> causes local vasodilation and increase of permeability
Clotting mechanism forms a future framework for the ____ process
repair
Complement system
a series of plasma proteins that are activated in a cascade fashion
Complement system cause?
-cause mast cells to release histamine-> vasodilation and increase of blood vessels permeability
-cause cytolysis(cellular death)
-cause opsonization: attach to the bacteria and stimulate WBC's to phagocytize them
Complement system form?
chemotactic factors for WBC's, and enhance phagocytosis
Other Biochemical Mediators of Inflammation that are released by the body are?
Prostaglandins and Lysosomal enzymes
Prostaglandins cause?
cause increased vascular dilation and permeability, tissue pain and redness, and changes in connective tissue
Lysosomal enzymes act as? and may cause?
act as chemotactic factos, may cause damage to connective tissue and to the clot
Other Biochemical Mediators of Inflammation that are released by pathogenic microorganisms are?
Endotoxin and Lysosomal enzymes
Endotoxins
-produced by cell walls of gram negative bacteria
-serves as chemotactic factor
-can activate complement
-function as an antigen, and damage bone and tissue
Lysosomal enzymes
have a similar chemical composition and action as theses real eased by WBC's
Systemic Manifestations of Inflammation
-fever
-leukocytosis
-lymphadenopathy
-elevated c reactive proteins
Fever is controlled by the?
hypothalamus
What is Normal temperature
37 C (98.6)
What produces pyrogens?
WBC's and pathogenic microorganisms
What is a pyrogen?
fever-pouducing substances
What does pyrogens produce?
produce fever by increasing synthesis and release of prostaglandins in hypothalamus
Increased temperature slows what?
slows the growth of many pathogenic microorganisms
What does leukocytosis mean?
increase in the number of WBC's
increases to 10,000 to 30,000 per microliter (primarily neutrophils)
Whats the normal number for leukocytosis
4,000-10,000 per microliter
Viral infection increase in?
lymphocytes
Bacterial infection increase in?
neutrophils
Allergic reaction increase in?
eosinophils
Lymphadenopathy
the involved nodes are palpable, feel firmer and larger than usual and may be tender
increase in the number of cells
Hyperplasia
enlargement of individual cells
Hypertrophy
Elevated C-Reactive Protein is produced in the?
Liver
Elevated C-Reactive Protein interacts with what two systems?
complement system and clotting mechanism
High level of elevated c-reactive protein occurs during?
acute or chronic inflammation and infection (reaches 100mg/L)
Concentration greater than ______ is considered to high
10mg/L
Elevated C-Reactive Protein may be used to ?
monitor tissue healing and as an early detection for possible infection in patients who had survey, organ transplant, severe burn
In Chronic inflammation what cells are involved?
neutrophils
monocytes
macrophages
lymphocytes
plasma cells
What else occurs in chronic inflammation?
proliferation of fibroblasts
Granulomatous inflammation
a distinctive form of chronic inflammation
Granuloma form
microscopic grouping of macrophages usually surrounded by lymphocytes and maybe plasma cells
Macrophages group together to form?
multi-nucleated giant cells
What are the reactive tissue responses?
Hyperplasia
Hypertrophy
Atrophy
Increase in the number of cells often in response to chronic irritation or abrasion
Hyperplasia
Hyperplasia: In oral cavity, epithelium becomes _______ and the tissue appears _____
thickened
paler or whiter
increase in the size of tissue or organ as a result of increase in the size of individual cells is?
Hypertrophy
decrease in size and function of a cell, tissue, organ, or the whole body is?
atrophy