Term
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Definition
Definition: nonspecific, physiological reaction of tissue to injury
> part of body's defense mechanism
- purpose is to rid tissue of foreign material
- generally designed to be beneficial, will cause damage to body when out of control |
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Term
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Definition
| necrotic debris MUST be removed before new growth can occur |
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Term
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Definition
- long duration, repeated injury
side effect noxious (unpleasant or harmful) ex: fever
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Term
| inflammation series of events - phases |
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Definition
- initiation phase - activated at injury
- amplification phase - chemicals direct more/different WBC to area
- termination phase- other chemicals stop inflammatory process
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Term
Leukocytes are divided into two groups:
(cells of Inflammation) |
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Definition
- Group 1- Granulocytes
- Group 2- Agranulocytes, Mast Cells, Plateles
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Term
Chemical mediators:
(Devided into three groups) |
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Definition
- Group 3- Lipopolysaccharides, Histamine, Serotonin, Platelet Activating Factor
- Group 4 - Prostaglandins, Leukotriene, Cytokines
- Groups 5- Complement system, clotting system, Kinin system
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Term
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Definition
> Granulocityes- active during initial stages of inflammation, shorter lived (6-9 hrs), faster to respond
-(PMN's) polymorphonuclear neutrophil
- eosinophils
- basophils
> Agranulocyted- active during later stages of the acute inflammatory process, longer lived (several months), slower to respond
- monocytes (macrophages)
- lymphocytes
> Mast cells
> Platelets
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Term
| (PMN's) Polymorphonuclear leukocytes |
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Definition
- neutrophils (FIRST cells to arrive on scene)
-60-70% of WbC's in the blood
- provides first defense
- average life span: 2-4 days
- mobile phagocytes: main goal is to kill infectious agent: phagocytosis
- attracted to area by chemotaxis; chemical signaling
- when bacteria are killed, enzymes are released that can cause injuty to patient (collagenase; enzyme which breaks peptide bonds in collagen)
- release and secrete cytokinins- interleukin 1 (small molecules used for cell signaling) promote inflammation |
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Term
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Definition
- involved in anaphylaxis: constriction of bronchioles of lungs and edema of throat
- role in inflammation related to allergic response
- have granules containing histamine (chemical mediator, released when granules break open, degranulate, in response to stimulus) |
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Term
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Definition
- 2-3% of WBC's in blood
- similar to neutrophils
- live longer; present in chronic inflammation
- slower: appear 2-3 days after neutrophils
- accumulate in hypersensitive reactions: allergies
- seen in paarasitic infections- tapeworm |
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Term
| Macrophages (agranulocyte) |
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Definition
- SECOND cells to arrive on scene
- 3-8% of WBC's
- Monocyte to macrophage as it goes from vessel into tissue
- motile
- live long: several months (seen in chronic inflammation)
- phagocytic
- several macrophages will form a giant cell to digest large matter and resistant microbes
serve many functions |
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Term
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Definition
- remove dead cells
- remove damaged tissue
- remove inhaled particles
- remove large foreign bodies
- secrete active substances- lysosomal enzymes, collagenase, complement protein, cytokines- interleukin 1
- processing of antigens for presentation to T cells: indroduce foreign substanced to the immune system (link between inflammatory response and immunity) |
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Term
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Definition
- agranulocyte found in the lymph system
- role in function of the immune system |
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Term
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Definition
- not a leukocyte (has some similalr properties as a basophil)
- created in bone marrow and travels through the circulatory system to a tissue site where it matures
> has granules containing histamine
- chemical mediator
- released when granules break open (degranulate) in response to a stimulus |
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Term
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Definition
- adhere to sites of vascular injury where vessels wall injured
- occlude the injury by homostatic plug: Fibrit clot
- produce prostaglandins: involved in vasodilation |
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Term
| chemical mediators of inflammation |
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Definition
- start or amplify the inflammatory response
- recriut other mediator and immune mechanisms, increasing the overall inflammatory process
- exogenous or endogenous
> exogenous- lypopolysaccharides: component of gram- bacteria
> endogenous: preformed, synthesized, plasma derived
- histamine and serotonin (vascular permeability)
- platelet -activating factor, prostaglandins, leukotrienes, cytokine( aggregation, vasodilation, permeability)
- the complement system, the clotting system, the kinin system- bradykinin |
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Term
preformed chemical mediator 2
Histamine |
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Definition
-formed in and released from platelets, mast cells, and basophils
- their release causes vasodilation of blood vessels
- endotheliasl cells contract forming gaps in wall, increasing blood vessel permeability which allows fluin to interstetial spaces
- occurs quickly with a short duration due to histaminase |
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Term
Preformed chemical mediators
serotonin |
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Definition
- released from platelets in response to platelet-activating factor (PAF)
- increases vascular permeability |
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Term
synthesized chemical mediators
Platelet-activatin factor (PAF) |
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Definition
- derived from leukocytes
> causes:
- aggregation (sticking together) of platelets
- the release of serotonin from platelets
- increases vasodilation and vascular permeability
-interacts with phagocytes (such as neutrophils and monocytes/ macrophages) to increase phagocytic action |
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Term
synthesized chemical mediatios:
Prostaglandins |
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Definition
- synthesized my leukocytes in response to stimulus
- associated with tissue destruction in periodontal disease
they cause:
- vasodilation and increase permeability of vessels
- sustained effects in later stages
- increased feeling of pain
-cronchoconstriction and smooth muscle contraction
- elevation in body temperature |
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Term
Synthesized chemical mediators
Leukotrienes |
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Definition
- synthesized by leukocytes and mast cells
- increase vasodilation and vascular permeability (sustained effects in later stages)
- bring inflammatory cells to injured area |
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Term
| synthesized chemical mediators |
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Definition
- produced by macrophages and lymphocytes
examples of cytokines are:
- chemokines: chemotactic (signaling)agents
- tumer necrosis factor + interleukin: produce fecer, increase need for sleep, decrease appetite, fivroblast production and prastaglandin synthesis during inlfammation process (involved in tissue destruction in periodontal disease) |
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Term
plasma-derived chemical mediators
complement system |
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Definition
- consist of several protein in blood that are activated in a cascade (C1-C9)
activation occurs 2 ways:
- classic pathway- triggered by specific antibodies in response to the antigen causing the inflammatory process (takes time)
- alternative pathway- triggered by bacterial lipopolysaccharides or aggregates of performed immunoglobulin already circulatin in body (faster response)
Purpose of system: destroy bacteria, recruit phagocytic cells, facilitate ingestion by osponization (coating bacteris to render then more digestible by macrophages), cause mast cells to release histamine (vasodilation, permeability, mediates the vascular response)
End product- Membrane Attack Complex (MAC)
- subtance that punches hole in membranes of microbe target for destruction by the immune system
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Term
plasma-derived chemical mediators
The clotting system |
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Definition
- activated when a plasma protein, called Hagen factor, comes in contact with debris from endothelial or vessels injury and causes blood to clot
activated the kinin system and complement system |
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Term
plasma-derived chemical mediators:
Kinin system - bradykinin |
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Definition
- formed by activation of Hagemen factor (as was the clotting system)- coagulation factor XII
> activation of kynin system cascade results in formation of the chemical bradykinin
- causes vasodilation and increased permeability
- capable of inciting pain |
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Term
| Three phases of inflammation |
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Definition
- Initiation phase- vascular response
- amplification phase- vascular response and early cellular response
- termination phase- late cellular response |
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Term
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Definition
- begins a change in blood flow (vascular response)
- a mechanical stimulus triggers nerves to transmit signals to smooth muscle cells on the arterioles
-frist response of arterioles is vasoconstriction- lasts only a few minutes or less to reduce bleeding and is quickly followed by vasodilation
>tissue damage initiates smooth muscle cells to relax (vasodilate) and release chemicacl mediators:
-mast cells- histamine
-factor XII- bradykinin
-PAF (platelet-activating factor)
- prostaglandin
- vasodilation allows increased blood flow into capillaries of injured area. more blood=more nutrients
-Hyperemia- excess blood in part of body (increased blood flow causes erythema and heat
- congestion due to increase blood flow leads to permeability (triggered by chemical mediators)
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Term
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Definition
> because of increased permeability of blood vessels due to increase in blood flow and congestion:
- the endothelial cells that line the capillary walls contract
- cells drew away from each other and form gaps
- fluid and plasma protein can exit into injured tissue as fluid called exudate
- exudate continues to escape into tissue- edema (swelling) of tissue develops- exudate dilutes and neutralized toxic substances
- histamine, resotonin, platelet-activating factor, bradykinin, prostaglandins, and leukotreines
-activated complement = potent permeability agent
> increaed blood viscosity (thicker) due to loss of plasma flulid, leads to dereased in blood flow - vascular stasis
- as bood flow slows down RBC pile into the center (get out fo the way) and WBC move toward vessel wall |
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Term
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Definition
Margination
nPMN’s begin movement (rolling) to periphery of blood vessel
nCauses an increase in resistance to blood flow
[image]Adhesion or Pavementing
nPMN’s stimulated by histamines attach (stick) to endothelial surface of vessel
nTumor necrosis factor, interleukin -1 are involved in adhesion
[image]Emigration/transmigration - due to vasodilation and an increase in permeability of the blood vessel, leukocytes move out of blood vessel, squeeze through gaps and enter tissue to injured area
[image]Chemotaxis - Movement of leukocytes along concentration gradient to injured area; chemical signaling drives them towards the injury
Leukotreines, chemokines, complemen |
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Term
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Definition
[image]Begins when leukocytes arrive at injured area
[image]Osponization occurs – leukocytes coat the surface of organism with chemical substances (called opsonins) making it easier for them to phagocytize.
nImmunoglobulins- (opsonin) example, complement (MAC)
[image]Phagocytosis- leukocytes ingest and digest foreign material via lysosomes
nDigestion of organism can lead to release of enzymes that can injure the host
nPlatelet- activating factor interacts with WBC
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Term
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Definition
[image]Foreign material and cellular debris removed through lymphatic system.
[image]Chemical mediators will inhibit or stop further action by the inflammatory process
[image]Healing and repair process begins
[image]If inflammatory process not halted, the process will become long term (chronic) and result in more damage of tissue instead of healing.
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Term
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Definition
[image]Injury to tissue
[image]1.Constriction of blood vessels
[image]2.Dilation of blood vessels
[image]3.Increase in permeability of blood vessel
nExudate leaves blood vessels
[image]4. Vascular stasis
nIncreased blood viscosity
nDecrease blood flow in blood vessel
nMargination, adhesion/pavementing, emigration/transmigration of leukocytes
[image]5. Chemotaxis
[image]6. Osponization
[image]7. Phagocytosis
[image]8. Termination of process: healing - regeneration and repair
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Term
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Definition
[image]Chronic inflammation – long-term, complicated inflammation
nIt is a possible outcome of acute inflammation
nMay occur without acute inflammatory process
[image]Irreversible destruction
[image]Purpose: To contain and remove foreign substance that the acute inflammatory process failed to remove from the tissue
[image]Macrophages- so powerful, can cause significant tissue destruction
[image]Lymphocytes- initiate the immune response
[image]Plasma cells- a lymphocyte (immune response) that produces antibodies – also seen in chronic inflammation
[image]Both macrophages and lymphocytes stimulate each other, leading to persistence of chronic inflammation
[image]Resolves only if cause is removed
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Term
| factors contributing to chronic inflammation |
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Definition
[image]Infectious agent in area of inflammation
[image]Remains of partially digested organism in area
[image]Foreign material in inflamed tissue
[image]Incomplete drainage of abscess
[image]Presence of dead or necrotic tissue
[image]Physical or mechanical irritation of the injured area of injured part
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Term
| tissue destruction in chronic inflammation - CAUSES: |
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Definition
[image]Chemicals are released from cells that are trying to remove pathogen
[image]Lysosomes of cells release enzymes that aide in digestion of foreign material
nDuring this process, lysosome enzymes are released into tissue.
ndestroy collagen fibers - destruction of connective tissue
ndestroy osteoclasts - destruction of bone
nEx. Bone loss in periodontitis
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Term
| granulomatous inflammation |
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Definition
[image]Associated with chronic inflammation
[image]Granuloma consists of large macrophages (giant cells), other inflammatory cells encircling foreign matter
[image]Purpose of granuloma is to form a wall around foreign material to prevent its spread
[image]Won’t heal until stimuli is removed
[image]Ex. Periapical granuloma
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Term
| acute inflammation vs. chronic inflammation |
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Definition
[image]Acute Inflammation
[image]Sudden onset
[image]Short duration (2 weeks)
[image]characterized by redness, swelling, heat, pain, and loss of function
[image]Eventually source is removed from tissue
[image]Tissue may return to original state or repair may begin immediately
[image]Involve PMN’s, macrophages
[image]Chronic Inflammation
[image]Irreversible destruction
[image]Long duration of weeks to years
[image]relatively non-painful, pale, firm, swollen
[image]Occurs if injury to tissues continues
[image]Involves macrophages, lymphocytes and plasma cells
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Term
| 5 cardinal signs of inflammation |
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Definition
[image]Redness - dialation of blod vessels lead to hyperemia in the tissues
[image]Heat -dialation of blod vessels lead to hyperemia in the tissues
[image]Swelling- permeability of blood vessels leads exudate fomation in tisss
[image]Pain - prssure on nerves by exudate fomatin. release of chemical mediators
[image]Disturbed function - evens asociated with swelling and pain
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Term
| systemic manifestations of inflammation |
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Definition
[image]Depends on the extent of the process and how long it has been present
[image]Pyrexia- fever
nCaused by pyrogens (pus-producing organisms)
nCytokines stimulate production of prostaglandins, which activate thermoregulatory center.
nRaise in temperature can help destroy pathogens
[image]Leukocytosis- increase in number if WBC’s in blood
nNeutrophils and PMN’S- indicate bacteria infections
nLymphocytes- viral infections
nMonocytes- chronic infections
[image]Lymphadenopathy- enlarged, firm, tender lymph nodes
nClearing cellular debris, foreign matter and drain exudates
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Term
| outcomes of acute inflammation |
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Definition
[image]Chronic Inflammation
[image]Abscess formation
[image]Resolution of inflammatory process
[image]Healing
nRegeneration
nRepair
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