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Intro to Clinical Medicine
Inflammation
52
Health Care
Graduate
06/30/2007

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Term
Three steps in the process of inflammation
Definition
1) initiation
2) amplification
3) termination
Term
inflammation
Definition
a reaction of the microcirculation characterized by movement of fluid and leukocytes from the blood into extravascular tissues
Term
initiation
Definition
the mechanisms responsible for the localization and clearance for foreign substances and injured tissues
Term
amplification
Definition
the inflammatory response in which mediators and cellular inflammatory systems are activated
Term
termination
Definition
inflammatory response after generation on inflammatory agents and elimination of foreign agent.
Term
List three vascular wall changes produced by inflammatory mediators at the site of injury
Definition
*loss of endothelial cell integrity
*leakage of fluid and plasma components from the intravascular compartment
*emigration of erythrocytes and leukocytes from the intravascular compartments
Term
Four possible outcomes of the acute inflammatory response
Definition
*resolution
*absces
*scar
*persistent (chronic) inflammation (leads to fibrosis and scar formation)
Term
hallmarks of acute inflammatory response
Definition
*accumulation of fluid and plasma components in the affected tissue
*intravascular stimulation of platelets
*presence of polymorphonuclear leukocytes
Term
hallmarks of chronic inflammation
Definition
*lymphocytes
*plasma cells
*macrophages
Term
resolution
Definition
source of injury eliminated, inflammatory response resolves, and noraml tissue architecture and physiologic function are restored
Term
fibrosis
Definition
formation or development of excess fibrous connective tissue in an organ or tissue as a reparative or reactive process, as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue.
Term
Distinguish between inflammatory and noninflammatory edema
Definition
*inflammatory- reponse to tissue injury and consequent changes in vasculature
*noninflammatory- fluid in extracellular space exceeds its clearance by the lymphatics
Term
edema
Definition
an increase in extravascular fluid
Term
Tell how the microvasculature is altered by vasoactive mediators in early response to tissue injury, causing edema
Definition
*transient vasoconstriction of the arterioles at the site of injury
*vasodilation of precapillary arterioles increases the blood flow to the injured tissue (causes redness and warmth)
*increase in the permeability of the endothelial cell barrier resulting in leakage of fluid from intravascular into extravascular space
Term
Eight types of extravascular accumulation in response to cellular injury
Definition
*effusion
*transudate
*exudate
*serous
*serosanguinous
*fibrinous
*purulent
*suppurative
Term
effusion
Definition
excess fluid in the cavities of the body
Term
transudate
Definition
edema fluid with a loss of protein content
Term
exudate
Definition
edema fluid with a high protein content
Term
serous
Definition
effusion/exudate with absence of cellular response components
Term
serosanguinous
Definition
effusion/exudate with erythrocytes
Term
fibrinous
Definition
exudate with large amounts of fibrin from activation of the coagulation system
Term
purulent
Definition
effusion/exudate with prominent cellular components
Term
suppurative
Definition
purulent exudate is accompanied by significant liquefactive necrosis (pus)
Term
Six cell types which are potenet sources of vasoactive mediators
Definition
*platelets
*tissue mast cells
*basophils
*polymorphonuclear leukocytes (PMNs)
*endothelial cells
*monocyte/macrophage
Term
vasoactive mediators
Definition
cellular components that influence responses of the microvasculature to injury
Term
platelet
Definition
a peripherial blood component arising from bone marrow that plays a primary role in the initiation and regulation of clot formation
Term
mast cell
Definition
cell within connective tissue containing receptors for IgE; when stimulated by an antigen, a variety of inflammatory mediators are secreted into extracellular tissues
Term
Describe the end result of complement pathway activation
Definition
*formation of a membrane attack complex capable of inducing cell lysis
*generation of the biologically active anaphylatoxins C3a and C5a
Term
complement system
Definition
a group of 20 plasma proteins that are a source of vasoactive mediators and play an important role in host defense against bacterial infection
Term
Second Phase of Cellular Recruitment of the Acute Inflammatory Response
Definition
the accumulation of leukocytes, especially PMNs at the site of tissue injury
Term
Four physiologic responses of circulating leukocytes exposed to chemotactic factors
Definition
*margination
*adherence
*emigration
*chemotaxis
Term
margination
Definition
slowing of blood flow in response to vasodilation in injured tissues, leukocytes concentrate adjacent to endothelial cells
Term
adherence
Definition
inflammatory cells attach to endothelial membrane
Term
emigration
Definition
neutrophils emigrage, then macrophages later in acute inflammation. follows a chemical gradient to the chemotactic stimulus
Term
chemotaxis
Definition
binding of chemotactic agents to specific receptors on the cell membrane of leukocytes which leads to subsequent phagocytosis
Term
Three events involved in the process of phagocytosis
Definition
*recognition of immunoglobulin molecules by the binding of opsonized particles to specific receptors on phagocytic cells
*internalization of opsonized particle
*digestion of foreign material
Term
Tell how chronic inflammation might occur, and the purpose it serves
Definition
occurs as a sequel to acute inflammation (nonimmunologic), or in an immune response to a foreign antigen. serves primarily to contain and remove a pathologic agent or process within a tissue.
Term
Cellular components of chronic response
Definition
*macrophage
*plasma cell
*lymphocyte
*eosinophil
Term
macrophage
Definition
a pivotal cell in regulating the reactions that lead to chronic inflammation; a source of both inflammatory and immunologic mediators
Term
plasma cell
Definition
lymphoid cells that are the primary source of antibodies
Term
lymphocyte
Definition
involved in both humoral and cell-mediated immune responses
Term
eosinophil
Definition
cells often involved in allergic reactions and parasitic infestations
Term
Describe how a granuloma is formed
Definition
*fever
*leukocytosis
*decreased appetite
*altered sleep pattern
*changes in plasma levels of actue phase proteins
Term
anaphylatoxins
Definition
products of complement activation which have potent effects of smooth muscle contraction and vascular permeability
Term
bacterial opsonization
Definition
process by which a specific molecule binds to the surface of bacterium
Term
cytokine
Definition
group of low molecular weight chemotactic proteins secreted by cells at site of inflammation
Term
cytokine
Definition
group of low molecular weight chemotactic proteins secreted by cells at site of inflammation
Term
phagocytosis
Definition
process of recognizing, internalizing, and digesting foreign material or debris of injured cells
Term
lysosomal enzyme
Definition
enzymes involved in the intracellular degredation of phagocytosed material
Term
neutropenia
Definition
an abnormally small presence of circulating PMNs in the peripheral blood
Term
epithelioid cells
Definition
macrophages that have undergone characteristic changes in response to chronic inflammation
Term
leukocytosis
Definition
an increase in numbers of circulating leukocytes commonly accompanying acute inflammation
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