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Inflamation, tissue repair, and wound healing
Chapter 18
87
Pathology
Undergraduate 2
01/29/2011

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Term
connective tissue
Definition

 It fills in a cut, but it won’t contract and it wont function. for example a MI will cause scar tissue and then it won’t contract. 


Term
regneration
Definition

Depends on cell type. Myocardium won’t regenerate cell types. Skin cells WILL regenerate.

Term
innate response
Definition
first line of defense
Term
inflammation
Definition
second line of defense
Term
third line of defense
Definition
adapted aquired defense
Term
what are some things that cause the inflammatory response?
Definition

Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes, radiation

Term
T or F...the inflammatory response will always happen?
Definition
true, however it's efficiency is always variable. 
Term
what are the two types of inflammation?
Definition
vascular versus cellular
Term
what is the vascular response?
Definition
vasodilation, increased permiability and leakage, wbc adherance to the inner walls, and migration through the vessels
Term
what are the two types of lymphocytes?
Definition
b and t cells
Term
what makes lymphocytes so important?
Definition
they help with immunity, NOT inflammation
Term
chronic inflammation
Definition
requires the immune system, good example is TB, will cause chronic tissue
Term
what do neutrophils do?
Definition
phagocytosis and they cause mast cells to migrate to the injury to release histamine. they are a type of leukocyte
Term
T OR F: the inflammatory response is non specific and is a aprt of the vascular component
Definition
true
Term
the vascular phase cause hemodynamic changes...what does that mean?
Definition
it means that it causes vasoconstriction or vasodilation. it changes the way blood circulates. 
Term
what is the cellular phase?
Definition
it is the phase that controls the actions of the wbc's. 
Term
inflammatory mediators are...?
Definition
instigators. 
Term
hyperemia:
Definition
increased blood flow to an area. it causes an area congested with blood. 
Term
what do kinins, histamine and prostagladins do?
Definition
they increase capillary permiability
Term
an increase in capillary permiability causes?
Definition
fluid exudate production and the vascular response
Term
mast cells
Definition
granular, cell derived cells, located in the connective tissue near blood vessels. degranulation causes histamine to be released
Term
where are plasma proteins synthesized?
Definition
the liver
Term
histamine
Definition
vasoactive chemical causes vasodilation and increased permiability. 
Term
what does histamine bond to?
Definition
h1 and h2 receptors
Term
why is the chemotactice factor important?
Definition
because it will make neutrophil chemotactic factor, which will cause neutrophils to come to the area of injury. 
Term
ECF-A
Definition
eosinophil chemotactic factor of anaphalaxis. attracks eosinophils. 
Term
what will be be activated once histamine is activated?
Definition
leukotrienes, prostaglandins, and platelet activating factor. 
Term
leukotrienes
Definition
a product of the arachidonic acid from mast cell membranes
Term
what causes similar affect to histamine?
Definition
leukotrienes, but it happens after histamine is released. 
Term
leukotrienes will cause...?
Definition
hemodynamic products to increase
Term
protaglandins
Definition
they are similar to leukotrienes, they induce pain
Term
what will stop prostaglandin affects?
Definition
ibufrofin
Term
platelet activating factor
Definition
similar to leukotrienes and platelet activation. they activate neutrophils. it has a clotting factor
Term
complement system
Definition
can destroy pathogens directly. activates every components of the inflammatory response
Term
what is coagulation of the clotting system so important?
Definition
no spreading of germs, it keeps germs where they are to be killed, forms a clot, provides a framework for healing
Term
what forms clots?
Definition
fibrin, an insoluble protein
Term
kinin system
Definition
activates and assists inflammatory cells
Term
what is the primary kinin?
Definition
bradykinin
Term
what does the kinin system do?
Definition
dilation of blood vessels, pain, smooth muscle contraction, leukocytes chemotaxis. 
Term
margination
Definition
adherence to leukocytes to endothelial cells
Term
diapedesis
Definition
emigration of cells through the endothelial junctions
Term
neutrophils
Definition
aka PMN's. part of early response. short lived and are a part of purulent exodate. 
Term
monocytes
Definition
produced in the bone marrow, enter circulation and go to the siteof injury. they develope into macrophages. 
Term
macrophages
Definition
develope from monocytes, arrive 24 hours alter after neutrophils
Term
what are the 2 types of cytokines?
Definition
interferons and interleukins
Term
interleukins
Definition
produced by macrophages and lymphocytes in response to a pathogen. 
Term
IL 1
Definition
interleukin 1 is a proinflammatory cytokine
Term
Ial-10
Definition
interleukin 10 is an anti inflammatory cytokine
Term
interferons
Definition
protect against viral infections, 2 types (IFN alpha and IFN beta), released by viral double stranded RNA
Term
serous
Definition
found early and it's mild. never pop a blister, it is msotly white blood cells
Term
what can exudate do?
Definition
it can dilute toxins, carry plasma proteins tothe area of injury, and help carry away dead cells and toxins from bacteria. 
Term
serosanguineous
Definition
early and usually moderate. pink fluid. 
Term
fribrinous
Definition
usually it's severe. it is an area with a lot of fibrin which can encourage adhesions. 
Term
what are the signs of inflammation?
Definition
rubor, calor, doler, tumor, functio laesa
Term
why do we get rubor?
Definition
because of hyperemia from vasodilation. 
Term
why do we get calor?
Definition
because of an increase in metabolism at the inflammatory site
Term
why do we get doler?
Definition
a change in ph causes nerve stimulation by chemicals. 
Term
why do we get tumor?
Definition
fluid shifts to interstitial spaces. it causes accumulations. 
Term
what do endothelial cells have that is so important?
Definition
it has growth factors that stimulate angionesis and extracellular synthesis.
Term
neutrophils and macrophages have manose receptors that bind to?
Definition
glycoprotein bacteria
Term
neutrophils 
Definition
a granulocyte, oxygen dependent that genarte toxic oxygen to engulf pathogens with. 
Term
what prodces hydrogen peroxide and nitric oxide? why is this so important?
Definition
neutrophils. it is important because they kill the pathogens
Term
leukocytosis
Definition
an increase in circulating wbc's
Term
immature neutrophil are called?
Definition
bands
Term
monocytes
Definition
derived from bone marrow, exit the circulation at the sign of inflammation and mature into macrophages. 
Term
what are vasoactive mediators?
Definition
prostaglandins, leukotrienes, platelet activating factor. they are produced by monocytes and macrophages
Term
what engulfs the largest pathogens: neutrophils or macrophages?
Definition
macrophages
Term
eosinophils
Definition
used during allergic reactions and parasites. 
Term
basophils
Definition
derived from bone marrow. contains histamine. they bind IgE to receptors which causes release of histamine. 
Term
what induced vasodilation?
Definition
histamine an nitric oxide (they are both mediators)
Term
what are the vascular stages?
Definition
vasodilation, permiability
Term
what happens after vasodilation of the vascular stage?
Definition
increased permiability of the microvasculature, and the pouring of exudate (protein rich) into the extravascular spaces.
Term
what does the loss of plasma proteins in the vacular stage cause?
Definition
it reduces intracapillary osmotic pressure of the interstitial fluid causes fluid to move in the cells which causes swelling
Term
what do histamine, bradykinin, and leukotrienes do during the vascular stage?
Definition
they cause vascular leakage which causes junctions to form. 
Term
immediate transient response
Definition
occurs with minor injury. reversable and short duration. 
Term
immediate sustained response
Definition
serious injuries and it lasts for days. due to direct damage to endothelium. (neutrophils can bind to the endothelium and cause damage)
Term
delayed hemodynamic response
Definition
due to radiation or burns. it is a delayed response
Term
what are the 3 types of vascular responses in response to different severities of injury?
Definition
immediate transient responses, immediate sutained response, and delayed hemodynamic response
Term
what are the stages of the cellular response?
Definition
margination and adhesion of the endothelium, transmigration across the enthelium, chemotaxis , and phagocytosis
Term
microbes can bind to bacteria via what receptors?
Definition
toll like and manose receptors
Term
histamine
Definition
binds to h1 cels on the endothelial cells. 
Term
how many proteins are in the complement system?
Definition
20 proteins in the plasma proteins
Term
bradykinin
Definition
causes contraction of smooth muscle, dilation of bloodvessels, and pain when injected. 
Term
what are cytokines?
Definition
proteins produced by macrophages, and lymphocytes.
Term
TNF-alpha
Definition
made by macrophages. encourage adhesions, aggregation of neutrophils.
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