Term
| What is the difference betweeen acute and chronic inflammation in terms of time, immune cells, and variability patterns? |
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Definition
| Acute: minutes/days; neutrophils; stereotypic (not variable). Chronic: days/years; macrophage and lymphocytes; variable pattern |
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Term
| What are the vascular events that occur with inflammation? |
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Definition
| Happens first in the arterioles and to the post-capillary venules. You CAN get immediate/transient vasoconstriction but earliest manifestation right after that is VASODILATION, leads to increased increased BF which leads to heat & redness. Loss of fluid leads to STASIS, wherein blood flow is slow and RBCs pack the BVs. exudate results in edema. During stasis development, WBCs( mostly PMNs) accumulate along endothelium, stick to it, and migrate into the interstitial tissue (extravasation). |
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Term
| 3 mechanisms of vascular leakage in acute inflammation? |
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Definition
| 1) Gaps: endothelial contraction of the venules via histamine and leukotrienes. 2) Direct injury: to arterioles, capillaries, venules due to toxins/burns/chemicals. 3) Gaps: cytoskeletal reorganization: mostly venules & capillaies, ctyokines (IL-1 and TNF) and hypoxia. |
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Term
| What is the sequential neutrophilic response to acute inflammation? |
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Definition
| 1) Margination of PMNs (and other leukocytes), aided by stasis of blood flow. 2) ROLLING: Selectins help. 3) ADHESION: PMNs come to rest due to stronger cell-cell interactions (mediated by ICAMs). 4) MIGRATION: through endothelium to ECM, following chemotractic signals to site of inflammation. |
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Term
| What are the outcomes of acute inflammation? |
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Definition
1) resolve
2) fibrosis (scar, tissue damage)
3) Abscess-->can heal (with regerenation, scarring)
4) progress to chronic inflammation (macrophages)
5) progression to atherosclerosis, or neoplasia |
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Term
| Harmful effects of inflammation? |
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Definition
| 1) extracellular leakage of lysosomal enzymes 2) free radicals 3) tissue damage |
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Term
| T/F ARDS (adult respiratory distress syndrome) leads to leukocyte-independent injury. |
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Definition
| False. it's LEUKOCYTE DEPENDENT (most venules, pulmonary capillaries, late response). |
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Term
| T/F: chronic inflammation is more variable than acut inflammation |
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Definition
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Term
| T/F: chronic inflammation can be determined only by the presence of macrophages (as opposed to PMNs). |
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Definition
| FALSE. it's mononuclear cells, which includes lymphocytes, plasma cells, macrophages. (did you get that right?? if not, SUCKA!!!!!!!!) |
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Term
Which of the following are NOT clinical signs/symptoms of chronic inflammation?
A) low grade fever, "night sweats."
B) weight loss, chronic fatigue
C) cough
D) weight gain
E) recurrent pain
F) progressive loss of function |
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Definition
| D. weight gain is not correct. (if you didn't get it right: Did you even study this material?!!!) |
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Term
| What other cells are recruited during chronic inflammation aside from monocytes (macrophages, lymphocytes, plasma cells)? |
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Definition
| granulocytes, EOSINOPHILS, and also migration of mixed cellular infiltrate. |
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Term
| Which (acute or chronic) type of inflammation is more associated with inflammatory infiltrates INTERSTITIALLY (within tissues)? |
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Definition
| CHRONIC! Acute inflammation is more associated with exudative infiltrates (pus). |
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Term
| Viruses: more likely to cause chronic, or acute inflammation? |
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Definition
| CHRONIC. (seriously, get with the program.) |
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Term
What is the ordero f vascular and tissue events in chronic inflammation?
-proliferation of capillary sized vessels
-collagen permanenetly deposited
-remodeling results in tissue destruction ie fibrosis
-vessels mature
-fibroblasts become quiescent
-production of new collagen
-proliferation of fibroblasts |
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Definition
-initally, have proliferation of capiillary sized vessels --> proliferation of fibroblasts --> collagen.
-later vessels mature
-fibroblasts become quiescent
-collagen is permanently deposited
-remodeling results in tissue destruction (ie fibrosis) |
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Term
| Describe granulation tissue. what does the tissue consist of? |
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Definition
| Healing of inflammation often involves ingrowth of capillaries and fibroblasts. This forms granulation tissue. Healing tissue could show histologically: numerous capillaries, and collagen being laid down to form a scar. (activated juice fibroblasts, new GAGs, angiogenesis, mixed inflammatory cells). |
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Term
| what is the major difference between fibrosis and granulation tissue? |
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Definition
| Fibrosis is a later event after fibroblasts have permanently laid down collagen. So in fibrosis, you see queiscent fibroblasts, abundant collagen, little GAGs, and replacement of normal tissue. Remember that granulation tissue consister of JUICY fibroblasts, NEW gags, but also angiogenesis adn mixed inflammatory cells. |
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Term
| what does fibrosis do to alveolar walls? |
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Definition
| makes them THICK ass alveolar walls (which you don't want!). causes tissue destruction! |
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Term
which of the following is the correct order of events in angiogenesis?
1. increased permeability through gaps, proteolysis of ECM, proliferation, lumen formation
2.migration/chemotaxis, proliferation, increased permeability
3. increased permeability, proteolysis, and migration/chemotaxis
4. lumen formation, maturation, and inhibition of growth-->proliferation-->proteolysis of ECM. |
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Definition
| #2 was correct. proteolysis-->migration-->proliferation-->lumen formation, maturation, and inhibition of growth--> increased permeability through gaps and transcytosis. |
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Term
| how does granuloma form in chronic inflammation? |
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Definition
| macrophages recuited and lose motility--> become epitheliod-->these cells fuse to make giant cells-->tissue destruction. granulomatous inflammation is a subset of chronic inflammation. |
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Term
| Describe histologically a granuloma. |
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Definition
| outer "capsule" of fibroblasts, then lymphocytes, then activated macrophages & giant cell layer, then inside is caseous necrosis (forms "cheese like" stuff, ie TB infection). |
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Term
| what is an epitheloid cell? |
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Definition
| activated macrophage resembling an epithelial cell. seen in granulomatous inflammation (chronic) |
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Term
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Definition
| granulomatous inflammatory condition, unknown etiology, with multiple non-caseating granulomas (means non necrotizing nodules), particularly in lungs and lymph nodes. |
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Term
| is wound healing an acute inflammatory response or chronic? |
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Definition
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Term
| erythema edema is indication of what type of inflammation process? |
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Definition
| acute, could be due to wound healing. |
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Term
| T/F: platelet/fibrin covering occurs in the first 24 hours of wound healing. |
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Definition
| FALSE. occurs 24-48 hrs when epithelial thickening iwth basal cell proliferation happens-->platelet/fibrin-->migration to midline. |
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Term
| during what day do macrophages replace PMNs in wound healing? |
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Definition
| day 3! along with granulation tissue invading the wound space and continued epithelial thickening. |
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Term
| T/F: maximum angiogenesis and granulation tissue happens on day 3 of would healing. |
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Definition
| FALSE. happens day 5 along with collagen bridging the wound and epithelium being restored. |
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Term
| What occurs by the 2nd week and by one month of wound healing? |
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Definition
| 2nd week: fibroblasts are proliferating and collagen is accumulating. vessels regress and more collagen deposited; results in blanching of the wound. edema and BV decreases. resolution of inflammatory infiltrate. By one month: there is cellular connective tissue comprising the scar, covered by intact epidermis. tensile strength increases over next several months. |
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Term
| In wound healing, what is the difference between "first intention" and "second intention"? |
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Definition
| There are 3 general "surgical" techniques of wound treatment: primary, secondary, and tertiary intentions. only primary and secondary discussed. Primary intention: used for all tissues including skin, closed with suture material after completion of operation; secondary in which wound left open and closes naturally; third intention is wound left open for number of days and then closed if found to be clean. |
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Term
| what is the difference between primary union and first intention? same for 2ndary union and 2ndary intention? |
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Definition
| primary union is healing by first intention. secondary union is healing by secondary intention. Secondary healing is more intense inflammation, more granulation tissue, dramatic wound contraction, 10% of original size, role of myofibroblasts (was a bigger wound to start with!). |
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Term
| what is turtle-like about myofibroblasts? |
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Definition
| they all know to converge to one point to close a wound. (ie they all know where to go like baby turtles!) |
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Term
| T/F: regeneration involves superficial skin wounds |
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Definition
| true! restitution of normal structure is regeneration (liver regeneration also.) |
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