Patho Notes

Patho Notes - Inflammation Initially rapid then stagnates...

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9/10/07 Inflammation Initially rapid, then stagnates PMNs (primarily neutrophils) leave the bloodstream and line the vessel, squeezed out and travel to the injured tissues = immigration o Immigration begins within a few minutes of injury Migration of WBCs is important because they can destroy the injurous agent, neutralize the toxins, and remove the inflammatory debris of dead cells and bacteria Chemotaxis – leukocytes are called to the site of inflammation by chemical signals sent by the injured tissue, directional orientation by leukocytes by chemical transmission Phagocytosis – engulfing and ingesting foreign debris is a very important part of the immune system, breakdown of products engulf eventually kills phagocytes o Major phagocytes – neutrophils and macrophages; produces protolytic enzymes which help destroy and digest WBCs release bacteriacidal enzymes (ex. lysozyme) Mast cells – important activator of inflammatory response, in connective tissue, mucous membranes Leukotriens – synthesized by mast cells, actions similar to histamine, cause neutrophil and eosinophil chemotaxis, response is slower and more prolonged than histamine, tend to be seen in later stages of inflammation Histamine and serotonin – major mediators of increased vascular permeability Also mediated by 3 key plasma protein systems – kinin (bradykinin most important), complement – major mediator in inflammatory response – enhances chemotaxis, increases vascular permeability (allows things to get to area), causes cell lysis in final conversion; clotting system – stops bleeding, can localize microorganisms, provides meshwork for repair and healing Terminology Exudate – fluids, cells, or other substances that have been discharged from other substances; need to know amount, color, odor, and consistency of it, 1 gram drainage = 1mL blood Serous – protein-rich fluid that escapes early in inflammation, clear Sanguinous – fresh bleeding Serosanguinous – combination of serous and sanguinous, more watery than bloody Purulent – thick, describe color Pus – dead cells and necrotic tissue Debridement – removal of dead tissue from wound Dehiscence – separation of wound edges Ecchymosis – black and blue marks caused by leakage of blood into subcutaneous tissue (bruise) Edema – abnormal accumulation of fluid (in interstitial fluid or compartments) Erythema – redness or inflammation of skin 5 cardinal signs of inflammation – heat, pain, redness, swelling, loss of normal function (result from vasodilation, exudation, and irridation of nerve endings) Amount of WBCs in blood increases with infection o Neutrophils increase early in inflammation o Erythrocyte sedimentation rate – RBCs settle faster when put in a centrifuge Resolution of inflammation o Simple – no destruction of any tissue, goes on continuously in the body Regeneration – lost or necrotic tissue is replaced by tissue of the same type
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