mod 3 inflammation lecture.pdf - 1 N5315 Advanced Pathophysiology Inflammation The inflammatory process is yet another complicated cascade of events

mod 3 inflammation lecture.pdf - 1 N5315 Advanced...

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1 N5315 Advanced Pathophysiology Inflammation The inflammatory process is yet another complicated cascade of events which is a foundational concept. It forms the foundation of many pathological processes and is the target of inhibition for many medications and treatments. The process starts with a precipitant which causes cellular injury. Cellular injury can be anything that causes damage to the cells. The mechanisms of cellular injury were covered in module 1. When cellular injury occurs, it triggers five initial steps in the inflammatory process. The first five steps are mast cell degranulation, activation of the coagulation cascade, activation of the kinin cascade, release of chemotactic factors, and the activation of the complement cascade. Each event has subsequent steps which contribute to the inflammatory cascade. Complement- functions include bacterial lysis, vasodilation and increase vascular permeability, triggers mast cell degranulation, chemotaxis and opsonization. Kinin is turned into bradykinin which is responsible for pain, chemotaxis, and increase vascular permeability and vasodilation The coagulation cascade has a role in activating the kinin system. Factor XII (Hageman factor) activates kinin. The ultimate function of this system is to form a fibrin mesh to stop bleeding and to trap microorganisms. Released chemotactic factors attract neutrophils, eosinophils & monocytes all of which begin to perform phagocytosis. Neutrophils will show up at the site of injury in 6-8 hours and monocytes will show up in 1-7days. They each are responsible for phagocytosis. They will eventually die and rupture releasing their intracellular contents. This also triggers the release of the acute phase reactants. Mast cell degranulation is the major step of the inflammatory cascade and has an effect on every other aspect of the inflammatory cascade. Mast cell degranulation leads to the additional activation of the acute phase reactants which are the coagulation proteins, kinin and complement, but this is not depicted on the diagram. I simply want you to know that mast cell degranulation also triggers the activation of the acute phase reactants. Mast cell degranulation results in the release of five main items: histamine, cytokines, leukotrienes, platelet-activating factor, & prostaglandins. Histamine is responsible for causing vasodilation. It also increases vascular permeability and increases blood flow to the site of injury which ultimately causes erythema and swelling at the site of injury. There are
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