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What are the 3 important cells involved in inflammation?
- 1. Endothelial
- 2. Platelets
- 3. Leukocytes aka (White Blood cells)
What are Endothelial cells?
- * They are single cell thick lining the insides of blood vessels.
- * They produce agents that maintain vascular patency. (abilty to flow through the blood vessel)
- * They provide selective permeability.
- * They also release inflammatory mediators
- * They participate in the repair process (This is called ANGIOGENESIS) by producing growth factors.
What are PLATELETS aka Thrombocytes?
Are membrane bound discs that circulate in the blood. They can be inactive or active.
*When platelets are activated it will release over 300 proteins including inflammatory mediators. (these mediators control the process of inflammation)
What are LEUKOCTYES?
- They are white blood cells.
- They are two classes of white blood cells (WBc's)
- 1. Granulocytes -
- 2. Agranulocytes (no grains)
What are the 3 different types of GRANULOCYTES? (all end with phils)
What are 3 Agranulocytes?
What are Neutrophils?
- *Neutrophils are the most abundant Leukocytes
- *They are the FIRST to arrive, move fast and they are at the site of acute inflammation within 90mins of injury.
- * Neutrophils engulf pathogens (phagocytosis)
- *Neutrophils will disappear between 24 & 48 hours after entering the site of inflammation
What are Eosinophils?
- * Eosinophils appear at the site of inflammation 2-3 hours after neutrophils.
- * Eosinophils play a large role in responding to parasites and allergic reaction.
- * Eosinophils have a longer life span than neutrophils
- Eosinophils are present in chronic inflammation
What are BASOPHILS?
- *Basophils play an important role in allergic reaction through the release of HISTAMINE.* Basophils are precursors of mast cells. Mast cells are basophils cells that have left the blood vessel.
What do Mast cells release?
They release histamine, prostagladin, and platelet activating factors.
- *Remember Histamine dilates the capilleries
- *Prostagladin (causes pain)
What are MONOCYTES?
* Monocytes produce potent vaso active mediators including prostogladin, plalete activating factors (PAF) and growth factors
* Monocytes are found in the blood vessel and are transported out to become MACROPHAGES.
What are the functions of MACROPHAGES?
- * Macrophages phagocytos (eat) pathogens (germs) and last 3 to 4 times longer than neutrophils.
- * Macrophages destroy the pathogen and signal other leukocytes for immunity response.
- * Macrophages aid in the healing process.
- * Macrophages are especially important in the chronic inflammatory process.
What are the functions of LYMPHOCYTES?
- * LYMPHOCYTES are the smallest amount of leukoctes.
- * Lymphocytes are called and come to both an injured site or respond to pathogens
What are the two types of Lymphocytes?
- 1. B Lymphocytes
- 2. T Lymphocytes
What are plasma cells?
* Plasma cells develop from activated B lymphocytes.
- * Plasma cells create anti-bodies.
- * These anti-bodies will fight the pathogens immediately.
What is ACUTE inflammation
*Remember Acute means SHORT and FAST
Acute inflammation is the immediate and early response of tissues and blood vessels to injury.
(Meaning the tissues and blood vessel are responding right away to the injury - sending the soldiers)
What is INFLAMMATION?
The bodies response to injury or invasion by a pathogen aka germ
What are the two phases of acute inflammations?
- 1. The vascular phase
- 2. The cellular phase
Describe the VASCULAR phase?
- * Begins w/momentary vasoconstriction (blood vessel getting smaller)
- * Then continues with rapid vasodiluation (blood vessels opening) This causes heat and redness (CARDINAL SIGNS OF inflammation)
- * Which is followed by an increase in vascular permeability with a leaking of protein rich fluid into the extravascular space. (outside the blood vessel)
- * The loss of proteins reduces the capillary osmotic pressure and increases interstitial pressure.
- * Now a lot of fluid is flowing out of the blood vessel and building in the tissue spaces causing swelling, pain, and impaired function. (cardinal signs)
- * As the fluid leaves the blood vessel, the blood flow starts to slow down and clotting of the begins
What are the FIVE signs of CARDINAL OF INFLAMMATION?
- 1. Pain
- 2. Sweling
- 3. Redness
- 4. Heat
- 5. Loss of function at cellular level.
What is osmotic pressure?
Osmotic pressure is the ability of water to move from one place to the other
Describe the Cellular phase
- 1. Now that the blood flow has slowed down and leukocytes (mostly nuetrophils who arrive 1st) arrive at the site of injury.
- 2. Leukocytes action is divided into 4 steps:
- i. Adhesion
- ii. Margination - (rolling around looking for
- a opening to slip through)
- iii.Tansmigration (Leukocyte moving from inside to outside Blood Vessel B.V.)
- iv. Chemotaxis (chemical movement - meaning the Leukocyte follows the chemical signal of the bacteria) (Chemical bread crumb trail - meaning both body cells and pathogen cells send off chemotaxis "chemical bread crumbs" trail.)
- 3. The Leukocytes (or neutophils) find the bacteria and destroy it in 3 stages:
- i. Stage 1 - Recognition and Adherence (Opsonization)
- ii. Stage 2 - Engulfment (Phagosome) Wraps around bacteria
- iii. Stage 3 - Intracellular killing (Lysosome) (chemical that melt bacteria and turn it into nothing)
What are inflammatory mediators?
Inflammtory mediators are chemical responsible for inflammation.
*Remember inflammation is a process that happens in the body from injury
What are the 2 places that inflammatory mediators come from?
1. The liver
produces the inflammatory mediators that are then stored in the plasma which is protein rich and is the clear part of the blood.
- 2. Comes from the bodies cells for example:
- i Macrophages cell (eats bad bacteria)
- ii. Mast cells (are like grenade that explode
- call more WBC to come to injured area)
- iii. Platelets cell (release chemicals change
- blood vessel tone (meaning thin &
- permeable and cells can transmigrate
- easily. Or IMpremeable and cells can
- not leave vessle easily)
What are the THREE outcomes of acute inflammation?
- 1. RESOLUTION - tissue injury
- 2. Chronic inflammation - Body doesnt know when to shut off the inflammation process. For example of RHEUMATOID ARTHRITIS
- 3. Scaring and Fibrosis - is a result of single neuclues. Cells that didnt heal properly
What are the TWO forms of tissue repair?
Clue - both answers start with T.R.
1. TISSUE REGENERATION: injured tissue cells are replaced by cells of the same type.
2. TISSUE REPLACEMENT: this happens when connective tissue leads to scared formation or fibrosis
What are the 3 phases for tissue repair?
- 1. Angiogensis and Granulation Tissue:
- i. which is formation of new blood vessels
- 2. Emigration of Fibroblast:
- i. Come to the site of injury and proliferate (duplicate) themselves and lay down extracellular matrix.
- 3. Mature and Reorganization: i. Tissue starts to remodel from granualtion to scar. (Granulation looks the a fresh open new wound. Looks glistening, red and moist) this is the beginning signs of healing.
What are the 3 phases of WOUND HEALING?
- 1. Inflammatory phase
- 2. Proliferative phase
- 3. Maturational phase
What happens in the Inflammatory phase of wound healing?
This phase begins at the time of injury and forms a blood clot as well as migration of WBC to site of injury. Growth factors are produced for the PROLIFERATIVE PHASE
What happens in the Proliferative phase of wound healing?
- Building new tissue to fill in the wound space
- The key cells are FIBROBLAST which produce growth factors and induce angiogensis. The final step of this phase is EPITHELIALIZATION. (this is where the cells at the wound edges duplicate to form a new surface layer (skin)
What happens in the Maturational phase of wound healing?
- This phase begins 3 WEEKS AFTER injury.
- There is a decrease in vacularity (blood vessels) and scar tissue continues to remodel and fibroblast lay down collegen (skin).
- Now the scar begins to shrink/ contract
List some factors that affect wound healing
- 1. Age - Old age or baby
- 2. Nutriton - proteins to repair tissue
- - Fats for cell membranse
- - Vit A & C for collegen
- 3. Immune responses -
- i. Diabetes or HIV, Chrones etc. (dysfunction in WBC.)
4. Blood flow and Oxygen delivery (Oxygen is needed to allow cells to phagocytos)