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IVMS| General Pathology, Inflammation Notes

IVMS| General Pathology, Inflammation Notes

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IVMS| General Pathology, Inflammation Notes
IVMS| General Pathology, Inflammation Notes

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Published by: Marc Imhotep Cray, M.D. on Dec 08, 2013
Copyright:Attribution Non-commercial


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Inflammation Notes
Access companion PowerPoint
Website: IVMS Mini-Medical School Course
Series Target Audience:
Medical students and student physicians preparing to sit for the USMLE Step 1
Toes inflamed by chilblains
, "I ignite, set alight")is part of the complex biological response of vasculartissues to harmful stimuli, such as pathogens, damagedcells, or irritants. The classical signs of acuteinflammation are pain, heat, redness, swelling, and lossof function. Inflammation is a protective attempt by theorganism to remove the injurious stimuli and to initiatethe healing process. Inflammation is not a synonym forinfection, even in cases where inflammation is causedby infection. Although infection is caused by amicroorganism, inflammation is one of the responses of the organism to the pathogen. However, inflammationis a stereotyped response, and therefore it is consideredas a mechanism of innate immunity, as compared toadaptive immunity, which is specific for each pathogen.Progressive destruction of the tissue would compromise the survival of the organism. However, chronicinflammation can also lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoidarthritis, and even cancer (e.g., gallbladder carcinoma). It is for that reason that inflammation is normally closelyregulated by the body.Inflammation can be classified as either
 Acute inflammation
is the initial response of the body toharmful stimuli and is achieved by the increased movement of plasma and leukocytes (especially granulocytes) fromthe blood into the injured tissues. A cascade of biochemical events propagates and matures the inflammatoryresponse, involving the local vascular system, the immune system, and various cells within the injured tissue.Prolonged inflammation, known as
chronic inflammation
, leads to a progressive shift in the type of cells present atthe site of inflammation and is characterized by simultaneous destruction and healing of the tissue from theinflammatory process.
BurnsChemical irritantsFrostbiteToxinsInfection by pathogensPhysical injury, blunt or penetratingImmune reactions due to hypersensitivityIonizing radiationForeign bodies, including splinters, dirt and debrisStressTraumaAlcohol
Comparison between acute and chronic inflammation:
Bacterial pathogens, injured tissuesPersistent acute inflammation due to non-degradablepathogens, viral infection, persistent foreign bodies, orautoimmune reactions
 Major cellsinvolved 
neutrophils (primarily), basophils (inflammatory response), andeosinophils (response to helminth worms and parasites), mononuclearcells (monocytes, macrophages)Mononuclear cells (monocytes, macrophages,lymphocytes, plasma cells), fibroblasts
Vasoactive amines, eicosanoidsIFN-and other cytokines, growth factors, reactiveoxygen species, hydrolytic enzymes
Few daysUp to many months, or years
Resolution, abscess formation, chronic inflammationTissue destruction, fibrosis, necrosis
Cardinal signsThe classic signs and symptoms of acute inflammation:
*Loss of function
 Functio laesa
All the above signs may be observed in specific instances, but no single sign must, as a matter of course, be present. These are the original, or "cardinal signs" of inflammation.*
 Functio laesa
is an apocryphal notion, as it is not unique to inflammation and is a characteristic of many disease states.

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