Professional Documents
Culture Documents
Definition:
is a local response (reaction) of living vascularized tissues
to burn.
Inflammation is fundamentally a protective (Physiologic)
2
Causes:
The same as causes of cell injury or diseases.
Nomenclature:
The name of the inflamed tissue or organ is suffixed with
'itis'.
pneumonia, etc.
3
Inflammation accomplishes its missions by
trying to dilute,
destroy or
of venules
Dolor (pain): caused by prostaglandin E2 and bradykinin
Vascular events
1. Transient vasoconstriction of arterioles
lasts only seconds
2. Vasodilation of arterioles
mast cells release histamine, which acts on vascular smooth
muscle and causes increased blood flow.
4. Swelling of tissue:
outflow of fluid surpasses lymphatic ability to remove fluid.
1. Margination:
Red blood cells (RBCs) aggregate into rouleaux ("stacks of
coins") in venules, with the neutrophils pushed to the
periphery.
2. Rolling:
Selectin molecules on the cell surfaces cause the neutrophils
to "roll" along the endothelium or to adhere to it temporarily.
3. Adhesion:
neutrophils adhere to endothelial cells.
4. Transmigration:
neutrophils move through the basement membrane
of venules and release type IV collagenase,
producing an exudate in the interstitial tissue.
5. Chemotaxis:
neutrophils migrate toward bacteria.
6. Phagocytosis:
neutrophils ingest opsonized bacteria.
chemicals etc...
Classification
paracytic:
chemicals:
immunologic deffieciencies,
coma,
anesthsea,
neuromuscular disorders,
drugs or chest pain (this may lead to aspiration of gastric
contents).
Tobacco s
anoxia
LOBAR peumonia Brochopeumonia
Route First L ung infection First bronchi and
bronchioles then lung
parenchyma
Age Young adult Extremes of age
Red hepatization
lasts 2nd to 4th day.
Lung is dry, firm, red and granular.
The pleural surface, grey-white and friable.
The capillaries engorged, filled with fibrin exudates, RBC and numerous
neutrophils.
Grey hepatization –
lasts 4th - 8th day:
Cut surface is dry, granular and grey.
Alveoli contain fibrins, dead and live neutrophiles and occasionally
degenerating erythrocytes.
Resolution –
after 8th day:
migration of macrophages from the alveolar space into the exudate,
which latter liquefied by fibrinolytic system
Complete resolution and aeration takes 1-3 weeks, but pleural
adhesion between the two layers usually persists.
P. Vivax
P. Ovale
P. Malariae
Anopheles mosquito.
P. fellciparum and P. Vivax are the most
Human skin
Sporozoites
Liver
Gametocytes
Schizonts
Merozoites
Rupture of
RBCs Schizonts
RBCs
Inside RBCs
P. Falciparum
the cause of severe malaria
aspects:
has no secondary hepatic stage.
there is high parasitemia and anemia.
there may be several parasites in a single RBC.
it charges the flow characteristics and adhesive qualities
of infected RBC so that
they adhere to the endothelial cells of small blood vessels.
The obstruction of small blood vessels frequently produces
severe tissue ischemia,
which is probably the most important factor , in the
virulence of P. falciparum
Pathology
Enlargement of the liver & spleen by sequestered red
blood cells.
These organs appear dark because of macrophages filled
with hemosiderin and malarial pigment.
Obstruction of Capillaries of deep organs by P.
Chills
Headache
Hypotension
hepatosplenomegally
anemia
P. falciparum:-
Ischemic injury to the brain
Somnolence
Hallucinations
the mortality is 20 % to 50 %
Chronic Inflammation
Inflammation of prolonged duration (weeks to years)
causing agent.
Injurious agents include infectious diseases (e.g.,
Morphology
1. Cell types:
Monocytes and/or macrophages,
Lymphocytes and/or plasma cells, eosinophils, fibroblasts,
endothelial cells
2. Necrosis:
not as prominent a feature as in acute inflammation
3. Destruction of parenchyma:
loss of functional tissue,with repair by fibrosis
Granulomatous inflammation
1. Causes
Infectious agents
include tuberculosis and systemic fungal infection;
usually associated with caseous necrosis
Noninfectious causes include
sarcoidosis and Crohn's disease;
associated with noncaseating necrosis
2. Morphology
Gross: pale
white nodule with or without central caseation
Microscopic
Usually well-circumscribed
Cell types:
epithelioid cells (activated macrophages),
mononuclear (round cell) infiltrate(CD4 helper T cells,
or TH cells of the TH 1 type)
Multinucleated giant cells:
fusion of epithelioid cells; nuclei usually at the
periphery
TUBERCULOSIS
Tuberculosis is a chronic communicable
disease
Etiology
M. tuberculosis (Principal)
M. bovis (rare)
M. hominis (rare)
The lungs are the prime target, but any organ may
be infected.
M. tuberculosis is a slender beaded, non- motile
acid fast bacillus.
Epidemiology
Disrupted through out the world
Annual incidence:
USA: 12/100,000
1. Primary infection
Pathogenesis
activated macrophages.
The development of a population of activated
Clinical picture
Cough, low grade fever, malaise, fatigue, anorexia, weight
Epidemiology:
M. leprae is shed in nasal secretions or from ulcerated lesions
of an infected person.
The mode of infection is unclear, but it probably involves
response that limits the proliferation of the bacillus and the extent of the
disease.
Pathology
Single lesion or very few lesions on the skin are characteristics.
Microscopic :
2. Lepromatous leprosy
Occurs in persons who fail to develop adequate immune
response to the bacteria.
There are progressive destructive lesions filled with
mycobacteria.
Pathology
Multiple tumor- like lesions of the skin eyes, testes,
Hammer toes
Saddle- nose
Blindness.
45
Day 1:
fibrin clot (hematoma) develops.
Day 3:
granulation tissue begins to form.
Initial deposition of type III collagen begins but does not bridge the
incision site.
Macrophages replace neutrophils.
46
Days 4-6:
granulation tissue formation peaks, and collagen bridges
Month 1:
collagenase remodeling of the wound occurs, with
defect
Often accompanied by significant wound contraction
49
50
Factors affecting Healing:
Systemic Local
Nutrition necrosis
Vitamin def.
Infection
Age
apposition
Immune status
Other diseases
Blood supply
Mobility
Foreign body