عرض تقديمي في powerpointnur.uobasrah.edu.iq/images/pdffolder/inflammation.pdf · chronic...
TRANSCRIPT
PATHOPHYSIOLOGY
Dr.Wasfi Dhahir Abid Ali
Department of medical sciences –College of Nursing –
University of Basrah
INFLAMMATION
Inflammation is a immune system 'response to stimulus. This can
be bacteria colonizing a wound or a splinter piercing your finger, for
example. Inflammation happens when the immune system fights against
something that may turn out to be harmful.
And also inflammation define as apart of the complex biological and
a protective response of body tissues to harmful stimuli, such as
pathogens, damaged cells, or irritants. It involves immune cells,
blood vessels, and molecular mediators.
Inflammation
Type of defenses First - Non-Specific defenses
Defenses Against Infection. Natural barriers and the immune
system defend the body against organisms that can cause
infection. Natural barriers include the skin, mucous
membranes, tears, earwax, mucus, and stomach acid. Also, the
normal flow of urine washes out microorganisms that enter the
urinary tract.
Second:Humoral Defense This line of defense against infection specifically targets molecules called antigens B
cells are primarily responsible for humoral immunity (relating to
antibodies).The molecules responsible for humoral immunity to disease are
called immunoglobulins, also known as antibodies,They are proteinaceous cell
markers. humoral response mainly protects against extracellular
pathogens and toxins
There are five major classes of immunoglobulins
1- Immunoglobulin G (IgG) accounting for over 80% of all of the circulating
immunoglobulins.
2- Immunoglobulin A (IgA) composes about 15% of the circulating
antibodies.
3- Immunoglobulin E (IgE) has a structure similar to that of IgG.
4- Immunoglobulin D (IgD) is also a single molecule, and is found in very
small (0.2%) concentrations.
5- Immunoglobulin M (IgM) is the largest of the immunoglobulins,
composing about 5% of the total quantity of circulating antibodies
Third: Cell-Mediated Defense (CMI)
Several cell types are responsible for the cell-mediated
immune response . CMI is responsible for detecting and
destroying intracellular pathogens
1-Natural killer cells (N-K cells) They target and destroy
host cells which have been invaded by viruses.
2- CytotoxicT cells have CD8 markers and kill any cell
expressing foreign antigens.
3- T memory cells retain genetic information about specific
antigens.
4-T helper and T suppressor cells regulate the activities of
other specific immune cell types.
1-Pain(Dolor) due to fluid pressure on nerve ends
2-Heat(Calor)
3-Redness(Ruber)due to increase blood flow
4-swelling(Edema) accumulation of protein and
fluids in the interstitial space.
5-loss of function(lake of nutrition)
local effects(inflammatory response)
1-vascular stage: increases increase blood flow ,vessels
permeability led to edema,
2-Cellular stage :immigration of leukocytes, cell release
chemical mediators(bradykinin,histamine and prostoglandin
3-chemotaxic stage(distribution of chemotaxic factors
(cytokinin)
4-phagositosis:phagositosis of debris by microphages
5- microbial killing :killing of bacteria by lysosome,
complements,H2O2
Stages of inflammation
Acute inflammation
Is a short-term process, usually appearing within a
few minutes or hours and begins to cease upon the
removal of the injurious stimulus. It is characterized
by five cardinal signs include pain, redness,
immobility (loss of function), swelling and heat
Types of inflammation
Chronic inflammation
If the injurious agent persists then chronic inflammation will
ensue. This process, marked by inflammation lasting many days,
months or even years, may lead to the formation of a chronic
wound. Chronic inflammation is characterized by the dominating
presence of macrophages in the injured tissue. These cells are
powerful defensive agents of the body, but the toxins they release
(including reactive oxygen species) are injurious to the organism's
own tissues as well as invading agents. As a consequence, chronic
inflammation is almost always accompanied by tissue
destruction.
Physical:
Burns ,Frostbite ,Physical injury, blunt or penetrating ,Foreign bodies,
including splinters, dirt and debris Trauma ,Ionizing radiation
Biological:
Infection by pathogens ,Immune reactions due to hypersensitivity
,Stress
Chemical:
Chemical irritants. Toxins and alcohol
Psychological:
Embarrassment and Excitement
Causes of inflammation
Granulomatous inflammation: Characterized by the
formation of granulomas, they are the result of a limited but
diverse number of diseases, which include among others
tuberculosis, leprosy, sarcoidosis, and syphilis.
Fibrinous inflammation: Inflammation resulting in a large
increase in vascular permeability allows fibrin to pass through
the blood vessels. tubes can be formed.
Morphological type of inflammations
Purulent inflammation: Inflammation resulting in large
amount of pus, which consists of neutrophils, dead cells, and
fluid. Infection by pyogenic bacteria such as staphylococci is
characteristic of this kind of inflammation. Large, localized
collections of pus enclosed by surrounding tissues are called
abscesses.
Serous inflammation: Characterized by the copious
effusion of non-viscous serous fluid, commonly produced by
mesothelial cells of serous membranes, but may be derived
from blood plasma. Skin blisters exemplify this pattern of
inflammation.
Ulcerative inflammation:
Inflammation occurring near an epithelium can result in the
necrotic loss of tissue from the surface, exposing lower layers.
The subsequent excavation in the epithelium is known as an
ulcer.
Comparison between acute and chronic inflammation
A chronic Acute
Persistent acute inflammation Bacterial pathogen , injured tissue Cause
Macrophage , lymphocytes
,fibroblast, monocytes and
plasma cells
Neutrophils(primarily,
basophils(inflammatory response)
eosinophils(worms and
parasites),monocytes and macrophages
Cells
involved
Delayed Immediate Onset
Up to month or years Few days Duration
Tissues destruction, fibrosis,
necrosis
Resolution. Abscess formation ,chronic
inflammation
Outcomes