Inflammation Vascular response to injury!!

Elimninate cause of cell injury And prevent necrosis Calor, tumor, rubor, dolor, functio laesa Can cause harm Acute (neutrophils): serous (clear fluid), fibrinous (fibrin, pink strands), phlegmonous (cellulitis is example, lots of edema and some PMN), suppurative (pus because PMN is bunched, lyses and fat from membrane) Vasodilation, vascular permeability, leukocyte cell events Vasodilate increase blood flow Permeabilityrbcs more concentrated stasis PMNS can accumulate in endothelium, get out of current Increases intravascular hydrostatic pressure transudate (clear, watery) Increasing vascular permeability exudate (stuff in it) Lose protein fluid reduces oncotic pressure Water and iolns accumulate in tissue edema Leakage (transcytosis): endothelial cell contraction due to histamine, brakykinin, leukotrienes Junctional retractions: tnf, il-1 Injury Leukocyte dependent injury- leukos release oxygen species, proteolyze Leukocyte cell events: margination, rolling Increased permeability fluid exits blood flow slowspmn marginate Roll by slectins Icam and vcam adhere for leukocytes, transmigration by pecam Once theyre out in a new environment Chemotaxis/activation: bacteria, mediated by C5a, products of lipoxygenase arachidonic acid, leukotriene b4, cytokines Phagocytosis/degranulation: recognition and ingestion Killing and degrdatino by h202 and granules which make hypocholorous radical Black dots in pmn= bacteria Defects in function Leukocyte adhesions defiency 1: lack of cd18 Type 2: absence of the oligosaccharide binding to selectins Chronic granulomatous disease: defective killing so histiocytes make granules Chediak higashi syndrome: impaired fusions of lysosomes to phagosomes, decreased granukles immunodefiency Cell derived mediator Histamine and serotonin dilation permeability and edema Arachidonic acid metabolites: prostaglandins, leukotrienes involed in rxn and chemotaxis Tnf and IL1 leukocyte recruitment

ROS, nitic oxide, lysosome kill microbes Plasma mediators Complement Coag proteins Kinins constriction/pain Outcomes Resolution: termination of response with lympatic drainage, macrophages, clearance of edema fulida and inflammatory cells ( non chronic) Chronic if agent is not removed Scarring/fibrosis: substantial tissue destruction, tissues dont regenerate Chronic (macrophages, lymphocytes, plasma cells, repair): lympocytic, plasmacellular, eosinophillic, granulomatous, fibrosing May appear that way from begingging (persistent infection, prolonged infection, autoimmune) Macrophages (histiocytes) monocytes while in blood. Macrophages once activated and in tissues Secrete: Acid and neutral protease, complement, coag factors, no and oxygen speicies, prostaglandins, leuikotrienes, cytokines Small nucleus large cytoplasm (nucleus is not as stained) Lymphocytes migrate into tissues, activated by macrophages producing cytokines to turn on macrophages and activate other lymphocytes Not lobular Plasma cells differentiated b cell antibodies Dots in nuclei, and nucleus to side, little clear next to nucleus, purple medium cytoplasm Cholelithisis gallstones: fair, fertile, forty, flatulent, female, fat an feather Diverticulum mucosa into muscle layer- chronic cholecystitis Rotanksi-haschoff Eosinophilic inflammation parasites/allergies Very red, less lobed Mast cells- can have ige antibodies, allergic shock, Granulomatous inflammation Macrophages, collected making granule Giant cell is a multinucleated cells around granulomas Granulomas: necrotizing (TB), necrotizing and supparative (pus) (cat scratch, fungi); non necrotizing (sarcoid) Caseating granuloma (cheesy, buttery necrosis) Fever: prostaglandin synthesis by TNF and IL1 increasing cyclooxygenase arachnidonic acid in to prostaglandins that act on hypothalamus reset temperatrure C reative protein- and serum amyloid protein- increased by hepatocytes and bind microbes Fibrinogen increased production and binds RBC clumping and raising sedimentation (old styles) Tnf and il-1 increases leukocytes Bacteria neutrophils Virus lymophocytes Parasites eosinophils