08.21.08: Inflammation and Repair IV

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Slideshow is from the University of Michigan Medical School's M1 Patients and Populations: Medical Genetics Sequence.

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08.21.08: Inflammation and Repair IV

  1. 1. Author(s): Gerald Abrams, M.D., 2009License: Unless otherwise noted, this material is made available under the termsof the Creative Commons Attribution–Non-commercial–Share Alike 3.0License: http://creativecommons.org/licenses/by-nc-sa/3.0/We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize yourability to use, share, and adapt it. The citation key on the following slide provides information about how youmay share and adapt this material.Copyright holders of content included in this material should contact open.michigan@umich.edu with anyquestions, corrections, or clarification regarding the use of content.For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use.Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosisor a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pleasespeak to your physician if you have questions about your medical condition.Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
  2. 2. Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicyUse + Share + Adapt { Content the copyright holder, author, or law permits you to use, share and adapt. } Public Domain – Government: Works that are produced by the U.S. Government. (USC 17 §105) Public Domain – Expired: Works that are no longer protected due to an expired copyright term. Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain. Creative Commons – Zero Waiver Creative Commons – Attribution License Creative Commons – Attribution Share Alike License Creative Commons – Attribution Noncommercial License Creative Commons – Attribution Noncommercial Share Alike License GNU – Free Documentation LicenseMake Your Own Assessment { Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. } Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (USC 17 § 102(b)) *laws in your jurisdiction may differ { Content Open.Michigan has used under a Fair Use determination. } Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair. To use this content you should do your own independent analysis to determine whether or not your use will be Fair.
  3. 3. M1 Patients and Populations: Inflammation and Repair IV Outcomes of Acute Inflammation Gerald D. Abrams MDFall 2008
  4. 4. The Inflammatory response1. vascular response-fluid exudate2. cellular response-leukocytic exudate3. macrophages4. exudates-non-cellular, cellular, mixed5. granulomas-granulomatous inflammation6. fate of the inflammatory reaction7. healing and scar formation8. healing of cutaneous wounds9. chronic inflammation
  5. 5. Possible Outcomes of Acute Inflammation•  Resolution•  Healing with Scar•  Chronic Inflammation
  6. 6. Purulent PneumoniaG.D. Abrams, University of Michigan Medical School
  7. 7. Resolution – Normal LungG.D. Abrams, University of Michigan Medical School
  8. 8. HEALING•  SCAR FORMATION•  REGENERATION
  9. 9. GRANULATION TISSUE•  Loose,young connective tissue with proliferating fibroblasts and endothelial cells. Granulation tissue matures to form scar.•  The process of granulation tissue ingrowth is termed organizaton .
  10. 10. FIBRINOUS EXUDATEG.D. Abrams, University of Michigan Medical School
  11. 11. FIBRINOUS EXUDATE EARLY ORGANIZATIONG.D. Abrams, University of Michigan Medical School
  12. 12. FIBROBLAST PROLIFERATIONG.D. Abrams, University of Michigan Medical School
  13. 13. ENDOTHELIAL PROIFERATIONG.D. Abrams, University of Michigan Medical School
  14. 14. GRANULATION TISSUEG.D. Abrams, University of Michigan Medical School
  15. 15. GRANULATION TISSUE Day 5-7 G.D. Abrams, University of Michigan Medical School
  16. 16. GRANULATION TISSUE Second Week G.D. Abrams, University of Michigan Medical School
  17. 17. MATURING SCARG.D. Abrams, University of Michigan Medical School
  18. 18. NECROTIC MYOCARDIUM Day 1-2G.D. Abrams, University of Michigan Medical School
  19. 19. NECROTIC MYOCARDIUM Day 5-6G.D. Abrams, University of Michigan Medical School
  20. 20. NECROTIC MYOCARDIUM Second WeekG.D. Abrams, University of Michigan Medical School
  21. 21. MYOCARDIAL SCARG.D. Abrams, University of Michigan Medical School
  22. 22. EPITHELIAL REGENERATION G.D. Abrams, University of Michigan Medical School
  23. 23. HEALING OF CUTANEOUS WOUNDS•  Healing by primary or first intention- wound edges in apposition at the start of healing.•  Healing by secondary or second intention- wound edges apart, wound open.
  24. 24. PHASES OF WOUND HEALING•  Inflammation•  Organization and Regeneration•  Deposition of ECM•  Remodeling
  25. 25. HEALING BY PRIMARY INTENTIONDepartment of Pathology, University of Michigan
  26. 26. HEALING BY SECONDARY INTENTION Department of Pathology, University of Michigan
  27. 27. WOUND CONTRACTIONGrillo, Watts and Gross
  28. 28. Complications of Wound Healing•  Deficient scar – dehiscence, hernia•  Excessive scar – hypertrophic scar, keloid•  Excessive granulation tissue – proud flesh , adhesions•  Contracture•  Traumatic neuroma
  29. 29. KELOIDProdunis, Wikimedia Commons
  30. 30. ADHESIONSDepartment of Pathology, University of Michigan
  31. 31. CHRONIC INFLAMMATION Inflammation sufficiently prolonged thatevidence of repair is seen at the same timeas evidence of tissue injury and continuing, active inflammation
  32. 32. CAUSES OF CHRONIC INFLAMMATION•  Prolonged or repetitive action of toxic agents•  Persistent infection•  Autoimmunity
  33. 33. CHRONIC INFLAMMATIONG.D. Abrams, University of Michigan Medical School
  34. 34. ACUTE PHASE RESPONSE•  Leukocytosis•  Fever•  Synthesis of acute phase proteins•  Miscellaneous systemic effects
  35. 35. What we want you to know and understand•  The 5 cardinal signs of inflammation – their mechanisms•  Mechanisms of the vascular response and the cellular response and how they relate to one another•  The cells participating in inflammatory and reparative responses, and their roles•  Exudates – various types, why they form, and their fate. Granulomatous inflammation•  Organization and scarring•  Wound healing – mechanisms, factors affecting healing, complications
  36. 36. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicySlide 6: G.D. Abrams, University of Michigan Medical SchoolSlide 7: G.D. Abrams, University of Michigan Medical SchoolSlide 10: G.D. Abrams, University of Michigan Medical SchoolSlide 11: G.D. Abrams, University of Michigan Medical SchoolSlide 12: G.D. Abrams, University of Michigan Medical SchoolSlide 13: G.D. Abrams, University of Michigan Medical SchoolSlide 14: G.D. Abrams, University of Michigan Medical SchoolSlide 15: G.D. Abrams, University of Michigan Medical SchoolSlide 16: G.D. Abrams, University of Michigan Medical SchoolSlide 17: G.D. Abrams, University of Michigan Medical SchoolSlide 18: G.D. Abrams, University of Michigan Medical SchoolSlide 19: G.D. Abrams, University of Michigan Medical SchoolSlide 20: G.D. Abrams, University of Michigan Medical SchoolSlide 21: G.D. Abrams, University of Michigan Medical SchoolSlide 22: G.D. Abrams, University of Michigan Medical SchoolSlide 25: Department of Pathology, University of MichiganSlide 26: Department of Pathology, University of MichiganSlide 27: Grillo, Watts and GrossSlide 29: Produnis, Wikimedia, http://commons.wikimedia.org/wiki/File:Verbrennungsnarbe_keloid1.jpg, CC:BY-SA 3.0, http://creativecommons.org/licenses/by-sa/3.0/Slide 30: Department of Pathology, University of MichiganSlide 33: G.D. Abrams, University of Michigan Medical School

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