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Inflammation 2


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Designed for UG pathology teaching.

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Inflammation 2

  1. 1. How do you differentiate acute from chronic inflammation? • Onset / duration • Type of inflammatory cells May-2015-CSBRP
  2. 2. FIGURE 2-1 The major local manifestations of acute inflammation, compared to normal. (1)Vascular dilation and increased blood flow (causing erythema and warmth) (2)Extravasation and extravascular deposition of plasma fluid and proteins (edema); (3)Leukocyte emigration and accumulation in the site of injury.May-2015-CSBRP
  3. 3. May-2015-CSBRP
  4. 4. ExudationExudation The escape of fluid, proteins, and blood cells from the vascular system into the interstitial tissue or body cavities is known as exudation May-2015-CSBRP
  5. 5. Terms • Exudate • Transudate • Edema • Pus May-2015-CSBRP
  6. 6. May-2015-CSBRP Increased HP OR Decreased OP Increased vascular permeability
  7. 7. Differences between Transudate and Exudate Transudate • Usually seen in congestive states • Increased HP • Sp. Gr: <1.020 • Proteins: <2 gm/dl • Few leucocytes Exudate • Seen in inflammatory states • Increased vascular permeability • Sp. Gr: >1.020 • Proteins: >2 gm/dl • Many leucocytes May-2015-CSBRP
  8. 8. May-2015-CSBRP
  9. 9. Vascular Events May-2015-CSBRP
  10. 10. Vascular events 1. Changes in Vascular Flow and Caliber 2. Increased Vascular Permeability (Vascular Leakage) 3. Responses of Lymphatic Vessels May-2015-CSBRP
  11. 11. Vascular events 1. Changes in Vascular Flow and Caliber Begins early in inflammation Consists of the following: Vasoconstriction (transient – a few seconds) Vasodilation (first – arterioles, then vascular bed) Histamine, NO Vasodilation with increased vascular permeability May-2015-CSBRP Histamine dilates post-capillary venules
  12. 12. Vascular events 1. Changes in Vascular Flow and Caliber 2. Increased Vascular Permeability o Contraction of endothelial cells resulting in increased interendothelial spaces o [histamine, bradykinin, leukotrienes, substance P] o Immediate transient response occurs rapidly / short-lived (15–30 minutes) o Delayed prolonged leakage [begins after a delay of 2 to 12 hours] may be caused by contraction of endothelial cells or mild endothelial damage. Eg: sunburn o Endothelial injury, resulting in endothelial cell necrosis and detachment o Direct damage to the endothelium - in burns, or by the actions of microbes, Neutrophils that adhere to the endothelium o Transcytosis, VEGF o Newly formed capillaries are leaky May-2015-CSBRP
  13. 13. Vascular events May-2015-CSBRP
  14. 14. Normal tight Gap junction Contraction Causing vascular leakage May-2015-CSBRP
  15. 15. Vascular events May-2015-CSBRP
  16. 16. Vascular events May-2015-CSBRP
  17. 17. Vascular events May-2015-CSBRP
  18. 18. Vascular events May-2015-CSBRP
  19. 19. Vascular events Although various mechanisms can cause vascular leak, combination of mechanisms discussed earlier may play a role in a given setting May-2015-CSBRP
  20. 20. Vascular events 1. Changes in Vascular Flow and Caliber 2. Increased Vascular Permeability 3. Responses of Lymphatic Vessels • Normally interstitial fluid is drained by lymphatics • Lymphatics proliferate to handle the increased load • May carry injurious substances away from the site • In this process they may get inflammed - Lymphangiitis May-2015-CSBRP
  21. 21. May-2015-CSBRP
  22. 22. Cellular EventsCellular Events May-2015-CSBRP
  23. 23. REACTIONS OF LEUKOCYTES IN INFLAMMATION • A critical function of inflammation is to deliver leukocytes to the site of injury and to activate the leukocytes to eliminate the offending agents. • Most important leukocytes in inflammatory reactions are the ones capable of phagocytosis, namely neutrophils and macrophages. • These leukocytes ingest and kill bacteria and other microbes, and eliminate necrotic tissue and foreign substances. • Leukocytes also produce growth factors that aid in repair. • Collateral damage: When strongly activated, leucocytes may induce tissue damage May-2015-CSBRP
  24. 24. The processes involving leukocytes in inflammation consist of: Recruitment Recognition Removal May-2015-CSBRP
  25. 25. The inflammatory response consists of TWO main components: 1. Vascular reaction and 2. Cellular reaction May-2015-CSBRP