INFLAMMATION

              DEFINITION

INFLAMMATION IS A HOST RESPONSE TO LOCAL
     INJURY IN VASCULARISED TISSUES.
CARDINAL SIGNS OF INFLAMMATION




•
INFLAMMATION- CARDINAL SIGNS: CELSUS


 RUBOR-REDNESS

 CALOR-HEAT


 TUMOR-SWELLING
 DOLOR- PAIN


 5TH SIGN DESCRIBED BY VIRCHOW-LOSS OF FUNCTION


 (FUNCTIO LAESA)
INFLAMMATION-TYPES

               ACUTE              CHRONIC

Onset          Rapid              Slow

Duration       Short              Longer
Predominant    Neutrophil         Lymphocytes and
cells                             macrophages
Chief          Exudation of fluid Proliferation of
pathological   and plasma         blood vessels and
event          proteins           fibrosis
INFLAMMATION-STIMULI

 Infection- bacterial, viral , parasitic

 Trauma

 Physical/chemical injury- burns, irradiation

 Tissue necrosis

 Foreign body

 Immune reaction
ACUTE INFLAMMATION


 VASCULAR CHANGES:
   Vascular caliber alteration.
   Change in vascular structure.


 CELLULAR EVENTS:
   leucocyte   emigration
ACUTE INFLAMMATION-
           VASCULAR CHANGES

  IMPORTANT TO BRING ANTIBODIES AND
               LEUCOCYTES
1. VASODILATATION
         EARLIEST EVENT
         ARTERIOLES- OPENING OF CAPILLARIES
         INCREASED BLOOD FLOW- RUBOR AND CALOR
2.   INCREASED PERMEABILITY
3.   STASIS
Increased Vascular Permeability (Vascular
                   Leakage)

 Contraction of endothelial cells resulting in
 increased interendothelial spaces is the most
 common mechanism of vascular leakage.
VASCULAR CHANGES-INCREASED
      PERMEABILITY-MECHANISMS

  FORMATION OF ENDOTHELIAL GAPS IN
              VENULES
 RAPID,SHORT LIVED

 Agent: Histamine,bradykinin

 MECHANISM: Phosphorylation Of Cytoskeletal

 Proteins Contraction

 IMMEDIATE TRANSIENT RESPONSE
Endothelial injury, resulting in endothelial
cell necrosis and detachment
VASCULAR CHANGES-INCREASED
    PERMEABILITY-MECHANISMS

               DIRECT INJURY

 IMMEDIATE SUSTAINED RESPONSE


 ALL LEVELS




 NECROTIZING INJURIES (e.g.SEVERE BURN)
VASCULAR CHANGES-INCREASED
   PERMEABILITY-MECHANISMS
     DELAYED PROLONGED LEAKAGE

 VENULES,CAPILLARIES


 THERMAL INJURIES,X-RADIATION


 AFTER 2-12 HOURS,LASTS FOR HOURS OR DAYS
Neutrophils that adhere to the endothelium during
inflammation may also injure the endothelial cells
and thus amplify the reaction.
VASCULAR CHANGES-INCREASED
    PERMEABILITY-MECHANISMS


   LEUCOCYTE MEDIATED ENDOTHELIAL
                 INJURY
 DELAYED PROLONGED RESPONSE


 COMMON IN GLOMERULI AND LUNGS
VASCULAR CHANGES-INCREASED
     PERMEABILITY-MECHANISMS

          INCREASED TRANSCYTOSIS

 ACROSS ENDOTHELIAL CYTOPLASM


 INCREASE IN NO: AND SIZE OF TRANSENDOTHELIAL
 CHANNELS

     LEAKAGE FROM NEW BLOOD VESSELS

 IMPORTANT DURING EARLY PHASES OF HEALING
VASCULAR CHANGES-
   INCREASED PERMEABILITY
 ESCAPE OF PROTEIN RICH FLUID AND BLOOD
 CELLS - FORMATION OF EXUDATE

 TRANSUDATE
   FLUID WITH LOW PROTEIN
   DUE TO OSMOTIC OR HYDROSTATIC IMBALANCE
   VASCULAR PERMEABILITY INTACT
Transcytosis:

may involve channels consisting of interconnected, uncoated
vesicles and vacuoles called the vesiculovacuolar organelle:
located close to intercellular junctions.
EXUDATE Vs TRANSUDATE

                   Exudate        Transudate
Protein content    High           Low
Cells & debris     High           Low
Specific gravity   > 1.020        < 1.012
Cause              vascular      hydrostatic
                   permeability   pressure; 
                                  osmotic pressure
Associated with    Inflammation
                   Exudate        Transudate
Responses of Lymphatic Vessels
 lymph flow is increased and helps drain edema fluid,
  leukocytes, cell debris, as well as microbes.
 Lymphatic vessels also proliferate.
 +/-(lymphangitis),+/-(lymphadenitis).
 Inflamed lymph nodes are often enlarged because of
  hyperplasia of the lymphoid follicles and increased
  numbers of lymphocytes and macrophages. This
  constellation of pathologic changes is termed
  reactive, or inflammatory, lymphadenitis
summary

 Inflammation-acute      and   chronic
 Acute - cardinal sign
          stimuli
          changes -vascular & cellular
•vascular- vasodilation;
             increased vascular permeability
             transcytosis
1. inflammation  with vascular events dr ashutosh kumar

1. inflammation with vascular events dr ashutosh kumar

  • 1.
    INFLAMMATION DEFINITION INFLAMMATION IS A HOST RESPONSE TO LOCAL INJURY IN VASCULARISED TISSUES.
  • 2.
    CARDINAL SIGNS OFINFLAMMATION •
  • 3.
    INFLAMMATION- CARDINAL SIGNS:CELSUS  RUBOR-REDNESS  CALOR-HEAT  TUMOR-SWELLING  DOLOR- PAIN  5TH SIGN DESCRIBED BY VIRCHOW-LOSS OF FUNCTION (FUNCTIO LAESA)
  • 4.
    INFLAMMATION-TYPES ACUTE CHRONIC Onset Rapid Slow Duration Short Longer Predominant Neutrophil Lymphocytes and cells macrophages Chief Exudation of fluid Proliferation of pathological and plasma blood vessels and event proteins fibrosis
  • 5.
    INFLAMMATION-STIMULI  Infection- bacterial,viral , parasitic  Trauma  Physical/chemical injury- burns, irradiation  Tissue necrosis  Foreign body  Immune reaction
  • 6.
    ACUTE INFLAMMATION  VASCULARCHANGES:  Vascular caliber alteration.  Change in vascular structure.  CELLULAR EVENTS:  leucocyte emigration
  • 8.
    ACUTE INFLAMMATION- VASCULAR CHANGES IMPORTANT TO BRING ANTIBODIES AND LEUCOCYTES 1. VASODILATATION  EARLIEST EVENT  ARTERIOLES- OPENING OF CAPILLARIES  INCREASED BLOOD FLOW- RUBOR AND CALOR 2. INCREASED PERMEABILITY 3. STASIS
  • 9.
    Increased Vascular Permeability(Vascular Leakage)  Contraction of endothelial cells resulting in increased interendothelial spaces is the most common mechanism of vascular leakage.
  • 10.
    VASCULAR CHANGES-INCREASED PERMEABILITY-MECHANISMS FORMATION OF ENDOTHELIAL GAPS IN VENULES  RAPID,SHORT LIVED  Agent: Histamine,bradykinin  MECHANISM: Phosphorylation Of Cytoskeletal Proteins Contraction  IMMEDIATE TRANSIENT RESPONSE
  • 11.
    Endothelial injury, resultingin endothelial cell necrosis and detachment
  • 12.
    VASCULAR CHANGES-INCREASED PERMEABILITY-MECHANISMS DIRECT INJURY  IMMEDIATE SUSTAINED RESPONSE  ALL LEVELS  NECROTIZING INJURIES (e.g.SEVERE BURN)
  • 13.
    VASCULAR CHANGES-INCREASED PERMEABILITY-MECHANISMS DELAYED PROLONGED LEAKAGE  VENULES,CAPILLARIES  THERMAL INJURIES,X-RADIATION  AFTER 2-12 HOURS,LASTS FOR HOURS OR DAYS
  • 14.
    Neutrophils that adhereto the endothelium during inflammation may also injure the endothelial cells and thus amplify the reaction.
  • 15.
    VASCULAR CHANGES-INCREASED PERMEABILITY-MECHANISMS LEUCOCYTE MEDIATED ENDOTHELIAL INJURY  DELAYED PROLONGED RESPONSE  COMMON IN GLOMERULI AND LUNGS
  • 16.
    VASCULAR CHANGES-INCREASED PERMEABILITY-MECHANISMS INCREASED TRANSCYTOSIS  ACROSS ENDOTHELIAL CYTOPLASM  INCREASE IN NO: AND SIZE OF TRANSENDOTHELIAL CHANNELS LEAKAGE FROM NEW BLOOD VESSELS  IMPORTANT DURING EARLY PHASES OF HEALING
  • 17.
    VASCULAR CHANGES- INCREASED PERMEABILITY  ESCAPE OF PROTEIN RICH FLUID AND BLOOD CELLS - FORMATION OF EXUDATE  TRANSUDATE  FLUID WITH LOW PROTEIN  DUE TO OSMOTIC OR HYDROSTATIC IMBALANCE  VASCULAR PERMEABILITY INTACT
  • 18.
    Transcytosis: may involve channelsconsisting of interconnected, uncoated vesicles and vacuoles called the vesiculovacuolar organelle: located close to intercellular junctions.
  • 19.
    EXUDATE Vs TRANSUDATE Exudate Transudate Protein content High Low Cells & debris High Low Specific gravity > 1.020 < 1.012 Cause vascular hydrostatic permeability pressure;  osmotic pressure Associated with Inflammation Exudate Transudate
  • 21.
    Responses of LymphaticVessels  lymph flow is increased and helps drain edema fluid, leukocytes, cell debris, as well as microbes.  Lymphatic vessels also proliferate.  +/-(lymphangitis),+/-(lymphadenitis).  Inflamed lymph nodes are often enlarged because of hyperplasia of the lymphoid follicles and increased numbers of lymphocytes and macrophages. This constellation of pathologic changes is termed reactive, or inflammatory, lymphadenitis
  • 22.
    summary  Inflammation-acute and chronic  Acute - cardinal sign stimuli changes -vascular & cellular •vascular- vasodilation; increased vascular permeability transcytosis