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Inflammation
The document summarizes inflammation and its outcomes. It discusses: 1) The possible outcomes of acute inflammation are resolution, scarring (fibrosis), abscess formation, or progression to chronic inflammation. 2) Morphologic patterns of acute inflammation include non-suppurative (serous, fibrinous) and suppurative (localized like abscesses, boils, and carbuncles or diffuse like cellulitis). 3) Abscesses form cavities containing pus, while chronic inflammation occurs when an injurious agent persists, leading to long-term damage.
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Inflammation
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- 2. Outcome of AcuteInflammation & Morphologic Patterns in Acute Inflammation
- 3. OBJECTIVES AND KEYPRINCIPLES TO BE TAUGHT: Upon completion of this lecture, the student should: • 1. Enumerate the fate of acute inflammation and the conditions that leads to resolution or fibrosis • 2. Discuss abscess formation and its fate • 3 .Discuss how chronic inflammation follows acute inflammation • 4. Enumerate the morphologic patterns of acute inflammation. • 5. Define: abscess, furuncle, carbuncle, and cellulitis and identify their aetiology and morphology
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- 6. Possible outcomes ofacute inflammation • Complete resolution – Little tissue damage – Capable of regeneration • Scarring (fibrosis) – In tissues unable to regenerate – Excessive fibrin deposition organized into fibrous tissue • Abscess formation occurs with some bacterial or fungal infections • Progression to chronic inflammation
- 7. Outcomes • Resolution – Thecomplete restoration of the inflamed tissue back to a normal status. Inflammatory measures such as vasodilation, chemical production, and leukocyte infiltration cease, and damaged parenchymal cells regenerate. In situations where limited or short lived inflammation has occurred this is usually the outcome. • Fibrosis – Large amounts of tissue destruction, or damage in tissues unable to regenerate, can not be regenerated completely by the body. Fibrous scarring occurs in these areas of damage, forming a scar composed primarily of collagen. The scar will not contain any specialized structures, such as parenchymal cells, hence functional impairment may occur.
- 8. Outcomes • Abscess formation –A cavity is formed containing pus, an opaque liquid containing dead white blood cells and bacteria with general debris from destroyed cells. • Chronic inflammation – In acute 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. Consequently, chronic inflammation is almost always accompanied by tissue destruction.
- 10. Morphologic patterns ofacute inflammation • Inflammation is classified into two main morphologic groups • A) Non suppurative inflammation • B) Suppurative inflammation • A) Non suppurative inflammation • 1- Serous – Watery, protein-poor effusion (e.g., blister) and contain few leukocyte.
- 11. BLISTER, “Watery”, i.e.,SEROUS
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- 13. Organ: Pericardium Diagnosis:Fibrinous Inflammation 2-Fibrinous Exudation of fluid rich in Fibrin
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- 15. Patterns (cont’d) • 3-Catarrhal-involve mucous secreting surfaces, fibrin and protein exudate mixed with mucus as in common cold affecting nasal passages . • 4-Membranous(pseudomembranous): false membrane formed by exudate adherent to underlying mucous surface e.g. diphtheria. • 5-Hemorrhagic: sever inflammatory exudate associated with damage to capillaries as in hemorrhagic pancreatitis • 6-Gangrenous : The acute inflammation is complicated by superadded death and putrefaction of the tissues
- 16. B) Suppurative inflammation •Characterized by purulent exudate containing large numbers of PMN which is localized or diffuse • 1- Localized • Abscess: cavity full of pus commonly due to Staph. Aureus infection • Special types of abscesses • 1.Boil(Furuncle):small abscess related to hair follicle or sebaceous glands • 2. Stye: Abscess in the eye lid related to eye lashes • 3. Carbuncle: multilocular abscess in the skin and subcutaneous tissue discharging pus through numerous openings
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- 19. • 2-Diffuse suppurativeinflammation : • a. Phlegmonous inflammation of hollow organ: e.g. acute suppurative appendicitis • b. Diffuse suppuration in a body cavity : e.g. • suppurative pleuritis and meningitis • c. Collection of pus in the lumen of an organ : e.g. Empyema of the gall bladder • d. Cellulitis: inflammation of connective tissue, Panniculitis inflammation of subcutaneous tissue
- 20. Empyema of thegall bladder
- 21. Redness of theleft foot due to cellulitis
- 22. Sequence of acuteinflammation • Ulceration(e.g. Peptic ulcers of the stomach or duodenum and diabetic ulcer of the legs ) – Necrotic and eroded epithelial surface – Underlying acute and chronic inflammation – Trauma, toxins, vascular insufficiency
- 23. Peptic ulcer ofthe stomach
- 24. • Fistula :communicationbetween two organs (epithelial surfaces) or organ and surface. • Sinus : Blind ended track from a cavity to the surface e.g. Pilonidal sinus . • Bacteremia , Toxemia , Septicemia • Pyemia : Septic emboli in blood stream arrested in different organs causing multiple small pyemic abscesses . Sequence of acute inflammation
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- 28. Continuous assessment • Focalcollection of pus is called • A) Abscess . • B) Ulcer . • C) Scar . • D) Fistula