Acute inflammation involves vascular and cellular events. Vascular events include hemodynamic changes like vasoconstriction and vasodilation, and permeability changes in endothelial cells. Cellular events involve the exudation of white blood cells through processes like rolling, adhesion, and chemotaxis. White blood cells then phagocytose pathogens and produce inflammatory mediators. Healing occurs through regeneration of original cells and repair by proliferation of connective tissue, forming granulation tissue through angiogenesis and fibrogenesis.

1. Inflammation andInflammation and
healinghealing

2. Acute inflammationAcute inflammation
 Vascular eventsVascular events
 Cellular eventsCellular events

3. Vascular eventsVascular events
 Hemodynamic changesHemodynamic changes
 Permeability changesPermeability changes

4. Hemodynamic changesHemodynamic changes
1.1. Transient vasoconstriction of ArteriolesTransient vasoconstriction of Arterioles
2.2. Persistant progressive vasodilatationPersistant progressive vasodilatation
3.3. Elevated local Hydrostatic pressureElevated local Hydrostatic pressure
4.4. Stasis of microcirculationStasis of microcirculation
5.5. WBC migrationWBC migration

5. Lewis experimentLewis experiment
1.1. Red lineRed line  vasodilatationvasodilatation
2.2. FlareFlare  vasodilatation of surroundingvasodilatation of surrounding
vesselsvessels
3.3. WhealWheal  traqnsudation of fluid into thetraqnsudation of fluid into the
extra vascular space..extra vascular space..

6. Vascular permeability changeVascular permeability change
1.1. Endothelial contractionEndothelial contraction  immediateimmediate
transienttransient
2.2. Endothelial retractionEndothelial retraction  delayed anddelayed and
prolongedprolonged
3.3. Direct endothelial injuryDirect endothelial injury  immediate andimmediate and
prolonged / delayed and prolongedprolonged / delayed and prolonged
4.4. Injury by WBCInjury by WBC
5.5. NeovascularisationNeovascularisation

7. Cellular eventsCellular events
1.1. Exudation of WBCExudation of WBC
2.2. PhagocytosisPhagocytosis

8. Exudation of WBCExudation of WBC
1.1. Margination( formed elements widen ) andMargination( formed elements widen ) and
pavementing( PMN comes in contact wothpavementing( PMN comes in contact woth
vessel wall )vessel wall )
2.2. Rolling and adhesionRolling and adhesion
3.3. EmigrationEmigration
4.4. ChemotaxisChemotaxis

9. RollingRolling
 SelectinsSelectins
 Three typesThree types
1.1. E selectinE selectin  in Endotheliumin Endothelium
2.2. P selectinP selectin  Endo + PlatletsEndo + Platlets
3.3. L selectinL selectin  WBCWBC

11. AdhesionAdhesion
 ICAM1ICAM1 LFA 1 ,Mac -1LFA 1 ,Mac -1 Adhesion andAdhesion and
TransmigrationTransmigration
 VCAM 1VCAM 1  VLA 4VLA 4  AdhesionAdhesion
 PECAM 1PECAM 1  CD31CD31 TransmigrationTransmigration

13. ChemotaxisChemotaxis
1.1. Bacterial ProductsBacterial Products  esp. with N formylesp. with N formyl
methionine terminalsmethionine terminals
2.2. Cytokines of Chemokine family IL 8Cytokines of Chemokine family IL 8
3.3. Complements –C 3a ,C5aComplements –C 3a ,C5a
4.4. LT B4LT B4

14. Leukocyte activationLeukocyte activation
 PhagocytosisPhagocytosis
 Production of substances that destroysProduction of substances that destroys
phagocytosed microbesphagocytosed microbes  lysosomallysosomal
enzynes , reactive oxygen and nitrogen speciesenzynes , reactive oxygen and nitrogen species
 Production of mediaters that amplifyProduction of mediaters that amplify
inflemmatory reactioninflemmatory reaction  AA metabolites andAA metabolites and
cytokinescytokines

15. PhagocytosisPhagocytosis
1.1. Recognition and attachment of particles toRecognition and attachment of particles to
WBCWBC
2.2. Formation of phagocytic vacouleFormation of phagocytic vacoule
3.3. Killing and degradation of ingestedKilling and degradation of ingested
substancesubstance

17. HealingHealing
 RegenerationRegeneration proliferation of parenchymalproliferation of parenchymal
cellscells
 RepairRepair proliferation of connective tissueproliferation of connective tissue
results in fibrosis and scarringresults in fibrosis and scarring

18. RegenerationRegeneration
 Proliferation of the original cells from theProliferation of the original cells from the
margin of the injurymargin of the injury
 Migrated cells will differentiates and maturatesMigrated cells will differentiates and maturates

19. RepairRepair
 Granulation tissue formationGranulation tissue formation
 Contraction of the tissueContraction of the tissue

20. Granulation tissueGranulation tissue
 Slightly granular and pink appearance of theSlightly granular and pink appearance of the
tissuetissue
 Each granule is a new small blood vesselEach granule is a new small blood vessel
there is thin covering of fibroblasts and youngthere is thin covering of fibroblasts and young
collagencollagen

21. Granulation tissue formationGranulation tissue formation
1.1. Phase of inflammationPhase of inflammation
2.2. Phase of clearancePhase of clearance
3.3. Phase of in growth of granulation tissuePhase of in growth of granulation tissue

22. Granulation growthGranulation growth
1.1. AngiogenesisAngiogenesis
2.2. FibrogenesisFibrogenesis

23. HealingHealing
 Healing by First intention / Primary UnionHealing by First intention / Primary Union
 Healing by second intention / secondary unionHealing by second intention / secondary union