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BMD 420 Module 2 (Chapter 5)

front 1

First line of defense

back 1

Physical and chemical barriers such as skin mucous membranes tears saliva and gastric acid

front 2

Second line of defense

back 2

Nonspecific inflammatory response phagocytosis and interferons

front 3

Third line of defense

back 3

Specific immune response involving antibodies and sensitized lymphocytes

front 4

Inflammation

back 4

Body's nonspecific response to tissue injury producing redness swelling warmth pain and possible loss of function

front 5

Common causes of inflammation

back 5

Infection, physical injury, chemicals, ischemia, allergic reaction, extreme temperatures, foreign bodies

front 6

Bradykinin

back 6

Chemical released from injured cells that activates pain receptors

front 7

Histamine

back 7

Released from mast cells causing vasodilation and increased capillary permeability

front 8

Basic steps of inflammatory process

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1. Injury 2. Bradykinin released from injured cells that activates pain receptors 3. Pain stimulates mast cells and basophils to release histamine 4. Bradykinin and histamine cause capillary dilation, increase blood flow and capillary permeability. 5. Break in skin allows bacteria to enter tissue; neutrophils and monocytes migrate to injury site 6. Neutrophils and macrophages phagocytize bacteria

front 9

Normal capillary exchange

back 9

Hydrostatic pressure pushes fluid out at arterial end and osmotic pressure pulls fluid back at venous end

front 10

Capillary change in inflammation

back 10

Injured cells release chemical mediators that cause vasodilation and increase permeability to allow proteins, fluid, and leukocytes to leave capillaries to form exudate and move towards site of injury to phagocytize foreign material

front 11

What are the four physiologies of inflammation and local effects?

back 11

1. Vascular Response (Causes local vasodilation and increased capillary permeability) 2. Cellular Response (WBC attracted by chemotaxis) 3. Excess fluid can collect in interstitial space (Exudate) 4. Inactivation of chemical mediators begins resolution of inflammation (Resolvins/metabolites of omega-3 fatty acids and lipoxins/derived from arachidonic acid)

front 12

Exudate

back 12

Fluid rich in protein cells and electrolytes that accumulates in inflamed tissue

front 13

Chemotaxis

back 13

Attraction of white blood cells to the site of injury

front 14

Diapedesis

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Movement of leukocytes through capillary walls into tissue

front 15

Hyperemia

back 15

Increased blood flow to inflamed tissue causing redness and warmth

front 16

Cardinal signs of inflammation

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Redness, heat, swelling, pain, and sometimes loss of function

front 17

Serous exudate

back 17

Watery fluid with protein and white blood cells

front 18

Fibrinous exudate

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Thick sticky exudate with fibrin that increases scar risk

front 19

Purulent exudate

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Pus containing leukocytes microbes and debris usually from bacterial infection

front 20

Abscess

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Localized pocket of purulent exudate in solid tissue

front 21

Hemorrhagic exudate

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Exudate containing blood due to vessel damage

front 22

Systemic effects of inflammation

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Fever (pyrexia), fatigue, malaise (feeling unwell), headache, anorexia (loss of appetite)

front 23

Cause of fever in inflammation

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Pyrogens released by macrophages reset hypothalamic temperature control

front 24

Leukocytosis

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Increased white blood cell count during inflammation

front 25

C reactive protein

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Protein appearing in blood during acute inflammation and necrosis

front 26

Erythrocyte sedimentation rate

back 26

Lab test elevated in inflammation due to increased plasma proteins

front 27

Chronic inflammation

back 27

Long term inflammation with more macrophages, lymphocytes, fibroblasts, tissue destruction, and scarring

front 28

Granuloma

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Mass of necrotic tissue surrounded by connective tissue in chronic inflammation

front 29

Complications of chronic inflammation

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Ulcers, local complications of specific site of inflammation, Infections, Skeletal Muscle spasms

front 30

Aspirin

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Decreases prostaglandin synthesis at the site of inflammation (anti-inflammatory) and reduces pain (analgesic) and reduces fever (antipyretic)

front 31

NSAIDs

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Anti inflammatory drugs that reduce prostaglandin synthesis and relieve pain fever and inflammation. Same thing as aspirin

front 32

Acetaminophen

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Analgesic and antipyretic drug but not anti inflammatory

front 33

NSAID COX-2 inhibitor

back 33

Anti-inflammatory and analgesic drug

front 34

Corticosteroids

back 34

Strong anti inflammatory drugs that decrease permeability and suppress immune response

front 35

Side effects of corticosteroids

back 35

Delayed healing, high blood glucose, fluid retention, tissue atrophy, adrenal suppression

front 36

RICE therapy

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Rest ice compression elevation used to reduce swelling and pain

front 37

Resolution healing

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Minimal tissue damage with complete return to normal structure

front 38

Regeneration healing

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Replacement of damaged tissue with identical new cells through mitosis

front 39

Replacement healing

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Extensive damage repaired by connective tissue forming scar

front 40

Healing by first intention

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Clean wound with edges close together minimal inflammation and small scar

front 41

Healing by second intention

back 41

Large wound with more inflammation slower healing and greater scar formation

front 42

Healing process

back 42

1. Injury 2. Blood clot forms and seals area 3. Inflammation develops in surrounding area 4. Granulation tissue grows into gap 5. Epithelial cells undergo mitosis, closing wound while granulation tissue forms 6. Fibroblasts and connective tissue cells enter area, producing collagen 7. Scar tissue remains, non-functional with no specialized structures

front 43

Granulation tissue

back 43

Fragile vascular connective tissue that fills wound during healing

front 44

Role of fibroblasts in healing

back 44

Produce collagen that strengthens repaired tissue

front 45

Scar tissue characteristics

back 45

Nonfunctional fibrous tissue lacking specialized structures

front 46

Factors that promote healing

back 46

Youth, good nutrition, adequate hemoglobin, effective circulation, clean wound, absence of infection

front 47

Example good nutrition factor

back 47

Protein and vitamins A and C support collagen formation and tissue repair

front 48

Factors delaying healing

back 48

Old age, poor nutrition, anemia, diabetes, infection, radiation, chemotherapy, prolonged steroid use

front 49

Contracture

back 49

Shrinking nonelastic scar tissue causing joint deformity or restricted movement

front 50

Stenosis

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Narrowing of tubes or ducts caused by scar tissue

front 51

Adhesions

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Bands of scar tissue joining surfaces that normally move freely

front 52

Hypertrophic scar

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Excess collagen forming raised thick scar

front 53

Keloid

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Excessive overgrowth of scar tissue beyond wound margins

front 54

Ulceration

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Impaired blood supply around scar area

front 55

Burn

back 55

Thermal electrical or chemical injury causing acute inflammation and tissue destruction

front 56

First degree burn

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Superficial burn affecting epidermis only and healing without scar

front 57

Second degree burn

back 57

Partial thickness burn affecting epidermis and part of dermis causing blisters pain and possible scarring

front 58

Third degree burn

back 58

Full thickness burn destroying all skin layers often charred and requiring grafting

front 59

Rule of nines

back 59

Method estimating percent body surface area burned

front 60

Eschar

back 60

Dead coagulated tissue forming hard crust over full thickness burn

front 61

Escharotomy

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Surgical incision through eschar (damaged tissue) to relieve pressure and restore circulation

front 62

Major burn complication hypovolemic shock

back 62

Loss of fluid and protein from bloodstream decreases blood volume and pressure

front 63

Major burn complication infection

back 63

Loss of skin barrier increases risk of bacterial invasion

front 64

Burn hypermetabolism

back 64

Increased metabolic demand requiring more protein and calories

front 65

Reason burn healing difficult fluid loss

back 65

Massive fluid and protein leakage causes shock and tissue damage

front 66

Reason burn healing difficult tissue destruction

back 66

Extensive loss of regenerative structures requires grafting and prolonged repair

front 67

Skin graft

back 67

Transplantation of skin to cover large burn wounds and promote healing

front 68

Compression garments

back 68

Used after burns to reduce hypertrophic scar formation