Download - Inflammation acute inflammation
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Inflammation- Acute Inflammation
Prepared by/ Mohamed Hassany AliB.Sc.
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Inflammation:
• When living tissue is damaged, a series of local processes are initiated in order to contain the offensive agent, to neutralize its effect, to limit spread and hopefully to eradicate.
• So, we can define it as :The mechanism by which the body deals with an
injury. Tissue injury stimulates inflammation.Inflammation known by Suffix “itis”.
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Signs and Symptoms:
• Rubor: redness• Calor: heat• Dolor: pain• Tumor: Swelling• Functio Laesae : loss of function
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Types of Inflammation:
• Acute inflammation• Chronic inflammation
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Acute inflammation:
• short duration, lasting from a few minutes to a few days and the cellular exudate is rich in neutrophil polymorphonuclear leucocytes with some macrophages arriving after the initial insult.
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Process of Acute inf.
• Microvasculature (vascular change)• Cellular mediators (cellular change)
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Microvasculature
• Vasodialation: increase the blood flow rate causing redness and heat.
• Permiability: of vessels causing swelling by outpouring of extracellular excudate. And the affected part lose the ability of proper function.
• Chemical mediator: and the stretching of tissue by exudate cause pain.
• exudate is the fluid within the extravascular spaces which is rich in protein and hence has a specific gravity of greater than 1.020.
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Cellular mediators:
• Leukocytes ingest offending agents, kill bacteria and other microbes, And get rid of necrotic tissue and foreign substances.
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This animation demonstrates the actions of neutrophils in the acute inflammatory process.
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As in the preceding diagram, here PMN's that are marginated along the dilated venule wall (arrow) are squeezing through the basement membrane (the process of diapedesis) and spilling out into extravascular space.
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Acute inflammatory cells:
• In most forms of acute inflammation, neutrophils predominate in the inflammatory infiltrate during the first 6 to 24 hours, then are replaced by monocytes in 24 to 48 hours.
• In viral infections: lymphocytes• In hypersensitivity reactions: eosinophils
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Neutrophils:
• Most abundant granulocyte and resembles (40-75%) of white blood cells in all mammals.
• Containing nucleus of 2-5 lobes.• Named due to H&E staining as it stains by neutral pink.• Polymorphonuclear cell.• Bacterial killing and phagocytosis.• Bone marrow origin.
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Eosinophils:
• Common in Allergic and parasites condition.• Named due to H&E staining as it stains by bright red
(acid-loving).• Resemble 1-6 % in normal persons.• Contain large granules.• Have two lobes.
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Basophils:
• Resembles less than 1% of all leukocytes.• Have large granules contain Histamine that cause
vasodialation.• Named due to H&E staining as it stains by dark blue
(Alkali-loving).• Bone marrow origin
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Lymphocyte:
• Agranulocyte with clear cytoplasm.• Have three types: (T cells, B cells and NK cells).• Resembles 25-35%• T cells: recognition, killing and regulation of immune
system.• Lymphoid tissue and thymus origin.• B cells: give rise to plasma cells.• Lymphoid tissue and bone marrow origin
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Monocyte:
• Resembles 6-9% of all white blood cells.• Agranulocyte large cell.• Unilobar nucleus.• Migrates to tissues to become macrophage which capable
of phagocytosis.• Bone marrow origin
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Plasma cell:
• Secretes large volumes of antibodies.• Lymphoid tissue and bone marrow origin.
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Pus cell:
a necrotic polymorphonuclear leucocyte, a major component of pus. Also called pus corpuscle.
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Acute inflammation, cytology:
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Types of Acute inflammation:
• Suppurative Acute inflammation “pus formation”.• Non suppurative Acute inflammation “no pus formation”.
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Types of suppurative inf.
• Localized• Diffuse
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Acute suppurative Inflammation:
• Def. : severe acute inf. Characterized by Pus formation.
• Causes: Pyogenic microorganisms like:» Staphylococcus aureus.» Streptococcus haemolyticus.» Pneumococcus.» Bacillus coli.
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Pus:
• Composition of Pus:– Living and dead bacteria and their toxins.– Liquefied necrotic tissue.– Cellular exudate: leucocytes, pus cells, macrophages and RBCs.– Inflammatory tissue exudate.
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Abscess:
• Acute localized suppurative inflammation.• Site: any tissue.• Cause: staphylococcus aureus
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Abscess
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Abscess
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Abscess, Brain
• Abscess is an exudative purulent localized inflammation. • In the white matter, a recent abscess consisting in pus :
neutrophils (normal or in lisis), fibrin, necrotic debris, germs. Vessels present congestion and important perivascular edema.
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Abscess, Brain
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Acute pyelonephritis
• is an acute suppurative inflammation of the kidney caused by bacterial infections (Escherichia coli in 70 - 80 % of cases, Proteus mirabilis, Klebsiella pneumoniae, Enterococus fecalis, Staphylococcus).
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Microscopic:
• The renal presents abscesses (suppurative necrosis), consisting of purulent exudate (pus) :
• neutrophils, fibrin, cell debris and central germ colonies (hematoxylinophils).
• Tubules are damaged by exudate and may contain neutrophil casts, which can be found in urine. In the early stages, glomeruli and vessels are spared.
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Acute Pyelonephritis
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Acute suppurative:
• The general morphology of a suppurative inflammation typically involves several layers:
A necrotic zone is a central focus of proteolytic liquefaction with lipid- rich detritus producing yellowish pus.A pus zone contains large numbers of neutrophils and surrounds the
central necrotic area.A hyperemic zone with perifocal edema of serous exudate is also
present.
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Acute suppurative appendicitis:
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Acute suppurative tonsillitis
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Purulent meningitis
• Purulent leptomeningitis (suppurative leptomeningitis) is a diffuse purulent inflammation.
• The leptomeninges (arachnoida and piamater) contain purulent exudate (pus): leukocytes (neutrophils), fibrin, germs, proteins, necrotic debris. Blood vessels in the subarachnoidian space and those intracerebral are congested and neutrophil margination is present.
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Purulent meningitis
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Acute non-suppurative:
1. Catarrhal Inflammation: mucous membrane.2. Membranous Inflammation.3. Sero-fibrinous Inflammation.4. Fibrinous Inflammation.5. Serous Inflammation.6. Haemorrahgic Inflammation.7. Necrotizing Inflammation.8. Allergic Inflammation.
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Catarrhal Inflammation:
• Def. Acute non-suppurative secreting exudate rich in mucin.
• Site: GIT, Nose.• Ex: Catarrhal rhinitis• Causes: Common cold virus.
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Catarrhal rhinitis:
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Hemorrhagic inflammation:
• Definition: Acute inflammation involving microvascular injury with massive microvascular bleeding, producing an exudate with a high erythrocyte content ( A).
• Biologic purpose: Exudative inflammation despite severe vascular injury.
• Morphology: The inflamed area is usually necrotic and filled with blood.
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Hemorrhagic Inflammation
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Fibrinous inflammation:• Definition: Acute inflammation with exudation of fibrinogen-containing
serum that polymerizes to fibrin outside the blood vessels ( A, B). Here the exudate takes the form of serum- containing fibrinogen.
• Biologic purpose: Immediate temporary barrier against additional effects of inflammation.
• Etiologic factors include:Infectious toxic tissue injury;Tissue injury from physical trauma;Chemical and toxic tissue injury;Excretion of toxic metabolites (uremic toxins);Ischemic tissue injury.
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Fibrinous inflammation
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Fibrinous pericarditis
• Fibrinous pericarditis is an exudative inflammation. The visceral pericardium (epicardium) is infiltrated by the fibrinous exudate.
• This consists in fibrin strands and leukocytes. Fibrin describes an eosinophilic (pink) network, amorphous.
• Leukocytes (mainly, neutrophils) are found within the fibrin.
• Vascular congestion is also present.
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Fibrinous Pericarditis
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Fibrinous Pericarditis
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Psedomembranous inf:
• Acute non-suppurative inflammation charactrized by exudate rich in membrane-like material.
• Site: mucous membrane, GIT, upper respiratory tract.• Cause: Diphtheria bacilli
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Pseudomembranous Diphtheria
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Pseudomembranous colitis
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Necrotizing inflammation:
• Definition: Acute inflammation in which tissue necrosis predominates.
• Several types are differentiated according to demarcation of the inflammation or infestation with putrefactive bacteria. These include:
Ulcerous necrotizing type;Diffuse necrotizing type;Nonreactive necrotizing type;Gangrenous type.
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Necrotizing inflammation
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