NJDS Pathology - The Host Response to Injury V: Local and General Effects of Injury and Inflammation

1. Vacular permeability normal

2. ↓ protein fluid; mostly ALBUMIN

3. Essentially an ultrafiltrate of blood plasma

1. Involved in ↑ vascular permeability

2. ↑ protein fluid

3. SEROUS exudate - relatively lower protein content, watery, few cells and occurs in blisters

4. FIBRINOUS exudate - higher protein content especially fibrin, few cells, found in fibrinous pericarditis

5. PURULENT exudate - ↑ protein content, thick fluid, contains luekocytes and tissue debris, like in abcess

- Resolution - exudate is absorbed by lymphatics and typically involves serous exudates

- Organization and Fibroplasia - exudates partially/completely replaced by fibrbrous tissue and typically involves fibrinopurulent exudate

Serous exudate with RBC's

1. Localized accumulation of fluid within/imediately below epithelium of skin

2. Filled with serous exudate

3. Due to friction, burns, virus, autoimmune disease

4. VESICLE - small blister, BULLA - large blister

5. Ex: herpes simplex virus, and autoimmune disorders like pemphigus vulgaris and pemphigoid

1. Localized acute inflammation with LIQUEFACTIVE necrosis, tissue destruction, and PURULENT exudate

2. Caused by pyogenic bacteria like staphylococcus, chlamydia, gonorrhea, and streptecoccous

3. Fibrous tissue may surround it in persistent abscesses

4. Pus drainage maybe needed for healing

1. Diffuse spreading of acute inflammtion of skin and underlying structures

2. Due to bacterial LYSINS like hyaluroniase, collagenase, elastase

3. Occurs on FACE and PERIORBITAL region

1. Open sores of localized tissue loss containing fibrinopurulent exudate

2. Ex: duodenal ulcer, cutaneous "stasis" ulcer, oral apthous ulcer

4. Caused by trauma, toxins, ischemia, nutritional deficiency and immune dysfunction

5. May be shallow or deep; surface loss of epithelium known as EROSION

6. Healing occurs through the base of the defect

7. May be due to VITAMIN B12 deficiency

8. Pressure ulcers from bedridden patients can occur due to ischemia and hypoxia

1. Incrase in body temperature

2. FEBRILE - people with fever; AFEBRILE - people w/o fever

3. ↑ in temp due to release of PYROGENS into circulation

4. Pyrogens IL-1, IL-6, TNF ⇒ affect hypothalamus ⇒ ↑ PGE-2 release ⇒ ↑ vasocontriction ⇒ ↑ heat retention

5. New thermoregulatory set-point causes present body temp to be perceived as hypothermic - thus ↑ shivering occurs to raise body temp to new set point

6. Vasodilation (heat loss) and sweating counteracts fever

1. Elevation of white cells in circulating blood

2. LEUKEMOID REACTION - when white cell number increases over 100,000/mm3 and blood resemebles that of leukemia

3. NEUTROPHILIA - occurs in acute inflammatory process but especially in PYOGENIC BACTERIAL infections

4. EOSINOPHILIA - occurs in allergic reactions, asthma, and parasitic infections

5. Lymphocytosis occurs in viral infections

1. Malaise (overall not feeling good)

2. Altered sleep patterns

3. Loss of apetite

4. ↑ protein sysnthesis in liver (C-reative proteins, C-RP)

5. ↑ erythrocyte sedimentation rate (ESR) due to fibrinogen causing RBC's to be stuck like a stack of coins (ROULEAUX)