Porth Chapter 14

Question 1

Cardinal signs of inflammation

Answer 1

1. rubor (redness)
2. tumor (swelling)
3. calor (heat)
4. dolor (pain)
5. functio laesa (loss of function)

Question 2

Factors involved in protective responses and bodily repair

Answer 2

1. inflammatory reaction
2. immune response
3. tissue repair and wound healing

Question 3

Causes of Inflammation

Answer 3

1. immune response to infectious organisms
2. trauma
3. surgery
4. caustic chemicals
5. extremes of heat and cold
6. ischemic damage to body tissues

Question 4

Granulomatous Inflammation

Answer 4

Associated with foreign bodies such as:

1. splinters
2. sutures
3. silica, asbestos

Associated with microorganisms that cause:

1. tuberculosis
2. syphilis, sarcoidosis
3. deep fungal infections
4. brucellosis

Question 5

Vascular changes that may occur with inflammation

Answer 5

1. An immediate transient response - occurs with minor injury
2. An immediate sustained response - occurs with more serious injury and continues for several days and damages the vessels in the area
3. A delayed hemodynamic response - involves an increase capillary permeability that occurs 4 to 24 hours after injury

Question 6

Cellular stage of acute inflammation

Answer 6

marked by movement of phagocytic white blood cells (leukocytes) into the area of injury; two types of leukocytes participate in the acute inflammatory response:

1. granulocytes (neutrophils, eosinophils, and basophils)
2. monocytes (the largest of the white blood cells)

Question 7

Direction of cellular response

Answer 7

1. margination, adhesion, transmigration
   - cytokines
2. adhesion molecules
   - selectins, integrins, and immunoglobulin
   - initiation of adhesion
   - aggregation of inflammatory cells
   - movement into underlying tissue

Question 8

Inflammatory mediators

Answer 8

1. histamine
2. cytokines
3. arachidonic acid metabolites
   - eicosanoids (prostaglandins, leukotrienes, Omega-3 polyunsaturated fatty acids)
4. platelet-activating factor
5. plasma proteins

Question 9

Classification of Inflammatory mediators by function

Answer 9

1. those with vasoactive and smooth muscle-constricting properties
2. chemotactic factors such as complement fragments and cytokines
3. plasma proteases that can activate complement and components of the clotting system
4. reactive molecules and cytokines liberated from leukocytes, which when released into the extracellular environment can damage the surrounding tissue

Question 10

Serous exudates

Answer 10

watery fluids low in protein content, result from plasma entering the inflammatory site

Question 11

hemorrhagic exudates

Answer 11

occur when there is severe tissue injury that causes damage to blood vessels or when there is significant leakage of red cells from the capillaries

Question 12

membranous or pseudomembranous exudates

Answer 12

develop on mucous membrane surfaces, are composed of necrotic cells enmeshed in a fibropurulent exudate

Question 13

purulent or suppurative exudates

Answer 13

contain pus; composed of degraded white blood cells, proteins, and tissue debris

Question 14

fibrinous exudates

Answer 14

contain large amounts of fibrinogen and form a thick and sticky meshwork

Question 15

acute inflammation

Answer 15

short duration; nonspecific early response to injury; aimed primarily at removing the injurious agent and limiting tissue damage; self limited; infiltration of neutrophils; exudate

Question 16

chronic inflammation

Answer 16

longer duration lasting for days to years; a recurrent or progressive acute inflammatory process or a low-grade smoldering response that fails to evoke an acute response; self-perpetuating; infiltration by mononuclear cells (macrophages) and lymphocytes; proliferation of fibroblasts

Question 17

Most prominent systemic manifestations of inflammation

Answer 17

acute-phase response; alterations in white blood cell count (leukocytosis and leukopenia)

Question 18

Parenchymal

Answer 18

tissues contain the functioning cells of an organ or body part (hepatocytes, renal tubular cells)

Question 19

Stromal tissues

Answer 19

consist of the supporting connective tissues, blood vessels, extracellular matrix, and nerve fibers

Question 20

Labile

Answer 20

continue to divide and replicate throughout life, replacing cells that are continually being destroyed

Question 21

Stable

Answer 21

normally stop dividing when growth ceases

Question 22

Permanent cells

Answer 22

cannot undergo mitotic division

Question 23

healing objective

Answer 23

to fill the gap created by tissue destruction and to restore the structural continuity

Question 24

primary healing

Answer 24

small, clean wound

Question 25

secondary healing

Answer 25

great loss of tissue with contamination

Question 26

components of Extracellular matrix

Answer 26

1. fibrous structural proteins - collagen and elastin fibers 2. water-hydrated gels that permit resilience and lubrication - proteoglycans and hyaluronic acid 3. adhesive glycoproteins that connect the matrix elements to each other and to cells - fibronectin and laminin

Question 27

basement membrane (ECM)

Answer 27

surrounds epithelial, endothelial, and smooth muscle cells

Question 28

interstitial matrix (ECM)

Answer 28

present in the spaces between cells the connective tissue and between the epithelium and supporting cells of blood vessels

Question 29

steps in development of a new capillary vessel

Answer 29

1. proteolytic degradation of the parent vessel basement membrane, allowing for formation of a capillary sprout 2. migration of endothelial cells from the original capillary toward an angiogenic stimuli 3. proliferation of the endothelial cells behind the leading edge of the migrating cells 4. maturation of the endothelial cells and proliferation of pericytes (for capillaries) and smooth muscle cells (for larger vessels)

Question 30

factors regulating the healing process

Answer 30

action of chemical mediators and growth factors that mediate the healing process; interactions between the extracellular and cell matrix

Question 31

two phases of scar formation

Answer 31

1. emigration and proliferation of fibroblasts into the site of injury; deposition of the ECM by these cells

Question 32

causes of impaired wound healing

Answer 32

malnutrition, impaired blood flow and oxygen delivery, impaired imflammatory and immu

Question 33

causes of impaired wound healing

Answer 33

malnutrition, impaired blood flow and oxygen delivery, impaired inflammatory and immune responses, infection, wound separation, foreign bodies, age effects