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What are some examples of mechanical barriers?
Examples of mechanical barriers include skin, mucous membranes and secretions
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What is the first line of defense?
Mechanical Barriers
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Inflammation is caused primarily by what?
Inflammation is primarily caused by the release of histamine and heparin from mast cells and basophils
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What is pyrexia caused by?
Fever (pyrexia) is caused by pyrogens’ direct action on the hypothalamus.
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What does the fever do?
A fever can increase mobility and phagocytosis in leukocytes, as well as decrease endotoxin effects of pathogens
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What are the only non specific defense lymphocytes?
Natural Killer (NK) cells are the only lymphocyte placed in the non-specific defense classification; normally on constant immunological surveillance, they are activated by cytokines to lyse any cell that does not produce the “self” surface protein (e.g., cancer cells).
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What are some nonspecific defense WBCs?
Phagocytosis is the process by which neutrophils (a leukocyte) and macrophages, the “vulture cells,” randomly engulf and destroy bacteria, cell debris, or foreign matter
- Macrophages-Monocytes (free monocytes)
- Microphages- Neutrophils, granulocytes
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What are some examples of specific defense cells?
- B cells (antibodies)
- T cells (sensitization)
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What is a chemical released into the body during inflammation response or immune response?
Chemical mediator
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What is a common protein making up connective tissue and bone?
Collagen
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What is a fluid which accumulates and may leak from tissue?
Exudate
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What is the rate at which RBCs settle out of a blood specimen?
ESR- Erythrocyte Sedimentation Rate
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What is a plasma protein that is formed into solid strands during clotting?
Fibrinogen
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What steroid hormones increase blood glucose levels which decrease inflammation
glucocorticoids
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What is newly developed fragile tissue that consists of fibroblasts and many vessels?
Granular tissue
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What is the pressure pertaining to pressure of liquids in equilibrium and to pressure exerted on liquirds?
Hydrostatic pressure
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What is the area in a joint space or cavity?
Intraarticular
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What are cell enzymes specific to certain organs, that differ slightly in structure but have similar FXs?
Isoenzymes
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What is a monocyte that has left the circulation and settled and matured in a tissue?
Macrophage
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What is a granular WBC, most common type and responsible for much of the bodys protection?
Neutrophils
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What is the force to which a solvent, usually water passes through a semi permeable membrane?
Osmotic pressure
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What means like pus (contains microbes, WBC and tissue?)
Purulent
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What is tissue repair through replacement by identical function cells
regeneration
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What is tissue repair of restoration of a structure to original position
Replacement
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What is decomposition, absorption or breaking down the products of inflammation?
Resolution
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What is stenosis?
Narrowing of a tube
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what is the reticuloendothelial system?
is the total combination of monocytes, mobile/tissue macrophages, and specialized endothelial cells found throughout the body.
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All macrophages are derived from?
Monocytes
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What are some types of macrophages?
free and fixed macrophages, dendritic cells (connective and lymphatic tissue), histiocytes (connective tissue), osteoclasts (bone marrow), Kupffer cells (liver), microglial cells (nervous tissue), Langerhans cells (skin), mast cells, alveolar macrophages, and macrophages located in the Peyer’s patches of the intestines.
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Active immunity is initiated by...
an antigen
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A primary exposure is needed before the production of what from what?
Antibodies (immunoglobins) from B cells (plasma cells)
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What is the third line of defense for the body?
Specific defense
T cells and B cells
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Net hydrostatic pressure is...
Net hydrostatic pressure is the difference between the capillary hydrostatic pressure and the interstitial fluid hydrostatic pressure.
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Capillary hydrostatic pressure represents the...
decreasing blood pressure value as the distance from the heart increases.
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Interstitial fluid hydrostatic pressure represents...
the amount of atmospheric pressure of the tissue surrounding the capillary
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The HP is approximately __ mm Hg on the arterial end of the capillary and approximately __ mm Hg on the venous end of the capillary.
33
13
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Usually all capillaries are open/not open in a particular capillary bed unless the cells’ metabolic needs are not being met by the blood supply to the area.
not open
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__________composed of smooth muscle restrict blood flow through some channels.
pre capillary sphincters
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This is an equation to determine the movement of fluid across capillary membranes
the starling equation
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The net oncotic pressure remains relatively constant largely due to the presence of ...
plasma proteins (primarily albumin),
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How do plasma proteins keep oncotic pressure constant?
maintain osmotic pressure (forces drawing water across a semipermeable membrane from an area of low concentration to an area of higher concentration).
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Excess fluid and any proteins are recovered from the interstitial area by way of the...
lymphatic system and eventually returned to the general circulation.
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Edema is caused by what type of pressures?
Increased capillary pressure (hypertensions)
Decreased plasma oncotic pressure (loss of albumin)
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Dehydration is caused by what types of pressures?
Decreased capillary pressure (hypotension)
Increased Plasma oncotic pressure (high serum sodium)
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An immune reaction commonly causes inflammation due to the release of ______ by reactant cells and can be easily seen in a hypersensitive reaction such as anaphylaxis.
cytokines
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What are the five cardinal signs of inflammation
Dolor, calor, rubor, tumor, functio lasea
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What is inflammation?
A localized protective response which serves to squester (wall off) , destroy or dilute injurous agents.
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____________ a protein in the blood, which proliferates in response to IL-6 (produced primarily by macrophages), and binds to the surface of dead or dying cells in order to activate the complement system. C-reactive protein levels rise dramatically in response to inflammation.
C-reactive protein CRP
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What are the responses to tissue damage?
- 1. Immediate transient vasoconstriction
- 2. Local vasodialation
- 3. Hyperemia
- 4. Increased capillary permeability
- 5. Migration of leukocytes
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What are the four types of exudate?
- Serious-water
- Fibrinous- Thick/sticking and high in fibrin
- Purulent- Thick yellow-green pus
- Hemorrhagic- Blood vessel damage
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2. The local vasodilation is caused immediately by
histamine, potentiated (enhanced) by prostaglandins and bradykinins, and maintained by leukotrienes
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Serous exudate is mostly _________________, and is common with burns (often seen in blisters) and allergic reactions.
water with small amounts of proteins and WBCs
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What are some S/S of acute systemic inflammation?
- Fever
- Malaise
- headache
- fatigue
- anorexia
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When the inflammation process occurs at a large enough level, certain _________(e.g., IL-1, IL-6, TNF, etc.) are released into the bloodstream. _______ that act in this manner are referred to as ________.
- cytokines
- cytokinds
- pyrogens
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Where does the reaction take place in the blood-brain barrier and with what chemical?
phospholipase and cyclooxygenase-2 (COX-2)
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The reaction with Cox-2 and pyrogens create what chemical which has a direct effect on the hypothalamus?
PGE2
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The person will feel what when their temperature is rising?
Chills
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The person will feel what when their temperature is dropping?
Hot and sweatttaayyyy
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Fevers serve to...
Fevers serve to increase mobility of leukocytes, enhance phagocytosis, decrease endotoxin effects, and proliferate T cells.
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what are are very specific and sensitive indicators of damage to the myocardium.
Troponin, namely cardiac troponin I and T,
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A small mass of cells with a necrotic center is?
Granuloma
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Characteristics of chronic inflammation include
less swelling and exudate but the presence of more lymphocytes, macrophages, and fibroblasts (connective tissue cells) than in acute inflammation.
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Severity of burn depends on..
Temp and duration of contact
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Efffects of burns are
- Shock without bleeding
- Fluid Shift - Hypovolemia and hypotension
- Acute renal failure
- Protein shift- Increased hematocrit
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What happens to a burn patient's metabolism
Hypermetabolism
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COX-2 examples are
Mobic (meloxicam) and Celebrex (celecoxib).
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Long term steroid use can cause what?
These side effects consist of leukopenia (owing to atrophy of lymphoid tissue), catabolism (e.g., wasting, osteoporosis, epithelial thinning), delayed healing, growth retardation in children, and sodium/water retention leading to hypertension and edema.
Effects similar to cushings sydrome
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Corticosteroids, when used for more than ______, must also be given and discontinued in tapered doses, due to production (and lack thereof) of endogenous glucocorticoids.
10 days
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ASA is never recommended for what demographic and why>
Children with viral infections 12 and below due to reyes syndrome
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it is usually necessary to discontinue taking ASA for______before any surgical procedure to prevent excessive bleeding.
7-14 days
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______- takes place in areas where cell damage/death cannot be corrected by mitosis due to the nature of the tissue in which it lies. Instead, fibrous scar tissue develops with no original tissue function. Good examples of where replacement healing would take place are brain tissue and the myocardium
replacement
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_______is the process that occurs when there is minimal tissue damage. The damaged cells recover, and the tissue returns to normal within a short period of time; for example, after a mild sunburn.
resolution
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___________is the healing process that occurs in damaged tissue in which the cells are capable of mitosis. Some types of cells (e.g., epithelial cells) are constantly replicating, whereas other cells such as hepatocytes in the liver are able to undergo mitosis when necessary.
regeneration
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after injury _____________ is highly vascular and appears moist and pink or red in color. It contains many new capillary buds from the surrounding tissue.
Granulation tissue
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A large injury which takes lots of time to heal and leaves a large scar is what type of healing?
Secondary intention
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_______an event in which musculoskeletal function is impeded due to the presence of scar tissue, usually resulting in fixation and deformity of a joint.
Contracture
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If an Adult's entire back, and entire right arm is burnt, what BSA is this?
17%
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If the front of an adults face, the posterior aspect of his leg and only his abdomen are burnt, what percent?
22.5
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What is the primary cause of death in large fires?
Smoke inhalation
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Carbon monixide treatments are...
hyperbaric chamber and blood transfusion
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during burns A. Purulent exudate B. Blue-green color indicates infection by ...
pseudomonas aeruginosa.
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Many burn patients are placed on __________________To reduce incidence and severity of stress ulcers.
H2-blockers or proton pump inhibitors
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What kind of dressing is satisfactory for a small burn
non stick dressings
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for smaller areas, where non stick dressings dont suffice, what is the way to cover the burn?
skin grafts
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What is used for major burns? Covering?
Biosynthetic skin replacement
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What are common with burn patients after they heal
hypertrophic scarring
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