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Inflammation is magnified in tissues with _____________, such as... (3)
high microvascular blood flow; brain, heart, lung
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Inflammatory reactions are oriented around ________ and the _____________.
blood vessels; adjacent mesenchymal tissues
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Inflammation must occur in ____________.
living tissues
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5 hallmarks of inflammation.
redness (rubor), swelling (tumor), heat (calore), pain (dolore), loss of function (functio laesa)
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5 etiologies of inflammation.
immunologic responses, living agents, mechanical damage, oncotic necrosis, xenobiotic chemicals
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Morphologic features of inflammation. (6)
damage tissues (necrosis, sometimes degeneration), inflammatory cells, inciting cause, altered regional circulation (hyperemia), fluid exudate, proliferation of parenchyma and stroma
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Inflammation is minimal in ____________.
poorly vascularized tissues
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Local vascular responses are modulated by... (2)
direct endothelial damage, release of vascular mediators from inflammatory cells
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The most critical initiating event of local vascular responses to inflammation.
direct endothelial damage
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The activation target of many inflammatory mediators are the _____________ in _______________.
contractile elements; endothelia and vascular smooth muscle cells
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___________ is the most important factor for acute inflammations.
Fluid exudation
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_____________ is the most important factor for chronic inflammations.
Cell proliferation
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Peracute inflammation is ________, and there are ____________ changes.
1-24 hours; fluid and vascular
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Acute inflammation is _________, and there are ______________ changes.
2-5 days; vascular, fluid, and cell (PMNs)
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Subacute is ___________, and there are ______________ changes.
7-14 days; predominantly lymphocytes and macs, beginning proliferation of angioblasts and fibroblasts
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Chronic is _________, and there are _______________ changes.
>14 days; cell infiltrate (macs, lymphs, plasma cells), proliferation of fibroblasts, angioblasts, parenchyma is well advanced, tissue is disfigured
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With chronic active inflammation, there is _____________ with an ongoing _______________.
chronic inflammation; acute response (PMNs)
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Exudative inflammation is defined by its ____________.
vascular response
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5 types of exudative inflammation.
serous, fibrinous, suppurative, hemorrhagic, catarrhal
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Proliferative inflammation is a _____________ reaction, causing ____________.
granulomatous; granulation tissue
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3 presentations of acute mixed inflammation.
serofibrinous, fibrinopurulent, mucopurulent
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2 presentations of mixed acute and chronic inflammation.
chronic suppurative, pyogranulomatous
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A surface inflammatory process that penetrates into the epithelial layer and has a pale lesion bed that does not bleed.
erosive
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A surface inflammatory process that penetrates through the epithelial layer and has a red and raw wound.
ulcerative
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A process where necrosis is a major part of the process.
necrotizing
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Inflammation is essential for ______________, but it is detrimental in that it can ________________.
suppression of microbes; cause excessive host tissue destruction
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Type of acute inflammation in which the exudate includes substantial mucus from inflamed epithelia.
catarrhal
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Type of acute inflammation in which the exudate includes many PMNs.
suppurative (purulent)
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Type of subacute inflammation in which exudate includes mainly lymphocytes.
nonsuppurative
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Type of subacute inflammation in which exudate includes lymphocytes and locally made plasma cells.
lymphoplasmacytic
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4 types of chronic inflammation.
nonsuppurative, lymphoplasmacytic, granulomatous, granulation tissue
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Type of chronic active inflammation in which exudate includes macrophages and PMNs.
pyogranulomatous
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Neutrophils have a ___________ nucleus in mature cells; immature cells are __________; the cytoplasm is ___(2)___.
segmented; bands; pale pink with granules
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____________ are the first responders of the innate immune system, especially against ___________.
Neutrophils; bacteria
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What are the 2 distinct pools of neutrophils?
circulating, marginating
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What are the antimicrobial functions of neutrophils? (2)
phagocytosis, tissue digestion
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Neutrophil function is reduced in ___________ environments.
acidic (pH< 6.8)
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Function of neutrophils is controlled by __________ and _________.
B cells (Ab); T cells (cytokines)
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_______________ is the predominant inflammatory cell component in purulent and suppurative inflammations.
Neutrophilic leukocytosis
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Monocytes are the __________ form.
circulating
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Inactive monocyte descendants in tissue interstitial spaces; indistinguishable from fibroblasts.
histiocytes
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Dendritic cells are __________ that are _____________.
macrophages; professional APCs
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_____________ are the main phagocytic form in tissues.
Macrophages
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A specialized form of macrophage in wounds to facilitate debris removal and wound repair.
fibrocyte
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The nucleus of monocytes/macs is ___(2)___; the cytoplasm is _________ with __(2)__.
large and oval; pink; granules and vacuoles
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The cytoplasmic borders of hitsiocytes are __________.
often indistinct
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What type of monocyte/mac may fuse to form multinucleated giant cells?
epithelioid (activated) macrophages
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____________ are the main late responders of the innate immune system.
Macrophages
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Macrophages bridge the gap b/w the initial __________ and the rise of the _________.
neutrophil flood; adaptive IR
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Macrophages are prominent players in ____________ reactions.
granulomatous
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What are the antimicrobial functions of monocytes/macrophages? (2)
phagocytosis, tissue degradation
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Macs are courses of many ______(2)______.
cytokines and growth factors
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Macrophages can remain active in ___________ environments, which are predominant in chronic inflammatory reactions.
acidic
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____________ are the primary drivers of the acquired immune response.
Lymphocytes
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Type of lymphocyte that is an effector that tends to stay at the site of differentiation.
B cells
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Type of lymphocyte that control immune responses.
T cells
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The nucleus of lymphocytes is ___(4)___; they cytoplasm is __(2)__.
round, monomorphic, basophilic, and eccentric; scant, basophilic
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Lymphocytes dominate in _____________ lesions.
nonsuppurative inflammatory
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Lymphocytes orient to the _________ of __________ inflammatory lesions.
periphery; more chronic
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Phenomenon describing the the fact that lymphocytes may get no further than the vascular adventitial spaces due to their limited motility.
perivascular cuffing
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What are the main functions of lymphocytes? (3)
recognize, response, and remember non-self Ag
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What are the common sites of nonsuppurative inflammation? (7)
cutaneous and mucosal surfaces, CNS, autoimmune disease, neoplasms, transplants, viral infections
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Mediate cytotoxic responses directed against intracellular pathogens.
Th1
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Mediate antibody production against extracellular pathogens and bacterial toxins.
Th2
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Mediate anti-microbial immunity at epithelial/mucosal surfaces.
Th17
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Cytotoxic innate immune cell that can kills pathogens without prior immune exposure and do no require MHC.
NK cells
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Major effectors in anaphylactic reactions, hypersensitivity disease, and metazoan parasite infections.
eosinophils
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Eosinophils secrete ___________ that suppress _____________.
prostaglandins; mast cell degranulation
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Granules of eosinophils are rich in... (3)
major basic protein, histiminase, and peroxidase/phospholipase that antagonize mast cell products
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Mast cells are found in ______________; they play a direct role in regulation of _____________; they play an indirect role in control of ___________; they also produce _______ to stimulate a Th2 response.
connective tissues; regional blood flow; secretions from intestine and pulmonary tract; IL-4
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Endothelia express _________ in response to pro-inflammatory cytokines.
adhesins
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The endothelial basement membrane provides a hold for _____________ and a substrate for launching the ______________.
transmigrating inflammatory cells; coagulation cascade
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The endothelium is an important source of _________ for the clotting cascade and ___________ to oppose pro-coagulant platelets.
Factor VIII; prostaglandins
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Fibroblasts can live in environments with ______________.
low oxygen tension
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Sheets of plump fibroblasts in association with new capillaries and scattered inflammatory cells.
granulation tissue
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Dense connective tissue with few cells and essentially no inflammation; end stage.
fibrosis (cicatrix)
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Fibroblasts can act a ___________ to produce adipocytes, osteoblasts, and smooth muscle cells (metaplasia).
pluripotent stem cells
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Soluble substances that interact with cell receptors to induce biological responses.
mediators
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What are the 3 general functions of mediators?
vasoactive, chemotactic, or opsonizing agents
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Soluble substances that interact with cell receptors to induce biological responses.
cytokines
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The predominant roles of cytokines are __________, including... (3)
anabolic; differentiation, growth, proliferation
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Two functions of cytokines.
pro-inflammatory (regulate acute inflammation), proliferative (prominent in chronic inflammation and repair)
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Soluble heparin-binding polypeptides from inflammatory cells and parenchymal cells that attract and sometimes also activate leukocytes.
chemokines
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-C-X-C are ______ family chemokines that are chemotactic for _______.
alpha; PMNs
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-X-C-C-X are _______ family chemokines that are chemotactic for ____(3)____.
beta; monocytes, eosinophils, and basophils
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-C- are ________ family chemokines that are chemotactic for ____(2)____.
gamma; lymphocytes and NK cells
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___________ but not __________ facilitate cell proliferation and differentiation, tend to be pre-formed, and act on both differentiated and stem cell populations.
Cytokines; mediators
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Major classes of cytokines involved in chronic inflammation. (5)
CSF, IFN, IL, TGF, TNF
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