Ch 14 Inflammation, Tissue, Repair, Wound Healing

• cells of inflammation: WBC
• vascular stage: change in blood vessels, vasodilation, increase permeabilt for immune cells + exudate
• cellular stage: migration of WBC to area, phagocytosis
• inflammatory mediators: cytokines and chemokines relased
• local manifestation: swelling, loss of function

• a.Nonspecific Chronic Inflammation:
• -This refers to a prolonged and sustained inflammatory response that may occur when the acute phase is not effectively resolved or in certain chronic diseases.
• -Often associated with the proliferation of blood vessels (angiogenesis), tissue necrosis, and fibrosis (scarring). Fibroblast proliferation.
• Granulomatous Inflammation:

Characterized by the formation of granulomas (macrophages), which are aggregates of immune cells, often seen in chronic infections or immune-mediated diseases.

a.Acute-Phase Response:

• The body's systemic reaction to inflammation, involving changes in the levels of certain proteins in the blood, such as C-reactive protein, fibrinogen, erythrocyte sedimentation rate (ESR).
• White Blood Cell Response: Leukocytosis

An increase in the number of white blood cells (leukocytosis) in response to infection or inflammation.

• Neutrophils are the primary early arrival cells.
• Lymphadenitis:

Inflammation of lymph nodes, which may occur as a part of the body's immune response to infection.

a.Tissue Regeneration:

The process where damaged tissues are replaced by new, functional cells of the same type, without forming a scar. This is common in tissues with a high regenerative capacity, such as the liver and skin.

Fibrous Tissue Repair: In situations where tissue regeneration is not possible, the body undergoes fibrous tissue repair, leading to scar formation. Fibrous tissue repair replaces the damaged tissue with a scar. This process involves the deposition of collagen fibers to provide structural support

• Primary Intention: Occurs when the wound edges are close together, promoting faster healing with minimal tissue loss. Examples include surgical incisions and paper cuts.
• Secondary Intention: Involves a more prolonged healing process with the wound healing from the bottom up. This occurs in wounds with larger tissue gaps, such as ulcers or extensive injuries.

Inflammatory Phase: Involves hemostasis and inflammation to control bleeding and prevent infection.

Proliferative Phase: Focuses on rebuilding the damaged tissue through angiogenesis, collagen deposition, and the formation of granulation tissue.

Maturation (Remodeling) Phase: In this phase, the tissue undergoes remodeling as collagen fibers reorganize to strengthen the wound.

• Nutrition: Adequate nutrients, especially proteins and vitamins, are crucial for proper wound healing.
• Blood Supply: Sufficient blood flow is necessary to deliver nutrients and oxygen to the healing site.
• Infection: Infections can significantly impair the healing process.
• Systemic Factors: Conditions such as diabetes or immunodeficiency can impact wound healing.

Wound healing tends to be slower in the elderly due to factors such as reduced collagen synthesis, diminished immune response, and slower tissue regeneration.