INFLAMMATION

(A) Acute Inflammation

It is characterized by the presence of fluid exudate,
fibrin threads and leucocytes and caused by an irritant
of short duration.

The acute inflammatory reaction consists of:

I. Local tissue damage.

II. Local vascular reactions.
III. Local reaction of histocytes.

 The hotness found in the inflamed area is resulted

from:
Vasoconstriction of arterioles
Vasoconstriction of venules
Vasodilatation of arterioles
Vasodilatation of venules
Vasostenosis
Pyrogenic substances are released from the bacteria,
virus and dead leucocytes responsible for;
Fever
Loss of function
Oedema
Pain
Redness

I-LOCAL TISSUE DAMAGE

Occurs at the centre of the inflamed area as the
causative agent is at its maximum action. The
central cells are killed, i.e. necrosis.
This local damage of cells together with the
inflammatory agent trigger the release and
activation of chemical substances called chemical
mediators.
These chemical mediators play an important role in
promoting the vascular and cellular changes in the
inflamed area.

Chemical mediators of inflammation

II. Local vascular reactions.

A- Transient Vasoconstriction
(1) Transient Constriction of the Blood Vessels
(2) Transient rapid blood flow

B- Persistence Vasodilatation
(3) Dilatation of the Blood Vessels
(4) Slowing of the Blood Stream (Stasis)

C(5)-

Inflammatory

(6)- Cellular Exudate

Fluid

Exudate
Exudate

II. LOCAL VASCULAR REACTIONS

A- Transient Vasoconstriction
(1) Transient Constriction of
the Blood Vessels: Caused
by a direct stimulating action
of the irritant on the vascular
wall.
Vasoconstriction
is
a
protective mechanism and
lasts for seconds to minutes
only.

(2) Transient rapid

flow:
resulted
vasoconstriction of
vessels

blood
from
blood

B- Persistence Vasodilatation

(3) Dilatation of the Blood Vessels:

a-Direct action of histamine on the
vascular wall.
b-The dilatation of the arterioles and
capillaries with increase in the blood
flow is called active hyperaemia.
c-The inflamed area becomes red and
hot.
(4) Slowing of the Blood Stream (Stasis):
Caused by:
(a) Increased viscosity of the blood
(the red blood cells become more
concentrated) due to increase of
permeability of the blood vessels and
formation of the inflammatory fluid
exudate (protein-rich fluid moves into
the extravascular tissues).
(b) Most of the capillaries in the inflamed
area open and dilate.

Formation of transudates and exudates. A, Normal process (no fluid loss or gain)
B, A transudate is formed when fluid leaks out because of increased hydrostatic
pressure or decreased osmotic pressure. C, An exudate is formed in inflammation
because vascular permeability increases as a result of increased interendothelial
spaces

(c)

The Inflammatory Exudate

5- Fluid Exudate

Formation: The inflammatory fluid exudate

leaves the dilated capillaries and venules due to:
(1) Increased vascular permeability to plasma and its
proteins caused by histamine and kinins is the main
cause.
(2) Increased capillary hydrostatic pressure due to
dilatation of the arterioles and increased blood flow.
(3) Increased osmotic pressure of the interstitial tissue
fluid (decrease of intravascular colloid osmotic pressure)
. This acts as a suction force from the capillaries.
Intravascular
hydrostatic
pressure

Intravascular
Colloid osmotic
pressure

= Edema

Functions of Fluid Exudate

(1) It dilutes toxins, chemicals and poisons, so
minimizes their effects.
(2) Brings antibodies from the blood to the site
of inflammation.
(3) Supplies nutrition for the cells and carries
away waste products.
(4) Supplies fibrinogen which changes to fibrin.
Fibrin has the following functions:
(a) Forms a network upon macrophages move
towards the irritant.
(b). Forms a network upon which fibroblasts
proliferate and start healing.
(c) Localizes infection by surrounding the
inflamed area

(3) Neurofibromatosis
A
hereditary
familial
disease transmitted as a
dominant trait. The disease
is characterized by:
(a) Multiple neurofibromas
which appear as small firm
nodules in the skin along
the
course
of
the
cutaneous nerves.
(b) Cafe au lait skin
pigmentation.
(c)
Pigmented
iris
hamartomas called Lisch
nodules.
Malignant
tumours:
Malignant
Schwannoma
(neurofibrosarcoma).

Multiple neurofibromas

Cafe au lait skin

Plexiform Neurofibroma

Malignant Neurofibroma