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- Inflammatory Exudate
(5)- Fluid Exudate
(6)- Cellular Exudate

The first step of vascular reaction of acute inflammation is

Vasoconstriction
Vasodilatation
Vascular rupture
Vascular stenosis
Vascular thrombosis

Prostaglandins act as chemical mediator responsible for

Chemotaxis
Increased capillary permeability
Pain
Tissue damage
Vasoconstriction

6- Cellular Exudate

Cellular Exudate Formation: the inflammatory

cellular exudate occurs along the following steps:
(1) Margination of Leucocytes (Pavementing of leucocytes)

(2) Emigration of Leucocytes

(3) Diapedesis of Red Cells
Leukocyte Recruitment and activation:
Activated leukocyte products (lysosomal enzymes) destroy
microbes can also injure normal host tissues.

Mechanism of cellular exudate formation

(1) Margination, rolling, Pavementing, and adhesion
of leukocytes:
The poly-morph nuclear leucocytes leave the axial
blood stream due to stasis and settle on the sticky
endothelial lining of the capillaries.
(2) Emigration of Leucocytes: The polymorphonuclear
leucocytes push their way between the swollen
endothelial cells through the widened inter-endothelial
spaces by means of pseudopodia and pass outside, the
vessels by amoeboid movement.

(3) Passive pushing (Diapedesis) of Red Cells: Is the

mechanical pushing of the red cells which have a small
diameter by the intra-vascular hydrostatic pressure
through the widened inter-endothelial spaces.

Inflammatory cells
segmented nucleus
Neutrophils

Basophils

Eosinophils

(1) Phagocytosis
( Microphage)
(2) Neutralize the toxic
products of bacteria and
other microorganism.

basophiles and mast cells

release
(heparin/histamine)
in
response to antigenantibody complexes

Eosinophils serve to
degrade
chemical
mediators
(especially
histamine) by histinase

Inflammatory cells
MONONUCLEAR LEUKOCYTES
Lymphocytes

Plasma Cells

lymphocytes
function Plasma
cells
are
primarily in the immune committed to antibody
response (including both
the humoral (B) and cell- production Ig.
mediated immunity(T).

Monocytes

The primary function of

monocytes
is
phagocytosis and they
are termed the "second
line of cellular defense.
Macrophage

Chemotaxis
The attraction of leukocytes from vascular channels
towards the site of inflammation within the tissue
space guided by chemical gradients (including virus,
bacteria----- and cellular debris) is called chemotaxis.
All granulocytes, monocytes and to lesser extent
lymphocytes respond to chemotactic stimuli.

How do leukocytes "see" or "smell"

the chemotactic agent?
This is because receptors on cell
membrane of the leukocytes react with
the chemo-attractants resulting in the
activation of phospholipase C that
ultimately leads to release of calcium
ions and these ions trigger cell
movement towards the stimulus.

III. LOCAL REACTION OF TISSUE

HISTIOCYTES
Phagocytosis is the process of engulfment and
internalization by specialized cells, which
includes invading microorganisms, damaged
cells, and tissue debris.
These
phagocytic
cells
include
polymorphonuclear leukocytes, monocytes and
tissue macrophages.

Phagocytosis involves three distinct steps:

Recognition
Engulfment
Killing or degradation

Steps of Phagocytosis

Recognition
The material to be phagocytized is coated with certain
plasma proteins called opsonins. These opsonins
promote the adhesion between the particulate material
and the phagocytes cell membrane. The three major
opsonins are: immunoglobulin, complement and
carbohydrate-binding proteins.
Engulfment:
During engulfment, extension of the cytoplasm
(pseudopods) flow around the object to be engulfed,
eventually resulting in complete enclosure of the
particle within the phagosome.
Killing or degradation
The ultimate step in phagocytosis of bacteria is killing
and degradation

Mechanism of Phagocytosis

Sequels of phagocytosis

(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