Inflammation

Describe acute inflammation

Explain in detail the vascular events and cellular events
Define with examples the chemical mediators
Chronic Inflammation
Explain general and granulomatous inflammation in detail.
Explain the morphologic patterns of acute and chronic inflammation.
Healing And Repair
Explain the normal controls of healing and repair.
How the repair by connective tissue occur.
Explain wound healing in detail.

Inflammation
Inflammation: Local defense and protective response
against cell injury or irritation or Local vascular and
cellular reaction, against an irritant.

Irritating or injurious agents (Irritant)

Living:
Bacteria,
Fungi,
Virus,
Parasite
or their toxins

Non-Living:
Chemical
Physical
Mechanical

Inflammation is designated by adding the suffix (itis) to the end

of the name of the inflamed organ or tissue.

Types of inflammation

1) Acute
inflammation
2) Sub acute
inflammation:
rarely occur.

3) Chronic
inflammation

1. Acute inflammation
Macroscopic signs:
Symptoms
1) Redness:
2) Hotness:
3) Swelling:
4) Pain and tenderness:
5) Loss of function:

Microscopic signs:
Inflammatory response

1. Local
vascular
change

2. Formation of
inflammatory
exudate

Inflammatory response: (microscopic signs)

First: Local vascular changes:
1. Initial temporary vasoconstriction for few seconds.
2. Active vasodilatation of arterioles and capillaries (by
chemical mediators: Histamine) and passive dilatation of
venules. Increase in capillary permeability (fluid exudate to
the extravascular tissue) thus concentration of blood cells,
slowing of blood flow (stasis)
3. Pavmentation: the margination of leukocytes.
Normal

Inflammation

Second: Formation of inflammatory

exudates:

Immigration or infiltration of the various leukocytes, fluid

and plasma proteins outside the blood vessels into the
surrounding tissue without injury of the blood vessels.
Leukocytes seem to leave the smallest blood vessels by
inserting pseudopodia into the interendothelial junctions and
sliding through the wall by amoeboid movement.
This is also due to the increased capillary permeability
caused by the high osmotic pressure of the surroundings.
The early stages are marked by the predominance of
polymorphs especially neutrophils migration, particularly
when the inflammation is caused by pyogenic cocci, later on
monocytes infiltration occurs.
****In some cases RBCs may also pass (Diapedesis)

Function of inflammatory exudates

1- Dilute the invading microorganism and its toxins.
2- Bring antibodies through the plasma to the inflamed
area.
3- Bring leukocytes
microorganisms.

that

engulf

the

invading

4- Bring fibrinogen through the plasma, which is

converted, to fibrin mesh, helping in trapping the
microorganism and localize the infection.

Blood stem cell

Cells of inflammatory response

1) Polymorphonuclear leukocytes: are basophils,

neutrophils and eosinophils; lobed nucleus and grainy
cytoplasm (granulocyte). Microphages (small eaters)
2) Monocytes or histocytes: macrophages. (big eaters)
3) Lymphocytes: leukocyte of fundamental importance;
they determine the specificity of the immune response
to infectious microorganisms and other foreign
substances.
4) Plasma cells: A type of immune cell that makes large
amounts of a specific antibody, developed from
activated B cells (Derived from lymphocytes originate
in the bone marrow). It is a type of WBCs and also
called plasmacyte.

Types of acute inflammation

(based on type of exudates)
1- Catarrhal inflammation:
2- Serous inflammation:
3- Fibrinous inflammation:
4- Membranous inflammation:
5- Hemorrhagic inflammation:
6- Gangrenous inflammation:
7- Allergic inflammation:
8- Suppurative or purulent
inflammation:

Name

Occur in

Characterized by
Exudates rich in mucous

Catarrhal

Mild inflammation in mucous membrane of

respiratory or alimentary tracts e.g. common cold
and catarrhal appendicitis

Serous

Mild inflammation in serous surface such as pleural Extensive watery low

cavity, joint cavity where no damage in endothelium protein exudates
ex. Tuberculosis pleurisy and Common blisters

Fibrinous

Exudates rich in fibrinogen

Outpouring of exudates with high protein and less
volume ex. in lobar pneumonia due to Streptococcus
pneumonia & pericardium inflammation

Fibrinous inflammation in which network of fibrin

entangling inflammatory cells and bacteria forms
Membranous
pseudo-membrane. Example: Diphtheria , Bacillary
dysentery.
Hemorrhagic
Gangrenous

Yellowish grey pseudo

membrane rich in fibrin ,
polymorphs & necrotic
tissues

In blood vessels e.g. in plague

Exudates rich RBCs

Acute appendicitis

Necrotic tissues resulting

from thrombi or emboli
Presence of edema &

Allergic

Result to Ag Ab reaction Hypersensitivity

increase in vascularity.

Suppurative

Caused by pyogenic bacteria and is characterized

by pus formation Example: Abscess.

Large amount of Pus &

Purulent exudates produced