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I think you have ready study the mechanisms of cell injury and today will
.start discussing the inflammation
As you know any organism to survive need to eliminate the invaders from
their body or from their tissues. And these invaders are made from
infectious agents (microbes or dead tissues or …..). So the main process
(mechanism) that these organisms beat harmful agents is what we called
INFLAMATION. The inflammation is a dynamic process of chemical or
physiological or cellular interactions that occur in response to stimuli that
cause cell injury in the vascularized tissue. So you should know types of
.cell injury, the causes of cell injury
And after that this inflammation process will eliminate such agent (By
diluting or neutralizing) and this will lead to necrotic cells (or dead
tissues), also the process itself is taking care of this to eliminate such
necrotic or dead or abnormal tissues or cells. After that it paves the way
for proper repair (subsequent events of inflammation), we need to repair
the tissue because inflammation of dead cells will lead to some kind
damage, after this damage to the cells (blood vessels) we need to repair
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and this process will set the seam for subsequent repairing and other
.regeneration effect
For inflammation process we use the suffix –it is after the tissue name
For the Meninges (the membranes around brain and spinal cord) we call it
.Meningitis
usually any cause that make cell injury will trigger an inflammatory (
)response
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So who are the players in this process (the participants)? So there are
different players from different categories which all together come to play
:this kind of inflammatory process
You know the extra cellular matrix interaction is one of the most
important things in pathogenesis of either inflammation (or any other
reaction process) because the extra cellular matrix is directly controlling
process or body on the growth of inflammation (interaction or different
.process)
Blood vessels
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Smooth muscles
Basement membrane
In the normal situation there is just a little space between the cells and it
allows only minimum escape some fluids (or proteins) outside to the
extracellular matrix, and in these blood vessels we have different
components, we have the plasma, plasma proteins and different kinds of
white blood cells including (monocyte, neutrophiles, eosinophiles and
basophiles, lymphocytes) also we have red blood cells and platelets in
addition to this we have clotting factors (Kininogens and complement
components)
And out of this we have the connective tissue cells (fibroblast and
macrophages and mast cells),Fibroblast is term of modified macrophages
and it has the heredity to differentiate into fibrous tissue to rebuild
.damaged tissue and that is why we call it fibroblast
We have the Matrix which contains the extracellular cells. And this
matrix consists of a lot of fibers like elastic fibers, collagen fibers or
proteoglycans. Anf the interactions between these cells and this matrix is
.very important to inflammatory process
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Is all inflammation is same (same type or same kind), the answer to this is
No.Of course we have different kinds of inflammation, the main two
:types are
So from the names Acute means (something that resolve rapid or quickly)
and Chronic means (it takes longer time to be prepared) So what is the
?main difference here
:Acute Inflammation
We have more exudation (Fluid & plasma protein) into the connective
.tissue,so it exudates because it has higher protein content
:Chronic Inflammation
Acute Inflammation
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Deliver plasma proteins: antibodies, complement systems, others -2
(which can help in counter acting and remove the infectious agents we
.have)
We have two main components: the vascular changes & the cellular
events
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This is example of Acute Inflammation process of the blood and you see
.the predominance of neutrophils, so this is example of pneumonia
Normally the hydrostatic pressure and the plasma colloid pressure will
control the blood flow in and out of the vessel, the plasma colloid
pressure is produced by the content of blood of proteins
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We normally have a net pressure to outside at the arteriolar side (the net
forces are to outside). We need the blood to get out for nutrition and to
……eliminate the other substances or to get oxygen etc
The pressure in the region in between the arteriole and the venule ( in the
.capillaries) is less different,it is equivalent
The pressure in the venule side is usually (the net pressure) to inside and
this is mainly to remove the fluid and the cells from outside back to the
.venule
You can see here, increase in the blood flow due to vasodilatation,
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action, escape of the fluid and the molecules to the outside which we call
it exudation (if it contains high protein content) and of course lead to the
.inflame process
Heat: It -1
occurs because of the increase in the blood flow and this will
.increase the temperature at the site of the increase blood flow
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.Redness: It occurs because of the Vasodilatation -2
?Now what are the specific forms of vascular changes that we have
Later stages: the blood vessels become leakier and this will
result in → loss (leakage) of proteins and more cells and this will lead to
.what call it exudate
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In the normal state the net flow is out (in arteriole side) & the net flow is
.in (in venule side) & there is no net flow of at the capillaries region
You can see here 1)that the net flow in the arteriole regoin is out and is
.longer than usual because of the vasodilatation and increasing blood flow
the venule will become dilated also. So the net flow will be out of the )3
.venule unlike the normal net flow which is in
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?How does inflammation lead to leakiness of endothelial cells
This will limiting the intracellular spaces between the endothelium, and
.this will allow the fluid to escape outside
.It is Reversible -
Immediate transient response with short life usually last for (15-30 -
.minutes)
.It is more prolong Starts 4-6 hours after injury and stays for 24 hours -
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:Leukocyte-Dependent Endothelial Injury -5
Doctor: Your husband needs a silent environment so that he can rest. Here
.are some sleeping pills
?Wife:كتب الليwill
When .منيI give
هاي مو
it toالنغاشة
him
.التفريغ هو اللي حطها
Doctor: Those are for you! : Wink
You can see the vesicle and this is because of accumulation of fluid
.outside the microvessles
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:Edema in Inflammation has two types
:TRANSUDATE -1
Mechanism: hydrostatic pressure imbalance across vascular -
endothelium (escape of more fluids)
Fluid of low protein content (ultra filtrate of blood plasma) -
.Specific gravity <1.012 -
:Exudate -2
Mechanism: alteration in normal permeability of small blood -
.vessels in area of injury
Fluid of high protein content (>.3g/dl) & increased -
.cellular debris
.Specific gravity >1.020 -
someone ask the dr about the specific gravity and he answered that *
.it just a number of measurement for a test
:Cellular Events
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.Release of leukocyte products -5
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Thanks to my all friends: Al-qaisi & Anagreh & Younes &
Khtaeeb and to heroes team : Shlool & Quaz'a & Tamimi &
………… Qudsi
When the Mirror of Life Gets Misty with the Fog of Reality, Just try wiping it with
....your Faith and You Will See the Clear Reflection of your Dreams Once Again
WWM
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