NURS 123 Inflammation

jasmine's version from 2016-01-31 06:38

Section 1

Question Answer
Although local manifestations of inflammation can affect all vascularized tissues... Lesions vary depending on the organ or tissue involved
The lesion resulting from widespread cellular death (necrosis)... Differs in myocardial (heart muscle), brain, and hepatic (liver) tissues
Cellular death resulting from myocardial infarction (deprivation of oxygen caused by cessation of blood flow) causes what? A response that proceeds to replacement of the dead tissue with a fibrinous scar
Cellular death resulting from injury to brain tissue more likely results in what? The formation of an abscess filled with necrotic tissue
Cellular death resulting from destruction of liver tissue causes or results in what? Stimulation of regrowth, or regeneration, of liver cells
3 systemic changes associated with Acute inflammatory response Fever, leukocytosis (a transient increase in the levels of circulating leukocytes), and plasma protein synthesis (increased levels of circulating plasma proteins
Chronic inflammation Characterized by a sense infiltration of lymphocytes and macrophages; If macrophages are unable to limit the tissue damage or infection, the body attempts of wall off and isolate the infected area, thus forming a granuloma (an inflammatory tumor or growth composed of granulation tissue)
The difference between acute and chronic inflammation Duration (chronic last 2 weeks or longer), histologic and mechanistic; Chronic is sometimes preceded by an unsuccessful acute inflammatory response
Regeneration The complete return of tissues to normal structure and physiologic function
Resolution A return of injured tissues to an approximation of their original structure and physiologic function
Repair The replacement of destroyed tissue with scar tissue
2 overlapping phases Resolution and Repair occur in Reconstructive and maturation
Reconstructive Phase Begins 3 to 4 days after the initial injury and continues for as long as 2 weeks.
Characteristics of the lesion in the reconstructive phase Fibroblast (connective tissue cell) proliferation, followed by collagen synthesis by the fibroblasts, epithelialization, contraction of the wound, and cellular differentiation
Maturation Phase Begins several weeks after injury and is normally complete within 2 years
Characteristics of the lesion in the maturation phase cellular differentiation, scar formation, and scar remodeling continue
Scar Tissue Is composed primarily of collagen that seals the lesion and restores tensile (of or relating to tension; capable of being drawn out or stretched strength, yet cannot execute the physiologic functions of destroyed tissue

Section 2

Question Answer
Heat and Redness The result of vasodilation and increased blood flow through the injured site
Swelling Occurs as exudate (fluid and cells) accumulates; Is usually accompanied by pain caused by pressure exerted by exudate accumulation, as well as the presence of soluble biochemical mediators such as prostaglandins and bradykinin (a peptide that causes blood vessels to dilate (enlarge), and therefore causes blood pressure to fall; a compound released in the blood in some circumstances that causes contraction of smooth muscle and dilation of blood vessels); Loss of function may be associated with these manifestations
Exudate A mass of cells and fluid that has seeped out of blood vessels or an organ, especially in inflammation
How does exudate vary in composition? It depends on the stage of the inflammatory response and, to some extent, the injurious stimulus
Serous Exudate In early or mild inflammation, the exudate is watery with very few plasma proteins or leukocytes. An example is the fluid in a blister
Fibrinous Exudate In more severe or advanced inflammation, the exudate may be thick and clotted, such as in the lungs of individuals with pneumonia
Purulent (Suppurative [the formation of, conversion into, or process of discharging pus]) Exudate If a large number of leukocytes accumulate, as in persistent bacterial infections, the exudate consists of pus; It is characteristic of walled-off (to divide or separate something) lesions (cysts or abscesses)
Hemorrhagic Exudate If bleeding occurs, the exudate is filled with erythrocytes

Section 3


Question Answer
Wounds that heal under conditions of minimal tissue loss are said to heal by this Primary intention
Healing always involve these processes Fill in, seal (epithelialization), and shrink (contraction) the wound
The process of healing begins... As granulation tissue grows inward from surrounding healthy connective tissue. Granulation tissue is filled with new capillaries (angiogenesis) that give it a red, granular appearance and is surrounded by fibroblasts and macrophages
What are the most important cells during the reconstructive phase of wound healing? Fibroblasts
Primary Intention Healing This occurs where the tissue surfaces have been approximated (closed). This can be with stitches, or staples, or skin glue (like Derma bond), or even with tapes (like steri-strips). This kind of closure is used when there has been very little tissue loss. An example of wound healing by this is a surgical incision.
Secondary Intention Healing A wound that is extensive and involves considerable tissue loss, and in which the edges cannot be brought together heals in this manner. This is how pressure ulcers heal.
Tertiary Intention Healing This type of wound healing is also known as “delayed” or “secondary closure” and is indicated where there is a reason to delay suturing or closing a wound some other way, for example when there is poor circulation to the injured area. These wounds are closed later. Wounds that heal by this require more connective tissue (scar tissue) than wounds that heal by secondary intention. An example of a wound healing by this is an abdominal wound that is initially left open to allow for drainage but is later closed.
3 ways that secondary intention healing differs from primary intention healing The repair time is longer, scarring is greater, and chances of infection are far greater.