question

How are the defenses of immunity divided?

answer

The defenses of immunity are divided into: 1. 1st line of defense 2. 2nd line of defense 3. 3rd line of defense

question

First Line of Defense

answer

Innate resistance

question

Second Line of Defense

answer

Inflammation

question

Third Line of Defense

answer

Adaptive (acquired immunity) -normal immune response

question

What does the first line of defense consist of?

answer

1st line of defense=innate resistance -via physical and chemical barriers 1. skin 2. lining of GI, genitourinary and respiratory tract.

question

Skin

answer

Part of the 1st line of defense of immunity -keeps a lot of things in our environment from getting into the internal organs. -skin also keeps fluid inside body and prevents dehydration

question

A burn victim will also have leaky skin. Why?

answer

The skin, part of the first line of defense, has been removed. -Increased risk of pathogens entering body -Increased risk of dehydration (fluid volume deficiency) -need for decrement of necrotic tissue

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It is better to kill off some epithelial cells than noneptitheial cells, because epithelial cells will divide rapidly, while non epithelial cells don't.

answer

...

question

Lining of the GI tract, respiratory tract and genitourinary

answer

First line of defense (physical barriers) -sloughing off of cells -coughing and sneezing (particles out of respiratory tract) -flushing (UTI with water) -vomitting (stomach) -mucus and cilia (respiratory tract)

question

If you have a UTI, you are recommended to drink a lot of water. Why?

answer

A lot of water will help to flush the bacteria out of the body and allow infection to heal faster.

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Biochemical barriers of first line of defense

answer

-synthesized and secreted saliva, tears, earwax, sweat, sebum -antimicrobial peptides (cathelicidins, defensins collectins) -normal bacterial flora

question

Why does sweat contain salt?

answer

The more salt concentration, the less amount of microbial growth. This is why sweat contains a lot of salt, to keep microbial growth at bay.

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All first line defense of immunity is (specific or nonspecific)

answer

nonspecific

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Earwax

answer

biochemical barrier for the first line of defense. keeps insects out of the ear. earwax must be synthesized

question

What is the second line of defense?

answer

Inflammatory response is the second line of defense

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Inflammatory response-what causes it?

answer

Inflammatory response is caused by many materials: -infection -mechanical damage -ischemia -nutrient deprevation -temp. extremes -radiation

question

Inflammatory response is a _____ manifestation

answer

local

question

What is the vascular response of inflammatory response?

answer

-blood vessels dilate -increased vascular permeability and leakage -white blood cells adhere to the inner walls of vessels and migrate through the vessels

question

What are the goals of inflammation?

answer

-limit and control the inflammatory process -prevent and limit infection and further damage -interact with components of the adaptive immune system -prepare the area of injury for healing

question

What are the major steps of inflammation?

answer

Major steps of inflammation include: 1. Increased vascular permeability 2. Emigration of neutrophils 3. antigen destruction and phagocytosis

question

increased vascular permeability

answer

involves chemical mediators

question

emigration of neutrophils to site of damage

answer

involves 1. chemotaxis 2. margination 3. diapedesis

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antigen destruction and phagocytosis

answer

involves -neutrophil -macrophage activation

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outside the vessel, and within the surrounding connective tissue

answer

extravascular

question

where are mast cells found?

answer

Mast cells are ALWAYS found in connective tissue. YOU WILL NEVER find a mast cell in the blood stream.

question

what are the cellular mediators in inflammatory response (i.e. the first step)?

answer

The cellular mediators in inflammatory response include: 1.

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Tissue injury will cause production of inflammatory mediator molecules-->

answer

1. vascular factor(cause increased vascular permeability, vasodilation and edema) 2. chemokines attract leukotrienes (actue inflammation and chronic inflammation)

question

What are the cellular components of cell mediators in inflammation?

answer

Cellular components of cell mediators: -granulocytes -platelets -monocytes -lymphocytes

question

Cell Surface Receptors

answer

PRP (pattern recognition receptors) PAMPS (pathogen associated molecular patterns) complement receptors scavenger receptors

question

How do the WBC know to go to the site of injury?

answer

Every WBC contains a number of surface cell receptors.

question

Cellular mediators of inflammation

answer

1. Cellular components -granulocytes -platelets -monocytes -lymphocytes 2. Cell Surface Receptors -PRP -PAMP -complement receptors -scavenger receptors

question

chronic inflammatory cells

answer

lymphocytes, monocytes, macrophages, and plasma cells are all referred to as chronic inflammatory cells

question

lymphocytes, monocytes, macrophages, and plasma cells

answer

chronic inflammatory cells

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acute inflammatory cells

answer

neutrophils (PMN's, eosinophils) are the acute inflammatory cells.

question

Lymphocyte: acute or chronic inflammatory cell

answer

chronic

question

monocyte: acute or chronic inflammatory cell

answer

acute

question

PMN

answer

polymorphonuclear neutrophils -WBC (called polymorphous because 2-5 lobed nucleus)

question

PMN's count

answer

PMN's during inflammation have a much higher count.

question

When would a PMN count in the blood be high?

answer

PMN's count in the blood often increases greatly during a inflammatory process, ESPECIALLY TO A BACTERIAL INFECTION

question

Neutrophil

answer

primary phagocyte that arrives early at the site of inflammation, usually within 90 minutes of injury. aka pmn's

question

How long do PMN's last?

answer

PMN's are released from the bone marrow and circulating PMN's have a 10 hour life span, so they must be constantly replaced if their numbers are to remain adequate.

question

Once you have injury extravascular, outside the vessel, what occurs?

answer

WBC (neutrophils or PMN's) will begin to: 1. marginate to the site of injury 2. adhesion of platelets 3. pavementing of neutrophils 4. emigration

question

In response to acute bacterial infection in the periphery, more PMN, often less mature, are released into the circulation (leukocytosis). Recruited cells die in inflamed tissues; but PMN have a short half life, perhaps less than a day, even in normal tissue. PMN are programmed to undergo apoptosis and are then phagocytosed by tissue macrophages.

answer

...

question

Marginate to the site of injury

answer

leukocyte (PMN's) begin to slow their movement and begin to accumulate along the endothelial surface

question

Why does margination of neutrophils occur?

answer

In response to injury, chemical mediators and cytokine are released that affect the endothelial cells and cause the leukotrienes to increase expression of adhesion molecules. The leukocytes begin to slow their movement and accumulate along the endothelial surface.

question

As leukocytes (PMN's) accumulate, they begin to adhere to the endothelial vessel.

answer

2nd step of PMN's in inflammation

question

After adhesion of platelets, _____ occurs.

answer

PAVEMENTING

question

Pavementing

answer

strong adhesion of PMN's to the endothelial wall

question

After pavementing, _____ occurs

answer

emigration of PMN's

question

mechanism by which leukocytes change shape, insert pseudopods into junctions between endothelial cells and squeeze through the junctions.

answer

emigration (of PMN's)

question

PMN's in inflammation:

answer

1. Margination 2. Adhesion 3. Pavementing 4. Emigration

question

Emigration of leukocytes (PMN's causes)

answer

1. Increased permeability of vessel wall and increased hydrostatic pressure-->transudate 2. Emigration of leukocytes-->exudate 3. Diapedesis of leukocytes and movement by chemotaxis.

question

Exudate

answer

after leukocytes has moved out into the extravascular considered exudate

question

chemotaxis

answer

movement along the gradient of chemical attractants released by bacteria (Receptor mediated)

question

Once PMN's get into extravascular tissue, how do they know where to go?

answer

PMN's once they get out, their movement is dictated by chemotaxis. Chemotaxis is the process which movement is followed along the gradient of chemical attractants that are released by bacteria. PMN's go to the greatest concentration of chemical attractions, receptor mediated.

question

Mast cells are found in ________

answer

extravascular tissue only!!!! You will never find a mast cell circulating in the blood.

question

Mast cells stay in the tissues.

answer

...

question

Cellular bags of granules that are located in the loose connective tissues close to the blood vessels

answer

mast cells

question

where are mast cells found?

answer

mast cells are found everywhere in connective tissue and epithelium: skin, digestive lining and respiratory tract.

question

How are mast cells activated?

answer

Mast cells are activated upon: -physical injury, chemical agents, immunologic process and toll-like receptors (receptor mediated)

question

How is chemicals released from mast cells?

answer

There are two ways in which chemicals may be released from mast cells: 1. degranulation 3. synthesis of lipid-derived chemical mediators

question

Mast cells are the 1st responders and start releasing quite amount of secretory granules.

answer

...

question

What is the main chemical released from mast cells?

answer

Histimine is the main chemical released from mast cells.

question

a vasoactive biogenic amine (protein) that causes temporary, rapid dilation of blood vessels and post capillary venules

answer

histamine

question

Histamine is one of the first mediators in inflammatory response

answer

causes dilation of arterioles, increased permeability of venules.

question

What are the two receptors found on histamine?

answer

histamine has two types of receptors: 1. H1 receptor (found in two places) 2. H2 receptor

question

H1 receptor

answer

found in both: 1. (smooth bronchial muscle cells) to constrict them 2. vessels->causes dilation and relaxation.

question

In H1, there are two sites for histamine...

answer

but each has the opposite effect!

question

H2 receptor

answer

predom. on parietal cells of the stomach mucosa -induces gastric acid secretion and food allergies.

question

Is histamine the only thing released from mast cells?

answer

No histamine is not the only thing released from mast cells. -Chemotactic factors are also released: 1. Neutrophil chemotactic factor 2. eosinophil chemotactic factor of anaphylaxis (ECF-A)

question

Neutrophil chemotactic factor

answer

released by mast cells upon degranulation. Attracts more neutrophils to the site of injury.

question

ECF-A

answer

Eosinophil Chemotactic Factor of Anaphylaxis (ECF-A) -released by mast cells upon degranulation -attracts eosinophils

question

proteins that attract or signal for other certain types of cells

answer

chemotactic factor

question

Derived from phospholipids through the action of phospholipases

answer

arachidonic acid

question

Acarchidonic acid may be further metabolized...how?

answer

2 pathways to further metabolize arachidonic acid: 1. lipoxygenase pathway 2. cyclooxygenase pathway

question

Where is arachidonic acid found?

answer

Release of arachidonic acid from membrane phospholipids in mast cells through enzymatic action of phospholipases.

question

Mast cells also synthesize mediators of inflammation:

answer

1. leukotrienes 2. prostaglandlins 3. platelet-derived factor

question

product of arachidonic acid from mast cell membranes, similar effects to histamine except occurs at a later stage. It serves to maintain the inflammatory response.

answer

Leukotrienes

question

Function: chemotaxis, vascular permeability, bronchospasm -arachidonic acid derivative

answer

leukotrienes

question

produce of arachidonic acid from mast cell membranes, similar effects to leukotrienes, but it may also induce pain.

answer

prostraglandins

question

Function: smooth muscle contraction and trigger pain receptors -arachidonic acid derivative

answer

prostaglandins

question

similar effect to leukotrienes and platelet activation

answer

platelet-activating factors

question

Function: vasodilation, inhibition of neutrophil chemotaxis and monocyte adhesion Serves to control inflammation -arachidonic acid derivative

answer

lipoxins

question

Function: Platelet aggregation to form clots and thromosis -arachidonic acid derivative

answer

thromboxane

question

Function:Opposite effect as thromboxane -arachidonic acid derivative

answer

prostacyclin

question

Monocytes are the garbage cleaners, the after party and clean up before healing may occur.

answer

...

question

If you don't remove damage with monocyte, then you won't obtain the proper healing

answer

...

question

secondary responders

answer

arachidonic acid derivatives -leukotrienes -lipoxones -thromboxones -prostaglandins -prostacyclin

question

What to corticosteroid/steroids do?

answer

Corticosteroids will inhibit the phospholipase enzyme, which prevents production of arachidonic acid from membrane phospholipids. The inflammation will be reduced and joint will be movable. Less pain and more free movement will occur.

question

Danger of steroids

answer

The area won't undergo a true healing until inflammation can occur. If you continually downplay inflammation, healing won't occur.

question

What are the secondary mediators in inflammation? Where did they come from?

answer

arachidonic acid derivatives -leukotrienes -lipoxones -thromboxones -prostaglandins -prostacyclin

question

How do mast cells move?

answer

Mast cells move up the [] gradient to the site of injury, via chemotaxis.

question

Chemotaxis vs. chemotaxins

answer

chemotaxis is the process chemotaxins are the factors

question

Where will you have the greatest concentration or amount of chemotaxtic factors?

answer

The site of damage or injury will prove the greatest amount of chemotaxtic factors.

question

hormone-like proteins secreted by cells that enhance inflammatory actions

answer

cytokines

question

when are cytokines secreted?

answer

cytokines are secreted after histamine to continue the inflammatory response.

question

polypeptide products synthesized in many cell types

answer

cytokines

question

What is the function of cytokines?

answer

Cytokines are secreted to enhance the inflammatory response: 1. leukocytic attraction-continue to attract PMN's to the site of injury 2. phagocytosis stimulation 3. vasodilation

question

What are the primary cells that secrete cytokines?

answer

Cytokines are secreted by many cell types but mainly: 1. lymphocytes 2. macrophages

question

subset of cytokines more specifically involved in chemotaxis; attract monocytes and leukocytes (PMN's) to the site of injury

answer

chemokines

question

IL

answer

interluekins

question

produced primarily by macrophages and lymphocytes to response to a pathogen or stimulation by other products of inflammation; usually indicate the end of acute inflammation and start of chronic inflammation

answer

interleukins (a subset of cytokines)

question

usually indicate the end of acute inflammation and the start of chronic inflammation

answer

interleukins (a subset of cytokines)

question

white blood cell count is high...what does this mean?

answer

WBC count is high when inflammation is occurring, because PMN (WBC) are leaving the vascular system into CT and site of injury. SO you need to replace the ones that are leaving

question

Protein derived protein systems

answer

proteins that are circulating in plasma (blood) and when plasma leaks out are involved in inflammation.

question

What are protein systems involved in inflammation?

answer

Protein systems: 1. complement system 2. coagulation system 3. kinnin system

question

What is an important feature of the protein systems involved in inflammation?

answer

All the protein systems: contain inactive enzymes (proenzymes) -sequentially activated 1. proenzyme-->active enzyme 2. substrate of active enzyme becomes next component in series

question

Complement system

answer

Unique: a protein system that may destroy something directly

question

opsinization (complement)

answer

enhanced binding of antigen to antibody or complement IT flags thing down for destruction

question

MAC in complement

answer

may function for cell lysis

question

coagulation system

answer

a protein system that forms a fibrinous meshwork at the injured or inflamed site.

question

Why is coagulation system important?

answer

The fibrin acts as a net over site of inflammation to keep it contained: 1. prevents spread of infection 3. keeps microorganisms and foreign bodies at the site of greatest inflame. cell activity 4. forms a clot that stops bleeding 5. provides a framework for repair and healing

question

main substance in coagulation system, which is an insoluble protein

answer

fibrin

question

acts as a net over the site of inflammation to keep it contained locally, produces a chicken wire frame so we can heal later.

answer

fibrin (product of coagulation system)

question

Kinin system

answer

a protein system involved in inflammation: function to activate and assist inflammatory cells -primary kinin is bradykinin

question

Function of bradykinin

answer

primary kinin of the kinin protein system involved in inflammation (protein from plasma). Activates pain receptors

question

What are the only two molecules associated with pain?

answer

1. Bradykinin-from kinin system (protein system from plasma) 2. prostaglandin- from archaiconic acid, secondary mediator

question

Function of bradykinin (important)

answer

Bradykinin functions to cause: 1. dilation of blood vessels 2. pain 3. smooth muscle contraction 4. vascular permeability 5. leukocyte chemotaxis

question

FIRST STUDIED HOW CELLS GOT TO INFLAMMATION, NOW STUDY HOW CELLS WORK TO DESTROY AT THE SITE OF INFLAMMATION

answer

...

question

process by which a cell ingests and disposes of foreign material

answer

phagocytosis

question

describe the movement of a phagocytic cell to the site of injury:

answer

Movement of phagocyte to site of injury: 1. phagocytes are in circulation 2.magination 3. adhesion and pavementing 4. diapedesis 5. exudation into inflamed tissue

question

any fluid that filters from the circulatory system into lesions or areas of inflammation.

answer

exudate

question

What are the steps of phagocytosis?

answer

Phagocytosis steps: 1. Opsonization 2. Recognition by the phagocyte 3. Adherence (receptor mediated) 4. Engulfment 5. Phagosome formation 6. Fusion with lysosomal granules-release all the hydrolytic enzymes 7. destruction of the target.

question

What occurs when phagocytosis is unsuccessful??

answer

When lysosomes are unsuccessful at killing and more and more lysosomes bind and then the higher content of hydrolytic enzymes in the cytoplasm. The phagocyte will eventually rupture due to high enzyme concentration. This will cause the enzymes and bacteria to be released from the phagocyte to the cytoplasm. Bacteria is not killed and will be able to infect another cell, while cells around phagocyte are affected.

question

Phagocytosis. The figure shows ingestion, digestion, and destruction of foreign particulate matter (a bacterium, in this example). A, Cell membrane receptors bind to antibody and complement molecules previously attached to the bacterial surface. B, The cell membrane creeps around the bacterium and envelopes it. C, The bacterium is trapped in a special space, the phagocytic vacuole, into which lysosomes discharge oxidants to kill it and digestive enzymes to dissolve it.

answer

...

question

The purpose of inflammation is to limit the extent and severity of injury, eliminate or neutralize the offending agent, and to initiate the repair process.

answer

...

question

What cells serve as phagocytes in the inflammatory response?

answer

Main phagocytes: 1. PMN (neutrophils) 2. Monocytes and macrophages

question

Are neutrophils phagocytes?

answer

Neutrophils (PMN's) are phagocytes in early inflammatory response -Function to inject bacteria, dead cells and cellular debris.

question

How long to neutophil phagocytes last?

answer

Neutrophil phagocytes last very short period of time and become component of purulent exudate.

question

Monocytes vs. macrophages.

answer

monocytes=in circulation in vascular system same thing, just different location macrophages=in tissues inflammatory site

question

Are monocytes or macrophages phagocytes?

answer

Macrophages are phagocytes in the inflammatory response. -takes 3-7 days to arrive after PMNS and initial tissue damage

question

Once macrophages (phagocytes) get to the site of injury, 3-7 days later what occurs?

answer

Macrophage activation results in: -increased size -plasma membrane area -glucose metabolism -number of lysosomes -secretory products Once they get to the site, they basically explode

question

Uncoiled chromatin

answer

indicates DNA is being transcribed into RNA

question

Do eosinophils have phagaocytic activity?

answer

Eosinophils have some phagocytic activity. -defense against parasites and regulation of vascular mediators (viral infection)

question

Basophils and lymphocytes have little to no phagocytic activity

answer

...

question

NK cells

answer

Natural killer cells

question

function is to recognize and eliminate cells infected with the viruses and some function in eliminating cancer cells

answer

Natural killer cells

question

cells that recognize something that is similar to self but has changed a little bit...i.e. cancer cells in the tissues

answer

NK cells

question

______ cells are more tissue regulating than circulatory regulating.

answer

NK cells

question

Platelets: ARe they phagocytes?

answer

Platelets are NOT phagocytes -activation results in degranulation and interaction with components of the coagulation system

question

thrombocytes

answer

aka platelets

question

Activation of platelets always stimulates...

answer

a small-scale of coagulation cascade

question

In cancer, natural killer cells may be used....

answer

and stimulated to activate and recognize cells similar to self-cells but has changed a little. Overstimulate to kill in cancer.

question

Pathogenesis of acute inflammation:

answer

1. Vasodilation (0-24 hours) 2. Edema (escadate and transdate) (24-34 hours is top swelling) 3. Peak of PMN's at 24-48 hours 4. Monocytes and macs begin to peak at days 3-4 to come for clean-up

question

Cardinal signs of inflammation (local)

answer

1. Rubor=reddness 2. Tumor=swelling or inflammation 3. Calor=measurement of heat 4. Dolor=pain

question

rubor

answer

reddness

question

tumor

answer

swelling or inflammation

question

calor

answer

measurement of heat

question

dolor

answer

pain

question

An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation.

answer

...

question

There is an important distinction between transudates and exudates. Transudates are caused by disturbances of hydrostatic or colloid osmotic pressure, not by inflammation. They have a low protein content in comparison to exudates. Medical distinction between transudates and exudates is through the measurement of the specific gravity of extracted fluid

answer

Transudate=caused by hydrostatic pressure Exudate=caused by inflammation

question

For a clinical standpoint, one ma classify the exudative fluids:

answer

1. serous exudate 2. fibrinous exudate 3. purulent exudate 4. hemorrhagic exudate

question

watery exudate, which indicates early inflammation because it hasn't become more complex or matured

answer

serous exudate (early in the inflammatory response)

question

thick, clotted exudate, which indicates a more advanced inflammation; contains more fibrin deprevation

answer

fibrinous exudate

question

exudate that contains pus; indicating a bacterial infection

answer

purulent exudate

question

exudate that contains blood; indicated bleeding

answer

hemorrhagic exudate

question

pus almost always indicates...

answer

a bacterial infection

question

A local manifestation of inflammation (redness, pain, swelling and heat) may spill over into a systemic manifestation of inflammation.

answer

...

question

systemic manifestation of inflammation.

answer

1. fever 2. leukocytosis (Increase in # WBC) 3. increased plasma protein synthesis 4. malaise

question

caused by exogenous and endogenous pyrogens of bacteria, which act directly on the hypothalmus

answer

fever

question

increased # of circulating leukocytes

answer

leukocytosis

question

increased plasma protein synthesis

answer

acute-phase reactants

question

malaise

answer

down in the dumps bc inflammatory mediators in circulation they are going to change the function in the body

question

Inflammatory response to infection

answer

a lot of inflammation is due to infections, which may be caused by: -bacteria -parasites -viruses

question

Anatomic characteristics of acute inflammation

answer

1. Swelling 2. Edema 3. Reddness 4. Heat Useful in diagnositc

question

Anatomic characteristics of systemic inflammation

answer

Not always visible, acute inflammation has much more visible and define anatomical characteristics.

question

Collection of fluid on leg may be due to a lot of things.

answer

If fluid is not clear, no pain and no heath may be edema caused by congestive heart failure. If it is acute inflammation, you will expect to see heat, pain, swelling and reddness

question

Triple Response of Lewis

answer

Intradermal effects of histamine: 1. Flush 2. Flare 3. Wheal

question

Flush

answer

compression enough to cause cells injury. dull red line, indicates vasodilation due to local release of histamine

question

flare

answer

red halo-->scratch expands and further dilation and increased flow. Fluid begins to move

question

wheal

answer

swelling and blanching-edema

question

blanching

answer

turn white in the middle of a wheal=

question

What are anatomical characteristics of acute inflammation?

answer

In fibrinous pericarditis, acute inflammation: 1. tend to be swollen 2. may appear wet looking 3. fibrin meshwork caused by actute inflammation is pretty noticeable in organs

question

absess

answer

localized pocket of inflammation

question

sinus and fissure are open, while an abbess is closed, a pustule and somewhat isolated

answer

...

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