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PA2 Inflammation (Overview (causes (infectious agents 傳染因子, physical,…

- - - - vascular change
      - leucocytes migration
      - activation
      - general responses
  - - - change of pressure without chnge in permeability ,↑ 靜水壓力 ↓ 膠體滲透壓
      - leakage of fluid to the extravascular space
    - - leakage of proteinaceous to the extravascular space
      - change in permeability
      - type
        
        sierofibrinosa血清纖維蛋白
        
        fibrinous纖維蛋白
        
        purulent exudate 化膿性滲出物
    - - interstitial liquid (transudate ,exudate) or in cavities (pericard, pleural space胸膜腔 , peritonei腹膜)
    - - exudate rich in PMN and cell rests
      - pus= purulent
      - abscess膿腫= pocket of pus
- - - - Chronic(monocytes, lymphocytes ,macrophages)
        
        cause
        
        prolonged exposure to insult 長期暴露得損害
        
        auto-immunity自身免疫
        
        persistence of infection
        
        time: slow. mononuclear
        
        cell component
        
        eosinophils 嗜酸性粒細胞
        
        parasites infection
        
        immune reaction associated with IgE(allergic condition )
        
        mast cells
        
        anaphylactic reaction過敏反應
        
        made of histamine
        
        morphological pattern形態學
        
        diffuse :unspecific
        
        granulomatous inflammation肉芽腫性炎症
        
        Types
        
        caseating
        
        對某些微生物具有持續的t細胞反應，其中t細胞衍生的細胞因子負責慢性巨噬細胞活化
        
        結核病是由感染引起的肉芽腫性疾病的原型，應該始終排除肉芽腫的原因
        
        non- caseating
        
        immune -mediated inflammatory disease (crohn disease),sarcoidosis結節病
        
        foreign body granulomas
        
        relatively inert foreign bodies
        
        example
        
        2 more items...
        
        defintion
        
        composed of activated macrophages
        
        pink, granular cytoplasm 粉紅色顆粒狀的細胞質
        
        surround by
        
        lymphocytes
        
        multinucleated giant cells多核鉅細胞: fusion of multiple activated macrophages
        
        肉芽腫是在許多疾病中發現的炎症期間形成的結構。它是被稱為巨噬細胞的免疫細胞的集合。當免疫系統試圖阻擋它認為是外來物質但無法消除的物質時形成肉芽腫。
      - Aute(PMN多形核中性粒細胞)
        
        time: fast, polynuclear
        
        outcome
        
        100 % complete resolution
        
        scar
        
        chronic inflammation
    - - migration and infiltration滲透 in the inflammatory -->transmigration and chemotaxis
      - leucocyte migration to the extravascular space
      - events
        
        margination (PMN go toward the wall)
        
        rolling(翻滾和堆積): cell roll on the endothelial cells
        
        adhesion
        
        transmigration (diapedesis:血細胞滲出)
  - - - calling PMN to the site of the injury
      - after transmigration
  - - - (1)Arteriolar Vasoconstriction: Neuron --> first seconds
      - (2)Arteriolar Vasodilation:histamine(三重反應是由於組胺的釋放) and Nitric Oxide --> minutes
      - (3) Luis responce
        
        1st- 2nd
        
        erythema. heat
        
        Increased permeability and Slow flow
        
        PGs, LT, P substance -- > minutes/hours
        
        3rd
        
        swelling due to exudate
        
        Leukocyte Margination --> Cellular events
        
        ps.
        
        1st：由於毛細血管擴張
        
        2nd：由於軸突反射介導的小動脈擴張導致周圍區域發紅。
        
        3rd：由於毛細血管和小靜脈中的液體滲出