inflammation
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inflammation
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OT Physdis
imflamation and healing
inflammation | ||||||
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Causes of cellular injury | hypoxia loss of o2 supply so cell dies/ becomes fibrotic scar tissue ( MI cells can't regenerate so heart stops to pump) ( Brain cells modify function and control impulse- no regeneration so brain stops)( skin- cells can regenerate) | trauma- will cause cellular injury | toxicity- things we inhale or ingest | |||
Inflammatory response | vasomotor response ( vasoconstriction limits further bleeding and extent of injury)(vasodilation increases blood flow to help heal<hyperremia- area will get red> in diabetes there is decreased blood flow hard to heal wounds | adhesion/ chemotaxis- neutrophils break from vessels and go to area and adhere to injured area ( selectins, Icams, integrins aid in migration and adhesion) | exudation- fluid coming out of blood vessels that contain fibrinogin ( originally thin it becomes thick and clots<cellular debris>) | Fibrin barrier formation- fibrinogin is activated to fibrin which clots | ||
Purpose of vasodilation | to bring WBC to injured area( leukocytosis) | netrophils and monocytes are increased | in acute inflammation that is short and first there is an increase in neutrophils | in chronic inflammation - an infection that you had for a long time there will be more lymphocytes than any other WBC | vasodilation increases o2 and nutirents | vasodilation neutralizes toxinsin the area |
Functions of fibrin | wards off infection by forming a wall barrier around the injured area and prevents infection spreading | forms meshwork for healing | provides for homeostasis- bleeding stops- and cooagulation | |||
Cardinal signs and symptoms of inflammation | hyperemia- redness or ruboor (vasodilation) | tumor- swelling (fluid) | calor- heat ( vasodilation) | Dalor -pain( from sensory nerve signals) | functo laesa- loss of function due to pain | |
Systemic signs and symptoms | malaise( weak) and fatigue (tired) fever, and myalga ( muscle pain) | leukocytosis (8,000 wbc),increase wbc synthesis in bone marrow | increase ESR (erythrocyte sedimentation rate) indicate RBC tissue breakdown | acute phase reactant- serum proteins are altered ( albumin, fibrinogen, globulin) | anorexia | hormone increase (cortisol- stress hormone from cortext of adrenal gland) |
Types of healing | resolution- damage cells suffer but don't die | regeneration- dead cells replaced by functional cells- (GIT,GUT, skin, and bone marrow are highly regenerative)( kidney, liver, bone, lungs, and muscle are moderately regen)(brain and heart do not regenrate) | repair- healing when tissues are replaced by non functional scar tissue | |||
3 levels of repair | healing by first intention- clean surgical ends of wound are together- starts from top- edges come together- no scar formation | healing by secondary intentions- deeper and larger wound ( draiing ulcer)- healing starts from below- inside comes out- works its way up - scarring is more intensive | 3. - healing of infected wounds or those of high risk infection- gaping wounds need to be sutured inorder to heal | |||
Delayed healing results from | infection | malnutrition | immunosupression - ( AIDS, chemo, autoimmune, transplant) | vascular problems ( diabetes, cardiac problems) | obesity | |
What helps heal | antibiotics ( can result in 2nd infection) | local application of heat or ice- ice - vasoconstrict heat- vasodilate | debrivment- remove puss and scabs and drain secretions | drug therapy ( steroids, NSAID- tylenol,immunosupressives, antihistamine | ||
Biologic response modifiers will increase wbc | interleukins stimulate wbc ( lymphocyte/monocyte) | GMSF | growth factor |