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General Pathology

General Pathology. Inflammation II Healing processes Classification. Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague. Inflammation. Definition: complex reaction of organism to damage (aim: homeostasis maintenance). Inflammation. Sense

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General Pathology

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  1. General Pathology Inflammation II Healing processes Classification Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

  2. Inflammation Definition: complex reaction of organism to damage (aim: homeostasis maintenance)

  3. Inflammation Sense defensive– agent elimination reparative – damage reparation

  4. rubor tumor calor dolor functio laesa Inflammation Celsus´ features:

  5. Time view acute (days) subacute (weeks) chronic (months-years) Inflammation - Classification:

  6. Phases of Inflammatory Response Proliferation Alteration Exsudation

  7. Healing of Inflammation

  8. Def.: processes leading to lost or damaged tissue substitution or adaptation to the organism or environment changed conditions Progressive Changes

  9. Regeneration (restitution) Reparation (substitution) Hypertrophy Hyperplasia Metaplasia Adaptation Progressive Changes

  10. Regeneration- restitution of former status Reparation – substitution with a less specialised tissue Hypertrophy – enlargement of the organ through cell enlargement Progressive changes 1.

  11. AngiogenesisEndogenous Promotors • VEGF - A,B,C,D • Angiopoietins • Angiogenin • basic FGF bFGF • Hepatocyte Growth Factor HGF • Interleukin-8 • PDGF • Transformation Growth Factor ß TGF ß • TNF 

  12. AngiogenesisEndogenous Inhibitors • Angiostatin • Brain Angiogenesis Inhibitor 1 BAI1 • Endostatin • Interferons • Platelet factor-4 cleavage products • Prolactin fragment (16kd) • Thrombospondin-1 • VEGI • Vasostatin

  13. Hyperplasia– enlargement of the organ through cell multiplication Metaplasia –transformation of one differentiated tissue into another differentiated tissue Adaptation- functional adjustment It is done by means of metaplasia, hypertrophy, hyperplasia, metalaxia, (rebuilding). Progressive changes 2.

  14. wounds per primam intentionen (wounds without infection, dislocation, foreign bodies) per secundam intentionen hematomaorganisation thrombusorganisation (possible recanalisation) Healing Processes 1.

  15. dissolution of exsudate & necrotic tissue granulation tissue fibronectin formation, fibroblasts & endothelia organisation collagen production scar maturation scar contraction myofibroblasts Proliferation - steps

  16. Day 0: fibrin – fibronectin gel Day 1: neutrophils Day 1-2: macrophages Day 2-4: fibroblasts, myofibroblasts, capillaries Wound Healing - steps

  17. PDGF from:mf, endoth., platellets causes: fbl proliferation, proteosynthesis Transforming GF from:mf, epithelia causes: fbl proliferation, angiogenesis IL- 1 from:mf, epithelia causes: fbl proliferation, endogenous pyrogen TNF α from:mf causes: endothelial growth, killing bacteria, cachexia Granulation Tissue Growth

  18. Healing Processes 2. • ischemic and traumatic necroses • foreign bodies healing • bone fractures

  19. Factors Influencing Wound Healing • age • nutrition status – protein deficit • vitamins A,C – collagen, epithelisation • Zinc – enzyme function • steroids • local factors • infection • necrosis • foreign bodis • patient´s motility • arterial perfusion • venous drainage

  20. According to the dominant phase: alterative EXSUDATIVE proliferative Inflammation - Classification:

  21. superficial mucous membranes serous membranes skin interstitial Inflammation- localisation

  22. Type of exsudate: serous nonpurulent – lymphoplasmocellular purulent fibrinous gangrenous Inflammation - Classification:

  23. Interstitial fibrinose inflammation • fibrin exsudation & fibrinoid change of the collagen containing connective tissue

  24. Fibrinoid Change of Collagen • vessels and connective tissue damage • plasmorrhagia (leakage of plasma) • deposits of Ag-AB complexes • staining characteristics fibrin - like

  25. Significance of Fibrinoid Change • diminished quality of the collagen ( firmness, permeability) • tendency to thrombosis in the vessels, aneurysms formation

  26. Type of exsudate: serous nonpurulent – lymphoplasmocellular purulent fibrinous gangrenous Inflammation - Classification:

  27. Gangrenous Inflammation • tends to be interstitial • putrefactive bacteria • severe alteration

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