Inflammation

INFLAMMATION
 DEFINITION:
 Inflammation is the reaction of vascularized living
tissue to local injury. It is a series of vascular and
cellular reactions aiming to protect the body against
the injurious agent .
 TYPES:
 -Acute: sudden onset and short duration ( hours -
days)
 -Chronic: gradual onset and long duration ( days -
years)
 INFLAMMATION
CAUSES:
Living irritants
Bacteria, viruses, parasites and fungi
Non-living irritants
 Physical, chemical and mechanical
 Antigens
 ACUTE INFLAMMATION
• Caused by an irritant of short duration of
action
• The tissue response is rapid i.e. sudden onset
• Inflammation lasts for days or weeks
• Characterized by presence of fluid exudate
and cellular exudate mainly polymorph-
nuclear leucocytes
 CARDINAL SIGNS AND SYMPTOMS OF
ACUTE INFLAMMATION

• REDNESS
• HOTNESS
• SWELLING
• PAIN
• LOSS OF
FUNCTION
 Major events in inflammation
Vascular events Cellular events

Vasodilatation of arterioles
•

and capillaries • Margination of leucocytes

• Emigration of leucocytes
• Increased blood flow
• Emigration of monocytes
• Slowing of blood stream • Chemotaxis:
Increased capillary
• (directed movement towards
permeability area of inflammation)
• Phagocytosis:
(engulfment of bacteria and
Formation of necrotic tissue)
Inflammatory
Fluid exudate
 Vascular Events
in inflammation

Vasodilatation of arterioles
•

and capillaries
• Increased blood flow
• Slowing of blood stream
Increased capillary
•

permeability
 Cellular Events in inflammation

• Margination , Emigration of neutrophils & monocytes

• Chemotaxis & phagocytosis
Phagocytosis,
Killing &
degradation
Chemical Mediator of
Inflammation
 CHEMICAL MEDIATORS
ACTIONS
Bind to specific receptors on the cells
Histamine
Vasodilatation Prostaglandins
C3a & C5a

Increase vascular permeability

Histamine, kinins, leukotriens

Chemotaxis Leukotriens & lysosomal components

 The Inflammatory Fluid Exudate
Function:
1. It dilutes bacterial toxins and chemical irritants.
2. It brings antibodies to the area of inflammation.
3. It brings the chemical mediators derived from plasma to the
area.
4. It contains fibrinogen which changes to fibrin by activation
of clotting system. Fibrin helps in localization of
inflammation by surrounding the area .
Fate:
Fluid exudate is absorbed by lymphatics.
 Fate of Acute inflammation
 Complete resolution
 Healing by scarring
 Progression and spread:
(direct, lymphatic & blood spread)
 Chronicity
TYPES OF ACUTE INFLAMMATION

SUPPURATIVE NON-SUPPURATIVE
INFLAMMATION INFLAMMATION
 I- SUPPURATIVE INFLAMMATION

Types:
II- Diffuse Supp. Inflamm.
I-Localized
Cellulitis,
Supp. Inflamm.
Suppurative appendicitis,
Abscess, Suppurative cholecystitis,
furuncle, Suppurative peritonitis,
carbuncle Suppurative meningitis
…etc.
 I- LOCALIZED SUPPURATIVE INFLAMMATION

Abscess

carbuncle
furuncle
 Abscess
Definition:
 Cavity containing
pus
 (pus is formed of
fluid exudate,
fibrin,pus cells,
polymprph,
macrophages,
necrotic tissue and
bacteria)
 Abscess
 Fate of abscess:
 Small abscess:
Pus may be absorbed followed by healing
 Large abscess:
Should be evacuated, spontaneous or surgical
 Abscess
Complication of abscess:
 Ulcer (local defect on

the surface)
 Sinus (blind end tract)

& Fistula (tract with Ulcer

two openings)
 Hemorrhage &

gangrene
 Spread of infection

Sinus Gangrene
II- DIFFUSE SUPPURATIVE INFLAMMATION

Acute supp. appendicitis

Diffuse sup.cholecystitis Suppurative meningitis

Cellulitis

Cellulitis
NON-SUPPURATIVE INFLAMMATION

 Catarrhal inflammation: e.g.common cold

 Pseudo-membranous inflam.: e.g.diphtheria
 Fibrinous inflammation: e.g. fibrinous pericarditis,
fibrinous pleurisy, fibrinous peritonitis.
 Serous inflammation: e.g. burns
 Haemorrhagic inflammation
 Gangrenous (necrotizing) inflammation
 Allergic inflammation
NON-SUPPURATIVE INFLAMMATION

Fibrinous pleurisy Fibrinous

pericarditis Fibrinous
pericarditis

Gangrenous inflammation
Haemorhagic
pericarditis. Fibrinous peritonitis
 CHRONIC INFLAMMATION
Characterized by:
 Mild irritant with a prolonged action
 Tissue response is gradual and prolonged
(mild vascular dilatation and congestion)
 Tissue destruction is progressive and
gradually replaced by fibrous tissue with
thickening and narrowing of blood vessels
(endarteritis obliterans)
 Scanty fluid exudate
 Chronic Inflammatory Cellular
Exudate
Composed of:
 Lymphocytes

 Plasma cells

 Macrophages

 Giant cells

 Esinophils in parasitic and allergic

inflammation.
 Types of Chronic Inflammation
1- Chronic non-specific inflammation
 Different irritants produce inflammatory
reaction of the same microscopic picture
2- Chronic specific inflammation
 Each irritant produces inflammation of a
characteristic microscopic picture
Chronic non-specific
inflammation
 Granuloma
 Definition:
 A type of chronic inflammation
characterized by focal accumulation of large
number of macrophages together with
lymphocytes, plasma cells, giant cells and
fibroblasts forming tiny granules
 Types of Granulomas
1-Infective granuloma
 a. Bacterial e.g.TB, leprosy & syphilis

 b. Parasitic e.g. Bilharziasis

 c. Fungal e.g. madura foot

2-Non-infective granuloma
 a. Silicosis and asbestosis

 b. Foreign body granuloma

3-Granuloma of unknown cause

 Sarcoidosis
 Tuberculous granuloma
of the lung

Granuloma