1. Inflammation & Repair

2. Inflammation

3. Acute Inflammation Cardinal signs –Red (rubor) –Swelling (tumor) –Warm (calor) –Tender (dolor) –Loss of function (functio laesa)

5. Neutrophils Polymorphonuclear Lekocytes (PMN) Margination –Pavementing Adhesion –Complementary adhesion molecules on leukocytes and endothelial cells

6. Leukocyte-Endothelial Adhesion

7. Neutrophils Rolling

8. Emigration & Chemotaxis Mediators Bacterial products - LPS Complement derivatives - C5a Arachidonic acid derivatives –leukotriene B4 Cytokines - IL-8

9. Emigration & Chemotaxis Mediators Neutrophil Chemotaxis in vitro

10. Emigration & Chemotaxis Defects WBC defects - –Chediak-Higashi Syndrome –Diabetes mellitus Chemotactic factor defects –C5 or immunoglobulin deficiency Serum chemotaxis inhibitors –C5 inactivators -  in cirrhosis, sarcoidosis, and other diseases WBC locomotion inhibitors –Chloroquine, cancer and other chronic diseases

11. Phagocytosis & Degranulation Phagocytosis requires three distinct steps –Recognition –Attachment –Engulfment

12. Recognition & Attachment Opsoninzation Opsonins –Fc fragment of IgG –C3b –Mannose-binding protein (produced in the liver) Covers the surface of microorganisms and is recognized by neutrophils and macrophages

13. Phagocytosis & Degranulation

15. Activation and Destruction (killing) Oxygen dependent killing –myeloperoxidase requires hydrogen peroxide and halide (e.g., Cl - ) to produce HOCl –Hydrogen peroxide and ferrous ion without myeloperoxidase will generate OH free radical

16. Chemical Mediators of Inflammation

17. Chemical Mediators of Inflammation Preformed & Newly Synthesized

18. Arachidonic Acid System

19. Noninflammatory and Inflammatory Conditions Transudate - fluid with low protein content and a specific gravity <1.012 Exudate - inflammatory extracellular fluid composed of plasma proteins, principally albumin, cells and cellular debris, and a specific gravity >1.020

20. Transudate - Pulmonary Edema

21. Pitting Edema

22. Laryngeal Edema

23. Pulmonary Edema

24. Ascites

26. Noninflammatory and Inflammatory Conditions Anasarca - edema which is severe and generalized Abscess - localized collections of pus caused by suppuration buried in a tissue, organ, or confined space Cellulitis - spreading suppurations in subcutaneous tissue

27. Types of Exudates Serous - blister in thermal burn Fibrinous - uremic pericarditis, viral/chemical pneumonitis, idiopathic Purulent - meningococcal meningitis Eosinophilic - IgE mediated - asthma & parasitic infection Hemorrhagic - rickettsial Pseudomembranous - diptheria & pseudomembranous enterocolitis

28. Serous Exudate - Blister

30. Fibrinous Exudate - Pericarditis

31. Fibrinous Pericarditis

32. Acute Inflammation - Purulent

36. Pseudomembranous Exudate Diphtheria

38. Diphtheria

39. Outcomes of Acute Inflammation

41. The End Acute Inflammation