If You Fail to Plan,

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Man is the maker of his own happiness..
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"There are powers inside of you, which, if you
could discover and use, would make of you
everything you ever dreamed or imagined you could
become Orison Swett Marden
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Pathology of Inflammation
Dr. Venkatesh M. Shashidhar. Senior Lecturer in
Pathology Fiji School of Medicine
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INFLAMMATION
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Introduction

• Inflame to set fire.
• Inflammation is dynamic response of vascularised
  tissue to injury.
• Is a protective response.
• Serves to bring defense healing mechanisms to
  the site of injury.

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Lewis Triple Response

• Flush capillary dilatation.
• Flare arteriolar dilatation.
• Weal exudation, edema.

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Cardinal Signs of Inflammation

• Rubor Redness Hyperaemia.
• Calor Warm Hyperaemia.
• Dolor Pain Nerve, Chemical med.
• Tumor Swelling Exudation
• Loss of Function

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Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Surgical wound inflammation
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Mouth Aphthus ulcer
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Gastric Ulcer
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Laryngitis
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Acute Enteritis
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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Pneumonia
Red, Warm Swollen (Flare, Flush Weal
)Calor, Rubor, Dolor, Tumor, Loss of function.
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The 5 Cardinal Signs of
Heat Redness Swelling Pain
Loss Of Func.
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Mechanism of Inflammation
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Emigration of Leucocytes
Diapedesis ?
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Inflammation - Mechanism

• Vaso dilatation
• Exudation - Edema
• Emigration of cells
• Chemotaxis
• Phagocytosis

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Neutrophil Margination
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Pneumonia Vascular changes
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Pneumonia - Exudation
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Chemical Mediators of Inflammation

• Vasoactive amines - Histamine, Seratonin
• Complement system C1 C9 (Classic/alt)
• Kinin System Kallikreins ? Bradykinin
• Clotting system FXII, FX, Fibrin, Plasmin
• Arachidonic acid metabolites
• Prostaglandins - (cyclooxigenase)
• Leukotrienes (Lipoxigenase)
• Lipoxins anti-inflammatory action also.
• PAF, Cytokines(interleukins), Chemokines.
• H2O2, Nitric Oxide, Lysozymes,O2 free radicles

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Inflammation Outcome
Chronic Inflammation
Injury
Acute Inflammation
Resolution/Healing
Abscess
Ulcer
Sinus
Fistula
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Types of Inflammation

• Acute Chronic inflammation.
• Suppurative
• Fibrinous
• Serous
• Granulomatous
• Eosinophilic

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Chronic Inflammation
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Chronic Inflammation

• Inflammation Healing - together
• Persisting injury / infection.
• Chronic Inflammatory cells Ly Macro.
• Less Vascular damage exudation
• Neo-vascularisation
• More fibrosis, scarring, giant cells.
• Eg. TB, Abscess, Fungal infections etc.

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Chronic inflammation - TB
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Chronic InflammationLung Abscess
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Coccidioidomycosis
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Tuberculous Granuloma
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Acute Vs Chronic

• Flush, Flare Weal
• Acute inflammatory cells - Neutrophils
• Vascular damage
• More exudation
• Little or no fibrosis

• Little signs - Fibrosis,
• Chronic inflammatory cells Lymphocytes
• New blood vessels.
• No/less exudation
• Prominent fibrosis

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Summary

• Definition Dynamic,vascularized, injury
• Lewis Flush, Flare, Weal.
• Calor, Rubor, Dolor, Tumor, Loss of funct
• Vasodilatation, exudation, chemotaxis,
  phagocytosis.
• Chemical mediators Prostaglandins, Kinins, etc
• Types Acute/Chronic, Suppurative, serous,
  fibrinous.
• Acute / Chronic differences.

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• Learning is the beginning of wealth.
• Learning is the beginning of health.
• Learning is the beginning of spirituality.
• Learning is where miracles begin.
• Jim Rohn

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"It gives me great pleasure to converse with the
aged. They have been over the road that all of us
must travel and know where it is rough and
difficult and where it is level and easy."
Plato