If You Fail to Plan,

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"Opportunities are usually disguised by hard
work, so most people don't recognize them." - Ann
Landers
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INFLAMMATION
Dr. Venkatesh M. Shashidhar. Associate Professor
of Pathology Fiji School of Medicine
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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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Red, Warm Swollen
(Flare, Flush Weal Lewis)
Triple response
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Gastric Ulcer
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Laryngitis
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Mouth Aphthus ulcer
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Acute Enteritis
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Pneumonia
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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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The 5 Cardinal Signs of
Heat Redness Swelling Pain
Loss Of Func.
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Inflammation - Mechanism

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

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

• Chemical substances synthesised or released which
  mediate the changes in inflammation.
• Histamine by mast cells - vasodilatation.
• Prostaglandins Cause pain fever.
• Bradykinin - Causes pain.

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"Everyone has a talent. What is rare is the
courage to follow the talent to the dark place
where it leads." -- Erica Jong
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Morphologic types

• Exudative Inflammation
• Suppuration Purulent - Bacterial
• Fibrinous pneumonia fibrosis
• Serous excess clear fluid lung
• Haemorrhagic gtDamage - anthrax.
• Chronic inflammation with healing.
• Grannulomatous clusters of epitheloid cells
  eg. TB, Fungus, Foreign body.

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Inflammation Outcome
Fungus Virus Cancers T.B. etc.
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Chronic Inflammation
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Edema
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Serous Inflammation - Effusion
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Serous Inflammation - Effusion
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Fibrinous Inflammation
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Purulent - Inflammation - PUS
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Purulent - Inflammation - PUS
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Purulent - Inflammation - PUS
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Chronic InflammationLung Abscess
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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
• Neo-vascularisation
• No/less exudation
• Prominent fibrosis

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The world is now living apart, in compartments on
the basis of race, religion, color, creed, caste,
convictions etc. The world has become united only
in the form of a heap it has not been melted in
the crucible of love and molded in the image of
God. -Baba
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Healing Repair
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Stages of Healing

• Inflammation
• Granulation tissue (soft callus)
• Scar Fibrosis (hard callus)
• Remodeling
• Wound strength

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Granulation tissue
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Healing Skin wound
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Healing - Skin Scar
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Factors affecting Healing

• Systemic
• Nutrition
• Vitamin def.
• Age
• Immune status
• Other diseases

• Local
• necrosis
• Infection
• apposition
• Blood supply
• Mobility
• Foreign body