NUR 376
Week 1 Module 1
Inflammation, Infection, Immune Outline
Applied Pathophysiology - Concordia St. Paul
Pass the Exam with Confidence
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NUR 376 Applied Pathophysiology
Week 1 Module 1: Inflammation, Infection, Immune Outline
by Rhaeven Ortiz
Learning Objectives:
● Distinguish between the phases of acute inflammatory reaction.
o Ch. 9
▪ Vascular Phase
● Vascular Permeability
o Figure 9.1
o Exudate, abscess, transudate, effusion
The fluid that leaves the capillaries is a protein-rich filtrate of blood that contains WBCs. As the WBCs perform defensive
activities, the fluid increases within the tissue spaces and causes edema, or swelling. If the fluid is rich in protein from
WBCs, microbial organisms, and cellular debris, it is called purulent exudate, or pus. An abscess is a localized, walled-off
collection of purulent exudate within tissue. In contrast, fluid that contains little protein and is mainly a watery filtrate
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of blood is called transudate. Other types of exudates include serous (clear, watery fluid), sanguineous (blood),
serosanguineous (bloody/watery fluid), or fibrinous (thick, fibrin-rich fluid).
Any accumulation of fluid in a body cavity is called an effusion. An effusion can occur due to inflammatory or
noninflammatory processes.
▪ Cellular Phase
● Chemotaxis - During the cellular phase of inflammation, a chemical signal from microbial agents,
endothelial cells, and WBCs attracts platelets and other WBCs to the site of injury. This is referred to
as chemotaxis.
▪ Leukocytosis - During this phase, an increased number of leukocytes (WBCs) are released from the bone
marrow into the bloodstream, a process known as leukocytosis.
▪ During inflammation, the WBC count in the blood commonly increases from a normal baseline of 4000 to
10,000 cells/mL to 15,000 to 20,000 cells/mL. The clinician can use the number of WBCs to determine
the severity of the infectious process that the patient is experiencing.
➢ Explain the functions of the key mediators of inflammation.
o Ch. 9
▪ Inflammatory Mediators - substances that promote or inhibit inflammatory reactions. These include
interleukins (ILs) and tumor necrosis factor alpha (TNF-alpha)
● Cytokines do what? Some of the inflammatory mediators released by WBCs are referred to as cytokines;
the most common are tumor necrosis factor (TNF) alpha and interleukins (ILs). Cytokines modulate the
inflammatory reaction by amplifying or deactivating the process. Simultaneously, they cause localized and
systemic effects.
● Chemokines do what? Chemokines are proteins that attract leukocytes to the endothelium at the area of
injury. Cytokines cause stimulation of the liver to release substances called acute phase proteins.
● Acute Phase Proteins do what? Acute phase proteins include C-reactive protein (CRP), fibrinogen, serum
amyloid A, and hepcidin. Acute phase proteins facilitate WBC phagocytosis of microbes and other foreign
material and assist in the analysis of the inflammation process occurring in the body.
● Table 9.1 (flashcards of each: tumor necrosis factor, interleukins, histamines, prostaglandins,
leukotrienes). Quizlet link:
https://quizlet.com/937853871/table-9-1-major-proinflammatory-mediators-flash-cards/
Clinical Concept: Laboratory tests that demonstrate elevated CRP, ESR, and fibrinogen levels in the bloodstream are
indicators that the patient is enduring an active inflammatory process.
Clinical Concept: Neutrophils are also referred to as polymorphonuclear leukocytes (PMNs); in their immature form,
they are called bands or stabs.
Rev. 5/24
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▪ White Blood Cells (WBC)
o Which blood cells are doing what job e.g. neutrophils, eosinophils, basophils, etc. (flashcards)?
o Granulocytes include neutrophils, eosinophils, and basophils. These cytoplasmic granules contain
important enzymes and antimicrobial proteins that support the inflammatory process and fight
infection.
o Neutrophils - short life span ranging from approximately 10 hours to a few days. Mature neutrophils
have distinctive multisegmented nuclei and are sometimes known as segmented neutrophils (segs). As
mature neutrophils die off and the supply becomes exhausted, the bone marrow responds with a rapid
release of immature neutrophils (bands). Neutrophils begin the process of phagocytosis of the foreign
matter immediately.
▪ While the neutrophils are involved in phagocytosis of microbial organisms and cellular debris, there
is a respiratory burst from the mitochondria. This burst releases free radicals (also called
superoxides or reactive oxygen species) that disrupt microbial membranes, leading to their
destruction. Free radicals contain a superoxide anion (O2), which is an oxygen molecule with a free
electron that is drawn to elements in tissue.
▪ Using different terminology, free radicals oxidize microbial membranes and some of the
surrounding host tissue cell membranes. However, host cells contain antioxidants that protect
against extensive tissue damage. A genetic disorder called chronic granulomatous disease causes a
deficiency of free radicals, which leads to immunodeficiency and increased risk of infections.
o White blood cell (WBC) differential is used in the diagnosis of infection and inflammation. This test is
part of a complete blood count (CBC) with a differential, which quantifies RBCs and WBCs. A WBC with
Rev. 5/24
3
Downloaded by Benjamin Luca ()
Week 1 Module 1
Inflammation, Infection, Immune Outline
Applied Pathophysiology - Concordia St. Paul
Pass the Exam with Confidence
, lOMoARcPSD|51648332
NUR 376 Applied Pathophysiology
Week 1 Module 1: Inflammation, Infection, Immune Outline
by Rhaeven Ortiz
Learning Objectives:
● Distinguish between the phases of acute inflammatory reaction.
o Ch. 9
▪ Vascular Phase
● Vascular Permeability
o Figure 9.1
o Exudate, abscess, transudate, effusion
The fluid that leaves the capillaries is a protein-rich filtrate of blood that contains WBCs. As the WBCs perform defensive
activities, the fluid increases within the tissue spaces and causes edema, or swelling. If the fluid is rich in protein from
WBCs, microbial organisms, and cellular debris, it is called purulent exudate, or pus. An abscess is a localized, walled-off
collection of purulent exudate within tissue. In contrast, fluid that contains little protein and is mainly a watery filtrate
Rev. 5/24
1
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
of blood is called transudate. Other types of exudates include serous (clear, watery fluid), sanguineous (blood),
serosanguineous (bloody/watery fluid), or fibrinous (thick, fibrin-rich fluid).
Any accumulation of fluid in a body cavity is called an effusion. An effusion can occur due to inflammatory or
noninflammatory processes.
▪ Cellular Phase
● Chemotaxis - During the cellular phase of inflammation, a chemical signal from microbial agents,
endothelial cells, and WBCs attracts platelets and other WBCs to the site of injury. This is referred to
as chemotaxis.
▪ Leukocytosis - During this phase, an increased number of leukocytes (WBCs) are released from the bone
marrow into the bloodstream, a process known as leukocytosis.
▪ During inflammation, the WBC count in the blood commonly increases from a normal baseline of 4000 to
10,000 cells/mL to 15,000 to 20,000 cells/mL. The clinician can use the number of WBCs to determine
the severity of the infectious process that the patient is experiencing.
➢ Explain the functions of the key mediators of inflammation.
o Ch. 9
▪ Inflammatory Mediators - substances that promote or inhibit inflammatory reactions. These include
interleukins (ILs) and tumor necrosis factor alpha (TNF-alpha)
● Cytokines do what? Some of the inflammatory mediators released by WBCs are referred to as cytokines;
the most common are tumor necrosis factor (TNF) alpha and interleukins (ILs). Cytokines modulate the
inflammatory reaction by amplifying or deactivating the process. Simultaneously, they cause localized and
systemic effects.
● Chemokines do what? Chemokines are proteins that attract leukocytes to the endothelium at the area of
injury. Cytokines cause stimulation of the liver to release substances called acute phase proteins.
● Acute Phase Proteins do what? Acute phase proteins include C-reactive protein (CRP), fibrinogen, serum
amyloid A, and hepcidin. Acute phase proteins facilitate WBC phagocytosis of microbes and other foreign
material and assist in the analysis of the inflammation process occurring in the body.
● Table 9.1 (flashcards of each: tumor necrosis factor, interleukins, histamines, prostaglandins,
leukotrienes). Quizlet link:
https://quizlet.com/937853871/table-9-1-major-proinflammatory-mediators-flash-cards/
Clinical Concept: Laboratory tests that demonstrate elevated CRP, ESR, and fibrinogen levels in the bloodstream are
indicators that the patient is enduring an active inflammatory process.
Clinical Concept: Neutrophils are also referred to as polymorphonuclear leukocytes (PMNs); in their immature form,
they are called bands or stabs.
Rev. 5/24
2
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
▪ White Blood Cells (WBC)
o Which blood cells are doing what job e.g. neutrophils, eosinophils, basophils, etc. (flashcards)?
o Granulocytes include neutrophils, eosinophils, and basophils. These cytoplasmic granules contain
important enzymes and antimicrobial proteins that support the inflammatory process and fight
infection.
o Neutrophils - short life span ranging from approximately 10 hours to a few days. Mature neutrophils
have distinctive multisegmented nuclei and are sometimes known as segmented neutrophils (segs). As
mature neutrophils die off and the supply becomes exhausted, the bone marrow responds with a rapid
release of immature neutrophils (bands). Neutrophils begin the process of phagocytosis of the foreign
matter immediately.
▪ While the neutrophils are involved in phagocytosis of microbial organisms and cellular debris, there
is a respiratory burst from the mitochondria. This burst releases free radicals (also called
superoxides or reactive oxygen species) that disrupt microbial membranes, leading to their
destruction. Free radicals contain a superoxide anion (O2), which is an oxygen molecule with a free
electron that is drawn to elements in tissue.
▪ Using different terminology, free radicals oxidize microbial membranes and some of the
surrounding host tissue cell membranes. However, host cells contain antioxidants that protect
against extensive tissue damage. A genetic disorder called chronic granulomatous disease causes a
deficiency of free radicals, which leads to immunodeficiency and increased risk of infections.
o White blood cell (WBC) differential is used in the diagnosis of infection and inflammation. This test is
part of a complete blood count (CBC) with a differential, which quantifies RBCs and WBCs. A WBC with
Rev. 5/24
3
Downloaded by Benjamin Luca ()
