Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University...
Transcript of Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University...
![Page 1: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/1.jpg)
Author(s): Gerald Abrams, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution–Non-commercial–Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact [email protected] with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
![Page 2: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/2.jpg)
Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicy
Use + Share + Adapt
Make Your Own Assessment
Creative Commons – Attribution License
Creative Commons – Attribution Share Alike License
Creative Commons – Attribution Noncommercial License
Creative Commons – Attribution Noncommercial Share Alike License
GNU – Free Documentation License
Creative Commons – Zero Waiver
Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (USC 17 § 102(b)) *laws in your jurisdiction may differ
Public Domain – Expired: Works that are no longer protected due to an expired copyright term.
Public Domain – Government: Works that are produced by the U.S. Government. (USC 17 §105)
Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain.
Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair. To use this content you should do your own independent analysis to determine whether or not your use will be Fair.
{ Content the copyright holder, author, or law permits you to use, share and adapt. }
{ Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. }
{ Content Open.Michigan has used under a Fair Use determination. }
![Page 3: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/3.jpg)
M1 Patients and Populations:
Inflammation and Repair IV Outcomes of Acute Inflammation
Gerald D. Abrams MD
Fall 2008
![Page 4: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/4.jpg)
The Inflammatory response 1. vascular response-fluid exudate 2. cellular response-leukocytic exudate 3. macrophages 4. exudates-non-cellular, cellular, mixed 5. granulomas-granulomatous inflammation 6. fate of the inflammatory reaction 7. healing and scar formation 8. healing of cutaneous wounds 9. chronic inflammation
![Page 5: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/5.jpg)
Possible Outcomes of Acute Inflammation
• Resolution
• Healing with Scar
• Chronic Inflammation
![Page 6: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/6.jpg)
Purulent Pneumonia
G.D. Abrams, University of Michigan Medical School
![Page 7: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/7.jpg)
Resolution – Normal Lung
G.D. Abrams, University of Michigan Medical School
![Page 8: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/8.jpg)
HEALING
• SCAR FORMATION
• REGENERATION
![Page 9: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/9.jpg)
GRANULATION TISSUE
• Loose,young connective tissue with proliferating fibroblasts and endothelial cells. Granulation tissue “matures” to form scar.
• The process of granulation tissue ingrowth is termed “organizaton”.
![Page 10: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/10.jpg)
FIBRINOUS EXUDATE
G.D. Abrams, University of Michigan Medical School
![Page 11: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/11.jpg)
FIBRINOUS EXUDATE EARLY ORGANIZATION
G.D. Abrams, University of Michigan Medical School
![Page 12: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/12.jpg)
FIBROBLAST PROLIFERATION
G.D. Abrams, University of Michigan Medical School
![Page 13: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/13.jpg)
ENDOTHELIAL PROIFERATION
G.D. Abrams, University of Michigan Medical School
![Page 14: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/14.jpg)
GRANULATION TISSUE
G.D. Abrams, University of Michigan Medical School
![Page 15: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/15.jpg)
GRANULATION TISSUE Day 5-7
G.D. Abrams, University of Michigan Medical School
![Page 16: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/16.jpg)
GRANULATION TISSUE Second Week
G.D. Abrams, University of Michigan Medical School
![Page 17: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/17.jpg)
MATURING SCAR
G.D. Abrams, University of Michigan Medical School
![Page 18: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/18.jpg)
NECROTIC MYOCARDIUM Day 1-2
G.D. Abrams, University of Michigan Medical School
![Page 19: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/19.jpg)
NECROTIC MYOCARDIUM Day 5-6
G.D. Abrams, University of Michigan Medical School
![Page 20: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/20.jpg)
NECROTIC MYOCARDIUM Second Week
G.D. Abrams, University of Michigan Medical School
![Page 21: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/21.jpg)
MYOCARDIAL SCAR
G.D. Abrams, University of Michigan Medical School
![Page 22: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/22.jpg)
EPITHELIAL REGENERATION
G.D. Abrams, University of Michigan Medical School
![Page 23: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/23.jpg)
HEALING OF CUTANEOUS WOUNDS
• Healing by primary or first intention- wound edges in apposition at the start of healing.
• Healing by secondary or second intention- wound edges apart, wound open.
![Page 24: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/24.jpg)
PHASES OF WOUND HEALING
• Inflammation
• Organization and Regeneration
• Deposition of ECM
• Remodeling
![Page 25: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/25.jpg)
HEALING BY PRIMARY INTENTION
Department of Pathology, University of Michigan
![Page 26: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/26.jpg)
HEALING BY SECONDARY INTENTION
Department of Pathology, University of Michigan
![Page 27: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/27.jpg)
WOUND CONTRACTION
Grillo, Watts and Gross
![Page 28: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/28.jpg)
Complications of Wound Healing • Deficient scar – dehiscence, hernia • Excessive scar – hypertrophic scar, keloid • Excessive granulation tissue – “proud flesh”, adhesions
• Contracture • Traumatic neuroma
![Page 29: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/29.jpg)
KELOID
Produnis, Wikimedia Commons
![Page 30: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/30.jpg)
ADHESIONS
Department of Pathology, University of Michigan
![Page 31: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/31.jpg)
CHRONIC INFLAMMATION
Inflammation sufficiently prolonged that evidence of repair is seen at the same time as evidence of tissue injury and continuing,
active inflammation
![Page 32: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/32.jpg)
CAUSES OF CHRONIC INFLAMMATION
• Prolonged or repetitive action of toxic agents
• Persistent infection
• Autoimmunity
![Page 33: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/33.jpg)
CHRONIC INFLAMMATION
G.D. Abrams, University of Michigan Medical School
![Page 34: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/34.jpg)
ACUTE PHASE RESPONSE
• Leukocytosis
• Fever
• Synthesis of acute phase proteins
• Miscellaneous systemic effects
![Page 35: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/35.jpg)
What we want you to know and understand
• The 5 cardinal signs of inflammation – their mechanisms
• Mechanisms of the vascular response and the cellular response and how they relate to one another
• The cells participating in inflammatory and reparative responses, and their roles
• Exudates – various types, why they form, and their fate. Granulomatous inflammation
• Organization and scarring • Wound healing – mechanisms, factors affecting
healing, complications
![Page 36: Author(s): Gerald Abrams, M.D., 2009 ... - Open Michigan€¦ · Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School](https://reader034.fdocuments.us/reader034/viewer/2022052100/603a69bf5902c63f8d7795ea/html5/thumbnails/36.jpg)
Slide 6: G.D. Abrams, University of Michigan Medical School Slide 7: G.D. Abrams, University of Michigan Medical School Slide 10: G.D. Abrams, University of Michigan Medical School Slide 11: G.D. Abrams, University of Michigan Medical School Slide 12: G.D. Abrams, University of Michigan Medical School Slide 13: G.D. Abrams, University of Michigan Medical School Slide 14: G.D. Abrams, University of Michigan Medical School Slide 15: G.D. Abrams, University of Michigan Medical School Slide 16: G.D. Abrams, University of Michigan Medical School Slide 17: G.D. Abrams, University of Michigan Medical School Slide 18: G.D. Abrams, University of Michigan Medical School Slide 19: G.D. Abrams, University of Michigan Medical School Slide 20: G.D. Abrams, University of Michigan Medical School Slide 21: G.D. Abrams, University of Michigan Medical School Slide 22: G.D. Abrams, University of Michigan Medical School Slide 25: Department of Pathology, University of Michigan Slide 26: Department of Pathology, University of Michigan Slide 27: Grillo, Watts and Gross Slide 29: Produnis, Wikimedia, http://commons.wikimedia.org/wiki/File:Verbrennungsnarbe_keloid1.jpg, CC:BY-SA 3.0, http://creativecommons.org/licenses/by-sa/3.0/ Slide 30: Department of Pathology, University of Michigan Slide 33: G.D. Abrams, University of Michigan Medical School
Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy