Blok 4 Radang

8/19/2019 Blok 4 Radang

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Shashi-Mar 2000

Inflammation -1

"Opportunities are usually"Opportunities are usuallydisguised by hard work, sodisguised by hard work, so

most people don't recognizemost people don't recognizethem."them."

- Ann Landers- Ann Landers


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Shashi-03/08/16

Inflammation -2

INFLAMMATIONINFLAMMATIONdr. Al Munawir, M.Kes., Ph.D.

Laboratorium Patologi AnatomiFakultas Kedokteran

Universitas Jember


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Shashi-Mar 2000

Inflammation -3

Introdu tion!

"In#lame$ % to set #ire.In#lammation is "d&nami res'onse o#vas ularised tissue to in(ur&.$Is a 'rote tive res'onse.

)erves to bring de#ense * healingme hanisms to the site o# in(ur&.


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Inflammation -4

Lewis +ri'le es'onse!

FlushFlush :: a'illar& dilatation.

FlareFlare :: arteriolar dilatation.WealWeal :: e-udation, edema.


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Shashi-Mar 2000

Inflammation -5

ed, arm * )wollen

/Flare, Flush * eal % Lewis0

+ri'le res'onse


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Shashi-Mar 2000

Inflammation -6

1astri Ul er!


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Inflammation -7

Lar&ngitis!


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Inflammation -8

Mouth A'hthus ul er


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Inflammation -9

A ute 2nteritis!


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Inflammation -10

Pneumonia


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Inflammation -11

3ardinal )igns o# In#lammation

Rubor Rubor :: edness % 4&'eraemia.Calor Calor :: arm % 4&'eraemia.Dolor Dolor : : Pain % 5erve, 3hemi al med.Tumor Tumor :: )welling % 2-udation

LossLoss of of FunctionFunction ::


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Shashi-Mar 2000

Inflammation -12

In#lammation 6 Me hanism

1. Vaso dilatation

2. Exudation - Edema

3. Emigration of cells

4. Chemotaxis


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Me hanism o# In#lammation!


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Shashi-Mar 2000

Inflammation -15

5eutro'hil Margination


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Inflammation -16

7as ular hanges


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Pneumonia 6 2-udation


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3hemi al Mediators!

3hemi al substan es s&nthesised orreleased whi h mediate the hanges inin#lammation.

4istamine b& mast ells 6 vasodilatation.Prostaglandins % 3ause 'ain * #ever.8rad&kinin 6 3auses 'ain.


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Shashi-Mar 2000

Inflammation -19

Mor'hologi t&'es

A ute!2-udative In#lammation! e- ess #luid. +8 lung.)u''uration9Purulent % 8a terial 6 neutro'hils

Fibrinous % 'neumonia % #ibrin)erous % e- ess lear #luid % 4eart, lung4aemorrhagi % b.v.damage 6 anthra-.

3hroni in#lammation! with healing.1rannulomatous % lusters o# e'itheloid: ellseg. +8, Fungus, Foreign bod&.


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“Never let the com etition define !ou.Instead" !ou have to define !ourself#ased on a oint of vie$ !ou care

dee l! a#out.% – om !happel


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Inflammation -21

In#lammation ;ut ome

&cuteInflammation

'esolution

ChronicInflammation

scess

(inus)istula

)i#rosis*(car

+lcer

In,ur!

)ungusVirusCancers

. . etc.


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Shashi-Mar 2000

Inflammation -22

3hroni In#lammation!


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Shashi-Mar 2000

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2dema


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)erous In#lammation 6 2##usion


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)erousIn#lammation

6 2##usion


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FibrinousIn#lammation


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Purulent 6 In#lammation 6 PU)


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Inflammation -28

Purulent 6In#lammation 6PU)


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Purulent 6In#lammation 6PU)


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3hroniIn#lammation!

Lung Abs ess


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1ranuloma!


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A ute 7s 3hroni

Flush, Flare *eal

A ute

in#lammator& ells6 5eutro'hils7as ular damage

More e-udationLittle or no #ibrosis

Little signs 6Fibrosis,3hroni

in#lammator& ells % L&m'ho &tes5eo6vas ularisation5o9less e-udationProminent #ibrosis


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eat 'edness ($elling 0ain oss f )unc.

+he < 3ardinal )igns o#

I fl i 35


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4ealing * e'air dr. Al Munawir, M.Kes., Ph.D.

Laboratorium Patologi AnatomiFakultas KedokteranUniversitas Jember


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Inflammation -36

)tages o# 4ealing!

4emorrhageIn#lammation

1ranulation tissue /so#t allus0) ar % Fibrosis /hard allus0emodeling * ound strength


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Inflammation -37

e'air

egeneration o# in(ured tissue b&'aren h&mal ells o# the same t&'e

e'la ement b& onne tive tissue

In other wordsegeneration

) ar


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Inflammation -38

Proli#erative Potential

Labile cells 6 ontinuousl& dividing2'idermis, mu osal e'ithelium, 1I tra te'ithelium et

Stable cells 6 low level o# re'li ation4e'ato &tes, renal tubular e'ithelium,'an reati a ini

Permanent cells 6 never divide5erve ells, ardia m&o &tes, skeletal mm


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Shashi-Mar 2000

Inflammation -39

Pol&'e'tide growth #a tors

Most Important Mediators affecting CellGrowthPresent in serum or 'rodu ed lo all&

2-ert 'leiotro'i e##e ts= 'roli#eration, ellmigration, di##erentiation, tissueremodeling

egulate growth o# ells b& ontrollinge-'ression o# genes that regulate ell'roli#eration


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Inflammation -40

e'air b& onne tive tissue

; urs when re'air b& 'aren h&malregeneration alone annot bea om'lished

Involves 'rodu tion o# Granulation Tissuere'la ement o# 'aren h&mal ells with'roli#erating #ibroblasts and vas ular

endothelial ells

h


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Shashi-Mar 2000

Inflammation -413om'onents o# the 'ro esso# #ibrosis

Angiogenesis 6 5ew vessels budding#rom old

Fibrosis, onsisting o# emigration and'roli#eration o# #ibroblasts and de'ositiono# 23M

) ar remodeling, tightl& regulated b&'roteases and 'rotease inhibitors


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ound healing

Indu tion o# a ute in#lammator& res'onseb& an initial in(ur&

Paren h&mal ell regenerationMigration and 'roli#eration o#'aren h&mal and onne tive tissue ells


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Inflammation -43

ound healing / ont>d0

)&nthesis o# 23M 'roteinsemodeling o# 'aren h&mal elements to

restore tissue #un tionemodeling o# onne tive tissue to

a hieve wound strength


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4ealing b&

First IntentionFo al Disru'tion o#8asement Membraneand loss o# onl& a #ew

e'ithelial ellse.g. )urgi al In ision


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Inflammation -45

4ealing b&Secon Intention

Larger in(ur&, abs ess,

in#ar tionPro ess is similar butesults in mu h larger

) ar and then3;5+ A3+I;5

6


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Inflammation -46

ound )trength

A#ter sutures are removed at one week,wound strength is onl& ?@ o#unwounded skin / alker> Law0

8& B6C months, wound strength is about@ o# unwounded skin / alker>s Law0

fl 47


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Inflammation -47

1ranulation tissue

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Inflammation -48

4ealing)kin wound

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Inflammation -49

4ealing 6 )kin ) ar

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Inflammation -50

Fa tors a##e ting 4ealing!

S!stemicS!stemic Age5utrition7itamin de#.Immune status

;ther diseases

LocalLocalIn#e tion)iEe or e-tent.a''osition8lood su''l&

Mobilit&Foreign bod&


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/Each time !ou are honest and conduct!ourself $ith honest!" a success force $illdrive !ou to$ard greater success. Eachtime !ou lie" even $ith a little $hite lie"there are strong forces ushing !outo$ard failure./

5ose h (ugarman&uthor and 6ar eting ( ecialist

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