INFLAMMATION

Ms. Aura Ydda Alyne S.

Toreja, RN

DEFINITION OF TERMS
An INFECTION is an
invasion of body tissue
by microorganisms and
their growth there.

DEFINITION OF TERMS
PATHOGENICITY is the
ability to produce
disease; thus a pathogen
is a microorganism that
causes disease.

DEFINITION OF TERMS
ASEPSIS freedom from
disease causing microorganism.
2 BASIC TYPES:
1. Medical Asepsis
2. Surgical Asepsis / Sterile
Technique

DEFINITION OF TERMS
MEDICAL ASEPSIS includes
all practices intended to
confine a specific
microorganism to a specific
area, limiting the no., growth
and transmission of
microorganism.

SURGICAL ASEPSIS or
STERILE TECHNIQUE
free of ALL
microorganism.
SEPSIS state of
infection

4 MAJOR CATEGORIES OF
MICROORGANISMS:
Bacteria most common
Viruses consist of nucleic acid; must enter
living cells to reproduce.
Fungi include yeasts and molds; C.
albicans is a yeast considered to be normal flora
in the vagina.
Parasites live on other living organisms.

COLONIZATION is the process
by which the strains of
microorganisms become
resident flora.
In this state, microorganisms may
GROW and MULTIPLY but DO NOT
CAUSE A DISEASE

TYPES OF INFECTION
LOCAL INFECTION
o Limited to a specific
body part
SYSTEMIC INFECTION
o Microorganisms
spread and damage
different parts of the
body

When a culture of the
persons blood
reveals
microorganisms, the
condition is called
BACTEREMIA.

When bacteremia
results in systemic
infection, it is referred
to as SEPTICEMIA.

NOSOCOMIAL
INFECTIONS are
classified as infections
that are associated
with the delivery of
health care services.

CHAIN OF INFECTION
Etiologic
Agent
Portal of entry
to a susceptible
host
Susceptible
host
Reservoir
Portal of Exit
Method of
Transmission

Bodys Defenses
Against Infection

NON SPECIFIC
DEFENSES
Protects the
person against
ALL
microorganisms.
SPECIFIC
or
IMMUNE
DEFENSES
Directed against
identifiable
bacteria, viruses,
fungi, or other
infectious
agents.

NON
SPECIFIC
DEFENSES

Nonspecific
Defenses anatomic
and physiologic barriers
and the inflammatory
response.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Intact skin and
mucous membrane
are the bodys first
line of defense.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Fungi can live on the skin, but they cannot
penetrate it.
The dryness of the skin also is deterrent to
bacteria. Bacteria are most plentiful in moist
areas of the body.
Resident bacteria of the skin also prevent
other bacteria from multiplying.
Normal secretions make the skin slightly
acidic also inhibits bacterial growth.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Nasal passages have
defensive function.
Air enters comes in contact
with moist mucous membrane
and cilia. These trap m.o., dust,
foreign materials.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Lungs have alveolar
macrophages (large
phagocytes). Phagocytes
are cells that ingest m.o.,
other cells and foreign
particles.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
SALIVA Laway contains
microbial inhibitors such as
LACTOFERRIN,
LYSOZYME and
SECRETORY IgA.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
EYE is protected from
infection by tears, which
continually wash m.o. away
and contain inhibiting
lysozyme.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
GIT high acidity of the
stomach prevents microbial
growth.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Resident flora of large
intestine help prevent the
establishment of disease
producing m.o.
Peristalsis also tends to move
microbes out of the body.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
VAGINA during puberty:
LACTOBACILLI ferment sugars in
the vaginal secretions, creating a
vaginal pH of 3.5 to 4.5. This low
pH inhibits the growth of m.o.

NON SPECIFIC DEFENSES:
Anatomic and Physiologic Barriers
Urine flowhas a flushing effect
and bacteriostatic action that
keeps the bacteria
(Staphylococcus epidermidis
coagulase from the skin & E. coli
from feces ) from ascending the
urethra.

NON SPECIFIC DEFENSES:
INFLAMMATORY RESPONSE
INFLAMMATION is a local
and non specific defensive
response of the tissues to
an injurious or infectious
agent.

INFLAMMATION
Aunt RUBY (RUBOR =
redness) CALLed (CALOR
= heat) and asked me what
do I want I told her I want a
TD bear (TUMOR = edema
& DOLOR = pain)
suddenly, the line got busy
(LOSS OF FUNCTION).

NON SPECIFIC DEFENSES:
INFLAMMATORY RESPONSE
INJURIOUS AGENTS:
Physical Agents mechanical objects causing
trauma, excessive heat or cold and radiation.
Chemical Agents EXTERNAL: strong acids,
alkalis, poisons and irritating gases. INTERNAL: HCL
Microorganisms bacteria, viruses, fungi and
parasites.

3 STAGES OF INFLAMMATORY
RESPONSE: V-E-R
First Stage: Vascular and Cellular
Responses
Second Stage: Exudate
Production
Third Stage: Reparative Phase

Vascular and Cellular
Responses
INJURY

CONSTRICT

Injured Tissues releases:

HISTAMINE

DILATION OF SMALL BLOOD
VESSELS

More blood flow in the area

Hyperemia
(redness: RUBOR)

Heat : CALOR

Increase Vascular Permeability at

the site with dilation

Release of chemical mediators: BSP

Bradykinin
Serotonin
Prostaglandin

Release of HISTAMINE

Fluids, proteins and leukocytes

leak
into interstitial space

Swelling, Edema: TUMOR

PAIN : DOLOR

Blood flow: slow in the dilated

vessels

Allows more leukocytes

aggregate or line up:
MARGINATION

Leukocytes then move through

the blood vessel wall into
affected tissue spaces:
EMIGRATION

In response to the exit of

leukocytes into the blood:
Dec. Leukocytes in the blood

Bone marrow produces large

number of leukocytes and
releases them into the blood
stream.

Leukocytosis

A normal leukocyte count is:

4,500 to 11,000 per cubic millimeter
20,000 or more when inflammation
occurs.

Exudate Production
Inflammatory EXUDATE is produced.
Consists of:
FLUID that escaped from the
blood vessels
Dead phagocytic cells
Dead tissue cells and products
that they release

Exudate Production
FIBRINOGEN [Fibrin]
THROMBOPLASTIN
PLATELETS
***Together they form an
interlacing network to wall off the
area and prevent spread of
injurious agent.

Exudate Production
During this stage the injurious
agent is overcome.
MAJOR TYPES OF EXUDATES:
SEROUS EXUDATES- contains
chiefly of serum (clear portion of blood)
Ex: blister from a burn

Exudate Production
PURULENT EXUDATES thicker
than serous exudate.
- contain PUS
- SUPPURATION [process of pus
formation]
- PYOGENIC BACTERIA [bacteria that
produces pus]
- Color exudates: depends on the causative
organism.

Exudate Production
SANGUINEOUS
(HEMORRHAGIC) EXUDATES
- Contains large amount of RBC.
- Commonly seen in opened wounds.

SANGUINEOUS
(HEMORRHAGIC) EXUDATES
BRIGHT SANGUINEOUS
EXUDATES fresh bleeding
DARK SANGUINEOUS
EXUDATES older bleeding

Exudate Production
SEROSANGUINEOUS
consists of clear and blood
tinge drainage; commonly
seen in surgical incisions.

Exudate Production
PUROSANGUINEOUS
- Consists of pus and blood,
often seen in new wound
that is infected.

Reparative Phase
REGENERATION
Replacement with
Fibrous tissue or
SCAR FORMATION

Reparative Phase
REGENERATIONis the
replacement of destroyed
tissue cells by cells that are
identical or similar in structure
and function.

Reparative Phase
REGENERATION not
possible

Repair occurs by FIBROUS

SCAR TISSUE
FORMATION

Reparative Phase
Inflammatory Exudates with its
interlacing network of fibrin
provides framework
for the new tissue to develop.

Damaged tissues are replaced

***Connective tissue elements: COLLAGEN,
BLOOD CAPILLARIES, LYMPHATICS

Reparative Phase
GRANULATION TISSUE fragile
gelatinous tissue, appearing
pink or red because of the
many newly formed capillaries.

Later: tissue shrinks, collagen

fibers contract

Reparative Phase

Collagen fibers contract

Firmer fibrous tissue remains.

CICATRIX / SCAR

Nursing Management
R - Rest
I - Ice
C - Compression: Elastic
Bandage
E - Elevate

SPECIFIC
DEFENSES

SPECIFIC
DEFENSES of the
body involves the
IMMUNE SYSTEM.

The IMMUNE RESPONSE
has 2 components:
Antibody Mediated
Defenses
Cell Mediated
Defenses

Antibody Mediated
Defenses: BCAH
B B lymphocytes; mediated by
antibodies produced by B
cells
C CIRCULATING immunity
A Antibody mediated defenses
H HUMORAL immunity

Antibody Mediated
Defenses
ANTIGEN substance that
induces a state of sensitivity.
ANTIBODIES
immunoglobulins; defend
primarily against bacterial and
viral infections.

2 MAJOR TYPES OF IMMUNITY:
ACTIVE
PASSIVE

ACTIVE antibodies are produced by
the body in response to an antigen.
Natural antibodies are
formed in the presence of an
active infection of the body.
Artificial Antigens (vaccines
or toxoids) are administered to
stimulate antibody production.

PASSIVE antibodies are
produced by another source.
Natural Antibodies are
transferred naturally from an
immune mother to the baby.
Artificial Immune serum
(antibody) from an animal or
another human is injected.

CELL MEDIATED DEFENSES:
TC
T - T cell system
C - Cell Mediated defenses
or
Cellular Immunity

CELL MEDIATED DEFENSES
Exposure to an ANTIGEN

Lymphoid tissues release

large number of activated T
cells

CELL MEDIATED DEFENSES:
There are 3 main group of T cells
Helper T cells help in the function of
the immune system.
Cytotoxic T cells attack and kill
microorganisms and sometimes bodys own
cells
Suppressor T cells suppress
the functions of the helper t cells and the
cytotoxic T cells.

HANDWASHING!
For routine client care, the WHO
(2005) recommends hand
washing under a stream of water
for at least 20 seconds using
plain granule soap, or liquid
soaps.