Blok 4 Radang
Transcript of Blok 4 Radang
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"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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INFLAMMATIONINFLAMMATIONdr. Al Munawir, M.Kes., Ph.D.
Laboratorium Patologi AnatomiFakultas Kedokteran
Universitas Jember
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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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Lewis +ri'le es'onse!
FlushFlush :: a'illar& dilatation.
FlareFlare :: arteriolar dilatation.WealWeal :: e-udation, edema.
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ed, arm * )wollen
/Flare, Flush * eal % Lewis0
+ri'le res'onse
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1astri Ul er!
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Lar&ngitis!
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Mouth A'hthus ul er
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A ute 2nteritis!
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Pneumonia
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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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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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5eutro'hil Margination
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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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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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In#lammation ;ut ome
&cuteInflammation
'esolution
ChronicInflammation
scess
(inus)istula
)i#rosis*(car
+lcer
In,ur!
)ungusVirusCancers
. . etc.
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3hroni In#lammation!
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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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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#
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4ealing * e'air dr. Al Munawir, M.Kes., Ph.D.
Laboratorium Patologi AnatomiFakultas KedokteranUniversitas Jember
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)tages o# 4ealing!
4emorrhageIn#lammation
1ranulation tissue /so#t allus0) ar % Fibrosis /hard allus0emodeling * ound strength
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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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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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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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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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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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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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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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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
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1ranulation tissue
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4ealing)kin wound
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4ealing 6 )kin ) ar
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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