Radang akut
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Transcript of Radang akut
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RADANG AKUT Dr. NK SUNGOWATI, SpPA
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RADANG AKUTPerubahan vaskuler a. Perubahan aliran dan ukuran pembuluh darah b. Peningkatan permeabilitas vaskulerPeristiwa seluler: ekstravasasi leukosit dan fagositosis a. Adhesi dan transmigrasi b. Kemotaksis dan aktivasi leukosit Outline
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c. Fagositosis (pengenalan, perlekatan, pelahapan dan degradasi)d. Pengeluaran produk leukosite. Defek fungsi leukosit
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Jejas pada sel
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RADANG AKUTMerupakan respon langsung dan dini terhadap jejasDitandai perubahan sirkulasi mikro, eksudasi cairan dan transmigrasi leukosit dari pembuluh darah ke tempat jejas
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CARDINAL SIGNRuborCalorTumorDolorFunctio laesa
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ISTILAH-ISTILAHEksudasiEksudatTransudatEdemaPus
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PERUBAHAN VASKULERPerubahan kaliber pembuluh darah dan aliran darah a. Vasodilatasi b. Perlambatan sirkulasi c. StasisPeningkatan permiabilitas vaskuler (vascular leakage)
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Mekanisme terjadinya vascular leakageKontraksi endotel (histamin,bradikinin, lekotrin)Reorganisasi sitoskeleton (sitokin)Jejas langsungLeakage diperantarai leukositLeakage dari endotel regeneratif
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PERISTIWA SEL DARAH PUTIHMarginasi, rolling, adhesiTransmigrasi (diapedesis)Migrasi menuju stimulus kemotaktik
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Peristiwa sel darah putih
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Adhesi leukosit pada endotel
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Interaksi endotel neutrofil
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TRANSMIGRASITerjadi sepanjang interseluler junctionTergantung umur lesi dan tipe stimulusNeutrofil (6-24 jam)Monosit (24-48 jam)Pseudomonas (neutrofil ~ 2-4 hari)Virus ~ limfositHipersensitivitas ~ eosinofil
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Reaksi radang akut
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Peristiwa Sel Darah Putih
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Ikatan ligan-reseptorIkatan ligan-reseptor
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FAGOSITOSISPengenalan dan perlekatanPelahapanPembunuhan atau degradasi
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FagositosisFcC3NADPHNADP+Oksidase aktifSITOPLASMAVAKUOLA FAGOSITIKOksidase sitoplasmikOksidase membranGranula spesifik
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PENGELUARAN PRODUK LEUKOSITTerdiri dari : E. lisosom, metabolit aktif O2, prostalglandin dan lekotrin.
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DEFEK FUNGSI LEUKOSITLebih rentan terhadap infeksiGenetik : a. LAD tipe1,2 (defisiensi molekul adhesi) b. CGD (defisiensi NADPH oksidase) c. Chediak-Higashi S. (neutrofenia, defektif degranulasi, perlambatan pembunuhan bakteri)
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Didapat : a. Kemotaksis : febris, diabetes , sepsis, immunodefisiensi b. Adhesi : hemodialisis, DM c. Fagositosis, aktivitas mikrobisidal : leukemia, anemia, sepsis, diabetes, neonatus, malnutrisi
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MANIFESTASI KLINIK(SISTEMIK)Febris : pirogen dan prostalglandinPerubahan hitung sel darah putih perifer - Neutrofil leukositosis - Neutropenia, limfositosisPerubahan protein plasma C-reactive protein, antitrypsin, fibrinogen, haptoglobin, ceruloplasmin
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RINGKASANReaksi radang akut :Aliran darah meningkat (dilatasi arteriol)Permeabilitas meningkat (interendotel junction melebar, jejas langsung endotel)
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Neutrofil (adhesi, transmigrasi, migrasi ke tempat jejas)FagositosisProduk leukosit
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Dr.NK Sungowati
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Acute Inflammation. A capillary surrounded by PMN leucocyte in are of inflammation.
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Purulent exudate in some alveoli of the lung (left). Alveoli to the right are dilated as compensatory measure for the obstruction of alveoli on the left.
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Alveolar exudate. Leucocytes in the alveoli together with strands of fibrin. Venules in the alveolar walls are dilated as part of the inflammatory response.
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Fibrinous exudate. Pink staining threads of fibrin with leucocytes in alveoli. The vessels are dilated.
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Pus. Section of skin showing an accumulation of the pus (pustule) in the epidermis. This is often seen in impetigo which superficial infection caused by coccal bacteria.
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Purulent exudate. The edge of an ulcer in the colon. Damaged colonic epithelium is seen on the left and purulent exudate in the base of the ulcer on the right.
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Fibrinopurulent exudate. The wall of an ulcer showing fibrinopurulent exudate on the surface (top) and newly formed vessels (granulation tissue) deeper down.
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Acute inflammation. Section of heart muscle an visceral pericardium showing pink layer of fibrin on the surface. Inflammatory cells and dilated vessels are present in the underlying connective tissue.
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Acute inflammation. Visceral pericardium. Movement of the heart in pericardial sac causes strands of fibrin to project into the lumen of the pericardial sac.
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Plasma cells and mast cells
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Mast cells with fibroblast on the right. The mast cell granules have stain bright red with solachrome cyanin.
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Mast cell granules also stain bright blue with toluidine blue.
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Eosinofil leucocyte.