Inflammation is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, is a protective response involving immune cells, blood vessels, molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, initiate tissue repair; the five classical signs of inflammation are heat, redness and loss of function. Inflammation is a generic response, therefore it is considered as a mechanism of innate immunity, as compared to adaptive immunity, specific for each pathogen. Too little inflammation could lead to progressive tissue destruction by the harmful stimulus and compromise the survival of the organism. In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, atherosclerosis, rheumatoid arthritis, cancer. Inflammation is therefore closely regulated by the body. Inflammation can be classified as either chronic.
Acute inflammation is the initial response of the body to harmful stimuli and is achieved by the increased movement of plasma and leukocytes from the blood into the injured tissues. A series of biochemical events propagates and matures the inflammatory response, involving the local vascular system, the immune system, various cells within the injured tissue. Prolonged inflammation, known as chronic inflammation, leads to a progressive shift in the type of cells present at the site of inflammation, such as mononuclear cells, is characterized by simultaneous destruction and healing of the tissue from the inflammatory process. Inflammation is not a synonym for infection. Infection describes the interaction between the action of microbial invasion and the reaction of the body's inflammatory response—the two components are considered together when discussing an infection, the word is used to imply a microbial invasive cause for the observed inflammatory reaction. Inflammation on the other hand describes purely the body's immunovascular response, whatever the cause may be.
But because of how the two are correlated, words ending in the suffix -itis are sometimes informally described as referring to infection. For example, the word urethritis means only "urethral inflammation", but clinical health care providers discuss urethritis as a urethral infection because urethral microbial invasion is the most common cause of urethritis, it is useful to differentiate inflammation and infection because there are typical situations in pathology and medical diagnosis where inflammation is not driven by microbial invasion – for example, trauma and autoimmune diseases including type III hypersensitivity. Conversely, there is pathology where microbial invasion does not cause the classic inflammatory response – for example, parasitosis or eosinophilia. Acute inflammation is a short-term process appearing within a few minutes or hours and begins to cease upon the removal of the injurious stimulus, it involves a coordinated and systemic mobilization response locally of various immune and neurological mediators of acute inflammation.
In a normal healthy response, it becomes activated, clears the pathogen and begins a repair process and ceases. It is characterized by five cardinal signs:An acronym that may be used to remember the key symptoms is "PRISH", for pain, immobility and heat; the traditional names for signs of inflammation come from Latin: Dolor Calor Rubor Tumor Functio laesa The first four were described by Celsus, while loss of function was added by Galen. However, the addition of this fifth sign has been ascribed to Thomas Sydenham and Virchow. Redness and heat are due to increased blood flow at body core temperature to the inflamed site. Loss of function has multiple causes. Acute inflammation of the lung does not cause pain unless the inflammation involves the parietal pleura, which does have pain-sensitive nerve endings; the process of acute inflammation is initiated by resident immune cells present in the involved tissue resident macrophages, dendritic cells, Kupffer cells and mast cells. These cells possess surface receptors known as pattern recognition receptors, which recognize two subclasses of molecules: pathogen-associated molecular patterns and damage-associated molecular patterns.
PAMPs are compounds that are associated with various pathogens, but which are distinguishable from host molecules. DAMPs are compounds that are associated with host-related cell damage. At the onset of an infection, burn, or other injuries, these cells undergo activation and release inflammatory mediators responsible for the clinical signs of inflammation. Vasodilation and its resulting increased blood flow causes increased heat. Increased permeability of the blood vessels results in an exudation of plasma proteins and fluid into the tissue, which manifests itself as swelling; some of the released mediators such as bradykinin increase the sensitivity to pain. The mediator molecules alter the blood vessels to
Charles Foix was a French internist and neurologist. Charles Foix was born in Pyrénées-Atlantiques, he studied medicine at the University of Paris and was a pupil of Pierre Marie at the Salpêtrière Hospital. He was an intern in 1906, Médecin des hôpitaux in 1919 and became agrégé in 1923. Foix taught at Georges Guillain's clinic at the Salpêtrière and at Emile Charles Achard's at the Hospital Beaujon, always distinguishing himself by his wide knowledge and rational approach. Foix' main contributions to the neurology was to relate thrombosis of specific arteries at autopsies with symptoms and signs that he had established in his patients and he wrote a book on the blood supply and anatomy of the brain. With Ion Niculescu he published an imposing treatise on the anatomy and blood supply of the midbrain and interbrain. A most impressive teacher and clinician, Foix was as much at home with general medicine as he was with neurology, he was an accomplished poet, but a better lyricist. Foix's syndrome I, Red nucleus syndrome.
Foix's syndrome II, Ophtalmoplegic disease secondary to intracranial aneurysmas or thrombosis of the cavernous sinus. Foix-Alajouanine disease, Softening of the grey matter of the spinal cord with obliterative sclerosis of the small vessels. Marie-Foix-Alajouanine syndrome, Ataxia of the cerebellum in advanced age due to abuse of alcohol. Schilder-Foix disease, Nonprogressive sclerotic lesions of the white matter of the cerebral hemisphere. Charles Foix @ Who Named It
Anatomical pathology or Anatomic pathology is a medical specialty, concerned with the diagnosis of disease based on the macroscopic, biochemical and molecular examination of organs and tissues. Over the last century, surgical pathology has evolved tremendously: from historical examination of whole bodies to a more modernized practice, centered on the diagnosis and prognosis of cancer to guide treatment decision-making in oncology, its modern founder was the Italian scientist Giovan Battista Morgagni from Forlì. Anatomical pathology is one of two branches of pathology, the other being clinical pathology, the diagnosis of disease through the laboratory analysis of bodily fluids and/or tissues. Pathologists practice both anatomical and clinical pathology, a combination known as general pathology. Similar specialties exist in veterinary pathology. Anatomic pathology relates to the processing and diagnosis of surgical specimens by a physician trained in pathological diagnosis. Clinical pathology is the division that processes the test requests more familiar to the general public.
Its subsections include chemistry, microbiology, immunology and blood bank. Anatomical pathology is itself divided in subspecialties, the main ones being surgical pathology, hematopathology cytopathology, forensic pathology. To be licensed to practice pathology, one has to complete medical school and secure a license to practice medicine. An approved residency program and certification is required to obtain employment or hospital privileges; the procedures used in anatomic pathology include: Gross examination – the examination of diseased tissues with the naked eye. This is important for large tissue fragments, because the disease can be visually identified, it is at this step that the pathologist selects areas that will be processed for histopathology. The eye can sometimes be aided with a magnifying glass or a stereo microscope when examining parasitic organisms. Histopathology – the microscopic examination of stained tissue sections using histological techniques; the standard stains are haematoxylin and eosin.
The use of haematoxylin and eosin-stained slides to provide specific diagnoses based on morphology is considered to be the core skill of anatomic pathology. The science of staining tissues sections is called histochemistry. Immunohistochemistry – the use of antibodies to detect the presence and localization of specific proteins; this technique is critical to distinguishing between disorders with similar morphology, as well as characterizing the molecular properties of certain cancers. In situ hybridization – Specific DNA and RNA molecules can be identified on sections using this technique; when the probe is labeled with fluorescent dye, the technique is called FISH. Cytopathology – the examination of loose cells spread and stained on glass slides using cytology techniques Electron microscopy – the examination of tissue with an electron microscope, which allows much greater magnification, enabling the visualization of organelles within the cells, its use has been supplanted by immunohistochemistry, but it is still in common use for certain tasks, including the diagnosis of kidney disease and the identification of immotile cilia syndrome.
Tissue cytogenetics – the visualization of chromosomes to identify genetic defects such as chromosomal translocation Flow immunophenotyping – the determination of the immunophenotype of cells using flow cytometry techniques. It is useful to diagnose the different types of leukemia and lymphoma. Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by non-surgeons such as general internists, medical subspecialists and interventional radiologists. Surgical pathology requires technologies and skills traditionally associated with clinical pathology such as molecular diagnostics. In the United States, subspecialty-trained doctors of dentistry, rather than medical doctors, can be certified by a professional board to practice Oral and Maxillofacial Pathology. Cytopathology is a sub-discipline of anatomical pathology concerned with the microscopic examination of whole, individual cells obtained from exfoliation or fine-needle aspirates.
Cytopathologists are trained to perform fine-needle aspirates of superficially located organs, masses, or cysts and are able to render an immediate diagnosis in the presence of the patient and consulting physician. In the case of screening tests such as the Papanicolaou smear, non-physician cytotechnologists are employed to perform initial reviews, with only positive or uncertain cases examined by the pathologist. Cytopathology is a board-certifiable subspecialty in the U. S. Molecular pathology is an emerging discipline within anatomical and clinical pathology, focused on the use of nucleic acid-based techniques such as in-situ hybridization, reverse-transcriptase polymerase chain reaction, nucleic acid microarrays for specialized studies of disease in tissues and cells. Molecular pathology shares some aspects of practice with both anatomic and clinical pathology, is sometimes considered a "crossover" discipline. Forensic pathologists receive specialized training in determining the cau
The spinal cord is a long, tubular structure made up of nervous tissue, that extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column. It encloses the central canal of the spinal cord; the brain and spinal cord together make up the central nervous system. In humans, the spinal cord begins at the occipital bone where it passes through the foramen magnum, meets and enters the spinal canal at the beginning of the cervical vertebrae; the spinal cord extends down to between the second lumbar vertebrae where it ends. The enclosing bony vertebral column protects the shorter spinal cord, it is around 45 cm in men and around 43 cm long in women. The spinal cord has a varying width, ranging from 13 mm thick in the cervical and lumbar regions to 6.4 mm thick in the thoracic area. The spinal cord functions in the transmission of nerve signals from the motor cortex to the body, from the afferent fibers of the sensory neurons to the sensory cortex, it is a center for coordinating many reflexes and contains reflex arcs that can independently control reflexes.
It is the location of groups of spinal interneurons that make up the neural circuits known as central pattern generators. These circuits are responsible for controlling motor instructions for rhythmic movements such as walking; the spinal cord is the main pathway for information connecting the brain and peripheral nervous system. Much shorter than its protecting spinal column, the human spinal cord originates in the brainstem, passes through the foramen magnum, continues through to the conus medullaris near the second lumbar vertebra before terminating in a fibrous extension known as the filum terminale, it is about 45 cm long in men and around 43 cm in women, ovoid-shaped, is enlarged in the cervical and lumbar regions. The cervical enlargement, stretching from the C5 to T1 vertebrae, is where sensory input comes from and motor output goes to the arms and trunk; the lumbar enlargement, located between L1 and S3, handles sensory input and motor output coming from and going to the legs. The spinal cord is continuous with the caudal portion of the medulla, running from the base of the skull to the body of the first lumbar vertebra.
It does not run the full length of the vertebral column in adults. It is made of 31 segments from which branch one pair of sensory nerve roots and one pair of motor nerve roots; the nerve roots merge into bilaterally symmetrical pairs of spinal nerves. The peripheral nervous system is made up of these spinal roots and ganglia; the dorsal roots are afferent fascicles, receiving sensory information from the skin and visceral organs to be relayed to the brain. The roots terminate in dorsal root ganglia, which are composed of the cell bodies of the corresponding neurons. Ventral roots consist of efferent fibers that arise from motor neurons whose cell bodies are found in the ventral gray horns of the spinal cord; the spinal cord are protected by three layers of tissue or membranes called meninges, that surround the canal. The dura mater is the outermost layer, it forms a tough protective coating. Between the dura mater and the surrounding bone of the vertebrae is a space called the epidural space; the epidural space is filled with adipose tissue, it contains a network of blood vessels.
The arachnoid mater, the middle protective layer, is named for its spiderweb-like appearance. The space between the arachnoid and the underlying pia mater is called the subarachnoid space; the subarachnoid space contains cerebrospinal fluid, which can be sampled with a lumbar puncture, or "spinal tap" procedure. The delicate pia mater, the innermost protective layer, is associated with the surface of the spinal cord; the cord is stabilized within the dura mater by the connecting denticulate ligaments, which extend from the enveloping pia mater laterally between the dorsal and ventral roots. The dural sac ends at the vertebral level of the second sacral vertebra. In cross-section, the peripheral region of the cord contains neuronal white matter tracts containing sensory and motor axons. Internal to this peripheral region is the grey matter, which contains the nerve cell bodies arranged in the three grey columns that give the region its butterfly-shape; this central region surrounds the central canal, an extension of the fourth ventricle and contains cerebrospinal fluid.
The spinal cord is elliptical in cross section, being compressed dorsolaterally. Two prominent grooves, or sulci, run along its length; the posterior median sulcus is the groove in the dorsal side, the anterior median fissure is the groove in the ventral side. The human spinal cord is divided into segments. Six to eight motor nerve rootlets branch out of right and left ventro lateral sulci in a orderly manner. Nerve rootlets combine to form nerve roots. Sensory nerve rootlets form off right and left dorsal lateral sulci and form sensory nerve roots; the ventral and dorsal roots combine to form one on each side of the spinal cord. Spinal nerves, with the exception of C1 and C2, form inside the intervertebral foramen; these rootlets form the demarcation between the peripheral nervous systems. The grey column, in the center of the cord, is shaped like a butterfly and consists of cell bodies of interneurons, motor neurons, neuroglia cells and unmyelinated axons; the anterior and posterior grey column present as projections of the grey matter and are known as the horns of the spinal cord.
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