HOMEOSTASIS

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HOMEOSTASIS
State of dynamic equilibrium; stability; balance Also called homeodynamics Regulated by negative feedback mechanism
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Stasis
standing still

There must be constancy or fixity of the internal environment despite changes in the eternal environment.

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Self-regulating
Compensatory or counter balancing Negative Feedback system Require several feedback mechanism to correct only one physiologic imbalance
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Medulla Oblongata Pituitary gland Thyroid gland Parathyroid gland Adrenals Pancreas
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 State of equilibrium Anxiety Vague feeling; pervasive form of fear Adaptation Phenomenon is which a sense organ shows a gradually diminishing response to continuous or repetitive stimulation

- A physical, chemical or an emotional factor that causes bodily or mental tension and that may be a factor in disease causation. - A state resulting from factors that tend to alter an existing equilibrium. - Nonspecific response of the body to any demand made upon it
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- threats

to the steady state

Forms of Stress
Physical cold, heat, chemical agents, radiation/ electricity Physiologic pain, fatigue, infection, inflammation

Psychosocial/Psychological fear of failing in an exam, losing a job, normal life transitions, unwanted pregnancy, lovers quarrel
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 Stress is not a nervous energy Man tends to adapt to stress whenever he encounters it Stress is not always something to be avoided Stress does not always lead to distress A single stress does not cause a disease Stress may lead to another stress Stress, when prolonged or intense may lead to exhaustion Stress is always a part of the fabric of daily life
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Anxiety Level

Psychological Responses Wide perceptual field Sharp senses Increased motivation Effective problem solving Increased learning ability Irritability

Physiological Responses Restlessness Gastrointestinal butterflies Difficulty sleeping Hypersensitivity to noise

Mild

Moderate

Perceptual field narrowed to immediate task Selectively attentive Cant connect thoughts or events independently

Muscle tension Diaphoresis Pounding pulse Headache Dry mouth High-pitched voice Fast rate of speech

Severe

Perceptual field reduced to one detail or scattered details Cant complete task Cant solve problems or learn effectively Behavior geared toward anxiety relief and usually not effective Doesnt respond to redirection Feels dread or horror Crying Ritualistic behavior
Perceptual field reduced to focus on self Cant process any environmental stimuli Distorted perceptions Loss of rational thought Doesnt recognize potential danger Cant communicate verbally Possible delusions and hallucinations (delusion false fixed belief; hallucination false sensory perception)

Severe headache Nausea and vomiting Diarrhea Trembling Rigid stance Vertigo Tachycardia Chest pain

Panic

May run away Totally immobile, mute Increased blood pressure & pulse rate Flight or freeze

1. 2. 3. 4. 5. 6. 7. 8.

Spirituality Smile Speak to me Socials Stress debriefing Scheduling Sounds and songs Sports
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9. 10. 11. 12. 13. 14. 15.

Stress reduction Sleep Siesta Sensation therapy Sale Shop Sex

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- constant, ongoing process that occurs along the time continuum. (beginning with birth and ending with death) - Adjustments that a person makes in different situations

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- Hans Selye - When man responds to stress, his whole body is involved

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1. Stage of Alarm person becomes aware of the presence of threat or danger - levels of resistance are decreased - adaptive mechanisms are mobilized (fight or flight) - if stress is intense enough, even at the stage of alarm, death may ensue
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2. Stage of Resistance - characterized by adaptation - levels of resistance are increased - person moves back to homeostasis
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3. Stage of exhaustion - results from prolonged exposure to stress and adaptive mechanisms can no longer persist - unless other adaptive mechanisms are mobilized, death may ensue
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- Man may respond to stress through a particular body part or body organ (eg. Inflammation, headache, diarrhea)

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Attempts to maintain homeostasis Whole body/total organism responses Have limits Require time Vary from person to person Inadequate or excessive Egocentric, tiring
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 Physiologic/Biologic Adaptive Mode eg. People living in hot areas develop dark skin Psychologic Adaptive Mode eg. Use of ego defense mechanisms Sociocultural Adaptive Mode eg. Talking, acting like the people in a particular place Technologic Adaptive Mode eg. Nurses learn how to use electronic devices and computers
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 Mild considered an asset of the client Moderate

Nurse must be certain that the client is following what the nurse is saying Speak in short, simple, easy to understand sentences Nurse must ensure that the client is still taking-in the information Redirect the clients attention

 Severe
Goal: decrease the persons anxiety to a moderate or mild level before proceeding with anything else Remain with the patient Talk to the patient in a calm, low, soothing voice If client is still restless: walk while talking with client Deep breathing exercise

 Panic
Safety of client is the primary concern Nurse keeps talking in a calm manner even though the client cant process what the nurse is saying Go to a quiet, non-stimulating environment Reassure the client that this is anxiety, that it will pass and that he is in a safe place Nurse remains with the client until the anxiety fades 5-30 minute May need to give anxiolytics

Health

Disease

Normal Cell

Adapted cell

Injured

Dead cell

Diseased cell Compensatory mechanism; Cells remain intact Pathophysiologic mechanism Loss of cell integrity

 regulated by circulatory and autonomic system

Negative Feedback
monitors the internal environment and restores homeostasis when conditions shift out from the normal state works by sensing deviation from a pre-determined setpoint/ range of adaptability and triggering a response aimed at setting the deviation to normal e.g., blood glucose level, body temperature, fluid and electrolyte, acid-base balance major organs affected: heart, lungs, kidneys, liver, GIT, skin

1. Hans Selye: General Adaptation Syndrome (GAS)

Alarm reaction stage Stage of resistance Stage of evaluation

2. Lazarus Theory focuses on the persons cognitive appraisal of the life events that ultimately determines the response as expressed by
Irrelevant appraisal occurs when the person confronts external appearance that does not pose a threat to his livelihood Positive benign appraisals events that enhance adaptation or stimulate a sense of well-being; generates positive feelings of pleasure, joy Stressful appraisal injurious, hazardous; like physical illness, loss of functioning

Neumanns System Model

person, nursing, health & environment

Person Neuman considers a person unique, composite of character within a normal range of normal response Nursing unique profession concerned with all the variables affecting the persons response to stressors Health synonymous to wellness, ability of the persons flexible line of defense to maintain equilibrium against stressors Environment includes all internal (ego) and external (coping abilities, lifestyle, developmental stages) factors

Roys Adaptation Model

Person biopsychosocial being in constant interaction with a changing environment the person makes use of the coping mechanism to have a positive response, the person must adapt to the changes Nursing the goal of nursing is to contribute to a persons health, quality of life and dying with dignity by promoting adaptation

physiologic needs self-concept role function interdependence

Health a state and a process of being and becoming an integrated whole person reflection of the level of adaptation if there is a lack of integration represents lack of health Environment includes conditions, circumstances and influences that surround and affect the development and behavior of the person

Peplaus Interpersonal Theory most influential theorist in the field of psychiatric nursing orientation phase working phase problem-identification exploitation termination phase person is unique in experiences, beliefs, expectations and patterns of relation to others nursing is a significant therapeutic interpersonal process health is a word symbol that implies forward movement of personality and other ongoing human process in the direction of creative and constructive personal and community giving environment includes the physiological, psychological and social fluidity that is in context with the nurse-client relationship

 Anger normal human emotion Strong uncomfortable human response to a real or perceive provocation Anger is felt: when we are hurt & afraid energize the body physically for self-defense when needed for by acting the fight-flight response Hostility verbal aggression an emotion expressed through verbal abuse, lack of cooperation, violation of rules or norms or a threatening behavior Physical aggression a behavior in which a person attacks or injures another person or that involves destruction property

 Phillips 1998: men who experience anger outburst have twice the risk to developing stroke than those who can control it Anger becomes negative when it is: suppressed denied expressed inappropriately

Serotonin plays a major inhibitory role in aggressive behavior; decreased in period of anger Dopamine & norepinephrine increased: associated with impulsively violent behavior

 As a child matures, he is expected to develop impulse control As the child matures, he develops socially appropriate behavior Children who are prone to aggressive behavior are those children who come from dysfunctional families, poor parenting, inconsistent responses of the childs behavior and those who belong to the lower socioeconomic status

1. Triggering phase
events or circumstances in the environment initiates the clients response which is often anger or hostility Clients responses represent escalating behavior that indicated movement toward loss of control

2. Escalation phase

3. Crisis phase
during a period of emotional and physical crises and the client loses control client regains physical and emotional control client attempts reconciliation with others and returns to the level of functioning before the aggressive incident and its antecedents

4. Recovery phase

5. Post-crisis phase

 1. Triggering Phase: Nurse approaches the client in a non-threatening calm manner Nurse encourages the patient to express anger verbally suggesting that the client is in control and maintain control Use clear, simple and short statements Go to a quiet room-away from stimuli Anti anxiety medications Nurse can help client use relaxation techniques Look into ways to solve problems that may exist

 2. Escalation Phase: Nurse must take control of the situation Nurse should provide directions to the client in a calm firm voice That client should be directed to take a time out for cooling off The nurse should tell the client that aggressive behavior is not acceptable and that the nurse is there to help the client regain control Ask for assistance if the situation cannot be handled

 3. Crisis Phase: The staff must take charge of the situation for safety of the client, staff & other client Can do restrain seclusion but must be based on the facilities protocol d rules Secure a doctors order right away Inform client that his behavior is out of control & the staff is taking control to prevent injury Nurse performs close assessment & document the actions taken

 4. Recovery Phase: Encourage the patient to talk about the situation or those that trigger the aggressive behavior Nurse should help the client by doing relaxation techniques Nurse helps the client explore the alternative solutions by asking what the client or staff can do next time Nurse assesses staff members for any injury Debriefing session- to discuss the aggressive episode, how it was handled, what worked well, what improvements could be made. Let client express feelings

 5. Post Crisis Removed from restrain or seclusion Discuss the clients behavior in a calm & rational manner The client can be given feedback for regaining control with the expectation that he will be able to handle feelings in a none aggressive manner in the future

 I. PHYSICAL DIMENSION - perceived as the dwelling place of the soul - treatment is directed towards providing an opening to extract the erroneous soul back to its habitat Eastern Belief: PD is possessing life energy & illness as related to energy Western Belief: PD is physical disequilibrium

 II. EMOTIONAL DIMENSION - Passion: emotion is including the phenomenon of fear, anger, jealousy & love III. INTELLECTUAL DIMENSION
intelligence was thought to develop a regular rate during childhood & decreases proportionately as brain tissues develops and ages. A person tendency to perform a variety of intellectual tasks at a similar level of proficiency

 IV. SOCIAL DIMENSION

altering of sex role differentiation especially in the areas of school & work

V. SPIRITUAL DIMENSION - Greeks believed that the body becomes ill because of disharmony between the body and the spirit

1.

2.
3. 4. 5. 6. 7. 8.

Primary focus is on the improvement of the capabilities & the competence of the person with psychiatric problems even in the most disabled. Insight is not a primary goal rather but rather, it focuses on the ability to function Use of various therapeutic constructions Improvement of a vocational outcome Emphasis on positive expectations & hope is essential to the process a deliberate increase in dependency as in a sheltered setting Active participation & involvement of client in rehabilitation & in the delivery of services to other clients. Environmental resource development is fundamental interventions in the rehabilitation process

THERAPEUTIC NURSE CLIENT RELATIONSHIP

Preinteraction develop self-awareness of feelings and tears conduct a self-assessment of professional assets and limitations Research any information available Review records Plan meeting with client/patient

Phases :
1. ORIENTATION a.Developing trust and open communication > patient should know the nurse > make a contract for termination b. Assessing the clients reason for seeking help or hospitalization

c. Establishing mutually agreed upon goals

d. Developing a therapeutic contract e. Formulating nursing diagnosis

2. WORKING
a. Planning outcomes and related interventions to meet goals and to assist the client b. Facilitating expression of thoughts and feelings c. Exploring problems

d. Encouraging constructive coping measures

e. Practicing and evaluating more adaptive behaviors f. Working through resistant behaviors/therapies

3. TERMINATION
a. evaluating therapeutic outcomes b. expressing feelings about termination

c. observing for regressive behavior

d. evaluating the nurse-client relationship DEFENSIVE MECHANISMS > protective mechanisms which are primarily unconscious behaviors however some are within voluntary control.

> can be therapeutic or pathologic

1. SUPPRESSION exclusion form awareness of anxiety producing feelings ideas or situations

- voluntary forgetting

2. REPRESSION involuntary forgetting of painful ideas, events, unpleasant experience - burying alive mechanism 3. RATIONALIZATION attempts to prove that ones feelings or behaviors are justifiable. 4. IDENTIFICATION attempt to model oneself after a respected person - the imitator 5. COMPENSATION covering up for a weakness by overemphasizing a desirable trait - making-up

6. REACTION-FORMATION expressing attitude directly opposite to unconscious wish or fear

- overcompensation 7. SUBSTITUTION replacing desired, unacceptable or unobtainable object with one that is acceptable or attainable - goal is replaced since it is blocked

8. DISPLACEMENT discharging of pent-up feelings to a less threatening object/persons

9. UNDOING/RESTITUTE attempt to reverse, undo an act, thought or feeling by doing something that indicates the opposite feeling

10. PROJECTION rejecting unwanted characteristics of self and assign them to others
- scapegoating / blaming others 11. SYMBOLIZATION use of external object as outward representations of internal ideas, attitudes or feelings 12. REGRESSION returning to an earlier developmental phase / level during stress 13. SUBLIMATION redirecting of a feeling into a socially productive activity

14. DENIAL failure to acknowledge an intolerable thought, experience or reality

- blocking the awareness of reality

15. INTROJECTION - a form of identification wherein there is symbolic taking into oneself the characteristics of another
- injecting philosophies, ideas and attitude 16. CONVERSION the expression of intrapsychic conflict symbolically through physical symptoms. 17. FANTASY imagined events or mental images to express unconscious conflicts and to gratify wishes 18. ISOLATION / DISSOCIATION detachment of the emotional conflicts from consciousness

19. INTELLECTUALIZATION transferring emotional concerns into the intellectual spheres.

20. FIXATION- shortening of maturity

- halting a stage that gives comfort

Exercises Directions: Identify the following responses/ situations according to the defense mechanisms being used. That professor hates me. Lets shoot spitballs at people! Yelling at the dog when angry with the boss. Being excessively kind to a person who is actually disliked. A small person excels in sports. Inability to remember a traumatic event. Im going to try to be nice to him. An alcoholic who says he does not have a drinking problem. Hes too critical because hes trying to help us do our best. This situation reminds me of how Nietzsche said that anger is ontological despair. 11. Experiencing somatic complaints like fever, diarrhea, etc. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

 SITUATION THAT OCCURS WHEN AN INDIVIDAULS HABITUAL COPING ABILITY BECOMES INEFFECTIVE TO MEET THE DEMANDS OF THE SITUATION TYPES : CRISIS STATE
LAST 4-6 WKS,SELF LIMITING INDIVIDUALIZED , AFFECTING SUPPORT SYSTEM CAN PROMOTE GROWTH AND NEW BEHAVIORS PERSONS BECOMES PASSIVE AND SUBMISSIVE

DENIAL INCREASED TENSION AND ANXIETY DISORGANIZATION ATTEMPTS TO REORGANIZE ATTEMPTS TO ESCAPE GENERAL REORGANIZATION

 MATURATIONAL / DEVELOPMENTAL CRISIS SITUATIONAL / ACCIDENTAL SOCIAL CRISIS GOAL N- TO ENABLE THE PATIENT TO ATTAIN OLOF.

GOAL DIRECTED, FOCUS ON HERE AND NOW FOCUS ON CLIENTS IMMEDIATE PROBLEM ACTIVE AND DIRECTIVE EXPLORE UNDERSTANDING OF PROBLEM HELP CLIENT BECOME AWARE OF FEELINGS AND VALIDATE THEM DEVELOP A PLAN FIND NEW COPING SKILLS AND MANAGE FEELINGS

 Anger is a completely normal, usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems problems at work, in your personal relationships, and in the overall quality of your life. And it can make you feel as though you're at the mercy of an unpredictable and powerful emotion. This brochure is meant to help you understand and control anger.

 Anger is "an emotional state that varies in intensity from mild irritation to intense fury and rage," according to Charles Spielberger, PhD, a psychologist who specializes in the study of anger. Like other emotions, it is accompanied by physiological and biological changes; when you get angry, your heart rate and blood pressure go up, as do the levels of your energy hormones, adrenaline, and noradrenaline. Anger can be caused by both external and internal events. You could be angry at a specific person (Such as a coworker or supervisor) or event (a traffic jam, a canceled flight), or your anger could be caused by worrying or brooding about your personal problems. Memories of traumatic or enraging events can also trigger angry feelings.

 The instinctive, natural way to express anger is to respond aggressively. Anger is a natural, adaptive response to threats; it inspires powerful, often aggressive, feelings and behaviors, which allow us to fight and to defend ourselves when we are attacked. A certain amount of anger, therefore, is necessary to our survival. On the other hand, we can't physically lash out at every person or object that irritates or annoys us; laws, social norms, and common sense place limits on how far our anger can take us. People use a variety of both conscious and unconscious processes to deal with their angry feelings. The three main approaches are expressing, suppressing, and calming. Expressing your angry feelings in an assertivenot aggressivemanner is the healthiest way to express anger. To do this, you have to learn how to make clear what your needs are, and how to get them met, without hurting others. Being assertive doesn't mean being pushy or demanding; it means being respectful of yourself and others.

 Anger can be suppressed, and then converted or redirected. This happens when you hold in your anger, stop thinking about it, and focus on something positive. The aim is to inhibit or suppress your anger and convert it into more constructive behavior. The danger in this type of response is that if it isn't allowed outward expression, your anger can turn inwardon yourself. Anger turned inward may cause hypertension, high blood pressure, or depression. Unexpressed anger can create other problems. It can lead to pathological expressions of anger, such as passive-aggressive behavior (getting back at people indirectly, without telling them why, rather than confronting them head-on) or a personality that seems perpetually cynical and hostile. People who are constantly putting others down, criticizing everything, and making cynical comments haven't learned how to constructively express theirEYE anger. Not surprisingly, they SIR aren't likely to have many successful relationships.

 Finally, you can calm down inside. This means not just controlling your outward behavior, but also controlling your internal responses, taking steps to lower your heart rate, calm yourself down, and let the feelings subside. As Dr. Spielberger notes, "when none of these three techniques work, that's when someoneor somethingis going to get hurt."
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 The goal of anger management is to reduce both your emotional feelings and the physiological arousal that anger causes. You can't get rid of, or avoid, the things or the people that enrage you, nor can you change them, but you can learn to control your reactions.

 Relaxation Simple relaxation tools, such as deep breathing and relaxing imagery, can help calm down angry feelings. There are books and courses that can teach you relaxation techniques, and once you learn the techniques, you can call upon them in any situation. If you are involved in a relationship where both partners are hot-tempered, it might be a good idea for both of you to learn these techniques. Some simple steps you can try: Breathe deeply, from your diaphragm; breathing from your chest won't relax you. Picture your breath coming up from your "gut." Slowly repeat a calm word or phrase such as "relax," "take it easy." Repeat it to yourself while breathing deeply. Use imagery; visualize a relaxing experience, from either your memory or your imagination. Nonstrenuous, slow yoga-like exercises can relax your muscles and make you feel much calmer. Practice these techniques daily. Learn to use them automatically when you're in a tense situation.

 Simply put, this means changing the way you think. Angry people tend to curse, swear, or speak in highly colorful terms that reflect their inner thoughts. When you're angry, your thinking can get very exaggerated and overly dramatic. Try replacing these thoughts with more rational ones. For instance, instead of telling yourself, "oh, it's awful, it's terrible, everything's ruined," tell yourself, "it's frustrating, and it's understandable that I'm upset about it, but it's not the end of the world and getting angry is not going to fix it anyhow." Be careful of words like "never" or "always" when talking about yourself or someone else. "This !&*%@ machine never works," or "you're always forgetting things" are not just inaccurate, they also serve to make you feel that your anger is justified and that there's no way to solve the problem. They also alienate and humiliate people who might otherwise be willing to work with you on a solution.

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 Problem Solving Sometimes, our anger and frustration are caused by very real and inescapable problems in our lives. Not all anger is misplaced, and often it's a healthy, natural response to these difficulties. There is also a cultural belief that every problem has a solution, and it adds to our frustration to find out that this isn't always the case. The best attitude to bring to such a situation, then, is not to focus on finding the solution, but rather on how you handle and face the problem. Make a plan, and check your progress along the way. Resolve to give it your best, but also not to punish yourself if an answer doesn't come right away. If you can approach it with your best intentions and efforts and make a serious attempt to face it head-on, you will be less likely to lose patience and fall into all-or-nothing thinking, even if the problem does not get solved right away.
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 Angry people tend to jump toand act onconclusions, and some of those conclusions can be very inaccurate. The first thing to do if you're in a heated discussion is slow down and think through your responses. Don't say the first thing that comes into your head, but slow down and think carefully about what you want to say. At the same time, listen carefully to what the other person is saying and take your time before answering. Listen, too, to what is underlying the anger. For instance, you like a certain amount of freedom and personal space, and your "significant other" wants more connection and closeness. If he or she starts complaining about your activities, don't retaliate by painting your partner as a jailer, a warden, or an albatross around your neck. It's natural to get defensive when you're criticized, but don't fight back. Instead, listen to what's underlying the words: the message that this person might feel neglected and unloved. It may take a lot of patient questioning on your part, and it may require some breathing space, but don't let your angeror a partner'slet a discussion spin out of control. Keeping your cool can keep the situation from becoming a disastrous one.

 "Silly humor" can help defuse rage in a number of ways. For one thing, it can help you get a more balanced perspective. When you get angry and call someone a name or refer to them in some imaginative phrase, stop and picture what that word would literally look like. If you're at work and you think of a coworker as a "dirtbag" or a "single-cell life form," for example, picture a large bag full of dirt (or an amoeba) sitting at your colleague's desk, talking on the phone, going to meetings. Do this whenever a name comes into your head about another person. If you can, draw a picture of what the actual thing might look like. This will take a lot of the edge off your fury; and humor can always be relied on to help unknot a tense situation.

 The underlying message of highly angry people, Dr. Deffenbacher says, is "things oughta go my way!" Angry people tend to feel that they are morally right, that any blocking or changing of their plans is an unbearable indignity and that they should NOT have to suffer this way. Maybe other people do, but not them!

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 When you feel that urge, he suggests, picture yourself as a god or goddess, a supreme ruler, who owns the streets and stores and office space, striding alone and having your way in all situations while others defer to you. The more detail you can get into your imaginary scenes, the more chances you have to realize that maybe you are being unreasonable; you'll also realize how unimportant the things you're angry about really are. There are two cautions in using humor. First, don't try to just "laugh off" your problems; rather, use humor to help yourself face them more constructively. Second, don't give in to harsh, sarcastic humor; that's just another form of unhealthy anger expression.
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 What these techniques have in common is a refusal to take yourself too seriously. Anger is a serious emotion, but it's often accompanied by ideas that, if examined, can make you laugh.
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 Sometimes it's our immediate surroundings that give us cause for irritation and fury. Problems and responsibilities can weigh on you and make you feel angry at the "trap" you seem to have fallen into and all the people and things that form that trap. Give yourself a break. Make sure you have some "personal time" scheduled for times of the day that you know are particularly stressful. One example is the working mother who has a standing rule that when she comes home from work, for the first 15 minutes "nobody talks to Mom unless the house is on fire." After this brief quiet time, she feels better prepared to handle demands from her kids without blowing up at them.

 Timing: If you and your spouse tend to fight when you discuss things at nightperhaps you're tired, or distracted, or maybe it's just habittry changing the times when you talk about important matters so these talks don't turn into arguments. Avoidance: If your child's chaotic room makes you furious every time you walk by it, shut the door. Don't make yourself look at what infuriates you. Don't say, "well, my child should clean up the room so I won't have to be angry!" That's not the point. The point is to keep yourself calm. Finding alternatives: If your daily commute through traffic leaves you in a state of rage and frustration, give yourself a projectlearn or map out a different route, one that's less congested or more scenic. Or find another alternative, such as a bus or commuter train.

 If you feel that your anger is really out of control, if it is having an impact on your relationships and on important parts of your life, you might consider counseling to learn how to handle it better. A psychologist or other licensed mental health professional can work with you in developing a range of techniques for changing your thinking and your behavior. When you talk to a prospective therapist, tell her or him that you have problems with anger that you want to work on, and ask about his or her approach to anger management. Make sure this isn't only a course of action designed to "put you in touch with your feelings and express them"that may be precisely what your problem is. With counseling, psychologists say, a highly angry person can move closer to a middle range of anger in about 8 to 10 weeks, depending on the circumstances and the techniques used.

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 1. 2. 3. 4. 5. 6. 7. 8. 9.

Bodily System Changes in Elderly Cardiovascular Respiratory Integumentary Reproductive Genitourinary Gastro-intestinal Musculo-skeletal Neurologic Sensory

- mobilization of specific and non specific defense mechanism in response to tissue injury or infection. Purpose of inflammation: Localize tissue injury To protect tissue injury To prepare tissue for repair

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Vascular Response - transitory vasoconstriction followed immediately by vasodilation - due to release of histamine, bradykinin, prostaglandin E

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2. Cellular Response neutrophils are first to be launched at site of injury

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Marginal/Pavementation - phagocytes line up at the peripheral walls of the blood vessels Emigration/ Diapedesis phagocytes shift out of the blood vessels Chemotaxis injured tissues release substances which exert magnet-like force to the phagocytes Phagocytosis phagocytes ingest or engulf the antigens

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3. Healing Process (Reparative Phase) Regeneration replacement of damaged tissue cells by new cells which are identical in function and structure Scar formation replacement of damaged tissue cells by fibrous tissue formation

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 First Intention occurs in clean-cut wound; edges are approximated Second Intention wound is extensive with great amount of tissue loss; repair time is longer Third Intention delayed surgical closure of infected wound

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The cardinal signs of inflammation are rubor (redness), calor (heat), tumor (swelling), dolor (pain), and loss of function. Seen here is skin with erythema, compared to the more normal skin at the far right.

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The arm at the bottom is swollen (edematous) and reddened (erythematous) compared to the arm at the top.
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