Inflammation and Repair 1 Outline (part-3) In Pathologic Basis Of Disease

11 - Brain, purulent inflammation, Haemophilus influenzae meningitis - Gross

Foci of white-tan purulent exudate are evident over the surface of the brain (acute meningitis).

12 - Brain, purulent inflammation, abscess - Gross, coronal cut surface

The destructive nature of the acute inflammatory reaction in the case of an abscess is apparent here.

13 - Larynx and trachea, pseudomembranous inflammation, diphtheria - Gross, cut and mucosal surfaces

• Epiglottis
• Pseudomembranous exudate in larynx
• Carina

The pseudomembrane is made up of a fibrinopurulent exudate combined with necrotic mucosa. It has a relatively tough consistency and, in this case, has caused suffocation.

14 - Colon, pseudomembranous inflammation, colitis caused by clindamycin - Gross, mucosal surface

Prolonged treatment with antibiotics can destroy the balance of normal intestinal flora, allowing overgrowth of Clostridium difficile. C difficile causes a pseudomembrane similar to that caused by Corynebacterium diphtheriae in the larynx. Notice the rubor (vascular congestion) in the background.

15 - Uterine cervix, chronic cervicitis - Very low power (Glass slide 131)

• Columnar mucosa of endocervix
• Area of chronic inflammation
• Cyst
• Squamous mucosa of ectocervix

Use this image for orientation. The chronic inflammation imparts a bluish hue to the stroma, though it is not well visualized at this power. A cyst has formed as a result of obstruction of an endocervical gland.

16 - Uterine cervix, chronic cervicitis - Medium power (Glass slide 131)

• Lymphoid follicle

A higher power view of the chronic inflammatory infiltrate reveals a lymphoid follicle, an indicator of chronic inflammation.

17 - Uterine cervix, chronic cervicitis - High power (Glass slide 131)

• Plasma cells

This high-power view demonstrates the mononuclear infiltrate typical of chronic inflammation. A mononuclear infiltrate typically consists of lymphocytes, plasma cells, and macrophages.

18 - Gallbladder, chronic cholecystitis and cholelithiasis - Gross, opened

• Gallstones removed from gallbadder lumen

In this case, cholelithiasis has led to chronic inflammation of the gallbladder with consequent fibrosis of the gallbladder wall, evidenced by thickening and firmness.

 

19 - Liver, chronic inflammation, postnecrotic cirrhosis - Gross, cut surface

Secondary to a prior episode of severe hepatitis, fibrosis has developed in this liver, altering its architecture.

20 - Spleen, granulomatous inflammation, sarcoidosis - Gross, cut surface

Granulomas are scattered diffusely throughout the splenic parenchyma. Sarcoidosis, a disease of unknown etiology, causes characteristic noncaseating granulomas in many tissues and organs (including the lung, lymph nodes, and spleen).

Inflammation and Repair 1 Outline (part-2) In Pathologic Basis Of Disease

6 - Lung, fibrinous and hemorrhagic inflammation, pneumonia - High power (Glass slide 41)

• Congested capillaries in alveolar walls
• Erythrocytes

At this higher power, the nature of the inflammatory exudate is clearer. It consists of erythrocytes that have leaked out of the very permeable and congested capillaries, thin strands of fibrin derived from fibrinogen in the exuded plasma, and leukocytes that have exited the vessels via diapedesis. 

7 - Hand, purulent inflammation, staphylococcal abscess - Clinical presentation

• Abscess

Inflammation involving a dense neutrophilic infliltrate is called purulent (referring to pus) or suppurative. A localized collection of neutrophils, necrotic cells, and edema fluid (pus) in tissue is an abscess. Collections of neutrophils tend to have a greenish-yellow or whitish-yellow color, as seen here.

8 - Trachea, bronchi and lungs, purulent inflammation, bronchopneumonia and abscess - Gross, cut surface

• Abscess
• Purulent inflammation 

Note the pale yellow color of the area of purulent inflammation. In one focus, this inflammation has formed an abscess.

9 - Lung, purulent inflammation, abscess - Very low power (Glass slide 46)

• Abscesses

In this section of the lung, the large, irregularly shaped defects lined by shaggy, basophilic material are abscesses. They appear empty, because the liquid purulent material washed away when the tissue was sectioned to prepare the slide. The remaining parenchyma appears consolidated.

10 - Lung, purulent inflammation, abscess - High power (Glass slide 46)

This high-power view of the wall of the abscess demonstrates the dense neutrophilic infiltrate.

Inflammation and Repair 1 Outline (part-1) In Pathologic Basis Of Disease

1 - Lung, fibrinous inflammation, pleuritis - Gross

The white shaggy material on the pleural surface of the lung is fibrin, formed from fibrinogen that leaked from the underlying vessels, due to increased vascular permeability, part of an acute inflammatory response.

2 - Heart, fibrinous inflammation, pericarditis in uremia - Gross

The pericardium should be shiny and smooth, but in this case, exudation of fibrinogen-containing fluid from vessels, due to increased permeability, has led to fibrin deposition.

3 - Lung, fibrinous and hemorrhagic inflammation, pneumonia with fibrinous pleuritis - Very low power (Glass slide 41)

• Pleural surfaces

This low-magnification view shows consolidation of the lung parenchyma in a case of lobar pneumonia (lung infection with acute inflammation). The pleural surface is identified for the purpose of orientation.

4 - Lung, fibrinous and hemorrhagic inflammation, fibrinous pleuritis - High power (Glass slide 41)

• Fibrinous exudate
• Macrophages
• Lung parenchyma

This is a high-power view of the fibrinous exudate covering the pleural surface. A few macrophages are present. These may engulf and digest the fibrin (resolution), or organization of the exudate may go on to produce a fibrous scar.

5 - Lung, fibrinous and hemorrhagic inflammation, pneumonia - Medium power (Glass slide 41)

• Alveolar septal walls
• Normal lung

In the lung parenchyma, the normally empty alveolar spaces are filled with leukocytes and pink fibrin.

The Hyoid Bone

Fig. 51.
Hyoid bone, seen from the front.

Fig. 52.
Hyoid bone seen from the lateral side.

Fig. 53.
Median section through the hyoid bone (body).

Fig. 54.
Attachments on the hyoid bone seen from the anterosuperior aspect.

Fig. 55.
Schematic parasagittal section through the body of the hyoid bone, to show the arrangement  of structures attached.

Fig. 56.
Schematic vertical section through a greater cornu of the hyoid bone to show the arrangement of structures attached.

The Mandible

Fig. 43.
The mandible seen from above.

Fig. 44.
Right half of mandible seen from the lateral side.

Fig. 45.
Right half of the mandible seen from the medial side.

Fig. 46.
Median part  of the mandible, anterior aspect.

Fig. 47.
Median part of the mandible, posterior aspect.

Fig. 48.
Attachments on the mandible as seen from the lateral side.

Fig. 49.
Attachments on the mandible as seen from the medial side.

Fig. 50.
Region of the symphysis menti, showing attachments, seen from behind.

The Nasal Cavity

Fig. 37A.
Bones in the lateral wall of the nose. The base of the lateral wall formed by the maxilla.

Fig. 37B.
Palatine bone overlaps the  posterior part of the maxilla.

Fig. 37C.
The lacrimal bone and the inferior nasal concha are placed over the maxilla and the palatine bone.

Fig. 38.
Lateral wall of the nasal cavity is completed by the ethmoid bone. The parts shown in dotted line can be seen only when the middle concha is lifted off. Compare with Fig. 37C.

Fig. 39.
Main bones forming the nasal septum.

Fig. 40.
Lateral wall of the nasal cavity seen after removal of the medial plate of the ethmoid bone to expose the ethmoidal air sinuses.

Fig. 41.
Schematic diagram to show the positions of the openings of paranasal sinuses into the nasal cavity.

Fig. 42.
Scheme to show the parts of the   ethmoid bone.

Foramina Of The Skull

Fig. 31.
Structures passing through the optic canal, the superior orbital fissure, and the inferior orbital fissure.

Fig. 32.
Structures passing through the foramen ovale, and through smaller foramina near it.
The lesser petrosal nerve sometimes passes through the canalis innominatus.

Fig. 33.
Scheme to show structures passing through the carotid canal and the foramen lacerum.

Fig. 34.
Scheme to show structures passing through the jugular foramen.

Fig. 35.
Scheme to show the position of the opening of the inferior tympanic canaliculus,
and of the mastoid canaliculus.

Fig. 36.
Scheme to show the arrangement of structures passing  through the foramen magnum.

Cranial Fossae Of The Skull

Fig. 28.
Parts of the anterior and middle cranial fossae seen from above. Compare with Fig. 7.

Fig. 29.
Schematic diagram to show some features in the anterior wall of the middle cranial fossa.

Fig. 30.
Features to be seen in the floor of the middle and posterior cranial fossae