A patient presenting with an inflamed toe suggests the body’s inflammatory response has been stimulated by something. This is most likely to be a reaction to an injury, infection, or allergy. Other reasons include the possibility of an increase in uric acid in the body namely gout. The reasons are numerous but the body’s response is always the same. To explain this process it is important to define what the ‘triple response’ is and to describe the role of the circulatory system in this process. Tortora et al (2014 pages 812-813) describe inflammation as a non-specific, defensive response of the body to tissue damage. This response has three phases and is described by this on line dictionary (inhttps://medicaldictionary.thefreedictionary.com/triple+response) as a triad of phenomena that occur in sequence after an intradermal injection of histamine. First, a red spot develops, spreading outward for a few millimetres, reaching its maximal size within 1 minute and then turning bluish. Next, a brighter red flush of colour spreads slowly in an irregular flare around the original red spot. Finally, a wheal filled with fluid forms over the original spot.
What is happening within the body and involves the circulatory system is firstly vasodilation and increased a permeability of blood vessels. (Tortora)It is the arterioles that supply the damaged area, local capillaries dilate and increase their permeability. . This allows defensive proteins eg antibodies and clotting factors to enter the injured areas Secondly, phagocytes, cells that are able to surround and digest micro-organisms and cellular debris migrates during this process to the sight of the inflammation. The main phagocytes involved in acute inflammation are the neutrophils, a type of white blood cell that contains granules of cell-destroying enzymes and proteins. . https://www.britannica.com/science/inflammation. After elimination of the invading organism, the fighting white blood cells start to get out of the site of the infection and return back to the blood stream.
Dead cells are taken away by phagocytosis. Thirdly tissue repair takes place
Fibroblasts tissue engineers start to repair the damage at the site of inflammation. After a period of time, the site returns to normal like it was before the inflammation. https://medical-diagonosis.wonderhowto.com/how-to/understand-process-inflammation-0126012/
During the inflammation process there are visible signs and a patient would feel the effect of these processes.
Smae 2017 lists the 5 cardinal signs of acute inflammation as redness caused by the local dilatation of small blood vessels within the damaged area. Heat caused by the increase of blood to the area raises the temperature. This would occur in peripheral parts of the body such as skin. Swelling occurs as a result of an accumulation of fluid in the extra vascular space and the amassing of the inflammatory cells migrating into the area. The patient would feel pain. This results from the stretching and distortion of tissue due to inflammatory oedema and if an abscess is present pus will be present in a cavity. The impaired function is caused by the inhibition of movement because of the accompanying pain.
Encyclopaedia Britannica informs us that an inflammatory response that lasts only a few days is called acute inflammation, while a response of longer duration is referred to as chronic inflammation.
O’Toole M, (2017). Mosby’s Pocket Dictionary of Medicine, Nursing and Health Professions. 8th edition. St Louis. Elsevier.
Tortora, G.J. and Derrickson, B (2014). Principles of Anatomy and Physiology 14th edition Danvers. Wiley.
The Smae Institute (2017) Module 4 The Circulatory System and The Inflammatory Response. (page 14)