Transcript Chapter 3

ALTERED CELLULAR
AND TISSUE BIOLOGY
Chapter 3
Key to Understanding Disease
“knowledge of structural and functional reactions
of cells and tissues to injurious agents” (including
genetic defects)
Cellular Adaptation
“cells adapt to their environment to escape and
protect themselves from injury”
 Common
 Central part of many disease states
Altered Cellular & Tissue Biology can
result from…
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Adaption
Injury
Neoplasm
Aging
death
Cellular Adaptation
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Physiologic verses Pathogenic
 Atrophy
 Hypertrophy
 Hyperplasia
 Metaplasia
 Dysplasia
(atypical hyperplasia)
Cellular Adaptation
Cellular Adaptation
Cell Injury…”BIG PICTURE”
Biochemical Mechanism
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 ATP
depletion
 Oxygen & oxygen derived free radicals
 Calcium alterations
 Defects in membrane permeable
Cell Injury
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Common forms
 Hypoxic
injury
 Free radicals/reactive oxygen species injury
 Chemical injury
Cellular Injury - Hypoxia
Cellular Injury:Reprofusion
Chemical Injury
“biochemical interaction with toxic substance”
1)
Direct toxicity – at cell membrane or organelles
2)
Formation of reactive free radicals and lipid
peroxidation
Chemical Injury
Chemical Injury
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Poisons – arsenic, cyanide
Air pollutants, insecticides, herbicides
Carbon monoxide – carboxyhemoglobin
(300 x O2)
Carbon tetrachloride – Figure 3-9
Lead – Ca++, Hgb, brain, kidney
Mercury – dental, fish, vaccines
Ethanol – “free radicals” – most organs
Social/street drugs
Common Drugs of Abuse
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Opioid narcotics
Sedative-hypnotics
Psychomotor stimulants
Phencycielidine-like drugs
Cannabinoids
Hallucinogens
Marijuana
Methamphetamine
Cocaine
Heroin
Table 3-5/6
Unintentional and Intentional Injuries
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Blunt force injuries
“application of mechanical energy to the body
resulting in tearing, shearing, or crushing of
tissues”
 Contusion
verses hematoma
 Abrasion
 Laceration
 fractures
Unintentional and Intentional Injuries
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Sharp injuries
 Incised
wounds
 Stab wound
 Puncture wound
 Chopping wound
Unintentional and
Intentional Injuries
Unintentional and
Intentional Injuries
Unintentional and Intentional Injuries
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Gunshot wounds
 Entrance
 Exit
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Asphyxial Injuries
 Suffocation
 Strangulation
 Chemical
 Drowning
– CO, cyanide, hydrogen sulfate
Infectious Injury
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Pathogenicity of a microorganism
 Invasion
and destruction
 Toxin production
 Hypersensitivity reaction → damage
Immunologic & Inflammatory Injury
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Phagocytic cells, antibodies, lymphokines,
complement and protease
↓
Cell membrane injury/function
↓
↑ water ↑ Na+ ↓K+
Manifestations of Cellular Injury
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Cellular accumulation (infiltrations)
 Water
– most common
 Lipids and carbohydrates – metabolic disorders
 Glycogen – metabolic (genetic) disorders
 Proteins – renal, B lymphocytes
 Pigments – melanin, hemoproteins
 Calcium
 Urates – gout
Hydropic Degeneration
Calcium Infiltration
Cellular Death
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Necrosis
 Sum
of the cellular changes after local cell death and
the process of cellular autodigestion (autolysis)
Cellular Death : Nucleus
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Processes
 Karyolysis
– nuclear dissolution, chromatinlysis
 Pyknosis – clumping of the nucleus
 Karyorrhexis – fragmentation of nucleus
Cellular Death
Necrosis …” different types in different organs”
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Coagulative – hypoxia, kidney, heart, adrenal
Liquefactive – bacterial infections, ischemia –
“lipids”
Caseous – tuberculosis – combination coagulative /
liquefactive
Fat – breast, pancreas – lipases
Gangrenous – “severe hypoxic injury”
Coagulative Necrosis (cont’d)
Liquefactive Necrosis:Brain
Caseous Necrosis (cont’d)
Fat Necrosis: Pancreas
Gangrenous Necrosis
Aptosis – single cell death
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Programmed Cell Death – 10 billion/day – suicide
genes
 Physiologic
– cell deletion during tissue turnover and
normal embryonic development, endocrine
dependent tissue
 Pathologic – intracellular and exogenous events
Example: Viral hepatitis, radiation, chemotherapy
Theories of Aging
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Accumulation of injurious events
Genetically controlled program
Somatic Death
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Death of the entire person
Postmortem changes
 Algor mortis - ↓ temperature 1 – 1.5°F/hr x 24°
 Livor mortis – blood settling – gravity
 Rigor mortis – muscle stiffening → 12° - ↓ 36 -72°
 Postmortem autolysis – release of enzymes and
lytic dissolution (microscopic level)