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…
Adaption
Injury
Neoplasm
Aging
death
Cellular Adaptation
Physiologic verses Pathogenic
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
(atypical hyperplasia)
Cellular Adaptation
Cellular Adaptation
Cell Injury…”BIG PICTURE”
Biochemical Mechanism
ATP
depletion
Oxygen & oxygen derived free radicals
Calcium alterations
Defects in membrane permeable
Cell Injury
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
Opioid narcotics
Sedative-hypnotics
Psychomotor stimulants
Phencycielidine-like drugs
Cannabinoids
Hallucinogens
Marijuana
Methamphetamine
Cocaine
Heroin
Table 3-5/6
Unintentional and Intentional Injuries
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
Sharp injuries
Incised
wounds
Stab wound
Puncture wound
Chopping wound
Unintentional and
Intentional Injuries
Unintentional and
Intentional Injuries
Unintentional and Intentional Injuries
Gunshot wounds
Entrance
Exit
Asphyxial Injuries
Suffocation
Strangulation
Chemical
Drowning
– CO, cyanide, hydrogen sulfate
Infectious Injury
Pathogenicity of a microorganism
Invasion
and destruction
Toxin production
Hypersensitivity reaction → damage
Immunologic & Inflammatory Injury
Phagocytic cells, antibodies, lymphokines,
complement and protease
↓
Cell membrane injury/function
↓
↑ water ↑ Na+ ↓K+
Manifestations of Cellular Injury
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
Necrosis
Sum
of the cellular changes after local cell death and
the process of cellular autodigestion (autolysis)
Cellular Death : Nucleus
Processes
Karyolysis
– nuclear dissolution, chromatinlysis
Pyknosis – clumping of the nucleus
Karyorrhexis – fragmentation of nucleus
Cellular Death
Necrosis …” different types in different organs”
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
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
Accumulation of injurious events
Genetically controlled program
Somatic Death
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)