Transcript Pathophysiology

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Plagiarism
Cheating
Allowing others to copy from you
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Pathology – focus on physical changes in
diseased organs and tissues
Pathophysiology – abnormal functioning of
diseased organs and how it applies to
medical treatment and patient care
Disease – loss of homeostasis, or when
physical or mental capacities cannot be fully
utilized (interuption, cessation or disorder in
the function of an organ or system).
Etiology = cause of the disease
When the etiology is unknown, the disease is
said to be idiopathic.
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Genetic disease– genes are responsible for a
structural or functional defect
Congenital disease– genetic information is
intact, but the intrauterine environment
interferes with normal development
Acquired disease – disease is caused by
factors encountered after birth (biological
agents, physical forces, and chemical agents)
Clinical manifestations – indications that the
person is sick
Symptoms – unobservable effects of a disease
reported by the patient
Signs – observable or measurable traits
Syndrome - a characteristic combination of
signs and symptoms associated with a
particular disease.
Diagnosis – identification of the specific
disease
Therapy – the treatment of the disease to
either effect a cure or reduce the patient’s
signs and symptoms
Prognosis – prediction of a disease’s outcome
The cell is the building block
of each living organism. Each
cell is a self-contained
system that undergoes the
functions of energy
production and usage,
respiration, reproduction, and
excretion
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Organization
Metabolism
◦ Catabolism
◦ Anabolism
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Responsiveness
◦ Conductivity
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Movement
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Reproduction
Growth
Differentiation
Respiration
Secretion
Excretion
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All cells composed
internally of
cytoplasm and
nucleus, and
surrounded
externally by cell
membrane.
The cytoplasm
includes everything
inside the cell but
outside the nucleus
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mitochondria ;energy
endoplasmic reticulum
and ribosomes; protein
synthesys
Golgi apparatus;
secretion of proteins
synthesized on the
ribosomes.
lysosomes ; digestive
enzymes.
Cytoskeleton.
Composed of lipid molecules in bilayer
Phospholipids have hydrophobic tail
Phospholipids have hydrophilic heads
Also contains embedded proteins
proteins are important for cell-cell
communication:
receptors for hormones
cell recognition
also important for metabolic
processes inside the cell:
channels
pumps
enzymes
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Phospholipid
bilayer
Membrane proteins
Cytoplasm
Nucleus
Ribosomes
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Mitochondria
Endoplasmic
Riticulum
Golgi Apparatus
Lysosomes
Generic Cell
Cytosol – aqueous gel-like medium
Important metabolic processes occur here
Organelles – membrane bound structures
Membranes provide compartments for
separation of chemical reactions
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large, membrane-bound organelle that
contains deoxyribonucleic acid (DNA), the
genetic material of the cell.
the DNA is folded up inside the nucleus
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Movement Through the Membrane
Lipid-soluble substances, such as oxygen,
carbon dioxide, alcohol, and urea, move
across the lipid bilayer by simple diffusion
Other substances that;not lipid soluble, i.e
most small ions, glucose, amino acids, and
proteins, move between the extracellular and
the intracellular compartments through pores
provided by the integral proteins or through
carrier-mediated transport systems.
Simple diffusion: osmosis,
Atrophy = shrinkage = decrease in cell size.
Due to :
decreased use
decreased blood supply
decreased nutrition
Of tissues or organs may be due to
cell shrinkage or due to cell death.
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Cellular Adaptation
Mechanisms of Cell Injury
Manifestations of Cell Injury
Cellular Death
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Atrophy
Hypertrophy
Hyperplasia
Dysplasia
Metaplasia
 Workload
(or disease state)
 Functionality
Efficiency
in disease
-OR- state
Size
Size
organelles
of oforganelles
 Energy Usage
 Workload
(or disease state)
 ability to
 Functionality
meet demands!
in disease state
-OR-
Size
Size
# of organelles
 #of
organelles
 contractility
 Workload
Physiological state
types:to
2ability
Compensatory
&
meet demands!
Hormonal
...
 tissue
 rate ofsize
by cell
 #division
of cells
 functionality
Epithelial
Tissue
Pathological
Mutation
Normal Cells
Abnormal
Shape & Size
Normal
Tissue
Abnormal
Tissue
Ex: Cigarette
Smoking
Pathological
Normal Cells
Abnormal
Cells
Replacement
Hypoxic 
Chemical 
Structural 
(trauma…tons next semester!) ◦
Infectious 
Immunologic / Inflammatory
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 Atmospheric Oxygen
 Respiratory Function
Loss of Hb
 Cardiovascular Function
 Hb function (CO)
 erythropoiesis
Most Common Cause of
Cellular Injury!
Elevated
“Markers”
ex CK, CKMB
Loss of
Phospholipids
Membrane
Damage
Release of
Enzymes
Hypertrophy = increase in cell size
We'll see this in heart, kidney (and others) w/
pathology
NOT due to increased cell volume or fluid
Rather, due to increased protein synthesis within
the cell, or decreased protein breakdown
Result is increased protein in organelles
Hyperplasia = increase in cell number
Due to increased cell division
Uterus and breast tissue
Parathyroid gland in kidney failure
Liver (compensatory hyperplasia)
Metaplasia = replacement of one cell type with
another
Reversible
An example: ciliated columnar epithelium
replaced by
stratified squamous epithelium
Dysplasia = change in cell resulting in abnormal cell
size, shape or organization
We'll see this in respiratory tract, cervix w/ pathology
In mature cells only
Immature cells would be expected to change
in size, shape as they grow and mature
Considered a reversible change
Neoplasia = associated with a malignant tumor
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Buildup of substances the cell can’t use or
dispose of.
◦ Normal body substances
◦ Abnormal products from inside the body (inborn
errors of metabolism)
◦ Substances from outside the body (transient or
permanent)
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Causes of cell injury:
Deficiency – lack of a substance necessary to
the cell
Intoxication or poisoning – presence of a
toxin or substance that interferes with cell
functioning
Trauma – physical injury and loss of cell’s
structural integrity
Deficiencies:
Deficiency in oxygen most important
Hypoxia = deficiency in oxygen at cell
Due to :
Decreased oxygen in air
Decreased hemoglobin or
decreased oxygen transported to cells
Diseases of the respiratory and/or
cardiovascular system
Important to cell because of
oxidative phosphorylation, which results
in the production of ATP
Oxidative: need oxygen to produce ATP
ATP: needed by cell for metabolism, cell life
Cellular response to hypoxia
Decreased mitochondrial reactions 
decreased ATP produced 
decreased energy
Ion pumps cease, so can't regulate ions
into/out of cell (ATP needed for this)
Can't pump Na+ and water out of cell, so get
cell swelling  organelle swelling 
cell death
Ischemia is inadequate blood supply to a cell or
tissue.
Ischemia can cause hypoxia.
Intoxication (or introduction of toxins into the cell)
Effect on cell depends on toxin and on cell
Some examples:
Lead -- injures nervous system
CO -- deprives body of oxygen
Ethanol -- effects central nervous system
Trauma -- physical disruption of cells
Ex: abrasion, cutting, burns,
microorganisms etc.
Free radicals :
uncharged atom or group of atoms with an
unpaired electron
Formed by radiation, redox reactions, chemicals
Atom is unstable
needs to gain or lose an electron
can alter chemical bonds in proteins,
lipids, carbohydrates and nucleic acids
can cause chain reaction in cell
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“fallen apart”
Regulated cell death
During development
Worn out cells
Diseased cells (tumor suppressor p53 gene,
natural killer or Tc cells)
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Messy cell death
Initiates inflammation
Gangrene – large mass of tissue undergoes
necrosis
Infections agents
Microorganisms can invade and harm cells
Cell injury can have effects on the entire body
Examples: fever, pain, increased heart rate