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193 Cards in this Set
- Front
- Back
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The study of underlying changes in physiology that results from disease or injury
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Pathophysiology
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patho means what in greek
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disease or suffering
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what is pathology?
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study of structual changes in cells tissues and organs of the body caused by disease
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what is functions of the human body?
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Physiology
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What does Pathophysiology deal with exactly?
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cellular and organ changes that occur with diseases and with effects these changes have on toatal body function...an example would be Type 1 Diabetes
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what is a disease?
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an interruption, cessation, or disorder in the function of a body organ or system that is characterized by 3 things....a. recognized etiologic agent...b. identifiable group of signs and symptoms..c. consistent anatomic alterations
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The disease process includes 6 things....EPMCDC
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etiology, pathogenesis, morpholoic changes, clinical manifestations, diagnosis, and clinical course
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There can be 4 different types of etiological agents, name them?
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biological, physical, chemical, and nutritional
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This descibes what sets the disease in motion
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etiology
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This tells how the disease progresses
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Pathogenesis
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morphology changes are concerned with two things?
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Gross anatomic changes...and..microscopic changes that are characteristic of disease
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What is Histology?EXample?
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Study of cells and extra cellular matrix of body tissues; biopsy tissue to identify cancer cells
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Signs and Symptoms do what?
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describe the structural and functional changes that accompany a disease
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What is a Syndrome?
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A compilation of signs and symptoms that are characteristic of a specific disease state
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What is a diagnosis?
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The designation to the nature or cuase of a health problem
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A cell is what ?
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The smallest functional unit that an organism can be divided into and retain the characteristics vital for life
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This cell has a true nucleus, contains nucleus, cytoplasm, cell memebrnare and is in higher animals and plants
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Eukaryotes cell
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This is seen in bacteria and rickettsiae
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Prokaryotes...has no organelles and nuclear material is not encased by membrane
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What are the functions of the cell?
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movement, conductivity, metabolic absorption, secretion, excretion, respiration, reproduction, and communication
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Protoplasm is how much of water?
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70-85%
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How much protein is protoplasm?
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10-20%
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Lipids form cell membrane and are how much of protoplasm?
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2-3%
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In the protopasm the CHO is what?
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a rapid source of energy
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There are many electrolytes in the protoplasm and what is the purpose ?
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generate electrical impulses
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There are two main regions in the protoplasm?
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cytoplasm- which lies outside the nucleus
karoplasm and nucleoplasm- lies inside nucleus |
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What does the nucleus do?
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contains RNA and DNA; is the control center
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DNA contains what?
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essential genes with essential info for the making of protein
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What is Messenger RNA?
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copies and carries DNA instructions for protein making to the cytoplasm
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What is ribosomal RNA?
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becomes a site of protein making
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What is tRNA?
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moves into cytoplasm where it moves amino acids to the elongating proteins
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The cytoplasm surrounds what and does what?
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nucleus and where the work of the cell takes place
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site of protein synthesis
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ribosomes
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EReticulum
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extensive intracellular membrane network...makes and moves proteins
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golgi apparatus
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like the UPS, refines and sorts material for export from cell...example would be insulin
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cellular waste disposal, the digestive system
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lysosomes
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Peroxisomes
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degrades peroxides, controls free radicals
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ROugh ER
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studded and assists with protein making
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smooth ER
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assist with lipid making and detox of certain hormones and drugs
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The golgi apparatus also does what
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hormone making and secretion and helps in production of glycoproteins
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What is hydrolases?
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40 enzymes from a lysosome
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mitochondria
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transforms organic compounds into energy, contains enzymes of the kreb cycle, which requires aerobic metabolism
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This structure contains microtubules which do what?
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Cytoskeleton , helps in intracellular transport mechanisms, and has cillia and flagella that help move
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What are 6 functions of cell membrane?
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1. separates cells from fluid around cell 2. controls enter and exit 3. receptor sites for getting messages 4. flexible and capable of movement 5. molecules extending from surface that help it be recognized as belonging to that person 6. capacity in some cells to send an electrochemical signal
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The lipid bilayer provides a basic structure and impearmable to most water soluble molecules
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fluid mosaic model
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4 functions of fluid mosaic model
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1. separates intracellular and extracell 2. provides receptors for hormones and other active subtances 3. particpates in electronic events that occur in nerve and muscle cells 4. aids in regulation,growth, proliferation
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The outter layer of lipid bilayer is what?
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water soluble hydrophilic
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Anaerobic
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without oxygen, gylcolic pathway occuring in the cytoplasm
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Aerobic
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with oxygen, in the mitochodriac, citirc acid cycle
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Glycolosis- anaerobic activity
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1. energy is liberated from glucose 2. important source of energy for cells that lack mitochondia
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THIS IS AN INEFFECIENT WAY TO PRODUCE ENERGY BUT IMPORTANT DURING PERIODS OF DECREASED OXYGEN DELIVERY
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GLYCOLISIS
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End product is NAD and pyruvate
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Glycolsis
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Under conditions such as heart attack pyruvate is converted to what?
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Lactic Acid
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Aerobic Metabolism does what?
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supplies 90% of energy needs in mitichondria, End product is C02 and H2o, and uses kreb cycle and citric acid cycle and is final pathway for metabolism of nutrients
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Passive movement requires no energy and includes what?
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filtration, diffusion , and osmosis
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active movement requires?
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energy and uses facilitated transport
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diffusion
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GREATER TO LESSER SOLUTES MOVE, greater the difference the faster the diffusion, larger particles move slower,
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Filtration
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movement of water and solutes thru membrane bc of a force
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hydrostatic pressure
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mechanical force of water pushing against membrane
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Osmosis
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passive movement of water across semipermeable membrane, GREATER TO LESSER WATER AND LESSER TO GREATER PARTICLES, OSMOTIC PRESSURE
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Facilitated diffusion
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HIGHER TO LOWER CONCENTRATION
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Active transport
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Lesser to Greater concentration, solutes moves solutes against gradient, pump puts K into cell and Na into intersitial space
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All body cells are electrically polarized with?
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Inside more negative than outside
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resting membrane is
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-70 to -85
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What are the 3 phases in a action potential?
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resting, depolarizing, and repolarizing
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not transmitting impulses -70 -85
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resting
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flow of positive charged Na into interior of membrane 30-45
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depolarizing
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polarity of membrane is reestablished- refreactory period
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repolarizing
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when resting where is K and NA
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Na is outside and K is inside
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What are the phases of the cell cycle?
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S-synthesis G2- gap M- mitosis G1- period btw M and start of DNA synthesis
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G1 phase is what?
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normal cell function, and growth
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what is S phase?
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DNA replication
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What is G2 phase?
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2nd gap phase, growth and prep for mitosis, replicates centrioles and makes enzymes for cell division
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What is M phase?
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nuclear and cytoplasmic division, pro,meta,ana,telephase
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Go phase
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cells that have left the cycle
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what are the ways that cells talk?
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1. direct communication btw adjacent cells thru gap junction 2. autocrine and paracrine signaling 3. endocrine or synaptic signaling
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Endocrine chemical signaling?
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they secrete hormone chemicals that travel thru blood stream to produce a response in other cells
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Paracrine chemical signaling?
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secrete local chemical mediators that affect nearby cells
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Autocrine?
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affect own activity
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Name the four different types of tissues?
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epithelial, connective, muscle, and nerve
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This is avascular, receiving nutrition from capillaries from underlying connective tissue
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epithelial tissue
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thin and flat
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squamous
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single layer epithelium
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single
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stratified epithelium
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2 or more layers
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apperas to have more than one layer
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psuedostratified epithelium
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lines most of upper respiratory tract
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psudostratified epithelium
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mouth and tounge
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stratified squamous non kertinized
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epidermis of skin
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stratified squamous kertinized
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Connective tissue
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functions as an exchange medium thru which nutrients and metabolic waste pass
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What are fibroblasts responsible for?
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making fibrous gel like substances that fill intracellular spaces, collagen, elastic, reticular fibers
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reticular connective tissue provide the framework for
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liver, bone marrow, lymphoid tissue
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Dense irregular tissue
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found in dermis of skin
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dense regular tissue
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rich in collagen, tendons and ligaments
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largest repository of enery in the body
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adipose tissue
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3 types of muscle tissue
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skeletal, cardiac , and smooth
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does not go under mitotic division , responsible for movement, 40-45% of body weight
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skeletal striated
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in heart and does not go under mitotic division
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cardiac striated
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smooth involuntary muscle
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may undergo mitotic division and proliferate
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PNervous System
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fibers and ganglia outside CNS
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when does cell death occur?
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when stress is overwhelming, or adaptation id ineffective that injury and maldaptive changes happens
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decrease in cell size or cell number due to decrease in work demand or adverse conditions in environment
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atrophy
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what are causes of atrophy
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disuse- cast in arm
denervation- cord injury loss of endocrine stimulation-estrogen poor nutrition decreased blood flow |
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why do cells decrease their size and energy
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means of survival
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hypertrophy
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increase in cell size with increase in functional mass tissue
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increase in muscle mass with exercise or myocardial valvular disease
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results of increase workload
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Hyperplasia
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increase in cell number in an organ or tissue due to an APPROPRIATE STIMULATION
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This occurs in tissue with with cells that are capable of mitotic division...not nerve, cardiac, or skeletal
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hyperpalsia.... physiological or non physiological
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what is it when breast and uterine gain estrogen during pregenancy(hormone stimulation)
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hyperplasia
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increase function demand- parathyroid hormone in chronic renal failure
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HYPERPLASIA OF PARATHYROID GLAND
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COMPENSATORY HYPERPLASIA
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SEEN WITH REGENERATION OF THE LIVER AFTER PARTIAL HEPTATOMY
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HYPERPLASIA- NON PHYSIOLOGICAL
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DUE TO EXCESSIVE HORMONAL STIMULATION
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EXCESSIVE ESTROGEN AND HYPERPLASIA
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ABNORMAL MENSTRAL BLEEDING
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due to synergetic action of estrogen and adrogens
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benign prostatic hyperpalsia
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skin warts and hyperplasia
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growth factors produced by hpv
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what is metaplasia
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a reversible change in which one adult cell type is replaced by another adult cell type
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joe has chronic irritation and inflammation what does probally have?
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metaplasia
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Chronic smoker and metaplsia
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stratified squamous epithial change to ciliated columar epithial of the trachea
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What is dysplasia?
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deranged cell growth of a specific tissue that results in cells that vary in shape, size, and appearance
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minor degrees that are seen with chronic irritation and inflammation
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dsyplasia
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This is strongly indicated as a precursor to cancer
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dysplasia
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what is intracellular accumulation?
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a build up of substances that cell cannot use or dispose of
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Name 3 types of intracellular accumulation?
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normal body substances, abnormal like lipofusion, and exogenous products like coal dust and lead
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dystrophic calcification
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dead or dying tissue, seen in damaged heart valves
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metastatic calcification
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normal tissue, elevated calcium levels, immobilization, renal failure, pagets disease
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Is cell injury reversible?
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only to a certain point - brain anoxia is reversible up to 4-6 min
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radiation can damage macromolecules in 2 ways
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direct- micromoecules r ionizd indirect - where water is ioninzed and produces free rdiacls that in turn damage macromolecules
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gi, bone marrow, lymphs, fetus, ovarian follicles
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cells that are susceptible to damage
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what is free radical
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molecule with extra electron
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cellular swelling and fatty changes
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reversible cell injury
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programmed cell death
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apoptosis
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gangrene
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dry/impaired arterial system
moist/imparied venous system gas/ due 2 clostridium |
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necrosis
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pathological form of cell injury
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what does cancer result from?
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process of altered cell differentiation and growth
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explain growth of neoplasm
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uncoordinated and autonomous in that it lacks normal regulatory controls over cell growth and division
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tissue renewal and repair involve cell
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proliferation and differentaition
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what is normal cell differentiation
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orderly process that provides the body with means for replacing cells that have limited life expectancy and provides for tissue and wound healing
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what are the 3 large groups of cells in proliferation
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permanent liable and stable
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what is a permanent cell?
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unable to divide and reproduce...nuerons, muscle and cardiac cells
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These cells are in the GI tract and hemopoietic system and are in a constant state of renewal
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liable cells
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These cells in the liver that are normally renewed more slowly but can become more rapid after tissue loss
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stable cells
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What is Normal cell differentiation?
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process where proliferating cells are transformed into different and more specialized cells
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give an example of normal cell differentiation?
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when a RBC develops into a concave disk and lives for 120 days
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most highly specialized cell loses its ability to go under mitosis
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neuron
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Tell about a stem cell?
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it remains differeniated thru life; they are on reserve until there is a need for cell replenishment then can divide and carry out the functions
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cell phase cycle, one word to remeber
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G1-protein making RG1-restricted point and new round of cell division
S- DNA synthesis ,all chromosomes are replicated G2- protein making continues M- cell division |
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Benign
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cells are microscopically similar to their tissue and are clustered in a single mass
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Malignant
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invade and destroy surrounding tissue, metatsize, cause death
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how are cancers named
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to the cell type of origin or historical reason
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Name some cancer cell characteristics
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1. dont go thru proliferation and differentiation
2. possibly that cancer cells develop from mutations that occur during differentiation process 3. mutations occur early in process, poorly diff and highly malignant 4. mutations that occur later in process are more fully diff and less malignant 5. anaplasia(without form) which the cell develops specialized orgainazation and functions(increaase in nuclear size, loss of differentiaion) |
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grade 1 - grade 4?
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grade 1 is well differentaited and grade 4 is poorly differentaited
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Six hallmarks of cancer
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Self-sufficiency in growth signals
Insensitivity to antigrowth signals Evading apoptosis Limitless replicative potential Sustained angiogensis Tissue invasion and metatasis |
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Methods of tumor spread
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1. Local spread by direct invasion of contiguous organs
2. Metastasis to distant organs by lymphatics and veins 3. Metastasis by implantation |
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spread depends on
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Rate of growth
Degree of differentiation Presence or absence of anatomic barriers Various biological factors |
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Two Perspectives:
of cancer cause |
Molecular origin within the cell
External origin in which factors such as age, heredity, and environmental agents influence the inception and growth |
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Oncogenesis
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genetic mechanism where normal cells are transformed into cancer cells
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Three kinds of genes control cell growth and replication:
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Proto-oncogenes – Growth promoting
Tumor suppressor genes – tumor suppressing Genes that control programmed cell death (apoptosis) |
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Mutations of proto-oncogenes (growth promoting)
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HER-2 – human epidermal growth factor receptor-2 appears in 30% of aggressive breasts cancers
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Inactivation of tumor suppressor gene
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Mutations of P53 gene on chromosome 17 (tumor suppressor gene) = lung, breast, bowel cancer
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Angiogenic factors
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Increase in angiogenic factors or a loss of angiogenic inhibitors
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Transformation of normal cells to cancer cells by carcinogenic agents is a multistep process, divided into three stages:
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Initiation
Promotion Progression |
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Initiation
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Exposure of cells to appropriate dose of a carcinogenic agent
Permanent changes resulting in DNA damage at cellular level may become neoplastic if not repaired |
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Promotion or tranformation
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Continual stimulation of carcinogen on abnormal cell still reversible
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Continued use of tobacco or estrogen leads to mutagenic change in DNA and malignant behavior
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progression
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Small changes in DNA
Found in many cancers, especially pancreatic and colorectal cancer |
point mutations
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Can cause excess production of a proliferation factor
Can lead to production of novel proteins with growth-promoting properties |
chromosome translocation
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Immune surveillance hypothesis
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Immune system plays a central role in resistance against the development of tumors
NK cells, T and B lymphocytes |
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Increases in cancer seen:
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With immunodeficiency diseases (HIV)
Aging – decrease in immune system = increase in cancers Transplant patient receiving immunosuppressive therapy |
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Radiation can damage macromolecules in two ways:
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Directly, where the micromolecules are ionized
Indirectly, where water is ionized and produces free radicals that in turn damage macromolecules. |
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Affects one half of the worlds population
Cause peptic ulcer disease, gastric lymphoma, and gastric carcinoma |
Helicobacter pylori
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Cancer compresses and erodes blood vessels, causing ulcerations and necrosis along with frank bleeding and sometimes hemorrhage
Sign of cancer = bleeding |
signs of cancer
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Cancer produces enzymes and metabolic toxins that is destructive to tissue
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Early sign of cancer = delayed healing
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Abdominal cancer compresses viscera = bowel obstruction
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Cancer grows and invades adjacent structures
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Cancer compresses other structures
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Compression = pain
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Many cancers associated with weight loss and wasting of body fat and muscle tissue
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Referred to as the cancer anorexia-cachexia syndrome
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pap test
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Cytological method used to detect cancer
Since cancer cells lack the cohesive properties of normal cells, so cancer cells tend to exfoliate and mix with secretions It can also be performed on other body secretions: Nipple drainage Pleural fluids Peritoneal fluids Gastric washings |
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Most diagnostic method for cancer
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biopsy
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tumor markers
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Antigens produced by cancer cells that are found on tumor plasma membranes or in the blood, spinal fluid, or urine
“blood test for cancer” Markers include CEA - colon rectal cancer, pancreas, lungs Alpha fetoprotein (AFT) – liver and testicular cancers Prostate specific antigen (PSA) – cancer of prostate CA-125 – ovarian cancer Nonmalignant diseases also produce tumor markers, so never used alone to diagnose cancer |
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According to histological or cellular characteristics of the tumor
Graded I to IV with increasing anaplasia or lack of differentiation |
grading cancer
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According to the clinical spread of the disease
Determining the size of the tumor The degree to which it has locally invaded The extent to which it has spread |
staging cancer
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Primary Tumor (T), Regional Lymph Nodes (N), Distant Metastasis (M)
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staging
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The goals of cancer treatment falls into three categories:
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Curative
Control Palliative |
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50 chemotherapeutic drugs in use
At the cellular level they prevent cell growth and replication Effective in treating tumors that have a high growth fraction Classified as cell cycle specific or cell cycle nonspecific Methotrexate interrupts S phase Combination therapy usually more effective CMF – cyclophosphamide, methrotrexate, fluorouracil |
chemo
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BM suppression = WBCs, RBCs, platelets = fatigue, bleeding tendency, hypoxia
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Immunosuppression (anemia, thrombocytopenia)
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Alopecia (hair loss)
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emporary, hair re-growth 1 month
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Used for:
Diagnosis - biopsy Staging Tumor removal Palliation – relief of symptoms |
surgery
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Premalignant conditions – remove the “at risk” tissue or organs
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Prophylaxis
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Cure- cure rate 25-30%
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Local excision, wide local excision, wide excision, extended radical excision
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Control (Cytoreductive surgery)
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“Debulking” remove part of tumor to enhance other therapies
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Palliation
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increase survival and decrease symptoms
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Therapy effectiveness
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(second look) re-diagnosis used to assess disease progress
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radiation
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Rationale – destroy cancer cells with minimal exposure of the normal cells to the damaging actions of radiation
Types of gamma radiation: Gamma rays – most common type used in treating cancer Beta rays – use in some types of diagnostic tests and in the body for radiation therapy Alpha rays – used in laboratory tests |
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Skin changes and hair loss are local but likely to be permanent depending on dose
Altered taste sensation an fatigue are two systemic side effects regardless of radiation site Radiation damage to normal underlying structures include inflammation, tissue fibrosis and scaring |
side effects of radiation
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Androgens and antiestrogens
Female – masculinization - chest and facial hair appear, menstrual periods stop, breast tissue shrinks, fluid retention Man – acne may develop, hypercalcemia, liver dysfunction may occur after prolonged use |
hormone side effects
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Interleukins – help body recognize and destroy abnormal body cells - IL-1, IL-2, and IL-6
Interferons – protect non-infected cells from viruses Monoclonal antibodies – Herceptin (breast cancer) and Rituxan (non-Hodgkins’s lymphoma)– binds to protein in cancer cells and prevents division |
Cytokines – enhance effectiveness of immune system
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