A&p Lec15 Intro To Patho, Cell Adaptations, Injury, And Death

Front 1

What is Pathology?

Back 1

The study of Disease.

Front 2

What are the 4 components of Pathology?

Back 2

-Etiology - causation

-Pathogenesis - development of disease

-Morphologic changes - lesions (Gross, LM, EM) things you can see/measure

-Functional Derangements - clinical tests on blood, serum, urine, etc.

Front 3

What is General Pathology?

Back 3

cell injury and death, inflammation, tissue repair, hemodynamic disorders, neoplasia, diseases of immunity, infectious diseases, genetic diseases, toxicity (environment), nutritional disorders

Front 4

What is Systemic pathology?

Back 4

Pathology of organ systems

-Circulatory, musculoskeletal, respiratory, alimentary, renal, endocrine

-Central and peripheral nervous systems, reproductive system

Front 5

What is cellular homeostasis?

Back 5

cells maintain relatively constant internal environment despite changes in external environment

Front 6

How do cells adapt?

Back 6

-changes in growth

-changes in defferentiation

Front 7

What happens when the cell's ability to adapt is exceeded?

Back 7

-cell injury

-cell death

Front 8

What is Hypertrophy and define two types of it?

Back 8

an increase in size (cell or organ)

-physiologic - exercise-induced increase in muscle mass

-pathologic - heart enlargement in hypertension

Front 9

What is Hyperplasia and define two types of it?

Back 9

an increase in cell number

-physiologic - increase in glands in uterine mucosa

-pathologic - PSYCHE - if its abnormal its considered neoplasia instead of hyperplasia, like in a tumor/cancer

Front 10

What is Atrophy and define two types of it?

Back 10

a decrease in size (cell or organ)

-physiologic - involution of the uterus

-pathologic - muscle atrophy after nerve damage

Front 11

What is a main cause of hypertrophy?

Back 11

often due to increased protein sythesis in response to hormones, cytokines, etc

Front 12

What does Tumor Necorsis Factor do? (TNF)

Back 12

causes cell atrophy

-mediates Cachexia - "wasting away"

Front 13

In atrophy, degradation exceeds synthesis. What is going on?

Back 13

-decreased synthesis

-increased degradation - cellular proteins mainly via the ubiquitin-proteasome pathway - increased autophagy

-lack of growth factor hormone

-Cachexia - wasting away - mediated by Tumor Necrosis Factor

Front 14

What is Autophagy?

Back 14

a catabolic process involving the degradation of a cell's own components through the lysosomal machinery

-its normal

Front 15

What is catabolic?

Back 15

set of metabolic pathways that break down molecules into smaller units

-releases energy

Front 16

What is anabolic?

Back 16

set of metabolic pathways that construct molecules from smaller units

-requires energy

Front 17

What is Metaplasia?

Back 17

the replacement of one mature cell type by another mature cell type.

Front 18

What are 3 points of Metaplasia?

Back 18

-change in differentiation from basal cells

-new cell type is more able to withstand new stress

-reversible in many cases if cause/stress is removed

Front 19

What are 3 examples of Metaplasia?

Back 19

-Squamous metaplasia of respiratory epithelium in response to smoking

-Glandular metaplasia of esophagus due to acid reflux

-Ossification in tendon due to mechanical stress

Front 20

What is necrosis?

Back 20

the premature death of cells - unplanned

Front 21

What is Apoptosis?

Back 21

programmed cell death

Front 22

List 5 steps to Necrosis?

Back 22

-Swelling of cell and organelles

-Chromatin clumping - discrete pieces of DNA

-Membrane damage

-Enzymatic digestion
--Autolysis - cell dissolves itself
--heterolysis - outside cell provides the enzymes to dissolve injured cell

-Elicits inflammation - due to released contents

Front 23

List 6 steps to Apoptosis?

Back 23

-Shrinkage (rounding)

-Nuclear condensation

-Cytoplasmic budding

-Membrane bound apoptic bodies

-Phagocytosis - by other cell/macrophage

-no inflammation

Front 24

Define Etiology.

Back 24

cause or origin of a disease or disorder

Front 25

What are the 3 classes of Etiology?

Back 25

-Intrinsic (genetic)
---single gene defect
---polygenic

-Aquired
---Oxygen deprivation, physical injury, infectious agent
---Chemical exposure, nutrition, immune reactions, aging

-Environmental - influences and interactions between agents

Front 26

What are the 4 possible outcomes when a stress is introduced?

Back 26

-Cellular adaptation
---hypertrophy, atrophy, hyperplasia, metaplasia

-Reversible cellular injury
---swelling, fatty change

-Irreversible injury
---Membrane damage, mitochondrial damage

-Cell death

Front 27

What are 3 factors that affect whether an injury is reversible or irreversible?

Back 27

-Magnitude of injury

-Duration of insult

-Type of cell/tissue

Front 28

What are 5 things that can cause necrosis?

Back 28

-Lack of Oxygen
---Hypoxia - decrease in arterial oxygen
---Ischemia - decrease in oxygen due to blockage in arteries

-Reactive oxygen species - hydrogen peroxide, carbon monoxide

-Chemicals - directly and indirectly

-Physical agents - heat, radiation, pressure

-Toxins and infectious agents - brown recluse toxin

Front 29

What is Hypoxia?

Back 29

decreased oxygen

-occurs in ischemia

other causes -

-anemia, cardiorespiratory failure, CO

-Adaptation - atrophy

Front 30

What is Ischemia?

Back 30

lack of perfusion

-includes hypoxia but worse due to lack of all nutrients and increase in waste products

Front 31

What is pathogenesis?

Back 31

the series of events from pathology (cause) to disease

ex.-

-etiologic agent - Vibrio cholerae

-pathogenesis - ingestion, colonization, production of toxin, subunit A of toxin ADP-ribosylates a G protein and turns on adenylyl cyclase, increased cAMP causes secretion of fluid, severe diarrhea, dehydration, shock, death

Front 32

What are some mechanisms of cell injury?

Back 32

-depletion of ATP

-Mitochondrial damage

-Loss of Ca++ homeostasis

-Accumulation of Oxygen-derived free radicals

-Defects in membrane permeability
---Direct - lipid peroxidation by ROS (reactive oxygen species)
---Secondary to loss of ATP

Front 33

If mitochondria are damaged, what are the effects on the cell due to decreased ATP. (reversible)

Back 33

-Na pump stops working
---Loss of microvilli, blebs, ER swelling, Cellular swelling - influx of Ca++, H2O, and Na+, Efflux of K+

-Increased Glycolysis
---Decreased glycogen storage, decreased pH - causes clumping of nuclear chromatin

-detachment of ribosomes, decreased protein synthesis, lipid deposition

Front 34

What happens if an injurious agent compromises the cell membrane and there is an increase in cytosolic Ca++? (reversible)

Back 34

increased activity of some enzymes

-ATPase - decreased ATP

-Phospholipase - Decreased phospholipids

-Protease - Disruption of membrane and cytoskeletal proteins

-Endonuclease - nuclear chromatin damage

Front 35

What are reactive oxygen species (ROS) and why are they so bad?

Back 35

O2*, H2O2, OH*, and other free radicals.

-Free radicals have an unpaired e-, chemically unstable, readily react with other molecules resulting in chemical damage.

-Free radicals initiate autocatalytic reactions; molecules that react with free radicals are in turn converted to free radicals

Front 36

Normal redox reactions generate free radicals so where do the bad ones come from?

Back 36

-Ionizing radiation (UV, X-rays) can hydrolyze water into hydroxyl (OH•) and hydrogen (H•) free radicals

-Metabolism of exogenous chemicals such as CCl4can generate free radicals

-antimicrobial reactions can generate free radicals

Front 37

What can happen when the cell can't cope with Free radicals?

Back 37

-membrane lipid peroxidation

-protein cross-linking and fragmentation

-DNA fragmentation

Front 38

What is neoplasia?

Back 38

the abnormal increase/proliferation of cells that can result in an abnormal mass of tissue.

Front 39

What is dysplasia?

Back 39

abnormality of development.

-in pathology, alteration in size, shape, and organization of adult cells

Front 40

What is pyknosis?

Back 40

a thickening, especially degeneration of a cell in which the nucleus shrinks in size and the chromatin condenses to a solid, structureless mass or masses

Front 41

What is karyolysis?

Back 41

the dissolution of the nucleus of a cell

Front 42

What is karyorrhexis?

Back 42

rupture of the cell nucleus in which the chromatin disintegrates into formless granules that are extruded from the cell

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