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ALTERED CELLULAR AND TISSUE BIOLOGYChapter 3
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Key to Understanding Disease
“knowledge of structural and functional reactions of cells and tissues to injurious agents” (including genetic defects)
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Cellular Adaptation
“cells adapt to their environment to escape and protect themselves from injury”
Common Central part of many disease states
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Altered Cellular & Tissue Biology can result from… Adaption Injury Neoplasm Aging death
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Cellular Adaptation
Physiologic verses Pathogenic Atrophy Hypertrophy Hyperplasia Metaplasia
Dysplasia (atypical hyperplasia)
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Cellular Adaptation
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Cellular Adaptation
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Cell Injury…”BIG PICTURE”
Biochemical Mechanism ATP depletion Oxygen & oxygen derived free radicals Calcium alterations Defects in membrane permeable
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Cell Injury
Common forms Hypoxic injury Free radicals/reactive oxygen species
injury Chemical injury
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Cellular Injury - Hypoxia
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Cellular Injury:Reprofusion
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Chemical Injury
“biochemical interaction with toxic substance”
1) Direct toxicity – at cell membrane or organelles
2) Formation of reactive free radicals and lipid peroxidation
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Chemical Injury
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Chemical Injury
• 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
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Common Drugs of Abuse Opioid narcotics Sedative-hypnotics Psychomotor stimulants Phencycielidine-like drugs Table 3-5/6 Cannabinoids Hallucinogens Marijuana Methamphetamine Cocaine Heroin
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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
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Unintentional and Intentional Injuries
Sharp injuries Incised wounds Stab wound Puncture wound Chopping wound
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Unintentional and Intentional Injuries
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Unintentional and Intentional Injuries
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Unintentional and Intentional Injuries
Gunshot wounds Entrance Exit
Asphyxial Injuries Suffocation Strangulation Chemical – CO, cyanide, hydrogen sulfate Drowning
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Infectious Injury
Pathogenicity of a microorganism Invasion and destruction Toxin production Hypersensitivity reaction → damage
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Immunologic & Inflammatory Injury
Phagocytic cells, antibodies, lymphokines,
complement and protease↓
Cell membrane injury/function↓
↑ water ↑ Na+ ↓K+
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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
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Hydropic Degeneration
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Calcium Infiltration
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Cellular Death Necrosis
Sum of the cellular changes after local cell death and the process of cellular autodigestion (autolysis)
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Cellular Death : Nucleus
Processes Karyolysis – nuclear dissolution,
chromatinlysis Pyknosis – clumping of the nucleus Karyorrhexis – fragmentation of nucleus
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Cellular Death
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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”
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Coagulative Necrosis (cont’d)
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Liquefactive Necrosis:Brain
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Caseous Necrosis (cont’d)
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Fat Necrosis: Pancreas
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Gangrenous Necrosis
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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 eventsExample: Viral hepatitis, radiation, chemotherapy
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Theories of Aging
Accumulation of injurious events Genetically controlled program
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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)