Introduction to pathology

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Introduction to pathology

  1. 1. Introduction to Pathology Cell Adaptation, Injury and Death By Noel C. Santos, M.D.
  2. 2. LEARNING OBJECTIVES
  3. 3. Introduction to Pathology <ul><li>Define Pathology </li></ul><ul><li>Give the two main divisions of Pathology </li></ul><ul><li>Give the four aspects of disease process </li></ul>
  4. 4. Cell Adaptation <ul><li>Define and review the concept of normal homeostasis </li></ul><ul><li>Define cellular adaptation </li></ul><ul><li>Give the six types of adaptive response that may occur in a cell </li></ul>
  5. 5. Cell Injury <ul><li>Define cell injury </li></ul><ul><li>Enumerate the general categories of the cause of cell injury </li></ul><ul><li>Give the two main phase of cell injury </li></ul><ul><li>Give the basic principles of cell injury </li></ul><ul><li>Give the general biochemical mechanisms of cell injury </li></ul><ul><li>Discuss the events that occur during ischemia with hypoxia </li></ul><ul><li>Discuss the events that occur during ischemia with reperfusion </li></ul><ul><li>Discuss the events that occur in free radical-induced cell injury </li></ul><ul><li>Discuss the mechanisms of chemical injury </li></ul><ul><li>Give the morphologic changes that occur during reversible cell injury </li></ul><ul><li>Enumerate and discuss each of the subcellular responses to cell injury </li></ul>
  6. 6. Cell Death <ul><li>Define cell death </li></ul><ul><li>Give the principal patterns of cell death in response to lethal and/or acute cell injury </li></ul><ul><li>Discuss the causes, biochemical features and mechanisms of apoptosis </li></ul><ul><li>Give examples of apoptosis </li></ul><ul><li>Give the morphologic changes of cells that undergo apoptosis </li></ul><ul><li>Give the morphologic changes that occur during irreversible cell injury and cell death </li></ul><ul><li>Enumerate the morphologic types of necrosis, and give examples </li></ul><ul><li>Give the morphologic cellular alterations in response to sublethal and/or chronic cell injury </li></ul>
  7. 7. Pathology <ul><li>Definition: </li></ul><ul><ul><li>“ pathos” = “suffering” or “disease” </li></ul></ul><ul><ul><li>“ logos” = “study” </li></ul></ul><ul><li>“ study of diseases” </li></ul><ul><li>study of the structural and functional causes of human disease. </li></ul>
  8. 8. Main Divisions of Pathology <ul><li>BASIC or GENERAL PATHOLOGY </li></ul><ul><li>SYSTEMIC PATHOLOGY </li></ul><ul><li>CLINICAL PATHOLOGY </li></ul><ul><li>ANATOMIC PATHOLOGY </li></ul><ul><li>PATHOPHYSIOLOGY </li></ul><ul><li>SURGICAL PATHOLOGY </li></ul>
  9. 9. Four Aspects of Disease Process <ul><li>ETIOLOGY – cause of a disease </li></ul><ul><li>PATHOGENESIS – mechanism/s of disease development </li></ul><ul><li>MORPHOLOGIC CHANGE – structural alterations induced in cells, tissues, organs, systems, body </li></ul><ul><li>FUNCTIONAL DERANAGEMENT and CLINICAL SIGNIFICANCE – functional consequences of the morphologic changes </li></ul>
  10. 10. HOMEOSTASIS <ul><li>“ steady state – normal function where there is a balance between physiologic demands and the constraints of cell structure and metabolic capacity.” </li></ul><ul><li>MAINTAINED STATE OF VIABILITY OR VITALITY </li></ul>
  11. 11. THE CELL <ul><li>Can alter their functional state in response to modest stress, maintain the steady state </li></ul><ul><li>More excessive physiologic stresses or adverse pathologic stimuli </li></ul><ul><ul><li>ADAPTATION </li></ul></ul><ul><ul><li>INJURY: Reversible or Irreversible </li></ul></ul><ul><ul><li>DEATH </li></ul></ul>
  12. 12. Normal Cell Cell Adaptation Cell Injury Reversible Irreversible Cell Death Hypoxia Infectious Chemical Physical Immunologic Genetic Nutritional Imbalance Duration Strength Intensity
  13. 14. ADAPTATION <ul><li>Stressful stimuli induce a new state that changes the cell </li></ul><ul><li>Preserves the cell’s viability </li></ul><ul><ul><li>HYPERPLASIA </li></ul></ul><ul><ul><li>HYPERTROPHY </li></ul></ul><ul><ul><li>ATROPHY </li></ul></ul><ul><ul><li>INVOLUTION </li></ul></ul><ul><ul><li>METAPLASIA </li></ul></ul><ul><ul><li>DYSPLASIA </li></ul></ul>
  14. 18. CELL INJURY <ul><li>REVERSIBLE </li></ul><ul><ul><li>Pathologic cell changes that can be restored to normal state </li></ul></ul><ul><li>IRREVERSIBLE </li></ul><ul><ul><li>Stress exceeds the capacity to adapt </li></ul></ul><ul><ul><li>“ point of no return” </li></ul></ul><ul><ul><li>Permanent changes – DEATH </li></ul></ul>
  15. 28. CELL DEATH <ul><li>2 patterns </li></ul><ul><ul><li>NECROSIS </li></ul></ul><ul><ul><ul><li>Always pathologic </li></ul></ul></ul><ul><ul><ul><li>Severe cell swelling </li></ul></ul></ul><ul><ul><ul><li>Denaturation and coagulation of proteins </li></ul></ul></ul><ul><ul><ul><li>Breakdown of cellular organelles </li></ul></ul></ul><ul><ul><ul><li>Cell rupture </li></ul></ul></ul><ul><ul><ul><li>Large number cells in the adjoining tissue are affected </li></ul></ul></ul><ul><ul><li>APOPTOSIS </li></ul></ul><ul><ul><ul><li>May be physiologic </li></ul></ul></ul><ul><ul><ul><li>Activation of internal “suicide” program </li></ul></ul></ul><ul><ul><ul><li>Orchestrated disassembly of cell components </li></ul></ul></ul><ul><ul><ul><li>Minimal disruption of the surrounding tissue </li></ul></ul></ul><ul><ul><ul><li>Chromatin condensation/fragmentation </li></ul></ul></ul>
  16. 30. Morphologic Types of Necrosis <ul><li>Coagulation </li></ul><ul><li>Liquefaction </li></ul><ul><li>Caseation </li></ul><ul><li>Enzymatic Fat </li></ul>

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