PATHOLOGY
Ultrastucture of a Cell
Importance of pathology
• Understanding cause of disease
• Progression of disease
• Early and effective diagnosis
• Prevention of diseases
• Management of disease conditions
• pathos = suffering, logos = study
• foundation of modern pathology is
understanding the cellular and molecular
abnormalities that give rise to disease
Cellular adaptation
• cellular adaptation refers to changes made by
a cell in response to adverse or varying
environmental changes
• physiologic (normal) or pathologic (abnormal).
Cellular Adaptation
• Atrophy – decrease in the size of the cells-thymus
• Hypertrophy – increase in the size of the cells-
skeletal muscle
• Hyperplasia-increase in the number of cells-
endometrium
• Metaplasia –change of one cell type to another-
esophagus
• Dysplasia-abnormal changes in cell size, shape or
organisation
METAPLASIA
CAUSES OF CELL INJURY
• Hypoxia and ischemia.
• Toxins
• Infectious agents.
• Immunologic reactions.
• Genetic abnormalities.
• Nutritional imbalances.
• Physical agents.
• Aging
Reversible Cell Injury
• Cellular swelling
• Fatty change
• Hyaline change
• Myxoid or mucoid change
Irreversible cell injury
• Autolysis – cell digested by enzymes of
lysosomes
• Necrosis
• Apoptosis
Cell Death
• Necrosis
• Apoptosis
NECROSIS
• is a form of cell death in which cellular
membranes fall apart, and cellular enzymes
leak out and ultimately digest the cell
• Always abnormal
• Always accompanied by Inflammation
• Coagulative necrosis
• Liquefactive necrosis
• Caseous necrosis
• Fat necros
• Fibrinoid necrosisis
Necrosis - coagulative
Liquefactive necrosis
GANGRENE
• Necrosis with putrefaction
• Dry gangrene
• Wet gangrene
• Gas gangrene
Dry gangrene
Wet Gangrene
GAS GANGRENE
Clostridium perfringens
APOPTOSIS
• Programmed cell death.
• Distinctive pattern of cell death to eliminate
unwanted cells
• Physiological or pathological (abnormal)
• No inflammation
Apoptosis
• Physiological – embryogenesis, endometrial
shedding during menstruation
• Pathological – viral infection, destruction of
cells by cancer drugs
Steps of apoptosis
• Initiation – trigger of FAS or lack of hormones
or heat or radiation
• Execution – activation of enzymes
• Caspases – cleave cytoskeletal proteins
• Nucleases – hromatin condensation
• Flipping out of phosphatidyl serine for
phagocytosis
• Appearance of thrombospondin bodies
Pathological calcification
• Dystrophic calcification – calcium depositd in
dead tissues
• Post TB lesion with calcification
• Metastatic calcification – deposition of
calcium in living tissue
• Hyperparathyroidism and hypervitaminosis D
INFLAMMATION
• Inflammation is a response of vascularized
tissues
• to infections and tissue damage that brings
cells and molecules of host defense
• from the circulation to the sites where they
are needed,
• to eliminate the offending agents.
Signs of Inflammation
• SWELLING
• REDNESS
• PAIN
• HEAT
• LOSS OF FUNCTION
Types of nflammation
• Acute inflammation
• Chronic inflammation
Acute inflammation
• Sudden and Short lived
• Neutrophils
• Mild and self limiting
• Signs and symptoms are prominent
Neutrophil
Changes in acute inflammation
• Vascular – dilation of blood vessel, increase in
microvasculature permeability
• Cellular – extravasation of neutrophils
Mediators of inflammation
• Cell derived – histamine, serotinin
• Plasma derived – kinin system, complement
system
Effects of acute inflammation
• Beneficial - Dilution of toxins, entry of
antibodies, drugs and nutrients
• Harmful – digestion of normal tissue, swelling,
allergic response
What does it look like
• Ulcer
• Abscess
• cellulitis
Result of acute inflammation
• Resolution
• Fibrosis
• Abscess
• Chronic inflammation
Chronic inflammation
• Slow onset and progressive
• Lymphocytes and monocytes/macrophges
• Severe tissue destruction
• Less local signs and synptoms
Monocyte and macrophage lymphocyte
What does it look like?
• Peptic ulcer
• Osteomyelitis
• Tuberculosis (chronic granulomatous
inflammation)
Systemic effects of chronic
inflammation
• Fever
• Anemia
• ESR elevetaed
• leucocytosis
PHAGOCYTOSIS
• Process of engulfment of solid material by
cells
• Phagocytes - Neutrophils and macrophages
• Steps – recognition and attachment,
engulfment, killing or degradation
Regeneration
• Replacement of injured cells by the same type
cell
• Stem cells / labile cells
Wound healing
• Orderly and timely reparative process that
results in durable restoration of the anatomy
and functionality of the organ
• Healing by primary intention
• Healing by secondary intention
Healing by primary intention
Factors influencing wound healing
• Local – infection, size, apposition of edges,
blood supply, mobility, presence of foreign
body, cellular hypoxia, ioniisng radiation.
• Systemic factors – age, nutritional status,
diabetes, immune status, innadequate
circulation, hormones.
Complications of wound healing
• Secondary Infection
• Deficient scar formation
• Keloids
• Contractures
keloid
Wound contracture
THANK YOU

pathology intro.pptx

  • 1.
  • 2.
  • 3.
    Importance of pathology •Understanding cause of disease • Progression of disease • Early and effective diagnosis • Prevention of diseases • Management of disease conditions
  • 4.
    • pathos =suffering, logos = study • foundation of modern pathology is understanding the cellular and molecular abnormalities that give rise to disease
  • 6.
    Cellular adaptation • cellularadaptation refers to changes made by a cell in response to adverse or varying environmental changes • physiologic (normal) or pathologic (abnormal).
  • 7.
    Cellular Adaptation • Atrophy– decrease in the size of the cells-thymus • Hypertrophy – increase in the size of the cells- skeletal muscle • Hyperplasia-increase in the number of cells- endometrium • Metaplasia –change of one cell type to another- esophagus • Dysplasia-abnormal changes in cell size, shape or organisation
  • 12.
  • 16.
    CAUSES OF CELLINJURY • Hypoxia and ischemia. • Toxins • Infectious agents. • Immunologic reactions. • Genetic abnormalities. • Nutritional imbalances. • Physical agents. • Aging
  • 17.
    Reversible Cell Injury •Cellular swelling • Fatty change • Hyaline change • Myxoid or mucoid change
  • 19.
    Irreversible cell injury •Autolysis – cell digested by enzymes of lysosomes • Necrosis • Apoptosis
  • 20.
  • 21.
    NECROSIS • is aform of cell death in which cellular membranes fall apart, and cellular enzymes leak out and ultimately digest the cell • Always abnormal • Always accompanied by Inflammation
  • 22.
    • Coagulative necrosis •Liquefactive necrosis • Caseous necrosis • Fat necros • Fibrinoid necrosisis
  • 23.
  • 24.
  • 25.
    GANGRENE • Necrosis withputrefaction • Dry gangrene • Wet gangrene • Gas gangrene
  • 26.
  • 27.
  • 28.
  • 29.
    APOPTOSIS • Programmed celldeath. • Distinctive pattern of cell death to eliminate unwanted cells • Physiological or pathological (abnormal) • No inflammation
  • 30.
  • 31.
    • Physiological –embryogenesis, endometrial shedding during menstruation • Pathological – viral infection, destruction of cells by cancer drugs
  • 32.
    Steps of apoptosis •Initiation – trigger of FAS or lack of hormones or heat or radiation • Execution – activation of enzymes
  • 34.
    • Caspases –cleave cytoskeletal proteins • Nucleases – hromatin condensation • Flipping out of phosphatidyl serine for phagocytosis • Appearance of thrombospondin bodies
  • 36.
    Pathological calcification • Dystrophiccalcification – calcium depositd in dead tissues • Post TB lesion with calcification • Metastatic calcification – deposition of calcium in living tissue • Hyperparathyroidism and hypervitaminosis D
  • 37.
    INFLAMMATION • Inflammation isa response of vascularized tissues • to infections and tissue damage that brings cells and molecules of host defense • from the circulation to the sites where they are needed, • to eliminate the offending agents.
  • 38.
    Signs of Inflammation •SWELLING • REDNESS • PAIN • HEAT • LOSS OF FUNCTION
  • 39.
    Types of nflammation •Acute inflammation • Chronic inflammation
  • 40.
    Acute inflammation • Suddenand Short lived • Neutrophils • Mild and self limiting • Signs and symptoms are prominent
  • 41.
  • 42.
    Changes in acuteinflammation • Vascular – dilation of blood vessel, increase in microvasculature permeability • Cellular – extravasation of neutrophils
  • 43.
    Mediators of inflammation •Cell derived – histamine, serotinin • Plasma derived – kinin system, complement system
  • 44.
    Effects of acuteinflammation • Beneficial - Dilution of toxins, entry of antibodies, drugs and nutrients • Harmful – digestion of normal tissue, swelling, allergic response
  • 45.
    What does itlook like • Ulcer • Abscess • cellulitis
  • 47.
    Result of acuteinflammation • Resolution • Fibrosis • Abscess • Chronic inflammation
  • 48.
    Chronic inflammation • Slowonset and progressive • Lymphocytes and monocytes/macrophges • Severe tissue destruction • Less local signs and synptoms
  • 49.
  • 50.
    What does itlook like? • Peptic ulcer • Osteomyelitis • Tuberculosis (chronic granulomatous inflammation)
  • 52.
    Systemic effects ofchronic inflammation • Fever • Anemia • ESR elevetaed • leucocytosis
  • 53.
    PHAGOCYTOSIS • Process ofengulfment of solid material by cells • Phagocytes - Neutrophils and macrophages • Steps – recognition and attachment, engulfment, killing or degradation
  • 55.
    Regeneration • Replacement ofinjured cells by the same type cell • Stem cells / labile cells
  • 56.
    Wound healing • Orderlyand timely reparative process that results in durable restoration of the anatomy and functionality of the organ • Healing by primary intention • Healing by secondary intention
  • 57.
  • 59.
    Factors influencing woundhealing • Local – infection, size, apposition of edges, blood supply, mobility, presence of foreign body, cellular hypoxia, ioniisng radiation. • Systemic factors – age, nutritional status, diabetes, immune status, innadequate circulation, hormones.
  • 60.
    Complications of woundhealing • Secondary Infection • Deficient scar formation • Keloids • Contractures
  • 61.
  • 62.
  • 63.