Pathophysiology part 4 paramedic

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Paramedic Care: Principles & Practice
Volume 1, 5e
Pathophysiology
Part 4

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Part 4
Disease at the Tissue Level

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Robert S. Porter
Disease at the Tissue Level
• Tissues
– Tissue: group of cells that serve common purpose.
 Epithelial, connective, muscle, nervous.
– Histology: study of tissues.
– Histopathology: study of abnormal or diseased tissue.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Germ layers: all tissues of the body derived from three
cell lines in embryonic development.
– Endoderm: innermost germ cell layer; gives rise to
epithelial tissue.
– Mesoderm: middle germ layer; gives rise to numerous
body tissues.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Ectoderm: outermost germ layer; gives rise to all
tissues that cover body surfaces as well as nervous
system.
– Epithelium: derived from all three germ layers.
– Epithelial tissues: cover body surfaces.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Connective tissues: framework on which epithelial
tissue rests and within which nerve and muscle tissue
embedded.
– Muscle tissues: responsible for movement of
substances through organism.
– Nerve tissues: coordinate activities of the body.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Epithelium forms barrier between organism and
environment.
– Epithelial tissue covers external and internal body
surfaces; lines passageways that communicate with
outside.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Epithelial tissue:
 Provides physical protection.
 Controls permeability.
 Provides special senses.
 Produces specialized secretions.

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Richard A. Cherry
Robert S. Porter
Figure 12-73 Types and locations of epithelial tissue.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Each type of epithelium has special purpose in
organism.
– Simple epithelium: single cell layer thick; provides
limited protection.
– Stratified epithelium: several layers thick; provides
greater degree of protection.

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Squamous epithelium: tissues with thin and flat cells.
– Cuboidal epithelium: cells cubelike or square shape.
– Columnar epithelium: cells tall and more slender.

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Robert S. Porter
Table 12-10 Types of Epithelial Tissue
Shape
Number
of Layers
Example Locations Functions
Squamous
(flat, scale-
like cells)
Simple
(single
layer)
Striated
(multilayers)
Linings of heart and blood vessels;
air sacs of lungs
Linings of mouth, esophagus,
vagina; outer layer of skin
Allows passage of
materials by diffusion
Protects underlying
areas
Cuboidal
(cube-shaped
cells)
Simple
Striated
Kidney tubules; secretary portions
of glands and ducts
Ducts of sweat glands, mammary
glands, salivary glands
Secretion; absorption
Protects underlying
areas
Columnar Simple
Striated
Most of digestive tract; bronchi;
excretory ducts of some glands;
uterus
Rare: urethra; junction of
esophagus and stomach
Absorbs; secretes
mucus, enzymes,
and other substances
Protects underlying
areas; secretes
mucus

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Richard A. Cherry
Robert S. Porter
Disease at the Tissue Level
• Tissues
– Connective tissues: deep tissues never exposed to
external environment.
– Bind together; support tissues of body.
 Collagen fibers
 Elastic fibers
 Reticular fibers

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Disease at the Tissue Level
• Tissues
– Cell types in connective tissues
 Fibroblasts
 Macrophages
 Adipocytes
 Mast cells
– Classes of connective tissue: physical properties of
ground substance.

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Disease at the Tissue Level
• Tissues
– Loose connective (areolar) tissue
 Adipose tissue
– Dense connective (fibrous) tissue
 Cartilage
 Bone
 Ligaments
 Tendons

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Disease at the Tissue Level
• Tissues
– Specialized connective tissues
 Blood
 Lymph

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Richard A. Cherry
Robert S. Porter
Table 12-11 Types of Connective Tissue
Type Example Locations Functions
Connective Tissue Proper
Loose, areolar Between muscles, surround
glands, wrapping small
blood vessels and nerves
Wraps and cushions organs
Loose,
adipose (fat)
Under skin, around kidneys
and heart
Stores energy, insulates, cushions organs
Dense Tendons, ligaments Attaches bone to bone (ligaments) or bone
to muscle (tendons)
Specialized Connective Tissue
Cartilage
(semisolid)
Nose (tip); rings in
respiratory air tubules;
external ear
Provides support and protection (by
enclosing) and serves as lever for muscles
to act on
Bone (solid) Skeleton Provides support and protection (by
enclosing) and levers for muscles to act on
Blood (fluid) Within blood vessels Transports oxygen and carbon dioxide,
nutrients, hormones, and wastes; helps
fight infections

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Disease at the Tissue Level
• Tissues
– Muscle tissues: specialized for contraction.
 Skeletal muscle
 Smooth muscle
 Cardiac muscle

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Table 12-12 Types of Muscle Tissue
Type Description Example Locations Functions
Skeletal Long, cylindrical cells;
multiple nuclei per cell;
obvious striations
Muscles attached to
bones
Provides
voluntary
movement
Cardiac Branching, striated cells;
one nucleus; specialized
junctions between cells
Wall of heart Contracts and
propels blood
through the
circulatory
system
Smooth Cells taper at each end;
single nucleus; arranged
in sheets; no striations
Walls of digestive
system, blood
vessels, and tubules
of urinary system
Propels
substances or
objects through
internal
passageways

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Disease at the Tissue Level
• Tissues
– Nervous tissue: found in brain, spinal cord, peripheral
nerves.
 Conducts electrical impulses from one part of body to another;
controls numerous body functions.
– Neurons: transmit electrical impulses.
– Neuroglia (glial cells): support, insulate, protect
neurons.

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Figure 12-77 Neuron.

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Disease at the Tissue Level
• Neoplasia
– Abnormal tissue growth; cells grow and multiply in
uncontrolled fashion.
– Tumor: mass of uncontrolled cell growth.
– Primitive nonspecialized cells (stem cells) mature into
specific cell types, depending on function.

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Disease at the Tissue Level
• Neoplasia
– Dysplastic (atypical) cells: develop abnormal growth
patterns.
– Tumors benign or malignant.
– Metastasis: malignant cells shed to other areas of body
through bloodstream.
– Cancer locally invasive; recurrence common.

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Figure 12-80 Abnormal cell development, progressing to invasive cancer.

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Disease at the Tissue Level
• Neoplasia
– Cancers: epithelial or connective tissue origin.
– Oncogenic factors: carcinogens and radiation.
– Oncogenic viruses: produce cancers.
– Genetics responsible for some cancers.

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Table 12-13 Tumor Origins and Names (1 of 2)
Origin/Prefix Cell Type Benign Tumor Malignant Tumor
Epithelial
Adeno- Gland Adenoma Adenocarcinoma
Basal cell Basal cell Basal cell adenoma Basal cell carcinoma
Squamous cell Squamous cell Keratoacanthoma Squamous cell
carcinoma
Melano- Pigmented cell Mole Melanoma
Terato- Multipotential cell Teratoma Teratocarcinoma
Supporting/Connective
Chandro- Cartilage Chondroma Chondrosarcoma
Fibro- Fibroblast Fibroma Fibrosarcoma
Hemangio- Blood vessel Hemangioma Hemangiosarcoma
Leiomyo- Smooth muscle Leiomyoma Leiomyosarcoma
Lipo- Fat Lipoma Liposarcoma
Meningio- Meninges Meningioma Meningiosarcoma
Myo- Muscle Myoma Myosarcoma

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Table 12-13 (continued) Tumor Origins and Names (2 of 2)
Origin/Prefix Cell Type Benign Tumor Malignant Tumor
Osteo- Bone Osteoma Osteosarcoma
Rhabdomyo- Striated muscle Rhabdomyoma Rhabdomyosarcoma
Blood/Lymphatic
Lympho- Lymphocyte Lymphoma or
lymphocytic leukemia
Erythro- Erythrocyte Erythrocytic leukemia
Myelo- Bone marrow Myeloma or
myelogenous leukemia

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Disease at the Tissue Level
• Neoplasia
– Environment is risk factor.
– Hormones play role in development of certain cancers.
– Carcinogenesis: process of developing a malignant
neoplasia.
– Initiation: event begins transformation from normal
tissue to cancer.

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Disease at the Tissue Level
• Neoplasia
– Promoter: carcinogen or any factor associated with
cancer development.
 Necessary for continued development of tumor and speeds up
process.
– Progression: malignancy exists and cells anaplastic in
appearance.
 Followed by growth, local tissue invasion, possible metastasis.

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Disease at the Tissue Level
• Neoplasia
– Once cancer develops, it becomes invasive.
– Cancer spreads along tissue planes; attaches to
various tissues.
– Spread of tumor cells makes treatment difficult; often
causes death.
– Cancer cells graded by degree of cell differentiation
present.