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Altered Cellular and Tissue BiologyChapter 2

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Cellular Adaptation Physiologic vs. pathogenic Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia

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Cellular Adaptation

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Cellular Adaptation

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Cellular Adaptation

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Cellular Injury Reversible Irreversible

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Cellular Injury Mechanisms Hypoxic injury

Ischemia Anoxia Cellular responses

Decrease in ATP, causing failure of sodium-potassium pump and sodium-calcium exchange

Cellular swelling Reperfusion injury

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Cellular Injury Mechanisms Free radicals and reactive oxygen species

Electrically uncharged atom or group of atoms having an unpaired electron

Lipid peroxidation Alteration of proteins Alteration of DNA Mechanisms for the inactivation of free radicals

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Cellular Injury Mechanisms Chemical injury

Lead Carbon monoxide Ethanol Mercury Social or street drugs

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Unintentional and Intentional Injuries Blunt force injuries

Application of mechanical energy to the body resulting in the tearing, shearing, or crushing of tissues

Contusion vs. hematoma Abrasion Laceration Fractures

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Contusions and Hematomas

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Unintentional and Intentional Injuries Sharp force injuries

Incised wounds Stab wounds Puncture wounds Chopping wounds

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Unintentional and Intentional Injuries

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Unintentional and Intentional Injuries Gunshot wounds

Entrance wounds Contact range entrance wound Intermediate range entrance wound

Tattooing and stippling Indeterminate range entrance wound

Exit wounds Shored exit wound

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Gunshot Wounds

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Unintentional and Intentional Injuries Asphyxial injuries

Caused by a failure of cells to receive or use oxygen

Suffocation Strangulation

Hanging, ligature, and manual strangulation Chemical asphyxiants Drowning

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Infectious Injury Pathogenicity of a microorganism Virulence of a microorganism Disease-producing potential

Invasion and destruction Toxin production Production of hypersensitivity reactions

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Immunologic and Inflammatory Injury Phagocytic cells Immune and inflammatory substances

Histamine, antibodies, lymphokines, complement, and enzymes

Membrane alterations

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Injurious Genetic Factors Nuclear alterations Alterations in the plasma membrane structure,

shape, receptors, or transport mechanisms Examples

Sickle cell anemia and muscular dystrophy

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Injurious Nutritional Imbalances Essential nutrients are required for cells to

function normally Deficient intake Excessive intake

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Temperature Extremes Hypothermic injury

Slows cellular metabolic processes Hyperthermic injury

Heat cramps Heat exhaustion Heatstroke

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Atmospheric Pressure Changes Sudden increases or decreases in atmospheric

pressure Blast injury Decompression sickness or caisson disease

“The bends”

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Ionizing Radiation Any form of radiation capable of removing

orbital electrons from atoms X-rays, gamma rays, alpha and beta particles

Mechanism of damage Effects of ionizing radiation

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Ionizing Radiation

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Cellular Injury Illumination injury

Eyestrain, obscured vision, and cataract formation

Caused by light modulation Mechanical stresses

Physical impact or irritation Noise

Acoustic trauma and noise-induced hearing loss

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Manifestations of Cellular Injury Cellular accumulations (infiltrations)

Water Lipids and carbohydrates Glycogen Proteins

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Hydropic Degeneration

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Manifestations of Cellular Injury Cellular accumulations (infiltrations)

Pigments Melanin, hemoproteins, bilirubin

Calcium Urate

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Calcium Infiltration

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Cellular Death Necrosis

Sum of cellular changes after local cell death and the process of cellular autodigestion

Processes Karyolysis

Nuclear dissolution and chromatin lysis Pyknosis

Clumping of the nucleus Karyorrhexis

Fragmentation of the nucleus

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Cellular Death

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Necrosis Coagulative necrosis

Kidneys, heart, and adrenal glands Protein denaturation

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Coagulative Necrosis

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Necrosis Liquefactive necrosis

Neurons and glial cells of the brain Hydrolytic enzymes

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Liquefactive Necrosis

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Necrosis Caseous necrosis

Tuberculous pulmonary infection Combination of coagulative and liquefactive

necrosis

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Caseous Necrosis

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Necrosis Fat necrosis

Breast, pancreas, and other abdominal organs Action of lipases

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Fat Necrosis

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Necrosis Gangrenous necrosis

Clinical term Dry vs. wet gangrene Gas gangrene

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Gangrenous Necrosis

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Apoptosis Programmed cellular death Mechanisms Necrosis vs. apoptosis

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Apoptosis

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Aging and Altered Cellular and Tissue Biology Aging vs. disease Normal life span Gender differences

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Theories of Aging Accumulation of injurious events Genetically controlled program Theories

Genetic and environmental lifestyle factors Alterations of cellular control mechanisms Degenerative extracellular changes

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Theories of Aging

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Aging Cellular aging Tissue and systemic aging

Frailty

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Somatic Death Death of an entire person Postmortem changes

Algor mortis Livor mortis Rigor mortis Postmortem autolysis