Pathophysiology

1. Pathophysiology

2. Study Tips • Frequent quizzes • Understand the material • Read the text • Study frequently for short periods • Find a study buddy

3. Classroom Etiquette and rules: Turn off cell phones ! No chewing gums Be considerate of others: Take out what you bring in. Be ontime, No late more than 5-10m Talk to me, NOT your neighbor! No absence from exams without prior excuse Do not ask for grades over the phone or internet.

4. Academic Integrity • Use Professional ethics • NO: • Plagiarism • Cheating • Allowing others to copy from you • Penalties can be severe !!

5. Terminology • Pathology – focus on physical changes in diseased organs and tissues • Pathophysiology – abnormal functioning of diseased organs and how it applies to medical treatment and patient care

6. Disease – loss of homeostasis, or when physical or mental capacities cannot be fully utilized (interuption, cessation or disorder in the function of an organ or system). Etiology = cause of the disease When the etiology is unknown, the disease is said to be idiopathic.

7. Categories of etiology • Genetic disease– genes are responsible for a structural or functional defect • Congenital disease– genetic information is intact, but the intrauterine environment interferes with normal development • Acquired disease – disease is caused by factors encountered after birth (biological agents, physical forces, and chemical agents)

8. Clinical manifestations – indications that the person is sick Symptoms – unobservable effects of a disease reported by the patient Signs – observable or measurable traits Syndrome - a characteristic combination of signs and symptoms associated with a particular disease.

9. Diagnosis – identification of the specific disease Therapy – the treatment of the disease to either effect a cure or reduce the patient’s signs and symptoms Prognosis – prediction of a disease’s outcome

10. Normal Functioning of Cells

11. Structural Levels

12. Cell The cell is the building block of each living organism. Each cell is a self-contained system that undergoes the functions of energy production and usage, respiration, reproduction, and excretion

13. CellularFunctions • Reproduction • Growth • Differentiation • Respiration • Secretion • Excretion • Organization • Metabolism • Catabolism • Anabolism • Responsiveness • Conductivity • Movement

14. Cell; continued • mitochondria ;energy • endoplasmic reticulum and ribosomes; protein synthesys • Golgi apparatus; secretion of proteins synthesized on the ribosomes. • lysosomes ; digestive enzymes. • Cytoskeleton. • All cells composed internally of cytoplasm and nucleus, and surrounded externally by cell membrane. • The cytoplasm includes everything inside the cell but outside the nucleus

15. Boundary – Cell membrane(plasma membrane) Composed of lipid molecules in bilayer Phospholipids have hydrophobic tail Phospholipids have hydrophilic heads Also contains embedded proteins proteins are important for cell-cell communication: receptors for hormones cell recognition also important for metabolic processes inside the cell: channels pumps enzymes

16. Cellular Components • Phospholipid bilayer • Membrane proteins • Cytoplasm • Nucleus • Ribosomes • Mitochondria • Endoplasmic Riticulum • Golgi Apparatus • Lysosomes

17. Generic Eukaryotic Cell Generic Cell

18. Cell Membrane

21. Cytoplasm Cytosol – aqueous gel-like medium Important metabolic processes occur here Organelles – membrane bound structures Membranes provide compartments for separation of chemical reactions

22. Rough Endoplasmic ReticulumContains ribosomes – make proteins

24. Smooth ERsynthesizes phospholipidsdetoxifies

25. Golgi ApparatusPackages protein for export

27. MitochondriaThe cell’s power plant

28. Nucleus • large, membrane-bound organelle that contains deoxyribonucleic acid (DNA), the genetic material of the cell. • the DNA is folded up inside the nucleus

29. NucleusDNA codes for proteins

30. Movement Through the Membrane • Lipid-soluble substances, such as oxygen, carbon dioxide, alcohol, and urea, move across the lipid bilayer by simple diffusion • Other substances that;not lipid soluble, i.e most small ions, glucose, amino acids, and proteins, move between the extracellular and the intracellular compartments through pores provided by the integral proteins or throughcarrier-mediated transport systems. • Simple diffusion: osmosis,

31. Cells change to adapt to their environment • Atrophy = shrinkage = decrease in cell size. • Due to : • decreased use • decreased blood supply • decreased nutrition • Of tissues or organs may be due to • cell shrinkage or due to cell death.

32. General Response to Injury • Cellular Adaptation • Mechanisms of Cell Injury • Manifestations of Cell Injury • Cellular Death

33. Atrophy Hypertrophy Hyperplasia Dysplasia Metaplasia Cellular Adaptation

34.  Size of organelles  Size of organelles Energy Usage Atrophy  Workload (or disease state)  Efficiency -OR-  Functionality in disease state

35.  Size  # of organelles  contractility Hypertrophy  Size  # of organelles  Workload (or disease state)  ability to meet demands! -OR-  Functionality in disease state

36.  rate of cell division  functionality Hyperplasia  Workload Physiological state  tissue size by  # of cells 2 types: Compensatory & Hormonal  ability to meet demands! ...

37. Hyperplastic endometrium

38. Mutation Normal Cells Abnormal Shape & Size Dysplasia Epithelial Tissue Pathological

39. Cerical Dysplasia Normal Tissue Abnormal Tissue

40. Normal Cells Abnormal Cells Replacement Metaplasia Ex: Cigarette Smoking Pathological

41. Hypoxic Chemical Structural (trauma…tons next semester!) Infectious Immunologic / Inflammatory Mechanismsof Injury

42. HypoxicInjury  Atmospheric Oxygen  Respiratory Function Loss of Hb  Cardiovascular Function  Hb function (CO)  erythropoiesis Most Common Cause of Cellular Injury!

43. Elevated “Markers” ex CK, CKMB Loss of Phospholipids Membrane Damage Release of Enzymes HypoxicInjury (pathway 1)

44. Hypertrophy = increase in cell size We'll see this in heart, kidney (and others) w/ pathology NOT due to increased cell volume or fluid Rather, due to increased protein synthesis within the cell, or decreased protein breakdown Result is increased protein in organelles Hyperplasia = increase in cell number Due to increased cell division Uterus and breast tissue Parathyroid gland in kidney failure Liver (compensatory hyperplasia)

45. Metaplasia = replacement of one cell type with another • Reversible • An example: ciliated columnar epithelium replaced by • stratified squamous epithelium

46. Dysplasia = change in cell resulting in abnormal cell size, shape or organization • We'll see this in respiratory tract, cervix w/ pathology • In mature cells only • Immature cells would be expected to change in size, shape as they grow and mature • Considered a reversible change • Neoplasia = associated with a malignant tumor

47. Intracellular accumulations • Buildup of substances the cell can’t use or dispose of. • Normal body substances • Abnormal products from inside the body (inborn errors of metabolism) • Substances from outside the body (transient or permanent)

48. Cellular injury – cell unable to maintain homeostasis • Causes of cell injury: • Deficiency – lack of a substance necessary to the cell • Intoxication or poisoning – presence of a toxin or substance that interferes with cell functioning • Trauma – physical injury and loss of cell’s structural integrity

49. Deficiencies: Deficiency in oxygen most important

50. Hypoxia = deficiency in oxygen at cell Due to : Decreased oxygen in air Decreased hemoglobin or decreased oxygen transported to cells Diseases of the respiratory and/or cardiovascular system