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Chapter 2 Cellular Pathology: Injury, Inflammation, and Repair Cell Response to Severe Injury

The Nature of Disease Pathology for the Health Professions Thomas H. McConnell. Chapter 2 Cellular Pathology: Injury, Inflammation, and Repair Cell Response to Severe Injury. Chapter 2: Cell Injury, Disease, and Death. Severe injury/stress -> cell death

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Chapter 2 Cellular Pathology: Injury, Inflammation, and Repair Cell Response to Severe Injury

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  1. The Nature of DiseasePathology for the Health Professions Thomas H. McConnell Chapter 2 Cellular Pathology: Injury, Inflammation, and Repair Cell Response to Severe Injury

  2. Chapter 2: Cell Injury, Disease, and Death Severe injury/stress -> cell death • Necrosis (Pathological death, usually in blocks of cells) • Coagulative • Liquefactive • Caseous • Fat • Apoptosis (Programmed, natural cell death of single cells)

  3. Cell Death: Necrosis • Necrosis • Cells die from some sudden insult (pathological) • Leakage of cell contents causes inflammation in surrounding area • Undergo autolysis • Karyolysis (nuclear dissolution) • Pyknosis (nuclear shrinkage) • Karyorrhexis (nuclear fragmentation) • Disintegration of cellular organelles Figure from: Huether & McCance, Understanding Pathophysiology, 5th ed., Elsevier, 2012

  4. Cell Death: Types of Necrosis • Four major types 1. Coagulative (kidney, heart, adrenals) • Typically from ischemia/hypoxia • Protein denaturation; albumin becomes gelatinous 2. Liquefactive (nervous tissue) • Typically from bacterial infection • Cells digested by their own hydrolases • Leukocytes release enzymes that dissolves tissue (pus) Figures from: Huether & McCance, Understanding Pathophysiology, 5th ed., Elsevier, 2012

  5. Cell Death: Types of Necrosis • Four major types 3. Caseous (pulmonary tuberculosis) • Combination of coagulative and liquefactive • Tissue has ‘clumped cheese’ appearance 4. Fat necrosis (breast, pancreas, abdominal organs) • Lipase breakdown of TG • FAs combine with Ca2+ • Saponification (soap is formed) Figure from: Huether & McCance, Understanding Pathophysiology, 5th ed., Elsevier, 2012

  6. Cell Death: Gangrenous Necrosis • Occurs over a large area (rather than at the cellular level) • Typically from ischemia/hypoxia (particularly in lower limbs) • Dry: result of caseous necrosis • Wet: neutrophil invasion resulting in liequefactive necrosis • Gas gangrene • Invasion of Clostridium sp. (anaerobes) • produce hydrolytic enzymes and toxins (exotoxins) • Destroy CT, cell membranes, cause bubbles of gas to form • Death usually by shock Figure from: Huether & McCance, Understanding Pathology, 5th ed., Elsevier, 2012 Gangrenous necrosis

  7. Cell Death: Apoptosis • Active (not accidental) process • No accompanying inflammation • Part of normal physiology • Embryogenesis • Involution of hormone-dependent tissue • Normal cell loss • Elimination of harmful (self-reactive) lymphocytes • May also occur in pathologic states but is part of programmed cell response to severe injury • Severe cell injury • Accumulation of misfolded proteins • Infections • Obstruction of tissue ducts Figure from: Huether & McCance, Understanding Pathology, 5th ed., Elsevier, 2012

  8. Cell Death: Mechanisms of Apoptosis Figure from: Huether & McCance, Understanding Pathology, 5th ed., Elsevier, 2012

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