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Cellular Injury and Adaptation. Pathology. - Morphology : gross and microscopic changes of cell and tissue - Use ancillary techniques as : Histochemical,immunohistochemical, molecular and cytogenetics - This will result in signs & symptoms
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Pathology -Morphology : gross and microscopic changes of cell and tissue -Use ancillary techniques as : Histochemical,immunohistochemical, molecular and cytogenetics - This will result in signs & symptoms At the end : the pathologist will give a diagnosis and guide therapy. Pathology is the discipline that bridges clinical practice and basic science
The Cell and the Environment • Cells are constantly adjusting their structure and function to accommodate changes in their environment (stress stimuli) • Achieving a new steady state and preserving viability i.e. ADAPTATION • if the cell adaptive capability is exceeded cell injury develops
The Cell and the Environment Stimuli Cell Adaptation Cell Injury Reversible Irreversible (cell death) apoptosis necrosis
Causes of Cell Injury • Hypoxia: (Oxygen deficiency) Mainly due to: • ischemia (impaired blood supply) most common • inadequate oxygenation of blood (cardio-respiratory failure) • loss of oxygen carrying capacity (anaemia) • Carbon monoxide poisoning • Physical Agents • Trauma, radiation, extremes of temperatures, electric shock • Chemicals and Drugs • Wide variety • Microbiologic Agents • Viruses, worms, bacteria ….. • Immunologic Reactions • Allergic reactions, autoimmune diseases • Genetic Defects • Obvious congenital malformations (Down syndrome) • Subtle single amino acid substitution (hemoglobin S of sickle cell anemia) • Nutritional Imbalances • Deficiency of nutrients/ or excess • Aging
There are 4 main forms of Adaptation • Atrophy: decrease in size or number of cells leading to reduction in tissue mass • Hypertrophy: increase in size of cells leading to increase in size of organ • Hyperplasia: increase in number of cells leading to increase size of organ • Metaplasia: reversible change in which one adult tissue type is replaced by another
Cellular Adaptation to Injury • Physiologic • Responses to normal processes • Pathologic • Allows cells to modulate environment and hopefully escape injury • Cellular adaptive responses can occur at any of these Steps: • Receptor binding, signal transduction, protein transcription, translation, export
Atrophy • Definition: Shrinkage in the size of a cell by loss of cell substance • Diminished cell function but cells are NOT dead • Organ Atrophy • Results when a substantial number of cells are involved by: • Cell atrophy (cells living)
Atrophy • Causes • Decreased workload • Loss of innervations • Diminished blood supply • Inadequate nutrition • Loss of endocrine stimulation • Aging
Atrophy • Biochemical Mechanisms • Decreased protein synthesis • Increased protein catabolism (degradation) • Or/ Both Morphology Decreased cell size • Atrophy represents a reduction in the structural components of the cells contain fewer mitochondria and myofilaments and a lesser amount of endoplasmic reticulum • Increased autophagic vacuoles • Increased residual bodies (lipofuscin)
Atrophy Normal
Kidneys, left side normal size right side atrophy