1 Altered Cellular and Tissue Biology Chapter 2

Mosby items and derived items © 2006 by Mosby, Inc. 2 Cellular Adaptation  Physiologic vs. pathogenic  Atrophy  Hypertrophy  Hyperplasia  Metaplasia  Dysplasia

Mosby items and derived items © 2006 by Mosby, Inc. 3 Cellular Adaptation

Mosby items and derived items © 2006 by Mosby, Inc. 4 Cellular Adaptation

Mosby items and derived items © 2006 by Mosby, Inc. 5 Cellular Adaptation

Mosby items and derived items © 2006 by Mosby, Inc. 6 Cellular Injury  Reversible  Irreversible

Mosby items and derived items © 2006 by Mosby, Inc. 7 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

Mosby items and derived items © 2006 by Mosby, Inc. 8 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

Mosby items and derived items © 2006 by Mosby, Inc. 9 Cellular Injury Mechanisms  Chemical injury Lead Carbon monoxide Ethanol Mercury Social or street drugs

Mosby items and derived items © 2006 by Mosby, Inc. 10 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

Mosby items and derived items © 2006 by Mosby, Inc. 11 Contusions and Hematomas

Mosby items and derived items © 2006 by Mosby, Inc. 12 Unintentional and Intentional Injuries  Sharp force injuries Incised wounds Stab wounds Puncture wounds Chopping wounds

Mosby items and derived items © 2006 by Mosby, Inc. 13 Unintentional and Intentional Injuries

Mosby items and derived items © 2006 by Mosby, Inc. 14 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

Mosby items and derived items © 2006 by Mosby, Inc. 15 Gunshot Wounds

Mosby items and derived items © 2006 by Mosby, Inc. 16 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

Mosby items and derived items © 2006 by Mosby, Inc. 17 Infectious Injury  Pathogenicity of a microorganism  Virulence of a microorganism  Disease-producing potential Invasion and destruction Toxin production Production of hypersensitivity reactions

Mosby items and derived items © 2006 by Mosby, Inc. 18 Immunologic and Inflammatory Injury  Phagocytic cells  Immune and inflammatory substances Histamine, antibodies, lymphokines, complement, and enzymes  Membrane alterations

Mosby items and derived items © 2006 by Mosby, Inc. 19 Injurious Genetic Factors  Nuclear alterations  Alterations in the plasma membrane structure, shape, receptors, or transport mechanisms  Examples Sickle cell anemia and muscular dystrophy

Mosby items and derived items © 2006 by Mosby, Inc. 20 Injurious Nutritional Imbalances  Essential nutrients are required for cells to function normally  Deficient intake  Excessive intake

Mosby items and derived items © 2006 by Mosby, Inc. 21 Temperature Extremes  Hypothermic injury Slows cellular metabolic processes  Hyperthermic injury Heat cramps Heat exhaustion Heatstroke

Mosby items and derived items © 2006 by Mosby, Inc. 22 Atmospheric Pressure Changes  Sudden increases or decreases in atmospheric pressure Blast injury Decompression sickness or caisson disease  “The bends”

Mosby items and derived items © 2006 by Mosby, Inc. 23 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

Mosby items and derived items © 2006 by Mosby, Inc. 24 Ionizing Radiation

Mosby items and derived items © 2006 by Mosby, Inc. 25 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

Mosby items and derived items © 2006 by Mosby, Inc. 26 Manifestations of Cellular Injury  Cellular accumulations (infiltrations) Water Lipids and carbohydrates Glycogen Proteins

Mosby items and derived items © 2006 by Mosby, Inc. 27 Hydropic Degeneration

Mosby items and derived items © 2006 by Mosby, Inc. 28 Manifestations of Cellular Injury  Cellular accumulations (infiltrations) Pigments  Melanin, hemoproteins, bilirubin Calcium Urate

Mosby items and derived items © 2006 by Mosby, Inc. 29 Calcium Infiltration

Mosby items and derived items © 2006 by Mosby, Inc. 30 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

Mosby items and derived items © 2006 by Mosby, Inc. 31 Cellular Death

Mosby items and derived items © 2006 by Mosby, Inc. 32 Necrosis  Coagulative necrosis Kidneys, heart, and adrenal glands Protein denaturation

Mosby items and derived items © 2006 by Mosby, Inc. 33 Coagulative Necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 34 Necrosis  Liquefactive necrosis Neurons and glial cells of the brain Hydrolytic enzymes

Mosby items and derived items © 2006 by Mosby, Inc. 35 Liquefactive Necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 36 Necrosis  Caseous necrosis Tuberculous pulmonary infection Combination of coagulative and liquefactive necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 37 Caseous Necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 38 Necrosis  Fat necrosis Breast, pancreas, and other abdominal organs Action of lipases

Mosby items and derived items © 2006 by Mosby, Inc. 39 Fat Necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 40 Necrosis  Gangrenous necrosis Clinical term Dry vs. wet gangrene Gas gangrene

Mosby items and derived items © 2006 by Mosby, Inc. 41 Gangrenous Necrosis

Mosby items and derived items © 2006 by Mosby, Inc. 42 Apoptosis  Programmed cellular death  Mechanisms  Necrosis vs. apoptosis

Mosby items and derived items © 2006 by Mosby, Inc. 43 Apoptosis

Mosby items and derived items © 2006 by Mosby, Inc. 44 Aging and Altered Cellular and Tissue Biology  Aging vs. disease  Normal life span  Gender differences

Mosby items and derived items © 2006 by Mosby, Inc. 45 Theories of Aging  Accumulation of injurious events  Genetically controlled program  Theories Genetic and environmental lifestyle factors Alterations of cellular control mechanisms Degenerative extracellular changes

Mosby items and derived items © 2006 by Mosby, Inc. 46 Theories of Aging

Mosby items and derived items © 2006 by Mosby, Inc. 47 Aging  Cellular aging  Tissue and systemic aging Frailty

Mosby items and derived items © 2006 by Mosby, Inc. 48 Somatic Death  Death of an entire person  Postmortem changes Algor mortis Livor mortis Rigor mortis Postmortem autolysis