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3/28/2011
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PROSES RADANG, PROSES RADANG, PROSES RADANG, PROSES RADANG, INFEKSI, PEMULIHAN INFEKSI, PEMULIHAN INFEKSI, PEMULIHAN INFEKSI, PEMULIHAN
JARINGAN DAN JARINGAN DAN JARINGAN DAN JARINGAN DAN DEGENERASI DEGENERASI DEGENERASI DEGENERASI
DEPARTEMEN PATOLOGI ANATOMIDEPARTEMEN PATOLOGI ANATOMIDEPARTEMEN PATOLOGI ANATOMIDEPARTEMEN PATOLOGI ANATOMI
FK FK FK FK ---- USU MedanUSU MedanUSU MedanUSU Medan
2008200820082008
DEGENERASI
� Terjadi perubahan morfologik (dalam sel / dalam zat antar sel) akibat gangguan metabolisme pada sel
Penyebab : jejas non-fatal
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Sifat degenerasi : • Ringan (reversibel)
• Berat (irreversibel) � Nekrosis
The sequential ultrastructural changes seen in necrosis (left) & apoptosis (right).
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Degenerasi Infiltrasi
Adanya jejas pada sel
Perubahan metabolisme
Adanya perubahan metabolisme
Jejas pada sel
Degenerasi & infiltrasi
Dapat terjadi gangguan yang bersifat biokimia/
biomolekuler
DEGENERASI
Sering disertai pengendapan zat-zat :
� Lemak
� Amiloid
� Lipoid (zat yang menyerupai lemak)
Degenerasi :
� D. Albumin
� D. Hidropik
(D.vakuoler)
� D. Hyalin
� D. zenker/ waxy deg.
� Deg / infiltrasi
glikogen
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DEGENERASI HIDROPIK(Degenerasi vakuoler)
� Edema intraseluler menonjol (> deg. bengkak keruh)
� Kerusakan tampak lebih berat
� Sediaan :
� Kuretage cavum uteri ( abortus imminens) � perdarahan hebat
� Hasil Kuretage (makroskopis): � Gelembung jernih � Ø bervariasi
� Diagnosa : Mola hidatidosa
Macroscopis (Hydatidiform Mole)� a mass of tissue with grape-like swollen villi
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Complete mole. All villi are markedly swollen.
Macroscopis (Hydatidiform Mole)
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Normal Villi The 1st trimester (7-8 weeks)(20X)
Microscopis (Hydatidiform Mole)
Avascular
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Complete mole showing large villi with stromal edema & markedtrophoblastic proliferation.
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Radang : reaksi jaringan hidup terhadap semua bentuk jejas (injury)
Rubor
Calor
Tumor
Dolor
Functio laesa
Akut
Kronik
Mikroskopis:
Infiltrasi sel-sel radang akut (PMN)
Vasodilatasi
Oedema
Mikroskopis:
Infiltrasi sel-sel radang kronik (MN)
Proliferasi jaringan fibroblast
Neovaskularisasi
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A B
ED
C
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ACUTE INFLAMATION
GROSS :
REDNESS (RUBOR)
HEAT (CALOR)
SWELLING (TUMOR)
PAIN (DOLOR)
LOSS OF FUNCTION (FUNCTIO LAESA)
ACUTE INFLAMATION
MICROSCOPIC :
Hyperaemia
Exudation
Emigration of Leucocytes
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Hyperaemia
Micro-vascular changes
(Lewis’s Triple Response) :
• Flush � Dull red line (capilar dilatation)
• Flare � Bright red (artery dilatation)
• Wheal
� Protein fluid � interstitial (wheal)
� Fluid ↑� dilution of toxin
� Protein ↑ :
- Globulin � antibodies
- Fibrin � to limit spread bacterial
� Wound healing
Exudation
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- Chemical Mediator
� Endothelial Damage
↑ Permeabilitas
Exudation (Mechanism)
Protein Passage :
� PMN & MN
� Pass (amoeboid)
Emigration of leucocytes
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1. Peradangan serosaDitandai : extravasasi cairan ↑ protein ↓ selSebagian besar peradangan akut bermula sebagai bentuk serosa
2. Peradangan fibrinosaDitandai : eksudasi plasma ↑ fibrinogen
3. Peradangan purulenDitandai : keluarnya neutrofil & pembentukan pus.
4. Peradangan pseudomembranosa
Gambaran Histologis Bentuk-Bentuk Makroskopik Peradangan :
Fig. 11.127. Outer aspect of appendix involved by acute inflammation.A thick purulent coating is seen together with marked hyperemia of the serosa.
Hyperemia (serosa)
Purulent
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Acute appendicitis with massive inflammatory infiltrate, extensive ulceration,and hemorrhage. An island of heavily inflamed residual mucosa is seen in the center.
Radang Kronik
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� WOUND HEALING
� COMPLICATIONS : - CONTRACTURE
- GRANULATION
- KELOID
- FIBROSIS
� REGENERATION
� SPECIAL SITUATION.
HEALING
� PRIMARY HEALING :
- CLEAN EXISED WOUND
- GOOD POSITION (PALNED SURG.INCIS)
� IMMEDIATELY: - BLOOD CLOT
� 2-3 HOURS : - INFLAMATION (+)
- MILD HYPERAEMIA
- FEW POLYMORPHS
WOUND HEALING
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� 2-3 DAYS : - MACROPHAGE � REMO-
VING CLOT
- FIBROBLASTIC
� 10-14 DAYS : - SCAB LOOSE
- EPITHELIAL COVERING.
- FIROUS UNION
WOUND HEALING
� WEEKS : - SCAR TISSUE SLIGHLY
HYPERAEMIA
- GOOD FIBROUS UNION
� MONTHS – YEAR:
- DEVASCULARISATION
- COLLAGEN(-) ENZYME
- SCAR MINIMAL.
WOUND HEALING
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� LOSS OF TISSUE >>
� NECROSIS (+)
� INFECTION (+)
� EARLY : BLOOD & FIBRIN CLOT (+)
ACUTE INFL. CELLS (+)
� FEW DAYS : - EPITH.PROLIFERATION
- NEW CAPILARY
- MACROPHAGE
- PMN, FIBROBLAST
SECONDARY HEALING
� 1 WEEK : - SURFACE DEBRIS (-)
- FIBROBLASTS >>
- EPITH.PROLIF’TION
- CAPILARY >>
- GRANULATION
SECONDARY HEALING
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� 2 WEEKS : - EPITH.COVERING COMPL
- TRANSVERS COLLAGEN
- DECREASED CAPILARY
- FEW CELLS
� MONTH : - FULL EPITH.COVERING
- SURFACE DEPRETION (< )
- THICK COLLAGEN SCAR
- VASCULAR ( < )
SECONDARY HEALING
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