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

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.

Use Professional ethics NO:

PlagiarismCheatingAllowing others to copy from you

Penalties can be severe !!

Pathology – focus on physical changes in diseased organs and tissues

Pathophysiology – abnormal functioning of diseased organs and how it applies to medical treatment and client care

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 diseaseWhen the etiology is unknown, the disease is

said to be idiopathic.

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)

Clinical manifestations – indications that the person is sickSymptoms – unobservable effects of a disease reported by the patientSigns – observable or measurable traits

Syndrome - a characteristic combination of signs and symptoms associated with a particular disease.

Diagnosis – identification of the specific diseaseTherapy – the treatment of the disease to either effect a cure or reduce the patient’s signs and symptomsPrognosis – prediction of a disease’s outcome

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

Organization Metabolism

◦ Catabolism◦ Anabolism

Responsiveness◦ Conductivity

Movement

Reproduction Growth Differentiation Respiration Secretion Excretion

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

mitochondria ;energy endoplasmic reticulum

and ribosomes; protein synthesys

Golgi apparatus; secretion of proteins synthesized on the ribosomes.

lysosomes ; digestive enzymes.

Cytoskeleton.

Composed of lipid molecules in bilayerPhospholipids have hydrophobic tailPhospholipids have hydrophilic headsAlso contains embedded proteins

proteins are important for cell-cellcommunication:

receptors for hormonescell recognition

also important for metabolic processes inside the cell:

channelspumpsenzymes

Phospholipid bilayer

Membrane proteins

Cytoplasm Nucleus Ribosomes Endoplasmic

Riticulum (protein synthesis and fat

metabolism)

Mitochondria Golgi Apparatus;

holds enzyme helps in metabolism

ATP; fuel made by methochondria

Lysosomes; enzymes that allow cytoplasmic digestion to be completed

Generic CellGeneric Cell

Cytosol – aqueous gel-like mediumImportant metabolic processes occur here

Organelles – membrane bound structuresMembranes provide compartments forseparation of chemical reactions

large, membrane-bound organelle that contains deoxyribonucleic acid (DNA), the genetic material of the cell.

the DNA is folded up inside the nucleus

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 through carrier-mediated transport systems.

Simple diffusion: osmosis,

Cell division and reproduction Individual cells don’t live as long as the

organism they’re a part of. Cell reproduction occurs in two stages:

◦ mitosis, the nucleus and genetic material divide◦ cytokinesis, the cytoplasm divides, beginning

during late anaphase or telophase. At the end of cytokinesis, the cell produces

two daughter

The great divide :Before division, a cell must double its

mass and content (interphase). Chromatin, the small, slender rods of the

nucleus that give it its granular appearance, begins to form.

Replication and duplication of DNA occur during the four phases of mitosis:◦ Prophase, metaphase, anaphase, and telophase.

Most cells reproduce as quickly as they die.

Meiosis, another type of cell division, occurs in the reproductive cells, the egg and sperm.

Meiosis involves two cell divisions resulting in a total of four daughter cells produced, each containing 23 single chromosomes rather than 23 pairs.

Pathophysiologic conceptsThe cell faces a number of challenges

through its life. Stressors, changes in the body’s health, disease, and other extrinsic and intrinsic factors can alter the cells’ normal functioning.

Adaptation Cells generally continue functioning despite

challenging conditions or stressors. However, severe or prolonged stress or changes may injure or destroy cells. When cell integrity is threatened, the cell reacts by drawing in its reserves to keep functioning, by adaptive changes or by cellular dysfunction.

If cellular reserve is insufficient, the cell dies. If enough reserve is available and the body doesn’t detect abnormalities>

The cell adapts by:◦ atrophy,◦ hypertrophy,◦ hyperplasia, ◦ metaplasia, or ◦ dysplasia.

Atrophy = shrinkage = decrease in cell size. Reversible Due to :

decreased use (disuse)decreased blood supplydecreased nutrition

denervation, or reduced endocrine stimulationOf tissues or organs may be due to cell shrinkage or due to cell death.

Sizeof organelles

Sizeof organelles

Workload(or disease state)

Workload(or disease state) Size

of organelles

Sizeof organelles

Energy Usage Energy Usage Efficiency

-OR-

Efficiency-OR-

Functionalityin disease state

Functionalityin disease state

Hypertrophyan increase in the size of a cell due to an increased workload.

It may be normal or abnormal.

Hypertrophy is primarily seen in cells that cannot adapt to increased work by increasing their numbers through mitosis (cardiac and skeletal muscle cells).

There are three main types of hypertrophy: -Physiologic hypertrophy (i.e., increased muscle bulk through exercise).

-Pathologic hypertrophy( hypertrophy of the left ventricle in response to longstanding hypertension) .

-Compensatory hypertrophy (the loss of one kidney causes the cells of the remaining kidney to undergo hypertrophy).

Size # of organelles

Size # of organelles

Size # of organelles

Size # of organelles

Workload(or disease state)

Workload(or disease state)

contractility contractility

ability to meet demands!

-OR-

ability to meet demands!

-OR-

Functionalityin disease state

Functionalityin disease state

HyperplasiaHyperplasia, an increase in the number of cells, caused by increased workload/ hormonal stimulation. It can only occur in cells that undergo mitosis ( liver, kidney, and connective tissue cells). Hyperplasia may be: *Physiologic (monthly in uterine endometrial cells) . *Pathophysiologic (with excessive hormonal stimulation, which is seen in acromegaly) . *Compensatory (cells of a tissue reproduce to make up for a previous decrease in cells ; liver cells after surgical removal of sections of liver tissue).

rate of cell division

rate of cell division

WorkloadPhysiological state

WorkloadPhysiological state

functionality functionality

ability to meet demands!

...

ability to meet demands!

...

2 types:Compensatory &

Hormonal

2 types:Compensatory &

Hormonal

tissue sizeby # of cells

Metaplasia is the replacement of one adult cell with

another adult cell that can better endure the change or stress.

It’s usually a response to chronic inflammation or irritation; the change in the cells of the respiratory passages from ciliated columnar epithelial cells to stratified squamous epithelial cells in response to years of cigarette smoking.

Stratified epithelial cells are better able to survive smoke damage. Unfortunately, they do not assume the vital protective role of ciliated cells.

PathologicalPathologicalPathologicalPathological

Normal CellsNormal Cells

Ex: CigaretteSmoking

AbnormalAbnormalCellsCells

Replacement

DysplasiaIn dysplasia, deranged cell growth of specific tissue results in abnormal size, shape, and appearance.;adaptive and potentially reversible, they can precede cancerous changes.

The most common sites of dysplasia are the respiratory tract (especially the squamous cells present as a result of metaplasia)and the cervix.

Cervical dysplasia usually results from infection of the cells with the human papilloma virus (HPV). Dysplasia is usually rated on a scale to reflect its degree, from minor to severe.

PathologicalPathologicalPathologicalPathological

Normal CellsNormal Cells

Epithelial Tissue

AbnormalAbnormalShape & SizeShape & Size

Mutation

Normal Tissue

AbnormalTissue

Cell injury A person’s state of wellness and disease is reflected in the cells.

Injury to any of the cell’s components can lead to illness.

One of the first indications of cell injury is a biochemical lesion that forms on the cell at the point of injury.

This lesion changes the chemistry of metabolic reactions within the cell. Consider, for example, a patient with HIV. The cells of the immune system may be altered, making the patient susceptible to infection.

Draw on your reserves, adapt, or die When cell integrity is threatened (toxins,

infection, physical injury, or deficit injury), the cell reacts in one of two ways:◦ • by drawing on its reserves to keep functioning◦ • by adapting through changes or cellular

dysfunction. If enough cellular reserve is available and

the body doesn’t detect abnormalities, the cell adapts.

If there isn’t enough cellular reserve, cell death (necrosis) occurs. Necrosis is usually localized and easily identifiable.

HypoxicChemical

Structural ◦(trauma…tons next semester)!

InfectiousImmunologic / Inflammatory

Atmospheric Oxygen Atmospheric Oxygen

Loss of HbLoss of Hb

Hb function (CO) Hb function (CO)

erythropoiesis erythropoiesis

Respiratory Function Respiratory Function

Cardiovascular Function Cardiovascular Function

Most Common Cause of Cellular Injury!

Most Common Cause of Cellular Injury!

Loss of Phospholipids

Loss of Phospholipids

MembraneDamage

MembraneDamage

Release ofEnzymes

Release ofEnzymes

ElevatedElevated““Markers”Markers”

ex CK, CKMBex CK, CKMB

ElevatedElevated““Markers”Markers”

ex CK, CKMBex CK, CKMB

Hypertrophy = increase in cell sizeWe'll see this in heart, kidney (and others) w/ pathologyNOT due to increased cell volume or fluidRather, due to increased protein synthesis within the cell, or decreased protein breakdownResult is increased protein in organelles

Hyperplasia = increase in cell numberDue to increased cell division

Uterus and breast tissueParathyroid gland in kidney failureLiver (compensatory hyperplasia)

Metaplasia = replacement of one cell type with anotherReversible

An example: ciliated columnar epithelium replaced by

stratified squamous epithelium

Dysplasia = change in cell resulting in abnormal cell size, shape or organizationWe'll see this in respiratory tract, cervix w/ pathologyIn 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

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)

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

Deficiencies:

Deficiency in oxygen most important

Hypoxia = deficiency in oxygen at cellDue to :

Decreased oxygen in airDecreased hemoglobin or decreased oxygen transported to cellsDiseases of the respiratory and/or

cardiovascular system

Important to cell because of oxidative phosphorylation, which results

in the production of ATP

Oxidative: need oxygen to produce ATP

ATP: needed by cell for metabolism, cell life

Cellular response to hypoxiaDecreased mitochondrial reactions

decreased ATP produced decreased energy

Ion pumps cease, so can't regulate ions into/out of cell (ATP needed for this)

Can't pump Na+ and water out of cell, so get cell swelling organelle swelling

cell death

Ischemia is inadequate blood supply to a cell or tissue.Ischemia can cause hypoxia.

Intoxication (or introduction of toxins into the cell)Effect on cell depends on toxin and on cell

Some examples:Lead -- injures nervous systemCO -- deprives body of oxygenEthanol -- effects central nervous system

Trauma -- physical disruption of cells

Ex: abrasion, cutting, burns, microorganisms etc.

Free radicals :uncharged atom or group of atoms with an

unpaired electronFormed by radiation, redox reactions, chemicals

Atom is unstable needs to gain or lose an electroncan alter chemical bonds in proteins, lipids, carbohydrates and nucleic acidscan cause chain reaction in cell

“fallen apart” Regulated cell death During development Worn out cells Diseased cells (tumor suppressor p53 gene,

natural killer or Tc cells)

Messy cell death Initiates inflammation Gangrene – large mass of tissue undergoes

necrosis

Infections agentsMicroorganisms can invade and harm cells

Cell injury can have effects on the entire bodyExamples: fever, pain, increased heart rate