Pathology: General
By Aiman Zaher
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Pathology - Aiman Zaher
Cell Injury & Adaptation
Definitions
Pathology: The study of disease; pathology is divided into general pathology (the study of basic cellular responses to injuries) and systemic pathology (the study of specific organ responses to diseases)
Etiology: The underlying causes of a disease
Pathogenesis: The mechanism that leads to the signs and symptoms of a disease
Morphology: The gross or microscopic appearance of cells and tissues
Etiologies of Cell Injury
Hypoxia is an insufficient supply of oxygen to tissues, resulting in a decline of ATP synthesis and subsequent cell injury due to impairment of the Na-K-ATPase pump
Degree of hypoxic cell injury
Degree varies with each type of tissue
Brain tissue is the most susceptible; the kidney and heart are also sensitive
Causes of hypoxia
Ischemia: Insufficient arterial or venous flow (e.g., atherosclerosis, thrombosis)
Hypoxemia: Decreased oxygen concentration in the blood due to abnormal perfusion, ventilation, or diffusion
Hemoglobin problems: Changes in the structure or decline in the serum level of hemoglobin (e.g., anemia, methemoglobinemia in CO poisoning).
Free radical cell injury is caused by molecules with a single unpaired electron in an outer orbital (e.g., superoxide O2−, hydroxyl OH, drug and chemical free radicals, and ultraviolet (UV) light or radiation free radicals) that are able to combine to other molecules, resulting in the destruction and degradation of nucleic acids, proteins, and lipids; this process leads to the injury of cell membranes and organelles, along with possible cell death
Molecules that degrade free radicals or block their formation
Intracellular enzymes (e.g., glutathione peroxidase, catalase)
Antioxidants (e.g., ascorbic acid, vitamin E, vitamin A, vitamin C, carotenes)
Free radicals that cause injury
Chemical free radicals (e.g., carbon tetrachloride, iron, acetaminophen), which can lead to liver cell damage and necrosis
Free radicals that are generated after ischemia and reperfusion, as in myocardial infarction or cerebral vascular accident (e.g., O2 −, Ca2+)
Causes of Cell Injury
Insufficient adaptation to stress
May be physical, genetic, oxygenation based, chemical, nutritional, immunologic, or infectious
Adaptation to Cell Injury
Overview of cellular adaptation
Adaptation is the cell’s reaction to prolonged stress and repeated injury to protect itself and prevent recurrent injuries
Adaptations are either physical (morphologic) or functional
Etiologies of