Cellular homeostasis
cell maintains its morphofunctional integrity
How is cell injury developed?
If the adaptive capability is exceeded or if the external stress is inherently harmful or excessive
if the stress is severe, persistent, or rapid in onset, it results in ___________ ____ ________ and necrosis or apoptosis of cells
irreversible injury
physiologic vs pathologic adaptation
responses of cells to normal stimulation vs to stress
Labile tissue - made by + ex
cells which retained the ability to proliferate in post-natal life and have a high rate of turnover, hematopoietic cells
Stable tissues + ex
good regenerative ability but low rate of turnover, bone
Permanent/differentiated tissues - made by + ex
cells which have lost the ability to proliferate being divided only during fetal life, muscle + neurons
Hyperplasia
enlargement of an organ or tissue due to the increase of cells
During hyperplasia in ________ tissues, the structure of the tissue is not affected
labile
Two types of hyperplasia
compensatory and hormonal
mechanical factors, chronic hypoxia, hormones overproduction, chronic inflammations, tissue repair, genetic factors are all causes of ___________
hyperplasia
Consequences of hyperplasia
malignant transformation (reversible)
Hypertrophy
increase in the size and weight of an organ or tissue due to increase of cells in volume, without division
Hypertrophy is caused either by
increased functional demand or by growth factor or hormonal stimulation
2 types of pathologic hypertrophy
adaptive (after workout) and compensatory
The mechanisms driving cardiac hypertrophy involve at least two types of signals:
mechanical triggers and soluble mediators (for cell growth)
Consequences of hypertrophy
metabolic disorders, sclerosis
Atrophy
decreasing of tissue or organ size by the loss of cell substance
Cellular atrophy results from a combination of decreased _________ _________ and increased __________ ___________
protein synthesis, protein degeneration
Generalized atrophy is associated with
cachexia, malnutrition, senile atrophy
Local atrophy is associated with
decreasing in size, vessels with winding direction
mechanical factors, loss of innervation, malnutrition, hormonal insufficiency, aging are causes of ____--
atrophy
What organs undergo involution/physiological atrophy
thymus + genital organs
Hypoplasia
failure of organ or whole body development, of morphogenesis, decreasing in size
Aplasia
lack of development/morphogenesis of an organ
Agenesis
lack of an organ and its primitive embryological structures
Metaplasia
transformation of a mature tissue into another mature tissue
In which type of cell adaptation does a cell type sensitive to a particular stress is replaced by another cell type better able to withstand the adverse environment?
metaplasia
The influences that induce metaplastic change in an epithelium, if persistent, may predispose to
malignant transformation
Types of metaplasia
squamous (smokers) + columnar (intestinal)
dystrophy
Metabolic disorders with morphological changes
Which disorders are reversible? Dysmetabolism, dystrophy, necrosis
dysmetabolism and partially dystrophy
Hypoxia, physical, infectious + chemical agents, immunological rxns, cell aging, metabolism errors and nutritional imbalances are causes of what?
cell injury
Reversible cell lesions
Cellular swelling
Na + /K+ pump
Steatosis (Fatty change)
Disorders of ER
Irreversible lesions - apoptosis and necrosis - what happens?
mitochondria + cell membrane fxn loss, cell fragmentation, nucleus necrosis, death
hydroelectrolitic balance disorder
cell hyperhydration due to its inability to regulate the ionic and fluid balance across the plasma membrane
where do hydroelectrolitic balance disorders occur
kidney, liver, myocardium
Parenchymatous (granular) changes of hydroelectrolitic balance disorder
swollen mitochondria, reversible or leads to other metabolic disorders or necrosis
Hydropic or vacuolar degeneration of hydroelectrolitic balance disorder
swollen cytoplasm, reversible process or cell necrosis
Fatty change
accumulation of triglycerides in the cytoplasm of those cells which do not contain them in physiological conditions
Fatty change - unaffected vs affected metabolism
unaffected - fatty infiltration, lipid accumulation caused by hyperlipemia affected - = fatty change caused by hypoxia/anoxia + toxins infections
Morphology of fatty change
enlarged organ, yellow, soft, friable, greasy when cut clear vacuoles in cytoplasms
localization of fatty change in liver
@ lobule periphery - hyperlipemia in center - hypoxia diffuse - toxins
localization of fatty change
liver heart (diffuse) kidney (tubular epithelial cells)
___________ is a simple protein (scleroprotein)
keratin
orthokeratosis
Thickening of stratum corneum without retained nuclei (hyperkeratosis w/o parakeratosis)
Hyperkeratosis
thickening of the stratum corneum
causes of hyperkeratosis
congenital + mech factors, sun, viruses
Parakeratosis
increased epidermal turnover lack of stratum granulosum and lucidum + retention of small nuclei in the stratum corneum pinkish red plaques with fine, silver scales
Dyskeratosis
abnormal keratinization occurring prematurely in the inferior epidermal layers
leukoplasia
mucosal keratinisation, abnormal location of keratinization process
cholesteatoma
abnormal location of keratinization process in tympanic cavity
__________ is a T cell-mediated inflammatory disease
psoriasis
Verrucae are proliferative lesions of _______________ that are caused by ________
squamous epithelial cells HPV
intracell accumulation of proteins causes
nephrotic syndrome, Russel bodies - plasma cells, alcoholic hyaline
bronze diabetes is caused by intracell accumulation of
hemosiderin
lipoidosis is an intracell accumulation of phospholipids and causes
Gaucher, Tay-Sachs disease
glicogenosis (intracell accumulation of glycogen) causes
diabetes, Gierke disease, inflammations (in granulocytes)
Intracellular hyaline deposits occurs where?
droplets in renal tubes
Mallory bodies, alcoholic hialin (liver)
Russel bodies (plasmocytes)
intracell accumulation of cholesterol causes
Cholesterolosis (gallbladder), Xantelasma, Aortic atherosclerotic plaques
Hb pigments w/o iron
bilirubin, porfirin
Hb pigments w/ iron
hemosiderin, hemomelanin (malaria pigment), acid hematin
Non-hemoglobin pigments
melanin, lipofuscin (aging pigment), lipochrom, lutein
exogenous pigments
Pneumoconioses (dust accumulation in lungs), dietary + skin pigmentations
________ is the end product of heme degradation
bilirubin
Localized accumulation of bilirubin occurs within
echymosis (Hb - Biliverdin - Bilirubin) tissues with necrosis
If unconjugated bilirubin levels rise, this unbound fraction may diffuse into ________ and produce toxic injury
tissues
Pathways of bilirubin metabolism
Hb - Biliverdin - Bilirubin-Albumin complex - thru liver - urobilirubin
Jaundice and icterus
yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood (hyperbilirubinemia)
Mechanic (obstructive or post-hepatic) jaundice - cause
obstruction of the bile ducts
Mechanic (obstructive or post-hepatic) jaundice - consequences
conjugated Bi billiary acids (cholemia) pale faeces (acholia) steatorrhea (fat in stools) lack of Ubg in urine cholangitis billiary hepatitis/cirrhosis
Hepatocellular (intrahepatic) jaundice - cause
lesions of hepatocytes
Hepatocellular (intrahepatic) jaundice - consequences
high levels of alcalin phosphatase + cholesterol decolored faeces (hypocholia) Bi- and Ubg-uria in urine
Hemolytic (pre-hepatic) jaundice - cause
increased hemolysis
Hemolytic (pre-hepatic) jaundice - consequences
hypercolored faeces (hypercholia) in urine: Bi- and Ubg-uria
Morphology of severe jaundice
icterus viridis (green) icterus melas (black)
morpho of jaundice in liver
plugs of Bi in hepatocytes bilirubin cylinders (bile ducts)
morpho of jaundice in kidney
biliary infarction
morpho of jaundice in brain
nuclear jaundice (only in newborns)
Gilbert-Meulengracht syndrome
Congenital disorders of Bilirubin metabolism, reduction of glucuronil-transferase activity fluctuating jaundice, tiredness
Crigler-Najjar syndrome
Congenital disorders of Bilirubin metabolism, lack of glucuronil-transferase, death within first year of life
Dubin-Johnson syndrome
Congenital disorders of Bilirubin metabolism, decreasing excretion of bilirubin, fluctuating jaundice, Bi and pigments within hepatocytes, conjugated Bi, hepatomegaly
Rotor syndrome
Congenital disorder of Bilirubin metabolism, fluctuating jaundice, benign outcome
lipofuscin
yellow-brown insoluble pigment in lysosomes, 'aging' pigment
lipofuscin accumulates in
hepatocytes myocardium neural cells seminal vesicles
decreased melanin consequences
albinism, vitiligo, leucoderma
Hyperpigmentation (melanin accumulation) consequences
chloasma (pregnancy), Addison disease, Peutz-Jeghers syndrome acanthosis nigricans, xeroderma pigmentosum
Pneumoconioses vs Anthrachosis
Pneumoconioses - dust, occupational lung diseases Anthrachosis - carbon, coal worker's pneumoconiosis
types of melanic tumours
nevi, benign and malignant lentigo, malignant melanoma
Silicosis
disease due to silica or glass dust in the lungs; occurs in mining occupations
Asbestosis
Mg silicate, causes fibrosis and risk for mesothelioma
Congenital metabolic diseases are due to
protein synthesis with defective function
Phenylketonuria (PKU)
Inherited defect of enzymes in the phenylalanine/tyrosine pathway, hyperphenylalaninemia-with impaired brain development (benign is asymptomatic)
Alpha-1-antitrypsin
plasma glycoprotein synthesized by hepatocytes which has an important role in inhibition of proteases, elastase, cathepsin G and proteinase 3 (neutrophils @ inflammation)
lack of alpha-1-antitrypsin - consequences
pulmonary emphysema - loss of alveolar wall elasticity, cause cholestasis - liver cirrhosis
cystic fibrosis - cause
dysfunction of chloride ion channels in cell membranes
mutations in the gene CF
abnormal water and electrolyte transport across cell membranes
cystic fibrosis - symptoms
mucus with abnormally high viscosity in glands lumen, cystic dilatation of glands
cystic fibrosis - localization
pancreas, bronchia, gut, testis
Gierke disease
Glycogen storage disease, in liver + kidney
Pompe's disease
Glycogen storage disease, in heart, liver and muscles