Chpt 1 Patho Terminology

Pathophysiology

Introduction to Pathophysiology

• Pathophysiology involves studying functional or physiological changes resulting from a disease process.

• It deals with disease development and associated changes to normal anatomy or physiology.

• Pathophysiology includes some aspects of pathology, specifically cellular and tissue changes.

Homeostasis

• Homeostasis is the maintenance of a relatively stable internal environment despite external changes.

• Maintaining homeostasis generally leads to good health.

• Failure to maintain homeostasis can lead to disease.

Health and Disease

• Health is a state of physical, mental, and social well-being.

• Disease is a deviation from the normal state of homeostasis.

• Homeostasis is maintaining a stable internal environment despite external factors.

Health Indicators

• "Normal" values occur within a range and may vary based on measurement technology.

• Adjustments are influenced by:

  • Age

  • Gender

  • Genetics

  • Environment

  • Activity Level

Seven Steps to Health

• Be a nonsmoker and avoid secondhand smoke.

• Eat 5 to 10 servings of vegetables and fruits daily; choose high-fiber, lower-fat foods; limit alcohol intake.

• Engage in regular physical activity.

• Protect yourself from the sun.

• Follow cancer screening guidelines.

• Visit a doctor or dentist if there are any changes in the normal state of health.

• Follow health and safety guidelines at home and work when using, storing, and disposing of hazardous materials.

Concept and Scope of Pathophysiology

• Pathophysiology uses knowledge of basic anatomy and physiology to study functional/structural changes in body tissue or cells due to disease.

• It includes some pathology.

• Cause-and-effect relationships, defined by signs and symptoms, guide the study of a specific disease.

• Examples: Jaundice, inflammation, and infection

Prevention of Disease

• It has become a primary focus in healthcare

  • Maintaining routine vaccination programs

  • Participation in screening programs

  • Community health programs

  • Regular routine doctor visits

Types of Prevention

• Primary: Prevent the development of disease/injury (e.g., seat belts, nutrition, education, vaccination).

• Secondary: After illness or risk factor diagnosis, follow medication regimen/follow-up with primary care physician.

• Tertiary: Manage complicated or long-term diseases (e.g., diabetes, CHF).

Stages of Research Process

• Stage 1: “Basic science”

  • Identification of technology to be used

  • Work is done in the laboratory

  • Might require animal or cell/tissue cultures

• Stage 2

  • Small number of human subjects

• Stage 3

  • Clinical trials

  • Involve a large number of patients with the disease or risk of the disease

  • “Double-blind studies"

Medical History

• Current and prior illnesses

• Allergies

• Hospitalizations

• Treatment

• Specific difficulties

• Any type of therapy or drugs

  • Prescription

  • Nonprescription

  • Herbal items, including food supplements

Basic Terminology

• Gross level: organ or system level.

• Microscopic level: cellular level.

• Biopsy: excision of small amounts of living tissue.

• Autopsy: examination of the body and organs after death.

Disease Process

• Diagnosis

  • Identification of a basic disease

  • Evaluation of signs and symptoms

  • Laboratory tests

• Etiology

  • Causative factors in a particular disease:

    • Congenital defects

    • Inherited or genetic disorders

    • Microorganisms

    • Immunologic dysfunctions

    • Degenerative changes

    • Malignancy

    • Metabolic, nutritional problems

    • Trauma, burns, environmental factors

Causes of Disease

• Idiopathic: cause of disease is unknown.

• Iatrogenic: error/treatment/procedure may cause the disease.

• Predisposing factors: age, gender, inherited factors, environment, etc.

• Prophylaxis: preserve health; prevent the spread of disease.

• Prevention: vaccinations; dietary/lifestyle modifications; prevention of potentially harmful activities, etc.

Characteristics of Disease

• Pathogenesis: Development of the disease

• Onset of disease:

  • Sudden/acute

  • Insidious: gradual, vague, or mild signs

• Acute disease:

  • Short-term, develops quickly

  • High fever, severe pain, etc.

• Chronic disease:

  • Develops gradually

  • Milder symptoms, often intermitted with acute episodes

• Subclinical state: Pathologic changes, no obvious manifestations

• Latent state: No symptoms or clinical signs are evident; in infectious diseases: incubation period

• Prodromal period: Early development of the disease; signs are nonspecific or absent

• Manifestations: Clinical evidence with signs and symptoms

  • Local: at the site of the problem

  • Systemic: general indicators of illness, i.e., fever

• Signs: Objective indicators of disease

• Symptoms: Subjective feelings

• Lesions: Specific local change in the tissue

• Syndrome: Collection of signs and symptoms

• Diagnostic tests: Various laboratory tests appropriate to manifestations and medical history

• Remissions and exacerbations mark the course or progress of a disease.

  • Remission: period during which manifestations subside

  • Exacerbation: a worsening of severity

• Precipitating factor: Condition that triggers an acute episode

• Complications: New secondary or additional problems

• Therapy: Measures to promote recovery/slow progress

• Sequelae: Potential unwanted outcomes

• Convalescence or rehabilitation: Period of recovery and return to a healthy state

Disease Prognosis

• Prognosis: defines the probability or likelihood of recovery or other outcomes.

• Morbidity: Disease rates within a group

• Mortality: Relative number of deaths resulting from the disease

• Autopsy: Postmortem examination

• Epidemiology: Tracking the pattern or occurrence of disease

  • Major data collection centers: WHO and CDC

• Occurrence of disease:

  • Incidence: Number of new cases in a given population within a given time period

  • Prevalence: Number of new, old, or existing cases within a given population and time period

• Epidemics: A higher number of expected cases of an infectious disease occur within an area

• Pandemic: Involve a higher number of infectious diseases in many regions of the globe

• Communicable diseases: Infectious diseases that can spread from one person to another

• Notifiable or reportable diseases

  • Must be reported by the physician to designated authorities

  • Authority varies with local jurisdiction.

  • Required diseases to be reported may change over time

  • Reporting is intended to prevent further spread of the disease.

Cellular Changes

• Cells can adapt their growth and differentiation to altered conditions in the body.

• Tissues may be modified due to hormonal stimulation, pregnancy changes in women, or environmental stimuli (i.e., irritation).

• Disease may develop when cell structure and function are changed to the point when homeostasis cannot be maintained.

Cellular Adaptations

• Atrophy: Decrease in the size of cells resulting in reduced tissue mass (e.g., muscle mass/tone loss).

• Hypertrophy: Increase in cell size resulting in enlarged tissue mass (e.g., muscle gain).

• Hyperplasia: Increased number of cells resulting in enlarged tissue mass (e.g., pregnancy changes or cancer).

• Metaplasia: Mature cell type is replaced by a different mature cell type (e.g. Cigarette smokers-body adapts and modifies the type of cell cilia are).

• Dysplasia: Cells vary in size and shape within a tissue (e.g., Pap-smear - precancerous cells).

• Anaplasia: Undifferentiated cells, with variable nuclear and cell structures, are common in tumors and used for tumor grading.

• Neoplasia: “New growth,” commonly called a tumor, can be benign or cancerous.

Cell Damage

• Apoptosis: Refers to programmed cell death, a normal occurrence in the body.

• Ischemia: Inadequate supply of blood to the cells.

• Hypoxia: Reduced oxygen in tissues; nutritional deficits.

• Pyroptosis: Cell death as a result of microorganism, Results in lysis causing nearby inflammation.

• Physical damage: Excessive heat or cold; radiation exposure.

• Mechanical damage: Pressure or tearing of tissue.

• Chemical toxins:

  • Exogenous: From the environment

  • Endogenous: From the inside of the body

• Microorganisms: Bacteria and viruses, for example.

• Abnormal metabolites:

  • Genetic disorders

  • Inborn errors of metabolism

  • Altered metabolism

• Imbalance of fluids or electrolytes

Necrosis

• Necrosis: is the death of a group of cells that causes further damage due to cellular disintegration.

• Liquefaction necrosis: Dead cells liquefy because of the release of cell enzymes; occurs in brain cells.

• Coagulative necrosis: Cell proteins are altered or denatured coagulation occurs with a heart attack.

• Fat necrosis: Fatty tissue is broken down into fatty acids.

• Caseous necrosis: Form of coagulation necrosis; a thick, yellowish, “cheesy” substance forms.

• Infarction: Area of dead cells as a result of oxygen deprivation.

• Gangrene: Area of necrotic tissue that has been invaded by bacteria.

Pathophysiology

Introduction to Pathophysiology

• Pathophysiology involves studying functional or physiological changes resulting from a disease process. This includes understanding how diseases disrupt normal bodily functions.

• It deals with disease development and associated changes to normal anatomy or physiology. This encompasses the mechanisms of disease progression and their effects on body structures and functions.

• Pathophysiology includes some aspects of pathology, specifically cellular and tissue changes, such as alterations observed under a microscope.

Homeostasis

• Homeostasis is the maintenance of a relatively stable internal environment despite external changes. It is crucial for optimal cellular function.

• Maintaining homeostasis generally leads to good health, ensuring that all bodily processes operate efficiently.

• Failure to maintain homeostasis can lead to disease, as deviations from the normal internal environment disrupt cellular and organ functions.

Health and Disease

• Health is a state of physical, mental, and social well-being, reflecting holistic wellness.

• Disease is a deviation from the normal state of homeostasis, indicating a disruption in the body's equilibrium.

• Homeostasis is maintaining a stable internal environment despite external factors. The body uses feedback mechanisms to regulate variables like temperature, pH, and blood glucose levels.

Health Indicators

• "Normal" values occur within a range and may vary based on measurement technology. Reference ranges are established through statistical analysis of healthy populations.

• Adjustments are influenced by:

  • Age: Physiological norms change throughout the lifespan.

  • Gender: Hormonal and anatomical differences impact normal values.

  • Genetics: Inherited traits can predispose individuals to certain health conditions.

  • Environment: External factors like pollution and climate affect health.

  • Activity Level: Physical exertion influences physiological parameters.

Seven Steps to Health

• Be a nonsmoker and avoid secondhand smoke to reduce the risk of respiratory diseases and cancer.

• Eat 5 to 10 servings of vegetables and fruits daily; choose high-fiber, lower-fat foods; limit alcohol intake to maintain a balanced diet and reduce the risk of chronic diseases.

• Engage in regular physical activity to improve cardiovascular health, maintain a healthy weight, and boost overall well-being.

• Protect yourself from the sun by using sunscreen and protective clothing to prevent skin cancer and sun damage.

• Follow cancer screening guidelines for early detection and treatment.

• Visit a doctor or dentist if there are any changes in the normal state of health to address potential health issues promptly.

• Follow health and safety guidelines at home and work when using, storing, and disposing of hazardous materials to prevent accidents and exposure to toxins.

Concept and Scope of Pathophysiology

• Pathophysiology uses knowledge of basic anatomy and physiology to study functional/structural changes in body tissue or cells due to disease. It integrates multiple scientific disciplines.

• It includes some pathology, such as examining tissue specimens to diagnose diseases.

• Cause-and-effect relationships, defined by signs and symptoms, guide the study of a specific disease. Understanding these relationships is crucial for diagnosis and treatment.

• Examples: Jaundice (yellowing of the skin), inflammation (redness, swelling, pain, and heat), and infection (invasion of pathogens).

Prevention of Disease

• It has become a primary focus in healthcare, emphasizing proactive measures to maintain health.

  • Maintaining routine vaccination programs to prevent infectious diseases.

  • Participation in screening programs for early detection of diseases like cancer and diabetes.

  • Community health programs promoting healthy lifestyles and disease prevention.

  • Regular routine doctor visits for health check-ups and early intervention.

Types of Prevention

• Primary: Prevent the development of disease/injury (e.g., seat belts, nutrition, education, vaccination). It focuses on reducing risk factors.

• Secondary: After illness or risk factor diagnosis, follow medication regimen/follow-up with primary care physician to manage the condition and prevent complications.

• Tertiary: Manage complicated or long-term diseases (e.g., diabetes, CHF). It aims to minimize the impact of the disease and improve quality of life.

Stages of Research Process

• Stage 1: “Basic science”

  • Identification of technology to be used in the research.

  • Work is done in the laboratory setting.

  • Might require animal or cell/tissue cultures to study disease mechanisms.

• Stage 2

  • Small number of human subjects are involved to assess safety and efficacy.

• Stage 3: Clinical trials

  • Involve a large number of patients with the disease or risk of the disease to evaluate treatment effectiveness.

  • “Double-blind studies" are often used to minimize bias.

Medical History

• Current and prior illnesses provide insights into the patient's health background.

• Allergies to medications, foods, or environmental factors are crucial for avoiding adverse reactions.

• Hospitalizations and the reasons for them offer significant information about past health issues.

• Treatment received for various conditions, including surgeries, therapies, and medications.

• Specific difficulties or symptoms experienced by the patient.

• Any type of therapy or drugs:

  • Prescription medications prescribed by a healthcare provider.

  • Nonprescription or over-the-counter drugs.

  • Herbal items, including food supplements, which may interact with other medications.

Basic Terminology

• Gross level: organ or system level, examining the body's macroscopic structures.

• Microscopic level: cellular level, studying cells and tissues under a microscope.

• Biopsy: excision of small amounts of living tissue for diagnostic examination.

• Autopsy: examination of the body and organs after death to determine the cause of death.

Disease Process

• Diagnosis

  • Identification of a basic disease through evaluation.

  • Evaluation of signs and symptoms to understand the patient's condition.

  • Laboratory tests used to confirm the diagnosis.

• Etiology

  • Causative factors in a particular disease:

  • Congenital defects present at birth.

  • Inherited or genetic disorders passed down through families.

  • Microorganisms, such as bacteria and viruses, causing infections.

  • Immunologic dysfunctions, including autoimmune diseases.

  • Degenerative changes associated with aging.

  • Malignancy or cancer.

  • Metabolic and nutritional problems affecting bodily functions.

  • Trauma, burns, and environmental factors causing physical damage.

Causes of Disease

• Idiopathic: cause of disease is unknown, making it challenging to develop targeted treatments.

• Iatrogenic: error/treatment/procedure may cause the disease, highlighting the importance of medical safety.

• Predisposing factors: age, gender, inherited factors, environment, etc., that increase the likelihood of developing a disease.

• Prophylaxis: preserve health; prevent the spread of disease through measures like vaccination and hygiene.

• Prevention: vaccinations; dietary/lifestyle modifications; prevention of potentially harmful activities, etc. These are crucial for reducing disease incidence.

Characteristics of Disease

• Pathogenesis: Development of the disease from initial cause to manifestation.

• Onset of disease:

  • Sudden/acute: rapid and abrupt.

  • Insidious: gradual, vague, or mild signs that develop over time.

• Acute disease:

  • Short-term, develops quickly, with a duration of days or weeks.

  • High fever, severe pain, etc.

• Chronic disease:

  • Develops gradually over months or years.

  • Milder symptoms, often intermitted with acute episodes.

• Subclinical state: Pathologic changes, no obvious manifestations, making early detection difficult.

• Latent state: No symptoms or clinical signs are evident; in infectious diseases: incubation period where the pathogen is present but not causing symptoms.

• Prodromal period: Early development of the disease; signs are nonspecific or absent, indicating the onset of illness.

• Manifestations: Clinical evidence with signs and symptoms

  • Local: at the site of the problem.

  • Systemic: general indicators of illness, i.e., fever.

• Signs: Objective indicators of disease, such as swelling or rash.

• Symptoms: Subjective feelings reported by the patient, such as pain or fatigue.

• Lesions: Specific local change in the tissue, indicating damage or abnormality.

• Syndrome: Collection of signs and symptoms that characterize a particular condition.

• Diagnostic tests: Various laboratory tests appropriate to manifestations and medical history for accurate diagnosis.

• Remissions and exacerbations mark the course or progress of a disease.

  • Remission: period during which manifestations subside, indicating improvement.

  • Exacerbation: a worsening of severity, indicating a flare-up of the disease.

• Precipitating factor: Condition that triggers an acute episode, such as stress or infection.

• Complications: New secondary or additional problems arising from the original disease.

• Therapy: Measures to promote recovery/slow progress, including medications, therapies, and lifestyle changes.

• Sequelae: Potential unwanted outcomes or long-term effects of the disease, such as scarring or disability.

• Convalescence or rehabilitation: Period of recovery and return to a healthy state, involving physical and occupational therapies.

Disease Prognosis

• Prognosis: defines the probability or likelihood of recovery or other outcomes, informing patient care decisions.

• Morbidity: Disease rates within a group, indicating the prevalence and impact of the illness.

• Mortality: Relative number of deaths resulting from the disease, reflecting its severity.

• Autopsy: Postmortem examination to determine the cause of death and gain insights into the disease process.

• Epidemiology: Tracking the pattern or occurrence of disease

  • Major data collection centers: WHO and CDC collect and analyze data to monitor and control diseases.

• Occurrence of disease:

  • Incidence: Number of new cases in a given population within a given time period.

  • Prevalence: Number of new, old, or existing cases within a given population and time period.

• Epidemics: A higher number of expected cases of an infectious disease occur within an area, requiring public health intervention.

• Pandemic: Involve a higher number of infectious diseases in many regions of the globe, posing significant global health threats.

• Communicable diseases: Infectious diseases that can spread from one person to another, necessitating infection control measures.

• Notifiable or reportable diseases

  • Must be reported by the physician to designated authorities for disease surveillance and control.

  • Authority varies with local jurisdiction.

  • Required diseases to be reported may change over time based on public health priorities.

  • Reporting is intended to prevent further spread of the disease through prompt action.

Cellular Changes

• Cells can adapt their growth and differentiation to altered conditions in the body, allowing them to survive in changing environments.

• Tissues may be modified due to hormonal stimulation, pregnancy changes in women, or environmental stimuli (i.e., irritation), illustrating tissue plasticity.

• Disease may develop when cell structure and function are changed to the point when homeostasis cannot be maintained, leading to organ dysfunction.

Cellular Adaptations

• Atrophy: Decrease in the size of cells resulting in reduced tissue mass (e.g., muscle mass/tone loss due to disuse). Decrease in cell size reduces oxygen demand allowing for survival.

• Hypertrophy: Increase in cell size resulting in enlarged tissue mass (e.g., muscle gain from exercise). Increase in cell size increases the ability to perform work.

• Hyperplasia: Increased number of cells resulting in enlarged tissue mass (e.g., pregnancy changes or cancer). Increase in cell number increases functional capacity.

• Metaplasia: Mature cell type is replaced by a different mature cell type (e.g. Cigarette smokers-body adapts and modifies the type of cell cilia are to a hardier but less functional cell). Replacement of one cell type with another allows for survival in altered conditions.

• Dysplasia: Cells vary in size and shape within a tissue (e.g., Pap-smear - precancerous cells). Disordered cell growth leads to increased risk of cancer.

• Anaplasia: Undifferentiated cells, with variable nuclear and cell structures, are common in tumors and used for tumor grading. Loss of cell differentiation indicates aggressive malignancy.

• Neoplasia: “New growth,” commonly called a tumor, can be benign or cancerous, requiring careful evaluation and treatment.

Cell Damage

• Apoptosis: Refers to programmed cell death, a normal occurrence in the body. This process eliminates damaged or unnecessary cells.

• Ischemia: Inadequate supply of blood to the cells, leading to oxygen and nutrient deprivation.

• Hypoxia: Reduced oxygen in tissues; nutritional deficits impair cellular functions.

• Pyroptosis: Cell death as a result of microorganism, Results in lysis causing nearby inflammation. This process triggers an immune response.

• Physical damage: Excessive heat or cold; radiation exposure can disrupt cellular structures and functions.

• Mechanical damage: Pressure or tearing of tissue causing cell rupture.

• Chemical toxins:

  • Exogenous: From the environment include pollutants and industrial chemicals.

  • Endogenous: From the inside of the body include metabolic waste products.

• Microorganisms: Bacteria and viruses, for example, can directly damage cells or trigger harmful immune responses.

• Abnormal metabolites:

  • Genetic disorders disrupt normal metabolic pathways.

  • Inborn errors of metabolism lead to accumulation of toxic substances.

  • Altered metabolism in diseases like diabetes can cause cell damage.

• Imbalance of fluids or electrolytes disrupts cellular functions and can lead to swelling or dehydration.

Necrosis

• Necrosis: is the death of a group of cells that causes further damage due to cellular disintegration. This process releases intracellular contents, leading to inflammation.

• Liquefaction necrosis: Dead cells liquefy because of the release of cell enzymes; occurs in brain cells due to high lipid and enzyme content.

• Coagulative necrosis: Cell proteins are altered or denatured coagulation occurs with a heart attack due to ischemia.

• Fat necrosis: Fatty tissue is broken down into fatty acids, often seen in pancreatitis or breast tissue trauma.

• Caseous necrosis: Form of coagulation necrosis; a thick, yellowish, “cheesy” substance forms, commonly found in tuberculosis.

• Infarction: Area of dead cells as a result of oxygen deprivation, leading to tissue destruction.

• Gangrene: Area of necrotic tissue that has been invaded by bacteria, often requiring amputation.