Cell Pathology Flashcards
(121 cards)
Intro
Our bodies react to physiological stress or pathological stimuli
Cells constantly adjust their structure and function to accommodate extracellular stresses
Maintain normal homeostasis
Adaptive changes lead to a new steady state to preserve viability and function
Cell death can occur as a normal or abnormal process
Causes of cell injury
Infectious agents range from viruses, bacteria and fungi to tapeworms
Immune reactions can cause cell and tissue injury e.g. autoimmune reactions or allergic reactions
Genetic defects may cause injury through deficiency of functional proteins, accumulation of DNA damage or misfolded proteins. Sickle cell anaemia a.a. substitution in hemoglobin S
Adaptive responses
Reversible changes in:
Number
Size
Phenotype
Metabolic Activity
Function
2 Adaptation examples
Physiological Adaptations
e.g. hormone-induced enlargement of breast during pregnancy
Pathological Adaptations
Pathological adaptations are cellular responses to adverse stimuli or diseases that, while attempts to survive, result in changes that impair normal function or lead to disease.
What are the principal adaptive responses?
Principal adaptive responses are:
Hypertrophy
Hyperplasia
Atrophy
Metaplasia
Hypertrophy
- Increased size of cells
- Increased size of organ
Cells enlarged due to increased amount of structural proteins and organelles
Occurs largely in cells that do not divide
Can be physiological or pathological
Can occur simultaneously with hyperplasia
Requires mechanical signals –stretch and trophic triggers eg alpha adrenergic stimulation
Which turn on genes that increase protein synthesis
Hyperplasia
- Increased number of cells
- Increased organ size
Takes place in cells capable of replication
Can occur together with hypertrophy
Can be physiological eg hormonal; compensatory hyperplasia
or pathological – excessive hormone or growth factor secretion
Gingival hyperplasia from phenytoin.
Examples e.g. receding gum, enlarging prostate
Atrophy
- Reduced size of Cells
- Reduced size of Organ
Diminished function but not dead, caused by decreased work load through: Loss of innervation; Diminished blood supply; Inadequate nutrition; Loss of endocrine stimulation; Ageing; Reduced protein synthesis (due to reduced metabolic activity), increased protein degradation
Metaplasia
- Reversible change in phenotype
- Replaced by a cell type which can better withstand the adverse environment
Cells are replaced with a different cell type.
This is thought to arise from genetic reprogramming of stem cells
. An example is epithelial metaplasia in smokers where specialised ciliated columnar epithelial cells are replaced with hardy squamous epithelial cells. This adaptation helps survival but protective mechanisms are lost eg cilia clearance
It is often caused by chronic irritation and persistence can lead to the a transformation to malignant cells.
Cellular changes in injury
Reversible
- Cell swelling
- Swelling of organelles
- Lipid deposition
- Detachment of ribosomes
- Loss of microvilli
- Clumping of chromatin
- Surface blebs
Irreversible
- lysosomal enzyme release
- Protein digestions
- Severe cell swelling
- Membrane damage
- Mitochondrial vacuolation
- Nuclear changes
Adaptive Responses FLOWCHAT
MEMORISE
Cellular changes in injury
What can the microscopes see
Light microscope
- fatty change
- vacuoles
- cloudy swelling
- Membrane blebbing
- Necrosis
- Nuclear changes
Electron microscope
- ER swelling
- loss of ribosomes
- loss of specialised membrane structures
- myelin bodies
- condensation of mitochondria
- vacuolisation of mitochondria
Summary
Our bodies react to any form of injury or assault
All adaptive responses are reversible
If stimulus is not removed, cells die or undergo neoplastic change
Cellular pathological investigations allow us to see the changes
What is apoptosis
Apoptosis is the process of programmed cell death. It is used during early development to eliminate unwanted cells; for example, those between the fingers of a developing hand. In adults, apoptosis is used to rid the body of cells that have been damaged beyond repair.
What is necrosis
Necrosis is the death of the cells in your body tissues. Necrosis can occur due to injuries, infections or diseases
Cell death
Main targets for cell injury are cell membranes, mitochondria, cytoskeleton and DNA
Loss of ability to divide
Loss of normal synthetic functions
Biochemical changes, followed by structural changes
Cell death via necrosis or apoptosis
How can cell death occur
1) Small blebs form; the structure of the nucleus changes
2) The blebs fuse and become larger; no organelles are located in the blebs
3) The cell membrane ruptures and releases the cell’s content; the organelles are not functional
Nuclear Changes in Cell Death
- Pyknosis
- Karyolysis
- Karyorrhexis
What is Pyknosis
Nuclear shrinkage
What is Karyolysis
Nuclear fading
What is Karyorrhexis
Nuclear fragmentation
What is necrosis + cause
Necrosis is caused by factors external to the cell or tissue e.g. infections, toxins or trauma
It results in unregulated digestion of the cell components
Loss of cell membrane integrity and uncontrolled release of products of cell death brought about by autolysis
Inflammatory response in the surrounding tissue
Tissue Response to Necrosis
Haemorrhage
Resolution
- Site, type and extent of injury
- If cannot resolve, body attempts to repair
Repair
- Removal of dead tissue
- Action of neutrophils and macrophages
- Granulation tissue
Necrosis can be divided into 5 distinct types based on the morphological changes that occur:
Necrosis can be divided into 5 distinct types based on the morphological changes that occur:
- Coagulative necrosis
- Liquefaction (colliquative necrosis)
- Caseating necrosis
- Fat necrosis
- Gangrenous necrosis