Chapter 2: Cell Injury Flashcards by Rahma Adel

What are the factors that affect cell injury?

5 points

Injured tissue type
Duration
Severity
Adaptability
Genetic Makeup

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What are the 2 examples that adapt to Hypoxia?

Brain tissue

Skeletal muscles

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Describe the Brain tissue in response to Hypoxia

Very sensitive

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For how long can the Brain tissue adapt to Hypoxia?

2-5 min

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For how long can the Skeletal muscles adapt to Hypoxia?

2-6 hours

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What are the causes of cell injury?

8 points

Oxygen:
Deprivation
Free radicals

Physical agents
Radiation
Trauma
Infectious Organisms
Immunologic Reactions
Genetic Derangements 
Nutritional Imbalances

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What are the 2 forms of Oxygen Deprivation?

Hypoxia

Ischemia

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What are the 2 types of Physical agents?

Heat

Cold

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Describe these 2 Physical agents

Excess

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What are the 2 forms of Nutritional Imbalances?

Starvation

Obesity

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What is the most important cause of cell injury?

Oxygen deprivation

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Define Adaptation

Cell modification

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What are the 2 cell factors which are modified in Adaptation?

Morphology

Function

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What gave rise to cell Adaptation?

Stress

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Describe Adaptation

Reversible

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What is a function of Adaptation?

Preserve

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What does Adaptation preserves?

Cell viability

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What are the 4 types of Adaptations?

Atrophy
Hypertrophy
Hyperplasia
Metaplasia

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What are affected in Atrophy?

2 points

Tissue
Or
Organ

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What are affected in these tissues or organs?

2 points

Size

Weight

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How are the size and weight affected in these tissues or organs?

Decrease

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What cause a decrease in size and weight of tissues or organs in Atrophy?

Parenchymal cells

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What exactly in the Parenchymal cells causes a decrease in size and weight of tissues or organs in Atrophy?

Component

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What are the 3 affected components of the Parenchymal cells that cause this decrease?

Number
Size
Number & Size

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How are these 3 components of Parenchymal cells affected?

Decrease

What are the 2 types of Atrophy?

Physiological | Pathological

What are the 2 types of Physiological and Pathological Atrophy?

General | Local

What is an example of General Physiological Atrophy?

Senility

Where does Local Physiological Atrophy occur in? (3 points)

New Born Adult Menopause

Where does Local Physiological Atrophy occur in New Born? (2 points)

Umbilical vessels | Adrenal cortex

Which New Born condition is Local Physiological Atrophy found in?

Ductus Arteriosus

Where does Local Physiological Atrophy occur in Adult?

Thymus

When does Local Physiological Atrophy is found in the Thymus of an adult?

At puberty

Where does Local Physiological Atrophy occur in Menopause?

Female genital tract

What is are the examples of General Pathological Atrophy? (4 points)

Starvation TB Cancer Hormonal

Which hormones does Hormonal Pathological Atrophy occur in?

Pituitary Tropic

How are these Pituitary hormones affected in Hormonal Pathological Atrophy?

Decreased

What are the examples of Local Pathological Atrophy? | 7 points

``` Disuse Pressure Neurogenic Immunologic Ischemic Thermal Hormonal ```

What is an example in which Disuse Pathological Atrophy occurs in?

Limb put in Plaster cast

What undergoes Atrophy when the limb is put in Plaster cast?

Limb muscles

What is an example in which Neurogenic Pathological Atrophy occurs in?

Poliomyelitis

What undergoes Atrophy in Poliomyelitis?

Muscle

What are the 2 types of Pressure Pathological Atrophy?

Exogenous | Endogenous

What is an example in which Exogenous Pressure Pathological Atrophy occurs in?

Aortic Aneurysm

What undergoes Atrophy in Aortic Aneurysm?

Vertebrae

What is an example in which Endogenous Pressure Pathological Atrophy occurs in?

Hydatid cyst

What undergoes Atrophy in Hydatid cyst?

Liver cells

What is an example in which Thermal Pathological Atrophy occurs in?

Undescended Testicles

Describe the Atrophy in this example of Thermal Pathological Atrophy?

Testicular

What is an example in which Immunologic Pathological Atrophy occurs in?

Autoimmune atrophic Gastritis

Describe the Atrophy in Hormonal Pathological Atrophy

Adrenal

What causes this Adrenal Atrophy?

ACTH absence

What is affected in Hypertrophy?

Organ

What are affected in these organs? | 2 points

Size | Weight

How are the size and weight affected in these organs?

Increase

What cause an increase in size and weight of organ in Hypertrophy?

Its cells

What exactly in the organ cells causes an increase in size and weight of organs in Hypertrophy?

Component

What is affected in the component of the organ cells that causes this increase?

Size

What is Hypertrophy related to?

Muscles

What are the 3 types of Hypertrophy?

Physiological Pathological Compensatory

What are the reasons of the occurrence of Physiological Hypertrophy? (2 points)

Demands | Hormonal

Describe these demands (2 points)

Excess | Functional

What is an example in which Hormonal Physiological Hypertrophy occurs in?

Smooth muscles

Where are the smooth muscles in which the the Hormonal Physiological Hypertrophy occurs in?

Uterus

What are the 2 types of Pathological Hypertrophy?

Hormonal | Adaptive

Describe this uterus

Pregnant

What are the examples in which Hormonal Pathological Hypertrophy occur in? (2 points)

Acromegaly | Gigantism

Where does the Adaptive Pathological Hypertrophy occur in?

Muscular hollow organs

Why does the Adaptive Pathological Hypertrophy occur in Muscular hollow organs?

To overcome distal obstruction

What are the examples in which the Pathological Adaptive Hypertrophy occur in? (2 points)

Heart | Smooth muscles

Where does the Pathological Adaptive Hypertrophy occur in the heart?

Ventricles

What is an example in which the Pathological Adaptive Hypertrophy occur in the left ventricle of the heart?

Pulmonary Hypertension

What are the examples in which the Pathological Adaptive Hypertrophy occur in the right ventricle of the heart? (2 points)

Aortic valve lesions | Systemic Hypertension

What are examples of organs in which their smooth muscles undergo Pathological Adaptive Hypertrophy? (2 points)

Oesophagus | Stomach

What is an example in which the Pathological Adaptive Hypertrophy occurs in, in the smooth muscles of the Oesophagus?

Cardiac achalasia

What is an example in which the Pathological Adaptive Hypertrophy occurs in, in the smooth muscles of the Stomach?

Pyloric stenosis

When can Compensatory Hypertrophy occur in?

After Nephrectomy

Which patient can Compensatory Hypertrophy occur in after Nephrectomy?

Young

Where can Compensatory Hypertrophy occur on after Nephrectomy of young patients?

One side

What are affected in Hyperplasia? | 2 points

Tissue Or Organ

What are affected in these tissues or organs? | 2 points

Size | Weight

How are the size and weight affected in these tissues or organs?

Increase

What cause an increase in size and weight of tissues or organs in Hyperplasia?

Specialized cells

What is affected in the Specialized cells that causes this increase?

Number

How is the number of these Specialized cells affected?

Increase

What does the Hyperplasia respond to?

Stimulus

Describe this stimulus

Particular

Where does Hyperplasia occur in? | 2 points

Tissues Or Organs

What are these tissues or organs ,where Hyperplasia occur in, composed of?

Dividing cells

What are the 2 types of dividing cells?

Labile | Stable

When do these cells divide in?

Postnatal life

What are the 2 types of Hyperplasia?

Physiological | Pathological

What is an example in which Physiological Hyperplasia occur in?

Female Glandular Hyperplasia

What are the 2 Female Glandular Hyperplasia?

Breast | Thyroid

When does Female Breast and Thyroid Glandular Hyperplasia occur?

At Puberty | During lactation

When does Female Breast Glandular Hyperplasia also occur at?

Pregnancy

What are the 3 types of Pathological Hyperplasia?

Compensatory Hormonal Irritative

What are the examples where Compensatory Pathological Hyperplasia occur in? (4 points)

Liver cells Thyroid Epithelial cells Kidney’s nephrons Bone Marrow

When does the Compensatory Pathological Hyperplasia occur in Liver cells and Thyroid Epithelial cells?

After their: Destruction Or Removal

Describe the destruction or removal of these Liver cells and Thyroid Epithelial cells?

Partial

When does the Compensatory Pathological Hyperplasia occur in the nephrons of the kidney?

After Nephrectomy

Which nephrons of the kidney is where the Compensatory Pathological Hyperplasia occur in?

Remaining

When does the Compensatory Pathological Hyperplasia occur in Bone marrow?

After hemorrhage

Describe the Hormonal Hyperplasia that occurs in females

Estrogen Endometrial

Describe the Hormonal Hyperplasia that occurs in males

Prostatic

What are examples of clinical significance of Hyperplasia? (3 points)

Mass Uterine Bleeding Neoplasia risk

Where can the mass be found in? (3 points)

Breast Prostate Thyroid

Describe the Hyperplasia where in which Uterine bleeding and Neoplastic risk occurs in

Endometrial

Describe the Neoplastic risk in Hyperplasia

Increased

Describe the Endometrial Hyperplasia in the Neoplastic risk

Atypical

What occurs in Metaplasia?

Substitution

What is substituted?

One adult fully differentiated cell type

What is this one adult fully differentiated cell types substituted by?

Another adult cell type

Describe the other adult cell type

Of same category

What does Metaplasia respond to?

Environmental changes

What type of cells does Metaplasia occur in?

Proliferating

When do these cells proliferate in?

Postnatal life

What are the 3 types of Metaplasia?

Epithelial Mesothelial Connective Tissue

What are the causes of Epithelial Metaplasia? (4 points)

Chronic irritation Gene activation Avitaminosis Unknown causes

What are the 2 types of Epithelial Metaplasia?

Squamous | Glandular

What occurs in Squamous and Glandular Metaplasia?

Epithelium Transformation

Which type of Epithelium transforms in Squamous Metaplasia?

Columnar

Which type of Epithelium does Columnar Epithelium transforms into?

Stratified squamous

Where can Columnar Epithelium be found in? | 3 points

Bronchi Endocervix Gall bladder

Where is the bronchi in which Columnar Epithelium can be found in?

Smokers

Which type of Epithelium transforms in Glandular Metaplasia?

Stratified squamous

Which type of Epithelium does Columnar Epithelium transforms into?

Intestinal

Where can Stratified Squamous Epithelium be found in?

Oesophagus

Which part of the Oesophagus is where Stratified Squamous Epithelium found in?

Lower end

What is an example in which Glandular Metaplasia occur in?

Reflux esophagitis

What is an example in which Connective tissue Metaplasia occur in?

Myositis ossificans

What occurs in this example of Connective tissue Metaplasia?

Fibrosis Transformation

What does this Fibrosis transform into?

Bone

Where does the Fibrosis changes to bone?

Muscle

Which muscle is where Fibrosis changes to bone?

Traumatized

What is the action of this Fibrosis in the traumatized muscle?

Replacement

What does this Fibrosis replace?

Hematoma

What is a Metaplasia Prognosis?

Reversible

What can the Metaplasia be as a Prognosis?

Precancerous

Which type of Metaplasia can be precancerous?

Epithelial

What are the 2 reversible cellular changes?

Hydrophobic | Fatty

What is Hydrophobic change also known as?

Cloudy Swelling

Why is Hydrophobic change reversible?

Agents can be removed

Describe these agents (2 points)

Injurious | Etiological

What are these agents? (5 points)

``` Toxins Chemicals Poisons Burns Fever ```

Describe these toxins

Bacterial

Describe this Fever

High

What does the Hydrophobic change results from?

Impaired regulation

What's regulation is impaired? (2 points)

Sodium | Potassium

At which level is sodium and potassium regulation impaired?

Cell membrane

What does the impaired regulation of sodium and potassium results in? (2 points)

Accumulation | Escape

Describe this accumulation

Intracellular

What is accumulated?

Sodium

What escapes?

Potassium

What is resulted from the intracellular accumulation of sodium and escape of potassium?

Water flow

Describe this flow

Rapid

What does the water flow into?

Cell

What is the purpose of this water flow?

Maintenance

What does the water flow maintain?

Iso-osmotic conditions

Where does the Hydropic Change occur in?

Organs

What are these organs rich in?

Mitochondria

Describe the size of the organ where the Hydrophobic change occurs in

Enlarged

Describe the color of the organ where the Hydrophobic change occurs in

Pale

Describe the capsule of the organ where the Hydrophobic change occurs in

Tense

Describe the borders of the organ where the Hydrophobic change occurs in

Rounded

Describe the organ where the Hydrophobic change occurs in ,when touched

Soft

Describe the cross section of the organ where the Hydrophobic change occurs in

Bulging

Describe the cells of the organ where the Hydrophobic change occurs in under the microscopic examination

Swollen

Describe the cytoplasm where the Hydrophobic change occurs in under the microscopic examination

Granular

Describe the nucleus of where the Hydrophobic change occurs in under the microscopic examination

Normal

What are examples where the Hydrophobic change can be found in? (3 points)

Hepatocytes Renal Tubules Cardiac Muscles

What is a form of Hydrophobic change?

Hydropic Degeneration

Describe Hydropic Degeneration

Severe

What is the action of cytoplasm in an organ where the Hydropic Degeneration occurs in?

Accumulation

What does the cytoplasm accumulates?

Water vacuoles

What is an example of an organ where the Hydropic Degeneration occurs in?

Liver

What may cause Hydrophobic Degeneration in the Liver

Alcohol

What is caused as a result of Hydrophobic Degeneration in the Liver, due to alcohol? (2 points)

CCL4 Toxicity | Viral Hepatitis

Describe Fatty Change

Triglycerides accumulation

Where do the Triglycerides accumulate inside?

Parenchymal cells

What causes Triglycerides accumulation?

Imbalance

What does the imbalance occur between? | 3 points

Uptake Utilization Secretion

What has an imbalance between its Uptake, Utilization and Secretion?

Fat

Where does Fatty Change usually occur in? | 3 points

Liver Heart Kidney

What are the causes of a Fatty Liver? | 5 points

``` Alcohol Diabetes Mellitus Malnutrition Obesity Poisoning ```

What are the fatty acid mechanisms that results in a Fatty Liver? (4 points)

Entry Synthesis Oxidation Esterification

Describe the fatty acid entry that results in a Fatty Liver

Increased

What are the causes that lead to increased fatty acid entry in the liver? (3 points)

Obesity Starvation Cortisone therapy

Describe the fatty acid synthesis that results in a Fatty Liver

Increased

What is this fatty acid synthesized from?

Acetate

What leads to increased fatty acid synthesis in the liver?

Alcoholism

Describe the fatty acid oxidation that results in a Fatty Liver

Decreased

What are the causes that lead to decreased fatty acid oxidation in the liver? (3 points)

Hypoxia Anemia Respiratory failure

Describe the fatty acid esterification that results in a Fatty Liver

Increased

What are the fatty acids esterified into?

Triglycerides

What are the causes that lead to increased fatty acid esterification into triglycerides in the liver? (2 points)

DM | Alcoholism

What mechanism also results in a Fatty Liver?

Apoprotein formation

How is the apoprotein formation affected resulting in a Fatty Liver?

Decreased

What are the causes that lead to decreased apoprotein formation? (3 points)

Protein mal-nutrition Alcoholism CCL4 toxicity

Describe the size of a Fatty Liver

Enlarged

What is the range weight of a Fatty Liver?

3-6 kg

What is the color of a Fatty Liver?

Yellow

Describe the borders of a Fatty Liver

Rounded

Describe the Fatty Liver when touched

Soft

Describe the cross section of a Fatty Liver

Bulging

Describe the cross section of a Fatty Liver when touched

Greasy

What is the Fatty Liver stained by?

H&E

What does the fat accumulated in the hepatocytes of a Fatty Liver appear like?

Vacuoles

Describe these vacuoles

Clear

Describe the size of these vacuoles at first

Small

What are these small vacuoles known as?

Microsteatosis

What happens to these vacuoles later on?

Fuse

What do these vacuoles form after their fusion?

One vacuole

Describe this single vacuole

Large

What does this single large vacuole do?

Pushes nucleus

Where is this nucleus pushed to?

One cell side

Describe this nucleus after it's pushed

Flattened

What would then the cell be known as?

Signet ring

What are the 2 types of a heart fatty change?

Localized | Diffusion

Describe the case where the localized fatty change occurs in the Heart

Moderate

What mostly causes the localized fatty change in a Heart?

Anemia

What does the localized fatty change in a Heart give? (2 points)

Streaks | Fibers

Describe the occurrence of these streaks and fibers together

Alternating

What is the color of these streaks?

Yellow

What is the color of these fibers?

Dark brown

Describe the appearance of these yellow streaks alternating with dark brown fibers (2 points)

Tigroid | Tabby cat

Which case is where the diffuse fatty change occurs in the Heart?

Toxicity

Describe this toxicity

Severe

What is an example where the diffuse fatty change occurs in the Heart?

Diphtheria

What does the diffuse fatty change that occur in the Heart results in? (2 points)

Myocarditis | Heart failure

Describe the myocarditis

Toxic

Describe this heart failure

Acute

What is a fat routinely stained by?

H&E

What happens to this fat?

Dissolved

What dissolved this fat?

Organic solvents

When is this fat dissolved by organic solvents?

During preparation

What are the other 2 stains used to demonstrate fat?

Sudan III | Osmic acid

What is the color of the fat when stained with Sudan III?

Orange red

What is the color of the fat when stained with Osmic acid?

Black

Which fat is demonstrated using Sudan III | and Osmic acid?

Frozen

Describe Necrosis

Death

What is dead?

Cells

Describe the occurrence of these cells

Group

Where do these cells die inside?

Organism

What is the nature of this organism?

Living

What are the 2 factors which characterize irreversible cell damage?

Damage/Dysfunction | Calcium

Describe this damage/dysfunction

Mitochondrial

Describe this Mitochondrial damage/dysfunction

Irreversible

Describe this Calcium

Intracellular

Describe the level of the intracellular Calcium so that it characterizes the irreversibility of cell damage

Increased

What does the irreversible Mitochondrial damage/dysfunction affect so that it characterizes the irreversibility of cell damage?

ATP

How is the ATP affected by the irreversible Mitochondrial damage/dysfunction affect so that it characterizes the irreversibility of cell damage?

Decreased

What does the increased level of intracellular Calcium cause so that it characterizes the irreversibility of cell damage?

Activation

What are activated due to the increased level of intracellular Calcium cause so that it characterizes the irreversibility of cell damage?

Many enzymes

What are the enzymes activated due to the increased level of intracellular Calcium cause so that it characterizes the irreversibility of cell damage? (3 points)

Protease Phospholipase Endonuclease

What are the cell components affected in Necrosis? | 4 points

Cell membrane Cytoplasm Mitochondria Nucleus

What happens to the cell membrane in Necrosis?

Disappears

Describe the cytoplasm and mitochondria in Necrosis

Swollen

What happens to the cytoplasm and mitochondria in Necrosis?

Rupture

What do the cytoplasm and mitochondria form after their rapture in Necrosis?

Myelin figures

What could happen to these Myelin figures?

Calcification

What could happen to these Myelin figures?

Calcification

What are the 3 Nuclear changes that occur in in Necrosis?

Pyknosis Karyorrhexis Karyolysis

What happens to the nucleus in Pyknosis?

Shrinks

What is also affected in Pyknosis?

Basophilia

How is Basophilia affected in Pyknosis?

Increased

Describe Karyorrhexis in Necrosis

Pyknoti nucleus fragments

What is affected in Karyolysis?

Chromatin

What is this chromatin for?

Basophilia

What happens to the chromatin of basophilia in Karyolysis?

Fades

What are the types of Necrosis? (6 points)

``` Coagulative Liquefactive Caseous Fat Fibrinoid Gangrenous ```

What is the most common type of necrosis?

Coagulative

What are the 2 types of fat necrosis?

Traumatic | Enzymatic

What is Coagulative necrosis known as?

Ischemic

Where does the Coagulative necrosis occur in? (2 points)

Infractions | All Organs

What is the site where Coagulative necrosis doesn't occur in?

CNS

What occur in Coagulative necrosis? | 2 points

Denaturation | Digestion

What is denatured in Coagulative necrosis?

Protein

Describe the digestion that occurs in Coagulative necrosis

Enzymatic

What predominates in Coagulative necrosis?

Protein denaturation

Describe the Cytoplasm in Coagulative necrosis (3 points)

Homogenous Glassy Eosinophilic

What are lost so that the Cytoplasm appear Homogenous, Glassy and Eosinophilic in Coagulative necrosis? (2 points)

RNA | Glycogen

Describe this RNA (2 points)

Cytoplasmic | Basophilic

Describe the cell's basic outline in Coagulative necrosis

Preserved

Describe the cell's basic details in Coagulative necrosis

Lost

What usually causes Liquefactive necrosis?

Dissolution

Describe this dissolution

Enzymatic

What is an enzyme that causes dissolution?

Proteolytic

Which cells release Proteolytic enzyme?

Neutrophils

What does Proteolytic enzyme dissolve?

Necrotic cells

Where does the liquefactive necrosis mostly occur in? (3 points)

Infraction CNS Abscesses

What causes Caseous necrosis? (2 points)

Mycobacterial TB | Infection

Describe this infection

Fungal

Where does Caseous Necrosis occur in?

Any organ

What does Caseous Necrosis appear like?

Cheese-like material

What is seen under the microscope in Caseous Necrosis? (2 points)

Granuloma | Debris

Describe the size of this Granuloma

Large

Where can this large Granuloma be found in?

Histiocytes

Describe the region of this debris

Central

Describe this debris (2 points)

Amorphous | Granular

What are lost in Caseous Necrosis? (2 points)

Nuclei | Cell outlines

What causes Fat necrosis?

Lipase action

What does Lipase act on?

Adipocytes

What is caused by Fat necrosis?

Pancreatitis

Describe this Pancreatitis

Acute

What is the color of Fat Necrosis?

Chalky white

What is the Fibrinoid Necrosis a form of?

Connective Tissue

What does the Fibrinoid Necrosis resemble?

Fibrin

Describe the appearance of Fibrinoid Necrosis under the microscope (2 points)

Eosinophilic | Homogeneous

What does Eosinophilic means?

Pink

Where is Fibrinoid necrosis usually seen in?

Blood Vessels walls

What does Fibrinoid necrosis cause?

Vasculitis

Describe Apoptosis

Death

Describe this death

Programmed

What is dead in Apoptosis?

Cell

How many cells die in Apoptosis?

Single

Which do the cells which are removed by Apoptosis have?

DNA damage

Describe this DNA damage

Irreparable

What causes this DNA damage? (4 points)

Irradiation Or Drugs Viruses Free radicals

What are these irradiation and drugs used for?

Chemotherapy

Through what do these irradiation/drugs ,used for Chemotherapy, result in DNA damage?

P53-dependent pathway

What is the function of Apoptosis?

Protection

What does Apoptosis protect against?

Neoplastic transformation

What does the Apoptotic cell appear as?

Mass

Describe the shape of this mass (2 points)

Round | Oval

Describe the color of the cytoplasm in the Apoptotic cell (2 points)

Dark | Eosinophilic

What are the 2 types of Apoptosis?

Physiological | Pathological

What are examples of Physiological Apoptosis? (3 points)

Embryogenesis Menstruation Thymus

What occurs in the Thymus in Apoptosis?

Selective death

Which cells selectively die in the Thymus in Apoptosis?

Lymphocytes

What are examples of Pathological Apoptosis? (3 points)

Viral Hepatitis Graft-Versus-Host disease Cystic Fibrosis

What is involved in Viral Hepatitis ?

Councilman body

What does Cystic Fibrosis cause? (2 points)

Duct obstruction | Pancreatic atrophy

What happens to the Apoptotic cell?

Shrinks

What happens to the Apoptotic cell's DNA?

Fragments regularly

What happens to the Apoptotic cell's membrane?

Bleeps

What is formed due to the bleeped membrane of Apoptotic cell?

Apoptotic bodies

What happens to these Apoptotic bodies?

Phagocytosis

Describe this Phagocytosis

Rapid

What is lost in Apoptotic cell? (2 points)

Microvilli | Cell Junctions

What is absent in Apoptotic cell?

Surrounding Inflammation

Which cell death type causes surrounding inflammation?

Necrosis

Chapter 2: Cell Injury Flashcards

(342 cards)