Workshop 3 - Cellular injury Flashcards
(79 cards)
1
Q
Cellular injury ( lesion )
A
Represents all the morphological and functional changes produced in
1.cells
2.tissues
3.organs
caused by the action of different agents ( physical , chemical, biotical )
2
Q
Levels of lesions ( 4 ) :
A
- tissular
- cellular
- subcellular
- molecular
3
Q
The cellular response to pathogens depends on ( 3 ) :
A
- type of cells
- duration of pathogen action
- intensity of pathogen action
4
Q
Cell type in relation with cell division (3)
A
- labile cells
- stable cells
- permanent cells
5
Q
labile cells
A
cells with high capacity of division
ex. basal cell
6
Q
stable cells
A
cells with **low **capacity of division
or **slow regeneration **
ex. glandular parenchyma ( liver, kindey )
* bone *
7
Q
permanent cells
A
high specialiazed with
NO capacity of division
ex. skeletal, heart, nerve cells
8
Q
Cellular injury type in relation with **intensity **of pathogen action ( 3 )
A
- low intensity agent
- moderate intensity agent
- severe intesity intensity
9
Q
Low intensity agent
A
- *Acute reversible lesion **
ex. Hydropic degeneration
10
Q
Moderate intensity agent
A
**Chronic reversible lesions **
- Adaptive reactions ( hypetrophy , hyperplasia, atrophy, involution, metaplasia )
- Intracellular accumulation ( lipides , proteins , glycogen )
11
Q
Adaptive reactions
A
moderate-intensity agents
chronic reversible lesions
- Hypetrophy , hyperplasia
- Atrophy , Involution
- metaplasia
12
Q
intracellular accumulations
A
moderate - intensity agent
chronic reversible lesions
- Lipids
- proteins
- glycogen
13
Q
Severe - intensity agent
A
Leads to instant CELL DEATH
irreversible lesions : necrosis and apoptosis
14
Q
Irreversible lesions ( 2 )
A
- necrosis
- apoptosis
15
Q
Injury of a cells leads to 2 things :
A
- degeneration ( nonlethal )
- necrosis ( lethal )
16
Q
Non lethal injury
A
**Cell degeneration **
Is reversible but may progress to –> *Necrosis *
* when is associated with adnormal cells fuction –> cell degeneration can cause clinical disease
17
Q
Lethal injury
A
**NECROSIS **
biochemical and structural changes : irreversible
18
Q
Types of cellular lesions
( intracellular )
A
- Acute reversible : hydropic degeneration
- Irreversible : necrosis , apoptosis
- Chronic reversible :
1. Adaptation of cell growth and differentiation
2. Intracellular accumulation : of lipis , proteins , glycogen
3. Intracellular accumulation of pigments
4. Injury caused by abnormalities in calcium metabolism ( *pathological calcification : *dystrophic , metastatic )
19
Q
Acute reversible intracellular lesion
A
hydropic degeneration
20
Q
Irreversible intracellular lesion
A
necrosis, apoptosis
21
Q
Chronic reversible ( intracellular lesion ) ( 4 )
A
- Adaptation of cell growth and differentiation
- Intracellular accumulation : of lipis , proteins , glycogen
- Intracellular accumulation of pigments
- Injury caused by abnormalities in calcium metabolism ( pathological calcification : dystrophic , metastatic )
22
Q
Types of extracellular lesions
A
- hyalinosis
- amyloidosis
23
Q
Hydropic degeneration
( edema )
definition , cause , organs
A
Acute reversible cell injury
caused by various pathogens : ( anoxia , toxins, viruses )
Its the *FIRST *manifistation of all lessions that appear in almost all cell types of aggression , of LOW intensity
Ex. Hydropic degeneration of LIVER
24
Q
Hydropic degeneration
pathogenesis
A
- alteration of Na-K pump at the level of cell membrane
- cells can no longer maintain hydro-ionic balance
- sodium ( Na ) and water ENTER the cell
- Potassium ( K ) EXITS the cell
25
Hydrotropic degeneration
| ( morphology )
**cell hyperhydration
cellular edema **
ex. parenchymal cells ( liver , kidneys etc )
26
Hydropic Degeneration
| ( macroscopically )
The affected organ is :
* increased in **Volume**
* **pale **
* **friable **
* ** **appearance of **boiled meat **( cloudy swelling )
27
Hydropic degeneration
| ( microscopically )
* Cell : cell **ballooning,** increased cell **volume**
* Capillaries : **Compressed** ( pale organ )
* Nucleus : **normal, central**
* Cytoplasm appearance varies :
1. fine vacuolisation ( **vacuolar degeneration** )
2. completely unstained ( **clear degeneration** )
28
Necrosis
( definition )
Is an irreversible cellular change
represent all *nucleo-cytoplasmatic* changes that follow *cellular death* in living tissue or organ
can :
directly
follow cell degeneration
29
Necrosis
processes that lead to necrosis ( 2 )
* **coagulative necrosis **
- denaturation of cytoplasm protein
- fragmentation of cell organelles
- cell swelling
* **Lysis necrosis **
cause by enzymes that are :
- derived either from death cell lysosomes ( *autolysis* )
-immigrants neutrophil lysosomes ( *heterolysis* )
30
What means Coagulative necrosis ? ( 3 )
- **denaturation** of cytoplasm protein
- **fragmentation** of cell organelles
- cell **swelling **
31
What is **lysis** caused by ?
cause by enzymes that are :
* derived either from death cell lysosomes ( **autolysis** )
* immigrants neutrophil lysosomes (** heterolysis** )
32
whats autolysis?
Lysis caused by enzymes that are derived from death cell lysosomes
33
whats heterolysis?
lysis caused by immigrant neutrophil lysosomes
34
Necrosis
Cytoplasm changes
About 6h after the cell undergoes necrosis
* its cytoplasm becomes **homogenous** and **acidophilic**
( due to:
1. denaturation of cytoplasm proteins
2. loss of ribosomes )
* then we have cytoplasm **vacuolation**
( caused by :
1. swelling of mitochondria
2. disruption of organelle membranes )
* then we have **autolysis**
( enzymatic digestion of cell by enzymes released by own lysosomes )
*
35
In necrosis :
what makes the cytoplasm to be **homogenous** and **acidophilic**?
1. denaturation of cytoplasm proteins
2. loss of ribosomes
36
In necrosis :
what causes **cytoplasm vacuolation**?
1. swelling of mitochondria
2. disruption of organelle membranes
37
Necrosis
nuclear changes ( 3 )
occur in 3 steps :
1. **Pyknosis**
nucleus becomes shrunken , dense, basophilic
2. **Karryorrhexis**
pyknotic nucleus breaks up into numerous small basophilic particles
3. **Karyolysis**
lysis as a result of the action of lysosomal deoxyribonucleases
38
Necrosis
nuclear changes : pyknosis
nucleus becomes :
* **shrunken**
* **dense**
* **basophilic**
39
Necrosis
nuclear changes : Karryorhexis
pyknotic nucleus ***breaks up*** into numerous small *basophilic* particles
40
necrosis
nuclear changes : Karyolysis
lysis results of the action of
**lysosomal deoxyribunocleases**
41
necrosis
how are the ( necrotic ) cells?
initially :
* intensely **eosinophilic**
( due to loss of cytoplasm RNA content )
* **vacuolated**
( due to enzyme digestion of cytoplasm organelles )
42
necrosis
why are the necrotic cells initially eosinophilic?
due to **loss** of cytoplasm **RNA** **content**
43
necrosis
why are the necrotic cells vacuolated?
due to enzyme **digestion** of cytoplasm organelles
44
Necrosis
TYPES ( 6 )
* **Coagulation **
( kidney, heart )
* **Liquefaction **
( brain, pus formation )
* **Hemorrhagic**
( lung )
* **Caseous **
( tuberculosis )
* **Fat**
( acute pancreatitis )
* **Gangrenous**
( dry, wet )
45
coagulative necrosis
what is it? how does it look like? examples.
Is a type of necrosis in with the necrotic cells retain its cellular outline for several days
Occurs in solid organs :
_1. kidney
2. heart
3. adrenal gland_
Result of : deficient blood supply , anoxia
Cell apperance :
devoid of its nucleus , appears as a mass :
* **coagulated**
* **pink staining**
* **homogenous cytoplasm**
46
coagulative necrosis
kidney : renal infraction
macroscopically
* **pale**
* **firm**
* **distinct limits**
on cut section : the infracted zone appears as a triangular pale white area
47
Coagulative necrosis
heart ( myocardial infraction )
microscopically
* nucleus :
* *disappearance**
* cytoplasm :
1. **hypereosinophilic**
2. **homogenous**
48
Liquefactive necrosis
results from?
examples
Results when **lysosomal enzymes** released by necrotic cells cause rapid **liquefaction**
examples :
_1. brain_ ( following ischemia )
_2. pus formation_
49
Hemorrhagic necrosis
what form is it? organs ?
hemorrhagic necrosis is a form of **ischemic** necrosis
occurs in organs with :
* loose structure
* double circulation
results in the:
infiltration of necrosis with blood
examples :
_Lungs_
50
hemorrhagic necrosis
Red pulmonary infraction
macroscopically
the necrotic zone has a **red colour**
because of the entrance of **blood cells** in the territory of necrosis
51
Caseous necrosis
what form is it? appearance? examples
Is a form of **coagulative** necrosis produced by **immune** mechanism
appearance :
**whitish**-**creamy** / **cheesy**
```
examples :
_Tuberculous inflammation ( ex kidney )_
```
52
caseous necrosis
kidney : renal tuberculosis
macroscopically
in caseous necrotic area the structure of the kidney is completely destroyed
and
replaced by cheesy material
53
Fat necrosis / enzymatic necrosis
cause of necrosis?
appearance
example
Occurs in **acute pancreatitis**
when pancreatic *enzymes* are liberated from the
*duct* into the *surrounding tissue*
appearance:
**opaque chalky white plaques**
in the **adipose tissue** surrounding the pancreas
( cloudy white )
example
_Pancreas_
54
Gangrenous necrosis / gangrene
form ?
cause?
types?
Is a form of **coagulative necrosis** of lower limbs
Types :
* **dry gangrene**
(which *lost* **blood** **circulation**)
* **wet gangrene**
(due to *bacterial infection*)
55
Cause of DRY gangrene
lower limbs which **lost blood circulation**
56
Cause of WET gangrene
over added **bacterial infection**
coagulation necrosis is modified by liquafactive
action of neutrophils
57
which types of necrosis can be consindered as coagulative ?
* coagulation necrosis
* caseous necrosis
* gangrenous necrosis
58
Chronic reversible
(cellular adaptation)
definition
adapting cells reactions are *adaptations*
of **cell growth** and **differentation**
in various physiological and pathological
conditions
59
Cellular adaptive reactions
Types
_1. Changes in cell size_
* **atrophy **
( reducing of cell size )
* **hypertrophy **
( increasing of cell size )
_2. Changes in cell number _
* **Involution**
( decreasing in cell number )
* **Hyperplasia**
( increasing in cell number )
_3. Changes in cell differantiation _
* **Metaplasia **
(changing of mature cell
to another mature cell type)
60
Atrophy
definition
Atrophy is an *adapative cell response* characterized by reducing in size of *tissue* or *organ*
by decreasing in **SIZE** of **cell components**
61
Whats the difference of atrophy and
1. agenesis
2. aplasia
3. hypoplasia?
*Agenesis, aplasia* and *hypoplasia* are abnormalities of
organ **development**
while *atrophy* is a decrease in size
of **normally formed** organ
62
Atrophy
Macroscopically
Microscopically
Macroscopically Organ :
* **smaller** than normal in size
* tan / **brown** appearance
Microscopically Cell
* Reduced **size**
* less **organelles**
* many **residual bodies**
63
Atrophy
Causes
causes :
1. decrease in blood supply ( **ischemia** )
2. lack of nutrients ( **malnutrition** )
3. prolonged **tissue compresion **
4. tissue **denervation**
5. loss of **trophic hormones**
64
Atrophy Types
* **Physiological **
( during body development )
* **Pathological**
1. Ischemic atrophy
2. pressure atrophy
-hydrocephalia
-hydronephrosis
65
Athrophy - Physiological
Occurs during body development:
* **fetal life**
* **postnatal life**
( ex. thymus in adolescence )
* **Adult life**
1.myometrium atrophy
( reduced endocrine secretion )
2.generalized senile atrophy elderly
( lack of functional activity and endocrine secretion )
66
Physiological atrophy in adult life
1.**myometrium atrophy**
( reduced endocrine secretion )
2.**generalized senile atrophy elderly**
( lack of functional activity and endocrine secretion )
67
Pathological atrophy
* **Ischemic atrophy**
* **Pressure atrophy**
- hydrocephalia
- hydronephrosis
68
Ischemic atrophy
definition, cause, examples
pathological type of atrophy
A decrease in blood supply ( ischemia ) to a tissue
as a result of arterial disease
examples
1._Atrophy of kidney_
2._Renal parenchyma:(benign nephroangiosclerosis)
3.Heart: ( myocardial ischemic fibrosis )_
All in hypertension
69
Pressure atrophy
definition, cause, examples
Pathological atrophy is caused by
prolonged compression of tissue
( can also be there is compression of small vessels which leads to ischemia and not directly compression of the cells )
examples ( pseudohypertrophy )
* Hydrocephalia
* hydronephrosis
70
Pseudohypertrophy
* **Hydrocephalia **
* **hydronephrosis **
the involved organs have a phalse hypertrophied appearance
71
Hydrocephalia
what is it? causes?
pressure atrophy - pseudohypertrophy
abnormal **accumulation** of **CSF** in *ventricles*
with **atrophy** of cerebral **parenchyma**
Cause :
**Obstruction** of normal drainage of CSF
by **tumor** of coroid plexus
72
Hydronephrosis
what is it? causes?
pressure atrophy - pseudohypertrophy
Dilation of **renal pelvis** and **calices**
with secondary **atrophy** of renal parenchyma
Cause :
**urine stasis**
due to **obstruction** of **urine flow**
73
**Hypertophy**
what is it?
what increased amounts does it have?
causes?
examples
Cellular adaptive reaction
Increasing in cell **SIZE** or tissue,
by increasing the cell components
cells : permanent
increases amounts of :
**cytoplasm**
cytoplasm **organelles** in cells
causes :
1. functional over demand
2. intense endocrine stimulus
examples
_concentric hypertophy of left ventricle in hypertension_
74
Hyperplasia
definition , causes
examples
Cell adaptive reaction
Increase size of tissue or organ
by increasing of **CELL NUMBER **
cells : labile , stable
the cells of the tissue are stimulated to undergo
**mitotic divition**
Causes :
1. **growth factor** in excess
2. **hormonal stimulation** in excess
examples
_1.hyperplasia of mammary gland_
_2.hyperplasia of myometrium
3.hyperplasia of prostate_
75
Hyperplasia
Types
**physiological**
and
**pathological**
( hyperplasia of prostate by hormonal stimulation )
| ( hyperplasia of mammary gland and myometrium during pregnancy )
76
Concentric hypertrophy of left ventricle
Is an adaptive heart reaction in systemic **hypertension**
77
Concentric hypertrophy of left ventricle
macroscopic
macroscopic :
* Thickness of left ventricle
( 3 cm , normally 1.5cm )
* ventricular cavity reduced
78
Concentric hypertrophy of left ventricle
microscopic
Microscopic:
hypertrophy of **myocardial fibers**
* **diameter** of myocardial cells : increased
* nuclei :
1. **enlarged**
2. **hyperchromatic**
3. **irregular** borders
79
Muscular hypertrophy of urinary bladder wall
in prostate hyperplasia
cause? consequences ?
caused by **obstruction** of **prostate urethra**
can lead to 2 things:
1. **hypertrophy** of bladder wall
( incomplete obstruction )
2. severe **atrophy** of bladder wall
( complete obstruction )
