Cell Injury and Healing Flashcards
Aetiology
The cause of disease (eg smoking)
Pathogenesis
The mechanism causing the disease (eg. genetic alteration)
Pathology
Molecular and morphological consequences of disease (eg. lung tumour)
Clinical manifestation
Signs and symptoms (eg breathlessness)
Complications
Secondary systemic or remote consequence of disease (eg metastasis)
Prognosis
The anticipated course of the disease (what happens next)
Epidiemiology
Incidence, prevalence and distribution, we look at how the disease affects the community
Pathogenesis of cell injury- general
- Reduced ATP synthesis/mitochondrial damage
- Loss of calcium homeostasis
- Disrupted membrane permeability
- Free radicals
Hypoxia
Ischaemia, inadequate oxygen supply -Local, eg. embolus -Systemic, eg. cardiac failure Hypoxaemia, an abnormally low level of oxygen in the blood -Oxygen problems, eg altitude -Haemoglobin problems, eg anaemia Oxidative phosphorylation- an effect on the chain by something -Cyanide (or other) poisoning
Effects of ROS
Lipid peroxidation, protein modifications, DNA damage
Principal structural targets for cell damage
Mitochondrial damage -decr. ATP -Incr ROS Entry of Ca -Incr Mitochondrial permeability, activation of multiple cellular enzymes Membrane damage -plasma-loss of cellular components -lysosomal- digestion of cellular components -Protein misfolding
Heat shock response genes
Expression up-regulated with stress, clean up damaged proteins. Can pre-stress tissues and organs, improve organ transplantation
Pyknosis
Irreversible condensation of chromatin in the nucleus of a cell
Karyorrhexis
Fragmentation of the nucleus
Karyolysis
Complete dissolution of the chromatin of a dying cell
Abnormal accumulations in cell death
Lipids, proteins
Coagulative necrosis
- Basic shape of tissue remains
- Most common in ischaemia
- Dead cells usually replaced by scar (fibrosis)
Liquefactive necrosis
- Complete dissolution of necrotic tissue
- Commonly because of massive infiltration of neutrophils (abscess formation)
- Ischaemia in brain
Caseous necrosis
Amorphous debris within an area of necrosis
-tissue architecture abolished, viable cells unrecognizable
-Tuberculosis, some fungal infections
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Infarction
Area of ischaemic necrosis in a tissue or organ
- White
- Red/hemorrhagic
Scarring
Injured tissue is replaced through regeneration of surviving cells and filling of residual defects with connective tissue-scars can be temporary (collagen rich, part of repair) or permanent (fibrotic)
Cells in healing
Fibroblasts
Endothelial cells
Epithelial cells
Osteoblasts
Fibroblasts
A cell in connective tissue which produces collagen and other fibres.
Growth factors- function
- stimulate cell division and proliferation
- cell migration
- promote cell survival