CELLULAR INJURY AND CELL DEATH Flashcards
• Alteration in cell structure or function due to stress or pathologic stimuli
• This is the most common response of the cells in almost all types of diseases.
CELLULAR INJURY
CAUSES OF CELLULAR INJURY
HPCIING
Hypoxia
Physical Agents
Chemical Agents and Drugs
Infectious Agents
Immunologic Reactions
Nutritional Imbalances
Genetic Abnormalities
There is loss of oxygen level on that specific organ or on that specific cell
Hypoxia
This can be due to accidents or any form of physically-induced type of injury
Physical Agents
Chemical and drugs that can be harmful to the body
Chemical Agents and Drugs
• Bacteria, parasites, and the viruses.
Infectious Agents
• Allergies
Immunologic Reactions
• Comes from parents; passed to you during pregnancy
Genetic Abnormalities
There is no homeostasis on the tissues that resulted to cellular injury
Nutritional Imbalances
MORPHOLOGICAL ALTERATIONS
• Generalizing swelling of cells and organelles
• Blebbing of plasma membranes
• Detachment of ribosomes from ER
• Clumping of nuclear chromatin
• The first and foremost or the earliest manifestation of cell iniurv
Generalizing swelling of cells and organelles
This one is due to increase in the number of free radicals and the plasma membrane will now protrude.
The protruded portion of the lasma membrane is called the Blebs.
Blebbing of plasma membranes
The ribosomes wil now be detached on the endopasmic reticulum, specifically the rough endoplasmic reticulum.
Detachment of ribosomes from ER
Cell injury vs Cell suicide
Necrosis vs Apoptosis
Cell size
Apoptosis: Reduced
Necrosis: Enlarged
Plasma membrane
Apoptosis: Intact
Necrosis: Disrupted
Cellular contents
Apoptosis: Intact
Necrosis: Enzymatic digestion
Adjacent inflammation
Apoptosis: No
Necrosis: Frequent
Nucleus
Apoptosis: Fragmentation into nucleosome size
Necrosis: PKK (Pyknosis > Karyorrhexis > Karyolysis)
Physiologic or Pathological
Apoptosis: Physiologic
Necrosis: Pathologic
(clumping) nucleosome-size
-> fragments (fragmentation) ->
(dissolution)
Pyknosis
Karyorrhexis
Karyolysis
-• Induced by a tightly regulated suicide program in which cells destine to die activate enzymes that degrade the cells’ own proteins and nuclear DNA
APOPTOSIS
Presence of cleaved _______ is a marker for cells undergoing apoptosis
active caspases
These are cysteine proteases that can cleave the aspartic residue.
CASPASES
Apoptosis
Cells break up into______, which are tasty targets for_____
apoptotic bodies
phagocyte
• The outcome usually of the cells that undergo apoptotic death is_____, the cell membranes and components are still_____, and there is no any form of_____.
shrunken
intact
leakage
The cause of this one can be hypoxia, physical agents, chemical agents, or biological products
Apoptosis
REASONS IN FOLLOWING CONDITIONS
Physiologic
Pathologic
• Eliminates cells that are no longer needed or those that have served their purposes
• Its timespan is alread finished
PHYSIOLOGIC
• Eliminates cells that are injured beyond repair without eliciting host reaction
PATHOLOGIC
• Consequence of severe injury
NECROSIS
TYPES OF NECROSIS ACCORDING TO LOCATION OR EXTENT
Focal
Massive
Necrosis
______
The inflammation or the injury only happened on the certain area of the body
______
The inflammation or the injury is widespread.
FOCAL
MASSIVE
TYPES OF NECROSIS ACCORDING TO MORPHOLOGY
Coagulative
Liquefactive
Gangrenous
Caseous
Fat
Fibrinoid
• Tissue is firm because architecture is preserved
COAGULATIVE
• Eosinohilic due to denaturation and precipitation of cellular proteins AND enzymes
COAGULATIVE
Occurs on affected tissue when vessel is obstructed leading to ischemia (except brain)
Coagulative
- localized area of necrosis
Infarct
Main cause of coagulative
Ischemia
• lack/low oxygen supply on organ/tissue
ISCHEMIA
This ty of necrosis appears to be firm. It looks like it was cooked. The tissues will appear dull or dirty.
Coagulative
Tissue becomes liquid viscous mass due to digestion of dead cells
Liquefactive
This can lead to pus formation. There is liquefaction. There is a softening of an infected part.
Liquefactive
Occurs during microbial infection
Liquefactive
It appears creamy yellow because of pus
Liquefactive
Liquefactive necrosis affects
Central Nervous System
This is considered as a “massive tissue death”
Gangrenous
Due to ischemia (loss of blood suppy); may be superimosed with bacterial infection
Gangrenous
Combination of coagulation and liquefaction necrosis
Gangrenous
Two Types of Gangrenous Necrosis:
Dry gangrene
Wet gangrene
arterial occlusion and ischemic type of necrosis.
Dry gangrene
There is a sharp demarcation line.
The demarcation line determines up to what extent the gangrene is.
Dry gangrene
Gangrene
As to the odor, it is less foul because there is less bacterial action.
Dry gangrene
Gangrene
This is a venous occlusion and the odor
Wet gangrene
Gangrene
more foul because there is increased bacterial actions plus ischemic injury. The appearance looks like it is rottening.
Wet gangrene
Gangrene
There is no sharp demarcation line.
Wet gangrene
Gangrene occlusion
Dry: Arterial
Wet: Venous
Gangrene odor
Dry: less foul
Wet: more foul
Demarcation line
Dry: Sharp
Wet: None
• Cheese-like
• Friable white appearance of necrotic area
CASEOUS
CASEOUS
Seen in
tuberculosis, granuloma
Fat destruction due to______
pancreatic lipase
Lipase splits the neutral fats into____&_____ without affecting the cell membrane
fatty acids (FA) and glycerol
____ + ____ = Chalky-white
areas soap-like appearance (fat saponification)
Fatty Acids + Calcium
FAT seen in
Acute pancreatitis
• Seen in immune reactions when antigen-antibody complexes are deposited in walls of arteries
FIBRINOID
Antigen + Antibody
Immune complex
Immune complex + fibrin=_______
bright pink and amorphous appearance in H&E staining.
fibrinoid
Fibrinoid = _____ + ______
Immune complex (antigen+antibody)
+
Fibrin