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N230A Pathophysiology > chapter 2: altered cellular and tissue biology > Flashcards

chapter 2: altered cellular and tissue biology Flashcards

1
Q

5 types of altered cellular and tissue biology

A
  1. adaptation
  2. injury
  3. neoplasia
  4. aging
  5. death
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2
Q

with adaptation, cells adapt to their environment to…

A

escape and protect themselves from injury

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3
Q

adaptation is ____ vs _____

A

physiologic vs pathologic

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4
Q

5 types of adaptation

A
  1. atrophy
  2. hypertrophy
  3. hyperplasia
  4. metaplasia
  5. dysplasia
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5
Q

atrophy is…

A

decrease or shrinkage in cell size

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6
Q

hypertrophy is…

A

increase in cell size

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7
Q

hyperplasia is…

A

increase in cell number resulting from an increased rate of cellular division

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8
Q

metaplasia is…

A

reversible replacement by 1 mature cell type to another less mature cell

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9
Q

dysplasia is…

A

deranged cell growth, not cellular adaptation but an atypical hyperplasia

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10
Q

atrophy can lead to

A

entire organ shrinkage

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11
Q

example of physiologic atrophy

A

thymus shrinks after infancy

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12
Q

atrophy is most common in _____, ____, _____, and ____

A

skeletal muscle, heart, secondary sex organs, brain

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13
Q

4 types of atrophy

A
  1. disuse atrophy (workload, neural)
  2. aging
  3. endocrine-dependent (hormonal)
  4. nutrition
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14
Q

hypertrophy is most common in ____ and ___

A

heart and kidneys

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15
Q

hypertrophy is an increase in cell size from increased accumulation of ____ in the cellular components and not with an increase in _____

A

increased accumulation of protein in the cellular components and not with an increase in cellular fluid

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16
Q

triggers for hypertrophy are ___

A

signals

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17
Q

signal types for hypertrophy are ____ and ____

A

mechanical (stretch) and trophic (growth factors, hormones, vasoactive agents)

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18
Q

muscular hypertrophy tends to diminish with removal of _____

A

excessive workload

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19
Q

physiologic hyperplasia can be____ or _____

A

compensatory or hormonal

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20
Q

hyperplasia occurs in cells which can

A

regenerate

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21
Q

_____ and _____ often occur together if cells can synthesize DNA

A

hyperplasia and hypertrophy

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22
Q

In non-dividing cells only ____ occurs

A

hypertrophy

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23
Q

____ hyperplasia is an adaptive mechanism that enables certain organs to regenerate (in the liver, skin, callus)

A

compensatory

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24
Q

___ hyperplasia occurs chiefly in estrogen dependent organs (uterus, breast)

A

hormonal

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25
Q

_____ is reversible replacement of one mature cell type by another less mature cell type

A

metaplasia

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26
Q

dysplasia is…

A

abnormal changes in size, shape, organization of mature cells

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27
Q

dysplasia is not

A

a true adaptive process

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28
Q

dysplasia is AKA

A

atypical hyperplasia

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29
Q

dysplasia is associated with ____ and ____

A

epithelial tissue of the cervix and lung (respiratory tract)

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30
Q

dysplasia has a strong associated with

A

neoplastic growths

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31
Q

cell injury occurs if a cell is unable to

A

maintain homeostasis

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32
Q

when cell injury is reversible you have

A

recovery

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33
Q

when cell injury is irreversible it leads to

A

death

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34
Q

cell injury is classified as ____/____ and ____/____

A

acute/chronic and reversible/irreversible

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35
Q

4 common biochemical themes of cell injury

A
  1. ATP depletion
  2. oxygen and oxygen derived free-radicals
  3. intracellular calcium and loss of calcium steady state
  4. defects in membrane permeability
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36
Q

hypoxia is the ___ of ____

A

lack of sufficient oxygen

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37
Q

4 steps in hypoxia

A
  1. ischemia
  2. anoxia
  3. cellular responses
  4. reperfusion injury
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38
Q

  • -
A
  • dec. atp, causing failure of sodium-potassium pump and sodium-calcium exchange
  • cellular swelling
  • vacuolation
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39
Q

____ is the single most common cause of cell injury

A

hypoxia

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40
Q

Free radicals - aka ____ injury

A

reactive oxygen species injury (ROS)

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41
Q

______ occurs when excess ROS overwhelms antioxidant systems

A

oxidative stress

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42
Q

_____ is an electrically uncharged atom or group of atoms having an unpaired electron

A

free radical

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43
Q

free radicals damage these 4 things

A
  1. lipid per oxidation
  2. alteration of proteins
  3. alteration of DNA
  4. mitochondria
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44
Q

chemical cell injury occurs when there is a biochemical interaction between _____ and the _____

A

toxic substance and the cells plasma membrane

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45
Q

chemical injury leads to

A

increased permeability

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46
Q

a patient sustained a fracture of his R arm 2 mo ago, requiring a cast placement. what kind of adaptation has occurred in the skeletal muscles?

  1. atrophy
  2. hypertrophy
  3. hyperplasia
  4. dysplasia
A
  1. atrophy
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47
Q

which of the following is the most common cause of cellular injury

  1. free radical-induced injury
  2. chemical injury
  3. hypoxia
  4. reactive oxygen species
A
  1. hypoxia
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48
Q

falls, MV injuries, poisonings, errors in healthcare are ____ injuries

A

unintentional

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49
Q

intentional injuries include ___ and ___

A

homicide and suicide

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50
Q

4 types of injuries

A
  1. blunt force
  2. sharp-force
  3. gunshot wounds
  4. asphyxial injuries
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51
Q

leading cause of injury from errors in healthcare

A

medication errors

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52
Q

____ are due to the application of mechanical energy to the body resulting in the tearing, shearing, or crushing of tissues

A

blunt force injuries

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53
Q

___ and ___ are the most common causes of blunt force injuries

A

MVA’s and falls

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54
Q

list 4 types of blunt force injuries

A
  1. contusion vs. hematoma
  2. abrasion
  3. laceration
  4. fractures
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55
Q

a ____ is bleeding into the skin or underlying tissues as a consequence of a blow that squeezes or crushes the soft tissues and ruptures blood vessels without breaking the skin

A

contusion (bruise)

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56
Q

a hematoma is a…

A

collection of blood in soft tissue or an enclosed space

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57
Q

a subdural hematoma occurs between

A

dura matter and the surface of the brain

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58
Q

an epidural hematoma occurs between

A

skull and dura

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59
Q

a _____ is the removal of the superficial layers of the skin and the injuring object

A

abrasion

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60
Q

a _____ is a tear or rip resulting when the tensile strength of the skin/tissue is exceeded

A

laceration

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61
Q

an avulsion is a

A

wide are of tissue pulled away, creating a large skin flap

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62
Q

fractures are when

A

bone breaks or shatters

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63
Q

sharp force injuries include these 4 things

A
  1. incised wounds
  2. stab wounds
  3. puncture wounds
  4. chopping wounds
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64
Q

incised wounds are cuts that are ____ than they re ____

A

longer than they are deep

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65
Q

incised wounds have ____ edges that are distinct and without _____

A

sharp edges that are distinct without abrasion

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66
Q

incised wounds produce significant _____ with minimal _____

A

significant external bleeding with minimal internal hemorrhage

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67
Q

stab wounds are a penetrating sharp-force unhurt that is ____ than it is _____

A

deeper than it is long

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68
Q

with stab wounds the depths of the wound are ____ and ____ without…

A

depths of the wound are clean and distinct, without underlying or associated crush injury

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69
Q

depending on the ____ and ___ of the stab wound it may have only a small amount of external bleeding but copious internal bleeding

A

size and location

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70
Q

puncture wounds are caused by instruments or objects with ____ but without _____

A

with sharp points but without sharp edges

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71
Q

puncture wounds have ____ of wound edges

A

abrasion

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72
Q

gun shot wounds: _____ has blow-back and muzzle imprint

A

contact range entrance wound

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73
Q

gun shot wounds: _____ has tattooing and stippling

A

intermediate range entrance wound

74
Q

type of exit wound with gun shot wounds

A

shored exit wound

75
Q

_____ occur when cells fail to receive or use oxygen

A

asphyxial injuries

76
Q

____ is choking asphyxiation

A

suffocation

77
Q

____ is hanging, ligature, and manual strangulation

A

strangulation

78
Q

cyanide and hydrogen sulfide are

A

chemical asphyxiants

79
Q

drowning results in

A

dry-lung drowning

80
Q

4 types of asphyxial injuries

A
  1. suffocation
  2. strangulation
  3. chemical asphyxiation
  4. drowning
81
Q

an infectious injury occurs due to

A

pathogenicity of a microorganism

82
Q

disease-producing potential depends on:

A
  1. invasion and destruction
  2. toxin production
  3. production of hypersensitivity reactions
83
Q

cellular membranes are injured by direct contact with _____ and _____ of the immune and inflammatory responses

A

cellular and chemical components

84
Q

phagocytic cells include

A

lymphocytes and macrophages

85
Q

list 5 immune and inflammatory substances

A

histamine, antibodies, lymphokines, complement and proteases

86
Q

inflammatory injury causes

A

membrane alterations

87
Q

with cellular injury you will have ____

A

cellular accumulations (infiltrations)

88
Q

7 types of cellular accumulations

A
  1. water
  2. lipids and carbohydrates
  3. glycogen
  4. proteins
  5. pigments
  6. calcium
  7. urate
89
Q

____ is the most common degenerative change with cellular accumulations

A

water

90
Q

infiltrations by lipids and carbohydrates will cause

A

metabolic disorders (liver fatty change)

91
Q

glycogen infiltration causes

A

glycogen storage diseases

92
Q

type of pigment infiltrations

A

hemosiderin, melanin, hemoproteins, bilirubin

93
Q

____ is cellular death leading to cellular dissolution

A

necrosis

94
Q

necrosis is the sum of cellular changes after local cell death and the process of cellular auto digestion or ____

A

autolysis

95
Q

cell death process (3 steps)

A
  1. pyknosis
  2. karyolysis
  3. karyorrhexis
96
Q

major types of necrosis (6)

A
  1. coagulative necrosis
  2. liquefactive necrosis
  3. caseous necrosis
  4. fatty necrosis
  5. gangrenous necrosis
  6. gas gangrene
97
Q

coagulative necrosis occurs in the

A

kidneys, heart, adrenal glands

98
Q

coagulative necrosis commonly results from

A

hypoxia (severe ischemia and chemical injury)

99
Q

coagulation is caused by

A

protein denaturation

100
Q

______ is commonly from ischemic injury to neurons and glial cells of the brain

A

liquefactive necrosis

101
Q

brain cells are rich in _____ and _____

A

digestive hydrolytic enzymes and lipids

102
Q

with liquefactive necrosis cells are digested by their own

A

hydrolases

103
Q

in liquefactive necrosis tissue becomes ____/____ and walled off from _____(_____)

A

tissue becomes soft/liquifies and walled off from healthy tissues (cyst formation)

104
Q

liquefactive necrosis is due to bacterial infection (like _____, _____, _____)

A

staphylococci, streptococci, and escherichia coli

105
Q

____ is usually from tuberculous pulmonary infection

A

caseous necrosis

106
Q

caseous necrosis is due to a combination of ____ and _____

A

coagulative and liquefactive necrosis

107
Q

tissues in caseous necrosis resemble

A

clumped cheese

108
Q

____ is cellular dissolution by action of lipases

A

fat necrosis

109
Q

fat necrosis occurs in _____, _____, and other _______

A

breast, pancreas, and other abdominal organs

110
Q

in fat necrosis lipases break down _______, releasing _______, which combine with calcium, magnesium, and sodium ions, creating soaps (aka _____)

A

lipases break down triglycerides, releasing free fatty acids, which combine with calcium, magnesium, and sodium ions, creating soaps (aka saponification)

111
Q

necrotic tissue appears ____ and ____

A

opaque and chalk-white

112
Q

______ is the death of tissue from severe hypoxic injury

A

gangrenous necrosis

113
Q

dry gangrene is usually the result of

A

coagulative necrosis

114
Q

with dry gangrene skin becomes ____ and ____ (____)

A

very dry and shrinks (wrinkles)

115
Q

with wet gangrene, ____ invade the site causing _____

A

neutrophils invade the site, causing liquefactive necrosis

116
Q

wet gangrene usually occurs in _____

A

internal organs

117
Q

with wet gangrene the site becomes ____, _____, ______, and has a _____

A

cold, swollen, black, ad has a foul odor

118
Q

wet gangrene has _____ associated with high mortality

A

systemic symptoms

119
Q

_____ is a special type of gangrene caused by infection with clostridium sp

A

gas gangrene

120
Q

with gas gangrene ______ produce _____ and toxins that destroy CT and cellular membranes

A

anaerobic bacteria produce hydrolytic enzymes and toxins that destroy CT and cellular membranes

121
Q

with gas gangrene _____ form in ____ and ____

A

bubbles of gas form in muscle and soft tissue

122
Q

gas gangrene is fatal if enzymes _____

A

lyse RBC membranes

123
Q

death with gas gangrene is caused by

A

shock

124
Q

apoptosis is “_____”

A

dropping off

125
Q

programmed cellular death =

A

apoptosis

126
Q

physiological apoptosis is the _____

A

development of body tissue

127
Q

pathological apoptosis is the result of ______ or ______

A

intracellular events or adverse exogenous stimuli (ex. viral hepatitis)

128
Q

3 characteristics of cellular aging

A

atrophy, decreased function, and loss of cells

129
Q

cells become progressively ___ and ____

A

stiff and rigid

130
Q

_____ is aka “poverty of flesh” and is the degenerative loss of skeletal muscle mass and strength due to aging

A

sarcopenia

131
Q

_____ is due to mobility, balance, muscle strength, motor activity, cognition, nutrition, endurance, falls, Fx, and bone density

A

frailty

132
Q

somatic death is the death of

A

an entire person

133
Q

4 postmortem changes

A
  1. algor mortis
  2. livor mortis
  3. rigor mortis
  4. postmortem autolysis
134
Q

in algor mortis the algor comes from the word in latin for

A

cold

135
Q

with _____ the body slowly cools once the heart stops beating

A

algor mortis

136
Q

measuring _____ can approximate the time of death

A

body temperature

137
Q

body loses heat at a rate of ____ degrees per hour until ___ temp is reached

A

1.5 degrees per hour until ambient temperature is reached

138
Q

rate of heat loss after death varies according to _____

A

envi. temp

139
Q

with algor mortis true body core temp is taken ____ or ____

A

rectally or liver

140
Q

once ambient temperature is reached ____ cannot be determined through taking core body temp

A

TOD

141
Q

in livor mortis the word livor is latin for

A

bluish color

142
Q

lividity is

A

black and blue

143
Q

livor mortis is the

A

settling of blood in the lower (dependent) portion of the body

144
Q

livor mortis causes

A

purplish red discoloration of the skin

145
Q

with livor mortis, heavy blood cells sing through the ___ by ____

A

serum by gravity

146
Q

livor mortis starts ___ to ___ after death

A

20 min to 3 hr after death

147
Q

blood is congealed in the capillaries within ___ to ____

A

4-5 hours

148
Q

maximum lividity occurs with ___ - ____

A

6-12 hours

149
Q

rigor mortis comes from the latin word for

A

stiffness

150
Q

the loss of ____ from body muscles after death causes rigor mortis (in which limbs of corpse stiffen)

A

ATP

151
Q

rigor mortis starts __-__ after death

A

2-3 hours

152
Q

rigor mortis progresses ____ (____ to ____)

A

downward, head to toe

153
Q

in ___-___ the whole body is stiff/rigid with rigor mortis

A

12-18 hours

154
Q

at around ___ rigor mortis starts to fade

A

2 days

155
Q

once rigor mortis has passed ___ sets in

A

decay

156
Q

which of the following terms best describes death of a cell from hypoxia, generally as a result of ischemia in the lower extremities

a. coagulative necrosis
b. liquefactive necrosis
c. fat necrosis
d. gangrenous necrosis

A

d. gangrenous necrosis

157
Q

a patient with severe drowning was admitted 5 days ago and has been declared brain dead. what kind of cell death would you expect to find on autopsy of his brain

a. coagulative necrosis
b. liquefactive necrosis
c. fat necrosis
d. gangrenous necrosis

A

b. liquefactive necrosis

158
Q

the ____ encloses the cell and controls the movements of substances across it

A

plasma membrane

159
Q

the plasma membrane is a…

A

bilayer of lipids and proteins

160
Q

the nucleus is surrounded by the ____ and generally is towards the _____

A

cytoplasm and generally towards the center of the cell

161
Q

the ____ is the largest membrane bound organelle

A

nucleus

162
Q

the nuclear envelope contains

A

two membranes

163
Q

two main functions of the nucleus

A

cell division and control of genetic information

164
Q

the ____ is a small dense structure composed of RNA, most of the cells DNA, and the DNA binding proteins that regulate its activity (histones)

A

nucleolus

165
Q

the ER is membrane factory that synthesizes and transports ____ and _____ to most of the cell’s organelles

A

protein and lipid components

166
Q

the smooth er contains _____ involved in the synthesis of ______

A

enzymes involved in the synthesis of steroid hormones

167
Q

the smooth er removes ____ from the cell

A

toxic substances

168
Q

the rough ER is responsible for ____ and _____

A

cells protein synthesis/folding and sensing cellular stress

169
Q

lysosomes are _____ that contain _____

A

saclike structures that contain more than 40 digestive enzymes (hydrolyses)

170
Q

____ are found in large numbers in most cells

A

mitochondria

171
Q

mitochondria are responsible for _____ and _____

A

cellular respiration and energy production

172
Q

the inner membrane of the mitochondria contains enzymes of the respiratory chain and are _____

A

responsible for ATP generation

173
Q

____ is a network of flattened and smooth membranes and vesicles near the nucleus

A

Golgi apparatus

174
Q

the golgi complex _____ and _____ proteins from the ER into _____

A

processes and packages proteins into small membrane-bound vesicles

175
Q

vesicles contain digestive enzymes that break substances into their _____

A

basic components

176
Q

microvilli are ____ that _____

A

cytoplasmic projections that INC cells surface area

177
Q

microvilli are often found on cells whose main function is ___ and ____

A

secretion and absorption (epithelial cells in the digestive tract)

178
Q

ribosomes provide sites for ____

A

cellular protein synthesis

179
Q

the cytoplasm is an aqueous solution that fills the space between the ___ and ____

A

nucleus and plasma membrane

180
Q

cilia are hairlike projections that propel ___ , ___, and ____ out of the body

A

mucus, pus, and dust particles

181
Q

cilia characterize the cells that line the

A

respiratory tract

N230A Pathophysiology (3 decks)

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