Chapter 2: Cell Injury Flashcards
What are the factors that affect cell injury?
5 points
Injured tissue type Duration Severity Adaptability Genetic Makeup
What are the 2 examples that adapt to Hypoxia?
Brain tissue
Skeletal muscles
Describe the Brain tissue in response to Hypoxia
Very sensitive
For how long can the Brain tissue adapt to Hypoxia?
2-5 min
For how long can the Skeletal muscles adapt to Hypoxia?
2-6 hours
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
What are the 2 forms of Oxygen Deprivation?
Hypoxia
Ischemia
What are the 2 types of Physical agents?
Heat
Cold
Describe these 2 Physical agents
Excess
What are the 2 forms of Nutritional Imbalances?
Starvation
Obesity
What is the most important cause of cell injury?
Oxygen deprivation
Define Adaptation
Cell modification
What are the 2 cell factors which are modified in Adaptation?
Morphology
Function
What gave rise to cell Adaptation?
Stress
Describe Adaptation
Reversible
What is a function of Adaptation?
Preserve
What does Adaptation preserves?
Cell viability
What are the 4 types of Adaptations?
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
What are affected in Atrophy?
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?
Decrease
What cause a decrease in size and weight of tissues or organs in Atrophy?
Parenchymal cells
What exactly in the Parenchymal cells causes a decrease in size and weight of tissues or organs in Atrophy?
Component
What are the 3 affected components of the Parenchymal cells that cause this decrease?
Number
Size
Number & Size
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
