- process that begins with ischemia - ends with degradation of plasma membrane

Chapter 4 Flashcards by Jon Zadok

Hydrophobic swelling

cellular swelling due to accumulation of water
 - first manifestation of most 
   forms of reversible cell injury
 - comes from malfunction of 
   NaK+ pump
 - any injury that results in loss 
   of ATP will also result in it

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Characteristics of hydrophobic swelling

large pale cytoplasm
dilated ER
Swollen mitochondria
increase in size and weight

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Intracellular accumulaions

excess accumulations of substances in cells. Can lead to cellular injury due to :

toxicity
immune response
taking up cellular space

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Characteristics of Intracellular Accumulations

accumulation of excessive amounts of normal intracellulat substance
accumulation of abnormal substances from faulty metabolism or synthesis
accumulation of pigment or particles that cell is unable to degrade
common site of accumulation ; liver
limit protein damage; chaperone proteins and ubiquitin-proteosome complex

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Atrophy

cells shrink and reduce their differentiated functions in response to normal an injurious factors

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General causes of Atrophy

disuse
denervation
ischemia
nutrient starvation
interruption of endocrine signal
persistent cell injury

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Hypertrophy

Increase in cell mass accompanied by an augmented functional capacity in response to physiologic and pathophysiologic demands

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General cause of hypertrophy

increased cellular protein content

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Hyperplasia

increase in the functional capacity related to an increase in cell number due to mitotic division

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Causes of Hyperplasia

usually in response to increased physiologic demands or normal hormonal stimulation
persistent cell injury
chronic irritation of epithelial cells

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Metaplasia

Replacement of one differentiated cell type with another

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Cause of Metaplasia

adaptation to persistent injury, with replacement of a cell type that is better suited to tolerate injurious stimulation (smokers)
(is fully reversible)

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Dysplasia

Disorganized appearance of cells because of abnormal variations in size, shape, and arrangement 
 - represents an adaptive effort 
   gone astray
 - significant potential to 
   transform into cancerous cell

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Necrosis (irreversible)

usually occurs as a consequence of ischemia or toxic injury (cell death)

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Coagulative Necrosis

process that begins with ischemia

- ends with degradation of plasma membrane

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Liquefactive Necrosis

occurs with dissolution of dead cells
liquification of lysosomal enzymes
formation of abscess or cyst from dissolved dead tissue

Fat Necrosis

death of adipose tissue
usually the result of trauma or pancreatitis
appears as a chalky white area of tissue

Caseous Necrosis

characteristic of lung damage secondary to tuberculosis

- resembles clumpy cheese

Reversible Cellular Damage

includes hypertrophy, hyperplasia, atrophy, metaplasia, and dysplasia
characterized by cell rupture, spilling of contents into extracellular fluid, and inflammation

Gangrene

cellular death in a large area of tissue

- results from the interruption of blood supply to a particular part of the body

Dry gangrene

a form of coagulative necrosis characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue

Wet gangrene

a form of liquefactive necrosis that is typically found in internal organs. Can be fatal

Gas Gangrene

Results from the infection of necrotic tissue by the anaerobic bacteria clostridium. Characterized by the formation of gas bubbles in damaged muscle tissue. Can be fatal

Apoptosis

Occurs when an injury does not directly kill the cell. Cell suicide. Doesn’t cause inflammation

Local and systemic indicators of cell death (necrosis)

- pain - ELEVATED SERUM ENZYME LEVELS - Inflammation - loss of function

Troponin

troponin levels are tested to confirm heart attack

Types of necrosis as related to tissue type

Heart(coagulative) Brain(liquefactive) Lung(caseous) Pancreas(fat)

Lipase

levels are checked when abdominal pain is present

Tissue Hypoxia

most often caused by ischemia; causes power failure in the cell (mitochondrial death). Disrupts oxygen supply and accumulates metabolic waste (tissue hypoxia to the whole body is less likely to cause death than hypoxia to a specific area)

Ischemia

- a restriction in blood supply to tissue - cellular events that lead to lactic acidosis (a rise in lactic acid that causes damage to the cell) - can be reversible up to a point

Reperfusion

when a blockage is removed and there is a rush of oxygenated blood to the ischemic area. This causes damage to the cell through calcium overload, formation of free radicals, and inflammation

Common causes of malnutrition

``` poverty chronic alcoholism acute/chronic illness self imposed dietary restrictions malabsorption syndromes ```

Weight numbers

BMI > 27 = health risk (overweight) | BMI > 30 = obesity

Factors of physical and mechanical injury

``` extreme temps abrupt changes in atmosphereic pressure mechanical deformation electricity ionizing radiation ```

- emia

coming from or of the blood

- tosis

abnormal or diseased condition

Somatic Death

``` death of the entire organism. Results in: - Rigormortis - release of lytic enzymes in body tissues (postmortem autolysis) - Brain death ```

Rigor Mortis

presence of stiffened muscles throughout body after death