Introduction, Cell physiology, body tissues, cellular adaption and cell death, inflammation and tissue repair Flashcards
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Physiology
mechanism of human body functioning
- different systems
pathology
branch of medicine, investigates the essential nature of the disease, especially changes in body tissues and organs that cause or are caused by the disease
clinical pathology
pathology applied to solution of clinical lproblems, esp. use of lab methods in clinical diagnosis
- body tissues
- body fluids
histology
microscopic study of tissues
pathophysiology
study of functional changes that occur in the body as a result of an injury, disorder or disease; often referred to as study of the mechanism of disease
ascites
fluid in abdominal cavity
pathogenesis
development of cellular events and reactions and other pathologic mechanism that occur in the development of the disease, basically how a disease develops
what is a cell?
building block of living organism
basic unit of the body
- more than 100 trillion cells
cell membrane/plasma membrane job
- protects the cell from environment while also being selective permeable; lipid bilayer
- cells have gates that open and close by proteins, chemical signals and electric charges
cytoplasm is
colorless viscous liquid containing water, nutrients, ions, dissolved gases and wastes products
organelles in cell (little organs)
nucleus, nucleolus, endoplasmic reticulum, ribosomes, golgi proteins, lysosomes, mitochondria, cytoskeleton
nucleus
control center of cells, regulates cell growth, metabolism and reproduction, contains genetic information (DNA)
nucleolus
produces RNA (translates genetic information)
endoplasmic reticulum
synthesis enzyme and proteins, lipids, and hormones
-smooth and rough
smooth ER
no ribosomes attached
rough ER
ribosomes attached
ribosomes
aid in protein production
golgi proteins
sorts, chemically modifies, packages proteins produced on the endoplasmic reticulum
lysosomes
digests excess or worn out organelles, food particles, virus, bacteria
mitochondria
complete breakdown of glucose and produces adenosine triphosphate (ATP), powerhouse of cells
cytoskeleton
internal support, helps with transportation
body tissues
structure and function of cells are specialized (differentiation) depending on where they are present in the body
group of cells makes up
tissues
types of tissues in the body
nervous, muscle, epithelial, connective
nervous tissue parts
neurons
muscle tissue types
skeletal muscle, smooth muscle, cardiac muscle
connective tissue types
blood cells, bone cells, fibroblasts, elastin, collagen
epithelial tissue covers
the outer surface of body and lines GI, respiratory, GU tract, secretory portion of glands and ducts
functions of epithelial tissue
- serve as barrier, physical protection
- absorption (villi)
- filtration (cilia)
- secretion
- permeability
- regeneration
types of epithelial tissue according to shape
squamous (thin/flat)
cuboidal (cube)
columnar (column)
where is cuboidal epithelial tissue found
surface of ovary and thyroid
where is columnar epithelial tissue found
lines intestine
types of epithelial tissue based on number of layers
- simple
- stratified
- pseudostratified
simple epithelial tissue has ______ layer(s)
1 layer
stratified epithelial tissue has ______ layer(s)
multiple
pseudostratified epithelial tissue has ______ layer(s)
looks like multiple but is 1 layer
simple epithelial tissue has _____ layer of cells
single
what is simple epithelial tissue designed for
filtration, absorption, or secretion
simple squamous covers…
lines blood vessels (endothelial cells), lymph nodes, and alveoli of lungs
simple cuboidal covers…
glands
simple columnar covers…
digestive tract
simple cuboital
columnar
stratified epithelial tissue
more than one layer of cells with deepest layer resting on the basement membrane, designed to protect body surfaces (lining of mouth and skin surfaces
types of stratified epithelial tissue
stratified squamous
stratified cuboidal
stratified columnar (rare)
stratified squamous covers…
skin
stratified cuboidal covers…
sweat glands, salivary glands
stratified columnar covers…
conjunctiva
stratified squamous
stratified cuboital
stratified columnar
pseudostratified columnar ciliated
all cells are in contact with underlying intercellular matrix but some do not extend to the surface
pseudostratified epithelial tissue
transitional epithelium
stratified epithelium with cells that can change shape and become thinner when the tissue is stretched
lining of organs that constantly change volume (urinary bladder, urethra, ureters)
transitional epithelium
what does connective tissue do
connects/binds/supports various tissues, fills body spaces, produce blood cells
- produce extracellular matrix
components of connective tissue
cells (fibroblast, macrophages, lymphocytes)
extracellular protein fibers (collagenous fibers, elastic fibers)
ground substance (unstructured material filling spaces between cells and containing fibers)
types of connective tissue
- tendons, ligaments
- adipose tissue
- cartilage
- bone
- blood and lymph
Marfan Syndrome
genetic condition that affects CT
can damage blood vessels, heart, eyes, skin, lungs, and bones
RARE (1 in 5000)
mutation changes the proteins needed to build CT
characteristics of Marfan Syndrome
- tall and slender build
- disproportionately long arms, legs, and fingers
- high arched palate
- nearsightedness
- abnormally curved spine
- flat feet
- aortic aneurysm
muscle tissue
contraction, movement of body and its parts and changes in size and shape of internal organs
3 types of muscle tissue
skeletal, smooth, cardiac
skeletal muscle characteristics
- long and cylindrical
- striated
- voluntary
smooth muscle characteristics
- nonstriated
- spindle shape
- involuntary
- intercalated disks/gap junctions
cardiac muscle characteristics
- shorter, branched
- involuntary
- striated
- intercalated disks/gap junctions
skeletal muscle
smooth muscle
cardiac muscle
red
perimysium
orange
fascicle
yellow
endomysium
green
sarcolemma
blue
epimysium
purple
myofibril
red
z-line
orange
h-zone
yellow
A band
green
I band
blue
M line
purple
myosin (thick) filaments
pink
actin (thin) filaments
heads have actin-binding site that is necessary for
cross bridge formation
hydrolyzes ATP
tropomyosin covers
binding sites on actin
there are ___ types of troponin
3
troponin T
attaches troponin to tropomyosin
Troponin I
inhibits the interaction between action and myosin
troponin C
calcium-binding protein
sarcolemma
muscle cell membrane
transverse T tubule
extensive network of muscle cell membrane
invaginates deep into the muscle fiber
carry depolarization from action potential at muscle cell surface to the interior of the fiber
Sarcoplasmic reticulum (SR)
- myofibrils are surrounded by SR
- site for storage and release of calcium for excitation-contraction coupling
- calcium is accumulated in the SR by the action of calcium ATPase in the SR
- pumps calcium from ICF of muscle fiber into the interior of SR
Steps in excitation-contraction coupling
- action potential in muscle membrane propagated to T tubules, that carry depolarization from surface to the interior of the muscle fiber
- depolarization of T tubules
- open SR calcium release channels
- increase intracellular calcium concentration
- calcium binds troponin C
- tropomyosin moves and allows interaction of actin and myosin
- cross-bridge cycling
- contraction/force generation
ATP =
force/energy
what is sliding filament theory
how muscles contract by describing the movement of actin and myosin filaments within muscle fibers
what happens to the A band during contraction of muscle?
A band remains the same
cardiac muscle cells are called
cardiomyocytes
intercalated disks contain
gap junctions that allow coordinated contraction of heart muscle
increase in troponin and other cardiac enzymes in blood used to help diagnose
heart attack
normal range of troponin
below 0.04ng/ml
heart attack range of troponin
above 0.40ng/ml
smooth muscle is an
involuntary muscle
smooth muscle lacks striations because
thick and thin filaments are not organized in sarcomeres
smooth muscle is found in
walls of hollow organs
- GI tract
- bladder
- uterus
- bronchioles
- eye muscles
functions of smooth muscle
to produce motility and maintain tension
what does smooth muscle rely on for protein binding
calmodulin
what shape is smooth muscle
spindle shape
cells are constantly challenged with stressors like
changes in oxygenation, temp, toxins, etc.
irreversible cell injury results
cell death
reversible cell injury results
normal cell adaptation
cell is able to recover homeostasis after the removal of stress
cellular adaptation
adapt by undergoing changes in size, number, type
can cells reverse their changes
potentially
adaptations to cells may lead to
- atrophy
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
red
normal
orange
atrophy (decreased cell size)
yellow
hypertrophy (increased cell size)
green
hyperplasia (increased cell number)
blue
metaplasia (conversion of one cell type to another)
purple
dysplasia (disorderly growth)
Atrophy characteristics
- decrease in cell size
- reduce oxygen consumptionc
causes of atrophy
-disuse (casted)
- denervation
- inadequate nutrition
- ischemia or decreased blood flow
physiologic atrophy
ageing
pathologic atrophy
muscle wasting due to spinal cord in injury
cerebral atrophy
cerebrum shrinking
- common feature of many diseases that affect the brain
- TBI
- infections
hypertrophy characteristics
- increase in cell size
- due to blockages
- seen in cardiac and skeletal muscle (cannot divide and form more cells)
cause of hypertrophy
increase in workload
increase in growth/trophic signals
increased hormonal output
result of normal physiologic hypertrophy
breast cells during pregnancy; increased muscle after exercises
result of abnormal pathologic hypertrophy
left ventricular hypertrophy
hyperplasia
increase in number of cells in an organ or tissue
- calluses
normal hyperplasia
breast enlargement during puberty, callus after prolonged use
abnormal hyperplasia
endometrial hyperplasia
metaplasia
one adult cell type is replaced by another adult cell type
what causes metaplasia
chronic irritation/inflammation
what is an example of metaplasia
GERD (causes narrowing of the esophagus
dysplasia
deranged cell growth of a specific tissue that results in cell that vary in size, shape, and organization
dysplasia is a precursor of what
cancer
what if the cells do not have the ability to adapt to stressors?
the cells will die
what are reversible cell injuries
swelling, membrane blebs
what are irreversible cell injuries
alteration in cell nucleus, mitochondria, and lysosomes
rupture of cell membrane
dead cells release contents into the ECF
Creatinine kinasae (CK-MM) found mostly in
skeletal muscles
Creatinine kinasae (CK-MB) found mostly in
heart muscle
Creatinine kinasae (CK-BB) found mostly in
brain tissue
necrosis
occurs in irreversibly damaged cells
- initiate inflammation
- due to stress
apoptosis
programmed cell death
- does not initiate inflammation
- suicide of cell
- plan of the body for normal aging
types of inflammation
acute and chronic
what are the body’s lines of defense
- skin and mucous membrane
- inflammation
- immunity
neutrophil
fast acting
defense against foreign substances like bacteria, fungi
monocytes
baby macrophages
immature macrophages, clean up debris/damaged cells
eosinophils
attack parasites, cancer cells and play a role in asthma and allergy
basophils
sneezing
produce allergic responses
lymphocytes (T and B)
“killing”
immune system
produce antibodies, kills antigens
what is inflammation?
all disease process cause injury and healing occurs with an effective inflammatory response
host’s protective response
add -itis
acute inflammation
appears within minutes to hours
chronic inflammation
days to years
altered inflammatory response
cardinal signs of inflammation
redness, swelling, heat, pain, loss of function
rubor =
redness
tumor =
swelling
calor =
heat
dolor =
pain
functio lasea =
loss of function
acute inflammation occurs in two phases
vascular and cellular phases
vascular phase of inflammation
tissue edema
momentary vasoconstriction followed rapidly by vasodilation
permeability increases
increased blood flow + increased permeability =
loss of exudate
(causes swelling, pain, and impaired function)
what is exudate?
protein rich fluid, fibrin, leucocytes
fibrinogen is an abundant plasma protein that
provides the main building blocks for the clot
cellular response events in sequence
chemotaxis (rolling), adhesion to the endothelium (find hole), transmigration across the endothelium (fill hole)
cells that are active in the cellular phase
- leukocytes/WBCs
- red blood cells
- platelets
- connective tissue cells (fibroblasts)
- elastin and collagen
neutrophils
type of WBC, earliest phagocytic responders
monocytes
immature macrophages
macrophages
type of WBC, phagocytes associated with chronic inflammation
red blood cells carry
oxygen to tissues
platelets do what
trap harmful substances, stops bleeding
fibroblasts do what
produce and replace connective tissue
mediators (cytokines) of inflammatory processes is
measuring parts of the blood
angiogenic is
more blood vessels
nonpharmacological treatment
rest, ice, compression, elevation
pharmacological treatment
aspirin, NSAIDS, steroids
how does White Blood cell count change with inflammation
increased
how does C-reactive protein (CRP) change with inflammation
increased
how does Prothrombin (time to coagulate) change with inflammation
reduced
how does fibrinogen change with inflammation
increased
how does white blood cell differential change with inflammation
neutrophils increase in acute inflammation
how does erythrocyte sedimentation rate (ESR) change with inflammation
increased, often above 100 mm/hr
erythrocyte sedimentation rate is
how fast blood samples (erythrocytes) sediments along a test tube in one hour
conditions associated with high ESR
cancer, autoimmune diseases, infections
CRP is synthesized in the
liver
CRP enhances
phagocytosis by macrophages
what is the correct sequence?
1. white blood cells migrate
2. phagocytosis of irritant
3. irritant enters the tissue
4. redness, heat and edema
5. inflammatory mediators
6. blood vessels dilate
7. cellular damage
3, 7, 5, 6, 4, 1, 3
tissue repair is
overlaps the inflammatory process; response to tissue injury - to maintain normal structure and function
2 types of tissue repair
regeneration and replacement
regeneration is
injured cells replaced with cells of same type leaving no evidence of previous injury
replacement is
with connective tissue - scar
phases of wound healing
- inflammation (5-10 days)
- proliferation and migration (3-20 days)
- remodeling and maturation (past 21 days)
fibronectin
provides structural support to the healing tissue
stabilizes fibrin which helps with blood clot
attracts fibroblasts and macrophages to the healing tissue
proteoglycans
secreted by fibroblasts, helps aid in hydration and stabilizing tissue during repair
elastin
secreted by fibroblasts, provides elasticity to tissue
collagen
- structural support and tensile strength for all tissues and organs
- each collagen type has a specialized function
- skin - mostly type 1 collagen
- hyaline cartilage - type 2 collagen
- vascular and visceral structure - type 3 collagen
factors that affect tissue healing
- growth factors
- general health of an individual
- presence of comorbidities
- infection
- off loading weight bearing surfaces may be necessary
- lack of desire to exercise or follow plan of care
- nutrition
- oxygen
inflammatory phase
begins at the time of injury
- vascular and cellular phase
- migration of phagocytic white blood cells into the injured area
proliferative stage
- building of new tissue to fill the wound space
- fibroblasts
- angiogenesis (formation of new blood vessels)
- granulation tissue: rich network of developing blood vessels with connective tissue matrix reddish granular layer of tissue
- re-epithelialization, epithelial cells at wound edges proliferate to form new surface layer “bridging the gap”
remodeling phase
begins 3 weeks after injury, can continue for 6 months or longer
- development of fibrous scar
- scar tissue changes from red to pink to white
types of wound closures
primary intention (wound healing quick)
secondary intention (pressure ulcers, longer repair time)
complications of healing include
infection, ulceration, adhesions, dehiscence, keloid development
using corticosteroids is bad for people with
wounds
using corticosteroids is good for people with
autoimmune diseases, RA, etc
hypertrophic scar/keloid is
excessive production of scar tissue
black wound means
dead
presence of necrosis/ delayed healing
yellow wound means
infected
wound exudate + adherent = bacterial growth
need to debride
red wound means
healing
granulation tissue
stage 2
- blood vessels
pink wound means
covered wound
end of stage 2
red/yellow wound means
need to remove yellow
promote growth of red granulation tissue
chronic inflammation
represents a persistent/recurrent state of inflammation lasting several weeks or longer
cells of chronic inflammation
monocytes, macrophages
fibroblasts
in some cases, chronic inflammation results in
granuloma
