Pathophysiology

The Cause

The Development

The Symptoms

genetic

Born with it

Screwed up chemical reactions

tissues/organs progressively degrate over time

abnormal growth of cells

dealing with the immune system

invastion of virus, bacteria, or parasite

like altitude, wetness, radiation, lightning, fire

nutrients not available

due to medical intervention

mental or emotional connection

unknown cause

• Inherited
• Congenital
• Metabolic
• Degenerative
• Neoplastic
• Immunologic
• Nutritional Deficiency
• Psychogenic

• Physical Agent Induced:
• Force
• Temperature
• Humidity
• Radiation
• Electricity
• Chemicals

• Infectious:
• Pathogenic organisms
• Viruses
• Bacteria
• Fungi
• Protozoa
• Insects
• Worms

Poor Perfusion or intterrupted blood flow

Lack of oxygen --> ATP deficit --> decrease in ion pump activity --> Na and water accumulate in the cytosol and in organelles --> anaerobic respiration --> acidification --> enzyme dysfunction due to abnormal pH

Ca ²⁺ ions suddenly become available --> enter cells and activate destructive enzymes that target lipids --> cell contents spill --> local immune cells activated --> Chemokines are released from immune cells --> Neutrophils arrive and release reactive oxygen species --> Inflammation

Lack of essential vitamins and minerals prevents cell funcion and cell division

Bacterial enzymes damage host connective tissue and plasma membranes --> bacterial exotoxins interfere with host neuromuscular signals --> Bacterial endotoxins cause inflammation

the immune system is activated by chemicals that are associated with injured host cells and/or infective agents

• free radicals that damage
• antimetabolites interfere with DNA synthesis
• conversion to toxic compounds

• Extreme cold
• extreme heat
• extreme atmospheric pressure
• Mechanical deformation --> cell membrane tear, ischemia, blunt force
• Electric Current --> disrupts neuromuscular signaling, causes burns, causes blood clots

• genetic damage
• acute cell destruction

damage is caused by breaking chemical bonds and by generating free radicals

Decreased ATP stalls Na+/K+ pumps --> Na+ accumulates inside cell

• Swelling of cells
• Large, pale cytoplasm
• Dilated ER
• Swollen mitochondria

• excess accumulation of normal stuff (e.g. fat, carbs, glycogen, proteins)
• OR
• excess accumulation of abnormal stuff
• OR
• excess accumulation of pigments/particles the cell normally would degrade

Cells become smaller and less active

• Disuse
• Lack of nutrients or oxygen
• Lack of hormonal stimuli
• Aging
• Injury due to inflammation or infection

• BIGGER cell
• may be more active or develop abnormal activities

• MORE cells
• cells divide more often so more cells then normal are present

• Caluses
• Liver cells in the presence of toxins
• Blood vessel endothelial cells in artherosclerosis

One normal cell type change to another cell type

e.g. ciliated columnar changes to stratified squamous in smoker's bronchi

• Normal cells go abnormal but are not yet malignant
• Abnormal variations in cell shape, size, and arrangement

Necrosis and Apoptosis

Ischemia or toxic injury

cell rupture, contents spill into extracellular space, inflammation

• cell commits suicide
• cell in ingested by neighboring cells

high intracellular Ca⁺² levels cause activation of destructive enzymes --> internal structures destroyed --> cell contents fine way into bloodstream --> inflammation, malaise, fever, increased heart rate, WBC increased, loss of appetite

• Coagulative Necrosis
• Liquefactive Necrosis
• Caseous Necrosis
• Fat Necrosis

• ischemia
• deals with denatured proteins and is solid

• inschemia in the brain tissue or a bacterial infection in any tissue with WBC involved
• causes cyst or abscess

• mycobacterial infection or tumors
• debris gets walled off by WBCs

• due to injury to fat or pancreatitis
• causes fatty acid calcium soaps to form

Wet, dry, and gas

large area of coagulative necrosis

blackened, dry, wrinkled tissue that has clear separation from healthy tissue

coagulative or liquefactive necrosis followed by infection

spreads rapidly, releases toxins into bloodstream --> very life threatening

wet gangrene has been infected with Clostridium perferingens, an anaerobid bacteria

infections spreads fast thru necrotic tissue

Apoptosis is programmed cell death, no cell contents are spilled, no inflammatory response occurs

Necrosis involves spillage of cell contents into interstitial space, causes inflammatory response, is alway abnormal

• -loss of survival signals from adjacent cells
• -delivery of Fas Ligand to activate "death" receptors on plasma membrane
• -DNA damage with accumulation of protein p53
• -Intracellular Enzymes and signals

• Activation of caspase enzymes
• Breakdown of cellular structures
• Cytoplasmic budding
• Apoptic bodies released
• Phagocytosis of apoptotic bodies

• Somatic Mutation Theory
• Free-Radical Theory
• Immunologic Theory
• Error-Prone Theory
• Neuroendocrine Theory
• Programmed Senesence Theory

DNA damaged by background radiation causes aging

Cumulative free radical damage causes aging

Autoimmune responses cause aging

Random errors in protein translation causes aging

The decline in hormone levels and hormone-receptor sensitivity causes aging

• Cells undergo a finite number of divisions and then die
• The telomeres shorten over time

• Pallor, dilated pupils, body temperature falls, fluids collect in dependent areas
• 6 hours later --> rigor mortis

accumulation of calcium and depletion of ATP --> prolonged crossbridge formation (can't release muscle contraction)

• Absence of reflexes
• Absence of respiratory effort
• Absence of brain waves
• Lack of cerebral blood flow

challenges that disrupt normal cell function

• Cell Adaptation
• Cell Injury --> Cell Death