Pathophysiology

ZOOL 3143

Dr. Diane M. Gilmore, O.D.

LSE 415 6 !" ! 3 mgilmore#astate.e$% &e' site( ))).*lt.astate.e$%+mgilmore

O,,i*e ho%rs(

Mon$ay an$ -%es$ay 1 " . p.m. &e$nes$ay /oon " . p.m. an$ 3"4 p.m. 0n$ 'y appointment

Lecture Text: Essentials of Pathophysiology Concepts of Altered Health States,2 nd ed., by Carol Mattson Porth. Lippincott Williams & Wilkins, pub.

1ramming is a s%re path to ,ail%re 2

It will blow up in your ace!

St%$y -ips

3se the st%$y g%i$e Daily 4%i55es 3n$erstan$ the material 6ea$ the te7t St%$y ,re4%ently ,or short perio$s 8Do something9 )ith the material :in$ a st%$y '%$$y

Classroom "ti#uette: Turn o pa$ers an% cell phones ! &o tobacco use o any kin% 'e consi%erate o others: Take out what you brin$ in. Talk to me, &(T your nei$hbor! )o not ask or $ra%es o*er the phone or internet.

+ca%emic Inte$rity
,se Pro essional ethics &(:
Pla$iarism Cheatin$ +llowin$ others to copy rom you

Penalties can be se*ere !!

- +tten%ance - Inclement weather - )isability ser*ices

.ra%es: / exams 0 1 paper 0 2pop3 #ui44es an% possibly seminars + ' C ) ; 5 5 5 5 5 6/7 8 /77 points 677 8 669 points :/7 8 :99 points :77 8 :69 points less than :77 points

Final exam Tuesday, Dec. 11 at 12:30p.m.

Terminolo$y
- Pathology < ocus on physical chan$es in %isease% or$ans an% tissues - Pathophysiology < abnormal unctionin$ o %isease% or$ans an% how it applies to me%ical treatment an% patient care

Disease < loss o homeostasis, or when physical or mental capacities cannot be ully utili4e% =interuption, cessation or %isor%er in the unction o an or$an or system>. Etiology 5 cause o the %isease When the etiolo$y is unknown, the %isease is sai% to be idiopathic.

Cate$ories o etiolo$y
- Genetic disease< $enes are responsible or a structural or unctional %e ect - ongenital disease< $enetic in ormation is intact, but the intrauterine en*ironment inter eres with normal %e*elopment - !c"ui#ed disease < %isease is cause% by actors encountere% a ter birth =biolo$ical a$ents, physical orces, an% chemical a$ents>

linical mani$estations % in%ications that the person is sick &ymptoms < unobser*able e ects o a %isease reporte% by the patient &igns < obser*able or measurable traits &ynd#ome 8 a characteristic combination o si$ns an% symptoms associate% with a particular %isease.

Pathogenesis 8 se#uence o e*ents in the o %e*elopment o a %isease &e"uelae < lesions or impairments resultin$ rom a %isease !cute conditions < rapi% onset, %e*elop #uickly, usually o short %uration h#onic conditions < lon$er %uration onset may be su%%en or insidious

)istribution o lesions may be: 'ocal < con ine% to one area o the bo%y &ystemic < wi%ely %istribute% throu$hout the bo%y Within an or$an %ama$e can be: Focal i there are only one or more %istinct sites o %ama$e Di$$use i the %ama$e is uni ormly %istribute%

Diagnosis < i%enti ication o the speci ic %isease The#apy < the treatment o the %isease to either e ect a cure or re%uce the patient?s si$ns an% symptoms P#ognosis < pre%iction o a %isease?s outcome

&ormal ;unctionin$ o "ukaryotic Cells

'oun%ary < Cell membrane =plasma membrane>

Compose% o lipi% molecules in bilayer Phospholipi%s ha*e hy%rophobic tail Phospholipi%s ha*e hy%rophilic hea%s +lso contains embe%%e% proteins proteins are important or cell8cell communication: receptors or hormones cell reco$nition also important or metabolic processes insi%e the cell: channels pumps en4ymes

Cytoplasm
Cytosol < a#ueous $el8like me%ium Important metabolic processes occur here (r$anelles < membrane boun% structures Membranes pro*i%e compartments or separation o chemical reactions

&ucleus
)&+ co%es or proteins

@ou$h "n%oplasmic @eticulum

Contains ribosomes < make proteins

Amooth "@
synthesi4es phospholipi%s %etoxi ies

.ol$i +pparatus
Packa$es protein or export

Mitochon%ria
The cell?s power plant

Cellular respiration

2sacs3 that hol% molecules within a cell lysosomes <%i$esti*e en4ymes molecules to be exporte%

Besicles

Inclusions
Temporary structures - ribosomes - ilaments < cytoskeleton < protein stran%s - other molecules without membranes: melanin lipi%s, etc.

Tissues
Ma%e up o cells with common unction ;our maCor tissue types: 1. "pithelial co*erin$ an% linin$ interacts with the bo%y?s en*ironment $lan%ular tissue

D. Connecti*e tissue
Important to structure , support an% protection

:. &er*ous tissue
Ma%e up o neurons an% supportin$ =$lial> cells recei*es in o rom outsi%e =or insi%e> the bo%y processes in ormation acts on the in ormation throu$h muscles, $lan%s, etc.

Muscle
- Important to mo*ement - Three types
< Akeletal < Amooth < Car%iac

Cells chan$e to a%apt to their en*ironment

Atrophy = shrinkage = decrease in cell size. Due to %ecrease% use %ecrease% bloo% supply %ecrease% nutrition ($ tissues o# o#gans may be %ue to cell shrinka$e or %ue to cell %eath.

Hypertrophy = increase in cell size WeEll see this in heart, ki%ney =an% others> wF patholo$y &(T %ue to increase% cell *olume or lui% @ather, %ue to increase% protein synthesis within the cell, or %ecrease% protein break%own )esult is inc#eased p#otein in o#ganelles Hyperplasia = increase in cell nu!"er )ue to increase% cell %i*ision ,terus an% breast tissue Parathyroi% $lan% in ki%ney ailure Li*er =compensatory hyperplasia>

#etaplasia = replace!ent of one cell type $ith another @e*ersible +n example: ciliate% columnar epithelium replace% by strati ie% s#uamous epithelium

Dysplasia = change in cell resulting in a"nor!al cell size, shape or organization WeEll see this in respiratory tract, cer*ix wF patholo$y In mature cells only *mmatu#e cells +ould ,e expected to change in si-e, shape as they g#o+ and matu#e Consi%ere% a re*ersible chan$e %eoplasia = associated $ith a !alignant tu!or

Intracellular accumulations
- 'uil%up o substances the cell can?t use or %ispose o .
< &ormal bo%y substances < +bnormal pro%ucts rom insi%e the bo%y =inborn errors o metabolism> < Aubstances rom outsi%e the bo%y =transient or permanent>

Cellular inCury < cell unable to maintain homeostasis

- auses o$ cell in.u#y: - De$iciency < lack o a substance necessary to the cell - *ntoxication o# poisoning < presence o a toxin or substance that inter eres with cell unctionin$ - T#auma < physical inCury an% loss o cell?s structural inte$rity

De$iciencies: De$iciency in oxygen most impo#tant

/ypoxia 0 de$iciency in oxygen at cell )ue to : Decreased oxygen in air Decreased hemoglobin or decreased oxygen transported to cells Diseases of the respiratory and/or cardiovascular system

Important to cell because o oxi%ati*e phosphorylation, which results in the pro%uction o +TP Oxidative: need oxygen to produce ATP ATP: needed by cell for metabolism, cell life

ellula# #esponse to hypoxia )ecrease% mitochon%rial reactions %ecrease% +TP pro%uce% %ecrease% ener$y Ion pumps cease, so canEt re$ulate ions intoFout o cell =+TP nee%e% or this> CanEt pump &a0 an% water out o cell, so $et cell swellin$ or$anelle swellin$ cell %eath

*schemia is ina%e#uate bloo% supply to a cell or tissue. Ischemia can cause hypoxia.

Intoxication =or intro%uction o toxins into the cell> E$$ect on cell depends on toxin and on cell &ome examples: Lea% 88 inCures ner*ous system C( 88 %epri*es bo%y o oxy$en "thanol 88 e ects central ner*ous system

Trauma 88 physical %isruption o cells Ex: a,#asion, cutting, ,u#ns, mic#oo#ganisms etc.

F#ee #adicals : unchar$e% atom or $roup o atoms with an unpaire% electron ;orme% by ra%iation, re%ox reactions, chemicals +tom is unstable nee%s to $ain or lose an electron can alter chemical bon%s in proteins, lipi%s, carbohy%rates an% nucleic aci%s can cause chain reaction in cell

+poptosis
2 allen apart3 @e$ulate% cell %eath )urin$ %e*elopment Worn out cells )isease% cells =tumor suppressor p/: $ene, natural killer or Tc cells>

&ecrosis
- Messy cell %eath - Initiates in lammation - .an$rene < lar$e mass o tissue un%er$oes necrosis

n ections a$ents 1ic#oo#ganisms can in2ade and ha#m cells

Cell in&ury can ha'e effects on the entire "ody "xamples: e*er, pain, increase% heart rate

Cell a$in$
- Pro$ramme% chan$e theories - "rror theories - Telomerase