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Pathophysiology
Chapter 1 Cell Injury
33
Physiology
Graduate
02/17/2010

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Term

Describe the essential components of a typical cell and functions

Definition

plasma membrane

lipid bilayer, proteins, and carbohydrate

forms the outer surface of cell

site of contact between cell and environment

 

nucleus

within cell surrounded by nuclear membrance

contains genetic material (DNA), RNA, and proteins

essential for survival of most cells

 

cytoplasm

matrix of cell

contains hyaloplasm, cytoskeleton, organelles

 

Term
Organelles
Definition

Mitochondria: consists of outer and inner membranes, site of TCA and oxidative phosphorylation, leads to production of ATP

 

ER: meshwork of membranes continuous with plasma membrane, is differentiated into RER and SER

 

Golgi Apparatus: system of tubules and flattened cisterne, processes protein from RER, synthesizes glycoproteins and lipoproteins

 

Ribosomes: consist of RNA and protein, free/attached to RER, necessary for protein synthesis

 

Lysosomes: vesicles that break off of golgi apparatus, contain digestive/lytic enzymes

Term
RER and SER
Definition

RER: site of protein synthesis

 

SER: metabolism or hormone synthesis

Term
Define homeostatis/steady state
Definition
State of balance or equilibruium/balance between cell and environment
Term
How is cellular steady state maintained and what does it mean when a cell reaches the point of no return
Definition

Maintained through the supply of O2 and nutrients to provide energy to maintain homeostasis

 

Point of no returnL injury to cell beyond its capacity to return to normal steady state, although this point is poorly understood

 

Term
List and categorize the most important causes of cell injury
Definition

Deficiency

  1. lack of oxygen, ischemia will decrease ATP formation
  2. primary nutrient deficiency
  3. secondary nutrient deficiency
  4. viral infection: virus infected cells use up nutrients

Intoxication

  1. exogenous: microbial toxins, drug OD, chemicals
  2. endogenous: accumulation of a normal substance in body to toxic levels

Trauma

  1. hypothermia: ice in cytoplasm
  2. hyperthermia
  3. mechanical pressure
  4. microbial injury
  5. radiation: production of free radicals
  6. immunological injury: Ab, complement
Term
What are oxygen radicals and how do they damage cells
Definition

Oxygen radicals are oxygen compounds with an extra electron in their orbital.

 

Oxygen radicals include superoxides and peroxide which causes cellular damage to DNA, cell membrances, and proteins

 

They can be formed by normal metabolism, by radiation, chemicals, NO.

 

Vitamins C and E and other antioxidants are thought to be protective against these

Term
Define reversible cell injury
Definition

Cellular response to adverse environmental stimulus within range of homeostasis caused by low level injury.

 

Cell will return to steady state with cessation of stimulus, usually mild and short-lived.

 

Cells can adapt by changing in size and number

Term
Describe 3 types of cell adaptations involving changes in size or number of cells in reversible cell injury
Definition

Atrophy: decrease in size of cell

  • physiologic: menopause
  • pathologic: muscle disuse/denervation

 

Hypertrophy: increase in size of cell

  • physiologic: muscle with exercise
  • pathologic: overwork of heart

Hyperplasia: increase in number of cells

  • physiologic: uterus in pregnancy
  • pathologic: callus on skin with excessive contact
Term
Explain the cytoplasmic changes in reversible cell injury
Definition

1. Hydrophic changes/vascuolar degeneration: Increased water entry into cell

 

If an injury decreases cell ability to make ATP, the Na+, K+, ATPase pump of a cell cannot pump Na+ out of the cell, therefore creating increase of osmotic pressure, causing water to enter the cell. 

 

Increase water causes swelling of cell, increased number of vacuoles, formation of blebs, swelling of organelles.

 

2. Cell cannot get rid of inclusions, may accumulate fat, lipofuscin

 

3. Other structural changes: Formation of myelin figures

Term
What are the microscopic signs of irreversible injury?
Definition
  • distortions and gaps in cell membrane
  • myelin figures
  • decreased numbers of lysosomes
  • nuclear changes which may be either: pyknosis, karyorrhexis, or karyolysis
Term
pyknosis
Definition
condensation of chromatin
Term
karyorrhexis
Definition
nuclear fragmentation into smaller particles
Term
karyolysis
Definition
lysis of nucleus and chromatin with dispersal of fragments throughout the cell
Term
Define and describe apoptosis
Definition

Programmed cell death

 

Examples:

embryonic development, hormone dependent changes, inflammation, immune responses, low level injury

 

Microscopic morphology:

cell shrinkage, chromatin condensation, nuclear fragmentation, blebs, apoptotic bodies, phagocytosis of apoptotic cells and bodies by healthy cells

 

Term
coagulative necrosis
Definition

most common type

 

  • cells die but outline of cell is maintained
  • no lysis of cell membrance
  • tissue appears like a solid mass of boiled meat
  • usually caused by anoxia in solid internal organs
Term
caseous necrosis
Definition
  • tissue looks yellow-white, cheesy
  • this is coagulative with some liquefaction
  • some cells fall apart
  • typical of TB
Term
liquefactive necrosis
Definition
  • characterized by dissolution of tissues, which become soft and diffluent, usually soft semifluid
  • mush ultimately transformed into a soft fluid-filled cavity
  • most often occurs in brain with brain injury
Term
fat necrosis
Definition
  • a special form of liquefactive necrosis limited to fat tissue usually found around the pancreas
  • area appear like liquefied fat with chalky soap spots
  • happens in acute pancreatitis
  • enzymes released by damaged cells break down surrounding fat
Term
What is difference between wet and dry gangrene?
Definition

Gangrene: Anaerobic bacteria grow in area of coagulative necrosis and produce toxic products

 

dry: necrotic tissue dries out

 

wet: some liquefaction occurs in necrotic tissue, due to enzymes of phagocytic cells

Term
What is the difference between dystrophic and metastatic calcification?
Definition

Distrophic calcification: Ca++ accumulation in dead/necrotic cells, necrotic tissue is rigid and brittle

 

Metastatic calcification: occurs in living cells especially lung, kidney, blood vessels, GI lining

Term
Give examples of injuries to specific cells and tissues
Definition

ischemia: CNS neurons have high metabolic rate and will die within a few minutes of oxygen deprivation, as in stroke, suffocation, drowning.

 

CCL4: toxic only to liver cells, since metabolized to a free radical, not metabolized by other cells

 

ionizing radiation: toxic to rapidly dividing cells

 

polio virus: can only enter cells of anterior horn of spinal cord

 

Term
What does the following clinical monitoring parameters indicate: bilirubin in blood
Definition
liver cell injury
Term
What does the following clinical monitoring parameters indicate: H+ in urine
Definition
kidney cell damage
Term
What does the following clinical monitoring parameters indicate: Altered O2 and CO2 in blood
Definition
lung cell injury
Term
What does the following clinical monitoring parameters indicate: Troponin in blood
Definition
cardiac cell injury
Term
What does the following clinical monitoring parameters indicate: Increased K+ in blood
Definition
hemolysis
Term
What does the following clinical monitoring parameters indicate: CPK in blood
Definition
injury to skeletal muscle, cardiac muscle, brain cells
Term
What does the following clinical monitoring parameters indicate: excessive GGT, ALP, OR AST in blood
Definition
these are liver enzymes, therefore liver cell damage
Term
What does the following clinical monitoring parameters indicate: excess of certain enzymes or hormones in blood
Definition
dysfunction of glands, tumor cells
Term
What monitoring is done by means of the following measurements of electrical activity: ECG/EKG
Definition
electrocardiogram: heart function
Term
What monitoring is done by means of the following measurements of electrical activity: EEG
Definition
electroencephalogram: brain function
Term
What monitoring is done by means of the following measurements of electrical activity: EMG
Definition
electromyogram: neuromuscular function
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