Response to Injury
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Created by:
enderii Plus on May 14, 2012
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52 terms
Terms | Definitions |
|---|---|
 Significance of Discussing Cellular injury(3) | - Must understand physiologic mechanisms as a whole. - Person has both internal and external environment. Information and matter are exchanged between each. - Goal is to produce a steady state. Homeostasis. |
| Outcome of cell injury (3) | - Reversible Injury - Programmed cell death - Cell death and necrosis. |
| Cellular adaptation (7) A. H. H. M. D. I. P | - Atrophy - Hypertophy - Hyperplasia - Metaplasia - Dysplasia - Intracellular Accumulations - Pathologic calcifications |
| Atrophy (2) | - Shrinkage in size of cell which leads to decrease in organ size. - Most common in skeletal muscle, heart, secondary sex organs and brain. |
| Causes of Atrophy (5) D. D. L. I. I. | - Disuse - Denervation - Loss of endocrine signals - Inadequate nutrition - Ischemia |
| Hypertrophy (4) | - Increase in cell size, leading to an increase in organ size. - Is in response to increased physiological or pathophysiologic demand - Subsides when increased demand is removed. - ie: muscles when you work out, uterus and mammary glands during pregnancy |
| Hyperplasia (3) | - Increase in number of new cells because of increased rate of cellular division. - Usually results from increased physiological demands or hormonal stimulation. - ie: breast changes in puberty, new RBCs in blood loss or response to high altitudes. |
| Metaplasia (4) | - One adult cell type is replaced with another adult cell type. - Adaptation to persistent injury with the replacement cell type being better able to tolerate injurious stimulation. - reversible when stimulus removed. - ie: changes in epithelial cells lining bronchi in response to smoke irritation. |
| Dysplasia (4) | - Deranged cellular growth - Abnormal changes in size, shape, and organization of mature cells. - Most likely an adaptive effort gone astray. - Regarded as a precursor of cancer, it has the potential to transform into cancerous cells. |
| Intracellular Accumulations (4) | - buildup of substances cells cannot use or dispose of. 3 categories: - Normal body substances (ie Lipids, proteins, carbs etc) - Abnormal endogenous products. (originate from within the body, ie an Inborn error in metabolism, like Tay-sachs disease) - Exogenous products (ie environmental agents or pigments, carbon in coal dust) |
| Pathogenic Calcification | - Involves abnormal tissue deposition of calcium salts, together with smaller amounts of iron, magnesium and other minerals 2 types: - Dystrophic Calcification - Metastatic Calcification |
| Dystrophic Calcification (2) | - Occurs in Injured cells as a reaction to tissue damage - Seen in lesions of advanced atherosclerosis. |
| Metastatic Calcification (2) | - occurs in normal tissues as the result of increased calcium levels - Caused by hyperparathyroidism, renal failure, cancer, immobilization and vitamin D intoxication. |
| Major Causes of Cellular injury: Function and types (7) P. R. C. B. G. N | - Any Stressor that alters homeostasis can lead to cell injury. - physical agents - Radiation Injury - Chemical Injury - biologic agents - Genetic derangement - Nutritional Imbalances |
| Injury from physical Agents | - Mechanical forces - Extremes of temperature - Electrical Injuries. |
| Mechanical Forces (2) | - Injury or trauma as a result of body impact with another object. - These types of injuries split and tear tissue, fracture bone, injure blood vessels, and disrupt blood flow. |
| Extremes of Temperature | - Injuries as a result of either hypo- or Hyperthermia |
| Electrical injuries (7) | - Can affect the body through extensive tissue injury and disruption of neural and cardiac impulses. mainly determined by - its voltage - the type of current (ac/dc) - Its amperage - the resistance of the intervening tissue - the pathway of current - the duration of exposure. |
| Radiation Injury types (3) | - Ionizing - Ultraviolet - Nonionizing |
| Ionizing Radiation (3) | - Affects cells by causing ionization of molecules and atoms in the cell. - vary with dose, dose rate, and sensitivity of the exposed tissue. - Cells that divide most frequently are the ones most susceptible. |
| Ultraviolet radiation (2) | - Causes sunburn and increases the risk of skin cancer - Damages DNA resulting in the formation of pyrimidine dimers |
| Nonionizing radiation (2) | - Injuries are dermal and subcutaneous - Found in Microwaves, radio waves, ultraviolet, radar, cell phones, infrared, and ultrasound |
| Chemical Injury (5) | - Block enzyme pathways and injure metabolism Types - Drugs - Alcohol - Heavy metals - Carbon Monoxide |
| Injury from biological agents (6) | - Viruses - Bacteria - Rickettsiae - Mycoplasmas - Fungi - Protozoa |
| Genetic derangement | - Produce effects indirectly throuh metabolic disturbances. - Also through altered immune responses. |
| Nutritional imbalances (3) | - Under-nutrition - Inadequate consumption of food or calories - Over-nutrition |
| Mechanisms of injury (3) | - Free radical injury - Hypoxic cell injury - Impaired calcium homeostasis |
| Free Radical Injury (4) | - Highly reactive chemical species arising from an atom that has a single unpaired electron in outer orbit. - cell normally has mechanisms that protect them from injurious effects. - Mechanisms break down when cell deprived of O2, exposed to certain chemical agents, or other injurious agents - Vitamin's A, C, E or other antioxidants help against this type injury |
| Hypoxic cell injury (hypoxia) (3) | - Oxygen deficiency or insufficient levels of oxygen in the blood or tissue. - Interrupts oxidative metabolisms and generation of ATP. - Causes power failure in the cell with widespread effects on the cell's structural and functional components. |
| Ischemia | - Local and temporary deficiency of blood supply due to obstruction of circulation to a part. |
| Causes of hypoxia (5) | - decreased blood supply to area - Decreased 02 carrying capacity of blood - ventilation-perfusion problems - problem with cell's enzyme system - decreased O2 in air |
| Effects of Hypoxia (3) | - Failure of sodium/potassium-ATPase membrane pump. - K leaves the cell and Na and water enter, causing swelling. - Cellular changes reversible if O2 restored. |
| Impaired Calcium Homeostasis (4) | - Messenger for release of many intracellular enzymes - Intracellular levels much lower than extracellular levels - Changes calcium/magnesium ATPase exchange system. - High Ca levels activate number of enzymes with damaging effects. |
| Responses/results of reversible cell injury (2) | - Cellular swelling - Fatty cellular changes |
| Cellular swelling (2) | - Increased sodium in cell - Creates osmotic gradient for water entry |
| Fatty Cellular changes (3) | - small vacuoles of fat disperse in cytoplasm. - Usually indicates severe injury - May occur because normal cells have increased fat load or injured cell unable to metabolize fat properly |
| Cell Death and Necrosis (3) | - Control of cell number regulated by balance of cell proliferation and death. - Cell death can involve apoptosis or necrosis - "point of no return" is biochemical puzzle. |
| Apoptosis (3) | - Controlled cell destruction - Normal cell deletion and renewal - "cell suicide" |
| Necrosis (4) | - Cell death resulting in organ or tissue damage that is still part of a living person - often interferes with cell replacement and tissue regeneration - Different types occur in different organs or tissues - Sometimes can indicate mechanisms or cause of cellular injury |
| Types of Necrosis (4) | - Liquefaction - Coagulation - Caseous - Gangrene |
| Liquefaction necrosis (3) | - Conversion of solid tissues to fluid or semi-fluid state. - Some cells die but catalytic enzymes are not destroyed. - From lecture: Softening in the center or an abscess with a discharge of the contents liquifies and walled off from healthy tissue |
| Coagulation necrosis (4) | - Most common type of necrosis - Occurs primarily in the kidneys, heart, and adrenal glands - Characteristic of hypoxia injury - Clumping together. Caused by protein denaturation |
| Caseous Necrosis (3) | - Dead cells persist indefinitely as soft, cheeselike debris - Thought to result from immune mechanisms - tissues resemble clumped cheese, soft and granular. |
| Gangrene | - Cellular death invovling a large mass of tissue 3 types - Dry - Moist or Wet - Gas |
| Dry Gangrene (3) | - Part becomes dry, shrinks, the skin wrinkles, and its color changes to dark brown or black. - Spread is slow - Obvious line of demarcation between gangrenous area and healthy tissue. |
| Moist or Wet Gangrene (4) | - area cold, swollen and pulse-less. - Skin is moist, black and under tension - Bleps form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action - Primarily results from interference with venous return from the part |
| Gas gangrene (8) | - Results from infection of devitalized tissues by one of several Clostridium bacteria. The bacteria produces toxins that - dissolve cell membranes, - causing death of muscle cells, - massive spreading edema, - hemolysis of red blood cells, - hemolytic anemia, - hemoglobin-uria - renal failure. |
| Cellular Basis of aging (3) | - Normal physiological process - not considered a disease - Gradual result of wear and tear |
| theories of aging (2) | - Stochastic - Nonstochastic |
| Stochastic (2) | - Aging is a result of lifelong genetic damage. - accumulation of lifelong random injuries and events |
| Nonstochastic | - Results of genetically controlled developmental program or built-in self destructive processes. |
| Physiological changes of aging | - Atrophy - Sclerosis - Decrease in organ funtions - No replacement of permanent cells - Decrease adaption to stress |
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