Pathophysiology

1. Pathophysiology

2. Study Tips • Daily quizzes • Understand the material • Read the text • Study frequently for short periods • Find a study buddy

3. Classroom Etiquette and rules: Turn off cell phones ! No chewing gums Be considerate of others: Take out what you bring in. Be ontime, No late more than 5-10m Talk to me, NOT your neighbor! No absence from exams without prior excuse Do not ask for grades over the phone or internet.

4. Academic Integrity • Use Professional ethics • NO: • Plagiarism • Cheating • Allowing others to copy from you • Penalties can be severe !!

5. Terminology • Pathology – focus on physical changes in diseased organs and tissues • Pathophysiology – abnormal functioning of diseased organs and how it applies to medical treatment and patient care

6. Disease – loss of homeostasis, or when physical or mental capacities cannot be fully utilized (interuption, cessation or disorder in the function of an organ or system). Etiology = cause of the disease When the etiology is unknown, the disease is said to be idiopathic.

7. Categories of etiology • Genetic disease– genes are responsible for a structural or functional defect • Congenital disease– genetic information is intact, but the intrauterine environment interferes with normal development • Acquired disease – disease is caused by factors encountered after birth (biological agents, physical forces, and chemical agents)

8. Clinical manifestations – indications that the person is sick Symptoms – unobservable effects of a disease reported by the patient Signs – observable or measurable traits Syndrome - a characteristic combination of signs and symptoms associated with a particular disease.

9. Diagnosis – identification of the specific disease Therapy – the treatment of the disease to either effect a cure or reduce the patient’s signs and symptoms Prognosis – prediction of a disease’s outcome

10. Normal Functioning of Cells

11. Structural Levels

12. Cell The cell is the building block of each living organism. Each cell is a self-contained system that undergoes the functions of energy production and usage, respiration, reproduction, and excretion

13. CellularFunctions • Organization • Metabolism • Catabolism • Anabolism • Responsiveness • Conductivity • Movement Reproduction Growth Differentiation Respiration Secretion Excretion

14. Cell; continued mitochondria ;energy endoplasmic reticulum and ribosomes; protein synthesys Golgi apparatus; secretion of proteins synthesized on the ribosomes. lysosomes ; digestive enzymes. Cytoskeleton. All cells composed internally of cytoplasm and nucleus, and surrounded externally by cell membrane. The cytoplasm includes everything inside the cell but outside the nucleus

15. Building Blocks of Life • Amino Acids -> Proteins • Structure & Function • Nucleic Acids -> DNA / RNA • Information Transmission, energy storage • Simple Sugars -> Polysaccharides • Energy Sources, structure • Fatty Acids -> Lipids • Structure, Energy Source

16. Boundary – Cell membrane(plasma membrane) Composed of lipid molecules in bilayer Phospholipids have hydrophobic tail Phospholipids have hydrophilic heads Also contains embedded proteins proteins are important for cell-cell communication: receptors for hormones cell recognition also important for metabolic processes inside the cell: channels pumps enzymes

17. Cellular Components • Phospholipid bilayer • Membrane proteins • Cytoplasm • Nucleus • Ribosomes • Mitochondria • Endoplasmic Riticulum • Golgi Apparatus • Lysosomes

18. Generic Eukaryotic Cell Generic Cell

19. Cell Membrane

22. Cytoplasm Cytosol – aqueous gel-like medium Important metabolic processes occur here Organelles – membrane bound structures Membranes provide compartments for separation of chemical reactions

23. Rough Endoplasmic ReticulumContains ribosomes – make proteins

25. Smooth ERsynthesizes phospholipidsdetoxifies

26. Golgi ApparatusPackages protein for export

28. MitochondriaThe cell’s power plant

29. Nucleus • large, membrane-bound organelle that contains deoxyribonucleic acid (DNA), the genetic material of the cell. • the DNA is folded up inside the nucleus

30. NucleusDNA codes for proteins

31. Human Genome as a Book • There are 23 chapters, called CHROMOSOMES • Each chapter contains several thousand stories, called GENES • Each story is made up of paragraphs, called EXONS • Each story is interrupted by advertisements called INTRONS • Each paragraph is made up of words, called CODONS. • Each word is written in letters called BASES

32. Movement Through the Membrane • Lipid-soluble substances, such as oxygen, carbon dioxide, alcohol, and urea, move across the lipid bilayer by simple diffusion • Other substances that;not lipid soluble, i.e most small ions, glucose, amino acids, and proteins, move between the extracellular and the intracellular compartments through pores provided by the integral proteins or throughcarrier-mediated transport systems. • Simple diffusion: osmosis,

33. Cellular respiration

35. Cells change to adapt to their environment • Atrophy = shrinkage = decrease in cell size. • Due to : • decreased use • decreased blood supply • decreased nutrition • Of tissues or organs may be due to • cell shrinkage or due to cell death.

36. General Response to Injury • Cellular Adaptation • Mechanisms of Cell Injury • Manifestations of Cell Injury • Cellular Death

37. Cellular Adaptation Atrophy Hypertrophy Hyperplasia Dysplasia Metaplasia

38. Atrophy  Size of organelles  Size of organelles Energy Usage  Workload (or disease state)  Efficiency -OR-  Functionality in disease state

39. Hypertrophy  Size  # of organelles  contractility  Size  # of organelles  Workload (or disease state)  ability to meet demands! -OR-  Functionality in disease state

40. Hyperplasia  rate of cell division  functionality  Workload Physiological state  tissue size by  # of cells 2 types: Compensatory & Hormonal  ability to meet demands! ...

41. Hyperplastic endometrium

42. Dysplasia Mutation Normal Cells Abnormal Shape & Size Epithelial Tissue Pathological

43. Cerical Dysplasia Normal Tissue Abnormal Tissue

44. Metaplasia Normal Cells Abnormal Cells Replacement Ex: Cigarette Smoking Pathological

45. Mechanismsof Injury Hypoxic Chemical Structural (trauma…tons next semester!) Infectious Immunologic / Inflammatory

46. HypoxicInjury  Atmospheric Oxygen  Respiratory Function Loss of Hb  Cardiovascular Function  Hb function (CO)  erythropoiesis Most Common Cause of Cellular Injury!

47. HypoxicInjury (pathway 1) Elevated “Markers” ex CK, CKMB Loss of Phospholipids Membrane Damage Release of Enzymes

48. Hypertrophy = increase in cell size We'll see this in heart, kidney (and others) w/ pathology NOT due to increased cell volume or fluid Rather, due to increased protein synthesis within the cell, or decreased protein breakdown Result is increased protein in organelles Hyperplasia = increase in cell number Due to increased cell division Uterus and breast tissue Parathyroid gland in kidney failure Liver (compensatory hyperplasia)

49. Metaplasia = replacement of one cell type with another • Reversible • An example: ciliated columnar epithelium replaced by • stratified squamous epithelium

50. Dysplasia = change in cell resulting in abnormal cell size, shape or organization • We'll see this in respiratory tract, cervix w/ pathology • In mature cells only • Immature cells would be expected to change in size, shape as they grow and mature • Considered a reversible change • Neoplasia = associated with a malignant tumor