1 Nursing Cell Injury, Adaptation and Cell Death 2015 (1)
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7/24/2019 1 Nursing Cell Injury, Adaptation and Cell Death 2015 (1)
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CELL INJURY,
ADAPTATION AND DEATH
Dr. Ayesha Ahmed.
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PATHOLOGY: Study ! su!!er"#$
% ETIOLOGY: Cause ! the
d"sease
% PATHOGENESIS:
&e'ha#"sm !de(e)*me#t ! d"sease.
% MORPHOLOGY:
Stru'tura) 'ha#$es "# 'e)).
% END RESULT: see#
')"#"'a))y.
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% HOMEOSTASIS: &a#ta"#a#'e! #rma) 'e))u)ar e#("r#me#t.
% ADAPTATION: Ne+ state "#rder t sur("(e 'ha#$ede#("r#me#t.
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ATROPHY: De'rease "#
'e)) s"e +"th de'rease "#
s"e ! r$a#.
Uterus "# me#*ause.
S-e)eta) mus')es "# "mm")"at"#.
De'reased )d su**)y t a# r$a#.
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Atr*hy
% Phys")$"'a):
/ Ne#ate:
% Um")"'a) (esse)s
/ Pst Ad)s'e#'e% T#s")s, a**e#d"0
/ Adu)t:
% Pst me#*ausa) atr*hy ! uterus, (ar"es a#d reast
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% Path)$"'a) / L'a)"ed
% D"suse e.$ "mm")"at"# Lss ! "##er(at"# e.$ #er(edama$e resu)ts "# atr*hy ! the mus')es they su**)y
% Ge#era)"ed / Star(at"#, ma)#utr"t"#
/ Hy**"tu"tar"sm
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HYPERTROPHY: I#'rease
"# s"e ! 'e))s +"th "#'rease
"# s"e ! r$a#s.
Uterus "# *re$#a#'y.
S-e)eta) mus')es "# e0er'"se.
Heart "# heart !a")ure.
I#'reased st"mu)at"# y $r+th hrm#e
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METAPLASIA: Re(ers")e 'ha#$e "#
+h"'h #e adu)t ty*e ! 'e))
3e*"the)"a) r mese'hyma) 4 "s
re*)a'ed y a#ther adu)t 'e)) ty*e .
&ay ''ur "# Res*"ratry
E*"the)"um "# '"$arette
sm-ers.
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S5uamus meta*)as"a
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2arrett6s Es*ha$us
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% CAUSES OF CELL INJURY
%Hy*0"a a#d "s'hem"a
% 7Chem"'a)8 a$e#ts
% 7Phys"'a)8 a$e#ts
% I#!e't"#s
% Immu#)$"'a) rea't"#s
% Ge#et"' de!e'ts% Nutr"t"#a) de!e'ts
% A$"#$
%Hy*0"a 30y$e# de!"'"e#'y4 a#d "s'hem"a 3)d !)+ de!"'"e#'y4
%7Chem"'a)8 a$e#ts: "#')ud"#$ dru$s a#d a)'h)
%7Phys"'a)8 a$e#ts: "#')ud"#$ trauma a#d heat
%Nutr"t"#a) de!e'ts: "#')ud"#$ ("tam"# de!"'"e#'"es,
%A$"#$: "#')ud"#$ de$e#erat"# as a resu)t ! re*eated trauma
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Ce)) I#1ury / Ge#era) &e'ha#"sms
% 9"(e 'e)) systems are*r#e t "#1ury:
/ Aerobic respiratio
/ m"t'h#dr"a
/ Me!braes 3'e))u)ar
a#d r$a#e))ar4
/ Protei s"t#esis
3R"smes4
/ Geetic apparat$s
3e.$., DNA, RNA4
/ C"tos%e&eto
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Ce&&$&ar a' bioc#e!ica&Ce&&$&ar a' bioc#e!ica&
sites o( 'a!a)e i ce&&sites o( 'a!a)e i ce&&
i*$r"i*$r"
Injurious Stimuli
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Re(ers")e 'e)) "#1ury Irre(ers")e 'e)) "#1ury
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9eatures ! re(ers")e a#d "rre(ers")e 'e))
dama$e
% Reversible% Cell swelling
% &"t'h#dr"a) ER
s+e))"#$
% Deta'hme#t ! r"smes
% Sur!a'e )es
% C)um*"#$ ! #u')ear
'hrmat"#
% L"*"d de*s"t"#3!atty
'ha#$e
% Irreversible% Membrane disruption
% Re)ease ! )yssma)
e#ymes
% Prte"# d"$est"#
% &emra#e de*s"t"#
% Lea-a$e ! 'e)) e#ymes
a#d *rte"#s
% Nu')ear 'ha#$es:
*y-#s"s,
-aryrrhe0"s,-ary)ys"s
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FATTY CHANGE
Mechanism:
• Impaired metabolism of fat
• Excessive tril!ceride into the cell"
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Fatt" c#a)e:
Definition: There is theaccumulation oftriglycerides inparenchymal cells,
especially liver.• Gross features:Gross features: The organ
enlarges and becomesyellow, soft, and greasy.
• LM:LM: Clear vacuoles withinparenchymal cells.
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Ce)) Death:
Ne'rs"s ;s A**ts"s
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% Apoptosis: It "s a *ath+ay ! 'e)) death y a su"'"de*r$ram "# +h"'h 'e))s that ha(e t d"e, a't"(atee#ymes that de$rade 'e))s +# #u')ear DNA , #u')eara#d 'yt*)asm"' *rte"#s.
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NECROSIS: Ce)) death due t )etha) "#1ury.
C"top&as!ic c#a)es :
Eosiop#i&ia+
<he# e#ymes ha(e d"$ested the 'e))s, the
'yt*)asm e'mes ,ac$o&ate' a' !ot# eate+
Ca&ci(icatio+
M"e&i Fi)$res:Phs*h)"*"ds!rm )ar$e masses, mye)"# !"$ures
The 'ha#$es see# "# t"ssue are a resu)t !de#aturat"# ! *rte"#s a#d re)ease !
d"$est"(e e#ymes +h"'h destry t"ssue.
Autolysis: d"$est"# y 'e))s +#
e#ymes
Hetero&"sis:
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N$c&ear c#a)es:
N$c&ear c#a)es:
-ar"o&"sis: Nu')eus rea-d+#.
P"%osis: Nu')eus shr"#-s.
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Patters O( Tiss$e Necrosis
Coa)$&ati,e ecrosis. Ce))s dead ut as"'
t"ssue stru'ture "s ma#ta"#ed. &y'ard"a)
I#!ar't"#3 a)) "#!ar'ts4
Li.$e(acti,e Necrosis: As'ess, 2ra"#
Caseo$s Necrosis: Tuer'u)s"s, Gra#u)ma
Fat ecrosis: 9'a) areas ! !at destru't"#
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Caseus Ne'rs"s
% Ne'rt"'
t"ssue has
'heese)"-e
a**eara#'e
% O!te# see# "#
T2
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Ga)ree/ Ca$u)at"(e #e'rs"s
+"th su*eradded "#!e't"#
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END RESULT
% Ne'rt"' 'e))s a#d the"r der"s d"sa**ear
y a 'm"#ed *r'ess ! e#ymat"'
d"$est"# a#d !r$ame#tat"#, !))+ed y
*ha$'yts"s ! der"s y )eu-'ytes.
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I#tra'e))u)ar A''uma)at"#s
% a: Nrma) 'e))u)ar '#st"tue#t
a''uma)ated "# e0'ess su'h as
H=O, *rte"# a#d 'arhydrate.
% : A#rma) susta#'e:
E#d$e#us E0$e#us.
% ': P"$me#ts
Cholesterol and
cholesterol esters.
Proteins:
Amyloidosis
lycogen:
!iabetes mellitus
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P"$me#ts are ')red
susta#'es .Sme ! these are
the #rma) '#stu"te#ts ! the'e))s.e.$ me)a#"#. Others are
a#rma) a#d '))e't u#der
s*e'"a) '"r'umsta#'es. Are !
t+ ty*es.
E0o)eo$s a' E'o)eo$s.
E0a!p&es are:
Hems"der"#.
2")"ru"#.
L"*!us'h"#.
&e)a#"#.
At#racosis
Tatooi)
&e)a#"#
Hems"der"#
L"*!us'h"#
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Ca)'"!"'at"# :Ca)'"!"'at"# :
!e"inition:!e"inition: A#rma) de*s"ts ! 'a)'"um sa)ts
''ur "# a#y t"ssues e0'e*t #es a#d teeth.
!ystrophic:I# #e'rt"' t"ssue.
Metastatic:<he# hy*er'a)'em"a due thy*er*arathyr"d"sm.
Art"' (a)(e, dystr*h"'
'a)'"!"'at"#
&"'rs'*"' *"'ture !
'a)'"!"'at"#
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% Tha#- yu