Compensation. Adaptation. Compensation. Adaptation. Tissue repair.Tissue repair.

Compensation – complex of Compensation – complex of some processes directed on some processes directed on restoration of destroyed or restoration of destroyed or

lost structure.lost structure.

Adaptation - complex of Adaptation - complex of some processes directed on some processes directed on adjustment to destroyed or adjustment to destroyed or

lost structure.lost structure.

-Hypertrophy (and hyperplasia);Hypertrophy (and hyperplasia);

- Atrophy;- Atrophy;

- Organization;- Organization;

- Adaptative tissue - Adaptative tissue reorganization;reorganization;

- Tissue repair (or regeneration).- Tissue repair (or regeneration).

Hypertrophy (and Hypertrophy (and hyperplasia)hyperplasia)

It is increasing of volume It is increasing of volume and number of functional and number of functional

structures associated with structures associated with increasing of the function.increasing of the function.

HypertrophyHypertrophy

Physiological – Physiological –

hypertrophy which hypertrophy which appearsappears

during healthy, notduring healthy, not

changed vital changed vital functionsfunctions

Pathological – Pathological –

hypertrophy which ishypertrophy which is

caused by differentcaused by different

pathological pathological influencesinfluences

Types of pathological Types of pathological hypertrophyhypertrophy

- working (compensatory);- working (compensatory);- substitute (in losing of one of - substitute (in losing of one of

pair organ);pair organ);- correlative (hypertrophy of - correlative (hypertrophy of

lymph. nodes in spleen lymph. nodes in spleen removing);removing);

- neurohumoral.- neurohumoral.

Compensatory hypertrophy Compensatory hypertrophy (compensation) has three (compensation) has three

phases:phases:

1. formation1. formation2. consolidation2. consolidation

3. depletion 3. depletion (decompenasation).(decompenasation).

Hyperplasia – increasing of Hyperplasia – increasing of functional elements functional elements

numbernumber

Atrophy Atrophy

Decreasing of functional Decreasing of functional elements volume elements volume

associated with decreasing associated with decreasing of the function in a living of the function in a living

organismorganism

AtrophyAtrophy

Physiological – Physiological –

atrophy which atrophy which appearsappears

during healthy, notduring healthy, not

changed vital changed vital functionsfunctions

Pathological – Pathological –

atrophy which isatrophy which is

caused by differentcaused by different

pathological pathological influencesinfluences

AtrophyAtrophy

General General

(cachexia or (cachexia or emaciation)emaciation)

LocalLocal

Most often causes of general Most often causes of general atrophyatrophy(cachexia or emaciation):(cachexia or emaciation):

- alimentary (in starvation);- alimentary (in starvation);- tumourous (in malignant tumours);- tumourous (in malignant tumours);- hypophisary (in hypophysis - hypophisary (in hypophysis pathology);pathology);- cerebral;- cerebral;- due to chronic diseases (infections - due to chronic diseases (infections

etc.)etc.)

Local atrophyLocal atrophy

- dysfunctional;- dysfunctional;

- due to insufficiency of circulation - due to insufficiency of circulation (especially in chronic ischemia);(especially in chronic ischemia);

- compressive (long time - compressive (long time compression);compression);

- neurotic;- neurotic;

- due to influence of physics or - due to influence of physics or chemical factorschemical factors

OrganizationOrganization

Growth of connective tissue Growth of connective tissue in focus of pathological in focus of pathological

changes (necrosis, changes (necrosis, thrombus, accumulations of thrombus, accumulations of

an exudate etc.)an exudate etc.)

Individual forms of Individual forms of organization:organization:

- encapsulation – growth of connective tissue around of - encapsulation – growth of connective tissue around of pathological focus with formation of capsule;pathological focus with formation of capsule;

- sclerosis – pathological process which is characterizing - sclerosis – pathological process which is characterizing by increased growing of connective tissue;by increased growing of connective tissue;

- scar – growth of connective tissue in focus of injury;- scar – growth of connective tissue in focus of injury;

- cirrhosis – widespread (diffuse, total) growth of - cirrhosis – widespread (diffuse, total) growth of connective tissue in organ with its structural connective tissue in organ with its structural reorganizationreorganization

According to etiology and According to etiology and pathogenesis sclerosis can be:pathogenesis sclerosis can be:

- as result of chronic proliferative inflammation;- as result of chronic proliferative inflammation;

- as result of connective tissue disorganization;- as result of connective tissue disorganization;

- substitutive sclerosis as outcome of atrophy, - substitutive sclerosis as outcome of atrophy, circulatory disorders etc.;circulatory disorders etc.;

- formation of scars in wounds and ulcers healing;- formation of scars in wounds and ulcers healing;

- organization of thrombi, hematomas, fibrinous - organization of thrombi, hematomas, fibrinous exudates. exudates.

In every time sclerosis it is In every time sclerosis it is connective tissue connective tissue

neoformation as result of neoformation as result of fibroblasts proliferation with fibroblasts proliferation with

increased synthesis of increased synthesis of collagen or increased collagen or increased

synthesis of collagen without synthesis of collagen without fibroblasts proliferation.fibroblasts proliferation.

Sclerosis can be:Sclerosis can be:

- reversible;- reversible;- semireversible;- semireversible;

- irreversible (progressive).- irreversible (progressive).

Structural reorganization of Structural reorganization of tissuetissue

Structural reorganization of Structural reorganization of tissue – it is changes of tissue – it is changes of tissue structure due to tissue structure due to

changes of its existence changes of its existence conditions.conditions.

Examples:Examples:

- development of collateral - development of collateral circulation in ischemia;circulation in ischemia;

- reorganization of osseous - reorganization of osseous tissue in changes of loading tissue in changes of loading

direction;direction;

- changes of alveolar - changes of alveolar epithelium in lung in zone of epithelium in lung in zone of

athelectasis.athelectasis.

Tissue repair – restoration Tissue repair – restoration of tissue structural of tissue structural

elements instead lost.elements instead lost.

Tissue repair can be:Tissue repair can be:

- physiological;- physiological;- reparative (regeneration);- reparative (regeneration);

- pathological.- pathological.

Reparative – regeneration Reparative – regeneration in different pathological in different pathological

processes due to injury of processes due to injury of cells and tissues.cells and tissues.

total (restitution)total (restitution)

RegenerationRegeneration non totalnon total

(substitution)(substitution)

Restitution – compensation Restitution – compensation of defect by the tissue of defect by the tissue

identical lost.identical lost.

Substitution - compensation Substitution - compensation of defect by the non of defect by the non

identical tissue (usually identical tissue (usually connective tissue – connective tissue –

scarring).scarring).

Restitution:Restitution:

- connective tissue;- connective tissue;- osseous tissue;- osseous tissue;

- epithelium;- epithelium;- blood.- blood.

Substitution:Substitution:

- muscular tissue (myocardium is - muscular tissue (myocardium is included);included);- neurons.- neurons.

Pathological tissue repair Pathological tissue repair (regeneration) it is (regeneration) it is

regeneration with disturbed regeneration with disturbed and distorted course.and distorted course.

hyperregenerationhyperregeneration

Pathological Pathological regenerationregeneration hyporegenerationhyporegeneration

metaplasiametaplasia

Examples of pathological Examples of pathological regeneration:regeneration:

- formation of keloid scar;- formation of keloid scar;- surplus bone corn;- surplus bone corn;

- nevroma after - nevroma after amputation;amputation;

- languid wound healing. - languid wound healing.

Metaplasia is reversible Metaplasia is reversible change in which one adult change in which one adult

cell type (epithelial or cell type (epithelial or mesenchymal) is replaced mesenchymal) is replaced

by another adult type.by another adult type.

Metaplasia is limited Metaplasia is limited by the one related by the one related

hystiotype.hystiotype.

Granulation tissue – young Granulation tissue – young connective tissueconnective tissue

Differences between young Differences between young and adult connective tissueand adult connective tissue

Granulation tissue:Granulation tissue:

Lot of proliferating young Lot of proliferating young connective tissue cells connective tissue cells (fibroblasts);(fibroblasts);

Lot of small blood vessels Lot of small blood vessels with thin walls and with thin walls and proliferating proliferating endothelium;endothelium;

Intensive Intensive lymphoplasmatic lymphoplasmatic infiltration;infiltration;

Low containment of Low containment of collagenic fibers.collagenic fibers.

Adult connective Adult connective tissue:tissue:

Lot of collagenic fibers;Lot of collagenic fibers;

Little cellular elements;Little cellular elements;

Little blood vessels.Little blood vessels.

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