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Frequent quizzes Understand the material Read the text Study frequently for short periods Find a study buddy 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. Use Professional ethics NO: Plagiarism Cheating Allowing others to copy from you Penalties can be severe !! Pathology – focus on physical changes in diseased organs and tissues Pathophysiology – abnormal functioning of diseased organs and how it applies to medical treatment and client care 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. 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) 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. 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 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 Organization Metabolism ◦ Catabolism ◦ Anabolism Responsiveness ◦ Conductivity Movement Reproduction Growth Differentiation Respiration Secretion Excretion 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 mitochondria ;energy endoplasmic reticulum and ribosomes; protein synthesys Golgi apparatus; secretion of proteins synthesized on the ribosomes. lysosomes ; digestive enzymes. Cytoskeleton. 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 Phospholipid bilayer Membrane proteins Cytoplasm Nucleus Ribosomes Endoplasmic Riticulum (protein synthesis and fat metabolism) Mitochondria Golgi Apparatus; holds enzyme helps in metabolism ATP; Lysosomes; fuel made by methochondria enzymes that allow cytoplasmic digestion to be completed Generic Cell Cytosol – aqueous gel-like medium Important metabolic processes occur here Organelles – membrane bound structures Membranes provide compartments for separation of chemical reactions large, membrane-bound organelle that contains deoxyribonucleic acid (DNA), the genetic material of the cell. the DNA is folded up inside the nucleus 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 through carrier-mediated transport systems. Simple diffusion: osmosis, Cell division and reproduction Individual cells don’t live as long as the organism they’re a part of. Cell reproduction occurs in two stages: ◦ mitosis, the nucleus and genetic material divide ◦ cytokinesis, the cytoplasm divides, beginning during late anaphase or telophase. At the end of cytokinesis, the cell produces two daughter The great divide : Before division, a cell must double its mass and content (interphase). Chromatin, the small, slender rods of the nucleus that give it its granular appearance, begins to form. Replication and duplication of DNA occur during the four phases of mitosis: ◦ Prophase, metaphase, anaphase, and telophase. Most cells reproduce as quickly as they die. Meiosis, another type of cell division, occurs in the reproductive cells, the egg and sperm. Meiosis involves two cell divisions resulting in a total of four daughter cells produced, each containing 23 single chromosomes rather than 23 pairs. Pathophysiologic concepts The cell faces a number of challenges through its life. Stressors, changes in the body’s health, disease, and other extrinsic and intrinsic factors can alter the cells’ normal functioning. Adaptation Cells generally continue functioning despite challenging conditions or stressors. However, severe or prolonged stress or changes may injure or destroy cells. When cell integrity is threatened, the cell reacts by drawing in its reserves to keep functioning, by adaptive changes or by cellular dysfunction. If cellular reserve is insufficient, the cell dies. If enough reserve is available and the body doesn’t detect abnormalities> The cell adapts by: ◦ ◦ ◦ ◦ ◦ atrophy, hypertrophy, hyperplasia, metaplasia, or dysplasia. Atrophy = shrinkage = decrease in cell size. Reversible Due to : decreased use (disuse) decreased blood supply decreased nutrition denervation, or reduced endocrine stimulation Of tissues or organs may be due to cell shrinkage or due to cell death. Workload (or disease state) Functionality Efficiency in disease -OR- state Size Size organelles of oforganelles Energy Usage Hypertrophy an increase in the size of a cell due to an increased workload. It may be normal or abnormal. Hypertrophy is primarily seen in cells that cannot adapt to increased work by increasing their numbers through mitosis (cardiac and skeletal muscle cells). There are three main types of hypertrophy: -Physiologic hypertrophy (i.e., increased muscle bulk through exercise). -Pathologic hypertrophy( hypertrophy of the left ventricle in response to longstanding hypertension) . -Compensatory hypertrophy (the loss of one kidney causes the cells of the remaining kidney to undergo hypertrophy). Workload (or disease state) ability to Functionality meet demands! in disease state -OR- Size Size # of organelles #of organelles contractility Hyperplasia Hyperplasia, an increase in the number of cells, caused by increased workload/ hormonal stimulation. It can only occur in cells that undergo mitosis ( liver, kidney, and connective tissue cells). Hyperplasia may be: *Physiologic (monthly in uterine endometrial cells) . *Pathophysiologic (with excessive hormonal stimulation, which is seen in acromegaly) . *Compensatory (cells of a tissue reproduce to make up for a previous decrease in cells ; liver cells after surgical removal of sections of liver tissue). Workload Physiological state types:to 2ability Compensatory & meet demands! Hormonal ... tissue rate ofsize by cell #division of cells functionality Metaplasia is the replacement of one adult cell with another adult cell that can better endure the change or stress. It’s usually a response to chronic inflammation or irritation; the change in the cells of the respiratory passages from ciliated columnar epithelial cells to stratified squamous epithelial cells in response to years of cigarette smoking. Stratified epithelial cells are better able to survive smoke damage. Unfortunately, they do not assume the vital protective role of ciliated cells. Ex: Cigarette Smoking Pathological Normal Cells Abnormal Cells Replacement Dysplasia In dysplasia, deranged cell growth of specific tissue results in abnormal size, shape, and appearance.;adaptive and potentially reversible, they can precede cancerous changes. The most common sites of dysplasia are the respiratory tract (especially the squamous cells present as a result of metaplasia)and the cervix. Cervical dysplasia usually results from infection of the cells with the human papilloma virus (HPV). Dysplasia is usually rated on a scale to reflect its degree, from minor to severe. Epithelial Tissue Pathological Mutation Normal Cells Abnormal Shape & Size Normal Tissue Abnormal Tissue Cell injury A person’s state of wellness and disease is reflected in the cells. Injury to any of the cell’s components can lead to illness. One of the first indications of cell injury is a biochemical lesion that forms on the cell at the point of injury. This lesion changes the chemistry of metabolic reactions within the cell. Consider, for example, a patient with HIV. The cells of the immune system may be altered, making the patient susceptible to infection. Draw on your reserves, adapt, or die When cell integrity is threatened (toxins, infection, physical injury, or deficit injury), the cell reacts in one of two ways: ◦ • by drawing on its reserves to keep functioning ◦ • by adapting through changes or cellular dysfunction. If enough cellular reserve is available and the body doesn’t detect abnormalities, the cell adapts. If there isn’t enough cellular reserve, cell death (necrosis) occurs. Necrosis is usually localized and easily identifiable. Hypoxic Chemical Structural (trauma…tons next semester!) ◦ Infectious Immunologic / Inflammatory Atmospheric Oxygen Respiratory Function Loss of Hb Cardiovascular Function Hb function (CO) erythropoiesis Most Common Cause of Cellular Injury! Elevated “Markers” ex CK, CKMB Loss of Phospholipids Membrane Damage Release of Enzymes 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) Metaplasia = replacement of one cell type with another Reversible An example: ciliated columnar epithelium replaced by stratified squamous epithelium 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 Buildup of substances the cell can’t use or dispose of. ◦ Normal body substances ◦ Abnormal products from inside the body (inborn errors of metabolism) ◦ Substances from outside the body (transient or permanent) Causes of cell injury: Deficiency – lack of a substance necessary to the cell Intoxication or poisoning – presence of a toxin or substance that interferes with cell functioning Trauma – physical injury and loss of cell’s structural integrity Deficiencies: Deficiency in oxygen most important Hypoxia = deficiency in oxygen at cell Due to : Decreased oxygen in air Decreased hemoglobin or decreased oxygen transported to cells Diseases of the respiratory and/or cardiovascular system Important to cell because of oxidative phosphorylation, which results in the production of ATP Oxidative: need oxygen to produce ATP ATP: needed by cell for metabolism, cell life Cellular response to hypoxia Decreased mitochondrial reactions decreased ATP produced decreased energy Ion pumps cease, so can't regulate ions into/out of cell (ATP needed for this) Can't pump Na+ and water out of cell, so get cell swelling organelle swelling cell death Ischemia is inadequate blood supply to a cell or tissue. Ischemia can cause hypoxia. Intoxication (or introduction of toxins into the cell) Effect on cell depends on toxin and on cell Some examples: Lead -- injures nervous system CO -- deprives body of oxygen Ethanol -- effects central nervous system Trauma -- physical disruption of cells Ex: abrasion, cutting, burns, microorganisms etc. Free radicals : uncharged atom or group of atoms with an unpaired electron Formed by radiation, redox reactions, chemicals Atom is unstable needs to gain or lose an electron can alter chemical bonds in proteins, lipids, carbohydrates and nucleic acids can cause chain reaction in cell “fallen apart” Regulated cell death During development Worn out cells Diseased cells (tumor suppressor p53 gene, natural killer or Tc cells) Messy cell death Initiates inflammation Gangrene – large mass of tissue undergoes necrosis Infections agents Microorganisms can invade and harm cells Cell injury can have effects on the entire body Examples: fever, pain, increased heart rate