1 Nursing Cell Injury, Adaptation and Cell Death 2015 (1)

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.



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.



% 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.







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#.



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



% 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



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





http://upload.wikimedia.org/wikipedia/en/6/64/Hyperplasia_vs_Hypertrophy.svg



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.



S5uamus meta*)as"a



2arrett6s Es*ha$us









% 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



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





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







Re(ers")e 'e)) "#1ury Irre(ers")e 'e)) "#1ury



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



FATTY CHANGE

Mechanism:

• Impaired metabolism of fat

• Excessive tril!ceride into the cell"



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.



Ce)) Death:

Ne'rs"s ;s A**ts"s



% 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.



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:



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.



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"#



Caseus Ne'rs"s

% Ne'rt"'

t"ssue has

'heese)"-e

a**eara#'e

% O!te# see# "#

T2



Ga)ree/ Ca$u)at"(e #e'rs"s

+"th su*eradded "#!e't"#



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.



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



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"#



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"#



% Tha#- yu

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1 Nursing Cell Injury, Adaptation and Cell Death 2015 (1)