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Paramedic Care:Paramedic Care:Principles & Practice Principles & Practice
Volume 1Volume 1Introduction to Advanced Introduction to Advanced
Prehospital CarePrehospital Care
Chapter 8Chapter 8 General Principles of General Principles of
Physiology and Physiology and PathophysiologyPathophysiology
Chapter 8, Part 1Chapter 8, Part 1The Cell and the The Cell and the
Cellular EnvironmentCellular Environment
Part 1 TopicsPart 1 Topics The Normal CellThe Normal Cell How Cells Respond to Change and How Cells Respond to Change and
InjuryInjury The Cellular Environment: Fluids and The Cellular Environment: Fluids and
ElectrolytesElectrolytes Acid-Base BalanceAcid-Base Balance
CELL THEORYCELL THEORY All Living Things Are Composed of All Living Things Are Composed of
CellsCells Cells Are the Functional Unit of the Cells Are the Functional Unit of the
BodyBody Continuity of Life: Cells come from Continuity of Life: Cells come from
other cellsother cells
CELL DIVERSITYCELL DIVERSITY Human Body contains 50-106 trillion Human Body contains 50-106 trillion
cellscells 200 different cell types200 different cell types
Range from 2 micrometers to 1 Range from 2 micrometers to 1 meter in lengthmeter in length
The Normal CellThe Normal Cell
The Normal CellThe Normal Cell The cell is the The cell is the
fundamental unit fundamental unit of the human of the human body.body.
Three main Three main elements: elements: Cell membraneCell membrane Cytoplasm Cytoplasm Organelles Organelles
Cellular ComponentsCellular Components Membrane encircles and protects the cell.Membrane encircles and protects the cell.
The membrane is selectively permeable The membrane is selectively permeable Cytoplasm viscous fluid that fills and Cytoplasm viscous fluid that fills and
gives shape to the cellgives shape to the cell Electrolytes, proteins, glucose (sugar), and Electrolytes, proteins, glucose (sugar), and
lipids lipids OrganellesOrganelles
Structures that perform specific functions Structures that perform specific functions within the cellwithin the cell
The Cell MembraneThe Cell Membrane
OrganellesOrganelles NucleusNucleus Endoplasmic reticulumEndoplasmic reticulum Golgi apparatusGolgi apparatus MitochondriaMitochondria LysosomesLysosomes PeroxisomesPeroxisomes
NUCLEUSNUCLEUS Cell control center- directs activitiesCell control center- directs activities Bounded by a double membrane, the Bounded by a double membrane, the
nuclear envelopenuclear envelope Contains genetic information (DNA) in Contains genetic information (DNA) in
the form of genes the form of genes Nucleolus - site of ribosome assemblyNucleolus - site of ribosome assembly Multinucleate - many nucleiMultinucleate - many nuclei Anucleate - no nucleusAnucleate - no nucleus
CYTOPLASMCYTOPLASM Cell forming materialCell forming material
viscous transparent fluidviscous transparent fluid organelles - “little organs”organelles - “little organs” Inclusions - chemical substances that Inclusions - chemical substances that
may be stored in the cytoplasmmay be stored in the cytoplasm
ORGANELLESORGANELLES Endoplasmic reticulumEndoplasmic reticulum
rough ER - transport & membrane synthesisrough ER - transport & membrane synthesis smooth ER - lipid synthesis & drug smooth ER - lipid synthesis & drug
detoxificationdetoxification Ribosome - synthesize proteinsRibosome - synthesize proteins Golgi apparatus - series of flattened Golgi apparatus - series of flattened
membrane sacs that process, sort and membrane sacs that process, sort and modify proteins and lipids for export or cell modify proteins and lipids for export or cell useuse
ORGANELLESORGANELLES Mitochondria - ATP formationMitochondria - ATP formation Lysosome - contain hydrolytic enzymes Lysosome - contain hydrolytic enzymes
that break down molecules, digest bacteria that break down molecules, digest bacteria Microtubules / Microfilaments - form part of Microtubules / Microfilaments - form part of
the cytoskeleton that serve as support the cytoskeleton that serve as support structures and assist with cell movement structures and assist with cell movement Cilia -numerous, short, transport substances Cilia -numerous, short, transport substances
across the membraneacross the membrane Flagella - often single, used to propel the cellFlagella - often single, used to propel the cell
ORGANELLESORGANELLES
Peroxisomes - contain enzymes that oxidize Peroxisomes - contain enzymes that oxidize toxic substances (neutralize free radicals)toxic substances (neutralize free radicals)
Centrosomes/centrioles - function in cell Centrosomes/centrioles - function in cell divisiondivision
Storage organelles - Vacuoles, Vesicles, Storage organelles - Vacuoles, Vesicles, may contain:may contain: fats, oils, melaninfats, oils, melanin
Size does matter!Size does matter! Cells range from Cells range from
1–200 1–200 mm Lower limit (0.2 Lower limit (0.2 m)m)
determined bydetermined byspace needed for space needed for ribosomes, DNA.ribosomes, DNA.
Upper limit determined Upper limit determined by need to transport by need to transport materials across surfacematerials across surface Large cells have lower Large cells have lower
surface to volume ratiosurface to volume ratio
Prokaryotic Cell StructureProkaryotic Cell Structure bacteria & archaeabacteria & archaea
very small 0.5 - 5 µm very small 0.5 - 5 µm no organelles, no organelles,
internal membranes rareinternal membranes rare DNA localized in nucleoid region, NO NUCLEUSDNA localized in nucleoid region, NO NUCLEUS growth due to increase in numbers rather than sizegrowth due to increase in numbers rather than size high surface to volume ratiohigh surface to volume ratio
Eukaryotic CellsEukaryotic Cells Internal Internal
membranes form membranes form different different compartments to compartments to carry out specific carry out specific activitiesactivities Energy metabolismEnergy metabolism Protein processingProtein processing RecyclingRecycling Information storageInformation storage
Essential ChemistryEssential Chemistry
Ions/Ionic bondsIons/Ionic bonds Some atoms can donate or Some atoms can donate or
accept electrons accept electrons # of protons (+ charge) and # of protons (+ charge) and
electronselectrons(- charge) become imbalanced. (- charge) become imbalanced.
Atom acquires a net charge.Atom acquires a net charge. A charged atom or group of A charged atom or group of
atoms is called an ion.atoms is called an ion. Oppositely charged atoms are Oppositely charged atoms are
attracted to each other, attracted to each other, forming an ionic bond.forming an ionic bond.
Covalent BondsCovalent Bonds Some atoms share electrons Some atoms share electrons
– forming covalent bonds– forming covalent bonds Shared electrons spend time Shared electrons spend time
orbiting both atomsorbiting both atoms Important elementsImportant elements
C – 4 bondsC – 4 bonds N – 3 bondsN – 3 bonds O, S – 2 bondsO, S – 2 bonds H – 1 bondH – 1 bond
Polar Covalent BondsPolar Covalent Bonds Some atoms such as O, N Some atoms such as O, N
attract electrons stronglyattract electrons strongly Unequal sharing of electrons Unequal sharing of electrons
creates partial charges at creates partial charges at ends (poles) of covalent bondends (poles) of covalent bond
Opposite partial chargesOpposite partial chargeson the same or separate on the same or separate molecules are attracted molecules are attracted to each other – forming to each other – forming hydrogen bonds hydrogen bonds (H-bonds)(H-bonds)
Why is water Why is water special?special?
Water is a polar molecule.Water is a polar molecule. Two ends of molecule have Two ends of molecule have
opposite charges.opposite charges. Water molecules stick to each Water molecules stick to each
other and to other things.other and to other things. Surface tensionSurface tension adhesion, capillary actionadhesion, capillary action
and redwood trees and redwood trees collapsed lungscollapsed lungs surfactantssurfactants cohesioncohesion
Water as a solventWater as a solvent Water can interact with Water can interact with
other polar substances, other polar substances, therefore they dissolve therefore they dissolve wellwell
Charged on ions areCharged on ions arestabilized by partial stabilized by partial charges in watercharges in water
Non- polar moleculesNon- polar moleculesdo not interact with do not interact with water.water.
Hydrophobic “interactions”Hydrophobic “interactions” Substances that do not interact with Substances that do not interact with
water referred to as hydrophobicwater referred to as hydrophobic hydrophobic molecules are aggregated to hydrophobic molecules are aggregated to
minimize disruption of water’s H-bonding minimize disruption of water’s H-bonding network.network.
Major Theme!!Major Theme!! Nature builds “big” things by Nature builds “big” things by organizingorganizing
and connecting “little” things.and connecting “little” things. The whole is greater than the sum of its parts.The whole is greater than the sum of its parts.
SocietiesSocieties FamiliesFamilies individuals/organismsindividuals/organisms organsorgans tissuestissues cellscells moleculesmolecules
Hydrated CarbonHydrated Carbon Carbohydrates have a base formula of (CHCarbohydrates have a base formula of (CH22O)O)nn names end with “ose”, e.g. - pentoses (n=5) – Ribose, names end with “ose”, e.g. - pentoses (n=5) – Ribose,
ribulose; hexoses – (n=6) - glucose, fructoseribulose; hexoses – (n=6) - glucose, fructose Monosaccharide = 1 sugarMonosaccharide = 1 sugar
Macromolecules Macromolecules
The most important chemical The most important chemical reactions in living organismsreactions in living organisms
Condensation - Removal of H and OH from two separate molecules forms water and Condensation - Removal of H and OH from two separate molecules forms water and connects the two molecules.connects the two molecules.
Hydrolysis - Water used to split a molecule Hydrolysis - Water used to split a molecule Can be continued Can be continued ad infinitum - monomers ad infinitum - monomers polymer polymer
DisaccharidesDisaccharides 2 monosaccharides can be 2 monosaccharides can be
linked to form a disaccharidelinked to form a disaccharide Oligosaccharides contain Oligosaccharides contain
several different sugars several different sugars linked inlinked indifferent types of different types of linkages. linkages. Present on cell surface Present on cell surface
proteins and lipids.proteins and lipids.
PolysaccharidesPolysaccharides Sugars (monosaccharides) can be connected to Sugars (monosaccharides) can be connected to
form polysaccharides – usually only 1 or 2 types form polysaccharides – usually only 1 or 2 types of linkage.of linkage.
Glucose is used to produce glycogen (animals), Glucose is used to produce glycogen (animals), starch (plants) and cellulose (plants).starch (plants) and cellulose (plants).
PolysaccharidesPolysaccharides Cellulose is also a polymer of glucose, but sugars are Cellulose is also a polymer of glucose, but sugars are
linked differently, difficult to breakdown.linked differently, difficult to breakdown. Fiber in the diet, paper, wood, Extra stomachs in ruminants Fiber in the diet, paper, wood, Extra stomachs in ruminants
(cows, sheep) with cellulose degrading bacteria(cows, sheep) with cellulose degrading bacteria Starch & Glycogen - branching creates more ends - Starch & Glycogen - branching creates more ends -
allows more rapid breakdown to individual sugarsallows more rapid breakdown to individual sugars
Nucleotides (nts)Nucleotides (nts) Sugar - ribose vs. deoxyriboseSugar - ribose vs. deoxyribose Base - A,C,G and T (DNA) or U Base - A,C,G and T (DNA) or U
(RNA)(RNA) Phosphates - 1 (mono), 2 (di) Phosphates - 1 (mono), 2 (di)
or 3 (tri)or 3 (tri) Important ntsImportant nts
ATP - energyATP - energy GTP - regulates GTP - regulates
protein activityprotein activity NAD, NADP carryNAD, NADP carry
electronselectrons
Nucleic AcidsNucleic Acids Nucleotides are linked Nucleotides are linked
together via together via dehydration synthesis dehydration synthesis reactionsreactions sugar phosphate sugar phosphate
backbonebackbone bases project to sidebases project to side
RNA has one strandRNA has one strand DNA is double strandedDNA is double stranded
Proteins are polymers Proteins are polymers of amino acidsof amino acids
Amino acidsAmino acids are connected together to form are connected together to form a chain linked by a chain linked by peptide bonds.peptide bonds.
Linkage by peptide bonds maintains amino Linkage by peptide bonds maintains amino and carboxyl termini, and carboxyl termini, directionalitydirectionality
20 different amino acids 20 different amino acids have “have “R groupsR groups” or ” or “side chains” with different “side chains” with different chemical properties.chemical properties.
Phospholipid structurePhospholipid structure Phospholipids - glycerol + 2 fatty acids + Phospholipids - glycerol + 2 fatty acids +
phosphate + something else.phosphate + something else. amphipathic amphipathic
hydrophobic tail +hydrophobic tail + hydrophilic head hydrophilic head
Lipid BilayersLipid Bilayers When mixed with water, phospholipids When mixed with water, phospholipids
spontaneously form a lipid bilayer.spontaneously form a lipid bilayer. Hydrophilic portion of phospholipid on surface, exposed to Hydrophilic portion of phospholipid on surface, exposed to
water.water. Hydrophobic portion in central region, away from water.Hydrophobic portion in central region, away from water.
Lipid bilayers formLipid bilayers formthe basis of membrane the basis of membrane structurestructure
Triglycerides = Fats/OilsTriglycerides = Fats/Oils Triglycerides = glycerol + 3 fatty acidsTriglycerides = glycerol + 3 fatty acids
Function as energy storage and insulationFunction as energy storage and insulation
Saturated vs. Unsaturated Saturated vs. Unsaturated FatsFats
SaturatedSaturated maximum number of hydrogensmaximum number of hydrogens no double bondsno double bonds more energy storage (more more energy storage (more
calories)calories) less fluid because straightless fluid because straight butter, lard, fatbutter, lard, fat
UnsaturatedUnsaturated less than maximum less than maximum
number of hydrogensnumber of hydrogens double bonds presentdouble bonds present less energy storageless energy storage more fluid because bentmore fluid because bent vegetable oilsvegetable oils
Other LipidsOther Lipids Isoprenoids - carotene, vitamin A, E, KIsoprenoids - carotene, vitamin A, E, K Sterols Sterols
cholesterol, a component of membranescholesterol, a component of membranes steroid hormones, testosterone, estrogen, steroid hormones, testosterone, estrogen,
cortisonecortisone
good cholesterol vs. bad good cholesterol vs. bad cholesterolcholesterol
Good cholesterolGood cholesterol bound to high density bound to high density
lipoprotein (HDL)lipoprotein (HDL) transports cholesterol transports cholesterol
to liverto liver blocks synthesis of blocks synthesis of
more cholesterolmore cholesterol
Bad cholesterolBad cholesterol bound to low bound to low
density lipoprotein density lipoprotein (LDL)(LDL)
transports transports cholesterol to cells cholesterol to cells of the bodyof the body
does not prevent does not prevent synthesis of more synthesis of more cholesterol by livercholesterol by liver
Other lipidsOther lipids Waxes - 1 fatty alcohol, very hydrophobicWaxes - 1 fatty alcohol, very hydrophobic
surface of leaves, ear waxsurface of leaves, ear wax detergents - fatty acid saltdetergents - fatty acid salt
amphipathic - hydrophobic part associates amphipathic - hydrophobic part associates with grease on your jeans,with grease on your jeans,hydrophilic part associates hydrophilic part associates with water to allow grease with water to allow grease to be washed awayto be washed away
emulsification - allows emulsification - allows oil and water to mixoil and water to mix
often forms micellesoften forms micelles
Fat substitutes - OlestraFat substitutes - Olestra Olestra = sucrose + 8 fatty acidsOlestra = sucrose + 8 fatty acids not absorbed by digestive tracknot absorbed by digestive track Advantage(s) Advantage(s)
can be used to fry foods can be used to fry foods without adding calorieswithout adding calories
DisadvantagesDisadvantages negative nutritional value - prevents negative nutritional value - prevents
absorption of many fat soluble absorption of many fat soluble vitamins that help prevent cancer vitamins that help prevent cancer
diarrheadiarrhea oily anal leakageoily anal leakage
Cell FunctionCell Function All human cells have the same general All human cells have the same general
structure and genetic material.structure and genetic material. Differentiation, or maturation, causes Differentiation, or maturation, causes
cells to become specialized.cells to become specialized. There are seven major functions of There are seven major functions of
cells.cells.
Major Functions of CellsMajor Functions of Cells MovementMovement ConductivityConductivity Metabolic absorptionMetabolic absorption SecretionSecretion ExcretionExcretion RespirationRespiration ReproductionReproduction
TissuesTissues Tissue refers to a group of cells that Tissue refers to a group of cells that
perform a similar function.perform a similar function. Four basic types of tissueFour basic types of tissue
EpithelialEpithelial Muscle Muscle ConnectiveConnective NerveNerve
TISSUE ORGANIZATIONTISSUE ORGANIZATION
Histology - is the study of Histology - is the study of tissuestissues
MAIN TISSUE TYPESMAIN TISSUE TYPES EpithelialEpithelial ConnectiveConnective MuscleMuscle NervousNervous
EPITHELIAL TISSUEEPITHELIAL TISSUE LocationLocation
sheets or layers lining body tubes, sheets or layers lining body tubes, cavities, or covering body surfacescavities, or covering body surfaces
Form many glandsForm many glands
GENERAL CHARACTERISTICSGENERAL CHARACTERISTICS Form sheets, layersForm sheets, layers Cells fit together tightlyCells fit together tightly One edge attached to basement One edge attached to basement
membranemembrane No blood supplyNo blood supply Regenerate quicklyRegenerate quickly Many are secretoryMany are secretory Supported by connective tissueSupported by connective tissue
FUNCTIONSFUNCTIONS ProtectionProtection AbsorptionAbsorption FiltrationFiltration SecretionSecretion Gas exchangeGas exchange
EPITHELIAL TISSUE TYPES EPITHELIAL TISSUE TYPES Number of layersNumber of layers
simple epitheliumsimple epithelium stratified epitheliumstratified epithelium pseudostratified epitheliumpseudostratified epithelium
Shape of cellsShape of cells squamous (flat)squamous (flat) cuboidal ( cubed)cuboidal ( cubed) columnar ( tall)columnar ( tall) transitional (varies)transitional (varies)
endocrine (ductless) - secrete hormones endocrine (ductless) - secrete hormones into bloodinto blood
exocrine- secrete through ducts to exocrine- secrete through ducts to specific locationsspecific locations
unicellular - “goblet cells”unicellular - “goblet cells” multicellularmulticellular
modes of secretion modes of secretion apocrine - apex pinches offapocrine - apex pinches off holocrine - accumulate until ruptureholocrine - accumulate until rupture merocrine -most common;secrete by exocytosismerocrine -most common;secrete by exocytosis
Glandular Epithelial Tissue Glandular Epithelial Tissue TypesTypes
CONNECTIVE TISSUECONNECTIVE TISSUE
Most abundant and Most abundant and widespread tissue found in widespread tissue found in
the bodythe body
GENERAL CHARACTERISTICS GENERAL CHARACTERISTICS Many types with great diversityMany types with great diversity Very good blood supplyVery good blood supply Cells usually spaced apart from each otherCells usually spaced apart from each other Intercellular material (matrix) separating Intercellular material (matrix) separating
cellscells No free surfaceNo free surface Derived from mesenchymeDerived from mesenchyme Consist of ground substance, fibers, cellsConsist of ground substance, fibers, cells
Connective Tissue FunctionsConnective Tissue Functions Physical protectionPhysical protection SupportSupport BindingBinding Absorb shockAbsorb shock InsulationInsulation Stores energyStores energy Blood productionBlood production ImmunityImmunity
Types of FibersTypes of Fibers Collagen - very tough and strong Collagen - very tough and strong
contains collagen proteincontains collagen protein Elastic - very flexible and stretchableElastic - very flexible and stretchable
contains elastin proteincontains elastin protein Reticular - forms network meshReticular - forms network mesh
contains collagen & glycoprotein contains collagen & glycoprotein
Connective Tissue ProperConnective Tissue Proper
Loose Connective(Areolar) - attaches Loose Connective(Areolar) - attaches skin to underlying body parts; skin to underlying body parts; superficial fasciasuperficial fascia
Adipose - energy storage; insulationAdipose - energy storage; insulation
Reticular - binds smooth muscles Reticular - binds smooth muscles togethertogether
Regular dense connective Regular dense connective tissue(fibrous)tissue(fibrous) tendon; ligamentstendon; ligaments
Irregular denseIrregular dense fascia, periosteumfascia, periosteum
Elastic connectiveElastic connective blood vessels, lung tissue blood vessels, lung tissue
CartilageCartilage
Hyaline cartilage (gristle)Hyaline cartilage (gristle) ends of long bone, nose tip, connects ends of long bone, nose tip, connects
ribs to sternumribs to sternum Elastic cartilageElastic cartilage
external earexternal ear FibrocartilageFibrocartilage
between pubic symphysisbetween pubic symphysis discs between vertebraediscs between vertebrae
OSSEOUS TISSUE - BONEOSSEOUS TISSUE - BONE
MATRIXMATRIX30% collagen fibers30% collagen fibers70% mineral salts70% mineral salts
Osseous TissueOsseous Tissue Types of CellsTypes of Cells
osteocytesosteocytes osteoblastsosteoblasts osteoclastsosteoclasts
Types of BoneTypes of Bone Cancellous (Spongy) Bone - trabeculaeCancellous (Spongy) Bone - trabeculae Compact Bone - Haversian Canal System Compact Bone - Haversian Canal System
Blood Tissue (Vascular)Blood Tissue (Vascular) Hemopoietic Tissue (blood forming Hemopoietic Tissue (blood forming
tissue)tissue) Types of Cells: Types of Cells:
erythrocytes (RBC’s)erythrocytes (RBC’s) leukocytes (WBC’s)leukocytes (WBC’s) platelets (thrombocytes) platelets (thrombocytes)
MUSCLE TISSUEMUSCLE TISSUE
Contractile tissue Contractile tissue Responsible for movementResponsible for movement
Skeletal Muscle - VoluntarySkeletal Muscle - Voluntary Long, threadlike cells with parallel Long, threadlike cells with parallel
fibersfibers
Cells are multinucleate with nuclei Cells are multinucleate with nuclei located peripherally; striatedlocated peripherally; striated
Usually attached to long bonesUsually attached to long bones
Smooth Muscle - Smooth Muscle - InvoluntaryInvoluntary
Spindle shaped cells with single Spindle shaped cells with single nucleus per cellnucleus per cell
No striationsNo striations Located in blood vessels, walls of Located in blood vessels, walls of
hollow organs, and the hollow organs, and the gastrointestinal tractgastrointestinal tract
Cardiac Muscle - InvoluntaryCardiac Muscle - Involuntary Branched cells with striated fibersBranched cells with striated fibers Intercalated discsIntercalated discs Only a single nucleus per cellOnly a single nucleus per cell Only found in the heart Only found in the heart
NERVE TISSUENERVE TISSUE
Characterized by the ability to Characterized by the ability to conduct electrical signals conduct electrical signals
Nervous TissueNervous Tissue Located in the brain and spinal cord Located in the brain and spinal cord
(CNS) and in the nerves (PNS)(CNS) and in the nerves (PNS) Sensitive to changes in the internal Sensitive to changes in the internal
and external environmentand external environment Conducts nerve impulses to other Conducts nerve impulses to other
neurons/body partsneurons/body parts
NERVE TISSUENERVE TISSUE Functions in coordinating, regulating, Functions in coordinating, regulating,
and integrating body activitiesand integrating body activities Types of Cells: Types of Cells:
neuroglial cells - support cellsneuroglial cells - support cells neuron - cell body, axon, dendritesneuron - cell body, axon, dendrites
MEMBRANESMEMBRANES
Thin sheet or layer of tissue Thin sheet or layer of tissue that covers a structure or that covers a structure or
lines a cavitylines a cavity
Epithelial MembranesEpithelial Membranes Cutaneous membrane - skinCutaneous membrane - skin Serous membrane - (serosa)Serous membrane - (serosa)
found in closed cavitiesfound in closed cavities parietal membrane - lines inside of cavitiesparietal membrane - lines inside of cavities visceral membrane - covers organsvisceral membrane - covers organs
Mucous membrane - mucosa Mucous membrane - mucosa line cavities that open to the exteriorline cavities that open to the exterior
Connective Tissue Connective Tissue MembranesMembranes
Synovial MembraneSynovial Membrane line spaces between bones in jointsline spaces between bones in joints secrete synovial fluidsecrete synovial fluid
Organs, Organ Systems, Organs, Organ Systems, and the Organismand the Organism
An organ is a group of tissues An organ is a group of tissues functioning together.functioning together.
A group of organs working together is A group of organs working together is an organ system.an organ system.
The sum of all cells, tissues, organs, The sum of all cells, tissues, organs, and organ systems makes up an and organ systems makes up an organism.organism.
Organ SystemsOrgan Systems CardiovascularCardiovascular RespiratoryRespiratory GastrointestinalGastrointestinal GenitourinaryGenitourinary ReproductiveReproductive
NervousNervous EndocrineEndocrine LymphaticLymphatic MuscularMuscular SkeletalSkeletal
System IntegrationSystem Integration Homeostasis is the body’s natural Homeostasis is the body’s natural
tendency to keep the internal tendency to keep the internal environment and metabolism steady environment and metabolism steady and normal.and normal. Cells do not tolerate extreme Cells do not tolerate extreme
environmental fluctuations. environmental fluctuations.
System IntegrationSystem Integration Two systems work together to maintain Two systems work together to maintain
homeostasis:homeostasis: Nervous systemNervous system Endocrine systemEndocrine system
Nervous system response is fastNervous system response is fast Endocrine response is longer lastingEndocrine response is longer lasting Responses are stimulated by Responses are stimulated by
pathological alterations pathological alterations
System IntegrationSystem Integration Chemical signals are received by Chemical signals are received by
various types of receptorsvarious types of receptors Interact with, and then respond to, the Interact with, and then respond to, the
chemical signals and other stimuli chemical signals and other stimuli ChemoreceptorsChemoreceptors BaroreceptorsBaroreceptors Alpha and Beta ReceptorsAlpha and Beta Receptors
System IntegrationSystem Integration Endocrine GlandsEndocrine Glands
Secrete hormones directly into the Secrete hormones directly into the circulatory systemcirculatory system
Exocrine GlandsExocrine Glands Secrete hormones directly onto surfaceSecrete hormones directly onto surface
Some glands are “mixed”Some glands are “mixed” Endocrine and exocrine functionEndocrine and exocrine function
Intercellular CommunicationIntercellular Communication Endocrine signalingEndocrine signaling
Hormones distributed throughout the bodyHormones distributed throughout the body Paracrine signalingParacrine signaling
Secretion of chemical mediators by certain Secretion of chemical mediators by certain cells that act only upon nearby cellscells that act only upon nearby cells
Autocrine signalingAutocrine signaling Cells secrete substances that act upon Cells secrete substances that act upon
themselvesthemselves Synaptic signalingSynaptic signaling
Cells secrete neurotransmitters that Cells secrete neurotransmitters that transmit signals across synapsestransmit signals across synapses
System IntegrationSystem Integration Stressors on a body system are inputs.Stressors on a body system are inputs. A system receiving input creates A system receiving input creates
feedback.feedback. A negative feedback loop exists when A negative feedback loop exists when
body mechanisms work to reverse the body mechanisms work to reverse the input.input.
Biological systems generally employ Biological systems generally employ negative feedback loops to maintain negative feedback loops to maintain stability. stability.
PathophysiologyPathophysiology ““The physiology of disordered The physiology of disordered
function” function” Our understanding is constantly Our understanding is constantly
expanding expanding During your career you will encounter During your career you will encounter
patient conditions or diseases that patient conditions or diseases that were not addressed in your initial were not addressed in your initial paramedic education. paramedic education.
How Cells Respond How Cells Respond To Change and InjuryTo Change and Injury
Cell ReproductionCell Reproduction Human cells (except sex cells) reproduce by Human cells (except sex cells) reproduce by
mitosis mitosis Most undergo division throughout the life of Most undergo division throughout the life of
the individualthe individual Epithelial cellsEpithelial cells Liver cellsLiver cells Bone marrow cellsBone marrow cells
Some divide until near time of birthSome divide until near time of birth Nerve cellsNerve cells Skeletal muscle cellsSkeletal muscle cells
Copyright © 2006, 2001, 1994 by Mosby, Inc. All rights reserved.
CELL DIVISIONCELL DIVISION Process by which a cell reproduces itselfProcess by which a cell reproduces itself Involves nuclear division - mitosis, meiosisInvolves nuclear division - mitosis, meiosis Involves cytoplasmic division - cytokinesisInvolves cytoplasmic division - cytokinesis Mitosis - somatic cell division in which the Mitosis - somatic cell division in which the
cell retains the same number of cell retains the same number of chromosomeschromosomes
Meiosis - reductional division in which the Meiosis - reductional division in which the chromosome number is reducedchromosome number is reduced
CELL CYCLE CELL CYCLE Growth Phase 1 - synthesis of lipids, Growth Phase 1 - synthesis of lipids,
proteins and carbohydratesproteins and carbohydrates S Phase - DNA synthesisS Phase - DNA synthesis Growth Phase 2 - formation of spindle Growth Phase 2 - formation of spindle
fibers for cell division, centrioles dividefibers for cell division, centrioles divide Mitosis / MeiosisMitosis / Meiosis INTERPHASEINTERPHASE
•STAGES OF MITOSISSTAGES OF MITOSISPROPHASEPROPHASE
METAPHASEMETAPHASEANAPHASEANAPHASETELOPHASETELOPHASE
PROPHASEPROPHASE Chromatin condenses into chromosomesChromatin condenses into chromosomes Spindle Fibers appearSpindle Fibers appear Nuclear membrane disappearsNuclear membrane disappears Nucleolus disappearsNucleolus disappears Centrioles move to opposite polesCentrioles move to opposite poles Chromosomes begins to migrate toward Chromosomes begins to migrate toward
equatorequator
METAPHASE / ANAPHASEMETAPHASE / ANAPHASE Chromosomes line Chromosomes line
up along equatorup along equator centromere of each centromere of each
pair attached to a pair attached to a spindle fiberspindle fiber
Centromeres split; Centromeres split; sister chromatids sister chromatids separateseparate
Chromatids Chromatids migrate to opposite migrate to opposite polespoles
TELOPHASE & CYTOKINESISTELOPHASE & CYTOKINESIS Opposite of ProphaseOpposite of Prophase Chromosomes elongate forming Chromosomes elongate forming
indistinct chromatinindistinct chromatin Nuclear membrane reappearsNuclear membrane reappears Nuclear reorganization occursNuclear reorganization occurs Two new daughter cells formedTwo new daughter cells formed
NUCLEIC ACID STRUCTURENUCLEIC ACID STRUCTURE DNA - forms genetic codeDNA - forms genetic code RNA - functions in the process of RNA - functions in the process of
protein synthesisprotein synthesis
DNA DNA DEOXYRIBONUCLEIC ACID DEOXYRIBONUCLEIC ACID
Double stranded helix; nucleusDouble stranded helix; nucleus Contains: 5 carbon sugar, phosphate Contains: 5 carbon sugar, phosphate
group, nitrogenous basegroup, nitrogenous base Nitrogenous basesNitrogenous bases
adenine-thymineadenine-thymine cytosine- guaninecytosine- guanine
Base pairing occursBase pairing occurs
DNA RELICATIONDNA RELICATION DNA makes an exact duplicate of itselfDNA makes an exact duplicate of itself DNA strands separate into separate DNA strands separate into separate
strands and each one is used as a strands and each one is used as a template for a new strand of nucleotidestemplate for a new strand of nucleotides
Two double- helix molecules are formed, Two double- helix molecules are formed, each contains an original strand and a each contains an original strand and a newly synthesized strand newly synthesized strand
RNARNARIBONUCLEIC ACIDRIBONUCLEIC ACID
Single strandedSingle stranded Uracil substitutes for thymineUracil substitutes for thymine consists of 5 carbon sugar ribose, consists of 5 carbon sugar ribose,
phosphate group, nitrogenous basephosphate group, nitrogenous base Bases: adenine, guanine, cytosine, Bases: adenine, guanine, cytosine,
uraciluracil RNA types: mRNA, tRNA, rRNARNA types: mRNA, tRNA, rRNA
TRANSCRIPTIONTRANSCRIPTIONRNA SYNTHESISRNA SYNTHESIS
mRNA is synthesized using a DNA mRNA is synthesized using a DNA molecule as a templatemolecule as a template
mRNA carries MESSAGE out of the mRNA carries MESSAGE out of the nucleus to the ribsome in the nucleus to the ribsome in the cytoplasmcytoplasm
TRANSLATIONTRANSLATIONPROTEIN SYNTHESISPROTEIN SYNTHESIS
Genetic code is translated forming a Genetic code is translated forming a specific sequence of amino acidsspecific sequence of amino acids
mRNA attaches to the ribosomes in the mRNA attaches to the ribosomes in the cytoplasmcytoplasm
tRNA molecules bring specific A.A. to tRNA molecules bring specific A.A. to the ribosome for placement in the the ribosome for placement in the dictated sequencedictated sequence
Ribosome bonds amino acids together Ribosome bonds amino acids together to form proteins / polypeptidesto form proteins / polypeptides
Protein is releasedProtein is released
Loose end - membranesLoose end - membranes Lipid bilayer closes to Lipid bilayer closes to
form a sphere (vesicle)form a sphere (vesicle) Inside of vesicle is a Inside of vesicle is a
separate compartmentseparate compartment Bilayer is Bilayer is
“semipermeable”“semipermeable” Small, uncharged Small, uncharged
molecules pass throughmolecules pass through Large or charged Large or charged
molecules cannot pass molecules cannot pass through hydrophobic part through hydrophobic part of bilayerof bilayer
Proteins are incredibly diverse – 20Proteins are incredibly diverse – 20(# of amino acids)(# of amino acids) possible possible combinations (3,200,000 combinations for a 5 aa protein).combinations (3,200,000 combinations for a 5 aa protein).
Different amino acids have different chemical properties, Different amino acids have different chemical properties, causing polypeptide chain to fold up on itself.causing polypeptide chain to fold up on itself. Hydrophobic amino acids are buried in the centerHydrophobic amino acids are buried in the center Hydrophilic are on the Hydrophilic are on the
surfacesurface Ionic and H-bonds can Ionic and H-bonds can
form between amino acidsform between amino acids Function is dependent onFunction is dependent on
folded structure, which isfolded structure, which isdependent on sequence dependent on sequence of amino acids.*******of amino acids.*******
Loose end– protein foldingLoose end– protein folding
Enzymes are proteins that catalyze Enzymes are proteins that catalyze (stimulate/ accelerate) chemical reactions(stimulate/ accelerate) chemical reactions
Names end in -aseNames end in -ase ExamplesExamples
DNA polymerase makes DNADNA polymerase makes DNA ATPase breaks down or produces ATPATPase breaks down or produces ATP Helicase unwinds the DNA double helixHelicase unwinds the DNA double helix
Metabolic pathway is a series of reactions Metabolic pathway is a series of reactions that produces (anabolic) or breaks down that produces (anabolic) or breaks down (catabolic) a molecule in the cell(catabolic) a molecule in the cell Defects cause genetic diseasesDefects cause genetic diseases
Loose end– enzymesLoose end– enzymes
Info Flow - What Info Flow - What Information?Information?
What is information?What is information? Representation of knowledge, Representation of knowledge,
thoughts; series of symbols that thoughts; series of symbols that have meaning.have meaning.
Digital – 1’s and 0’sDigital – 1’s and 0’s Alphanumeric – letters and Alphanumeric – letters and
numbersnumbers Graphic – illustrationGraphic – illustration Genetic – chemical – order of Genetic – chemical – order of
bases (ACGTU) in a nucleic acid bases (ACGTU) in a nucleic acid tells a cell how and when to make tells a cell how and when to make specific proteins – which then specific proteins – which then perform some function for the cell.perform some function for the cell.
Storage of InformationStorage of Information Information is stored in the sequence of Information is stored in the sequence of
bases in DNA.bases in DNA. What Information?What Information?
Genes - instructions on how to make proteinsGenes - instructions on how to make proteins hemoglobin gene contains the information on the hemoglobin gene contains the information on the
order of amino acids that are linked together to order of amino acids that are linked together to make hemoglobinmake hemoglobin
Regulation - when and where to make proteinsRegulation - when and where to make proteins only bone marrow cells make hemoglobin only bone marrow cells make hemoglobin
DNADNA DNA = deoxyribonucleic acidDNA = deoxyribonucleic acid
Sugar = deoxyriboseSugar = deoxyribose Base –Base –
Purines (2 rings) = A, GPurines (2 rings) = A, G Pyrimidines (1 ring) = C, T Pyrimidines (1 ring) = C, T
Phosphate – negative charge Phosphate – negative charge – gives DNA a negative – gives DNA a negative chargecharge
Nucleic AcidsNucleic Acids Nucleotides are Nucleotides are
linked together via linked together via dehydration dehydration synthesis reactionssynthesis reactions sugar phosphate sugar phosphate
backbonebackbone bases project to sidebases project to side
DNA structureDNA structure Bases can form H-bondsBases can form H-bonds C’s and G’s pairC’s and G’s pair A pairs with T or UA pairs with T or U
Two strands of DNA are Two strands of DNA are said to be said to be complementarycomplementary
Strands are antiparallel, Strands are antiparallel, have 5’ phosphate & 3’ OHhave 5’ phosphate & 3’ OH
5’-GCTAGGTAGTCCT-3’5’-GCTAGGTAGTCCT-3’3’-CGATCCATCAGGA-5’3’-CGATCCATCAGGA-5’
The Central DogmaThe Central Dogma Information Flow within OrganismsInformation Flow within Organisms
What Information?What Information? Replication: DNA Replication: DNA DNA DNA
exact copy - photocopyexact copy - photocopy Transcription: DNA Transcription: DNA RNA RNA
still a sequence of nucleotidesstill a sequence of nucleotides writing notes from screen - still writing notes from screen - still
same letters, different form (cursive)same letters, different form (cursive) Translation: RNA Translation: RNA protein protein
nucleotide seq. nucleotide seq. amino acid seq. amino acid seq. english english russian russian
TranscriptioTranscriptionn
Messenger RNA (mRNA) functions Messenger RNA (mRNA) functions as a “working copy” of the as a “working copy” of the information on DNA.information on DNA.
RNA polymerase uses 1 strand of RNA polymerase uses 1 strand of DNA as a template to make mRNA.DNA as a template to make mRNA. Starting position determined by Starting position determined by
RNA polymerase binding to RNA polymerase binding to PROMOTERPROMOTER
RNA polymerase moves down RNA polymerase moves down DNA and connects nucleotides to DNA and connects nucleotides to make RNAmake RNA
bases - A,C,G in both RNA and bases - A,C,G in both RNA and DNA, T in DNA, U in RNADNA, T in DNA, U in RNA
TranscriptioTranscriptionn
After RNA is made, the 2 DNA After RNA is made, the 2 DNA strands come back together, strands come back together, RNA molecule is releasedRNA molecule is released in eukaryotes - each RNA in eukaryotes - each RNA
contains the info from 1 contains the info from 1 gene – produces 1 proteingene – produces 1 protein
in prokaryotes - RNAs may in prokaryotes - RNAs may contain info from multiple contain info from multiple gene – produce multiple gene – produce multiple proteinsproteins
RNA processingRNA processing
Once transcription does Once transcription does occur, RNA produced occur, RNA produced referred to as “primary referred to as “primary transcript”transcript”
In Eukaryotes, RNA is In Eukaryotes, RNA is processed to form mRNA processed to form mRNA before export from before export from nucleus to cytoplasmnucleus to cytoplasm
RNA splicingRNA splicing Eukaryotic genes are interrupted by DNA sequences called introns or Eukaryotic genes are interrupted by DNA sequences called introns or
intervening sequences, parts that will be used to make protein are intervening sequences, parts that will be used to make protein are exons.exons.
Introns are cut from primary RNA transcript, exons are spliced together.Introns are cut from primary RNA transcript, exons are spliced together.
RNA ProcessingRNA Processing Poly-A tail added to 3’ end to enhance Poly-A tail added to 3’ end to enhance
stability of mRNAstability of mRNA 7-methyl-guanine “cap” added to 5’ end – 7-methyl-guanine “cap” added to 5’ end –
required for export from nucleusrequired for export from nucleus
The Genetic CodeThe Genetic Code What is a code?What is a code? Morse CodeMorse Code The genetic code The genetic code
translates nucleotide translates nucleotide sequence into amino sequence into amino acid sequenceacid sequence codoncodon - sequence of 3 - sequence of 3
nucleotides that nucleotides that specifies 1 amino acid.specifies 1 amino acid.
AUG=start codonAUG=start codon UAA, UGA, UAG are UAA, UGA, UAG are
stop codons.stop codons.
The Genetic CodeThe Genetic Code Genetic code is Genetic code is
degenerate - 64 degenerate - 64 possible combinations, possible combinations, but only 20 amino but only 20 amino acids.acids.
Most amino acids are Most amino acids are encoded by multiple encoded by multiple codonscodons
The Genetic Code is The Genetic Code is Universal - same for all Universal - same for all organismsorganisms
The Genetic CodeThe Genetic Code Codons are read sequentially, not-Codons are read sequentially, not-
overlapped.overlapped. 3 Possible Reading Frames3 Possible Reading Frames
AUG GGA UCC ACA UUU GCA UGAAUG GGA UCC ACA UUU GCA UGA Met Gly Ser Thr Phe Ala StopMet Gly Ser Thr Phe Ala Stop A UGG GAU CCA CAU UUG CAU GAA UGG GAU CCA CAU UUG CAU GA Trp Asp Pro His Leu HisTrp Asp Pro His Leu His AU GGG AUC CAC AUU UGC AUG AAU GGG AUC CAC AUU UGC AUG A Gly Ile His Ile Cys MetGly Ile His Ile Cys Met
The Big PictureThe Big Picture
RibosomesRibosomes Translation occurs on ribosomesTranslation occurs on ribosomes Ribosomes are ribonucleoproteins Ribosomes are ribonucleoproteins
(RNA and protein components)(RNA and protein components) Small subunit contains Small subunit contains
16S rRNA and 33 proteins16S rRNA and 33 proteins Large subunit contains Large subunit contains
23S rRNA, 5S rRNA and 23S rRNA, 5S rRNA and 45 proteins45 proteins
rRNAs are functional components, rRNAs are functional components, proteins proteins provide scaffoldingprovide scaffolding
““Functional” Functional” RNAsRNAs
mRNA function is mRNA function is information transfer – information transfer – info is used to make info is used to make proteinprotein
Some RNAs are not Some RNAs are not translated – tRNA, rRNAtranslated – tRNA, rRNA
Intramolecular base Intramolecular base pairing causes RNA to pairing causes RNA to fold into a specific fold into a specific shape (like a protein)shape (like a protein)
Paired regions twist to Paired regions twist to form helixform helix
tRNA structuretRNA structure Transfer RNA (tRNAs) are the adaptors that Transfer RNA (tRNAs) are the adaptors that
associate RNA codons with amino acidsassociate RNA codons with amino acids anticodon at one end base pairs with codons on anticodon at one end base pairs with codons on
mRNA. mRNA. amino acid at other end amino acid at other end
attached by amino acyl-attached by amino acyl-tRNA synthetasestRNA synthetases
Each amino acid has Each amino acid has 1-2 tRNAs1-2 tRNAs
TranslationTranslation 1. Ribosomes bind mRNA, position start codon.1. Ribosomes bind mRNA, position start codon. 2. Initiator tRNA base pairs with AUG codon.2. Initiator tRNA base pairs with AUG codon. 3. tRNA that base pairs with next codon is lined up.3. tRNA that base pairs with next codon is lined up. 4. Two amino acids are connected.4. Two amino acids are connected.
TranslationTranslation 4. Two amino acids are connected.4. Two amino acids are connected. 5. Ribosome moves down mRNA to next codon.5. Ribosome moves down mRNA to next codon. 6. New tRNA pairs with next codon.6. New tRNA pairs with next codon. 7. Return to step 47. Return to step 4
TranslationTranslation When ribosome reaches a stop codon - When ribosome reaches a stop codon -
no tRNAs can pair with it. no tRNAs can pair with it. Polypeptide is released, folds into a Polypeptide is released, folds into a
functional protein.functional protein. See animationSee animation
The Big PictureThe Big Picture DNA is transcribed DNA is transcribed
to mRNA.to mRNA. Ribosome binds Ribosome binds
mRNA.mRNA. tRNAs with amino tRNAs with amino
acids pair up with acids pair up with codons on mRNA.codons on mRNA.
Amino acids Amino acids connected to connected to produce proteinproduce protein
Questions?Questions?
How Cells Respond How Cells Respond To Change and InjuryTo Change and Injury
Cellular AdaptationCellular Adaptation Cellular InjuryCellular Injury Cellular DeathCellular Death
Cellular AdaptationCellular Adaptation Cells, tissues, organs, and organ Cells, tissues, organs, and organ
systems can adapt to both normal and systems can adapt to both normal and injurious conditions.injurious conditions.
Adaptation results in alteration of Adaptation results in alteration of structure and function.structure and function.
Many of these cellular adaptations are Many of these cellular adaptations are successful.successful. May also be part of the process of a May also be part of the process of a
disease disease
Types of Cellular Types of Cellular AdaptationsAdaptations
AtrophyAtrophy Decreased size resulting from a decreased Decreased size resulting from a decreased
workloadworkload HypertrophyHypertrophy
An increase in cell size resulting from an An increase in cell size resulting from an increased workloadincreased workload
HyperplasiaHyperplasia An increase in the number of cells resulting An increase in the number of cells resulting
from an increased workloadfrom an increased workload
Types of Cellular Types of Cellular AdaptationsAdaptations
MetaplasiaMetaplasia Replacement of one type of cell by another Replacement of one type of cell by another
type of cell that is not normal for that type of cell that is not normal for that tissuetissue
DysplasiaDysplasia A change in cell size, shape, or appearance A change in cell size, shape, or appearance
caused by an external stressorcaused by an external stressor
Cellular InjuryCellular Injury HypoxicHypoxic ChemicalChemical InfectiousInfectious Immunologic or Immunologic or
Inflammatory Inflammatory
Physical agentsPhysical agents Nutritional Nutritional
balancesbalances Genetic factors Genetic factors
Cellular InjuryCellular Injury Hypoxic InjuryHypoxic Injury
Usually a deficit in the respiratory or Usually a deficit in the respiratory or cardiovascular system cardiovascular system
Blockage or reduction of blood flow to a Blockage or reduction of blood flow to a cell may result in ischemia.cell may result in ischemia.
Results in anaerobic metabolismResults in anaerobic metabolism Cell and some of its organelles then begin to Cell and some of its organelles then begin to
swell swell Reversible if intervention is earlyReversible if intervention is early
Infarction occurs if no intervention Infarction occurs if no intervention
Cellular InjuryCellular Injury Chemical InjuryChemical Injury
Cellular injury due to chemical products is Cellular injury due to chemical products is very common. very common.
Heavy metals, carbon monoxide, ethanol, drugs, Heavy metals, carbon monoxide, ethanol, drugs, and insecticides are examplesand insecticides are examples
Injuries include:Injuries include: Disruption of the cellular membrane Disruption of the cellular membrane Alteration of coagulation Alteration of coagulation Death of the cell Death of the cell
Cellular InjuryCellular Injury Infectious InjuryInfectious Injury
Caused by bacteria, viruses, prions, fungi, Caused by bacteria, viruses, prions, fungi, and parasites and parasites
Majority are harmlessMajority are harmless Pathogens cause diseasePathogens cause disease
Degree of damage depends on the Degree of damage depends on the pathogens numbers, its virulence, and the pathogens numbers, its virulence, and the body’s ability to contain or destroy it body’s ability to contain or destroy it
Cellular InjuryCellular Injury Immunologic/Inflammatory InjuryImmunologic/Inflammatory Injury
Protective responses of the body can cause Protective responses of the body can cause cell injury and even death. cell injury and even death.
HypersensitivityHypersensitivity AnaphylaxisAnaphylaxis An immune response may harm healthy An immune response may harm healthy
cells as well as damaged cells.cells as well as damaged cells.
Cellular InjuryCellular Injury Injurious Physical AgentsInjurious Physical Agents
Extreme variances in temperature Extreme variances in temperature Atmospheric pressure changesAtmospheric pressure changes Exposure to ionizing radiationExposure to ionizing radiation Illumination Illumination NoiseNoise Mechanical stresses Mechanical stresses
Cellular InjuryCellular Injury Injurious Nutritional ImbalancesInjurious Nutritional Imbalances
Excessive intake of saturated fats and Excessive intake of saturated fats and cholesterolcholesterol
Excessive carbohydrate (glucose) intake Excessive carbohydrate (glucose) intake Insufficient intake of nutrients Insufficient intake of nutrients
Cellular InjuryCellular Injury Injurious Genetic FactorsInjurious Genetic Factors
Some cellular dysfunctions are caused by Some cellular dysfunctions are caused by genetic predisposition. genetic predisposition.
This can involve alterations to the nucleus or This can involve alterations to the nucleus or the cell membrane, the shape of the cell, the the cell membrane, the shape of the cell, the receptors on the cell membrane, or the receptors on the cell membrane, or the transport mechanisms that carry substances transport mechanisms that carry substances across the cell membrane. across the cell membrane.
The interaction of genes and environmental The interaction of genes and environmental factors determine that person’s development. factors determine that person’s development.
Manifestations of Cellular Manifestations of Cellular InjuryInjury
When cells are injured metabolism is When cells are injured metabolism is changed, causing substances to changed, causing substances to infiltrate or accumulate to an abnormal infiltrate or accumulate to an abnormal degree in cells and tissues.degree in cells and tissues.
The most commonly seen effects of cell The most commonly seen effects of cell injury and accumulation are cellular injury and accumulation are cellular swelling and fatty change.swelling and fatty change.
Manifestations of Cellular Manifestations of Cellular InjuryInjury
Cellular SwellingCellular Swelling Results from a permeable or damaged Results from a permeable or damaged
cellular membranecellular membrane Caused by an inability to maintain stable Caused by an inability to maintain stable
intra- and extra-cellular fluid andintra- and extra-cellular fluid andelectrolyte levelselectrolyte levels
Fatty ChangeFatty Change Lipids invade site of injuryLipids invade site of injury Ominous sign of impending cellular Ominous sign of impending cellular
destruction destruction
Manifestations of Cellular Manifestations of Cellular InjuryInjury
Systemic Signs and Symptoms of Systemic Signs and Symptoms of Cellular Change Cellular Change Fatigue and malaiseFatigue and malaise Altered appetiteAltered appetite FeverFever Increased heart rate associated with feverIncreased heart rate associated with fever PainPain
Cellular DeathCellular Death ApoptosisApoptosis
The body’s way of ridding itself of The body’s way of ridding itself of destroyed or nonfunctional cells destroyed or nonfunctional cells
Result of both normal and pathological Result of both normal and pathological tissue changes tissue changes
In apoptosis, cells shrink In apoptosis, cells shrink Apoptosis has specificityApoptosis has specificity
Contained to specific cells or areas Contained to specific cells or areas
Cellular DeathCellular Death NecrosisNecrosis
A pathological processA pathological process Cells swell and ruptureCells swell and rupture Necrotic tissue changesNecrotic tissue changes
Coagulative, liquefactive, caseous, and fattyCoagulative, liquefactive, caseous, and fatty Gangrenous necrosisGangrenous necrosis