PATHOLGYPATHOLGY

Pathology is "Pathology is "Scientific study ofScientific study of diseasedisease" Study of structural and " Study of structural and functional changes in disease. You functional changes in disease. You need to have a basic knowledge of need to have a basic knowledge of normal Anatomy (structure) and normal Anatomy (structure) and Physiology(function) to understand Physiology(function) to understand PathologyPathology..

What is a “disease”What is a “disease”

A disease may be defined as an A disease may be defined as an

abnormal alteration of structure or abnormal alteration of structure or function of any part of body.function of any part of body.

Factors Causing DiseaseFactors Causing Disease

Environmental or external factorsEnvironmental or external factors

Acquired diseasesAcquired diseases..

Genetic or Internal factorsGenetic or Internal factors Congenital diseasesCongenital diseases

Familial diseasesFamilial diseases

Study Of Pathology Divided IntoStudy Of Pathology Divided Into

General PathologyGeneral Pathology It deals with general principles and It deals with general principles and

mechanisms of the disease productionmechanisms of the disease production

Systemic PathologySystemic Pathology It deals with the disease of specific It deals with the disease of specific

organ or system of the bodyorgan or system of the body

Branches of PathologyBranches of Pathologyo Histopathology / Anatomic Pathology : : Patholgists specializing in anatomical changes Patholgists specializing in anatomical changes

in disease,usuallly using tissue biopsy.in disease,usuallly using tissue biopsy.

o Cytopathology: Pathologists specialising in study : Pathologists specialising in study of body fluids & Cells.of body fluids & Cells.

o Haematology: Study of blood and blood : Study of blood and blood forming organs.forming organs.

o Morbid Anatomy: Autopsy or Post mortem : Autopsy or Post mortem study for legal or educational purpose. study for legal or educational purpose.

Aspects of disease processAspects of disease process

Pathology of a disease is formally Pathology of a disease is formally studied under four subdivisions. studied under four subdivisions.

EtiologyEtiology PathogenesisPathogenesis MorphologyMorphology Clinical SignificanceClinical Significance

Cellular Adaptation

Cellular AdaptationsCellular Adaptations

Cellular adaptation refers to Cellular adaptation refers to changes made by a cell in response changes made by a cell in response to adverse environmental to adverse environmental changes.The adaptation may be changes.The adaptation may be physiological (normal) or physiological (normal) or pathological (abnormalpathological (abnormal ) )

VariousVarious Types of Types of AdaptationsAdaptations

Cells may undergo various adaptations in physiological and Cells may undergo various adaptations in physiological and pathological conditions controlled by complex pathological conditions controlled by complex molecular mechanismsmolecular mechanisms

Common types of cellular adaptationsCommon types of cellular adaptations

I.I. Atrophy Atrophy

II.II. HypertrophyHypertrophy

III.III. HyperplasiaHyperplasia

IV.IV. MetaplasiaMetaplasia

V.V. DysplasiaDysplasia

. .

Diagramic representationDiagramic representation

AtrophyAtrophy

• AtrophyAtrophy is a decrease in cell size. If enough cells in is a decrease in cell size. If enough cells in an organ atrophy the entire organ will decrease in sizean organ atrophy the entire organ will decrease in size

• Sites Sites :: Tissue and organs especially susceptible to Atrophy Tissue and organs especially susceptible to Atrophy

includesincludes : : Skeletal musclesSkeletal muscles Cardiac musclesCardiac muscles Secondary sex organsSecondary sex organs BrainBrain

Denervation AtrophyDenervation Atrophy

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Atrophy associatedwith Malnutrition

Atrophy associatedwith Malnutrition

HYPERTROPHYHYPERTROPHY

HypertrophyHypertrophy is an increase in cell size. If is an increase in cell size. If enough cells of an organ hypertrophy so will enough cells of an organ hypertrophy so will the whole organ.the whole organ.

Causing Signals:Causing Signals:

Hypertrophy may be caused byHypertrophy may be caused by• mechanical signals mechanical signals • trophic signals trophic signals

● ● increased number of cells in an organ or tissueincreased number of cells in an organ or tissue ● ● may sometimes co-exist with hypertrophymay sometimes co-exist with hypertrophy

● ● classified asclassified as::

Physiologic Physiologic - hormonal - hormonal - compensatory - compensatory

PathologicPathologicPathologic hyperplasia is an Pathologic hyperplasia is an

abnormal increase in cell division. abnormal increase in cell division. (endometriosis(endometriosis

HYPERPLASIAHYPERPLASIA

METAPLASIAMETAPLASIA

MetaplasiaMetaplasia occurs when a differentiated cell occurs when a differentiated cell of a certain type is replaced by another cell of a certain type is replaced by another cell

type, which may be less differentiated.type, which may be less differentiated.

(e.g., the changes in respiratory tract, or on (e.g., the changes in respiratory tract, or on distal esophagus )distal esophagus )

CauseCause Metaplastic changes usually result from chronic Metaplastic changes usually result from chronic

irritation.irritation.

Metaplasia of Respiratory Epithelium

Metaplasia of Respiratory Epithelium

Metaplasia of Uterine Cervix

Metaplasia of Uterine Cervix

Metaplasia of Uterine Cervix

At Higher Magnification

Metaplasia of Uterine Cervix

At Higher Magnification

DysplasiaDysplasia

DysplasiaDysplasia refers generally to abnormal changes in refers generally to abnormal changes in cellular shape, size, and/or organization.cellular shape, size, and/or organization.

Sites:Sites:

(1) Tissues prone to dysplasia include cervical and (1) Tissues prone to dysplasia include cervical and respiratory epithelia. respiratory epithelia.

(2)Dysplasia often occurs in the vicinity of cancerous (2)Dysplasia often occurs in the vicinity of cancerous cells cells

(3)it may be involved in the development of breast (3)it may be involved in the development of breast cancercancer

Dysplastic cells

Introduction to

Hypertrophy

DEFINITIONDEFINITION

THE increase in cell size that leads to the THE increase in cell size that leads to the increase in size of the organincrease in size of the organ

It involves an increase in intracellular It involves an increase in intracellular proteinsproteins rather than rather than cytosolcytosol. .

Define as increase in cell numbersDefine as increase in cell numbers

THERE ARE TWO TYPES OF THERE ARE TWO TYPES OF HYPERTROPHYHYPERTROPHY

1.1. Physiological hypertrophyPhysiological hypertrophy

2. Pathological hypertrophy2. Pathological hypertrophy

Muscle hypertrophy seen in Muscle hypertrophy seen in striated skeleton muscles striated skeleton muscles cells because they have cells because they have limited capacity to divide limited capacity to divide

The weightlifters develops The weightlifters develops strong and heavy muscle strong and heavy muscle physique by increasing physique by increasing the functional demand of the functional demand of skeleton muscle,skeleton muscle,

1. Both hypertrophy and hyperplasia occur together in uterus enlargement during pregnancy consequence release of estrogen by smooth muscle hypertrophy and smooth muscle hyperplasia.

CellularCellular

hypertrophy includes hypertrophy includes cardiac enlargement cardiac enlargement that occur in that occur in hypertension or aortic hypertension or aortic valve disease. valve disease.

EXAMPLES OF HYPERTROPHYEXAMPLES OF HYPERTROPHY

Tonsils hypertrophyTonsils hypertrophy Skin hypertrophySkin hypertrophy Muscle hypertrophyMuscle hypertrophy Heart hypertrophyHeart hypertrophy

Skin HypertrophySkin Hypertrophy

HEART HYPERTROPHYHEART HYPERTROPHY

Robbins pathology Web pathology Google search engine

CARDIAC HYPERTROPHY

Main article: Ventricular hypertrophyMain article: Ventricular hypertrophy Ventricular hypertrophy is the increase in Ventricular hypertrophy is the increase in

size of the ventricles of the heart. Changes size of the ventricles of the heart. Changes can be beneficial or healthy if they occur in can be beneficial or healthy if they occur in response to aerobic or anaerobic exercise, response to aerobic or anaerobic exercise, but ventricular hypertrophy is generally but ventricular hypertrophy is generally associated with pathological changes due to associated with pathological changes due to high blood pressure or other disease stateshigh blood pressure or other disease states

Left ventricular hypertrophy is enlargement Left ventricular hypertrophy is enlargement (hypertrophy) of the muscle tissue that makes up (hypertrophy) of the muscle tissue that makes up the wall of your heart's main pumping chamber (left the wall of your heart's main pumping chamber (left ventricle). ventricle).

If you have left ventricular hypertrophy, you're at If you have left ventricular hypertrophy, you're at increased risk of heart disease, including heart increased risk of heart disease, including heart attack, heart failure, irregular heartbeats attack, heart failure, irregular heartbeats

(arrhythmia) and sudden cardiac arrest.(arrhythmia) and sudden cardiac arrest.

Left ventricular hypertrophy develops in Left ventricular hypertrophy develops in response to some factor, such as high blood response to some factor, such as high blood pressurepressure

The incidence of left ventricular hypertrophy The incidence of left ventricular hypertrophy (LVH) increases with age and is more (LVH) increases with age and is more common in people who have high blood common in people who have high blood pressure or other heart problems.pressure or other heart problems.

MACHANISMSMACHANISMS

Two mechanisms involved in cardiac Two mechanisms involved in cardiac hypertrophyhypertrophy

1.1. Mechanical trigger.Mechanical trigger.

2.2. Trophical trigger.Trophical trigger.

CHANGES IN CARDIACCHANGES IN CARDIACHYPERTROPHYHYPERTROPHY

In the case of cardiac hypertrophy there is In the case of cardiac hypertrophy there is

1.1. Degenerative changes occur in myocardial Degenerative changes occur in myocardial fibrils.fibrils.

2.2. FragmentationFragmentation

3.3. Loss of myofibril contractile elements Loss of myofibril contractile elements

These changes may b occur due toThese changes may b occur due to

1.1. Low blood supply.Low blood supply.

2.2. Low ATP supply.Low ATP supply.

REFERENCES

GOOGLE ALTAVISTA MSN WIKKIPEDIA

MUSCLE HYPERTROPHY

HYPERTROPHY IN MUSCLEHYPERTROPHY IN MUSCLE

What is muscular hypertrophy?What is muscular hypertrophy?

Definition: Definition: Muscular hypertrophy is an increase Muscular hypertrophy is an increase in muscle mass and cross-sectional area . in muscle mass and cross-sectional area .

The increase in dimension is due to an increase in The increase in dimension is due to an increase in

the size (not length) of individual muscle fibers.the size (not length) of individual muscle fibers.

Skeletal muscle has two basic Skeletal muscle has two basic functions functions

(1)(1) to contract to cause body movement to contract to cause body movement

(2)(2) to provide stability for body posture.to provide stability for body posture.

Hypertrophied musclesHypertrophied muscles

Muscle HypertrophyMuscle Hypertrophy Hypertrophy: increasing muscle size. Hypertrophy Hypertrophy: increasing muscle size. Hypertrophy

refers to increase in both the cross-sectional area of refers to increase in both the cross-sectional area of

the muscle (more myofibrils) and increase in length the muscle (more myofibrils) and increase in length

of the muscle (more sarcomeres per myofibril).of the muscle (more sarcomeres per myofibril).

Fibers do split as they get larger to maintain a Fibers do split as they get larger to maintain a

minimal surface area to volume ratio. minimal surface area to volume ratio.

This splitting of fibers is beneficial because if volume increases more This splitting of fibers is beneficial because if volume increases more than surface area diffusion distance will increase and access to than surface area diffusion distance will increase and access to oxygen and other compounds might be limited. oxygen and other compounds might be limited.

Splitting is not considered hyperplasia Splitting is not considered hyperplasia

because the fiber shares nuclei.because the fiber shares nuclei.

microtraumamicrotrauma

Microtrauma, which is tiny damage to the fibres, is Microtrauma, which is tiny damage to the fibres, is seen as the basis for hypertrophy. When seen as the basis for hypertrophy. When microtrauma occurs (from weight training or other microtrauma occurs (from weight training or other strenuous activities), the body responds by strenuous activities), the body responds by overcompensating, replacing the damaged tissue and overcompensating, replacing the damaged tissue and adding more, so that the risk of repeat damage is adding more, so that the risk of repeat damage is reduced. This is why progressive overload is reduced. This is why progressive overload is essential to continued improvement, as the body essential to continued improvement, as the body adapts and becomes more resistant to stress.adapts and becomes more resistant to stress.

Structural changes that occur as a Structural changes that occur as a result of muscle fiber hypertrophyresult of muscle fiber hypertrophy

Increase in actin filamentsIncrease in actin filamentsIncrease in myosin filamentsIncrease in myosin filamentsIncrease in myofibrilsIncrease in myofibrilsIncrease in sarcoplasmIncrease in sarcoplasmIncrease in muscle fiber connective tissue Increase in muscle fiber connective tissue

Growth factors:Growth factors:

Growth factors are highly specific proteins, Growth factors are highly specific proteins, which include hormones and cytokines, that which include hormones and cytokines, that are very involved in muscle hypertrophy .are very involved in muscle hypertrophy .

(1)insulin-like growth factor (IGF) (1)insulin-like growth factor (IGF) (2) fibroblast growth factor (FGF) (2) fibroblast growth factor (FGF) (3) hepatocyte growth factor (HGF).(3) hepatocyte growth factor (HGF). These growth factors work in conjunction These growth factors work in conjunction

with each other to cause skeletal muscle with each other to cause skeletal muscle hypertrophyhypertrophy

REFERENCES

WIKKIPEDIA YAHOO GOOGLE

INTRODUCTION TO HYPERPLASIA

HYPERPLASIA

An increase in the number of cells or proliferation of cell caused by mitosis in organ

or tissue which may then lead to increase volume of that organ or tissue

hyperplasia

physiologic pathologic

compensatory hormonal

Physiologic Hyperplasia

Physiological hyperplasia is a normal response to stimuli. It is of two types

Hormonal hyperplasiaCompensatory hyperplasia

Hormonal hyperplasia is increase in the number of cell due to hormonal stimulation

Example like in female there is proliferation of glandular epithelium of breast at puberty and during pregnancy due to estrogen and

prolactin2-:Proliferation in uterus during pregnancy is

due to estrogen

NODULAR REGENERATION

Example of compensatory hyperplasia

Hyperplasia in female breast

Normal breast

Hyperplasic breast

Hyperplasia in uterus during pregnancy

Endometrial hyperplasia

Compensatory Hyperplasia

In compensatory hyperplasia there is increase in the number of cell when the portion of tissue is removed or diseased

Example when the liver is partially resects, mitotic activity in remaining cell began to restore the liver in its normal weight and

the stimuli for such hyperplasia is hepatocyte polypeptide growth factors

which is produce by parenchymal(hepatocytes) as well as

nonparencymal cell in liver

Pathologic hyperplasia is mostly caused by due to excessive hormonal or growth factor stimulator

Example:- if the balance between estrogen and progesterone is disturbed it results in

abnormal menstrual bleeding

Endometrial hyperplasia

Benign prostate hyperplasia

It is increase in size of prostate gland which is due to low level of testosterone in aged male and high level of dihydrotestosterone or estrogen

Focal epithelial hyperplasia

also known as Heck's disease) - This is a wart-like growth in the mucous tissues of the mouth or, rarely, throat that is

caused by certain sub-types of the human papillomavirus

other example of pathologic hyperplasia

1-:Hyperplasic goiter

2-:Hyperplasia of bronchial epithelium

3-:Hyperplasia of biliary epithelium 4-:Gingival hyperplasia

5-:Sebaceous gland hyperplasia

Goiter

Sebaceous gland

hyperplasia

Gingival

hyperplasia

Imagination is better than knowledge - Einstein

DIFFERENCE BETWEEN HYPERTROPHY AND HYPERPLASIA

DIFFERENCE CONTI….

HYPERTROPHY

Hypertrophy is an increase in cell size and functional ability due to increased synthesis of intracellular components.

HYPERPLASIA

Hyperplasia an increase in the number of cells in a tissue or organ.

DIFFERENCE CONTI….

Causes of hypertrophy

1. Increased mechanical demand Physiologic

striated muscle of weight lifters

Pathologic cardiac muscle in hypertension.

Causes of hyperplasia

1.Physiologic causes: compensatory

e.g. after partial hepatectomy

Hormonal stimulation e.g. breast development at puberty.

DIFFERENCE CONTI….

Cardiac hypertrophy

DIFFERENCE CONTI….

2. Increased endocrine stimulation Puberty Lactating breast

2. Pathologic causes: Endometrial

hyperplasia Prostatic hyperplasia

of aging.

DIFFERENCE CONTI…. The striated muscle

cells in both the hearts and the skeletal muscle are most capable of hypertrophy, because they are non dividing cells.

The cardiac ,skeletal and never muscles are unable to exhibit the hyperplasia.

Similarities Hyperplasia is

mediates by

Growth factor,cytokines andother tropic stimuli.

Hypertrophy is mediates by

Growth factor,cytokines andother tropic stimuli.

CONCLUSION Although hyperplasia and

hypertrophy are two distinct

process frequently both occur

together(GRAVID UTERUS)and

may well be triggered by the

same mechanism.