Altered Cellular and Tissue Biology Chapter 2 Mosby items and derived items © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.

Altered Cellular and Tissue BiologyAltered Cellular and Tissue Biology

Chapter 2Chapter 2

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Cellular Injury MechanismsCellular Injury Mechanisms

Hypoxic injuryHypoxic injury IschemiaIschemia AnoxiaAnoxia Cellular responsesCellular responses

• Decrease in ATP, causing failure of sodium-potassium pump Decrease in ATP, causing failure of sodium-potassium pump and sodium-calcium exchangeand sodium-calcium exchange

• Cellular swellingCellular swelling

Reperfusion injuryReperfusion injury

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Cellular Injury MechanismsCellular Injury Mechanisms

Free radicals and reactive oxygen speciesFree radicals and reactive oxygen species Electrically uncharged atom or group of atoms Electrically uncharged atom or group of atoms

having an unpaired electronhaving an unpaired electron Lipid peroxidationLipid peroxidation Alteration of proteinsAlteration of proteins Alteration of DNAAlteration of DNA Mechanisms for inactivation of free radicalsMechanisms for inactivation of free radicals

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Free Radical InjuryFree Radical Injury

The result of oxidative stressThe result of oxidative stress An atom or group of atoms having an An atom or group of atoms having an

unpaired electronunpaired electron Unstable moleculeUnstable molecule To stabilize itself, it gives up an electron or To stabilize itself, it gives up an electron or

steals one from long chains of phospholipids steals one from long chains of phospholipids in cell membranes (lipid peroxidation)in cell membranes (lipid peroxidation)

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Oxidation vs. ReductionOxidation vs. Reduction

OxidationOxidation Losing an electronLosing an electron

ReductionReduction Gaining an electronGaining an electron

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Cellular Injury MechanismsCellular Injury Mechanisms

Chemical injuryChemical injury LeadLead Carbon monoxideCarbon monoxide EthanolEthanol MercuryMercury Social or street drugsSocial or street drugs

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Unintentional and Intentional Unintentional and Intentional InjuriesInjuries

Blunt force injuriesBlunt force injuries Application of mechanical energy to the body Application of mechanical energy to the body

resulting in the tearing, shearing, or crushing of resulting in the tearing, shearing, or crushing of tissuestissues

Contusion vs. hematomaContusion vs. hematoma AbrasionAbrasion LacerationLaceration FracturesFractures

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Unintentional and Intentional Unintentional and Intentional InjuriesInjuries

Sharp force injuriesSharp force injuries Incised woundsIncised wounds Stab woundsStab wounds Puncture woundsPuncture wounds Chopping woundsChopping wounds

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Unintentional and Intentional InjuriesUnintentional and Intentional Injuries

Gunshot woundsGunshot wounds Entrance woundsEntrance wounds

• Contact-range entrance woundContact-range entrance wound

• Intermediate-range entrance woundIntermediate-range entrance wound Tattooing and stipplingTattooing and stippling

• Indeterminate-range entrance woundIndeterminate-range entrance wound

Exit woundsExit wounds• Shored exit woundShored exit wound

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Unintentional and Intentional InjuriesUnintentional and Intentional Injuries

Asphyxial injuriesAsphyxial injuries Caused by a failure of cells to receive or use oxygenCaused by a failure of cells to receive or use oxygen SuffocationSuffocation StrangulationStrangulation

• Hanging, ligature, and manual strangulationHanging, ligature, and manual strangulation

Chemical asphyxiantsChemical asphyxiants DrowningDrowning

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Infectious InjuryInfectious Injury

Pathogenicity of a microorganismPathogenicity of a microorganism Virulence of a microorganismVirulence of a microorganism Disease-producing potentialDisease-producing potential

Invasion and destructionInvasion and destruction Toxin productionToxin production Production of hypersensitivity reactionsProduction of hypersensitivity reactions

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Immunologic and Inflammatory InjuryImmunologic and Inflammatory Injury

Phagocytic cellsPhagocytic cells Immune and inflammatory substancesImmune and inflammatory substances

Histamine, antibodies, lymphokines, complement, Histamine, antibodies, lymphokines, complement, and enzymesand enzymes

Membrane alterationsMembrane alterations

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Injurious Genetic FactorsInjurious Genetic Factors

Nuclear alterationsNuclear alterations Alterations in the plasma membrane Alterations in the plasma membrane

structure, shape, receptors, or transport structure, shape, receptors, or transport mechanismsmechanisms

ExamplesExamples Sickle cell anemia and muscular dystrophySickle cell anemia and muscular dystrophy

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Injurious Nutritional ImbalancesInjurious Nutritional Imbalances

Essential nutrients are required for cells to Essential nutrients are required for cells to function normallyfunction normally

Deficient intakeDeficient intake Excessive intakeExcessive intake

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Temperature ExtremesTemperature Extremes

Hypothermic injuryHypothermic injury Slows cellular metabolic processesSlows cellular metabolic processes ROS productionROS production

Hyperthermic injuryHyperthermic injury Heat crampsHeat cramps Heat exhaustionHeat exhaustion Heat strokeHeat stroke

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Atmospheric Pressure ChangesAtmospheric Pressure Changes

Sudden increases or decreases in Sudden increases or decreases in atmospheric pressureatmospheric pressure Blast injuryBlast injury Decompression sickness or caisson diseaseDecompression sickness or caisson disease

• ““The bends”The bends”

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Ionizing RadiationIonizing Radiation

Any form of radiation capable of removing Any form of radiation capable of removing orbital electrons from atoms orbital electrons from atoms X-rays, gamma rays, alpha and beta particlesX-rays, gamma rays, alpha and beta particles

Mechanism of damageMechanism of damage Effects of ionizing radiationEffects of ionizing radiation

Somatic, genetic, fetalSomatic, genetic, fetal

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Cellular Injury Cellular Injury Illumination injuryIllumination injury

Eyestrain, obscured vision, and cataract Eyestrain, obscured vision, and cataract formationformation

Caused by light modulationCaused by light modulation Mechanical stressesMechanical stresses

Physical impact, irritation, overexertionPhysical impact, irritation, overexertion NoiseNoise

Acoustic trauma and noise-induced hearing lossAcoustic trauma and noise-induced hearing loss

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Manifestations of Cellular InjuryManifestations of Cellular Injury

Cellular accumulations (infiltrations)Cellular accumulations (infiltrations) WaterWater Lipids and carbohydratesLipids and carbohydrates GlycogenGlycogen ProteinsProteins

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Manifestations of Cellular InjuryManifestations of Cellular Injury

Cellular accumulations (infiltrations)Cellular accumulations (infiltrations) PigmentsPigments

• Melanin, hemoproteins, bilirubinMelanin, hemoproteins, bilirubin

CalciumCalcium Urate Urate

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Cellular DeathCellular Death NecrosisNecrosis

Sum of cellular changes after local cell death and Sum of cellular changes after local cell death and the process of cellular autodigestion (autolysis)the process of cellular autodigestion (autolysis)

ProcessesProcesses KaryolysisKaryolysis

• Nuclear dissolution and chromatin lysisNuclear dissolution and chromatin lysis

Pyknosis Pyknosis • Clumping of the nucleusClumping of the nucleus

KaryorrhexisKaryorrhexis• Fragmentation of the nucleusFragmentation of the nucleus

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NecrosisNecrosis

Coagulative necrosisCoagulative necrosis Kidneys, heart, and adrenal glandsKidneys, heart, and adrenal glands Protein denaturationProtein denaturation

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NecrosisNecrosis

Liquefactive necrosisLiquefactive necrosis Neurons and glial cells of the brainNeurons and glial cells of the brain Hydrolytic enzymesHydrolytic enzymes

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NecrosisNecrosis

Caseous necrosisCaseous necrosis Tuberculous pulmonary infectionTuberculous pulmonary infection Combination of coagulative and liquefactive Combination of coagulative and liquefactive

necrosisnecrosis

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NecrosisNecrosis

Fat necrosisFat necrosis Breast, pancreas, and other abdominal organsBreast, pancreas, and other abdominal organs Action of lipasesAction of lipases

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NecrosisNecrosis

Gangrenous necrosisGangrenous necrosis Clinical termClinical term Dry vs. wet gangreneDry vs. wet gangrene Gas gangreneGas gangrene

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ApoptosisApoptosis

Programmed cellular deathProgrammed cellular death MechanismsMechanisms Necrosis vs. apoptosisNecrosis vs. apoptosis

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Aging and Altered Cellular Aging and Altered Cellular and Tissue Biologyand Tissue Biology

Aging vs. diseaseAging vs. disease Normal life spanNormal life span

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Theories of AgingTheories of Aging

Accumulation of injurious eventsAccumulation of injurious events Genetically controlled programGenetically controlled program TheoriesTheories

Genetic and environmental lifestyle factorsGenetic and environmental lifestyle factors Alterations of cellular control mechanismsAlterations of cellular control mechanisms Degenerative extracellular changesDegenerative extracellular changes

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AgingAging

Cellular agingCellular aging Tissue and systemic agingTissue and systemic aging

FrailtyFrailty

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Somatic DeathSomatic Death

Death of an entire personDeath of an entire person Postmortem changesPostmortem changes

Algor mortisAlgor mortis Livor mortisLivor mortis Rigor mortisRigor mortis Postmortem autolysisPostmortem autolysis