Integrated Physiology and Anatomy

Class 1 Outline

I. Cell Adaptation, Cell Injury, and Cell Death

A. Definitions
a. Anatomy: the study of body Structure and the relationships between structures
b. Physiology: the study of body ________________
c. Pathology: the study of ______________ and _________________ functional abnormalities
expressed as diseases of organs and systems; the study of cell _________________ and the
expression of a cell’s pre-existing capacity to adapt to such injury.
B. Cells
a. 100 trillion cells in the human body
b. Size and shape are related to function
c. Major parts of the cell
i. Plasma membrane: functions include _________________ within the body and with non-
self-cells; defines boundaries and _______________; controls what gets in and out
(______________ permeability)
1. Intracellular fluid
2. Extracellular fluid
ii. Nucleus: _______________ center; contains ________________
iii. Cytoplasm: everything in between the nucleus and plasma membrane
C. Cell Injury
a. Cellular basis of disease is comprised of cells response to stress
b. If the injury is greater than the cell’s capacity to ______________, then the cell ____________
c. Death of individual cells can result in permanent organ injury
d. Individual cells can adapt to injury by conserving resources
e. Some cellular changes can reverse with discontinuation of stress
f. Cells __________ to hostile environments
i. Adaptive responses include atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia
g. Atrophy:
i. Decrease in ________ and _______________ or an organ resulting from pathologic or
physiologic circumstances
ii. At the cellular level, this means that the cell ________________ to changes in its
environment while remaining viable
1. Reversible and irreversible
iii. Caused by: reduced ______________ demand, inadequate supply of _____________,
insufficient nutrients, interruption of trophic signals, increased ____________, and chronic
disease
h. Hypertrophy:
i. Adaptive change that results in an increase in cellular size to satisfy increased functional
demand or trophic signals
ii. In some organs, this just occurs at the cell level, in other organs it can mean change in cell
size or number
iii. Cause by: inhibition of programmed cell death, increase in the degradation of proteins
i. Hyperplasia:
i. Occurs when there is an increase in the number of cells in an organ. It involves stimulating
resting cells to enter the cell cycle and __________________.
ii. Hypertrophy and hyperplasia often occur together (eg hormones stimulation organ system
especially estrogen)
 iii. Temporary causes blood clot especially when fly
j. Metaplasia: conversion
i. Conversion of one differentiated cell type to another
ii. Typically, an adaptive response to stress whether its external or internal
iii. Acid reflex can change the type of tissue
k. Dysplasia: abnormal change and cell lost its function
i. disruption of the monotonous appearance of the epithelium, or the morphologic expression
of a molecular disturbance in growth regulation. (change is function, structure and hard to
trace back into original form) eg cancerous tissue undergo dysplasia.
ii. Dysplastic cells have:
1. ______________ in cell size and shape
2. Nuclear enlargement irregularity
3. Disarray in the arrangement of cells within the epithelium
D. Viral Cytotoxicity
a. Direct toxicity: viruses may disrupt cellular __________________ homeostasis (no stress and cell
need to do what they need to do)
b. Manipulation of Apoptosis virus manipulates DNA to prolong cell life for viral division.
c. Immunologically mediated cytotoxicity: cells will induce apoptosis to affected viral cells to stop its
spread (T-cell will enter virus cells and say hey you need to die, that way virus cell no longer
replicates and die itself.)
E. Cell Death
a. Necrosis: an accidental or passive process cell death caused by a hostile environment to which a cell
could not effectively adapt. (Hostile environment that exceeds cell ability to adapt therefore cell die
away)
b. Apoptosis: an active process form of cell death in which the cell ______________ participates in its
own death
c. Autophagy: an active signaling process that occurs when a stressful environment causes
autodigestion of a portion of the cell’s macromolecular materials (cell will rid of nonfunctional
components of cell and normal physiological process)
F. Biologic Aging
a. Functional and structural cellular changes are an inevitable result of longevity
b. Several cellular theories exist, but there is no consensus
c. Important to remember that aging does not equal _disease, although aging does create vulnerability
to _disease.

II. Inflammation
a. Definition: The Systemic or local reaction of tissues and microcirculation to a pathogenic insult
i. Characterized by movement of fluid and leukocytes from the blood to the extravascular tissues
b. Clinical signs:
i. Redness- blood vessels widen leads to increase diameter (slower blood flow)
ii. Heat
iii. Swelling-endothelial cells activated
iv. Pain
c. Phases (good test question)
i. Initiation: rapid flooding of the injured tissue with fluid, coagulation factors, cytokines,
chemokines, platelets, and inflammatory cells
1. Also known as acute inflammation
 ii. Amplification: depends on the extent of injury and the activation of mediators. Additional
leukocytes and macrophages are recruited. (Arrive the cite of injury, clean them up, and
leukocytes/macrophages clean up the injury site to prevent from disease)
iii. Destruction: phagocytes reduce or eliminate foreign material or infectious organisms
iv. Termination: mediated by anti-inflammatory mechanisms that limit tissue damage.
1. Restoration: return to normal physiologic function
2. Repair: development of scar
d. Acute Inflammation
i. Transient Vasoconstriction of arterioles (narrowing the blood vessel)
ii. Vasodilation of precapillary arterioles. (Hyperemia: movement of blood to area of the body)
iii. Increase in permeability of endothelial cell barrier—this is cellular events (movement of fluid to
the tissue
iv. Edema: hallmark of acute inflammation
e. Vascular Components of Inflammation: Definitions
i. Edema: accumulation of fluid within the ____________________________ compartment and
interstitial tissues
ii. Transudate: edema fluid with a ____________ protein content; tends to occur in non-
inflammatory conditions
iii. Exudate: edema fluid with _____________ protein content; frequently contains inflammatory
cells; observed in acute inflammatory reactions
iv. Serous exudate (aka _____________________): yellow, straw-like color; characterized by
absence of a prominent cellular response
v. Fibrinous exudate: contains large amount of ________________
vi. Purulent effusion: contains prominent cellular components; frequently associated with
pathologic conditions such as bacterial infections
f. Cells of Inflammation
i. Neutrophils
1. Major cellular participant in acute inflammation
2. Stored in _________________
3. Circulate in the blood
4. Rapidly accumulate at site of injury/infection
ii. Endothelial cells
1. Comprise a monolayer of cells lining blood vessels
2. Help to separate __________________ and ______________ spaces
3. Produce agents that maintain blood vessel patency
4. Injury to a vessel wall interrupts the endothelial layer
5. ___________________ in inflammatory cell recruitment
iii. Monocytes and Macrophages
1. Originate in bone marrow
2. Exit circulation to migrate into tissue and become _______________
3. Accumulate at sites of acute inflammation
a. Ingest and process microbes
iv. Mast Cells and Basophils
1. Regulate vascular permeability and bronchial smooth muscle tone (especially during
allergic reactions)
2. Found in __________________________
v. Eosinophils
1. Type of ______________ __________________ cell
2. Circulate in the blood
 3. Recruited to tissue, especially during allergic responses
4. Modulate inflammatory response
g. Outcomes of Acute Inflammation
i. Acute inflammatory responses are usually followed by a _________________ of normal tissue
architecture and physiologic function (resolution).
ii. _____________________:
1. Removal of dead cells
2. Clearance of acute response cells
3. Reestablishment of the stroma
iii. Acute inflammatory responses can also lead to:
1. Scarring
2. Abscess
3. Lymphadenitis
4. Persistent inflammation
h. Chronic Inflammation
i. Inflammatory cells persist
ii. Stroma becomes hyperplastic
iii. Tissue destruction and scarring lead to _________________ ___________________
iv. May be localized, but often leads to more disabling conditions, such as:
_____________________________________________________________
i. Chronic Inflammation: Injury and Repair
i. Persistent tissue injury caused by chronic inflammatory cells plays a role in the development of
certain conditions, such as:
1. _________________________________
2. ______________________________
3. Gout
4. Adult respiratory distress syndrome
ii. Granulomas: An area of inflamed tissue, most often the result of a ___________________
response to chronic infections
iii. Systemic Manifestations
1. ________________: occurs when chemicals released into the bloodstream to fight
infection cause inflammatory responses in the body
2. _________________________________________________ (SIRS):
a. Leukocytosis: increase in white blood cells
b. Fever
c. Shock