BASIC PATHOPHYSIOLOGY

Definition: pathology is the study of disease states or disease conditions of the

body. It is multifaceted but in this course, we are concerned with
Pathophysiology. Pathophysiology studies the functional and morphological
changes in tissues and organs of the body.

Morphological changes: means structural changes for eg when the liver is bigger
than normal or the kidney being larger or smaller than normal.

Functional changes: Means change in functions or loss of functions of a mass of

tissue, organ or cells of the body. Eg when the gullet losses its peristaltic
movement, it becomes abnormal. Or when the heart beat is either higher or
lower than normal.

Therefore, pathology is about the study of what has happened in the body, and
how it has happened. The pathologic condition of the body presents as disease
state for the tissue and ill-health to the human or animal person that is involved.

DISEASE AND ILLNESS

Definition: Illness is the reaction between the disease and the individual. In other
words, individual plus disease=illness.

Disease is the deviation from normal functioning of the cell, group of cells, organ
or even system of the body. This is the kinetic definition of disease. In the clinics,
we study the interaction of the disease and the patient.

Disease at its initial stage is no more than a slight departure from the normal
condition. Disease process is a condition that arose as a result of deviation of the
health tissues and cells, that even in severe deformity; many cells of the body or
the affected organ, or system are still within normal limits.
TERMS USED IN THE STUDY OF PATHOLOGY
There are many terms that are commonly used in the study of pathology and
they are:

1. Aetiology. [2] Pathogenesis [3] Lesion. [4] Virulence [5] Trauma. [6] Clinical
signs [7] Sequalea. [8] Diagnosis. [9] Biopsy. [10] Gross pathology. [11]
Prognosis. [12] Clinical symptoms etc.
AETIOLOGY: Refers to the primary cause of a disease. However, there are
often many predisposing or contributing factors.
E.g. For lobar pneumonia, in an alcoholic patient who is malnourished and has
poor oral hygiene, and who is exposed to the adverse elements while sleeping
on a door step, the aetiologic agent is the pnenmococcus organism. Other
factors like low immunity will contribute to the disease.
PATHOGENESIS: Is the mechanism or sequence of the development of
disease ie step-wise development of a disease. Or lesion and how it has
happened.
LESION: Is the characteristic change in an organism as a result of disease
state. Hence the morphologic changes are the lesion. Many of these could be
recognized grossly with un-aided eyes or microscopically. However, many
diseases produce lesion at the level of constituent metabolic units of
molecules. E.g. Sickle cell disease; which is due to abnormal hemoglobin
molecule with an abnormal pattern of amino acid sequence in the protein.
Hence, a lesion can be defined to be a tissue, cellular or molecular alteration,
which develops as a result of disease producing agents.
A simple e.g. of a lesion is “boil”.
VIRULENCE: This is the disease producing power of a pathologic agent. That
is the power of a pathologic agent to overcome its host resistance.eg:
plasmodium falciparium is said to be more virulence than other plasmodia that
causes the same malaria.
TRAUMA: This is the physical injury to the body.eg: physical body hit by a
stick or a bullet. Trauma could also be emotional eg. Emotional shock on
hearing a bad news.
CLINICAL SIGNS: Are changes exhibited or those that can be described in the
life of a sick person. E.g. the clinical sign of malaria may be a “paleness of
mucous membrane due to loss of blood or yellowish of the eyes in severe
cases. The symptoms on the other hand may be rise in temperature (pyrexia)
and loss of appetite.
In cholera, the characteristic clinical sign is diarrhea (watery stool).

CLINICAL SYMPTOMS: This is sometimes inter-woven with clinical signs,

only that symptom is a subjective concept. It is the manifestation of a disease.
E.g. fever or pyrexia (increase in temperature) may be a symptom of malaria.

SEQUALEA: Is the forecast of the possible outcome of a disease or

pathological consequences of a disease. E.g. pock marks seen after smallpox
disease.
DIAGNOSIS: Is the use of available evidence to determine the disease that is
affecting the animal. Under diagnosis, we have 2 types:
Definitive diagnosis: This is diagnosis made by identifying the aetiologic
agent of the disease.
Tentative or morphological diagnosis: Is diagnosis made using the
morphological changes of the tissues or organs. Eg when liver is enlarged, It is
called “hepatomegally”. This is not definitive because so many things can
cause it. Also, pneumonia (inflammation of the lungs) is tentative or
morphologic change because so many things can cause it. But for definitive
diagnosis, you must know the causative agent- eg: streptococcus pneumonia.
We also have clinical diagnosis made by a doctor by correlating the clinical
signs and symptoms with the clinical history.
We also have laboratory diagnosis made by examining samples of tissue fluid
taken from a patient and then radiological/ imaging diagnosis made by
obtaining the image of the diseased organ or tissue of interest
BIOPSY: Is the examination of tissue obtained from a life animal for
histological studies.
 Eg: Skin infection, “when in confusion of which type of infection it is,” a
sample of the diseased skin is taken out and examined histologically. Biopsy
needles are used in taking specimen of the organ, tissue or cells to be
examined.
GROSS PATHOLOGY: Are morphological changes that can be seen with un-
aided eyes after the death of the animal.eg. The gross pathology of pneumonia
is inflammation of the lungs and the lungs becomes coarse and rough.
PROGNOSIS: Is the forecast of the probable course and termination of a
disease. ie how mild or fatal the progress of a disease might be and the likely
outcome at the end at the day related to time. E.g for a Breast cancer, if
discovered late, the prognosis may be poor and death may occur between 10-
15years from the initial time of development of cancer cells.
ANIMAL CELL
The human body is a vast highly organized and intricate accumulation of
normal cells. Their conditions determine the state of health of the body or any
parts of the body. Every organ consists of recognizable basic histological
pattern of cells of different types. The cell is therefore the basic unit of any
organism. The basic structural and functional components of an animal cell can
be divided into 2 groups:
(1) those that are essential for cell survival
(2) Those that serve specialized functions.
Assignment
(1) Draw and label fully a diagram of a magnified human cell.
(2) Give the functions of different organelles that make up the human cell.
(3) CELL ADJUSTMENTS
(4) A normal cell always tries to adjust. If for some reason, the cell is incapable of
adjusting, bi-products will accumulate so that disease condition crops on.
Nevertheless, the cell adjustment is genetically in built. When cellular
adjustment is grossly inadequate, cells will suffer from degeneration and
death. In pathological conditions, cells still try to adjust. In doing so, to
produce a stable stage; cells may decrease in size (atrophy), or increase in size
(hypertrophy) and sometimes one component of the cell may become
 overwhelmingly prominent (cancerous). When the cells fail to adjust after
being affected by a toxic agent, it leads to cell injury.
CELL INJURY
Injury to cell refers to degenerative disease that affects the cell either due to
external injury or internal injury. This degenerative disease could either be
reversible or irreversible. Injury to a cell may result in changes such as cloudy
swellings, fat accumulation; which if the injurious agent are withdrawn, injury
could be reversed or not.
CELL INJURY COULD BE OF TWO TYPES VIZ:
1. R eversible cell injury.
2. Irreversible cell injury.
CAUSES OF CELL INJURY
1. TOXIC SUBSTANCES; which includes
A. General toxic substances eg corrosives and phenols affects proteins.
B. Tissue specific toxic substances eg carbon tetrachloride (cccl4) which
produces liver necrosis and alloxan giving rise to necrosis of B-cells of
pancreatic islet.
C. Biochemically specific toxic substances-these are enzymes poisons such as
cyanide whose effect is commonly felt in cytochrome oxidase.
2. PHYSICAL AGENTS; Includes

(A).Trauma from RTA or from hit bullet.

(B).Cold (C) Heat (D) Ionizing radiation.

3. NUTRITIONAL IMBALANCE; Including
A. Over nutrition leading to obesity
B. Under nutrition leading to marasmurs and kwashiorkor.
C. Failure of cell absorption eg Diabetes mellitus and malabsorption.
D. Generalized lack of nutrient leading to diminished amount of blood
(anemia) and diminished amount of oxygen to tissue (hypoxia) and
respiratory failure.
E. Hormonal deficiency
4. INFECTIONS AGENTS AND PARASITES:
(A) Viral (B) Bacterial (C) Parasites etc
Injury induced by release of toxins from bacteria, competition for essential
nutrient provocation of hypersensitivity reactions, and
intracellular multiplication of these agents.
5. IMMUNOLOGICAL REACTIONS: Including
Hypersensitivity to previously sensitized patients & hyper sensitivity state e.g.:
contact dermatitis, and autoimmune disease.
6. GENETIC DERANGEMENTS: Including
(A) DNA/RNA changes or alterations
(B) Congenital malformation of single gene
(C) Inborn error of metabolism etc.

If these injurious agents are withdrawn, and the cell recovers, they are
reffered to as reversible degenerative changes .If when the injurious agent
persist, the cell may degenerate further becoming irreversibly damaged and
may eventually die. In some circumstances, the injury may be so catastrophic
that the cell dies without showing these immediate changes. Note that when a
injurious environmental agent producing lesser degree of cell injury persist,
the cell may adapt to this altered environment and establish a new steady
state (cell adjustment). It is only when cell fail to establish an altered state in
response to injury, then cell death is inevitable.
LECRURE NOTE ON BASIC PATHOPHYSIOLOGY

PREPARED BY:

Chris Ike Obetta.

June 29, 2011