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Joseph R. Panaligan M.D.

 the basic unit of all organisms
 varies in size and shape but have similar
intracellular organization and generally
have the same formed structures or
 the cell is made up of the nucleus and the
cytoplasm. A unit membrane surrounds
both the nucleus (nuclear membrane) and
the cytoplasm (cell or plasma membrane.
The cell forms the boundary of the cell and
separates it from its environment.
A. Chemical Composition:
 1. Water - 75-85% of the cell is water
which may be:
• Free water - water available for metabolic
• Bound water - water loosely attached to protein
– Water serves as solvent of the vehicles for suspension of
cellular chemicals and particles. Since water would not
allow diffusion of dissolved medium of transport of
substances from one part of the cell to another.
 Proteins - 10-20% of the cell. There are
two types:
• Fibrous ( or structural)
• Globular (enzymatic)
– Proteins are responsible for the characteristic structure of
the cell. Enzyme protein control the metabolic functions
of the cell. A type of protein called nucleo-protein
regulate cellular functions and the transmission of
hereditary characteristics.
 Lipids - 2-3%
– lipids are made up of fats, waxes,
phospholipids, carbohydrates, carotenoids and
• Lipids serve as food reserve. They also form part
of the structure of the cell like the formation of the
cell membrane, and the other membranes lining te
nucleus and the other organelles.
 carbohydrates - 1%
– Carbohydrates in the cell are made up of:
• monosaccharides (glucose, glycogen, ribose,
• disaccharides (sucrose, lactose)
• polysaccharides (cellulose, pectin, lignin, chitin)
• Mucopolysaccharides (structural materials, secreted
by animal cells. Ex. intercellular cement substances;
matrix of connective tissue and cartilage)
 Salt - about 1%
– The most important are sodium, potassium,
calcium, magnesium, phosphates,
bicarbonates, chlorides.
• These electrolytes are used by the cell in many
cellular reactions including those concerned with
controlling mechanisms.
B. Structure and Functions of
Different Parts of the Cell:
 1. Nucleus - control center of the cell
– contains large quantities of DNA, which we have
called genes. The genes determine the characteristics
of the cell’s CHON, including the enzymes of the
cytoplasm that control cytoplasmic activities.
– they also control reproduction; a process called
– regulates metabolic processes of the cells including
synthesis of CHON and other substances
 Nuclear membrane - also called the
nuclear envelope is actually two separate
membranes, one layered inside the other.
– The outer membrane is continuous with the
endoplasmic reticulum, and the space between
the two nuclear membranes is also continuous
with the compartment inside the endoplasmic
 Endoplasmic reticulum
– a network of tubular and flat vesicular
– their walls are constructed of lipid bilayer
membrane that contain large amounts of
CHON, similar to the cell membrane.
• Rough ER - attached to the outer surfaces of many
parts of small granular particles called ribosomes.
The ribosomes are composed of a mixture of
ribonucleir acid (RNA) and CHON and they
function in the synthesis of CHON in the cells.
• Smoothe ER- has no ribosomes attached to it. This
functions in the synthesis of lipid substances and in
many other enzymatic process of the cell.
 Some of the functions attributed to the ER
are the ff:
– allows intercommunication between the outside
and the inside of the cell
– possibly used for storage and/or synthesis of
materials like CHON
– membrane contains enzymes which are
important in the synthesis of lipids and perhaps
even glycogen
– may be the means of conducting excitation
from the surface of the cells to the myofibrils in
the muscle
 Ribosomes
– Sites of protein synthesis
– particulate units in the ground substance,
usually attached to the outer surfaces of the ER.
– made up of RNA attached to protein hence,
sometimes referred to as ribonucleoprotein
 Golgi apparatus (complex)
– a canalicular system of various shapes with
fattened sacs (cisternae are associated with
vesicles and vacuoules. The surface of the
canal and sacs is always smooth.)
– this structure is prominent in actively secreting
• functions in assoc. with ER. ER vesicles continually
pinch off and fuse with the golgi apparatus. In this
way, subs entrapped in the ER vesicles are
transported from the ER to the Golgi apparatus. The
transported subs are then processed in the Golgi
apparatus to form Lysosomes (secretory vesicles) or
other cytoplasmic compartments
 Lysosomes - “digestive system of the
– granular structures surrounded by a unit
– contains several hydrolytic enzymes. These
enzymes are released from the lysosomes
by the action of the lytic agents which
destroys the membrane.
• the digestive action is important for;
– lysis of dying or dead useless cells
– removal of structures which are no longer useful to
the organism
– digestion of the engulfed material, for example, those
taken in by pinocytosis
 Mitochondria - “powerhouse” of the cell
– the number of mitochondria reflects the energy
requirements of the cell.
– the enzyme complex found in the mitochondria
enables the synthesis of the high-energy
phosphate compound ATP to take place
• compose of mainly two lipid bilayer: outer and the
inner membrane
• infoldings of the inner membrane form shelves onto
which oxidative enzymes are attached
• the inner cavity of the mitochondrion is filled with a
matrix that contains large amounts of dissolved
enzymes that are necessary for extracting energy
from nutrients.
• ATP is then transported out of the mitochondrion
and it diffuses througout the cell to release its
• mitochondria are self-replicative, which means that
one mitochondrion can form a second one
wherever there is a need in the cell for increased
amounts of ATP.
• indeed, it contains DNA similar to that found in the
 Microtubules and microfilaments
– they may be in the outer areas of the
cytoplasm oriented with the long axis of the
• may serve as a framework or “skeleton” of the cell
• may be contractile (as observed in cilia)
• possibly serving for intracellular transport of ions
and molecules
 Cilia and flagella - may be found in
some animal and plant cells
– consists of nine (9) pairs of peripheral
fibers sorrounding two large centrally
placed fibers
• provide means of locomotion. ciliated cells
are also able to move subs across their
 centrioles and centrosomes
– pair of cylinders whose structures are
similar to the cilia
– associated with cell division
 Nucleoli/nucleolus
– does not have a limiting membrane instead, it is
simply a structure that contains large amounts of
RNA andCHOn of the types found in ribosomes.
• becomes enlarge when the cell is actively
synthesizing CHON.
 peroxisomes - physically similar to
lysosomes but different in two important
• they are believed to be formed by self-replication
• they contain exidases rather than hydrolases
– oxidize subs that might be harmful to the cell
Transport of ions and
molecules through the
cell membrane
1. Diffusion (passive transport)
> random molecular movement of substances molecule
by molecule either through intermolecular spaces or in
combination with a carrier protein
> the energy that causes diffusion is the normal kinetic
> Rate of diffusion is affected by : amount of
substances available; velocity of kinetic motion;
number of openings in the cells

Simple diffusion-
Facilitated diffusion-
 Osmosis- net movement of water affected by the
concentration difference of water
– osmotic pressure- the amount of pressure required to stop
2. Active Transport
> movement against the energy gradient
(opposite to diffusion)
> uphill movement
> large quantities of atoms, molecules,
electrolytes are needed in a compartment even if
there is a minute amount in the other
> transport depends on carrier protein that
penetrate through the cell membrane
a. Primary Active Transport
> energy is derived from ATP
Na- K Pump
> pumps sodium ions outward from inward
> pumps K ions from outside to inside
> present in all cells and is responsible for maintaining differences across the
cell membrane
> basis of nerve function to transmit nerve signal throughout the nervous system
> controls the volume of cells
> other samples:
a. Calcium
b. hydrogen ions
> Saturation of primary active transport

b. Secondary Active Transport
> energy is derived secondarily from the energy stored in the form of ionic
concentration differences between two sides of the membrane
> Co transport and counter transport (e.g. movement of sodium)
Cell Division
DNA (deoxyribonucleic acid)- composed (1) phosphoric acid, (2) a
sugar called deoxyribose and four nitrogenous bases (two purines :
adenine and guanine, two pyramidines: thymine and cytosine.
* adenine binds with thymine
* guanine binds with cytosine
The phosphoric acid and deoxyribose form the two helical strands
that are the backbone of the DNA molecule

Nucleotides- first stage in formation of a DNA, a combination of one
molecule of phosphoric acid and deoxyribose and one of the four

Codon- three complimentary code triplets (RNA) that will be
synthesized in the cytoplasm
Ribonucleic acid (RNA)

Building blocks- like DNA but D is replaced by ribose
Thymine is replace by uracil

Formation of RNA nucleotide- same with DNA but with small changes
Activation of the nucleotide- occurs by adding to each nucleotide two
phosphate radicals to form the triphosphate at the far right during
RNA chain formation (combined by a high energy phosphate bonds
derived from the ATP of the cell)
Transcription- code of DNA is transferred to RNA (RNA goes out of the
nuclear pores and controls the protein synthesis in the cytoplasm
(see figure 2)
Types of RNA
 Messenger RNA
• Long single RNA strands
• Carries the genetic code to the cytoplasm for controlling
the formation of proteins
 Transfer RNA
• transports activated amino acids to the ribosomes to be
used in assembling the protein molecules
 Ribosomal RNA
• Along with 75 different proteins forms the ribosomes, the
physical and chemical structures on which protein
molecules are actually assembled
Organizations of cells into
Tissues: Types and functions
Cells with similar fxn are often organized
into larger fxnal units called tissues, and
these tissues in turn associate with other
dissimilar tissues to form the various
organs of the body
Types of Tissues
Connective tissue
 The most abundant tissue of the body
found in variety of forms ranging from
solid bones to large cells that circulate in
the vascular system
Epithelial tissue
 form sheets that covers the body’s outer
surface, lines internal surfaces and forms
grandular tissues
 is supported by a basement membrane and
is avascular
 must receive nourishment from capillaries
in supporting connective tissues
Muscle tissue
> contains actin and myosin filaments that
allows it to contract and provide
locomotion and movement of skeletal
structures, pumping blood through the
heart and contraction of blood vessels and
visceral organs
Nervous tissue
 provides means for controlling body
 for sensing and moving about the
 is a normal protective reaction to tissue injury
caused by physical trauma, noxious chemical, or
microbiologic agents
 is a body’s effort to inactivate invading
microorganisms, remove organisms and set stage
for tissue repair
 Inflammation is usually triggered by the release
of chemical mediators from injured tissues and
migrating cells.
1. amines – histamines and 5 hydroxyptamine
2. lipids - prostaglandins
3. small peptides- bradykinin
4. larger peptide - interleukin
Local Manifestation of
 Redness (rubor)
 Heat (calor)
 Pain (dolor)
 Swelling (tumor)
 Loss of function (funcia laesa)
Inflammatory response
Vascular response
 movement of fluid from capillaries into tissue
 three patterns of responses
– immediate transient response – occurs with minor
– immediate sustained response – occurs with more
serious injury and continues for several days and
damages vessels in the area
– delayed hemodynamic response – the increase in
capillary permeability occurs 4 to 24 hours after
injury. It often accompanies radiation types of
injuries, such as, sunburn
Inflammatory response
Cellular response
 blood flow through capillaries of the area
slows as fluid is lost and viscosity rises.
 Leukocytes move to the inner surface of
the capillaries (margination), in amoeboid
fashion, through the capillary walls
( diapedesis) and to the site of injury.
 Chemicals released by injured cells exert
an attractive force called chemotaxis, on
white blood cells in the circulation
 is formed from both fluid and cells that
move to the site as well as from cellular
 its nature and quantity depends on the type
and severity of injury and the tissues
Types of exudates
• seen in early stage of inflammation
 Ex. Skin blisters and pleural effusions
fibrinous exudates –
• occurs with increasing vascular permeability and fibrinogen leakage into
interstitial spaces
• it may coat tissue surfaces and cause them to adhere
• adhesions may develop in the healing and bind surfaces to pleura
 Ex. Pleura adhering together secondary to pneumonia
Purulent or suppurative exudates
• Pus consists of leukocytes, microorganism, (deadand alive, liquefied dead
cells and other debris)
Catarrhal exudates
• Found in tissues where cells could produce mucous
Hemorrhagic exudates
• Occurs when there is rupture or necrosis of the blood vessel walls
 Core temperature is a reflection of the balance between
heat gain and heat loss by the body. Metabolic processes
produce heat, which must be dissipated
 The hypothalamus is the thermal control center- it
receives information from the peripheral and central
thermoreceptors and compares the information with its
temperature set point
 Heat loss occurs through transfer of body core heat to the
surface through circulation. Heat is lost from skin
through radiation, radiation, conduction, convection and
 An increase in core temperature is affected by
vasoconstriction and shivering, a decrease in temperature
by vasodilation and sweating

Mechanism of heat production
 metabolism if the body’s main source of
heat production
 an increase of .56 C in every 7% increase
in metabolism
 epinephrine and norepinephrine are
released when there is a need to increase
temperature, acts at thecellular level sothat
energy production may be reduced and
heat production increased
 is an increase in body temperature (due to
vasoconstriction and shivering) due to a response to a
cytokine-induced increase in hypothalamic set point
 is an adaptive response to bacterial and viral infections or
tissue injury. The growth rate of MO is inhibited and
immune fxn is enhanced
 infxn or tissue injury (exogenous pyrogen) induce the
production of prostaglandins in the hypothalamus, which
causes the increase in temperature set point
 In response to increase inset point, the hypothalamus
initiates physiologic responses to increase core
temperature to match the new set point
Circulatory Failure (Shock)
 Hypovolemic-
 Obstructive
 Distributive- characterized by the loss of blood vessel tone, enlargement of
the vascular compartments and displacement of the vascular volume away
from the heart and central circulation
 Neurogenic- shock caused by the decrease in symphathetic control of
the BV’s tone due to a defect in the vasomotor center of the brain stem or the
symphathetic outflow of the BV ‘s. Output from the vasomotor center can
be interrupted by brain injury, hypoxia, the depressant action of drugs,
general anesthesia, or lack of glucose
 Anaphylactic-characterized by massive vasodilation, pooling of blood
in the peripheral BV’s and increased permeability caused by
immunologically mediated reaction in which vasodilator substances such as
histamines are released into the blood
 Sepsis and septic shock- associated with severe infection and
systemic response to infection, pathologic complications such as pulmonary
insufficiency, DIC, and multiple organ failure.
An unpleasant sensory & emotional experience associated with actual
and potential tissue damage or described in terms of such damage


This theory postulated the presence of neural gating
mechanism at the segmental spinal cord level to account for
interactions between pain and other sensory modalities
In Acute pain, therapy is directed at providing pain relief by
interrupting the nociceptive stimulus

Chronic pain management requires early attempts to prevent pain
and adequate therapy for acute bouts of pain

Includes nonpharmacologic, pharmacologic treatment and surgical
Pain may be assessed according to nature, severity, location and radiation.

Observation of facial expression and posture may provide additional information

However, temperature and blood pressure, the nature, severity and distress of pain cannot be
measured objectively. Thus, various method have been developed for quantifying a person’s pain:

1. Numeric Pain Intensity

2. Visual Analog

3. Verbal Descriptor
Pain may be classified according to location, site
of referral or duration

Arises from superficial structures, such as the skin and
1. CUTANEOUS PAIN subcutaneous tissue

Originates in deep body structures such as the periosteum,
2. DEEP SOMATIC PAIN muscles, tendons, joints and blood vessels

3. VISCERAL PAIN Pain that has its origin in visceral organs

Pain that is perceived at a site different from its point of
4. REFERRED PAIN origin but innervated by the same spinal segment


Classifically defined as pain lasting 6 months
or longer