Altered Cellular & Tissue Biology

Selected Themes from Chapter 2 - McCance & Huether 8th Edition

by Otto Sanchez

September 2020

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Pathophysiology Topics
• Cellular Adaptation
How do cells adapt to changes in their environment?

• Cellular Injury & Manifestations of Cellular Injury

How do cells get sick?
What are the consequences of cell injury?

• Cellular Death
Why and how can human cells die?

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 Environmental
Change
Noxious Agent

Stages of Cellular
Adaptation, Cell
Injury & Cell Death

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 Cellular Adaptation

How do cells adapt to adversity?

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Adaptation is:

 Reversible
 Structural or functional
 Response to physiologic
& adverse conditions

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 Atrophy

Decrease or shrinkage in
cellular size

Physiologic vs Pathologic

Skeletal muscle
Cardiac muscle
Secondary sex organs
Brain

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Hypertrophy: Increase in the size of cells that consequently
increases the size of the affected organ.

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Mechanisms
Of
Myocardial
Hypertrophy

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 Hyperplasia: Increase in the number of cells in an organ or tissue resulting
from an increased rate of cellular division

• Compensatory hyperplasia (physiologic)

Partial hepatectomy
Skin callus
• Hormonal hyperplasia (physiologic)
Post-ovulatory endometrial hyperplasia
Lobular hyperplasia of the breast
• Pathologic hyperplasia
Bronchial epithelial hyperplasia
Endometrial hyperplasia
Benign prostatic hyperplasia
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Metaplasia: Reversible replacement of one mature cell type by another

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Dysplasia = Atypical Hyperplasia = Atypical Metaplasia
Abnomal changes in the size, shape, and organization of mature cells

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 Cellular Injury

How are human cells injured?

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 Examples of cell injury
• Hypoxic injury
• Free radicals
• Toxic chemical agents: CCl4, Pb, CO, ethanol, Hg
• Traumatic injuries: Blunt or sharp force, gunshot wounds, asphyxia
• Infections
• Inflammatory injury
• Genetic alterations
• Nutritional imbalances
• Physical agents: Temperature extremes
Changes in atmospheric pressure
Ionizing radiation
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Hypoxia:
Lack of sufficient oxygen

Ischemia:
Reduced blood supply

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Hypoxic Cell
Injury

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Release of intracellular calcium causes cell injury

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Reactive Oxygen Species

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Ethanol causes cell injury called “fatty change” or “fatty degeneration”

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 Cellular Death

How do human cells die?

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 Cells have different ways of dying…
• Necrosis
Most common
Often caused by hypoxia
Typically many cells die at once (i.e. multicellular)
Intracellular proteins and enzymes will leak to extracellular space and blood
Provokes inflammation in surrounding tissues
Types: coagulative, liquefactive, caseous, gangrenous & fat necrosis

• Apoptosis (= “programmed cell death”)

More rare (documented in embryo development and DNA damage in cancer)
Caused by specific stimuli (e.g. lack of growth factors)
Typically individual cells die (i.e. unicellular)
Does not provoke inflammation in surrounding tissues
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 Common examples of types of necrosis

Myocardial infarct (coagulative necrosis) Cerebral infarct or “stroke” (liquefactive necrosis)

Lung tuberculosis: granuloma – caseous necrosis Gangrene (gangrenous necrosis) 22

Dystrophic Calcification Necrosis caused by Ionizing Radiation

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Post any questions @ Canvas Discussion Board

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