NR283 Pathophysiology Study Guide for Exam 1
Chapter 01
1. Describe the cellular adaptations made in each of the following processes:
Atrophy- refers to a decrease in the size of cells, resulting in a reduced tissue mass.
Hypertrophy- refers to an increase in the size of individual cells, resulting in an enlarged tissue
mass
Hyperplasia- is defined as an increased number of cells resulting in an enlarged tissue mass.
Dysplasia- is the term applied to tissue in which the cells vary in size and shape, large nuclei are
frequently present, and the rate of mitosis is
increased.
Metaplasia- occurs when one mature cell type is replaced by a different mature cell type.
2. Discuss causative factors of each of the above cellular adaptations.
Atrophy- reduced use of the tissue, insufficient nutrition, decreased neurologic or hormonal
stimulation, and aging. EX: is the shrinkage of
skeletal muscle that occurs when a limb is immobilized in a cast for several weeks.
Hypertrophy- increase may be caused by additional work by the tissue, as demonstrated by an
enlarged heart muscle resulting from increased
demands. A common example of hypertrophy is the effect of consistent exercise on skeletal
muscle, leading to an enlarged muscle mass.
Excessive hormonal stimulation may also stimulate cell growth.
Hyperplasia- hypertrophy, and hyperplasia occur simultaneously, as in the uterine enlargement
that occurs during pregnancy.
·
Hyperplasia may be a compensatory mechanism to meet increased demands, or it may be
pathologic when there is a
hormonal imbalance.
·
,In certain instances, there may be an increased risk of cancer when hyperplasia occurs.
Dysplasia- Dysplastic changes often are encountered in epithelial tissue of the cervix and
respiratory tract, where they are strongly associated
with common neoplastic growths and often are found adjacent to cancerous cells.
Metaplasia- an adaptive mechanism that provides a more resistant tissue—for instance, when
stratified squamous epithelium replaces ciliated
columnar epithelium in the respiratory tracts of cigarette smokers.
3. Identify the most common cause of cellular injury.
• Ischemia, a decreased supply of oxygenated blood to a tissue or organ, due to circulatory
obstruction
Decreased oxygen in the tissue may occur locally because of a blocked artery or systemically
because of respiratory impairment. Cells with a
high demand for oxygen, such as those of the brain, heart, and kidney, are quickly affected by
hypoxia (reduced oxygen in the tissue). A severe
oxygen deficit interferes with energy (ATP) production in the cell, leading to loss of the sodium
pump at the cell membrane as well as loss of
other cell functions.
4. Describe cellular injury caused by infection and inflammation.
Infectious diseases cause cell injury through the actions of microorganisms (living organisms too
small to be seen with the naked eye) such as
bacteria and viruses. Certain types of intracellular microorganisms induce a type of cell death
referred to as pyroptosis. Pyroptosis differs from
apoptosis in that pyroptosis results in the lysis or dissolution of the cell, releasing destructive
lysosomal enzymes into the tissue, which
cause inflammation (swelling, redness, and pain) as well as damage to nearby cells and reduced
function. The apoptotic bodies formed through
apoptosis do not cause an inflammatory response as they are quickly engulfed through
phagocytosis. Some genetic defects or inborn errors of
metabolism can lead to abnormal metabolic processes. Altered metabolism leads to the
accumulation of toxic intermediary compounds inside the
,cells, ultimately destroying them.
15. Describe the major mechanism of tissue damage caused by chemical injury.
Chemicals from both the environment (exogenous) and inside the body (endogenous) may
damage cells, either by altering cell membrane
permeability or producing other reactive chemicals, known as free radicals, which continue to
damage cell components. I
6. Discuss the manifestations of the four major types of necrosis, and give examples of the
tissue types affected by each type of necrosis.
Necrosis is the term used when a group of cells die and cause further damage due to cellular
disintegration.
• Liquefaction necrosis refers to the process by which dead cells liquefy under the influence of
certain cell enzymes. This process occurs when
brain tissue dies or in certain bacterial infections in which a cavity or ulcer may develop in the
infected area
• Coagulative necrosis occurs when the cell proteins are altered or denatured (similar to the
coagulation that occurs when cooking eggs), and the
cells retain some form for a time after death. This process typically occurs in myocardial
infarction (heart attack) when a lack of oxygen causes
cell death
• Fat necrosis occurs when fatty tissue is broken down into fatty acids in the presence of
infection or certain enzymes. These compounds may
increase inflammation.
• Caseous necrosis is a form of coagulation necrosis in which a thick, yellowish, "cheesy"
substance forms. Tuberculosis (TB) offers an
interesting example of caseous necrosis
7. Discuss apoptosis.
Apoptosis refers to programmed cell death, a normal occurrence in the body, which may
increase when cell development is abnormal, cell
numbers are excessive, or cells are injured or aged.
, Cells self-destruct, appearing to digest themselves enzymatically, and then disintegrate into
vesicles called apoptotic bodies. These vesicles are
quickly engulfed through the phagocytic activity without eliciting an inflammatory response.
8. Discuss the types of tissue necrosis.
Gangrene refers to an area of necrotic tissue, usually associated with a lack or loss of blood
supply that is followed by an invasion of bacteria.
·
Necrotic tissue can provide a good medium for infection by microorganisms. Such an infection
frequently occurs after an
infarction in the intestines or in a limb in which blood supply is deficient and bacteria are
normally present. Depending on
its location, gangrene may be described as wet or dry.
Dry gangrene is often caused by coagulative necrosis in which the tissue dries, shrinks, and
blackens.
Wet gangrene is a result of liquefaction causing the tissue to become cold, swollen, and black.
Gas gangrene is caused by the buildup of gases within tissue and further reduces blood supply.
Gangrenous tissue frequently must be removed surgically (eg, by amputation) to prevent the
spread of infection to other parts of the body.
Chapter 02: Fluids and Electrolytes, Acids and Bases
1. Discuss the two functional fluid compartments of the body.
Fluid is distributed between the intracellular compartment (ICF), or fluid inside the cells, and
the extracellular compartment (ECF).
ECF includes the following:
• Intravascular fluid (IVF) or blood
• Interstitial fluid (ISF) or intercellular fluid
• Cerebrospinal fluid (CSF)
• Transcellular fluids present in various secretions, such as those in the pericardial (heart) cavity
or the synovial cavities of the joints
Chapter 01
1. Describe the cellular adaptations made in each of the following processes:
Atrophy- refers to a decrease in the size of cells, resulting in a reduced tissue mass.
Hypertrophy- refers to an increase in the size of individual cells, resulting in an enlarged tissue
mass
Hyperplasia- is defined as an increased number of cells resulting in an enlarged tissue mass.
Dysplasia- is the term applied to tissue in which the cells vary in size and shape, large nuclei are
frequently present, and the rate of mitosis is
increased.
Metaplasia- occurs when one mature cell type is replaced by a different mature cell type.
2. Discuss causative factors of each of the above cellular adaptations.
Atrophy- reduced use of the tissue, insufficient nutrition, decreased neurologic or hormonal
stimulation, and aging. EX: is the shrinkage of
skeletal muscle that occurs when a limb is immobilized in a cast for several weeks.
Hypertrophy- increase may be caused by additional work by the tissue, as demonstrated by an
enlarged heart muscle resulting from increased
demands. A common example of hypertrophy is the effect of consistent exercise on skeletal
muscle, leading to an enlarged muscle mass.
Excessive hormonal stimulation may also stimulate cell growth.
Hyperplasia- hypertrophy, and hyperplasia occur simultaneously, as in the uterine enlargement
that occurs during pregnancy.
·
Hyperplasia may be a compensatory mechanism to meet increased demands, or it may be
pathologic when there is a
hormonal imbalance.
·
,In certain instances, there may be an increased risk of cancer when hyperplasia occurs.
Dysplasia- Dysplastic changes often are encountered in epithelial tissue of the cervix and
respiratory tract, where they are strongly associated
with common neoplastic growths and often are found adjacent to cancerous cells.
Metaplasia- an adaptive mechanism that provides a more resistant tissue—for instance, when
stratified squamous epithelium replaces ciliated
columnar epithelium in the respiratory tracts of cigarette smokers.
3. Identify the most common cause of cellular injury.
• Ischemia, a decreased supply of oxygenated blood to a tissue or organ, due to circulatory
obstruction
Decreased oxygen in the tissue may occur locally because of a blocked artery or systemically
because of respiratory impairment. Cells with a
high demand for oxygen, such as those of the brain, heart, and kidney, are quickly affected by
hypoxia (reduced oxygen in the tissue). A severe
oxygen deficit interferes with energy (ATP) production in the cell, leading to loss of the sodium
pump at the cell membrane as well as loss of
other cell functions.
4. Describe cellular injury caused by infection and inflammation.
Infectious diseases cause cell injury through the actions of microorganisms (living organisms too
small to be seen with the naked eye) such as
bacteria and viruses. Certain types of intracellular microorganisms induce a type of cell death
referred to as pyroptosis. Pyroptosis differs from
apoptosis in that pyroptosis results in the lysis or dissolution of the cell, releasing destructive
lysosomal enzymes into the tissue, which
cause inflammation (swelling, redness, and pain) as well as damage to nearby cells and reduced
function. The apoptotic bodies formed through
apoptosis do not cause an inflammatory response as they are quickly engulfed through
phagocytosis. Some genetic defects or inborn errors of
metabolism can lead to abnormal metabolic processes. Altered metabolism leads to the
accumulation of toxic intermediary compounds inside the
,cells, ultimately destroying them.
15. Describe the major mechanism of tissue damage caused by chemical injury.
Chemicals from both the environment (exogenous) and inside the body (endogenous) may
damage cells, either by altering cell membrane
permeability or producing other reactive chemicals, known as free radicals, which continue to
damage cell components. I
6. Discuss the manifestations of the four major types of necrosis, and give examples of the
tissue types affected by each type of necrosis.
Necrosis is the term used when a group of cells die and cause further damage due to cellular
disintegration.
• Liquefaction necrosis refers to the process by which dead cells liquefy under the influence of
certain cell enzymes. This process occurs when
brain tissue dies or in certain bacterial infections in which a cavity or ulcer may develop in the
infected area
• Coagulative necrosis occurs when the cell proteins are altered or denatured (similar to the
coagulation that occurs when cooking eggs), and the
cells retain some form for a time after death. This process typically occurs in myocardial
infarction (heart attack) when a lack of oxygen causes
cell death
• Fat necrosis occurs when fatty tissue is broken down into fatty acids in the presence of
infection or certain enzymes. These compounds may
increase inflammation.
• Caseous necrosis is a form of coagulation necrosis in which a thick, yellowish, "cheesy"
substance forms. Tuberculosis (TB) offers an
interesting example of caseous necrosis
7. Discuss apoptosis.
Apoptosis refers to programmed cell death, a normal occurrence in the body, which may
increase when cell development is abnormal, cell
numbers are excessive, or cells are injured or aged.
, Cells self-destruct, appearing to digest themselves enzymatically, and then disintegrate into
vesicles called apoptotic bodies. These vesicles are
quickly engulfed through the phagocytic activity without eliciting an inflammatory response.
8. Discuss the types of tissue necrosis.
Gangrene refers to an area of necrotic tissue, usually associated with a lack or loss of blood
supply that is followed by an invasion of bacteria.
·
Necrotic tissue can provide a good medium for infection by microorganisms. Such an infection
frequently occurs after an
infarction in the intestines or in a limb in which blood supply is deficient and bacteria are
normally present. Depending on
its location, gangrene may be described as wet or dry.
Dry gangrene is often caused by coagulative necrosis in which the tissue dries, shrinks, and
blackens.
Wet gangrene is a result of liquefaction causing the tissue to become cold, swollen, and black.
Gas gangrene is caused by the buildup of gases within tissue and further reduces blood supply.
Gangrenous tissue frequently must be removed surgically (eg, by amputation) to prevent the
spread of infection to other parts of the body.
Chapter 02: Fluids and Electrolytes, Acids and Bases
1. Discuss the two functional fluid compartments of the body.
Fluid is distributed between the intracellular compartment (ICF), or fluid inside the cells, and
the extracellular compartment (ECF).
ECF includes the following:
• Intravascular fluid (IVF) or blood
• Interstitial fluid (ISF) or intercellular fluid
• Cerebrospinal fluid (CSF)
• Transcellular fluids present in various secretions, such as those in the pericardial (heart) cavity
or the synovial cavities of the joints
