Professional Documents
Culture Documents
OF
PATHOPHYSIOLOGY
“Cellular Physiology”
Ray Taylor
Valencia Community College
Department of Emergency Medical Services
Topics
Introduction
The Cell
Types of Tissue
Disease Causes
Disease Pathophysiology
The Cell and the Cellular
Environment
Introduction
Correlation of pathophysiology with
disease process
Cells appear similar to multicellular “social”
organism
Cells communicate electrochemically
When interrupted disease processes can
initiate and advance
Introduction
Knowledge of coordination of specific bodily functions
leads to better understanding of the disease process
Endocrine
Exocrine
Other coordinating receptors
Chemoreceptors
Baroreceptors
Adrenergic
Others: Neurotransmission
Introduction
Understanding disease process is important for
paramedics to better anticipate, correct, and
provide appropriate care
Once knowledge of physical laws and principles
have been gained paramedics can apply these to
the mechanisms and complications of disease
Cells of the immune system and inflammatory
responses are found with every type of trauma or
disease process
The Normal Cell
Lysosomes
Contain digestive
enzymes
Protect against disease
Production of nutrients
Breaking down bacteria
and organic debris
entering cell and
releasing unstable
substances
Perozisomes
Absorb and neutralize
toxins
Cilia and Flagella
Cilia
Short hair like projections
from cell
Create fluid movement
around cell
Flagella
Long whip like
projections from cell
Moves cell through
extracellular fluid
Cell Function
Movement Secretion
Conductivity Excretion
Metabolic Respiration
absorption Reproduction
Tissues
Specialized tissue
that transmits
electrical impulses
throughout the body.
Examples include
the brain, spinal
cord, and peripheral
nerves.
Organs, Organ Systems, and
the Organism
Cardiovascular Nervous
Respiratory Endocrine
Gastrointestinal Lymphatic
Genitourinary Muscular
Reproductive Skeletal
System
Integration
Homeostasis
Secrete
substances such
as sweat, saliva,
tears, mucus,
and digestive
juices onto the
epithelial surfaces
via ducts
Signaling
Nerve endings
Sensory organs
Proteins that interact with, and then
respond to the chemical signals and
other stimuli
Many medications act upon
these receptors…
Chemoreceptors respond to
chemical stimuli.
Baroreceptors respond to
pressure changes.
Alpha and beta receptors
respond to neurotransmitters
and medications.
When normal intercellular
communication and normal
metabolism are disturbed, the body
will respond in various ways to
compensate and attempt to restore
normal metabolism,
a.k.a. — homeostasis.
Stressors on a body system are
inputs.
The portion of the system creating
the input is an effector.
A negative feedback loop exists
when body mechanisms work to
reverse an input.
Decompensation occurs when the
system cannot compensate and
restore homeostasis.
Negative Feedback Loop
Body mechanisms that function to reverse or
compensate for a pathophysiological process (or to
reverse any physiological process, whether
pathological or nonpathological
Output of a system corrects the situation that created
the input
Feedback negates the input caused by the original
stressor
Feedback must be orchestrated and synchronized to
maintain homeostasis
Pathology and Pathophysiology
Pathology
Study of diseases and its cause
Pathophysiology
The study of how diseases alter
the normal physiological
processes of the human body
Disease may include illness or injury
From the root “patho” meaning
disease.
How Cells Respond to
Change and Injury
Cellular and Tissue Alteration
Body tends to maintain a constantly
balanced environment and to adapt
(correct or compensate) for any change
that disturbs the balance
Cellular adaptation
Cells adapt to their environment to avoid and
protect themselves from injury
Adapted cells are neither normal or injured (they
are somewhere between these two states)
Cellular Adaptation
Atrophy—decreased
size resulting from a
decreased
workload.
Hypertrophy—an
increase in cell size
resulting from an
increased workload.
Types of Cellular Adaptations
Hypoxic
Chemical
Infectious
Immunologic/ Inflammatory
Physical agents
Nutritional balances
Genetic factors
Cellular Injury
Hypoxic injury
Most common cause of
cellular injury
May result from:
Decreased amounts of
oxygen in the air
Loss of hemoglobin or
hemoglobin function
Decreased number of
red blood cells
Disease of respiratory
or cardiovascular
system
Loss of cytochromes
Iron containing protein in
the mitochondra (electron
transport system)
Cellular Injury
Chemical agents causing cellular injury
Poisons
Lead
Carbon monoxide
Ethanol
Pharmacological
Cellular Injury
Infectious injury
Disease causing agents (Pathogens)
Virulence or pathogenicity of microorganisms
depends on their ability to survive and reproduce
in the human body, where they injure cells and
tissues
Disease producing potential depends upon its
ability to
Invade and destroy cells
Produce toxins
Possible outcomes
Pathogen wins
Pathogen and body battle to a draw
Apoptosis
Injured cell releases enzymes
that engulf and destroy the cell.
Cells shrink.
Eliminating damaged and
dead cells allows tissues to
repair and possibly regenerate.
Cellular Necrosis
Cell death; a pathological cell change
Four forms of necrotic cell change
Coagulative
Liquefactive
Caseous
Fatty
Cellular Necrosis
Coagulative necrosis
Generally results from hypoxia and commonly occurs in
kidneys, heart, and adrenal glands
Transparent viscous albumin of the cell becomes firm
Liquefactive necrosis
Cells become liquid and contained in walled cysts
Common in ischemic death of neurons and brain cells
Caseous necrosis
Common in TB
Cells become infected and look like fried cheese
Fatty necrosis
Fatty acids combine with calcium, sodium, and
magnesium ions
Gangrenous Necrosis
Tissue death over a wide area
Types
Dry gangrene: results from coagulative
necrosis
Wet gangrene: results from liquefactive
necrosis
Gas gangrene: results from bacterial
infection in tissue generating gas bubbles
in cells
Dispatch
Patient presents as
Fully immobilized
Alert and oriented
Complaining of rib
pain
You note
Significant front-end and passenger-side
damage
One foot of intrusion into driver’s
compartment
Windshield on driver’s side intact
Glass on driver’s door shattered
Vital signs
HR = 104 regular
RR = 20 regular
BP = 136/80
SaO2 = 96% on room air
Interpretation?
© 2007 by Pearson Education, Inc.
Pearson Prentice Hall, Upper Saddle River, NJ
Treatment/Assessment
A 12-gauge
thorocostomy
needle is affixed to
a 10 cc syringe
Heimlich valve
attached
Reassessment reveals:
Lung sounds increased on left
Color returning to skin
Vital signs
HR = 108 regular
RR = 22 regular
BP = 130/76
SaO2 = 97% on 15 Lpm
Vital signs
HR = 102 regular
RR = 20 regular
BP = 126/76
SaO2 = 98% on 15 Lpm
ABCs assessed
Oxygen administration continued
Central venous access obtained
Imaging studies
Trauma radiograph series obtained
Left-sided pneumothorax and pulmonary
contusion identified
No other injuries noted
Laboratory studies
Complete blood count (CBC), type and
cross, coagulation profiles
Arterial blood gas (ABG)