Eustress: Positive events that stimulate growth

Distress: Harmful or unpleasant stress

T or F:

Stress is a non-specific response of the body to any demand placed on it?

Stress comes in a variety of doses

(ranging from small to large)

What are some ways the body reacts to stressors?

ALARM PHASE

Which system (symp or parasymp) provides an immediate response?

Sympathetic Nervous System:

Blood supply increases

Eyes dilate

Digestion decreases 

ALARM PHASE

During this phase the "fight or flight" response is triggered;

What is the dominant hormone involved?

Supporting hormones?

Dominant:

Epinephrine: adrenaline

Supporting:

Renin: overall retains Na+ and increases bp

ADH: retains H2O, reabsorption & bp increase

Glucocorticoids: increase blood sugar

RESISTANCE PHASE

When does this phase occur? 

RESISTANCE PHASE

What is the dominant hormone involved?

Supporting hormones?

DOMINANT: 

Glucocorticoids 

Supporting:

Epinephrine, GH, thyroid

RESISTANCE PHASE

 What role do hormones play in this phase?

Mobilize lipid and protein reserves to conserve glucose for neural tissues

NOTE:

Insulin decreases blood sugar

Glucagon increases blood sugar

RESISTANCE PHASE

T or F:

Goals of this phase include-

1. Mobilize lipid and protein reserves

2. Conserce glucose for neural tissues

3. Elevate blood glucose concentrations

4. Conservation of salt and water

RESISTANCE PHASE

What are the individual causes for these problems?

1. Anti-inflammatory suppresses healing & immune system

2. High bp leads to stress for L ventricle

3. Structural proteins are tore down

1. Glucocoticoids

2. Conservation of fluid

3. Depletion of lipid reserves

EXHAUSTION PHASE

What is the main result of this phase?

Collapse of vital systems;

If no corrective actions are taken immediately, one or more system failures can prove fatal

EXHAUSTION PHASE:

T or F

Possible causes of this phase include:

1. Lipid reserve exhaustion

2. Inability to produce glucocorticoids 

3. Failure of electrolyte balance

4. Structural or functional damage to vital organs

Match the words to definitions:

1. Disease 2. Etiology

3. Pathogenesis 4. Pathophysiology

a. Cause of disease

b. Sequence of events in the development of disease

c. Failure to maintain homeostatic conditions

d. Study of functional & structural changes caused by disease

1. C

2. A

3. B

4. D

MATCH

1. Inherited 2. Congenital 3. Acquired 4. Multifactorial

5. Idiopathic 6. Iatrogenic

a) Present at birth 

b) Developed during lifetime

c) Due to a genetic defect

d) More than one factor

e) Treatment induced

f) No understood cause

1. C

2. A

3. B

4. D

5. F

6. E

Intrinsic etiologies (from within the body) include:

MATCH

1. Degenerative 2. Immunologic 3. Metabolic

4. Nutritional 5. Psychogenic

a) Abnormal body chemistry

b) Abnormal immune response

c) Progressive loss of normal structure & function

d) Related to psychological state

e) Abnormal dietary intake or nutrient use

1. C

2. B

3. A

4. E

5. D

T or F:

Extrinsic etiologies are produced from the environment?

Which does not cause extrinsic etiologies?

a) Trauma

b) Chemicals, drugs, toxins

c) Infectious

d) Psychogenic

e) Hypoxia

f) Environmental agents

How are adapted cells classified?

a) Abnormal

b) Normal

c) Stressed

T or F

Cellular injury can be reversible or irreversible?

T or F:

Programmed cell death is necrosis, while cell death is apoptosis?

FALSE

Apoptosis: programmed cell death

Necrosis: cell death

Atrophy is the shrinkage in cell size by loss of cell substance (also diminished function). 

What are some causes of this?

T or F:

Hypertrophy is the decrease in size of individual cells?

FALSE!

It's the increase of size of individual cells

During hypertrophy, no new cells are formed. The cells aren't swollen by fluid either.

(Swell by an increase of structural protein and organelle processes)

What are some examples of hypertrophy?

Skeletal muscles

Cardiac muscles

Kidneys

T or F:

Hyperplasia is a decrease in the number of individual cells in an organ or tissue

FALSE:

It's an increase in # of individual cells, not decrease

Skeletal cells

Cardiac cells

Nerve cells

MATCH types of hyperplasia

1. Compensatory 2. Hormonal 3. Pathologic

a) Estrogen dependent

b) Excess hormones or growth factors

c) Enables organs to regenerate

1. C

2. A

3. B

T or F:

Metaplasia is the reversible replacement of one cell type by another in response to a particular stress or stimuli

In metaplasia, a (disorderly/orderly) arrangement of the new cell type is found.

T or F:

An example of metaplasia can be found in cigarette smokers?

Orderly

TRUE

T or F:

Dysplasia may be reversible and is often called atypical hyperplasia?

T or F:

If a stimulus persists during dysplasia, it may progress to neoplasia?

Some examples of dysplasia can occur in the cervix and breast?

TRUE 

&

TRUE

When a cell is injured, it (can/cannot) maintain homeostasis.

With cell injury it is (easy/difficult) to distinguish between primary target of injury from any secondary or ripple effect.

FALSE:

It's difficult to determine

Which three things influence cellular response to cell injury?

1. Depth of injury

2. Type of injury

3. Severity of injury

4. Duration of injury

Which three factors do consequences of cell injury depend on?

1. Type of cell injured

2. Size of cell injured

3. Cell's current health status

4. Cell's adaptability

Diseases can be described by the degree, onset and distribution. 

(i.e.)

1. mild -> moderate -> severe

2. acute -> subacute -> chronic

3. focal/localized -> multifocal -> systemic/generalized

1. Hypoxic injury

2. Free radicals & reactive oxygen species

3. Chemical injury

4. Tissue trauma

5. Infections

6. Immunologic

7. Inflammatory

8. Genetic

Unstable, unpaired electrons 

Come from:

UV lights, xrays, oxidative rxns, normal metabolism

MATCH:

In what way do free radicals cause injury?

1. Lipid peroxidation

2. Fragmentation of polypeptide chains

3. Alteration of DNA 

a) W/ proteins

b) Destroy unsaturated fats

c) Breakage leads to decrease of protein synthesis

1. b

2. a

3. c

T or F:

Damage from free radicals can be decreased with antioxidants?

(i.e. superoxide, vit C & E, beta carotene)

MATCH:

Chemical injury can be caused by the following..

1. Carbon tetrachloride

2. Carbon Monoxide

3. Alcohol

and the results of such..

a) Special affinity for hemoglobin & decrease ability to carry O2

b) Metabolized by liver enzyme, toxic free radicals

c) liver disease, nutritional disorder, CNS impairment

1. b

2. a

3. c

Match the traumatic tissue injury with it's example

1. Blunt force 2. Contusion 3. Abrasion 4. Stab wound

5. Incision 6. Avulsion 7. Gunshot wound 8. Asphyxiation

a) Bruise b) Accident c) Scrape d) Longer e) Deeper

f) Speed = (1/2)mv^2 g) Skin tearing away h) Drowning

1. b

2. a

3. c

4. e

5. d

6. g

7. f

8. h

MATCH

Three types of hypoxic injury include:

1. Anoxia 2. Hypoxia 3. Ischemia

a) Lack of sufficient oxygen supply to tissues

b) Inadequate blood flow in tissues

c) Complete lack of oxygen

1. c

2. a

3. b

1. Decreased oxygen levels in air

2. Respiratory or cardiovascular diseases

3. Lack of RBC's/anemia

4. Inadequate/dysfunctional hemoglobin (CO)

1. Anaerobic glycolysis: lactic acid produced,

decrease pH, less efficient (36 v. 2 ATP), glycogen depleated

2. Failure of Na/K pump: Na+ accumulates in cell,

K+ diffuses out of cell, net gain of Na+ results in 

osmotic gain of H2O in cell

3. Acute cellular swelling results (NOT hypertrophy)

T or F:

Cellular swelling causes dilation of the endoplasmic reticulum.

T or F:

Lysosomal swelling leads to leakage of lysosomal enzymes autolysis.

TRUE 

&

TRUE

Which of the following aren't present during reversible cellular injury?

1. ATP production restored

2. Cell recovery due to pumping out water

3. Cell returns to homeostasis from acute cellular swelling

4. Injury is prolonged and severe

4. Injury is prolonged and severe;

At this point, the injury is no longer reversible

Extent cell membrane damage:

1. increased permeability of membrane

2. Loss of volume regulation

3. Massive calcium influx

4. Loss/leakage of proteins, essential coenzymes and ribonucleic acids

Match types of cell death:

1. Necrosis

2. Apoptosis

3. Autolysis

a) Programmed cell death that occurs normally in developing and adult tissues

b) Changes that follow cell death in living tissue

c) Postmortem dissolution and disintegration of cells or tissues by the enzymes present in those tissues

1. b

2. a

3. c

What do coagulative & liquefactive necrosis have in common? 

What happens in coagulative necrosis and where does it affect?

1. Protein denaturation

2. Kidneys, heart

1. Solid tissue is dissolved into fluid by hydrolases

2. Affects brain - neural & glial cells

Dead cells disintegrate, debris is not entirely digested

EX: tuberculosis

T or F:

During fat necrosis, lipases degrade triglycerides & free fatty acids combine with calcium ions to form soaps

TRUE

EX: located in pancreas, breast

MATCH:

1. Wet gangrene

2. Dry gangrene

3. Gas gangrene

a) Area of coagulative necrosis becomes dried out, wrinkled & dark black

b) Infection of necrotic tissue by Clostridium species

c) Neutraphils invade necrotic site causing secondary infection

1. c

2. a

3. b

MATCH:

Where can you find examples of each gangrene?

1. Gas gangrene

2. Wet gangrene

3. Dry gangrene

a) Distal extremities

b) Moist areas of body

c) GI tract

1. c

2. b

3. a

T or F:

Dystrophic calcification is deposition of calcium in dead or dying tissues.

Dystrophic calcification is advanced in arteriosclerosis and acts as evidence of previous cell injury. It is often a cause of organ dysfunction.

What is an example?