Chapter 1: Introduction to Pathology

Neoplasms: Malignant tumors spread in three ways. What are they?

1. Seeding tumors invade natural body cavity (peritoneal cavity) 2. Lymphatic spread tumor spread through lymphatics Major route of carcinomas (breast and lung) 3. Hematogenous spread tumors penetrate blood vessels traveling in circulatory system

staging

1. extensiveness of tumor at the primary site 2. presence or absence of metastases to lymph nodes and distant organs

Malignant tumors: grading and staging

1. grading- assesses aggressive of tumor, degree of malignancy 2. staging- extensiveness of tumor at primary site and presence or absence of metastases to other lymph nodes and other organs -aids in deterring the correct therapy for the patient

Tumors have two components:

1. parenchyma (organ tissue) -made up of the neoplastiic cells 2. Supporting stroma (supporting tissue) -made up of connective tissue, blood vessels, ect.

22 chromosomes are ________ chromosomes

22

autosomes

44 chromosomes other than X and Y

____ chromosomes arrange in ____ pairs

46 23

Additive Conditions

Acromegaly Exostosis Aortic aneurysm Ascites Cirrhosis Organ hypertrophy Atelectasis CHF Malignancy Pleural effusion Pneumonia Hydrocephalus Metastases (osteoblastic) Osteochondroma Late Paget's disease Abscess Edema Sclerosis Empyema Military Tuberculosis Chronic osteomyelitis Osteoma Acute kyphosis

What are the two types of pathologies?

Additive and Destructive

what is it called when reduction in the size or number of cells in an organ or tissue, with a corresponding decrease in function?

Atrophy

Summary of terms for alterations in cell growth

Atrophy hypertrophy hyperplasia dysplasia neoplasia oncology benign malignant carcinoma anaplastic sarcoma lymphatic spread hematogenous spread grading staging epidemiology morbidity mortality

Which one has a large microbe and a small microbe out of bacterial infection and virus infection?

Bacteria- large microbe virus- smallest of the microbes

What type of infection is transmitted by direct contact with infected person, animal or contaminated food or water?

Bacterial infection -localized

Destructive Conditions

Bowel obstruction Free air Emphysema Pneumothorax Gout Metastases (osteolytic) Multiple myeloma Early Paget's disease Active osteomyelitis Osteoporosis Atrophy Emaciation Malnutrition Lung Abscess Atrophy Active tuberculosis Degenerative arthritis Hemangioma Hodgkin's disease

Genotype

Chromosomes and their component genes 46 chromosomes arranged in 23 pais 22 are autosomal chromosomes (autosomes) the 23rd pair are sex chromosomes XY- male genotype XX- female genotype

Nosocomial infections

Contracted from the acute care facility

Iatrogenic

Disease caused by physician or treatment.

Destructive Pathology

Diseases or conditions that decrease the absorption of x-ray photons. Results in decreased attenuation of beam. Decreased kVp EX: pneumothorax

Additive pathology

Diseases or conditions that increases absorption of X-ray photons. Results in increased attenuation of beam. Increased kVp. Ex: pleural effusion

Accumulation of abnormal amounts of fluid in the intercellular tissue spaces or body cavities is called what?

Edema

Terms related to edema

Edema Anasarca Elephantiasis

Symptoms

Feelings that the patient describes- subjective manifestations

Granulation tissue

Fibrous scar replaces destroyed tissue

Anasarca

Generalized edema occurs with pronounced swelling of subcutaneous tissues throughout the body.

Alterations of cell growth

Refers to the changes in the number and size of cells, their differentiation, and their arrangement. May develop in response to physiologic stimuli. Numerous terms associated with alterations in cell growth. Atrophy- reduction in size or # of cells in organ or tissue -EX: disuse atrophy -Limb immobilized in cast, muscle mass reduces Irreversible atrophy -loss of innervation -Hormonal stimulation -Decreased blood supply Hypertrophy- increase in size of cells in organ or tissue in response to a demand for increased function. -occurs in cells that cannot multiply -EX: occurs in second kidney after loss of first Hyperplasia- an incase in the number of cells in a tissue or organ. -EX: proliferation of granulation tissue in the repair of injury -increased cellularity of bone marrow in patients with hemolytic anemia or after hemorrhage Dysplasia- loss in the uniformity of individual cells and their architectural orientation. -associated with prolonged chronic irritation or inflammation

What are the three types of hemorrhage?

Petechiae- bleeding into mucous membrane or serial surfaces Purpura- larger hemorrhage Ecchymosis- largest hemorrhage (more than 1-2 cm)

Bacteremia

Potential involvement of other organs and tissues in the body by organisms invading the blood vessels

Recessive traits

albinism freckles normal digits attached earlobes straight hair blonde hair red hair lack of A, B surface antigens Inability to roll tongue into U shape

Permeable membrane

allows fluids/cells to pass from one tissue to another tissue or location.

Mutations

alterations in the DNA structures that may become permanent hereditary changes

Mutations

alterations int he DNA structure that may become permanent hereditary changes if they affect the gonadal cells. can be caused by radiation, chemicals or viruses autosomal dominant disorders- transmitted from one generation to the next. EX: marfans syndrome -symptoms: aorta weakens and expands (dilated ascending aorta) autosomal recessive disorders- result only when a person is homozygous for the defective gene. EX: sickle cell anemia sex-linked disorders- result from defective genes on the X chromosome EX: color blindness, muscular dystrophy (thin, de-mineralized bones) all sex-linked disorders are recessive

dominant genes

always produces an effect

Hyperplasia

an increase in the number of cells in a tissue or organ EX: proliferation of granulation tissue in the repair of injury. -increased cellularity of bone marrow in patients with hemolytic anemia or after hemorrhage alterations of cell growth

grading

assessment of aggressiveness or degree of malignancy

which mutation result only when a person is homozygous for the defective gene?

autosomal recessive disorders

Recessive traits come from what?

both parents

Community- Acquired infections

contracted in a public setting outside of the acute care facility.

Edema

edema is the accumulation of abnormal amounts of fluid in the intercellular tissue spaces or body cavities. Localized Generalized (anasarca) -occurs most often in patients with: CHF, Liver cirrhosis, and some renal diseases Present in lower part of body (lower legs, ankles) can produce pleural effusions, pericardial effusions and peritoneal ascites

XX

female genotype

what type of infection is transmitted via air and contact and can live on its own?

fungus -localized

hereditary process

genetic information contained in the nucleus of each cell passed to the next generation

Benign

growth which closely resembles their cells of origin in structure and function

Summary of terms for heredity diseases

hereditary process autosomes dominate genes recessive genes mutations

sarcoma

highly malignant tumor originating from connective tissue

chronic

illness that lasts 6 months or longer ex: asthma

Acute disease

ilness or medical problems that begins and progresses rapidly begins and ends quickly ex: heart attack

Inflammatory response

increase in blood flow in and around injury site. Produces heat and redness (hyperemia). vascular permeability produces swelling (tumor). Pressure on nerve endings produces pain. Leukocytes (white blood cells) migrate to area. Conduct removal (phagocytosis) of dead cells and tissue elements. Repair is possible by regeneration of parenchymal cells or scar formation (keloid). Some tissues cannot heal (ex: heart muscle, nerves cannot regenerate).

hyperplasia

increase in the number of cells in a tissue or organ

hypertrophy

increase in the size of the cells of a tissue or organ in response to a demand for increased function

A localized area of ischemic necrosis within a tissue or organ is called what?

infarction

Infarction

infarction is a localized area of ischemic necrosis within a tissue or organ. -myocardial -pulmonary Produced by occlusion of either arterial or venous blood supply infarction often occurs in elderly patient's when they are least able to stand them EX: gangrene

What is the initial response to the tissue to local injury?

inflammation

Inflammation

inflammation is defined as the initial response of body tissues to local injury. Five clinical signs: Rubor ( redness) Calor (heat) Tumor (swelling) Dolor (pain) Loss of function

Disease

is defined as "the pattern of the body's response to some form of injury that causes a deviation from or variation of normal conditions. Causes: Hereditary (genes) Trauma Infectious organisms Vascular processes Metabolic Processes

Infection: Bacteria

large microbe can grow on nonliving surfaces transmitted by direct contact with infected person, animal or contaminated food or water antibiotics kill bacteria some are useful such as in the GI tract to aid in digestion. EX: strep throat

Dysplasia

loss in the uniformity of individual cells and their architectural orientation. -associated with prolonged chronic irritation or inflammation alterations of cell growth

Irreversible atrophy

loss of innervation hormonal stimulation decreased blood supply alterations of cell growth

dysplasia

loss of unifomirty of individual cells and their architectural oreientation

lymphatic spread

major route of carcinoma to metastasize

XY

male genotype

carcinoma

malignant neoplasm of epithelial cell origin

metastasize

malignant neoplasms that travel to distant sites

hematogenous spread

malignant tumors that have invaded the circulatory system and travel as neoplastic emboli

Recessive genes

manifest themselves when a person is homozygous for the trait

Signs

measurable or objective manifestations

Fungus

microbe that can live on its own transmitted via air and contact anti fungal drugs can kill the microbes EX: athletes foot

morbidity

rate that an illness or abnormality occurs

Atrophy

reduction in size or # of cells in organ or tissue Ex: disuse atrophy EX: Limb immobilized in cast, muscle mass reduced. alterations of cell growth

Ischemia

refers to an interference with the blood supply to an organ or part of an organ. It deprives cells and tissues of oxygen and nutrients. May be caused by: -Narrowing of an artery, as in atherosclerosis. -Thrombotic occlusion ( thrombus- blood clot in vascular system. -Embolic occlusion (embolus- any foreign matter (blood clot, air bubble) carried in the bloodstream). Can lead to infarction

mortality

reflects the number of deaths by disease per population

The 23rd pair of chromosomes are what?

sex chromosomes

Infection: virus

smallest of the microbes needs a living host to survive transmitted by direct contact with infected person or contaminated object vaccine can fight virus all viruses are harmful EX: flu

epidemiology

study of determinants of disease events in given populations

oncology

study of neoplasms (tumors)

Infections

the invasion of microorganisms not normally present in the body. Localized: 1. bacterial 2. fungal Systemic: 3. Viral

Pyogenic bacteria

thick, yellow fluid called pus (dead white cells).

autosomal dominant disorders

transmitted from one generation to the next

anaplastic

undifferentiated cell growth- without form (bizarre)

neoplasia

ungoverned abnormal proliferation of cells

Alleles

various forms of genes Homozygous both chromosomes carry the same allele of a particular gene -genes inherited from each parent the same Heterozygous both chromosomes carry different alleles of the same gene -genes inherited differ from each parent

what type of infection is transmitted by direct contact with infected person or contaminated object?

virus -systemic

Immunity

your body's defense system

Phenotype

The physical expression of a genotype (what makes you unique) Dominant traits One allele determines phenotype, the other is suppressed -produced an effect regardless of whether person is homozygous or heterozygous Recessive traits only if allele is present on both chromosomes -appear only when the person is homozygous for that trait

Pathology

The study of diseases that cause abnormalities in the structure or function of various organ systems. Can alter the absorption characteristics of the anatomic part being examined. 2 types: Additive Destructive

Idiopathic

Underlying cause is unknown.

Abscess

Localized, usually encapsulated, collection of fluid.

What type of infections are there?

Localized: 1. bacterial 2. fungal systemic: 3. viral

Hemorrhage

Hemorrhage is the rupture of a blood vessel that allows blood to escape externally or internally, within surrounding tissues or cavity. - bleeding into tissues results in a hematoma. Almost always creates by some form of injury: Trauma Atherosclerosis Erosion of vessel wall 3 types: Petechiae- bleeding into mucous membrane or serial surfaces purpura- larger hemorrhage Ecchymosis- largest hemorrhage (more than 1-2 cm)

Hereditary diseases

Hereditary diseases result from an abnormality in the DNA. -most common abnormality is enzyme deficiency EX: albinism- absence of pigmentation resulting from enzyme deficiency that prevents synthesis of melanin They pass from one generation to the next through the genetic information contained in the nucleus of each cell.

Hypertrophy

Increase in size of cells in organ or tissue in response to a demand for increased function occurs in cells that cannot multiply EX: occurs in second kidney after loss of first alterations of cell growth

Body Reactions from Disease

Inflammation Edema Ischemia and infarction Hemorrhage Alterations of cell growth (neoplasms/ tumors)

Summary of terms for inflammatory process

Inflammation Permeable membrane Granulation tissue Pyogenic bacteria Abscess Bacteremia

Summary of terms related to blood vessels

Ischemia- interference of blood supply to an organ: deprives cells and tissues of oxygen and nutrients infarct- localized area of ischemic necrosis; produced by occlusion of either arterial supply or venous drainage. Hemorrhage- implies rupture of blood vessel. hematoma- accumulation of blood trapped within body tissues.

Elephantiasis

Localized lymphatic obstruction resulting in localized edema.

What are the five clinical signs of inflammation?

Rubor (redness) Calor (heat) Tumor (swelling) Dolor (pain) Loss of function

Terms Related to disease

Signs Symptoms Iatrogenic Nosocomial infections Community- acquired infections Idiopathic

Neoplasia

neoplasia is from the Latin word for "new growth". it is defined as an abnormal proliferation of cells that are no longer controlled by the factors that govern the growth of normal cells. neoplasms are commonly referred to as tumors. They may be benign or malignant (cancer). study of tumors is oncology. Benign tumors- closely resemble their cells of origin in structure and function (remain localized). -can be dangerous due to their location. Malignant tumors- invade and destroy adjacent structures (metastasize) causing death -refereed to as cancer -carcinogens- possible causative factors Tumors have two components: 1. Parenchyma (organ tissue) -made up of the neoplastic cells 2. Supporting stroma (supporting tissue) -made up of connective tissue, blood vessels, etc. Carcinoma- malignancy of epithelial cell origin (skin, mucous membrane linings) Adenocarcinoma- malignancy of glandular tissue (breast, liver, pancreas) Sarcoma- malignancy of connective tissue (bone, muscle) Malignant tumors spread in three ways: 1. seeding -tumors invade natural body cavity (peritoneal cavity) 2. Lymphatic spread -tumor spread through lymphatics -major route of carcinomas (breast, lung) 3. Hematogenous spread -tumors penetrate blood vessels traveling in circulatory system. Malignant tumors: 1. Grading- assesses aggressive of tumor, degree of malignancy 2. staging- extensiveness of tumor at primary site and presence or absence of metastases to other lymph nodes and other organs -aids in determining the correct therapy for the patient

Malignant

neoplastic growth that invades and destroys adjacent structures

Dominant traits

normal skin pigmentation lack of freckles brachydactly (short fingers) free earlobes curly hair color vision presence of Rhfactor on red blood cell membranes

The study of tumors is called?

oncology