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Pathophysiology

DR . Ahmed Zaki Abdullah Al‐
DR . Ahmed Zaki Abdullah Al‐Ani
Professor of Medicine
The Hashemite Kingdom Of Jordan
Lecture One
Introduction to Pathophysiology
Levels of Organization
Levels of Organization
• Chemical
Ch i l
• Cellular
• Tissue
• Organs
• System Level
System Level
• Organismic 
Level

Principles of Human Anatomy and Physiology, 11e 3
LEVELS OF ORGANIZATION
LEVELS OF ORGANIZATION
• The human body consists of several levels of structural 
organization 
• The chemical level
– atoms, the smallest units of matter that participate in 
, p p
chemical reactions, and molecules, two or more atoms 
joined together.
• Cells
C ll
– the basic structural and functional units of an organism.
• Tissues
Ti
– groups of similarly specialized cells and the substances 
surrounding them that usually arise from a common origin
surrounding them that usually arise from a common origin 
and perform certain special functions.

Principles of Human Anatomy 
4
and Physiology, 11e
LEVELS OF ORGANIZATION
LEVELS OF ORGANIZATION
• Tissues
– ggroups of similarly specialized cells and the substances 
p y p
surrounding them that usually arise from a common origin 
and perform certain special functions.
• Organs
O
– structures of definite form that are composed of two or 
more different tissues and have specific functions
more different tissues and have specific functions.
• Systems
– related organs that have a common function.
related organs that have a common function
• The human organism
– a collection of structurally and functionally integrated 
ll ti f t t ll d f ti ll i t t d
systems; any living individual.

Principles of Human Anatomy 
5
and Physiology, 11e
LEVELS OF ORGANIZATION
LEVELS OF ORGANIZATION
• The systems of the human body are the 
i t
integumentary, skeletal, muscular, nervous, 
t k l t l l
, , y p
endocrine, cardiovascular, lymphatic, ,
respiratory, urinary, digestive, and 
reproductive

Principles of Human Anatomy 
6
and Physiology, 11e
LEVELS OF ORGANIZATION
LEVELS OF ORGANIZATION
• The human body consists of several levels of structural 
organization 
• The chemical level
– atoms, the smallest units of matter that participate in 
, p p
chemical reactions, and molecules, two or more atoms 
joined together.
• Cells
C ll
– the basic structural and functional units of an organism.
• Tissues
Ti
– groups of similarly specialized cells and the substances 
surrounding them that usually arise from a common origin
surrounding them that usually arise from a common origin 
and perform certain special functions.

Principles of Human Anatomy 
7
and Physiology, 11e
Health and Disease
Disease ‐ Deviation from normal (physical, mental and social).

Homeostasis‐ Stable internal environment (BP, temp, fluids, electrolytes) values are 
represented in ranges that can be adjusted for additional factors like 
age and activity level.
T
Terms used in Pathophysiology
d i P th h i l

Pathophysiology ‐ study of functional or physiological changes in the body         
g p , g g
resulting from disease process, both gross changes  and 
cellular changes.
Pathology ‐ lab study of cell and tissue changes associated with disease
Biopsy ‐ Surgical specimens.
Surgical specimens
Diagnosis ‐ Identification of a disease through the evaluation of signs 
and symptoms, lab tests and other tools.
Etiology ‐ The causative factors of a disease (congenital, genetic, 
The causative factors of a disease (congenital genetic
microorganisms, metabolic dysfunction, burns, nutritional 
deficiency).
Idiopathic ‐ Cause unknown.
Cause unknown
Iatrogenic ‐Caused by an error in treatment or procedure  bladder  
infections after a cath insertion, bone marrow damage from 
prescription  of  a drug
i ti f d
Predisposing factors -Tendencies that promote development of a
disease in an individual.
-Indicates high risk, not certain development
-Age, gender, diet, occupational exposure, genetic

Prevention - Vaccine, dietary and lifestyle modifications e.g (stop smoking)


Terms used to describe the characteristics of a 
Terms used to describe the characteristics of a
particular disease
Pathogenesis‐ Development of a disease or sequence of events involved 
in tissue changes related to a disease process.
Acute ‐sudden short term illness with marked signs.
sudden short term illness with marked signs
Chronic ‐ milder condition but persists for a long time.
Sub clinical ‐ Pathological change occurs but no obvious manifestations 
are exhibited by the patient
Latent‐ “silent”, no clinical signs (incubation period).
y p
Prodromal ‐ The time in early development of the disease where the 
patient is aware of some changes but the signs are 
nonspecific e.g ‐fatigue, loss of appetite.
Manifestation ‐ Clinical evidence or effects of a disease.
Clinical evidence or effects of a disease
Local ‐ Found at the site of the problem like swelling.
Systemic ‐ A general indicator of  illness like fever.
Signs ‐ Objective indications of diseases like fever or rash
Symptoms ‐ Subjective feelings like pain or nausea.
Lesion ‐ Specific local tissue change .
‐ can be either microscopic changes or things like blisters
Syndrome ‐ A collection of signs and symptoms that occur together in 
response to a certain condition
response to a certain condition.
Diagnostic tests ‐ lab tests that assist in diagnosing a disease.
Remission ‐ manifestations of disease subside.
Exacerbations ‐ manifestations of a disease increase.
Precipitating factor ‐ something that triggers an acute episode.
Complications‐ additional problems that arise after the original disease  begins.
Therapy/therapeutic interventions ‐ Measures that promote recovery or 
slow disease progress e g surgery, 
slow disease progress e.g surgery
drugs, behavioral
Sequelae
q ‐ Potential unwanted outcomes of condition.
Convalescence ‐ Period of recovery and return to normal state.
Prognosis ‐ Probability for recovery.
Morbidity ‐ Disease rates within a group.
Mortality ‐ Relative number of deaths resulting from a particular disease
Epidemiology ‐ The science of tracking pattern and occurrence of diseases
The science of tracking pattern and occurrence of diseases
‐ infectious diseases, flu vaccine.
Epidemics ‐ Many cases of infectious diseases within a given area.
Many cases of infectious diseases within a given area.
Pandemic ‐ High number of cases over several areas (often worldwide).
Incidence ‐ # of new cases within a given stated time period
Communicable disease ‐ Infections that can be spread from one person 
t
to another.
th
Notifiable/Reportable diseases ‐ Must be reported to authorities
‐intended
intended to protect public health
to protect public health
‐ measles, AIDS.
Autopsy ‐ An exam of the body after death by a pathologist, gross and 
microscopic  exam of the tissues , organs, and fluids.
Terms used for some of the common changes in cells
Atrophy ‐ Decrease in size of cells which leads to a decrease in tissue mass
‐muscles in a cast.
Hypertrophy ‐ Increase in the size of cells which leads to an  increase 
in tissue mass e.g exercise.
Hyperplasia ‐
l i Increase in the number of cells leading to an increase in tissue mass
i h b f ll l di i i i
‐Hormonal changes.
Metaplasia ‐One mature cell type is replaced by another mature cell type
‐One mature cell type is replaced by another mature cell type
‐Smokers lungs.
Dysphasia ‐ Tissue in which cells vary in shape and size 
‐Chronic irritation, infection.  
‐ Precancerous.
Anaplasia ‐ cells that are undifferentiated and have variable nuclei and  structure and 
numerous mitotic figures .Malignancy/cancer, basis for grading a tumor.
Neoplasm ‐ New growth/ tumor.
New growth/ tumor
Benign ‐ Don’t spread, not life threatening.
g
Malignant ‐ cancer
Cell damage and Necrosis Ways of injuring cells in the 
g y j g
body
Ischemia ‐ Deficit of oxygen to cells.
Hypoxia ‐ Decrease in oxygen in tissue.
‐ Interferes with ATP,
I f i h ATP stops sodium pumps and leads to 
di dl d
rupture of cell.
Physical agents ‐ Heat cold, radiation damages DNA and changes blood 
Physical agents  Heat cold, radiation damages DNA and changes blood
supply.
Mechanical damage ‐ pressure and tearing.  
Ch i l
Chemical toxins or foreign substances
i f i b
Exogenous ‐ outside of the body
Endogenous ‐ inside of the body
Endogenous  inside of the body
Microorganisms‐bacterial, viruses, parasites.
Abnormal metabolites accumulating in cells.
N ii
Nutritional deficiencies.
l d fi i i
Imbalance of food and electrolytes.
C ll D
Cell Damage (2 stages)
(2 )

1 .Initial       ‐ Alteration in the metabolic reaction leading to loss of function
p g / g
‐ Leads to morphological/structural changes that lead to cell 
death by rupture.
2.Lysis ‐ Dissolution‐releasing  lysosomal enzymes which leads 
to inflammation which leads to the damaging of nearby cells.
i fl i hi h l d h d i f b ll
‐Necrosis ‐ dead cells liquefy under the presence of certain cell enzymes.
Infarction ‐ an area of dead cells resulting from lack of oxygen.
‐Infarction an area of dead cells resulting from lack of oxygen.
‐Gangrene ‐ an area of necrotic tissue that has been invaded by bacteria.
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