Cell Injury Overview

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Questions and Answers

Which of the following is a physical agent that can cause cell injury?

  • Viruses
  • Insecticides
  • Electric shock (correct)
  • Tobacco

What type of cellular adaptation involves an increase in cell size?

  • Hypertrophy (correct)
  • Metaplasia
  • Atrophy
  • Hyperplasia

Which of the following is an example of metaplasia?

  • Pseudostratified columnar epithelium changing to squamous epithelium due to cigarette smoke (correct)
  • Hypertrophy of cardiac muscle due to hypertension
  • Increase in kidney cell number after nephrectomy
  • Skeletal muscle atrophy after paralysis

What is the main consequence of unresolved cell injury?

<p>Irreversible cell injury (D)</p> Signup and view all the answers

Which mechanism is involved in hypoxic cell injury?

<p>Altered cellular metabolism (C)</p> Signup and view all the answers

What defines hyperplasia in a cell context?

<p>Increase in cell number (A)</p> Signup and view all the answers

Which of the following statements about cellular responses to stress is true?

<p>Cells can adapt to overcome stress but may ultimately be injured. (C)</p> Signup and view all the answers

Which condition is an example of atrophy?

<p>Decreased muscle mass after prolonged immobility (B)</p> Signup and view all the answers

Which of the following is associated with an autoimmune disease?

<p>Immunologic reaction (B)</p> Signup and view all the answers

What type of cell injury results from a lack of oxygen?

<p>Hypoxic injury (C)</p> Signup and view all the answers

What type of epithelium replaces the normal ciliated columnar epithelium in response to chronic irritation?

<p>Stratified squamous epithelium (C)</p> Signup and view all the answers

Which cellular component is primarily affected by hypoxic cell injury, leading to ATP depletion?

<p>Mitochondria (A)</p> Signup and view all the answers

What is the first manifestation of cell injury?

<p>Cell swelling (D)</p> Signup and view all the answers

Which of the following best describes reversible cell injury?

<p>Cells recover from the injury. (B)</p> Signup and view all the answers

What typically leads to irreversible cell injury?

<p>Severe hypoxia or anoxia (D)</p> Signup and view all the answers

Which condition is most closely associated with decreased oxygen in the plasma?

<p>Hypoxemia (A)</p> Signup and view all the answers

What phenomenon is often seen in the liver, heart, and kidney during fatty change?

<p>Accumulation of lipid vacuoles inside the cytoplasm (D)</p> Signup and view all the answers

What role does lactic acid accumulation play in anaerobic glycolysis during hypoxic conditions?

<p>Contributes to protein denaturation (D)</p> Signup and view all the answers

Hypoxic injury does NOT include which of the following causes?

<p>Lung infections (C)</p> Signup and view all the answers

Which of the following actions results from a failure in the Na+/K+-ATPase pump during hypoxic injury?

<p>Cellular swelling due to Na+ and water influx (D)</p> Signup and view all the answers

Flashcards

Cellular Adaptation

The ability of cells to adjust their structure and/or function to cope with environmental changes.

Hyperplasia

An increase in the number of cells in a tissue or organ. Think of a growing muscle.

Hypertrophy

An increase in the size of individual cells, leading to an increase in the size of the organ. Think of a heart muscle pumping harder.

Atrophy

A decrease in the size and/or number of cells in a tissue or organ. Think of a muscle shrinking after not being used.

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Metaplasia

A reversible change where one cell type is replaced by another type of the same category. Imagine a change in the cell's 'costume.'

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Cell Injury

A state where the cell is unable to function normally due to excessive stress. Think of a cell being under immense strain.

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Hypoxia

A lack of sufficient oxygen supply to cells, often a major cause of cell injury. Imagine a cell gasping for breath.

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Reversible Cell Injury

Cell injury that can be reversed if the stress is removed. Think of a cell that can bounce back.

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Irreversible Cell Injury

Cell injury that is permanent and leads to cell death. Think of a cell that cannot be saved.

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Apoptosis

The process of programmed cell death, a controlled and organized process. Imagine a cell committing 'suicide' for the greater good.

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Metaplasia in the respiratory system

A change from the normal ciliated columnar epithelium lining bronchi and bronchioles to stratified squamous epithelium.

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Mitochondrial damage in reversible cell injury

The disturbance of the cell's ability to produce energy.

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Oxygen derived free radicals in reversible cell injury

The accumulation of harmful molecules that damage cell components.

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Tissue Hypoxia

Inadequate oxygen supply to tissues.

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Ischemia

A decrease in arterial blood flow to tissues, often caused by atherosclerosis.

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Cell swelling

The first manifestation of cell injury, occurring when cells fail to maintain ionic and fluid balance.

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Fatty change

The appearance of lipid vacuoles in the cytoplasm, indicating abnormal fat accumulation in the cell.

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Point of no return in cell injury

The point at which cell injury becomes irreparable and no intervention can save the cell.

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Study Notes

Cell Injury - Overview

  • Cells are constantly exposed to stresses
  • Cells initially try to adapt
  • If stress is severe or prolonged, cell injury results

Intended Learning Objectives

  • List causes of cell injury
  • Describe forms of adaptation with examples for each
  • Recall types of cell injury
  • Describe mechanisms and morphology of reversible cell injury
  • Recall definition, causes and consequences of hypoxic cell injury
  • Describe the mechanism of irreversible cell injury

Causes of Cellular Injury

  • Physical agents: Hypoxia, mechanical trauma, burns, radiations, electric shock
  • Chemical agents: Poisons (toxins), insecticides, alcohol, tobacco
  • Infectious agents: Viruses, bacteria, fungi, parasites
  • Immunologic reactions: Anaphylaxis, autoimmune disease
  • Genetic derangements: Abnormal proteins (hemoglobinopathies), abnormal or absent enzymes (storage disorders)

Adaptation

  • Hyperplasia: Increase in cell number (e.g., compensatory hyperplasia of the kidney after nephrectomy)
  • Hypertrophy: Increase in cell size (e.g., hypertrophy of the left ventricle due to aortic stenosis)
  • Atrophy: Decrease in cell number and/or size (e.g., skeletal muscle atrophy after paralysis)
  • Metaplasia: Change of one type of cell to another type of the same category (e.g., change from columnar epithelium to squamous epithelium)

Cell Injury Classification

  • Reversible: Affected cells can recover from the injury
  • Irreversible: Affected cells die

Mechanisms of Reversible Cell Injury

  • Disturbance in the function of:
    • Cell membranes: Leads to loss of structural integrity and loss of function
    • Mitochondria: Leads to decreased energy production (decreased ATP)
    • Ribosomes: Leads to decreased protein synthesis
  • Accumulation of oxygen-derived free radicals (e.g., Hâ‚‚Oâ‚‚)

Hypoxic Cell Injury

  • Definition: Inadequate oxygenation of tissues
  • Causes:
    • Hypoxemia: Decreased amount of oxygen dissolved in plasma
    • Hemoglobin-related abnormalities: Anemia
    • Ischemia: Decreased arterial blood flow to tissues (usually due to atherosclerosis)
  • Consequences:
    • Decreased ATP synthesis
    • Impaired Na+/K+-ATPase pump leading to cellular swelling
    • Shift to anaerobic glycolysis leading to:
      • Accumulation of lactic acid
      • Decrease in intracellular pH causing denaturation of proteins and decreased activity of many enzymes
      • Clumping of nuclear chromatin
    • Ribosomal detachment leading to decreased protein synthesis and accumulation of lipid (fatty change)

Morphology of Reversible Cell Injury

  • Cell swelling: First manifestation of cell injury, occurs when cells fail to maintain ionic and fluid homeostasis, manifests as small clear vacuoles inside the cytoplasm (also known as hydropic change)
  • Fatty change: Manifested by the appearance of lipid vacuoles in the cytoplasm, often seen in the kidney, heart, and liver

Irreversible Cell Injury

  • Mechanism: Persistent or severe injury (severe hypoxia or anoxia)
  • Results:
    • Point of no return - Injury cannot be reversed
    • No intervention to save the cell
  • Hallmark: Severe mitochondrial damage

Mitochondrial Damage

  • Reduction in ATP production leads to mitochondrial damage, formation of high conductance channels (Mitochondrial Permeability Transition (MPT) channels)
  • Release of cytochrome c into cytosol triggers cell death

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