Introduction to Pathological Physiology PDF

Introduction to Pathological Physiology. Biological etiological factors. Infection and inflammation Prof. Dr Ilija Jeftić Lecture content Subject of Pathological Physiology Definition of health Definition of disease Stages of disease development Etiology of the disease...

Introduction to Pathological Physiology. Biological etiological factors. Infection and inflammation Prof. Dr Ilija Jeftić Lecture content Subject of Pathological Physiology Definition of health Definition of disease Stages of disease development Etiology of the disease Pathogenesis of the disease Introduction to Pathological Physiology Pathological physiology is a part of medicine that has the task of explaining how disease occurs, how physiological and biochemical functions change when an organism moves from a state of health to a state of disease. A change in the structure and/or function of cells and tissues determines the disease and all its characteristics Health and disease as dynamic processes The existence of higher animals and humans takes place in two environments: external (milieu exterieur) internal (milieu interieur) HOMEOSTASIS – stability of the internal environment A healthy human organism continuously maintains the constancy of its structure, its chemical composition, biochemical reactions and physiological functions Health and disease as dynamic processes constancy of the internal environment, i.e. health exists as long as the organism is able to resist the penetration of harmful influences or to repair the changes that have occurred in it the moment when the external harmful influences become too strong, when the defense mechanisms weaken or the regulatory mechanisms stop working, changes in the internal environment begin, which manifest themselves as disease HOMEOSTASIS – a state of dynamic balance Health and Disease (Definition) health is a state of complete physical, mental and social well-being, not just the absence of disease and incapacity health is a harmonious balance of structure and function of the organism and mental experience, which is a requirement for full working capacity, and thus full enjoyment of life illness is a disturbance of that harmonious balance, with reduced work capacity and reduced enjoyment of life, as well as mental stress Health and Disease (Definition) health - what is normal, illness - deviation from normal health - life with maintained homeostasis, disease a state with disturbed homeostasis Symptoms and signs of the disease the changes that occur in the disease are manifested in certain ways, which are called symptoms and signs in every disease, a series of certain signs and symptoms appear that reflect both morphological and functional changes that occurred during the course of the disease it is very rare that a pathological process takes place without the appearance of at least some symptom or sign, when such a disease is called asymptomatic Symptoms and signs of the disease Symptoms and signs of the disease signs are objective and symptoms are subjective manifestations of the disease subjective symptoms are those felt by the patient himself, not noticed by another person, and which often cannot be objectively proven (pain, nausea, weakness, ringing in the ears...) objective signs of the disease are noticed by another person, and they can be proven in an objective way, for example during a physical examination of the patient or some functional test Symptoms and signs of the disease Symptoms and signs of the disease Symptoms can be divided into: non-specific and specific (pathognomonic) Syndrome - a group of symptoms that appear together in a disease Stages of disease development INCUBATION STAGE (LATENT) PRODROMAL STAGE MANIFEST STAGE - period of illness - period of decline RECOVERY STAGE Incubation period the first stage of disease development it is the period when the etiological factor acts on the organism, but has not yet managed to cause such changes that would lead to visible disorders the incubation stage is best expressed in infectious diseases Prodromal stage in this stage, the organism shows certain very weakly expressed pathological disorders that occur in many diseases in this period the disease has not yet started Given that most diseases go through the incubation and prodromal stages, the study of these periods is very important, because they help to detect diseases in the earliest stages of development - the best therapeutic effect Manifest stage in this stage, the complete picture of the disease is manifested with all pathological changes in structure and function the etiological factor managed to fully develop its effect and lead to certain damages at this stage it is possible to make an accurate diagnosis Diseases are divided into: acute subacute and chronic Period of convalescence at this stage, the organism is completely healthy when it comes to the disease from which it was suffering, but its condition, both physical and psychological, has not yet been brought to the best possible state impaired defense mechanisms A convalescent woman. Photo by Paolo Monti. Disease outcomes complete recovery (restitutio ad integrum) incomplete healing transition to a pathological state lethal outcome or death of the organism (exitus lethalis) Temporary stopping of the disease development is called a remission The continuation of the disease in the direction of worsening is called exacerbation Etiology aitia=cause, logos=science a causative agent that is capable of disrupting the balance between the body's defense forces and its environment, i.e. to disrupt homeostasis and thereby cause disease, is called an etiological factor Etiological factors According to origin, etiological factors are divided into: external and internal External etiological factors Internal etiological factors biological etiological factors modified non-specific defenses physical etiological factors modified specific defense chemical etiological factors etiological factors of inheritance etiological factors of nutrition etiological factors of life age etiological factors of the social environment etiological factor of sex Biological etiological factors biological etiological factors include all living agents that penetrate the human body and cause infection, pathological changes and disease bacteria, viruses, fungi, parasites... Infection is a set of disorders caused by the penetration of pathogenic microorganisms foreign to the human body (heteroinfection) or, more rarely, by the development of germs found in the body (autoinfection) the entrance doors are: respiratory tract, digestive tract, skin and mucous membranes sources of infection are: a sick person, less often healthy people (carriers), polluted air, water, food, diseased animals (zoonosis), insects... Infection Infection = number of germs x virulence/ resistance of the organism Physical etiological factors they include all forces of a physical nature that are capable of causing pathological changes in the body through physical action high and low temperature, pressure changes, electric current, mechanical forces, intense sound and noise, various types of radiation Chemical etiological factors all substances that, acting chemically, cause pathological changes in the body exogenous and endogenous chemical etiological factors Internal etiological factors they represent a set of features of the organism itself that are important for the emergence and development of diseases hereditary diseases or hypersensitivity reactions age and gender also represent additional internal etiological factors disorders of nervous and humoral regulation Etiological factors According to the role they play in the development of the disease, they can be divided into: primary and Secondary The main etiological factor that causes the disease and on which the type of disease depends is called the primary etiological factor, and the others that enable its effect are called secondary etiological factors (tuberculosis). Pathogenesis pathos= suffering, illness, genesis=origin studies the mechanisms of structural and functional disorders the way in which the etiological factor leads to pathological changes in the organism Pathogenesis cause and effect relationship (inflammation of the gallbladder - bleeding) determining the mutual dependence of pathological processes in the organism is very important because pathological processes in diseases do not occur independently but influence each other or one pathological process enables the development of another Pathogenesis pollen sneeze Bjermer, L et al. The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option. Allergy Asthma Clin Immunol 15, 24 (2019). Pathogenesis stomach ulcer Catarina Serafim et al. A Review of the Role of Flavonoids in Peptic Ulcer (2010–2020) Pathogenesis acute pancreatitis John C. Marshall, Acute Pancreatitis, Critical Care Medicine (Third Edition), 2008 THANKS