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Lecture 17

NURS 364 Lecture Notes - Lecture 17: Lactic Acidosis, Cellular Adaptation, Metaplasia


Department
Nursing
Course Code
NURS 364
Professor
Deborah Van Kuiken
Lecture
17

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Cellular Adaptation, Injury & Death
Pathophysiology NURS 364-04
What is adaptation?
Cellular Adaptation, Injury & Death
All disease occurs because of cell injury
Either because of the injury itself or the repair process that follows
Cellular Adaptation
Allows the stressed tissue to survive or maintain function
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
Atrophy
Decreased size & function
Metabolic processes shut down to conserve energy
Due to
Lack of use
Aging
Ischemia
Lack of nutrients
lack of nerve or hormonal stimulation
Hypertrophy
Increased size & functional capacity
Due to
Hormonal stimulation
Increased functional demand
Hyperplasia
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Increase in number of cells
Due to
Hormonal stimulation
Increased functional demand
Chronic stress or injury
What would determine whether there is hypertrophy or hyperplasia?
Metaplasia
One cell type to another cell type
Reversible
Dysplasia
Disorderly overgrowth of cells
Vary is size, shape, & organization
Premalignant (Precursor to cancer)
Due to:
Repeated inflammation/irritation
Follows metaplasia
What causes cell injury?
Causes of Cell Injury
Hypoxia
Physical Agent
Mechanical forces
Extreme temperatures
Electrical forces
Chemical Injury
Immune response
Biologic agents (infectious)
Nutritional imbalances
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Genetic derrangement
Most Common Causes of Cell Injury
1. Hypoxia / Ischemia
Increased Cytoplasmic Na+
Increased Cytoplasmic Ca++
Lactic acidosis
2. Generation of Reactive Oxygen Species/free radicals
Oxidative stress
3. Chemical injury
1. Hypoxia – Ischemia Mechanism
1. Hypoxia – Ischemia Mechanism
Increase Intracellular Na+
Cell usually maintains low intracellular calcium
1. Hypoxia – Ischemia Mechanism
Increase Lactic Acid
Hypoxic Injury
2. Reactive Oxygen Species
(Free Radical Injury)
Molecules with an unpaired electron in the outer orbit (valence shell)
ROS are a product of the mitochondrial respiration
Normally removed from the body by antioxidants
Oxidative stress – Occurs when the generation of oxidative free radicals exceeds that
ability of the body to eliminate or neutralize them.
2. Reactive Oxygen Species
(Free Radical Injury)
Can react with normal cell components: protein, lipids & carbohydrates
ROS - CELL INJURY results in:
a. Lipid peroxidation
membrane damage/permeability
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