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Introduction To Pathology

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Introduction To Pathology

  1. 1. Introduction to Pathology Chapter 1 Heather Johnson, A.S., R.T. (R)
  2. 2. Good to know… <ul><li>you need to have a good understanding of normal anatomy in order to differentiate it from pathology </li></ul>
  3. 3. <ul><li>remember that medical terminology class way back in first semester? </li></ul>
  4. 4. Why take a pathology class? <ul><li>“We’re not supposed to read the x rays!” </li></ul><ul><li>A basic understanding of pathology helps you do your job better. </li></ul>
  5. 5. Why take a pathology class? <ul><li>better care for your patient – more careful positioning, alternative positioning, care to protect immunocompromised patient, protect yourself, more understanding </li></ul><ul><li>change in routine projections to make a subtle pathology stand out </li></ul><ul><li>change in technique </li></ul>
  6. 6. Disease <ul><li>Pathology is defined as: the study of disease that can cause abnormalities in body structure or function </li></ul><ul><li>can be hereditary </li></ul><ul><li>can be the result of previous injury, infection, vascular or metabolic abnormality </li></ul><ul><li>presents as signs or symptoms </li></ul>
  7. 7. <ul><li>iatrogenic – pathology caused by a physician and their treatment </li></ul><ul><li>nosocomial infection – hospital-acquired </li></ul><ul><li>community acquired infection – acquired outside of a health care facility </li></ul><ul><li>idiopathic – cause is unknown </li></ul>
  8. 8. Inflammation <ul><li>swelling </li></ul><ul><li>body’s response to injury, can be anywhere in / on the body, but is often localized </li></ul>
  9. 9. <ul><li>process of inflammation: </li></ul><ul><li>increased blood flow and vascular permeability (capillaries allow for more permeation of exudate) </li></ul><ul><li>white blood cells migrate to injured tissue </li></ul><ul><li>injured (dead) cells are eaten (phagocytosis)…yuk </li></ul><ul><li>proliferation of normal parenchymal cells and granulation (scar) tissue </li></ul>
  10. 10. <ul><li>some tissues cannot heal by regeneration – heart, damaged area replaced by scar </li></ul><ul><li>some partially heal, partially scar – cirrhosis of liver, mix of regenerated cells and scar tissue </li></ul>
  11. 11. 5 signs of inflammation <ul><li>rubor (redness) </li></ul><ul><li>calor (heat) </li></ul><ul><li>tumor (swelling) </li></ul><ul><li>dolor (pain) </li></ul><ul><li>loss of function </li></ul>
  12. 12. Edema <ul><li>accumulation of fluid in tissue or body cavities in abnormal amounts or for a prolonged amount of time </li></ul><ul><li>can be localized (inflammatory reaction) or generalized (subcutaneous accumulation throughout the body) </li></ul>
  13. 13. localized edema <ul><li>area of inury, area of blocked lymphatic drainage </li></ul><ul><li>filariasis – parasitic worm causing lymphatic obstruction </li></ul>
  14. 14. Elephantiasis (filariasis)
  15. 15. generalized edema <ul><li>fluid accumulation over entire body or regions </li></ul><ul><li>CHF, cirrhosis of the liver, renal disease </li></ul><ul><li>ambulatory patients – accumulates in distal lower extremities </li></ul><ul><li>sedentary patients – accumulates in back and lungs </li></ul>
  16. 16. ischemia <ul><li>interference of an organ or tissue’s blood supply </li></ul><ul><li>caused by narrowing of arterial vessels, most often from atherosclerosis, thrombus/embolus; less often external force (post-traumatic swelling, unintentional mechanism) </li></ul><ul><li>less dangerous when occlusion is slow-growing and in a healthy patient </li></ul><ul><li>more dangerous when it occurs rapidly, or happens in patients with anemia </li></ul><ul><li>incidence increases after a patient has surgery </li></ul>
  17. 18. infarct <ul><li>localized necrosis (death) of tissue or an organ due to venous or arterial ischemia </li></ul><ul><li>most common form are myocardial and pulmonary </li></ul><ul><li>can also lead to gangrene </li></ul>
  18. 19. hemorrhage <ul><li>rupture of a larger artery or vein </li></ul><ul><li>may be caused by trauma, atherosclerosis, or erosion of a vessel wall (cancer) </li></ul><ul><li>accumulations of blood trapped within the body is called a hematoma </li></ul><ul><li>ecchymosis – subcutaneous hematoma (bruise) </li></ul>
  19. 21. <ul><li>facts: </li></ul><ul><li>a patient can lose up to 20% of their total blood supply with little clinical significance </li></ul><ul><li>urgency of hemorrhage depends on location in the body </li></ul>
  20. 22. alterations in cell growth <ul><li>atrophy - the reduction in size or number of cells in organ or tissue; results in decreased function; disuse or pathologic </li></ul><ul><li>hypertrophy – increase in size of cells due to increased use; ex. muscles </li></ul><ul><li>hyperplasia – increase number of cells; ex. granulation tissue </li></ul><ul><li>dysplasia – loss of cell uniformity due to irritation (premalignant) </li></ul>
  21. 23. Hyperplasia, cortical thickening
  22. 24. neoplasms / oncology <ul><li>neoplasia – abnormal growth of cells (tumors) </li></ul><ul><li>benign tumors – resemble tissue of origin, do not spread to other areas (do not metastasize); not as dangerous , but can still cause complications </li></ul><ul><li>malignant tumors (cancer) – invade and destroy tissue, spread (metastasize) </li></ul>
  23. 25. <ul><li>carcinoma – cancer of epithelial cells (mucous linings in body) </li></ul><ul><li>sarcoma – cancer of bone, muscle, and cartilage, highly malignant </li></ul><ul><li>metastases occur via the lymphatic or hematogenous systems </li></ul><ul><li>cancer grading – cell’s aggressiveness </li></ul><ul><li>cancer staging – extent of entire body involvement </li></ul>
  24. 26. hereditary diseases <ul><li>abnormal DNA passed from one generation to another </li></ul><ul><li>mutations may occur by enzyme mutation, radiation, chemicals, or viruses </li></ul>
  25. 27. Right foot image with seven metatarsals and eight digits demonstrating polydactyly
  26. 28. immunity disorders <ul><li>most immunity is acquired by exposure to antigens or artificial immunizations </li></ul><ul><li>vaccine – low dose of dead or deactivated viruses that stimulate the body to produce antibodies </li></ul><ul><li>active immunity – when a body forms antibodies due to exposure </li></ul><ul><li>passive immunity – a dose of preformed antibodies from an animal; acts quickly, but doesn’t stay in body </li></ul>
  27. 29. AIDS / HIV <ul><li>acquired immunodeficiency syndrome </li></ul><ul><li>most commonly affected homosexual men, IV drug users, but now rising in incidence among heterosexual partners, and third world countries </li></ul><ul><li>once epidemic amongst hemophiliacs </li></ul><ul><li>primarily affects the lungs, GI tract, and CNS </li></ul>
  28. 30. <ul><li>radiographically: </li></ul><ul><li>pneumocystis carinii – hazy infiltrates in lungs, consolidation resembling pneumonia </li></ul><ul><li>Kaposi’s sarcoma – nodules in small bowel that invade the lumen </li></ul>
  29. 31. 1-6 Kaposi’s sarcoma . Small bowel study shows multiple intramural nodules (predominantly involving the jejunum) that distort the mucosal pattern
  30. 32. 1-7 Pneumocystis carinii pneumonia. Diffuse bilateral air-space consolidation
  31. 33. <ul><li>treatment: </li></ul><ul><li>incurable </li></ul><ul><li>symptom management </li></ul><ul><li>lifestyle changes – avoid stress, alcohol, drugs, infections </li></ul>

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