etiology of disease as a result of surgical/medical intervention
Incidence
,NSG 533 PATHOPHYSIOLOGY
the new number of cases in a given population in a specific time period; 1 in 690
births - 1/690 x 100 = 0.14%
Prevalence
number of cases, both old and new, during a specific time period; 400,000 in a
population of 314 million - 400,000/314,000,000 x 100 = 0.13%
4 common mechanisms of cell injury and death
1. ATP Depletion
2. Oxygen and oxygen-derived free radicals
3. intracellular calcium and loss of calcium state
4. defects in membrane permeability
The disease mechanism that is the basis of much of the disease today- and most of
the cases involve hypoxia. Refers to the inability of the cell to produce adequate
energy to fuel normal activities of that particular cell type (cell membrane pumps
and protein synthesis) and function.
ATP deletion - the inability of the cell to produce adequate energy
what are the two phases of ATP production?
,NSG 533 PATHOPHYSIOLOGY
1. Aerobic (oxidative phosphorylation)
2. Anaerobic (glycolysis)
how many ATP does glycolysis yield?
2
How many ATP does oxidative phosphorylation yield?
36
What is the most common method of impairing oxygen and ATP production?
Hypoxia - respiratory abnormalities, flow problems such as ischemia, lack of
sufficient hgb to carry (anemia), and hemoglobinopathies
Can lead to irreversible cell injury directly through impairment of energy
production in the cell.
Ischemia
What are the cellular events that occur with ischemia-induced- hypoxic injury?
, NSG 533 PATHOPHYSIOLOGY
1. Decreased oxygen -> decreased ATP production within the mitochondria
declines
2. The drop in ATP causes NA-K- ATPase pump on CM to fail. Na and Ca influx
into the cell, K diffuses out of the cell. Na and H20 enter freely into the cell.
3. Increase in water in cell causes cell and it's organelles to swell.
4. When RER swell it's ribosomes fall off and protein synthesis stops.
5. ATP production through phosphorylation declines and glycolysis (anaerobic
metabolism) increases. When glycolysis increases in the cell glycogen stores are
depleted.
6. Glycolysis also produces lactic acid as by-product. Lactic acid increases and pH
declines ( the cell functions within narrow range of pH and even slight drop can
incapacitate the cell).
7. Drop in pH causes clumping of nuclear material called pyknosis. Leads to
fragmentation of the nuclear material (karyorrhexis) and then to dissolution of
nuclear membrane (karyolysis). Decline in pH - rupture of already swollen
lysosomes and release of proteolytic enzymes - autodigestion of cell contents and
cell membrane.
8. Disruption of CM also increases Ca+ influx into the cell and organelles -
activate proteases, endonucleases, and phospholipases that proceed to destroy the
cell.
Pyknosis
Karyorrhexis
Karyolysis
Pyknosis - clumping of nuclear material from drop in pH
Karyorrhexis - fragmentation of the nuclear material
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