UNIT 4 : CLASSIFICATION OF / anomalie -occurs in the embryo

DISEASES s
Congenita Birth Defect: Any structural/functional disorder -neither present at birth or shortly thereafter
l present at birth. -dont need to have a genetic basis
and -Genetically Ex : harelip, cleft palate, spina bifida
determined Traumati -Abnormalities sustained at delivery time.
Hereditar -Environmentally influenced during gestation. c
y lesions -Birth trauma indicates : obstetric problems (prolonged
Circulator Circulatory system: labor,
y difficulty of large head passing a small pelvis)
Disorders -Heart (central pumping station) CIRCULATORY DISORDERS
-arteries, arterioles, capillaries, small venules, veins
(series of channels through which blood is pumped, HYPEREM Congestion, excess of blood in a body part
collected, and IA
returned to the heart) HEMORRHA Blood escape from vasucular system
Circulatory GE
disturbances: -(hemorrhage per
1. Affect restricted/ localized areas of the body rhexis)
2. Produce generalized changes rupture of heart of vascular wall
Inflammati -Sum of reactions in the body, incited by an injury. -(hemorrhage per diapedesis)
on passage of RBC through intact capillary walls w/o
-Not a pathologic condition visible injury
-Active exaggeration of physiologic processes set in EDEMA Constant amount of fluid maintained in the tissues by
motion by an balanced
irritant or injurious relation between fluid passage from capillaries to the
agent. tissue
Degenera 1. Atrophy spaces, and its removal from tissue spaces by lymph
tive channel/ its
or Decrease in size of part or organ of the body return to capillaries.
(previously normal in EDEMA : Balance is upset, excessive amount of fluid
Retrogres size) accumulates
sive in the tissue outside
diseases 2. Degenerations BV
-Regressive tissue alterations SHOCK -State of collapse that follows severe tissue injury.
-Char: -swelling of -Disturbance of the circulation wherein theres an
cells acute
-chemical changes within the cytoplasm reductino in blood flow and inadequate supply to body
(appearance of tissue.
normally absent substances inside the cell) -Dramatic event clinically, weakness, pallor, rapid
Metabolic Gout, Uric Acid infarcts, Pigmentation, Stones feeble pulse,
Disturban low BP.
ces *Cardiogenic shock = cardiac malfunction
Nutrition Rickets/ Rachitis, Pellagra, Beriberi, Scurvy, Primary
al vit.deficiency,
Deficienc Secondary vit.deficiency, malnutrition, protein-calories
y deficiency,
States kwashiorkor, iron deficiency, calcium deficiency,
potassium
deficiency, iodine deficiency.
Neoplasm -Special + abnormal type of excessive tissue
s growth of a
destructive nature.
-serves no purpose, has a predisposition toward
increasing in size-
progressing-persisting at the expense of the body.
-Not controlled, limited or regulated by any factors
normally
restraining growth and multiplication of cells in the
body.
CONGENITAL & HEREDITARY
DISEASE
Heredita -Disturbances in the inheritance mechanism
ry
Diseases -Inherited traits/char received from ancestors,
transmissible to
offspring
-May skip generation
1. Normal = body physique, hair color, eye color, mental
capabilities,
emotional make up
2. Abnormal = coor blindness, mental deficiencies,
tendency towards
allergic condition, drugs susceptibility, predisposition
toward
metabolic diseases
**Familial disorders = inherited, run in the families,
Congenit -First 3 months after conception
al
Disorder -Result from a failure/ abnormality in the developmental
s/ process
 *Peripheral circulatory collapse = pathologic -Mechanical injury of the heart/
processes of the rest vessels -Disease/altered
function of BV walls
of the circulation. -Defects in factors related to the blood clotting
THROMBO -Formation of a solid mass(thrombus) /blood clot, Types of Hemorrhage
SIS within Apoplexy Hemorrhage & its effect within cranial activity
heart/BV during life.
Cardiac Amount of blood in pericardial cavity is enough to
*Thrombi = composed of all blood constituents in interfere
normal
tamponade with action of the heart
proportion or 1/more components to the exclusion of
Contusions/ Impact of a blunt injury transmitted throught the
others
skin to the
Ex: platelet and fibrins, or only platelet
bruise subcutaneous tissue with enough physical force to
Attached to 1 spot of wall of a vessel and protrude into the tear the
vessel for a short distance. walls of small BV, causing hemorrhage to the tissue
*Parietal thrombi = leaving a passageway for the
but
blood
without a break in the overlying skin.
*Obstructive thrombi = completely occlude the vessel
When the bleeding is superficial, the bruise is
EMBOLIS Condition of a solid/gaseous object (embolus) floating
visible almost at
M free in the
once through the skin.
blood stream.
Ecchymoses Larger than petechiae >10mL
*Emboli = portion of thrombi, clumps of fibrin from
diseased Epistaxis nosebleed
heart valves, atheromatous material from vessel wall, Hematemesis Vomiting of blood
agglutinated bacteria, tumor cells, air, fat, animal Hematomas Tumorlike collection of blood in the tissue
parasites, Hematuria RBC in the urine
foregin bodies (bullet). Hemopericardi Blood in pericardial cavity
Emboli = sterile/septic. um
ISCHEMIA Crucial reduction in the arterial supply of a part of the
, body.
INFARCTI ISCHEMIC FOCUS
ON
-reduced in size, pale & cold, functionally less acti ve
-persistent = necrosis of tissue
INFARCTION = Necrosis of tissue caused by
interference in blood
supply.

-Artery supplying organ/part occluded area becomes
necrotic.
GANGREN An area of ischemic necrosis/infarct becomes the site
E of growth
of saprophytic bacteria.
CIRCULATORY DISORDERS: HYPEREMIA

Active/ -Increase of arterial blood

arterial -site : red & warmer
a) Active physiologic = supply nourishment to
organs/tissue doing
increased work
b) Active pathologic = initiates inflammation, forms a
feature of
inflammation
Passive/ -Increase blood produced by interference with the
v venous return
enous -always pathologic
a)Localized passive = because of vein obstruction
by:
-thrombus/embolus
-thickening of a vessel wall
-pressure from outside lesion (neoplasm, scar contraction,
enlarged/
misplaced organ)
Site: bluish red, swollen (asso.edema), cold.
b) Generalized passive = because of an obstruction
to the passage of
blood through a diseased heart.
-heart may be in failure
-pump efficiency is impaired
-blood is dammed back into veins draining in blood from
gen.
circulation
-blood flow effectivity is reduced
-anoxemia (less blood is oxygenated)
-dyspnea (shortness of breath)
-cyanosis (bluish discoloration of lips, nail beds, mucus
membranes)
-edema of lower extremities often present.

CIRCULATORY DISORDERS: HEMORRHAGE

Causes:
Hemoperitone Blood in peritoneal cavity extremities clammy
um BP Quite low, hard to determine
Hemoptysi Blood in the breathing Swallow
s sputum eyes Sunken
Hemothor Accumulation of blood into pleural cavities Urinary Oliguria (very small amt), anuria (no urine at
ax output all)
Menorrhag Excessive uterine bleeding during menstrual period
ia CIRCULATORY DISORDERS: THROMBOSIS
Metrorrha Uterus bleeding between mestrual period CAUSES:
gia -BV lining injury by trauma, inflammation or
Petechia Very small hemorrhage in the tissue degeneration -slowing of blood flow
Purpura 3-10ml, presence of varying hemorrhage size in -eddies in the
widespread bloodstream -diseases
areas of the skin and mucus membranes of the blood itself

CIRCULATORY DISORDERS: / CIRCULATORY DISORDERS: ISCHEMIA AND INFARCTION

EDEMA CAUSES OF ISCHEMIA:
-Embolus/thrombus -external pressure
Causes
-thickening of vessel wall -nervous influences
-weakened heart action in heart -venous obstruction
-action of drugs/cold
failure
-nephritis -nutritional factors
CIRCULATORY DISORDERS: GANGRENE
-allergy -inflammation
DRY No bacteria/infection.
-lymphatic obstruction
TYPES OF -Interference in the artery supply of a part without
invasion by saprophytes.
EDEMA
-NOT TRUE
Ascites Fluid in the periotenal cavity GANGRENE -an
Anasarca/Dro Generalized collection of edema fluid in body infarct
psy cavities -confined almost entirely to the extremities
Hydropericard Fluid in the pericardial cavity
ium
Hydrothor Fluid in the pleural cavity
ax
Transudat Collection of edema fluid in the tissue/body cavities
es
CIRCULATORY DISORDERS:
SHOCK
Primary Fainting/syncope.
-Develops right after injury, tends to be of short
duration, usually
mild.
-presumed to be caused by a neurovascular reaction
elicited by
pain, emotion, and nerve impulses arising in injured
tissues.
-after more severe injuries, prolonged primary shock
may merege
imperceptibly into secondary shock.
Secondary -State of collapse and prostration after injury, requires
interval of
time to develop.
-Surgical, wound or traumatic shock, more severe than
primary
shock.
-trauma, crush injuries, burn, severe and fulminating
infections
(pneumonia, septicemia, diptheria, gas gangrene, acute
peritonitis), heatstroke, freezing injury, radiation injury,
blood
transfusion reaction, bile peritonitis, myocardial
infarction,
anesthetic accidents, drowning, asphyxia from CO,
perforation of
abdominal viscera, pancreatitis, poisonings by chemical
agents
Hemorrha Occurs after sudden and rapid loss of significant
gic amount of blood.
-related to blood loss
-associated with many severe traumatic injuries with
sizable
hemorrhage
-secondary shock + coexistance of hemorrhagic shock
Manifestation of patients with secondary shock:

Body Very weak, restless, trash about, exceedingly

thirsty
pulse Rapid, feeble
Body Low
temperature
Body Cold,
 -skin color: purplish Purulent PMN (pus)
brown/black -complete Caused by pyogenic organisms (strep, staph,
mummification pneumo,
-slow spreading menigo, gono)
MOIST -TRUE gangrene Serous Liquid portion (serum) + few cells + little fibrin.
-rapid spread Simplest form of acute inflammation, often
-saprophytic represent
invasion
earlies type of exudative process + few
-affect extremities and internal organs
leukocytes.
-caused by mechanical obstruction, compression by
fibrous bands, twisting of pedicles and thrombosis or If 2 components of exudate are prominent, the
embolism of blood vessels -part: cold, swollen, inflammatory exudate is so designated (eg: serofibrinous,
pulseless fibrinopurulent)
-skin: moist, black, undertension, blebs on the
surface, liquefaction occurs, foul odors CARDINAL SIGNS OF INFLAMMATION (RuDoTuCaf)
Rubor/Redness Increase in blood flow + stagnation +
INFLAMMATION engorgement of BV
PURPOSES: Dolor/Pain Pressure + action of toxic substances in sensory
1. Destroy irritating and injurious agent, remove it, and its nerve
related by-products endings.
2. Limit the extension of the causative agent, and its effects >>solid & inelastic tissue, >> severe pain
through the body *throbing quality of the pain = from increased
3. Repair or replacement of tissue damaged or destroyed by pressure
offending agent
PARTS OF INFLAMMATORY PROCESS
1. Localized vascular and cellular process at injury site
2. Gen. body reactions (fever, leukocytosis, Ab formation)
3. Events designed to repair the injury done and restore part to
normal
CAUSES:
Living Infection.
agents Bacteria, viruses, fungi, protozoan parasites, metazoan
parasites,
isects, higher plants and animals
Nonliving -Physical
agents Mechanical agents of trauma (knives, guns, sharp edged
weapons,
extremes of cold, electricity, radiant energy)
-Chemical
Strong acids, alkalis, irritating gases
-Immunologic
Consequent to Ag-Ab reaction
TYPES ACCORDING TO THE TIME
Acute Few days few weeks
**PMN
**fluid & fibrin
Chronic Many months many years. Causative agent is able to
persist partly
unchecked by the body for an indefinite periode of time.
Or is able
to produce injury in the body repeated over a period of
time.
**Chiefly lymphocytes, plasma cells + pus sometimes.
**no fibrin
**little fluid
**proliferation of conn. Tissue cells
Subacute Intermediate. Few weeks few months
KINDS OF EXUDATE

Catarrhal Inflammation of mucous membrane + great

outpouring of
mucus, like in cold
Fibrinous -Presence of large amount of fibrin.
-Occurs most frequently on the serous surface of
body
cavities.
-Often lead to permanent fibrous adhesions
(fibrin once
deposited in serous cavity is poorly reabsorbed
by the
body)
Hemorrha Has many RBC, damage to capillaries and
gic consequent
diapedesis
Pseudomembra Necrosis of epithelium when fibrin is deposited on
nous ept
surface, many leukocytes, dead ept cells,
bacteria are
enmeshed in fibrin threads.
Ex: throat of diptheria.
 transferred from BV with each heartbeat to the Gout Abnormality in metabolism of UA in the body +
nerve accum of large
endings at the site of inflammation. amount of UA in the blood (hyperuricemia) & body
Tumor/Swelling Presence of inflammatory exudate + increase amt tissues.
of blood *Tophi (deposition of crystalline urate) in the joints,
Calor/Heat Increase blood in the part, and increase in rate of kidneys,
flow. cartilage of external ear & eyelid.
Functio laesa/ Pain + interference with nerve supply + limitation Char : acute attacks during theres intensely painful
of swelling of
disturbance of movement because of inflammatory exudate and joints.
function destruction of tissue. Uric acid Increased UA excretion shortly after birth, extensive
deposits of
SYSTEMIC RECOGNITION IN ACUTE INFLAMMATION / infarcts UA in renal tubules of newborn infant.
Pigmentatio -Endogenous pigmentation
n
-Fever
Increase amount or irregularity in distribution of
-Increased WBC (leukocytosis) with increased proportion of normal
neutrophils (shift to left) -elevated ESR
-Increased lever of CRP in serum pigments
-Exogenous pigmentation
DEGENERATIVE /RETROGRESSIVE DISEASES : Deposition within tissue of pigments that gain access
DEGENERATIONS to the
Cloudy -Most common, least damaging body from without by way of the mouth, lungs, or
swelling skin.
-occurs in all infectious diseases Stones/Calcu Solid calcific masses formed within the passages or
-follows extensive burns , maybe found with inanition li hollow
-organs: liver, kidneys, less heart muscle organs of the body
-caused by increased water content in the affected
cells METABOLIC DISTURBANCES: PIGMENTATION
(enlarged) ENDOGENOUS PIGMENTATION
-cloudy cytoplasm Freckles Localized areas, increased melanin content of the
-organ: large, pale, plump, dipped in water skin
apprearance. Albinism Congenital absence of melanin from skin & eyes
-complete recovery
-on severe action of causative agent, cloudy swelling
may
change to fatty metamorphosis/necrosis
Hydrophic -similar to cloudy swelling
degeneration -water content of cells is sogreat
-globues are visible microscopically in cytoplasm
form
Fatty -Abnormal accum. / distribution of visible fat in
parenchymal
metamorpho cells
sis/
fatty change -liver: heavier, yellowish, soft, rounded margins,
greasy cut
surface.
-follow couldy swelling
-may be present in metallic poisoning, anoxic states,
chronic
passive hyperemia, prolonged fevers, chronic
alcoholism,
malnutrition, chronic wasting diseases.
-other organs: heart, kidneys, (follow severe anemia,
severe
infections, ingestions of chemical poisons)
Amyloid -unexplained accumof pathologic, waxy starchlike
tissue protein subs,
formed in the body, deposited in various organs
(kidneys, liver,
spleen, adrenal glands)
-accompaniment of long-continued suppurative
conditions
(tuberculosis + osteomyelitis)
Pathologic -deposit within tissue of earthly salts w/o consistent
attempt at
calcification bone formation.
-most found in dead/dying tissue and maybe
aftermath of
various types of degeneration.
Ex: tuberculous areas, arteriosclerosis, tumors,
trichinosis
Hyaline Conn.tissue take on a glassy appearance
degeneration
Mucoid Cells of certain tumor swell and become converted
into jellylike
degeneration masses
METABOLIC DISTURBANCES
Pigment Tumors made up of melanin containing cells. unable to
moles metabolize given nutrients.
or nevi & MM : rapidly fatal tumors. Iatrogenic: therapeutic drugs, block the metabolism of
malignant nutrients in
melanomas the body.
Icterus/ Retention within the body of bilirubin, pigment giving Protein Starvation : deficient calorie intake, relative to caloric
color to expenditure.
jaundice bile. calorie Consequence : protein deficiency.
EXOGENOUS deficiency Marasmus : severe state.
PIGMENTATION Kwashiork Protein def. in infants in certain tropical and
Carotenemi Yellow discoloration of the skin, folow the or semitropical areas.
a consumption of large Px: very sick, edematous, skin rash, depigmented hair,
amounts of carotene fatty liver
Anthracosis Large amounts of dust (carbon pigments/coal dust) Iron Consequence: anemia
are inhaled deficiency
over long periods of time. A portion is deposited in Ca def
the lungs & K def
lymph nodes receiving drainage from the lungs. Iodine def
Argyria Medications containing silver salts are taken over a NEOPLASM NEOPLASTIC TISSUE:
long period S
of time. Conjuctivae and skin assume an ashen gray Parenchym Active element of tumor, made up of tumor cells
color a
(caused by deposit of silver albuminate just beneath Stroma Conn. Tissue framework with lymphatic and vascular
the channels
epitheliu Grading
m) factors:
Plumbism Formation of blue line known as lead line along the -Cells -N:C ration
margins of polarity
the gums caused by chronic lead poisoning. -Number & char of -Hyperchromaticity
KINDS OF CALCULI mitosis

Bladder Vesical
calculi
stones
Broncholit Calculi in the bronchi
hs
Choleliths Gallstones
Fecaliths Stone made up of feces and found in the appendix
Pneumolit Stones in the substances of the lungs
hs
Prostatic Deposit of salts on corpora amylacea
calculi
Renal Kidney
Calculi stones
Rhinoliths Stones formed in the nose
NUTRITIONAL DEFICIENCY STATES

Rickets/ -Constitutional disease of infancy.

rachitis -Diet deficiency in Vit D
-overproduction of bone matrix in the skeleton,
deficient in bone
salts
-incomplete and imperfect calcified growth and
development of
bones
Clinical features: bone deformity, long bones, bones of
the skull
Pellagra -Seasonal variation
-Skin erruption, GI disturbances, nervous and mental
changes
-diet deficiency in nicotinic acid & vit B complex
Beriberi Polyneuritis
-diet deficient in Vit B1 (thiamine hydrochloride)
-disturbances in sensation and motion, dropsy,
involvement of the
heart
Scurvy Lack of Vit C (ascorbic acid)
Primary Vit Inadequate intake of specific vitamin
Deficiency
Secondary Vitamin intake is adequate, another factor is operative
(failure of
vit absorption, failure of utilization, increase need/loss from
deficiency the body)
Malnutritio Extrinsic : Environment, availability of food in certain
n geo location,
cultural attitudes on certain foods.
Intrinsic : interfere with proper absorption and
utilization of
nutrients. Genetic factors, rare deficiency states,
DIAGNOSTIC FEATURES OF TUMOR CELLS / Bone Osteoma Osteosarcoma
Changes of Intercellular structural pattern Osteochrondroma
-increase in Synovial membrane Synovioma Synovial sarcoma
size -irregular Serous membrane Benign mesothelioma Malignant
shape mesothelioma
-Irregular NEOPLASM OF
pattern MUSCLE
-anisocytosis & anisokaryosis observed Tissue of origin benign Malignant
in clusters -indistinct cell membrane
-excessive grouping and crowding of cells to form clusters Smooth muscle Leiomyoma Leiomyosarcoma
Cytoplasmic changes Striated muscle rhabdomyoma Rhabomyosarcoma
-Acidophilia/marked
orangeophilia -excessive
cytoplasmic inclusion bodies
-abnormal vacuolation
Nuclear changes
-large nucleus (low N:C
ratio) -irregular nucleus
(size, shape)
-more deeply pigmented (hyperchromaticity due to
increased DNA) -multinucleated, abnormal cell
division (more mitotic activity) -increase in # & size of
nucleoli
-increased distribution and irregular size of
chromatin materials -markedly thickened nuclear
membrane
-necrotic/degenerative changes (abnormal vacuolation, dissolution of
nucleus)

CLASSIFICATION OF NEOPLASMS
CLINICAL MANIFESTATION
Benign Innocent, little harm, not life threatening,
nonmalignant. -common in younger age, grow
slowly, usually by expansion -not fixed to the
tissues, easily removed at operation with less
changes for recurrences
-usually encapsulated and movable.
-rare metastasis, no blood or
lymphatic invasion -no cachexia
(anemia and emaciation)
-cells: normal, differentiated, less mitotic figures
(<1/1000), not hyperchromatic, less tendency to
hemorrhage and necrosis
Malignant Very dangerous, cause death
-common in older age, grow rapidly, infiltration or
by expansion, more fixed to tissues
-not encapsulated, more difficult to remove, high
tendency for recurrence
-Metastasis is produced through lymphatic and
blood invasion, produce ultimate death by
cachexia, mechanical pressure or hemorrhage or
infection.
-malignant cells = indifferentiated, more mitotic
figures (20/1000), hyperchromatic, more tendency to
hemorrhage and necrosis.
HISTOLOGIC CLASSIFICATION (origin and nature of cells
composing the neoplasm)
*Tissue of origin = tissue/group of cells in which neoplasm arises
Benign Suffix oma + stem (name of tissue from which tumor is
derived)
Malignant a) carcinoma (tumor of epithelia origin)
b) sarcoma (tumor of connective tissue origin)

NEOPLASM FROM EPITHELIUM

Tissue of origin Benign Malignant
Pavement epithelium Papilloma -Squamous cell
(squamous, (epidermoid)
transitional) carcinoma
-Basal cell carcinoma
-Transitional
(urothelial)
cell CA
Glandular epithelium
-Adenoma -Adenocarcinoma
-Cystadenoma -Cystadenocarcinoma
-Adenomatous polyp
NEOPLASM ARISING FROM CONNECTIVE

Tissue of origin benign Malignant

Fibrous (adult type) Fibroma Fibrosarcoma
Embryonic tissue Myxoma Myxosarcoma
Fat Lipoma Liposarcoma
Cartilage Chrondoma Chrondrosarcoma
NEOPLASM ARISING IN NERVOUS SYSTEM
Tissue of origin benign Malignant
Peripheral nerve Neuroma Neurogenic sarcoma
sheats
Neurofibroma (neurofibrosarcoma)
Neurilemoma
Sympathetic nervous Ganglioneuroma Neuroblastoma
system (neurinoma)
Neuroglia Glioma
Meninges Meningioma Retinoblastoma
NEOPLASMS OF ENDOTHELIUM AND
STRUCTURES
Tissue of origin benign Malignant
Blood vessels Hemangioma Hemangioendotheliom
a
(hemangiosarcoma)
Angiosarcoma
Lymph vessels Lymphangioma Lymphangiosarcoma
Lymphangioendothelio
ma
Bone marrow Multiple myeloma
Leukemia
Lymphoid tissue Malignant lymphoma
Hodgkins disease
Lymphosarcoma
PIGMENTED
NEOPLASM
Tissue of origin benign Malignant
Melanocytes Nevus Malignant melanoma
NEOPLASM OF TROPHECTODERM

Tissue of origin benign Malignant

Trophoblasts of Hyatidiform mole Chroriocarcinoma
placenta
villi (chroioepithelioma)
COMPLEX NEOPLASMS OCCURING IN

Tissue of origin benign Malignant

Ovary Dermoid cyst Teratoma
Testis Teratoma
Choriocarcinoma
Kidney Mixed tumor
Salivary glands Mixed tumor