PROF.ABDUL JABBAR N.

AL-SHAMMARI
Pathology Definition
Pathology is the study(logos) of
suffering/diseases(pathos) Involves
basic medical sciences and clinical
practice to investigates of the
causes(etiology) of the diseases and
the mechanism(pathogenesis)
Basic terminology in Pathology
Disease
Etiology
Pathogenesis
Diagnosis
Clinical manifestation-Signs andsymptoms
Prognosis
Epidemiology
Disease/dis-ease
Disease is a condition in which the presence of an
abnormality of the body causes a loss of normal health
Idiopathic–no identifiable causes
Iatrogenic–occur as a result from medical treatment
Congenital–disease existing at birth or before birth,
involves in the development of fetus.
Acquired-develops post–fatally
Nosocomial–due to being in a hospital environments
Etiology
Refers to the study of the cause of the disease
General categories of etiological agents;
Genetic abnormalities,
infective agents,
chemical,
radiation,
Mechanical trauma,
malnutrition
Pathogenesis
Is a mechanism of the disease which
etiology operates to produce the
pathological and clinical manifestation
For examples–
inflammation,
degeneration,
Immune response
Diagnosis: Refers to the process of
attempting to determine or identify
a possible disease or disorder.
Prognosis : Refers to the expected
outcome of a disease.
Complication and sequel:
Complication: is the onset of the
disease in a person who is already
coping with another existing
disease. Sequel: unwanted
outcomes of having disease or are
the result of trauma.
Clinical Manifestation:
Are the signs and symptoms or evidence of
disease.
Signs: objective alteration that can be
observed or measured by another person;
pulse rate, blood pressure, Temperature etc..
Symptoms: subjective experiences reported
by the person, complains such as pain,
nausea, vomiting etc..
Epidemiology:
Is the study of tracking patterns
of disease occurrence and
transmission among populations
and by geographic areas.
Incidence of a disease: is the number of
new cases occurring in specific time of
period.
Prevalence of a disease: is the number
of existing cases within a populations
during the specific time of period.
Prefixes and Suffixes and Roots:

Root: the foundation of the word.

Prefix: place before the root to
modify its meaning.
Suffix: places after root to modify
and give essential meaning to the
root.
Examples:
Hyperlipoproteinemia:
Prefix:hyper(higher).
Roots:lipoprotein.
Suffix:-emia(blood condition)
Hepatosplenomegaly:
Root: hepato (hepar), spleno(spleen).
Suffix: megaly (enlargement)
Meningitis:
Root: mening (meninges).
Suffix:-it is (inflammation)
Tachycardia:
Root: cardia(heart).
Prefix: tachy–(fast/rapid)
Quiz

Mention 10 Examples for prefixes,

Suffixes and Roots
Relationship between Cell
Adaptation, Cells degeneration,
Cell Death
Cells adaptation
injuries

injuries

Normal cells Cells degeneration

Cell death
injuries (necrosis / apoptosis)
Cellular Adaptation
Under normal conditions, cells must constantly adapt to changes in
their environment (physiological, pathological).
Atrophy
Hypertrophy
Hyperplasia
Dysplasia
Metaplasia
 Atrophy
Shrinkage of the size of the cells by the lost of the cells substance. The entire
tissue or organs diminishes in size and function.
May be due to:
decrease in work load,
lost of nerve innervations,
Lack of blood supply,
inadequate nutrition,
lost of endocrine stimulation
and aging process.
Hypertrophy
Increase the size of the cells and consequently the size of the organs.
 Increased the synthesis of structural protein and organelles.
 Can be physiologic (ex; increase workload during exercise , uterine
myometrium during pregnancy)
 and pathologic (hyper trophy of myocardium–hypertension/ aortic
valve disease
Hyperplasia

Increase the number of cells in an organ or tissue. (increase rate of
cellular division).
 Hypertrophy and hyperplasia are closely related(exp:gravid uterus).
 Can be compensatory hyperplasia(exp:liver), hormonal
hyperplasia(exp:uterus,breast )
and pathological(exp:endometrium ).
 Metaplasia
Is a reversible change in which one adult cell
type is replaced by another cell type
(Transitional epithelium to squamous
epithelium).
Adaptation of cells that sensitive to particular
stress to cell types better able to withstand the
adverse of environment
Displasia

Not a true cellular adaptation A typical hyperplasia.
 Abnormal change in the size, shape and organization of mature cells.
 Strongly associated with common neoplastic growth
Exp:CIN–cervical intraepithelial neoplasia, hip dysplasia
Cell Injury
Non lethal injury-cell
degeneration
Lethal injury–necrosis
Cell Degeneration(Non lethal
Injury)
Non lethal injury may produce cell degeneration.
 Manifested as a abnormality of biochemical function, structural
changes or combination.
 Its reversible but may become irreversible(necrosis/apoptosis).
 May produce clinical disease.
(Lethal Injury) Necrosis
Definition–un programmed cell death and living tissues.(opposite to
apoptosis).
 Irreversible.
 Accompanied with by biochemical and morphological changes.
Due to hypoxia, chemical substances, free radical, immunologic
response, infections …etc.
Stages of Necrosis
Early changes: morphologically normal.
Nuclear changes: pyknosis–chromatin clumps into coarse strands,
nucleus become shrunken.
Cytoplasmic changes: denaturation of cytoplasmic protein and lost of
ribosomes, swelling of mitochondria and disruption of organelle
membranes and autolysis occur via lysosomes
Type of Necrosis
Different cells shows different morphologic changes after they undergo
necrosis. Base on that necrosis can be classified into:
1.Coagulative necrosis
2.Liquefactive necrosis
3.Caseous/gummatous necrosis
4.Fatnecrosis
5.Gangrenous Necrosis
Coagulative Necrosis
Typically occur in solid organ;
heart ,kidney, adrenal glands
Due to hypoxia(may be from
severe ischemia or chemical)
.
Normally, this necrotic cells
retains its cellular outline.
Denaturation of protein
albumin. Causes coagulation.
Liquefactive Necrosis
Normally occurs in CNS which affects neuron and neuroglia cells.
Associated with focal bacterial and fungus infections.
The affected cells completely digest by hydrolytic enzymes thus
changes the tissue into liquid viscous mass.
 Caseous Necrosis
Caseous–cheese like
appearance.
Associated with
tuberculous
pulmonary(TB)infection,
by Mycobacterium
Tuberculosis
 Fat Necrosis
Occur in pancreas, breast and other abdominal structures.

 Caused by lipases enzymes which break down

triglycerides(lipid) in to fatty acids and glycerol.

 Fatty acids and glycerol then combine with Ca,Mg,Na to

form Calcium Soaps(Saponification) .
The necrotic tissue appears opaque and chalk white.
GangrenousNecrosis(gangrene
)
Extensive tissue necrosis.
Divide into two; dry and wet.
Dry–occurs in extremities as a results of ischemic coagulative necrosis
due to arterial obstruction .
Wet–occurs in extremities and internal organ as a results of liquefactive
necrosis due to bacterial infection.
Gas–necrotic tissue infected by clostridium perfringes
Causes of Cell Injury
Oxygen deprivation.

Chemical agents.
Infectious agents
 Immunologic reactions
 Genetic defects
Nutritional imbalances.
Physical agents
Aging
Oxygen deprivation.
Hypoxia–oxygen deficiency
Due to ischemia–lost/lack of blood supply( due to arterial blockage or
reduce venous drainage).
 Hypoxia also can occurs via:
 Lack of oxygen inside blood
 Reduction in oxygen carrying capacity in RBC (anemia)
Carbon monoxide poisoning.

Chemical agents
Most of the chemical substances can cause cell injury For example:
poisons, air pollutants, insecticides, CO, asbestos, ethanol,
therapeutics drugs etc.
 This agents can cause cell death by:
Altering membrane permeability
Altering osmotic homeostasis
Altering integrity of an enzyme
Infectious agent
Viruses,
bacteria,
fungi,
parasites,
helminths
Immunologic Reactions

Autoimmune disease–immunity against its own tissues.
 For examples
 SLE,
Rheumatoid Arthritis etc
GeneticDefects
Abnormalities to the genomes-mutation.
This chromosome anomaly is associated with missing, or irregularities
or extra in portion of chromosomal DNA
Syndrome Down, Alzheimer's Disease, Huntington’s Diseas
Nutritional Imbalance
Cause by directly or indirectly lack of essential nutrients (malnutrition)
Or it may be related to excessive of food intake (Diabetic Mellitus) For
example
protein deficiency
Calcium deficiency–osteoporosis
Vitamin C-Scurvy
Physical agents
Trauma,
extreme s of temperature,
radiation,
Electrical shock
 all have wide ranging effects on cells.
Aging
Aged cells become larger, less able
to divide and multiply.
Lose their ability to functions, or
function abnormally.
Terms
Anaplasia (structural differentiation loss within cell or group of cells)
Aplasia (organ or part of organ missing)
Hypoplasia (congenital below-average number of cells, especially when inadequate)
Hyperplasia (proliferation of cells)
Neoplasia (abnormal proliferation)
Dysplasia (change in cell or tissuephenotype)
Metaplasia (conversion in cell type)
Prosoplasia (development of new cell function)
Desmoplasia (connective tissue growth)
Atrophy (reduced functionality of an organ, with decrease in the number or volume of cells)
Hypertrophy (increase in the volume of cells)
End of lecture one