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Tissue%20Injury%2c%20Inflammation%20#2

Tissue%20Injury%2c%20Inflammation%20#2 - Alterations in...

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Alterations in Homeostasis Tissue Injury, Inflammation
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Tissue Injury Causes Hypoxia Free Radicals Thermal Extremes Radiation Chemical and Biological agents Other Causes
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Hypoxia Most common cause of cellular injury. Decreased oxygen in the air Decreased hemoglobin Pulmonary or Cardiac disease Shock – Respiratory failure ( ↓ PO 2 ) Disruption in oxidative enzymes within the cells (i.e. cyanide poisoning)
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Most Common Causes of Hypoxia Ischemia most common cause Impaired blood flow d/t clot or arterial occlusive disease Impaired O 2 carrying capacity (CO) Hypoxia vs. Anoxia Severe damage occurs in 3-5 minutes
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Effects of Hypoxia
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Free Radicals Unstable molecules Capable of injurious bonding with proteins, lipids and carbohydrates to damage membranes and nucleic acids Final common pathway for injury from many sources Can be an issue reperfusion injury
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Free Radicals Sources Tobacco smoke Radiation Pollutants Internal unstable molecules Oxidative stress Antioxidants Block synthesis or inactivate free radicals Endogenous : The five important endogenous antioxidants are superoxide dismutase (sod), glutathione peroxidase, alpha lipoic acid (ala), catalase and coenzyme Q10 (CoQ10). Exogenous Vitamin A, C, E Beta-carotene
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Reperfusion Injury Restoration of O 2 can cause additional injury. Hypoxia ↓ cellular protection against free radicals Reperfusion replenishes O 2 but also provides a fresh supply of free radicals
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Thermal Tissue Injury Excessive heat coagulates proteins
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Cold Tissue Injury Cold effects Crystallizes cell water Alters blood flow by vasoconstriction Freezing tissue damages cell wall causing ischemia, and necrosis
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Radiation Tissue Injury Can be caused by Ultraviolet Radiation - Ionizing Radiation
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Ultraviolet Radiation Primarily from the Sun Disease Examples: Sunburn Skin cancer Cataracts Issues with sensitive skin (lupus & porphyria)
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Ultraviolet Radiation Benefits Hyperbilirubinemia Vitamin D activation
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Ionizing Radiation Sources: X-rays: Dr. Clarence Dally 1890 Radioactive isotopes Gamma radiation: cancer, food, sterilize medical equipment, comes off rocks and soil Radiation therapy for cancer treatment Damage due to: DNA damage → chromosome abnormalities
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Ionizing Radiation Tissue most sensitive: Bone marrow, thyroid, skin epithelium Examples:
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Chemical / Biological Tissue Injury Damage caused by: Clotting Key enzymes blocked Osmotic damage (cellular swelling) Examples: Acids, alkali, other chemicals: CO; (CCL4); (Lead, Mercury, ETOH, methamphetamine, and other street recreational drugs) Viruses, toxins, parasites (Bovine Spongiform Encephalopathy: Mad Cow Disease)
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