Cell Injury, death and adaptation

Causes of Cell Injury:

• Hypoxia
• Physical agents (heat, cold, radiation, trauma)
• Chemical agents and drugs
• Microbiologic agents
• Immunologic reactions

• Genetic defects
• Nutritional imbalances

Principles of Cell Injury:

• Dependent upon:
- the etiology
- duration
- severity of the inciting injury

- cell type
- stage of cell cycle
- cell adaptability

• Cellular membranes, mitochondria, endoplasmic reticulum and the genetic

apparatus are particularly vulnerable
• Injury at one focus often has a cascade effect
• Morphologic reactions occur only after critical biochemical (molecular) damage
.

Normal Cell
[ homeostasis]

Stress. increased
Injurious stimulus
demand

Adaptation Cell injury Cell death

Done By: Bas Dh. Inability to adapt

1 2006-2007
© class of 205
Atrophy:
Acquired shrinkage in the size of the cell.
- physiologic :
 Fetus
- branchial clefts
- thyroglossal dust
 Neonate
- ductus arteriosus
- umbilical vessel
 Post adolescence
- lymphoid tissue: tonsils, thymus , appendix
 adult
- post-menopausal atrophy of the uterus, ovaries and breast.
- Pathologic
 localized
- ischemia : e.g. cerebral atrophy due to arthrosclerosis
- pressure : e.g. hydronephrosis
- disuse : e.g. immobilization, obstruction of a duct draining an exocrine gland
- loss of innervation : e.g. nerve damage result in atrophy of the muscles they

supply
- hormonal stimulation : e.g. decreased estrogen after menopause result in
atrophy of the endometrium, vaginal epithelium and breast; testicular
atrophy in cirrhosis, estrogen therapy etc.
 generalized
- starvation , malnutrition
- senility
- hypopituitarism

Hypertrophy :
• An increase in the size of the cells and thus an increase in the size of the tissue
or organ
[ thus, hypertrophy is seen often in those tissues that are unable to divide:
their only effective response is to enlarge]
• The end result is to lessen the amount of increased work that each individual
cell must perform in response to the stimulation or stress
• In a pure form, it is found only in muscle and is usually a response to :
- increased demand for work
- increased stimulation by growth hormone e.g. tongue and heart acromegaly

Done By: Bas Dh. 2 2006-2007

© class of 205
Hyperplasia :
• An increase in the number of cells in an organ or tissue [ thus, this response is
seen only in those tissues in which cell division can still occur]
• May or may not be seen in conjunction with hypertrophy
• Endocrine glands e.g.:
- adrenal cortex due to increased ACTH
- parathyroid: primary or secondary to chronic renal failure
• Endocrine target organs e.g.
- breast either physiologic or pathologic
- endometrium
- prostate
• Skin and lining epithelia : e.g. in chronic dermatitis; warts ; margins of healing
ulcer
• Bone marrow where there is increased demand for RBC’s

Done By: Bas Dh. 3 2006-2007

© class of 205