College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K.
Haddao
Lec. 4 Cell injury
Results when cells are stressed so severely that they are not able to adapt or when cells
are exposed to damaging agents or suffer from intrinsic abnormalities (e.g., in DNA or
proteins).
Reversible Injury : The 2 main morphologic correlates of reversible cell injury are
cellular swelling (hydropic change) and fatty change.
Normal Reversible Cell swelling Irreversible Cell death
Cellular swelling (cloudy swelling): Is result of failure of energy dependent ion pump in
plasma membrane, leading to an inability to maintain ionic and fluid homeostasis.
Fatty change : occurs in hypoxic injury and various forms of toxic or metabolic injury,
and is manifested by appearance of small or large lipid vacuoles in cytoplasm. It occurs
mainly in cells involved in and dependent on fat metabolism, such as hepatocytes and
myocardial cells .
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College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K. Haddao
There are 2 types of cell death — Necrosis and Apoptosis — which differ in their
morphology, mechanisms, and roles in disease and physiology .
Necrosis : A range of morphological
changes that follows cell death in living
tissues
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College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K. Haddao
Types of Necrosis :
1. Coagulative Necrosis: Is a form of tissue necrosis in which the component cells
are dead but the basic tissue architecture is preserved for at least several days .
2. Liquefactive Necrosis: Is seen in
focal bacterial or, occasionally,
fungal infections, because
microbes stimulate the
accumulation of inflammatory
cells and the enzymes of
leukocytes digest (“liquefy”) the
tissue .
3. Gangrenous Necrosis: Is not a
special pattern of cell death, the term
is still commonly used in clinical
practice. It is usually applied to a
limb, generally lower leg that has
lost its blood supply and has
undergone Coagulative necrosis
involving multiple tissue layers.
When bacterial infection is super
imposed, Coagulative necrosis is
modified by the Liquefactive action
of the bacteria and the attracted
leukocytes (so called wet gangrene).
4. Caseous Necrosis: Is encountered
most often in foci of tuberculous
infection. The term “Caseous”
(cheese like) is derived from the
friable yellow white appearance of
the area of necrosis.
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College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K. Haddao
Causes of cell injury
1- Apoptosis: Is a pathway of cell death in
which cells activate enzymes that
degrade the cells’ own nuclear DNA and
nucleus and cytoplasmic proteins.
2-Oxygen deficiency (Hypoxia): Can be caused by Ischemia, Anemia, Carbon
monoxide poisoning, and poor oxygenation of blood due to pulmonary disease.
A- Ischemia: فقر دم موضعيIs decreased blood flow to or from an organ. Ischemia can be
caused by obstruction of arterial blood flow–the most common cause, or by decreased
perfusion of tissues by oxygen carrying blood as occurs in cardiac failure,
hypotension, & shock.
B- Anemia: A reduction in the number of oxygen-carrying red blood cell.
C- Carbon monoxide poisoning (CO): CO decreases the oxygen-capacity of red blood
cells by chemical alteration of hemoglobin .
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College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K. Haddao
D- Poor oxygenation of blood due to pulmonary disease cause increased carbon dioxide
retention, which may cause drowsiness, headaches, and in severe cases lack of
respiration, which may lead to death .
3.Chemical Agents: Agents commonly known as poisons cause severe damage at
cellular level by altering membrane permeability, osmotic homeostasis, or integrity of
an enzyme or cofactor, and exposure to these poisons can culminate in the death of the
whole organism. These include air pollutants, insecticides, CO, asbestos, and social
“stimuli” such as ethanol. Even therapeutic drugs can cause cell or tissue injury in a
susceptible patient or if used excessively or inappropriately.
4. Infections Agents: These range from submicroscopic viruses to meter-
long tape worms; in between are the rickettsia, bacteria, fungi, and
protozoans .
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College of Engineering Biomedical Engineering Dep " 1st. Semester - L.Dr. K. Haddao
5. Immunologic Reactions: Include auto immune reactions against
one’s own tissues and allergic reactions against environmental
substances in genetically susceptible individuals.
6. Genetic Defects.
7. Nutritional Imbalances.
8. Physical Agents: Trauma, extremes of temperatures, radiation, electric
shock, and sudden changes in atmospheric pressure all have wide-ranging
effects on cells .
9. Aging الشيخوخة: Cellular senescence leads to alterations in replicative and
repair abilities of individual cells and tissues.
