Transcript What is pathophysiology?

Welcome to
Pathophysio
logy
Contents of the lecture
Introduction
1
2
Conspectus of Disease
What is Pathophysiology?
A subject to explore the rule of
origin and evolution of diseases and
the underlying mechanisms.
Subjects involved in
Pathophysiology
All diseases seen in all clinical
departments
 All diseases reproduced in animal
models

Differences from Physiology

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Physiopathology
Physiology of Disease
Clinical Physiology
Medical Physiology
Physiology of Disordered Function
Physiology under diseased situation
Differences from Pathology

“Pathology” emphasizes the structural
changes

pathophysiology deals with functional
and metabolic alterations and the
mechanisms.
The Methodologies Used in
Pathophysiology
As a subject, the experiments are
assigned in systemic or organic levels.
 Animal study
 Clinical observation
 Epidemiological study
For scientific research, studies in
cellular and molecular levels are
required.
Why Is Pathophysiology
Important?
An essential introduction to clinical medicine.
 A bridge: basic medicine and diseases.
 Enables us to understand why and how
diseases develop and various clinical
manifestations appear.
 What are the underlying mechanisms, and in
so doing devise rational therapeutics.
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How Pathophysiology is
Arranged?
Introduction: what pathophysiology is
and what disease is.
 Fundamental pathological processes:
fluids and electrolytes imbalance, acid
and base disturbances, stress, fever,
edema, ischemia and reperfusion, shock,
multiorganic dysfunction, and hypoxia.
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Fundamental pathological
processes
Some common and whole set alterations
in metabolism, function and structure,
which may appear in different
disorders
How Pathophysiology is
Arranged? (cont.)
Organic pathophysiology: heart, lung,
liver, kidney and brain
 Cellular and molecular pathophysiology:
signal transduction and diseases and
cell apoptosis in diseases
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Major Points in Learning
Pathophysiology
The general concepts
 The etiology and pathogenesis
 The alterations of metabolism and function
 The principles for prevention and therapies
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How to Learn Pathophysiology
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Grasp the major points: causes, pathogenesis,
alterations in metabolism and functions
Use dialectical thinking and methods, such as
views of contradictory and unification,
transformation, etc.
Selectively review related knowledge learned
previously, such as physiology, biochemistry,
molecular biology, immunology, pathology, and
so on.
How to Learn Pathophysiology
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Pay attention to experimental courses
Pay attention to clinical practices
Disease
Concept of Disease
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Aberrant manifestation of deregulated
homeostasis caused by harmful agents.
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The development of a disease is a
pathologic process with a characteristic
set of signs and symptoms involved in the
whole body or any of its parts.
Concept of Health

The state of the organism when it functions
optimally without any evidence of disease.
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The definition of health from WHO:
Without any evidence of disease, and a state
of complete well-being physically, socially
and psychologically.
Etiology of Disease
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Etiology is to study the causative agents,
microorganisms, environmental, social
factors and personal habits as contributing
factors that cause diseases.
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Answer the question why disease happens.
Etiology
Dis-beneficial （Inducer）
（+）
Healthy body
Pathogen
Diseased body
（）
Beneficial
Pathogeny: causes disease and endue the
characteristics of the diseases
Etiological Factors
1.
Extrinsic Factors
 Biological agents: microorganisms and
parasites: Roup virus
 Chemical agents: non-specific and specific
 Physical agents: mechanical injuries,
extremes of temperature, electricity, and
radiation
 Nutritional imbalance: excesses or
deficiencies
2. Intrinsic Factors
 Genetic factors: gene mutation, sickle cell anemia,
colorblindness
 Congenital factors: abnormal embryonic
developmental error
 Immunological factors: the immune response is
deficient or inappropriately strong or misdirected.
 Psychological factors: Anxiety, strong or persistent
psychological stress, such as hypertension, peptic
ulcer, coronary heart disease, and depression.
Predisposing factors
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Genetic constitution
Physiological diathesis
Psychological characteristics
Psychological characteristics
Basic Mechanisms for Disease
 Neural regulations
 Hormonal regulations
 Organic regulations
 Cellular regulations
 Molecular regulations
General rules for the onset and
development of diseases
(1)
(2)
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(4)
Disruption of homeostasis
Process of damage and anti-damage
Reversal role of cause and result
Correlation between systemic and
local regulations
Radiation
Trauma
Microbe
Monocyte
Detoxification
Carcinoma
Physic barrier
Coagulation
Stress
Eyewinker
Teratologic
Inflammation
Immunoreaction
Pyrogen
Stressor
Process of damage and anti-damage
Reversal rule of cause and result
(-)
(+)
Primary
causes
Further
alterations
Responses
Secondary
alterations
(cause)
Systemic and local regulations
 Interact and restrict each other
 Learn to grasp the key
Outcome of Disease
Recovery
Complete
recovery
Incomplete
recovery
Outcome of
a disease
Death
Phases of Diseases
高潮
序曲
前奏
尾声
Clinic symptoms
Disease
Prodrome
Latency
Recovery
Death
 The body as a whole stop working
forever
 Brain dearth is the marker for the
diagnosis
Brain Death (WHO criteria)
Cessation of spontaneous respiration
Irreversible coma
Absence of cephalic reflexes
Dilated or fixed pupils
Absence of any electrical activity of the
brain
 Absence of brain blood flow
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Significance for diagnosis of
brain death
 In favor of recording the time of
death
 Define the time to terminate for
the rescue
 In favor of organ transplantation