Anatomical pathologyHistorical dates, introduction, tasks

and evolution

Anatomical pathology

• AP is one of the most important subjects in the system of physician training.

• AP deals with the material basis of the disease and its morphology.

• AP is anatomy of an unhealthy body.• AP is complex knowledge about a sick person.

Evolution of AP

• Hippocrates (460-377 B.C.) –he first affirmed that disease was alteration in the body.

• Morgagni (1682-1771) –first scientific book in pathology << On site and causes of diseases revealed by anatomists>>.He had studied 700 corpes.

• Beily (1799-1858)-first textbook on Special Pathological Anatomy.

• Schleiden,Schwann – structure of cellular membrane • Rokitansky (1804-1878)- description of amyloidosis• Virchow (1821-1902)-”Cellular pathology”

Абрикосов А.И.(1875-1955)-

• Tuberculosis , renal problems, pathology of oral cavity

• The first textbook on pathological anatomy

Полунин А.И. (1820-1888)-

• he was the first chief of PA department of the Moscow university

Давыдовский И.В. (1887-1968)

• he was the teacher of all soviet and Russian pathologists

Anatomical pathology

• AP is closely connected with clinical medicine and pathological physiology, microbiology, hygiene and other sciences.

Etiology and pathogenesis

• Etiology –causes of diseases – chemical,physical,biological

• Pathogenesis – mechanisms of pathological processes development-

• -functional shifts (phisiological,biochemical,immunological)

• -structural changes (step by step)• -localization of pathological process

Tasks of AP

• Population may has 1000000 diseases. Person suffers from 1000 diseases. Organ - 100diseases. Cell has 10 diseases. Membrane only 1 disease –destruction

• Changes in different organs and tissues are similar no matter where they are located –in the liver,kidneys,heart. They are named – typical pathological processes .These common processes are studied by the branch of AP – general course.

typical pathological processes

• They have similar pathogenesis, mechanisms, stages , morphology, outcomes and results.

• They do not depended from etiology and localization

General pathology

• Death• Cellular disturbances • Disturbances of local and general circulation• Inflammation• Tumors • Adaptive processes

Methods of AP

• Autopsy(dissection)• Biopsy• Experiment

Autopsy(dissection)

• To revel the cause of death• To improve the quality of diagnosis• Information about morphological

manifestation of disease• To revel the stage of pathological process

Biopsy-28 kinds of biopsies

• Visual examination• Microscopical examination

Methods of work with students

• Lectures• Practical classes• Scientificall students society• Additional classes according program• Additional extraprogram classes.

Typical pathological processes. Cellular pathology. Alteration (injury).Necrosis

Necrosis

• Cellular death in the living organizm

• Autolysis – is posthumous changes .

Causes of necrosis

• 1gr – external causes –

• Physical (temperature, mechanical, x-rays, space rays …)

• Chemical (acids, organic and nonorganic subst.)

• Biological (microbes, viruses, toxins)

• 2gr - internal – abnormal pregnancy, hyperthyroidosis

• Blood circulation frustration

(more often ischemia, for example in ischemic heart disease)

• Immunologic factors

• Genetic changes

• Infringements of nervous trophizm

Kinds of necrosis due to mechanisms

• Direct - due to direct action of pathological causes on tissue

• Indirect – due to destraction of blood supply or nervous system

The main morphologic types of necrosis

• Dry• Wet• Gangrene (dry and wet)

• Infarction – pathogenetic type• Sequestration – outcome of necrosis

Macroscopic appearances of necrosis

• Color – white, red , white with red ring and black (gangrene)

• Consistence – dry and wet

Necrosis of the pancreas

Gangrene of the intestine

Gangrene of the foot

Microscopic signs of necrosis

• Nuclear changes – karyopicnosis, karyorrhexis, karyolysis

• Cytoplasmatic changes – coagulation proteins of plasma, plasmorrhexis, plasmolysis.

Necrosis of cells in the brain

Necrosis of convoluted tubules epithelium in the kidney

Necrosis of convoluted tubules epithelium in the kidney

Necrosis of the pancreas

Necrosis of lymphatic node in case of tuberculosis

Necrosis of pulmonary tissue

Outcomes of necrosis

• Rezolution with subsequent regeneration of tissue• Organization• Capsule formation• Petrification• Cyst formation• Sequestration

• Saprogenic fusion of necrotic focus

Organization

back connection

• You must write –• your name and group• Answers on my questions • There will be 4

Question 1

• African student- boy has a close- friend – Russian student- girl. When they finish of education he decide back Africa. But at home he has a pretty wife. Girl was very pity - she take the knife and …..

• It will be direct or indirect necrosis?• What you will see inside cardiac cells ???

Question 2• African student- boy has a close- friend –

Russian student- girl. When they finish of education he decide back Africa. But she does not want to live in Africa . Boy was very pity - he can not sleep, can not work, can not eat,- great stress - systemic spasms of blood vessels- hypoxia – in the heart it will be infarction

• It will be direct or indirect necrosis?• What you will see inside cardiac cells ???

To the following lecture read intracellular and extracellular accumulations