NURS 5315 Advanced Pathophysiology Altered Cellular Function and Cancer
Module Objectives with Advanced Organizers
Cellular Adaptation Patterns
1. Analyze the differences between cellular adaptation patterns.
...
NURS 5315 Advanced Pathophysiology Altered Cellular Function and Cancer
Module Objectives with Advanced Organizers
Cellular Adaptation Patterns
1. Analyze the differences between cellular adaptation patterns.
a. Differentiate between the etiology and the pathophysiology of atrophy, hypertrophy, hyperplasia, dysplasia, and metaplasia and identify an example of each.
Disease Etiology (cause by) Pathophysiology (causes) Example
Atrophy An increase in catabolismos the intracellular organelles that causes a reduction of the structural components of the cell such as less mitochondria, myofilaments, and endoplasmic reticulum.
Physiologic atrophy occurs with early development
Pathologic atrophy occurs due to decrease in workload, blood supply, nutrition, hormonal stimulation, and nerve stimulation Physiologic=thymus gland shrinks during childhood
Pathologic=skeleton muscle atrophy
Hypertrophy It is caused by hormonal stimulation or
increased functional demand,
which increases the cellular protein in the plasma membrane,
endoplasmic reticulum, myofilaments, and mitochondria (not cellular fluid) Cardiomegaly, removing a kidney the other enlarges
Hyperplasia
(only cells that can undergo mitosis) Phy=Increase rate of cellular division
Path= can be caused by increased hormonal stimulation
Phy=An increase in tissue mass after damage or partil resection.
Path=Response to an injury if the injury has been severe or prolonged Liver regenerating, callus, uterus enlargement during pregnancy
Dysplasia Due to persistent, severe cell injury or irritation Disordered cell growth. Epithelial tissue of the cervix and respiratory tract
Metaplasia Cell exposed to chronic stressors, injury or irritation A stimulus induces a reprogramming of stem cells. The stem cell differentiates along a new cellular pathway. Barrett Esophagus
b. Identify a physiologic and pathophysiologic example for atrophy, -
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-promote digestion of connective tissue capsules and other structural barriers by secreted proteases; changes in cell-to-cell adhesion, often by changes in the expression of cell adhesion molecules such as cadherins and integrins, making the cancer cell more slippery and mobile; and increased motility of individual tumor cells. The mechanism of capsular dissolution is unclear.
To transition from local to distant metastasis, thecancer cell must also be able to invade local blood and lymphatic vessels, a task facilitated by stimulation of neoangiogenesis and lymphangiogenesis by factors such as VEGF. Finally, a successful metastatic cell must be able to survive in the circulation, attach in an appropriate new environment, and multiply to produce an entire new tumor.
e. Explain the TNM staging system for cancers and describe its significance for clinical practice.
Staging involves determining the size of the tumor, the degree to which it has locally invaded, and the extent to which it has spread (metastasized). (see figure 12-25, pg394) A four stage system is used, with carcinoma in situ regarded as a special case.
Stage 1 = Cancer confirmed to the organ of origin
Stage 2 = Cancer that is locally invasive
Stage 3 =Cancer that has spread to regional structure, such as lymph nodes
Stage 4 = Cancer that has spread to different sites, such as liver cancer spreading to lung or prostate CA spreading to bone.
The World Health Organization’s TNM system:
T = tumor spread
T0 = Breast free of tumor
T1 = Lesion <2 cm in size
T2 = Lesion 2-5 cm
T3 = Skin and/or chest wall involved by invasion
N= Lymph Node involvement
N0 = no axillary node involved
N1 = mobile node involved
N2 = Fixed nodes involved
M= metastasis
M0 = No metastasis
M1 = demonstrable metastasis
M2 = suspected metastasis
The prognosis generally worsens with increase tumor size, lymph node involvement, and metastasis. Staging may alter the choice of therapy, with more aggressive therapy being delivered to more invasive diseases.
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