INTRODUCTION

TO PATHOLOGY
Dr. Gifty Kumi- Ampofo

HISTORY OF
PATHOLOGY
It started in the Middle East during the
Islamic Golden Age and in Western Europe
during the Italian Renaissance.
The first physician to have performed
postmortem dissections was an Arabian
called Avenzor(1091- 1161). He proved
that scabies was caused by a parasite.

WHAT IS PATHOLOGY

PATHOLOGY = PATHOS + LOGOS

SUFFERING + STUDY

DEFINITION OF PATHOLOGY
A bridging discipline involving both basic
science and clinical practice which studies the
structural and functional changes in cells tissues
and organs that underlie diseases.
OR
The study of the anatomical and physiological
deviations from the normal that constitute
diseases or characterize a particular disease. Eg.
sickle cell disease, G6PD, Diabetes Mellitus.

MAIN TYPES OF PATHOLOGY

GENERAL
SYSTEMIC

GENERAL PATHOLOGY
It is the study of basic reactions of
cells and tissues to abnormal
stimuli that underlie all diseases.
Eg: inflammation, edema,
haemostasis.

SYSTEMIC PATHOLOGY
The study of the specific
responses of specialized organs
to a defined stimuli.
E.g.Atherosclerosis,myocardial
infarction, lung cancer

CORE ASPECTS OF PATHOLOGY

The four aspects of disease process that form the core of
pathology are:
AETIOLOGY: The study of the cause(s) of a disease; a
scientific explanation of the origin of a particular disease.
PATHOGENESIS: The mechanisms of the development of
a disease.
MORPHOLOGIC CHANGES: The structural alterations
induced in the cells and organs of the body as a result of
disease.
CLINICAL SIGNIFICANCE: The functional consequences
of the morphologic changes as a result of disease

SHORT TEST
Explain briefly the
essence of pathology as
far as physiotherapy is
concerned.

ASSIGNMEMT

Identify and briefly

explain five branches of
pathology.

GROUP WORK
Using a named disease explain
the terms aetiology,
pathogenesis, morphological
changes and clinical
significance.

CELLULAR
RESPONSE TO
STRESS AND
NOXIOUS STIMULI
Dr. Gifty Kumi- Ampofo

STRESS
It is an organisms response
to a stressor or external
stimuli.
It is the bodys method of
reacting to a challenge.

NOXIOUS STIMULI
Events that can potentially lead to
tissue damage.
Modes: mechanical, chemical,
thermal
Some noxious stimuli cause pain
whilst others do not.

HOMEOSTASIS/ CELLULAR
ADAPTATION
It is maintenance of equilibrium.
It is a property of cells, tissues and organisms that
allows the maintenance and regulation of the stability
and constancy needed to function properly. It is
achieved by the constant adjustment of biochemical
and physiological pathways. Eg: maintenance of
normal blood pressure, blood glucose level.
It is an achievement of a new but altered steady state
in a cell after a the action of a stressor or a noxious
stimuli preserving the viability of the cell and
modulating its function as a response to such stimuli.

MODES THROUGH WHICH CELLS

ADAPT TO STRESS

Hypertrophy
Hyperplasia
Atrophy
Metaplasia

Hypertrophy
It is an increase in the size of cells and as
such an increase in the size of the organ.
There are no new cells, just larger ones
due to synthesis of more structural
components.
It could be caused by increased functional
demand or specific hormonal stimulation.
It could be physiologic or pathologic.

PHYSIOLOGICAL HYPERTROPHY

Growth of uterus during

pregnancy
Breasts enlargement during
lactation

PATHOLOGICAL HYPERTROPHY

Enlargement of the heart as a

result of a faulty heart valve.
Enlarged skeletal muscles as a
result of increased workload.

HYPERTROPHY

HYPERPLASIA
An increase in the number of cells in
a tissue or organ which may then
have increased volume.
It could be physiologic or pathologic.
It is an important response of
connective tissue cells in wound
healing.

PHYSIOLOGIC HYPERPLASIA

There are two types:

Hormonal: eg: breast
enlargement during lactation
and puberty
Compensatory: eg: liver
regeneration

PATHOLOGICAL HYPERPLASIA

It usually arises from excessive

hormonal stimulation or the
effects of growth factors on
target cells. Eg: endometrial
hyperplasia, skin warts.

HYPREPLASIA

METAPLASIA
It is a reversible change in which one
adult cell type is replaced by another
adult cell type (usually the epithelial cells
or mesenchymal cells).
It is an adaptive substitution of cells that
are sensitive to stress by cell types better
able to withstand the adverse
environment.

METAPLASIA CONT
The most common epithelial metaplasia is the
columnar squamous as occurs in respiratory tract in
response to chronic irritation. Eg: in a habitual
smoker.
Others are: presence of stones in the excretory ducts
of the salivary glands, pancreas or bile duct can
cause replacement of the normal secretory columnar
epithelium with a non functioning stratified
squamous epithelium.
Myositis ossificans.

METAPLASIA CONT
Although the metaplastic change is an adaptive
mechanism, it often leads to loss of vital functions
of the cells. It can thus bring undesirable changes
in the cells.
For instance loss of mucous secretion from the
squamous metaplastic cells in the respiratory tract.
The influence or stress that predispose to
metaplasia can induce cancer transformation in
metaplastic cells.

METAPLASIA

ATROPHY
It is a shrinkage in the size of the cell by
loss of cell substance.
There are two types:
Physiologic atrophy:eg: atrophy of the
notochord and thyroglossal duct during
fetal development
Pathologic: usually arising from an
external stressor.

ATROPHY
An atrophic cell is not a dead cell it can
be revived. It is only when the blood
supply to cells is inadequate to maintain
the life of the shrunken cells then injury
and cell death may occur.
In atrophy there is an imbalance between
protein synthesis and degradation.

ATROPHY

SHORT TEST

With the aid of a named example

briefly explain the following
terms:
Hypertrophy
Hyperplasia
Atrophy

ASSIGNMEMT

Name and briefly

explain the common
causes of atrophy.

LIFE IS WHAT YOU

MAKE OF IT.