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Ultrastructural pathology of cells. Of damage. Parenchymal dystrophy.

Relevance of the topic: The basis of many pathological processes are changes in the ultrastructure of cells. These changes occur under the influence of many damaging environmental factors - a variety of biological, chemical and physical agents under vozdystviem hypoxia, congestion, and the resulting changes in the inheritance of the genetic apparatus. they are often stereotyped and show how the process of damage and adaptation processes, adaptation and compensation for damaged structures. Knowing their need for understanding many processes obschepatologicheskih and diseases. Also, very often Injurious eniya parenchyma cells, which leads to a decrease in organ function and form the basis of many diseases to be studied in our and other medical disciplines.

The purpose of (total): be able to represent the essence of the ultrastructural changes of cells in lesions and other pathological processes, understand the causes and mechanisms of parenchymatous dystrophy, to be able to macro-and microscopic manifestations distinguish between types of parenchymatous dystrophy, treated their outcomes and value for the organism.

^ The specific objectives The objectives of the entry-level

Be able to:

1.Raspoznavat ultrastructural changes nuclei, cell membranes, granular and agranular network, mitochondria, lysosomes, cytoskeleton in pathology.

1.Predstavlyat ultrastructural features of intact cells (Department of Histology).

2.Raspoznovat vacuolar, hyaline droplet degeneration in the cornea and micropreparations, understand their causes, pathogenesis, and outcomes and value.

2.Rospoznavat gistologiicheskoe building organs: heart, liver and kidneys are normal, (Department of Histology).

3.Raspoznavat fatty degeneration of the macro and micropreparations, understand its causes, pathogenesis, and outcomes and value.

4.Umet identify morphological changes in carbohydrate dystrophy, to assess their importance in diabetes mellitus and congenital glycogen storage disease

In order for you to understand as to whether the initial level of your knowledge, skills required, we offer a number of tasks to perform.


Target number 1. With electron-microscopic study of cells in its cytoplasm, membranous vesicles found small size of about 0.2-0.5 microns, filled structureless substance containing hydrolases. On what organelle do you mean?

  1. Ribosomes;

  2. Mitochondria;

  3. Peroxisomes;

  4. Lysosomes;

  5. Golgi complex.

Task number 2. Microscopic examination of tissue viyavleno that her unit has srtrukturnaya hexagonal prism shape, bounded by two vessels and the duct. In the center of Vienna is located, into which sinusoidal capillaries, the cells form a beam. What is the authority?

  1. Heart;

  2. Liver;

  3. Kidney;

  4. Brain;

  5. Spleen.

Task number 3. Nephron - a structural and functional unit of the kidney. What is included in its composition?

  1. Glomerular capsule, proximal, dorsal, curved and straight canals;

  2. Glomerular capsule, the thin tubule;

  3. Collecting tube, curved and straight canals;

  4. Glomerular capsule, the thin tubule, collecting tube;

  5. Proximal, dorsal, curved and straight tubules.

Target number 4. Body consists of cells with elongated, their ends are connected to each other, so that chains of cells are functional fibers. In the center, the cells have oval nuclei located in the cytoplasm of myofibers. As these cells are called?

  1. Smooth muscle cells;

  2. Cardiomyocytes;

  3. The cells of the striated muscles;

  4. Myoepithelial cells;

  5. Miosotelitotsity.

Standards of responses to the solutions of jobs for self-examination and self-knowledge source-level skills: 1.-4, 2.-1, 3.-1, 4-2.

Information necessary for knowledge, skills can be found in the following literature:

  1. Prywes M., Lysenko, N., V. Bushkovich / / Anatomy .- "Hippocrates", 2001, sec. 282-287, 308-316, 322-327, 387-340.

  2. Afanasyev YM, Yurina IA / / Histology, Cytology and Embryology .- M., Science, 1999, pp.42-92.

The content of education should achieve the goals of education, which promotes thethere exists a graph-logical structure of the theme: "The ultrastructural pathology of cells. Damages. Parenhimatoznіye dystrophy." (Appendix № 1) Theoretical issues on which you can do the task activities.

  1. Modern ideas about changing the ultrastructure of cells as a manifestation of damage, adaptation processes and compensation, tumor growth, and examples of these changes in the nucleus and cytoplasm of different structures.

  2. The essence of the damage, their classification.

  3. The essence of the dystrophies, their general classification, the classification of parenchymal dystrophy protein, modern morphological methods viyavleniya dystrophy.

  4. The morphological nature, causes, mechanism of vacuolar degeneration, its location, morphology, outcomes, value.

  5. Hyaline droplet degeneration, causes, mechanism of development, localization, morphology, outcomes, value.

  6. Cornea dystrophy, examples of general and local dystrophy, their causes, morphology, and outcomes.

  7. Structurally stable and free labile lipids, Histochemical methods for their detection in tissues.

  8. Parenchymal fatty, its causes and mechanisms of development, macro-and microscopic changes in the myocardium, liver, kidneys, and the value of its outcomes.

  9. Carbohydrate dystrophy, glycogen storage disease, changes in the kidney in diabetes mellitus.

Books for learning the required knowledge, skills on this topic:

  1. Strukov AI, Serov VV / / Pathological Anatomy. - Kharkov, "Fact", -1999 .- pp.15-70.

  2. Department Lectures on "The ultrastructural pathology of cells. Damage. Parenchymal dystrophy."

  3. Count the logical structure of the themes (Appendix 1)

  4. Algorithm for differential diagnosis of vacuolar, fat and carbohydrate dystrophy

Further reading:

  1. Serov VV, Yarygin NE, Spider VS / / Pathological Anatomy. An atlas. -M. Medicine. - 1986.-p.5-27.

  2. Shlopov VG / / Basic Human Pathology. - Kiev, 1999.-p.20-50.

After examining the above tasks for self-mastery of the material on the subject predlagaetsya the following targets.

Vipolnite following targets

Target number one. According electron microscopy, the nuclei of the tumor increased several times, their chromatin compact, kondensovany. The amount of DNA in two, three, four or more times higher than it in normal tissue. This is evidence of:

  1. Activation of cell functions

  2. Polyploidy

  3. Aneuploidii

  4. Polyploidy and aneuploidii

  5. Reducing the function of cells

Task number 2. In the plasma cell, which actively synthesize immunoglobulins increased cytoplasm, the nucleus is displaced to the periphery. By increasing public ultrastructures did this happen?

  1. Increasing the number of mitochondria

  2. Increase (hyperplasia), agranular endoplasmic reticulum

  3. Increase in granular endoplasmic reticulum

  4. Increasing the number of ribosomes not associated with endoplasmic reticulum

  5. Swelling, enlargement of mitochondria.

Task number 3. Coronary heart disease, was found microscopically plot, in which cardiomyocytes increased in all sizes, with a pale, clear cytoplasm, which resembles lace, Schick-negative. Nuclei little changed. What is the diagnosis?

  1. Vacuolar degeneration

  2. Hyaline droplet degeneration

  3. Cell death

  4. Lipophanerosis

  5. Glycogenosis

Target number 4. The child died of diphtheria, endocarditis in the heart of a band of yellow found on a red background infarction. Myocardium resembles the "skin of a tiger." What is the diagnosis?

  1. Fatty degeneration of the parenchymal

  2. Vascular-stromal fatty

  3. Vacuolar degeneration

  4. Hyaline droplet degeneration

  5. Glycogen storage in glycogenosis

Task number 5. A child bolevshego salmonelezom at autopsy revealed a large liver is light brown in color. Large areas of yellow.

What is the process in the liver rozvilsya?

  1. Lipophanerosis

  2. Vacuolar degeneration

  3. Carbohydrate dystrophy

  4. Hyaline droplet degeneration

Target number 6. In a patient with viral hepatitis B, microscopic examination of liver biopsy punktsinnogo found enlarged hepatocytes, the cytoplasm of which is light, like lace. In the PAS-reaction of glycogen in them is reduced. What is the pathological process in hepatocytes?

  1. Lipophanerosis

  2. Vacuolar degeneration

  3. Hyaline droplet degeneration

  4. Glycogenosis

Target number 7. Patient 35 years old, was admitted to the intensive care unit with ethylene glycol poisoning, acute renal failure from which he died. Microscopic examination of renal tubule, the cells has increased dramatically, the cytoplasm is light, frothy, like lace. What type of degeneration in the epithelium of the tubules of kidneys?

  1. Hydropic;

  2. Hyaline droplet;

  3. Fat;

  4. Balloon;

  5. Carbohydrate.

Target number 8. At autopsy the patient died of sepsis with severe intoxication, found "tiger heart". In the histochemical study in the cytoplasm of cardiomyocytes detected lipids. What is the most probable mechanism of this degeneration?

  1. Decomposition;

  2. Infiltration;

  3. Transformation;

  4. Perverted synthesis;

  5. Violation of secretion and stagnation of secretion.

Target number 9. The man on the oral mucosa was found a white spot. With electron-microscopic study in the cytoplasm of cells, a sharp increase in Number of filamentary shape ultrastructures formed by keratin. At some sites, many of them turn into keratohyalin. For what type of parenchymatous degeneration is characterized by?

  1. Fat;

  2. Carbohydrate;

  3. Hydropic;

  4. Horn;

  5. Hyaline droplet.

Guidelines for student work on a practical lesson: "The ultrastructural pathology of cells. Damages. Parenchymal dystrophy."

In early studies on the standards of answers Be sure homework solutions. Then, by means of test control will be tested to prepare your lesson.

You must learn self-diffraction, macro-and micropreparations, solve situational tasks. The macroscopic features of parenchymatous dystrophy study on drugs "fatty liver", "tiger heart". Using micropreparations ofuchayut morphological manifestations of various dystrophies, Histochemical methods for detecting them, "vacuolar degeneration of tubular epithelial buds," "fatty liver" - painting with hematoxylin-eosin, and fat with Sudan 3-4. It uses "The algorithm of the microscopic diagnosis of vacuolar and fatty degeneration" (Appendix 2), "An algorithm describing makropreparatov" (Appendix 3).

Session ends with an analysis of the results of independent work of each student by checking the description micropreparations, testsOn the control of learning.

^ Flow chart classes

Number p / p



In min.

Textbooks learning tools




Checking and correction of baseline


Test tasks



Independent work. Description of the macro-and micropreparations.


Count the logical structure (dopolnenie1) algorithm parenhim morphological diagnosis. Dystrophy. Algorithm and study makropreparatov micropreparations

Microscope, macro-and micropreparations, tracings


Self-testing and correction of learning styles


Targeted training task


The final test control




Summarizing the results of studies


Appendix 1

Count the logical structure of the theme: "Damage. Parenchymal dystrophy. "

Parenchymal dystrophy



Vacuolar degeneration



Morphological. diagnosis



(Viral hepatitis)

Damage to the lysosomes





A reversible process


Of intoxication.

exogenous .- glycols


Balloon degeneration


Microscopic changes


General characteristics of hyaline droplets, horny dystrophy




Morphological diagnosis




A reversible process





Micro-and macroscopic changes






Carbohydrate dystrophy

The concept of glycogenosis

Morphological changes in the kidney in diabetes mellitus

Supplement number 2

^ The algorithm of morphological diagnosis of fatty degeneration of parenchymal




Enlarged, flabby, the cut, the fabric is striped, yellow color band under endokardom. kind of "tiger heart"

Enlarged, flabby, dull crust with a touch of Zsolt

Increased, clay type, flabby, dull

In the cytoplasm miokardiotsitov deposition of droplets of fat (Sudan III staining, etc.), round clear vacuoles in normal preparations

In the cytoplasm of hepatocytes deposition of droplets of fat. Round clear vacuoles in normal preparations

In the epithelium of the convoluted tubules droplets of fat. Round clear vacuoles in normal preparations

Fatty degeneration of parenchymal

Supplement number 3

The algorithm description makropreparatov

  1. Identify the organ

  2. Rosemary (normal, enlarged, reduced)

  3. Form (normal, altered)

  4. Surface (smooth, bgristaya, granular).

  5. Consistency (loose, tight)

  6. Paint (the degree of blood flow).

  7. Drawing on the cut.

  8. The nature of focal changes (location, quantity, shape, size, color, consistency, contours).

  9. Dіagnoz patologicheskogonogo process.


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