Welcome to Welcome to PathophysioloPathophysiologygy

Contents of the lecture

1 Introduction

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

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.

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.

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

Major Points in Learning Pathophysiology

The general concepts The etiology and pathogenesis The alterations of metabolism and function The principles for prevention and therapies

How to Learn Pathophysiology

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.

Pay attention to experimental courses Pay attention to clinical practices

How to Learn Pathophysiology

Disease

Concept of Disease

Aberrant manifestation of deregulated homeostasis caused by harmful agents.

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.

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

Etiology is to study the causative agents, microorganisms, environmental, social factors and personal habits as contributing factors that cause diseases.

Answer the question why disease happens.

Healthy bodyHealthy body PathogenPathogen Diseased bodyDiseased body

Dis-beneficial Dis-beneficial

Beneficial Beneficial

Pathogeny: causes disease and endue the Pathogeny: causes disease and endue the characteristics of the diseasescharacteristics of the diseases

（ + ）

（ ）

（（ InducerInducer ））

Etiology

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

Genetic constitution Physiological diathesis Psychological characteristics Psychological characteristics

Neural regulationsNeural regulations Hormonal regulationsHormonal regulations Organic regulationsOrganic regulations Cellular regulationsCellular regulations Molecular regulationsMolecular regulations

Basic Mechanisms for Disease

General rules for the onset and development of diseases

(1) Disruption of homeostasis

(2) Process of damage and anti-damage

(3) Reversal role of cause and result

(4) Correlation between systemic and local regulations

Eyewinker

Monocyte

Physic barrier

Stress

Immunoreaction

Inflammation

Coagulation

Detoxification

Radiation

Microbe

StressorPyrogen

Teratologic

Carcinoma

Trauma

Process of damage and anti-damage

Primary Primary causescauses

ResponsesResponsesFurther Further alterations alterations

Secondary Secondary alterationsalterations

(cause)(cause)

(+)(-)

Reversal rule of cause and result

Systemic and local regulations

Interact and restrict each other Learn to grasp the key

Outcome of Disease

Outcome of a disease

Recovery

Death

Complete recovery

Incomplete recovery

Phases of Diseases

序曲前奏

高潮

尾声

LatencyProdrome

Clinic symptoms

RecoveryDiseaseDisease

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

Significance for diagnosis of brain death

In favor of recording the time of death Define the time to terminate for the res

cue In favor of organ transplantation