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INTRODUCTION%20TO%20STUDY%20OF%20PATHOPHYSIOLOGY

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Title: INTRODUCTION%20TO%20STUDY%20OF%20PATHOPHYSIOLOGY


1
INTRODUCTION TO STUDY OF PATHOPHYSIOLOGY
  • Prof. J. Hanacek, M.D., Ph.D.,

2
What the pathophysiology is
Physiologia, ae, f. gr. fysis nature
logos science
Pathophysiologia, ae, f. gr. pathos
disease, pain, suffering
3
Physiology
Pathophysiology
Life
Logic
Healthy
Diseased
Study
The calligraphy done by the Korean artis Kim
Hyun-Seung
4
Pathophysiology - definitions
/PaPhy/
  • PaPhy is a biomedical science on the mechanisms
  • related to development and elimination of
  • pathological processes and diseases

? PaPhy is a biomedical science dealing with
functional changes in diseased organism
? PaPhy deals with the dynamic aspects of
pathological processes and diseases. It
studies disordered or altered functions -
the physiologic mechanisms altered by disease
in the living organism
5
Pathophysiology deals with temporal and
spatial dynamics in the intensity of
pathological processes
Pathophysiology is devoted to study of
protective and defensive mechanisms of body
tissue, organs and systems, and their role in
defence against noxae, in pathogenesis of
disease, and in sanogenesis
Pathophysiology belongs to core subjects of
undergraduate medical education
6
Pathophysiology deals with logic of life under
pathological conditions
Pathophysiology help us to understand the logic
of life during development of pathological
processes
Pathophysiology creates a bridge between
sciences and clinical subjects in undergraduate
medical education
7
? Pathophysiology is a modern integrative
biomedical science founded on basic and clinical
research that is concerned with the
mechanisms responsible for the initiation,
development, and treatment of pathological
processes in humans and animals.
International Society for Pathophysiology (1998)
8
Why pathophysiology is important for medical
students and physicians
  • It helps them to find answers to important
  • questions related to disease processes
  • a) What is the cause/causes of the disease,
    and why
  • the disease is developing
  • b) What are the mechanisms responsible for
  • disease onset, progression, and recovery
  • c) What are the mechanisms responsible for
  • development of symptoms and signs of
    disease

2. If doctors are able to understand the causes
and mechanisms of the disease, then they are
able to find the way how to influence them
rationally
9
Relation among pathophysiology and other
subjects of unergraduate medical education
Biology pathological processes begin frequently
at the cell level Anatomy and
histology macro- and microstructural
properties of the human body is essential
for understanding their
pathology Biochemistry biochemical processes
are changed under
pathological condition
10
Biophysics biophysical properties of cells,
tissues and organs
determine their structural
and functional characteristics Physiology
firstly, we have to understand the functions of
the healthy tissues, organs
and systems of the body,
than we are able to distinguish pathological
functions
Pathological anatomy to understand the
microstructural and
macrostructural changes under pathological
conditions helps to understand
functional changes and
vice versa
11
Microbiology and immunology the subject help us
to understand of the mechanisms
involved in development of disease
caused mainly by biologic noxas and
disorders of immune system Pharmacology PaPhy
enables the doctor to treat
diseases rationally (causally) Clinical
subjects PaPhy is a theory of disease, clinic
is medical
practice Humanistic subjects (psychology, ethics,
sociology, antropology...)
psychologic and social factors play an
important role in disease development
12
The position of Pathophysiology in undergraduate
medical education
  • It becomes an integrative biomedical subject
  • It becomes a bridge between the subjects of
  • sciences and clinical medicine
  • It is an important part of undergraduate medical
  • education

THE MAIN TASKS OF PATHOPHYSIOLOGY
  • To teach mechanisms of diseases
  • To help to understand the substance of health

? To help students to understand the logic of
life under pathological conditions
13
Thanks to pathophysiology the medical student
can understand the inner logic of the
pathological processes, their relationships, and
their biological significance. On this basis
student is able, as a result, to built an
individual model of disease in a given patient
14
House of Medicine
Neurology Gynekology and Obtetrics
Surgery Internal medicine
Ceiling plate
P A T H O P H Y S I O L O G Y
Pathology
Pharmacology
Microbiology
walls
P H Y S I O L O G Y
Base plate
Anat
Biol
Histol
Bioch
Chem
Biophys
Foundations
15
Structure of pathophysiology
1. General pathophysiology
2. Special /organs, systems/ pathophysiology
  • General pathophysiology content
  • It deals with general pathologic
    processes, and
  • pathomechanisms -thay are involved in
    pathogenesis of more than one disease. It also
    contain explanation of some basic medical terms

? Examples of general pathological processes
inflammation, fever, hyperthermia,
hypothermia, shock, stress, edemas,
disturbances of control mechanisms,
hyperreactivity, hyporeactivity, damage of
genetic information....
16
? Defensive and adaptive mechanisms -
non-specific and specific immunity, hypertrophy,
atrophy, hyperfunction, hypofunction,
homeostasis
? Incresed predisposition to onset of disease
(diathesis, athopy) due to genetic or/and
environmental factors
17
Essential terminology
a) Nosology /nosos disease logos science/
Systematically describes the specific type of
disease and this is the base for creation
classification system of diseases
b) Etiology of disease /aitiá cause/
Deals with noxae (causes) which are involved in
disease onset and with conditions under
which the causes are able to induce disease
processes (Oposit - etiology of health
deals with factors which promote
the health)
c) Pathogenesis /pathos pain, suffering,
distress, genesis - onset/ Deals with
mechanisms involved in disease onset and diseases
development (pathomechanisms)
18
d) Sanogenesis /sanos health/ Deals with
mechanisms involved in recovery from disease
to health
e) Semiology /sémeion sign, symptom/
Deals with symptoms and signs of diseases ?
Symptoms subjective feeling of disease ?
Signs objective parameters of changed functions
and structures of body
systems
f) Tanatogenesis /thanatos death/ Deals
with processes leading to death
19
2. Special pathophysiology - is devoted to
analysis and explanation of pathomechanisms
involved in functional disturbances of the
organs and systems of the organism
Content of special pathophysiology
  • hematologic disorders
  • disorders of cardiovascular system
  • dysfunctions of respiratory system
  • disorders of uropoietic system
  • neurologic disorders
  • dysfunctions of of endocrine system
  • metabolic disorders
  • disorders of reproductive system
  • dysfunctions of of GIT

20
SPECIAL SECTIONS OF PATHOPHYSIOLOGY
  • Clinical pathophysiology
  • /clinical physiology/
  • Space pathophysiology
  • Experimental pathophysiology
  • Pathophysiology of extreme - events
  • Ocupational pathophysiology and PaPhy of sports
  • Adaptation pathophysiology

? Cellular and molecular pathophysiology
21
REMARKS TO PATHOGENESIS
? Pathogenesis of disease processes can not be
reduced to only quantitative changes of
structures, functions and mechanisms
presenting in healthy people
? It is necessary to take into account
development of qualitatively new processes,
which are harmful for the body structure and
functions
One example of such new pathologic mechanism is
vicious circle (a complex of events that
reinforces itself through a feedback loop toward
greater instability)
22
Examples of vicious circle
  • 1st example Development of LV
    insufficiency
  • Mitral stenosis decreased cardiac
    output of left ventricle
  • activation of sympathetic n.s.
  • vasoconstriction
  • (skin, splanchnic, kydney aa.)
  • heart rate
  • end diastolic vol of LV
    shorter diastola of LV

arter resist
?
23
  • 2nd example Development of edema during RV
    failure
  • Right ventricle failure
    hydrostatic pressure in
  • venous system

  • formation of edema
  • COLV activation
    sympathic

  • ? fluid volume
    vasoconstriction
  • in venous system

  • blood flow
  • in kydney

  • resorbtion Na
    activation of
  • in kydney R -
    A- A system

volume overload
24
HISTORY OF PATHOPHYSIOLOGY
  • Hippocrates (460-370 BC)- he was the first to
  • construct theories of the causes of disease
    based on
  • what he had observed in his patients
  • His fundamental truth there are two factors
    acting
  • alone or in combination which cause illness
  • the intrinsic or constitutional make-up of the
    person,
  • and an extrinsic or environmental agent, is
    still valid.
  • Once normal functions of the body had been
    described
  • it was but a step to investigate states of
    disease (from
  • the end of 16th century)

25
HISTORY OF PATHOPHYSIOLOGY
  • C. Bernard (1813-1878)-Introduction to
    experimental
  • medicine
    (1865)
  • Rudolf Wirchov - he introduces term
    pathological
  • physiology to
    medical terminology
  • Galliot /1819 / - author ofManual in general
    pathology
  • and pathological physiology
  • A.F. Hecker / 1790/ -authorTextbook in
    pathophysiology

Excellent pathophysiologist from the past J.E.
Purkyne, Prof. Pashutin, Prof. Pavlov /from
Russia/, Prof. Hans Selye /Canada-1907-1982/
-Stress theory ...
26
Methods used in pathophysiological research
1. Observation
2. Animal experiment
3. Clinical pathopysiological study
  • Elaboration of experimental to create
  • models of pathological processes animal's
    models, mathemathical models...

Research at the Dept. of Pathophysiology
It is devoted to research on PaPhy of respiratory
system, especially to defensive mechanisms of
the airways and lungs, and to visceral
neurophysiology and PaPhy
27
The main aims of teaching pathohysiology
  • Students should understand fundamental general
    and
  • specific pathomechanisms involved in onset,
    development and ending of diseases

To fulfil this aim is necessary a) to know
and understand pathophysiological terms b)
to know and understand essential
pathomechanisms c) to connect separate
pathomechanizms to rational
pathogenetic network characteristic for different
pathological processes d) to
understand a pathologic process as event which
influence the whole body e) to
understand pathomechanizms as dynamic events
28
The roles of studets and teachers in teaching
prosess
a) Student has to study, not simply memorise
facts b) Individual study and seminars should be
focused to obtain lasting knowledge on
pathophysiology c) Teacher will help students
with creation of complex view on pathogenesis
of diseases
  • The source of lasting knowledge is understanding
    of
  • the pathomechanisms
  • (Understunding is a kind of ecstasy)

29
Textbooks and other sorces for study of PaPhy
?Sylvia Anderson Price, Lorraine Mc Carty Wilson,
Pathophysiology - Clinical concepts of disease
processes 6th edition Mosby Year Book, St.Luis,
Baltimore, Boston, Chicago, London,
Sydny. ?Stefan Silbernagel, Florian Lang Color
Atlas of Pathophysiology Thieme, Stuttgart - New
York, 2000, 406pp. ?S.J. McPhee, V.R. Lingappa,
W.F. Ganong, J.D.Lang Pathophysiology of Disease
An Introduction to Clinical Medicine Prentice -
Hall International Inc., 1995, 521pp. ? Tatar M,
Hanacek J. Pathophysiology. Topics for seminars.
Comenius University 2001, 220pp.
?Handouts of lectures on Pathophysiology from
Dept . of Pathophysiology JFM CU in Martin
30
Staff involved in teaching process
Head Professor M. Tatar, M.D., Ph.D. Teaching
staff Teachers Prof. Jan Hanacek, M.D., Ph.D. -
Vice-Head Prof. Milos Tatar, M.D., Ph.D.
Assoc. Prof. R. Pecova, M.D., Ph.D.
Assoc. Prof. M. Brozmanova, RNDr., Ph.D.
Assoc. Prof. J. Plevkova, M.D.,
Ph.D. Technicians Mr. M. Vrabec,Ing., Ms. L.
Mazurova, Mrs. K. Strbova Mr. T.
Zatko PhD student Mr. J. Halicka, M.D., Ms. S.
Gavliakova, Ing. Secretary Mrs. M. Ilovska
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