Welcome to

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• Welcome to
• Pathophysiology

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Contents of the lecture
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What is Pathophysiology?
A subject to explore the rule of origin and
evolution of diseases and the underlying
mechanisms.
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Subjects involved in Pathophysiology

• All diseases seen in all clinical
• departments
• All diseases reproduced in animal
• models

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Differences from Physiology

• Physiopathology
• Physiology of Disease
• Clinical Physiology
• Medical Physiology
• Physiology of Disordered Function
• Physiology under diseased situation

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Differences from Pathology

• Pathology emphasizes the structural
• changes
• pathophysiology deals with functional
• and metabolic alterations and the
• mechanisms.

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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.

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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.

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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.

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Fundamental pathological processes

• Some common and whole set alterations in
  metabolism, function and structure, which may
  appear in different disorders

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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

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Major Points in Learning Pathophysiology

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

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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.

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How to Learn Pathophysiology

• Pay attention to experimental courses
• Pay attention to clinical practices

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Disease
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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.

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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.

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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.

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Etiology
Dis-beneficial
(Inducer)
()
Pathogen
Diseased body
Healthy body
( )
Beneficial

• Pathogeny causes disease and endue the
• characteristics of the diseases

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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

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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.

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Predisposing factors

• Genetic constitution
• Physiological diathesis
• Psychological characteristics
• Psychological characteristics

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Basic Mechanisms for Disease

• Neural regulations
• Hormonal regulations
• Organic regulations
• Cellular regulations
• Molecular regulations

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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

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Process of damage and anti-damage
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Reversal rule of cause and result
Primary causes
(-)
()
Further alterations
Responses
Secondary alterations (cause)
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Systemic and local regulations

• Interact and restrict each other
• Learn to grasp the key

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Outcome of Disease
Complete recovery
Recovery
Incomplete recovery
Outcome of a disease
Death
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Phases of Diseases
??
??
??
??
Clinic symptoms
Prodrome
Disease
Recovery
Latency
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Death

• The body as a whole stop working
• forever
• Brain dearth is the marker for the
• diagnosis

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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

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Significance for diagnosis of brain death

• In favor of recording the time of death
• Define the time to terminate for the rescue
• In favor of organ transplantation