PATHOLOGY: RT 91 INTRODUCTION

1. PATHOLOGY: RT 91 INTRODUCTION CHAPTER 1 Spring 2008

2. HEALTH IN THE UNITED STATES • Chronic diseases continues to be the leading causes of death in the U.S. • Diseases of the heart and malignant neoplasm were the top two causes of deaths in 2000. • Responsible for over 50% of all deaths.

3. As of 2004 it continues to be… • Heart disease: 654,092 • Cancer: 550,270 • Stroke (cerebrovascular diseases): 150,147 • Chronic lower respiratory diseases:123,884 • Accidents (unintentional injuries): 108,694 • Diabetes: 72,815 • Alzheimer's disease: 65,829 • Influenza/Pneumonia: 61,472 • Nephritis, nephrotic syndrome, and nephrosis: 42,762 • Septicemia: 33,464 • Source: Deaths: Preliminary Data for 2004

4. HEALTH CARE RESOURCES • HEALTH CARE: 13% OF THE GROSS NATIONAL DOMESTIC PRODUCT • US SPENDS MORE MONEY ON HEALTH CARE THAN AN OTHER INDUSTRALIZED NATION • 17% OF U.S. POPULATION: NO HEALTH INSURANCE.

5. US Dept. of Health and Human Services www.cms.hhs.gov • 16.0 percent of GNP in 2004 • The U.S. spent $1.9 trillion on health care, or $6,280 per person, in 2004.  Health spending rose 7.9 percent in 2004, slower than the 8.2 percent growth in 2003 and 9.1 percent growth in 2002. • Of this increases 20% was spent on new technology

6. TRENDS IN HEALTH CARE • PREVENTION • MUCH CHEAPER TO PREVENT DISEASES THAN TREAT DISEASES • HOW IS THIS AFFFECTING RADIOLOGY?

7. STRUCTURAL VS FUNCTIONAL DISEASE • STRUCTURAL – HEREDITARY DISORDERS, INFLAMMATORY DISEASES, ETC • FUNCTIONAL – NO LESION PRESENT EX: MENTAL ILLNESS, TENSION HEADACHES, IBS

8. CONGENITAL & HEREDITARY INFLAMMATORY DEGENERATIVE METABOLIC TRAUMATIC NEOPLASTIC DISEASE CLASSIFICATION

9. CONGENITAL & HEREDITARY DISEASE • DISEASES THAT ARE PRESENT AT BIRTH AND RESULT FROM GENETIC OR ENVIRONMENTAL FACTORS. • 2% TO 3% OF ALL LIVE BIRTHS SHOW CONGENITAL ABNORMALITIES. • TYPES OF CONGENITAL ABNORMALITIES? HEREDITARY

10. INFLAMMATORY DISEASE • DISEASE THAT RESULTS FROM THE BODY’S RXN TO LOCALIZED INJURIOUS AGENT • EXAMPLES ? • AUTOIMMUNE DISORDERS

11. INFLAMMATION • THE BODY’S RESPONSE TO INJURY LOCALIZE/ISOLATE TOXIC SUBSTANCES – DESTROYS “ENEMY” BEGINS WOUND HEALTING AND REPAIR • ACUTE INFLAMMATION – 5 SIGNS

12. ACUTE INFLAMMATION • RED SKIN – CONGESTION OF BLOOD VESSELS • SWELLING (EDEMA) • HEAT – TEMPERATURE OF THE SKIN • PAIN • LOSS OF FUNCTION • CELLULAR NECROSIS IS COMMON

13. CHRONIC INFLAMMATION • LASTS FOR LONG PERIODS OF TIME OR LIFETIME • NECROSIS NOT COMMON • EX: EMPHYSEMA, DENTAL CARIES

14. Transudates Watery serum passing through a membrane Exudates Thick cloudy, protein rich fluid INFLAMMATION FLUIDS

15. Inflammatory Lesions • Abscess • Cellulitis • Ulcers

16. REPAIR • Regeneration • Fibrous Connective Tissue

17. DEGENERATIVE DISEASE • DISEASES ARE CAUSED BY A DETERIORATION OF THE BODY • EX: OSTEOPOROSIS, OSTEOARTHRITIS, ATHEROSCLEROSIS

18. METABOLIC DISEASE • DISEASES CAUSED BY A DISTURBANCE OF THE NORMAL PHYSIOLOGICAL FUNCTION OF THE BODY. ENDOCRINE DISORDERS • EX: DIABETES

19. TRAUMATIC DISEASE • DISEASES FROM MECHANICAL FORCES • EX: FRACTURES, BRUISES

20. NEOPLASTIC DISEASE • ABNORMAL TISSUE GROWTH • BENIGN • MALIGNANT • CARCINOMA • SARCOMA • LEUKEMIAS • LYMPHOMAS

21. GROWTH DISTURBANCES • INCREASED RATE OF THE GROWTH OF CELLS (PROLIFERATION) • 2 TYPES : Hyperplasia & Hypertrophy • HYPERPLASIA – INCREASE IN THE NUMBER OF CELLS IN TISSUE – EXAGGERATED RESPONSE TO STIMULI – STOPS AFTER STIMULI IS REMOVED. EXAMPLE ? – PYLORIC STENOSIS

22. CELL GROWTH TERMS • HYPERTROPHY – INCREASED CELL SIZE • METAPLASIA – NORMAL TO ABNORMAL CELL CHANGES • DYSPLASIA – ABNORMAL DEVELOPMENT OF TISSUE

23. NEOPLASMS • NEW, ABNORMAL TISSUE GROWTH. • LESION: DESCRIBES THE MANY TYPES OF CELLULAR CHANGES IN RESPONSE TO DISEASE • ABNORMAL CELL GROWTH LEADS TO EITHER A BENIGN OR MALIGNANT TUMOR OR NEOPLASM

24. TUMORS – BENIGN/MALIGNANT • BENIGN – NONCANCEROUS, LEAST SERIOUS, BUT CAN BE FATAL ? • MALIGNANT – CANCEROUS, GROWITH UNCONROLLED

25. BENIGN NEOPLAMS • REMAIN LOCALIZED • GENERALLY NONINVASIVE

26. MALIGNANT NEOPLASM • CONTINUES TO GROW, SPREAD AND INVADE OTHER TISSUES • DIFFERENTIATED • BENIGN • UNDIFFERENTIATED • HIGHLY SUSPISIOUS

27. METASTATIC SPREAD • HEMATOGENOUS SPREAD • LYMPHATIC SPREAD • INVASION • SEEDING

28. CANCERS • CARCINOMA-EPITHELIAL TISSUE • SARCOMA-CONNECTIVE TISSUE • LEUKEMIA-BLOOD • LYMPHOMA-LYMPHATIC SYSTEM

29. BENIGN VS MALIGNANT • BENIGN = WORD ROOT IS ADDED TO “OMA” – LIPOMA • MALIGNANT = WORD ROOT IS ADDED TO “CARCINOMA” - ADENOCARCINOMA

30. STAGING OF CANCER • STAGING HELPS DETERMINE THE APPROPRIATE TREATMENT OF MALIGNANT TUMORS AND DETERMINING PROGNOSIS. • TNM SYSTEM

31. TNM • T = THE SIZE OF THE UNTREATED PRIMARY CANCER OR TUMOR • N = LYNPH NODE INVOLVEMENT • M = EXTENT OF DISTANT METASTASIS

32. Epidemiology • Measured over a period of time usually 1 year • Frequency • Incidence • Prevalence

33. QUESTIONS? • HOMEWORK ASSIGNMENT • Pathology Terms

34. DISEASE PATHOGENESIS SYMPTOM SIGNS SYNDROME ASYMPTOMATIC ETIOLOGY NOSOCOMIAL IATROGENIC ISCHEMIA IDIOPATHIC ACUTE CHRONIC DIAGNOSIS PROGNOSIS EPIDEMIOLOGY MORTALITY RATE MORBIDITY RATE INFARCT NECROSIS THROMBI/EMBOLI PATHOLOGIC TERM ACTIVITYFOR NEXT CLASS MEETING