3) Morphology of general atrophy (cachexia, exhaustion):

sharp emaciation, lack of subcutaneous fat, brown color of subcutaneous fat due to lipochrome

muscles are atrophic, skin is dry, flabby, osteoporosis

the internal organs are reduced in size

the phenomena of brown liver and myocardial atrophy (due to the accumulation of lipofuscin in cells)

atrophy and dystrophy of the endocrine glands

areas of dead neurons in the brain

4) Types of local atrophy:

1. Dysfunctional A. (from inaction): muscle atrophy in case of limb fracture, optic nerve after eye removal, edges of the dental cell after tooth extraction - the intensity of metabolism, the amount of blood and nutrients flowing in are reduced

2. A. from insufficient blood supply: atherosclerosis of the coronary arteries  myocardial atrophy; hypoxia  dystrophy of parenchymal cells, stimulation of fibroblast proliferation  sclerosis

3. A. from pressure: violation of the outflow of urine and the transformation of the kidney into a thin-walled bag of urine (hydronephrosis); based on insufficient blood flow due to compression of blood vessels

4. Neurotic A.: death of motor neurons sp/m or destruction of nerve trunks  muscle atrophy (in polio) due to trophic disorders, proliferation of connective and adipose tissue instead of muscles (false hypertrophy)

5. A. under the influence of physico-chemical factors: ionizing radiation  bone marrow atrophy; GCS  atrophy of the adrenal cortex

Morphology of the local a.: more often the organ is reduced, the surface is smooth (smooth atrophy), less often granular (granular atrophy); sometimes the organ is enlarged (hydronephrosis, hydrocephalus, false hypertrophy), but not at the expense of parenchyma

4. The significance and outcomes of atrophy:

1. reversible in the initial stages after the elimination of the causal factor

b) far-reaching atrophic phenomena are irreversible

90. Hypertrophy: definition of the concept, types, macro- and microscopic changes in organs, examples of diseases.

1) Hypertrophy is an increase in the volume and mass of an organ.

Types :

1. true - an increase in mass due to an increase in the number of functioning cells

b) false — an increase in an organ due to an increase in connective tissue, adipose tissue, blood vessels.

Types of true hypertrophy:

1. working (compensatory)

2. vicarious (substitutive)

3. neurohumoral

4. hypertrophic growths.

Causes of hypertrophy:

1. increased functional load on the organ

2. as compensation for the removal of one of the paired organs

3. violation of neurohumoral regulation

4. chronic inflammation

5. impaired lymph circulation, etc.

2) Morphology of various types of hypertrophy:

1. Working (compensatory) - with increased work of one or another organ (hypertrophy of the heart in malformations, hypertension; hypertrophy of the bladder in prostate adenoma).

Concentric myocardial hypertrophy is a compensated condition due to hypertrophy of muscle fibers, eccentric hypertrophy occurs during decompensation, eccentric hypertrophy and decompensation of cardiac activity occur (general venous fullness).

2. Vicarious (substitution) - hypertrophy of the second paired organ when the first one is removed or when part of the organ is removed.

3. Neurohumoral (correlative):

a) uterine enlargement during pregnancy is a physiological process

b) glandular cystic endometrial hyperplasia in ovarian dysfunction, menopause (precancerous process)

c) gynecomastia (enlargement of the mammary glands in men) with testicular atrophy

d) acromegaly - an increase in organs and protruding parts of the skeleton with an increase in STH production

4. Hypertrophic growths:

a) polyps, warts on mucous membranes with chronic inflammation

b) elephantiasis in case of impaired lymph circulation

c) partial or complete atrophy of the organ and the development of false hypertrophy: with diabetes, adipose tissue grows between the lobules of the pancreas, with a decrease in pressure in the vessels, their intimacy grows

3) Organization - replacement of a site of pathological changes (necrosis, tissue defect, thrombus or fibrinous exudate) with connective tissue, which leads to sclerosis.

Sclerosis is a diffuse or focal compaction of internal organs and blood vessels due to excessive overgrowth of dense connective tissue.

Morphology of the organization:

a) the actual organization is the replacement of a site of necrosis or thrombotic masses of young connective tissue and its subsequent transformation into scar tissue

b) encapsulation - the proliferation of connective tissue around dead parasites, foreign bodies, necrotized tissue that has undergone petrification

4) Tissue restructuring - structural changes in tissues (hyperplasia, regeneration, accommodation) during the development of adaptive reactions:

a) obstruction of blood flow in the main arteries; collateral circulation (dilation of the vascular lumen, thickening of the walls due to hypertrophy of muscle and newly formed elastic fibers)

b) restructuring of the spongy substance in the bones when the direction of the load on the bone changes (in case of fracture, rickets)

c) histological accommodation (reconstruction of tissue under changed conditions of its existence): cessation of air access in the lungs in areas of atelectasis  the flattened alveolar epithelium becomes cubic

5) Metaplasia is the transition of one type of tissue to another, related to it, within one germ leaf. It always occurs with the previous proliferation of undifferentiated cells (i.e. it is NOT DIRECT):

a) chronic inflammation of the respiratory tract, hypovitaminosis a  the transition of the prismatic epithelium to the flat bronchi (reverse transition - prosoplasia)

b) chronic gastritis  metaplasia of the gastric epithelium into the intestinal epithelium (enterolysis of the gastric mucosa)

c) metaplasia of connective tissue in cartilage or bone - in scars, aortic wall in atherosclerosis, in the capsule of healed foci of primary tuberculosis

d) myeloid metaplasia of the spleen, L.U., extramedular foci of hematopoiesis are also a special type of metaplasia.