Vinnytsya National Pirogov Memorial Medical University Pathophysiology Department Lecture: Subject and task of the pathophysiology. Etiology. Pathogenesis. PhD., Viсtoriya Piliponova

Pathophysiology is the science which studies the vital functions of a sick organism. Pathophysiology studies the basic rules of origin, development and outcomes of a disease. Pathophysiology studies why and in which way a disease develops.

Parts of the pathophysiology: Disease and a sick organism are the objects of pathophysiology. Parts of the pathophysiology: common studies about a disease II. typical pathological processes III. pathophysiology of organs and systems.

Methods of pathophysiology are: Experimental method 2.The method of mathematical modeling 3. The evolutional method 4.The method of clinical observation

Experimental method

A disease is the state of an organism, which emerges as a result of external environmental factors injuring action, characterized by the decrease of its adaptation possibilities and capacity.

The pathological reaction is a transitory, extraordinary, inadequate answer of an organism or its systems to the different irritants action. The pathological process is the regularly emerging sequence of changes in the organism, which is related to the injuring action of the pathogenic factor.

The pathological condition - is a stable (durable) deviation from the normal structure and function of an organ or a tissue that has a biologically negative significance for the organism

Classification of a diseases : By etiology: infectious noninfectious By pathogenetic classification : allergic diseases tumors inflammatory diseases By topographical - anatomic principle: diseases of the heart the kidneys the lungs troubles.

By the topographical - functional classification diseases of the cardiovascular system the urinary system the respiratory system the nervous system the blood system According to the age and sex children diseases, new-born diseases, gerontological diseases, gynecologycal diseases, males’ diseases. The ecological classification tropical diseases diseases of the extremal north The clinical course classification acute (last up two weeks) subacute (2-6 weeks) chronic diseases (more than 6 weeks).

PERIODS OF A DISEASE The latent period (incubation period) It lasts from the moment of the cause action until the appearance of the first clinical signs of a disease. The prodromal period – lasts from the moment of the appearance of the first clinical signs till the general symptoms of a disease, nonspecific for different diseases The period of the marked manifestation of a disease is the appearing of typical clinical symptoms of the concrete a disease.

Outcomes of a disease Recovering is the process (complete and incomplete) Transition in the chronic form 3.Complication 4. Disability. 5. Death

Terminals stages Preagony - inhibition of the brain work’s, dizziness of consciousness, decrease of reflexes, tachypnea, the arterial hypotension, tachycardia, acidosis. Agony (from Greek „fight”) – is characterized by the gradual ceasing of all the organism functions and extraordinary tension of protective mechanisms which become purposeless.

The clinical death (lasts 4-6 min The clinical death (lasts 4-6 min.) - is reversible ceasing of the organism as the integral system vital functions. The biological death is the irreversible ceasing of the organism as integral system vital functions.

Reanimation is the complex resuscitation measures which are directed at the renewal of the vitally important functions of the organism, first of all the blood circulation and breathing. V.O. Negovskij is the founder of reanimatology. Pathophysiological principles of reanimation cover three stages: Restoring 2. Substitution 3. Support  

Etiology is the science that studies causes and conditions of the diseases development. Classification of etiologic factors: According to their origin: external and internal. 1) The external (exogenous) reasons are: mechanical; physical; chemical; biological; psychical. 2) The internal (endogenous) reasons are: inherited constitution; age; sexual and others.

Pathogenesis - is the study about the origin mechanisms, development and outcomes of diseases. The role of etiologic factor in pathogenesis - the nature of an etiologic factor; - its intensity and duration of an action; - the time of interaction of an etiologic factor with an organism; - the conditions under which it acts on an organism; -the state of an organism; - localization of the primary action of an etiologic factor (e. g. the consequences of tromboembolism substantially depends on its localization).

The role of etiologic factor in pathogenesis - the nature of an etiologic factor; - its intensity and duration of an action; - the time of interaction of an etiologic factor with an organism; - the conditions under which it acts on an organism; -the state of an organism; - localization of the primary action of an etiologic factor

Causality-effective relations. A direct type: when one cause leads to one consequence. Pathogenesis develops on a straight line.  

Causality-effective relations. Convergence is the type of causality- effective relations when a few different links of pathogenesis lead the development of one consequence. Histamine Serotonin Prostaglandins Arterial hyperemia Kinins  

Causality-effective relations. Divergence when one link of pathogenesis results in development of many consequences. carbohydrate metabolism Deficit of insulin protein metabolism in diabetes mellitus lipid metabolism results in disorders of the: water-salt metabolism acid-base state  

The main link of pathogenesis is the process without which all the cause-consequences interrelations do not take place. Liquidation of the pathogenesis the main link results in liquidation of the pathological process itself. Principle of the pathogenetic treatment is based on liquidation of the pathogenesis main link. So, in diabetes mellitus the deficit of insulin is the main link of pathogenesis. The injection of insulin results in disappearance of hyperglycemia.

Vicious circle Is the type of causality- effective relations, in which a certain link of pathogenesis strengthens itself through a certain sequence of events.  

Hypoxia tachypnea ↓respiratory volume diminishing of the minute volume of breathing  

for the pathogenetic treatment; for the prognosis of a disease. The significance of the common study of the pathogenesis for the practical medicine the knowledge of pathogenesis is necessary: for making a correct diagnosis; for the pathogenetic treatment; for the prognosis of a disease.