Fundamentals of general human pathology. The meaning of the word pathology

Anokhin Yu.N.

BASICS OF GENERAL HUMAN PATHOLOGY

(Teaching about illness)

Obninsk 2010

1.Basic provisions general pathology person

2. The doctrine of causation in pathology (Etiology of diseases)

2.1. Reactivity of the body in pathology

3. Pathogenesis and sanogenesis of diseases

4. Adaptation for pathology

4.1. Compensatory and adaptive processes in illness.

5. Pathology at the cellular level.

5.1 Dystrophy

5.2 Atrophy

5.3 Necrosis

5.4 Apoptosis

6.Typical pathological processes

6.1.Inflammation

6.2.Blood coagulation disorders. Thrombosis and DIC syndrome

6.3. Tumor process

6.4.Swelling

6.5.Fever

6.6. Infectious process. Sepsis

6.7.Pathology of immunity

6.8.Allergies

6.9. Autoimmune conditions

1. Basic principles of general human pathology

General human pathology is a fundamental branch of medicine that studies the patterns of occurrence, development and completion of life disorders, i.e. diseases. Thus, general pathology serves as the scientific foundation of medicine, analyzing disorders of functioning and structure and their manifestations at all levels of organization of living matter - from the molecular to the whole organism. General pathology studies the patterns of occurrence and development of deviations from the norm, identifies typical forms of disease processes.

The connection between structure and function in the study of disease is the most important philosophical category in medicine. With any pathological process, structural and functional changes appear and there is always a cause-and-effect relationship between these phenomena. Here it is important to understand the basic concepts - what is meant by the terms “structure” and “function” in biology and medicine?

Biological structure is a living material system or part of it organized in space that ensures the performance of some activity (molecule, organelle, cell, organ, system, organism).

Biological function– this is an activity, i.e. a change in time in the state or properties of a living system or part of it, aimed at obtaining a result useful for it and self-preservation.

The concept of “disease” focuses on all the main problems of the theory and practice of medicine. Illness must be analyzed together with health, since both of these phenomena are nothing more than two forms of one essence - life. Adaptation processes take place in both healthy and sick bodies. Only in healthy body they prevent the occurrence and development of the disease and maintain health. In a sick body, adaptive processes prevent its death and are aimed at recovery. Insufficient adaptation reserves lead to illness and death of the body. Both health and illness characterize the state of the body as a whole.

However, illness and health are opposite phenomena, since they are characterized by peculiarities of the course and development of adaptation processes. In a healthy body, all processes have a beneficial result, ensuring successful existence in changing conditions. In case of illness, in addition to the beneficial result, it is possible to develop negative result adaptation. There are many examples of this among typical pathological processes: tissue necrosis, malignant growth, scarring. That is, typical pathological processes can lead not only to recovery, but also cause damage and aggravate the disease process.

According to WHO (World Health Organization) definition, “ Health–it is a state of physical, spiritual and social well-being, and not just the absence of disease and physical defects.”

In contrast to this, disease–is a form of life that arises as a result of the interaction of pathogenic factors and the body and is characterized by damage to metabolic processes, structure and function of organs and systems, as well as the development of adaptive reactions to eliminate damaging factors and disorders.

During evolution, disease is one of the methods of natural selection that removes a poorly adapted individual (or individual) and thereby ensures inheritance best properties adaptation. The most significant contribution to the understanding of disease as a form of life was made by the great Russian pathologist Academician I.V. Davydovsky.

Fig. 1 DavydovskyIppolit Vasilievich

(1887-1968)

Famous Russian pathologist,

Academician of the USSR Academy of Medical Sciences

In general pathology, several other key concepts of disease state are often used. These are such as:

-nosological form of the disease- a type of disease that distinguishes it from other diseases by etiology, pathogenesis and a set of changing indicators, such as syndromes, symptoms, outcomes,

- symptoms– visible (objectively determined) signs of the disease, syndromes- a collection of interrelated symptoms

- stages development of the disease – latent (incubation), prodromal (initial symptoms), clinically expressed and outcome stage. The outcome of the disease can be favorable (recovery) or unfavorable (end in death),

-recovery– the process of normalization of life, accompanied by the elimination of disorders and restoration of adaptation of the body. Recovery is never a return to original state; During recovery, the body acquires new properties,

-relapse(return) – resumption of the same disease after recovery as a result of weakening of the body’s adaptive potential,

-diagnosis– a brief definition of the patient’s disease, its complications and outcomes, formulated on the basis of observations, complaints of the patient and the results of objective research methods.

In the study of illness, an important place is occupied by typical pathological processes– stereotypically occurring general pathological processes that have developed evolutionarily, become entrenched and improved, ensuring the adaptation and survival of species. Typical pathological processes are characterized by such general features as stereotypical manifestations, high prevalence and a wide range of etiological factors. These include regeneration (hyperplasia), hypertrophy

fiyu, thrombosis, inflammation, fever, immunity, infectious process, hypoxia, edema, tumor process. Typical processes underlie many diseases, so in the following presentation they will be presented in more detail.

Security questions:

1. Define the concepts of “human health” and “disease”.

2.Define the differences between health and disease states.

3. What is biological function and biological structure?

4. Define the concepts - symptom, nosological form of the disease, diagnosis.

5.What are typical pathological processes? Name them.

From normal condition or development process.

• ru (med.)
• It should be noted that the word " pathology" also denote any deviation from the norm.
• Spotting in the middle of the cycle is pathology, quite common in many women of all ages.
• Degree of expression pathology Fetal development may be different.

Synonyms for pathology

• • disease

Hyponyms for pathology

• • echopathology

Hypernyms for pathology

• • violation
  • deviation

The term "pathology" has two main meanings. The first is a synonym for disease, a painful condition, a deviation from the norm. In the second case, pathology is deviations; it has many sections and narrower areas dealing with specific organs or organ systems. There are also related disciplines: pathological anatomy, pathophysiology, histology and others.

In a general sense, this term is used in the first meaning, as a synonym for the words “disease” or “painful condition.” In this meaning, a distinction is made between congenital and acquired abnormalities. In the first case, violations occur at the stage of formation or intrauterine development, and in the second - during life.

As a rule, congenital pathology is the object of study, first of all, of prenatal and perinatal diagnosis, that is, problems are identified during pregnancy and immediately after birth. Serious disorders are detected in the first or early second trimester. In many cases, even before they are detected or even before the fact of pregnancy is established, its spontaneous termination occurs. Most often this indicates gross chromosomal abnormalities, but sometimes it indicates problems in the acquired pathology may be due to diseases in more or less mature age- as a result of exposure various kinds factors. These include injuries, influence chemicals, previous diseases, etc.

In general, “pathology” is one of the most popular terms in medicine. It can relate to any section: neurology, orthopedics, surgery, gastroenterology, gynecology, pediatrics, psychiatry, and so on. In pathology, as in science, there are also several specialized sections that deal, for example, only with cell dysfunction or explain the occurrence of diseases by changes in the internal environment of the body; some disciplines even study the occurrence of diseases at the molecular level.

There is even experimental pathology: this area deals with modeling various processes and conditions in animals. So this section of medicine is distinguished by a variety of areas.

Treatment of pathologies is carried out by medical specialists depending on what symptoms the patient experiences. There is one subtlety: due to various factors The concept of the norm is changing, and in medicine such changes occur quite quickly and often. What was considered a serious pathology a couple of decades ago may now be a variant of the norm. On the other hand, if a deviation from the norm can be treated, why not get rid of it, even if it is not

interferes?

By the way, “pathology” is a term used not only in medicine. For example, this concept is used in sociology to designate painful processes in society, which indicates its ill health. For example, this is what they call human actions and types of behavior that society perceives as immoral and harmful - alcoholism, drug addiction, crime, etc. Such phenomena weaken the functioning of society and therefore need to be counteracted.

So there is no need to be alarmed when you read the word “pathology” in a medical record or doctor’s note, because in many cases it is just a synonym for the term “disease.”

I. Subject of pathology.

Pathology (general pathology)- the doctrine of disease, combines pathophysiology and pathological anatomy, is the foundation of medicine. The term "pathology" is often used to refer to disability and disease. In this sense, the terms “pathological” and “morbid” are identical.

Pathophysiology- the science of the patterns of occurrence, development and outcome of diseases. Pathophysiology studies the causes and conditions for the occurrence of diseases (etiology), mechanisms of their development (pathogenesis) and recovery (sanogenesis).

Components of pathophysiology:

1. General pathophysiology (includes nosology- general doctrine of illness, general etiology and general pathogenesis of diseases and section - typical pathological processes).

2. Particular pathophysiology organs and systems.

3. Clinical pathophysiology - applied discipline dealing with information technology
the use of pathophysiological patterns in clinical settings for inter
presentation of laboratory and instrumental research data.

Pathological anatomy- a branch of pathology that studies the structural (morphological) manifestations of diseases. In practical medicine, a pathologist examines the corpses of the dead to determine the cause of illness and death.

//. Modern concept norms and health.

IN explanatory dictionary S.I.Ozhegova and N.Yu.Shvedova norm interpreted as a standard, typical option, ideal example. Pathology is usually viewed as the opposite of normal. In medicine, there are three main approaches to determining the norm.

1. Average norm is based on the establishment of average values ​​by statistical methods various indicators, characteristic of healthy people. In this way, normal values ​​were obtained blood pressure, pulse, body weight, blood glucose concentration, erythrocyte and leukocyte content in the blood and other indicators of homeostasis. Most often, the average statistical norm is given in the form of tables (nomograms) from which the spread can be determined normal values parameter (for example, vital capacity of the lungs) based on the gender, height, age and other properties of the subject. Another option is mathematical formulas for calculating normal indicators. For example, the indices are well known normal weight bodies calculated based on height and gender (Brock's indices And Quetelet).

2. Individual norm. This approach is the opposite of the previous one and consists in idealizing individuality. According to R. Williams (1960), every person is a deviation from the norm. Studying biochemical features healthy individuals, the author noted the presence of variations in individual indicators up to 800% (for the concentration of some amino acids in the blood) And even up to 5000% (for the level of many blood enzymes). Therefore, it can be argued that each person is healthy in his own way. This approach requires the physician to take individuality into account in the diagnostic and treatment process. However, it is obvious that the individual norm cannot be used as a basis for diagnosing diseases, since there are no criteria for its assessment. ^

3. Optimal rate. This approach is based on the idea of ​​statistically establishing the values ​​of parameters at which morbidity and mortality are minimal. For example, obesity and high concentrations of cholesterol in the blood are unfavorable, as they increase the risk of death from heart disease (Fig. 1.1). But this does not mean that it is necessary to achieve a minimum concentration of cholesterol in the blood, since this, in turn, increases the risk of death from malignant tumors.

Figure 1.1. Development risk cardiovascular diseases in men, depending on each individual risk factor and their combination [Kappe1 ^.B. Pruepyue karsIo1o§y. Rose1§ha€1 My 1977;61: 71-85]

Note: values ​​outside the normal range are in dark cells.

Therefore, there is some optimal value cholesterol concentration (optimal norm), which minimizes the risk of loss of health and death. In practical medicine, the optimal norm is used quite rarely, since its establishment requires large number expensive mass examinations.

Health. Most scientists agree that currently there is no universal definition of the concept of “health”. Among the various formulations proposed, several fundamentally different ones can be identified.

1. Health as the norm. It is based on the identification of the concept of “health” with the concept of “norm”. With this approach, health is considered as the absence of significant deviations from the norm of basic vital important indicators,

2. Health as the absence of disease. Traditionally, individual health is assessed mainly from the perspective of the presence or absence of certain diseases in a person, pathological abnormalities, physical defects. IN in this case health and illness are seen as mutually exclusive concepts. In practice, this approach is most often used by doctors. What does a doctor do when he tries to determine whether a person is healthy? It more or less consistently and systematically excludes diseases. If no disease is detected, the person is healthy.

3. Health as successful adaptation. This approach to the concept of individual health arose in the 60s of the last century. The definitions of the concepts of “health” and “disease” from the perspective of this approach are based on ideas about adaptation. The transition from health to illness is considered in this case as a process of reducing the degree of adaptation of the body to environmental conditions, the result of insufficiency of adaptation mechanisms, their exhaustion and failure [Meyerson F.Z., 1973; Kaznacheev V.P., Baevsky R.M., 1980].

Health from the point of view of adaptation theory can be characterized by successful adaptation of the body to natural life situations or standardized conditions of special tests. Most of the methods currently proposed for assessing health are based specifically on assessing adaptive capabilities various systems body.

4. Health as well-being. This approach is most fully reflected in the distribution
the vague definition of the concept of “health” given by WHO back in 1946 “... the health of

"should be understood as a state of complete physical, mental and social well-being, and not merely as the absence of disease or physical defects."

4. Three-dimensional health model. This model is based on ideas about the multidimensionality of health [Kulikov V.P., 2000]. Attempts to assess health on the basis of a one-dimensional model, most often based on the physical parameters of the body, cannot claim sufficient depth and reliability. The three-dimensional model (Fig.2) considers health in three dimensions: quantity of life, quality of life and freedom of life.