Trauma & Cell Injury

TRAUMA & CELL INJURY
Dr. Nadia Arif

Assistant Professor Pathology
FUMC/FFH
CELL INJURY
Definition:
variety of stresses a cell encounters as a result
of changes in its internal and external
environment
Cell injury is usually reversible up to a certain point, after

which irreversible cell injury and death occur.
CELL INJURY
CELL INJURY
CELL INJURY
CELL INJURY
Causes of Cell Injury:
1. Injury from physical agents
2. Radiation injury
3. Chemical injury
4. Injury from biologic agents
5. Injury due to abnormal immunological
reactions
6. Injury from nutritional imbalances
CELL INJURY
CELL INJURY
 Injury from Physical Agents
1. Mechanical Forces: Injury or trauma due to
mechanical forces occurs as the result of body
impact with another object.
These types of injuries split and tear tissue,
fracture bones, injure blood vessels, and
disrupt blood flow.
2. Extremes of Temperature: Extremes of heat
and cold cause damage to the cell, its
organelles, and its enzyme systems.
CELL INJURY
Exposure to heat:
causes cell injury by inducing vascular injury,
accelerating cell metabolism, inactivating temperature-
sensitive enzymes, and disrupting the cell membrane.
With more intense heat, coagulation of blood vessels and
tissue proteins occurs.
Exposure to cold:
increases blood viscosity and induces vasoconstriction
by direct action on blood vessels and through reflex
activity of the sympathetic nervous system. The resultant
decrease in blood flow may lead to hypoxic tissue injury,
depending on the degree and duration of cold exposure.
CELL INJURY
3. Electrical Injuries:
extensive tissue injury and disruption of neural
and cardiac impulses. Voltage, type of current,
amperage, pathway of the current, resistance
of the tissue, and interval of exposure
determine the effect of electricity on the body.
In electrical injuries, the body acts as a
conductor of the electrical current.
CELL INJURY
 Radiation Injury
Ionizing Radiation: Ionizing radiation impacts cells by
causing release of free radicals that destroy cells and by
directly hitting the target molecules in the cell. It can
immediately kill cells, interrupt cell replication, or cause a
variety of genetic mutations, which may or may not be
lethal.
Damage depends on
a. dose rate (a single dose can cause greater injury than
divided or fractionated doses)
b. the differential sensitivity of the exposed tissue to
radiation injury.
CELL INJURY
 Ultraviolet Radiation. Ultraviolet radiation
causes sunburn and increases the risk of skin
cancers. The degree of risk depends on the
type of UV rays, the intensity of exposure,
and the amount of protective melanin
pigment in the skin.
CELL INJURY
 Nonionizing Radiation:
Nonionizing radiation includes infrared light,
ultrasound, microwaves, and laser energy.
Unlike ionizing radiation, which can directly
break chemical bonds, nonionizing radiation
exerts its effects by causing vibration and
rotation of atoms and molecules.
CELL INJURY
 Chemical Injury:
Chemicals include
1. Tobacco smoke and some processed or preserved foods.
2. Gases such as carbon monoxide
3. Insecticides
4. Trace metals such as lead
5. Drugs: alcohol, antineoplastics,

immunosuppressants,acetaminophen
Chemical agents can injure the cell membrane and other
cell structures, block enzymatic pathways, coagulate cell
proteins, and disrupt the osmotic and ionic balance of the
cell.
CELL INJURY
 Lead Toxicity:
Lead is a particularly toxic metal
Sources include flaking paint, lead-contaminated dust
and soil, lead-contaminated root vegetables, lead
water pipes or soldered joints, pottery glazes,
newsprint and toys
Leadinactivate enzymes, compete with calcium for
incorporation into bone, and interfere with nerve
transmission and brain development. The major
targets of lead toxicity are the red blood cells, the
gastrointestinal tract, the kidneys, and the nervous
system.
CELL INJURY
Injury from biologic agents
CELL INJURY
 Injury from biologic agents:
• they are able to replicate and can continue to produce
their injurious effects
• range from submicroscopic viruses to the larger
parasites
• Viruses enter the cell and become incorporated into
its DNA synthetic machinery
• Certain bacteria elaborate exotoxins that interfere
with cellular production of ATP
• Other bacteria, such as the gram-negative bacilli,
release endotoxins that cause cell injury and increased
capillary permeability
CELL INJURY
CELL INJURY
 Injury from nutritional imbalances:
HYPOXIC CELL INJURY
• Hypoxia deprives the cell of oxygen and
interrupts oxidative metabolism and the
generation of ATP
• Produces irreversible cell damage
• Depends on the degree of oxygen deprivation
and the metabolic needs of the cell. Some cells,
such as those in the heart, brain, and kidney,
require large amounts of oxygen to provide
energy to perform their functions. Brain cells, for
example, begin to undergo permanent damage
after 4 to 6 minutes of oxygen deprivation
MECHANISM OF CELL INJURY
 Three major mechanisms whereby most
injurious agents exert their effects are:
1. Free radical formation
2. Hypoxia and ATP depletion
3. Disruption of intracellular calcium
homeostasis
MECHANISM OF CELL INJURY
Types of Cell Injury
1. Reversible
2. Irreversible
Types of Cell Injury
 Cell injury is classified as reversible if the injured
cell can regain homeostasis and return to a
morphologically (and functionally) normal state
 Severe or persistent injury can overwhelm the
cell's capacity to restore homeostasis, in which
case potentially reversible acute cell swelling can
become irreversible and progress to cell death
 The morphologic features of cell death change
with the passage of time and depend on the
manner of death (oncotic necrosis versus
apoptosis) and the type of cell or tissue

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TRAUMA & CELL INJURY

Dr. Nadia Arif

Cell injury is usually reversible up to a certain point, after

2. Gases such as carbon monoxide

4. Trace metals such as lead

5. Drugs: alcohol, antineoplastics,

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