2022
Algemene Pathologie
SAMENVATTING
-
,Inhoudsopgave
Inleiding .................................................................................................................................................................................... 7
Definitie ............................................................................................................................................................................... 7
Soorten pathologische veranderingen ......................................................................................................................... 7
Onderzoekstechnieken ................................................................................................................................................... 8
Macroscopie .................................................................................................................................................................. 8
Histologie ....................................................................................................................................................................... 8
Histochemie ................................................................................................................................................................... 8
Enzymhistochemie ........................................................................................................................................................ 8
Immunohistochemie .................................................................................................................................................... 9
TUNEL techniek ........................................................................................................................................................... 9
Scanning elektronenmicroscopie .............................................................................................................................. 9
Transmissie elektronenmicroscopie ........................................................................................................................ 9
Stofwisselingsstoornissen .................................................................................................................................................. 11
Inleiding.............................................................................................................................................................................. 11
Definities....................................................................................................................................................................... 11
Belangrijkste oorzaak/etiologie van degeneratie: hypoxidose ......................................................................... 12
Algemene noxen verantwoordelijk voor degeneratie ...................................................................................... 13
Algemene pathogenese van degeneratie............................................................................................................... 14
Cytopathologie ................................................................................................................................................................ 15
Kern ............................................................................................................................................................................... 15
Ribosomen ................................................................................................................................................................... 16
Ruw Endoplasmatisch Reticulum ............................................................................................................................ 16
Golgicomplex .............................................................................................................................................................. 16
Mitochondriën ............................................................................................................................................................. 16
Lysosomen ................................................................................................................................................................... 17
Peroxisomen................................................................................................................................................................ 18
Glad Endoplasmatisch Reticulum............................................................................................................................ 18
Cytoplasmatische Grondsubstantie ....................................................................................................................... 18
Cytoskelet .................................................................................................................................................................... 18
Plasmamembraan ........................................................................................................................................................ 19
Cytologische letsels bij hypoxidose ....................................................................................................................... 19
Celdood............................................................................................................................................................................. 20
Apoptose ...................................................................................................................................................................... 20
Necrose ........................................................................................................................................................................ 22
Apoptose vs Necrose .................................................................................................................................................... 25
1
,Dood van het individu ................................................................................................................................................... 26
Vaststellen van de dood ............................................................................................................................................ 26
Postmortale veranderingen en vaststellen van tijdstip van sterven ............................................................... 26
Pathologie van de waterhuishouding van de cel ...................................................................................................... 27
Inleiding ......................................................................................................................................................................... 27
Dehydratatie ................................................................................................................................................................ 27
Vormen van degeneratie door stoornissen in de waterhuishouding ............................................................ 27
Pathologie van de koolhydraatstofwisseling ............................................................................................................. 29
Inleiding ......................................................................................................................................................................... 29
Diabetes mellitus ........................................................................................................................................................ 29
Letsels bij ketonemie ................................................................................................................................................. 31
Myoglobinurie bij het paard ..................................................................................................................................... 31
Stapelziekten of thesaurismen van koolhydraten ............................................................................................... 32
Hypoglycemie door insulinomen ............................................................................................................................ 32
Pathologie van de vetstofwisseling.............................................................................................................................. 33
Normaal vetmetabolisme ......................................................................................................................................... 33
Stoornissen in vetresorptie en vettransport ....................................................................................................... 33
Stoornissen in vetstofwisseling van parenchymen.............................................................................................. 34
Stoornissen in stofwisseling van vetdepots .......................................................................................................... 35
Vetstapelziekten.......................................................................................................................................................... 36
Pathologie van de eiwitstofwisseling .......................................................................................................................... 37
Eiwittekort ................................................................................................................................................................... 37
Pathoproteïnemieën .................................................................................................................................................. 37
Intracellulaire eiwitstapelingen ................................................................................................................................ 37
Pigmentstofwisselingsstoornissen ............................................................................................................................... 38
Inleiding ......................................................................................................................................................................... 38
Exogene pigmenten .................................................................................................................................................... 38
Endogene pigmenten ................................................................................................................................................. 39
Pathologie van de intercellulaire matrix .................................................................................................................... 42
Proteoglycanen ........................................................................................................................................................... 42
Elastinevezels ............................................................................................................................................................... 42
Collageenvezels........................................................................................................................................................... 42
Arteriosclerose ........................................................................................................................................................... 44
Hyaliene degeneratie ................................................................................................................................................. 44
Fibrinoïde degeneratie .............................................................................................................................................. 45
Amyloïdose .................................................................................................................................................................. 45
Kraakbeenmatrix ........................................................................................................................................................ 46
2
, Beenmatrix ................................................................................................................................................................... 47
Pathologie der mineralen .............................................................................................................................................. 48
Calciumhomeostase ................................................................................................................................................... 48
Hypocalcemische tetanie .......................................................................................................................................... 48
Osteomalacie en rachitis .......................................................................................................................................... 49
Osteodystrophia fibrosa ........................................................................................................................................... 49
Fluorosis ....................................................................................................................................................................... 50
Hypervitaminose D en metastatische verkalkingen ........................................................................................... 50
Dystrofische verkalkingen ........................................................................................................................................ 50
Jicht ................................................................................................................................................................................ 51
Concrementvorming ................................................................................................................................................. 52
Stoornissen in de keratinestofwisseling..................................................................................................................... 53
Inleiding ......................................................................................................................................................................... 53
Hyperkeratose ............................................................................................................................................................ 53
Parakeratose ................................................................................................................................................................ 53
Leukoplakie .................................................................................................................................................................. 53
Circulatiestoornissen .......................................................................................................................................................... 55
Inleiding.............................................................................................................................................................................. 55
Cardiale circulatiestoornissen ..................................................................................................................................... 56
Stoornissen in het geleidingssysteem van het myocard .................................................................................... 56
Stoornissen aan het myocard .................................................................................................................................. 56
Stoornissen aan de hartkleppen.............................................................................................................................. 56
Oorzaken buiten het hart zelf gelegen.................................................................................................................. 57
Letsels bij hartinsufficiëntie ...................................................................................................................................... 57
Stase ................................................................................................................................................................................... 57
Hyperemie ........................................................................................................................................................................ 58
Arteriële hyperemie .................................................................................................................................................. 58
Veneuze hyperemie ................................................................................................................................................... 58
Hypostase ..................................................................................................................................................................... 59
Anemie .............................................................................................................................................................................. 59
Definitie ........................................................................................................................................................................ 59
Vormen ......................................................................................................................................................................... 59
Letsels bij anemie ....................................................................................................................................................... 59
Ischemie............................................................................................................................................................................. 60
Definitie ........................................................................................................................................................................ 60
Oorzaken...................................................................................................................................................................... 60
Gevolgen....................................................................................................................................................................... 60
3
Algemene Pathologie
SAMENVATTING
-
,Inhoudsopgave
Inleiding .................................................................................................................................................................................... 7
Definitie ............................................................................................................................................................................... 7
Soorten pathologische veranderingen ......................................................................................................................... 7
Onderzoekstechnieken ................................................................................................................................................... 8
Macroscopie .................................................................................................................................................................. 8
Histologie ....................................................................................................................................................................... 8
Histochemie ................................................................................................................................................................... 8
Enzymhistochemie ........................................................................................................................................................ 8
Immunohistochemie .................................................................................................................................................... 9
TUNEL techniek ........................................................................................................................................................... 9
Scanning elektronenmicroscopie .............................................................................................................................. 9
Transmissie elektronenmicroscopie ........................................................................................................................ 9
Stofwisselingsstoornissen .................................................................................................................................................. 11
Inleiding.............................................................................................................................................................................. 11
Definities....................................................................................................................................................................... 11
Belangrijkste oorzaak/etiologie van degeneratie: hypoxidose ......................................................................... 12
Algemene noxen verantwoordelijk voor degeneratie ...................................................................................... 13
Algemene pathogenese van degeneratie............................................................................................................... 14
Cytopathologie ................................................................................................................................................................ 15
Kern ............................................................................................................................................................................... 15
Ribosomen ................................................................................................................................................................... 16
Ruw Endoplasmatisch Reticulum ............................................................................................................................ 16
Golgicomplex .............................................................................................................................................................. 16
Mitochondriën ............................................................................................................................................................. 16
Lysosomen ................................................................................................................................................................... 17
Peroxisomen................................................................................................................................................................ 18
Glad Endoplasmatisch Reticulum............................................................................................................................ 18
Cytoplasmatische Grondsubstantie ....................................................................................................................... 18
Cytoskelet .................................................................................................................................................................... 18
Plasmamembraan ........................................................................................................................................................ 19
Cytologische letsels bij hypoxidose ....................................................................................................................... 19
Celdood............................................................................................................................................................................. 20
Apoptose ...................................................................................................................................................................... 20
Necrose ........................................................................................................................................................................ 22
Apoptose vs Necrose .................................................................................................................................................... 25
1
,Dood van het individu ................................................................................................................................................... 26
Vaststellen van de dood ............................................................................................................................................ 26
Postmortale veranderingen en vaststellen van tijdstip van sterven ............................................................... 26
Pathologie van de waterhuishouding van de cel ...................................................................................................... 27
Inleiding ......................................................................................................................................................................... 27
Dehydratatie ................................................................................................................................................................ 27
Vormen van degeneratie door stoornissen in de waterhuishouding ............................................................ 27
Pathologie van de koolhydraatstofwisseling ............................................................................................................. 29
Inleiding ......................................................................................................................................................................... 29
Diabetes mellitus ........................................................................................................................................................ 29
Letsels bij ketonemie ................................................................................................................................................. 31
Myoglobinurie bij het paard ..................................................................................................................................... 31
Stapelziekten of thesaurismen van koolhydraten ............................................................................................... 32
Hypoglycemie door insulinomen ............................................................................................................................ 32
Pathologie van de vetstofwisseling.............................................................................................................................. 33
Normaal vetmetabolisme ......................................................................................................................................... 33
Stoornissen in vetresorptie en vettransport ....................................................................................................... 33
Stoornissen in vetstofwisseling van parenchymen.............................................................................................. 34
Stoornissen in stofwisseling van vetdepots .......................................................................................................... 35
Vetstapelziekten.......................................................................................................................................................... 36
Pathologie van de eiwitstofwisseling .......................................................................................................................... 37
Eiwittekort ................................................................................................................................................................... 37
Pathoproteïnemieën .................................................................................................................................................. 37
Intracellulaire eiwitstapelingen ................................................................................................................................ 37
Pigmentstofwisselingsstoornissen ............................................................................................................................... 38
Inleiding ......................................................................................................................................................................... 38
Exogene pigmenten .................................................................................................................................................... 38
Endogene pigmenten ................................................................................................................................................. 39
Pathologie van de intercellulaire matrix .................................................................................................................... 42
Proteoglycanen ........................................................................................................................................................... 42
Elastinevezels ............................................................................................................................................................... 42
Collageenvezels........................................................................................................................................................... 42
Arteriosclerose ........................................................................................................................................................... 44
Hyaliene degeneratie ................................................................................................................................................. 44
Fibrinoïde degeneratie .............................................................................................................................................. 45
Amyloïdose .................................................................................................................................................................. 45
Kraakbeenmatrix ........................................................................................................................................................ 46
2
, Beenmatrix ................................................................................................................................................................... 47
Pathologie der mineralen .............................................................................................................................................. 48
Calciumhomeostase ................................................................................................................................................... 48
Hypocalcemische tetanie .......................................................................................................................................... 48
Osteomalacie en rachitis .......................................................................................................................................... 49
Osteodystrophia fibrosa ........................................................................................................................................... 49
Fluorosis ....................................................................................................................................................................... 50
Hypervitaminose D en metastatische verkalkingen ........................................................................................... 50
Dystrofische verkalkingen ........................................................................................................................................ 50
Jicht ................................................................................................................................................................................ 51
Concrementvorming ................................................................................................................................................. 52
Stoornissen in de keratinestofwisseling..................................................................................................................... 53
Inleiding ......................................................................................................................................................................... 53
Hyperkeratose ............................................................................................................................................................ 53
Parakeratose ................................................................................................................................................................ 53
Leukoplakie .................................................................................................................................................................. 53
Circulatiestoornissen .......................................................................................................................................................... 55
Inleiding.............................................................................................................................................................................. 55
Cardiale circulatiestoornissen ..................................................................................................................................... 56
Stoornissen in het geleidingssysteem van het myocard .................................................................................... 56
Stoornissen aan het myocard .................................................................................................................................. 56
Stoornissen aan de hartkleppen.............................................................................................................................. 56
Oorzaken buiten het hart zelf gelegen.................................................................................................................. 57
Letsels bij hartinsufficiëntie ...................................................................................................................................... 57
Stase ................................................................................................................................................................................... 57
Hyperemie ........................................................................................................................................................................ 58
Arteriële hyperemie .................................................................................................................................................. 58
Veneuze hyperemie ................................................................................................................................................... 58
Hypostase ..................................................................................................................................................................... 59
Anemie .............................................................................................................................................................................. 59
Definitie ........................................................................................................................................................................ 59
Vormen ......................................................................................................................................................................... 59
Letsels bij anemie ....................................................................................................................................................... 59
Ischemie............................................................................................................................................................................. 60
Definitie ........................................................................................................................................................................ 60
Oorzaken...................................................................................................................................................................... 60
Gevolgen....................................................................................................................................................................... 60
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