Pathophysiology

EXTREME CONDITION CAUSED

External factor

Introduction
Various environmental factors, or "extraordinary stimuli that constantly faced man can have pathogenic effects on the human body. These environmental factors may be mechanical, physical, chemical, biological, psychological. Pathogenic effects of such environmental factors occurs when the superiority of force of their impact on the body's ability to adapt, as well as in cases of a change in its reactivity. Moreover the degree of virulence of their relative and depends on the conditions associated external and internal environment of the body. The impact of all these effects on humans occurs in specific social conditions of existence, which have a large and often decisive significance in the occurrence of diseases.
It is important to identify the main conceptual idea disease and health, and adaptability of the human body. This is due to the fact that the disease is a new quality of a particular form of life of the organism. Disease, human interaction is a dialectical emergency stimulus, certain conditions and reactivity. Pathogenic environmental factors influence the overall reactivity and, above all, on its neurohumoral system, which determines the functional state of the activity and the degree of protective-adaptive and compensatory reactions. Depending on the cause of the disease, the reactivity of the organism and the environment in which there is a disease created by a combination of a variety of disorders, or a combination of functions and structure of cells, tissues, organs and regulate their systems.
In this paper, we consider the external pathogenic factors, such as (physical, mechanical and chemical) factors.
Virulence IMPACT

MOTOR FACTORS

Mechanical energy has on the body and damaging pathogenic action depending on the size and nature of the energy supplied physiological, physical, chemical and mechanical properties and the state of tissues and organs, subjected to the action of this energy.

Elasticity or elastic strain is called a property called material his property to be returned to its original state. The coefficient of elasticity (Young's modulus) haizes stiffness of the material, ie, its ability to resist deformation, and is given by E = v / E, where E - Young's modulus, the tensile stress, e - elongation.
a) Sprains and fractures. Elasticity and extensibility of tissues vary considerably in pathological processes. Thus, inflammation of tissue break easier when applying less tearing strength than healthy tissue. The bones of the old man who had lost elasticity due to calcification, broken by the action of a lesser tensile strength.
Sudden stretching may occur in combat and domestic trauma (separation of parts of the body, limbs, etc.) are destroyed when all tissue structures: skin, muscles, ligaments, bones, etc.
When a low impact and duration of restretching, and more pathogenic multiple effects that may result, for example, to a weakening of ligaments, joints and loosening habitual dislocation. When excessive filling content of hollow organs (stomach, bladder, intestines, etc.) as a result of the delay the evacuation of them can come smooth muscle atrophy, thinning of the walls of the body, atrophy of the glandular system and reduction of their secretory function. Aneurysm after a long stretch atrophy of the blood vessels and can cause them to break, accompanied by heavy bleeding.
b) Compression. Resistance of the tissues to compression varies. Have the greatest stability of the bone. So, for the deformation of the femur by compression required with a load of 685 kg cm. To crush the skull, requires 500 kg cm, since the skull bone plates have a peculiar connection and position in space, which increases the overall strength of the static pressure. However, if applied kinetic energy (load falling from a height of 1 - 1.5 m), to break the skull, rather load 0.5 kg/cm2.
The consequences of compression depends on the strength and duration of exposure, as well as the physiological state of a tissue or organ, and may include:
a) mild, when impaired circulation and nutrition of tissues are reversible and disappear after the elimination of squeezing factor;
b) moderate - small in force, but the long-term action sponding factors that after the blood circulation and nutrition of tissues lead to necrosis of tissue necrosis and pressure sores. From prolonged compression may occur atrophy organ or tissue (eg, atrophy of the healthy tissue around the growing tumor). When compression of the growing tissue, their growth slows or stops altogether (for example, the custom of "swaddling" stop the girls in Japan and China);
c) serious degree with a strong compression of essentially destroyed all amazed structure. Remain alive only those tissues that are not subjected to direct pressure.
c) Impact. Strike - effects on the body object moving with positive acceleration, or impact the air waves.
The damaging effect of a moving object on the body depends on the nature of the traumatic object, its speed and the magnitude of the kinetic energy, the area of ​​contact with the surface of his body and the state of the tissue.
The mechanism of the damaging effect of the kinetic energy of a moving body is reduced mainly to compression, and then the deformation of tissue structures traumatic body tears of soft tissue and blood vessels, bone fractures, etc. When you hit a blunt object and a relatively large area of ​​contact with the body of the subject is typical damage to internal organs with preservation intact integument concussion when struck on the head, viscera breaks when struck on the abdominal wall, etc.
In addition to local and distant organ injury and tissues, causing shock and the general reaction of the body, which in its most severe form occurs as a traumatic shock.
Blow air wave can occur at break bombs, shells, etc. mini air waves produced by explosions, characterized by sudden jump of pressure.
Destruction by air wave is the result of sharp contraction and thinning of concentric layers of air. Shock wave duration is approximately 0.001 second. Air shock wave can cause unilateral or bilateral rupture of the eardrum, bleeding in her defeat of the cochlea and vestibular apparatus. In addition, it can compress on abdominal wall and move the abdominal organs. By inhalation air wave causes rupture of alveoli and lung capillaries. In this case, damage to internal organs develop in the perfect no visible signs of damage to the skin and muscles.
Shock air waves are especially dangerous for the central nervous system. Skull and brain are physically liquid system enclosed in a hard shell. The brain, like water, is almost incompressible, but the blow may change its form without changing the volume (concussion).
Blow air wave on the skull can cause it to deform or break. Sometimes the bone structure of the skull are not deformed, but it gets a linear or rotational acceleration, which is transmitted to the brain. Linear acceleration brain moves as a whole without dividing it into parts. In the rotational acceleration, a shift of the brain within the skull and cause destruction (breaking) of the brain substance.
REACTIVITY AND RESISTANCE
Under the reactivity of the organism usually understand its property to react a certain way to impact the environment.
Resistance of the body is its resistance to the action of pathogenic factors. Both terms reflect the basic properties of a living organism and interrelated.
Understanding of the reactivity and resistance began to take shape in the period of ancient medicine. Even then, doctors knew that various people suffer in different ways, in other words, to respond to different pathogenic effects. The explanation of this is in unequal dimensional displacement of the body juices - dyscrasia. In the most precise form this view was given by Hippocrates. Influenced by the teachings of Hippocrates Plotomey Dioskarid Sektus Empirikus and introduced the concept of "idiosyncratic" to refer to individual sensitivity associated with a special mixture of juices.
A new direction in the study of reactivity that had started in the late XY1I century. Glisson (1672) first described the property of all living irritability (irratabilitas). By this he, seems to understand the susceptibility to irritation and desire to respond to them strated appearances. Brown (1780) introduced a provision that life requires two conditions: the body and the corresponding environment. Emanate from the last stimulation, resulting in the active state of the body as a result of their inherent properties respond. This property is called the Brown excitability (incitabilitas)
The introduction of the concept of "reactivity" took to the XX century, when pathologists have to focus on the reaction tions of the body. Then were described phenomena peculiar reactivity (anaphylaxis, serum sickness, etc.), which were named Pirquet (1906), allergy (altered reactivity).
In the teaching of reactivity protective nature played a large role comparative pathological studies II Mechnikov (1892.1903) in inflammation and immunity. It can be called the founder of the theory of immunological reactivity. In what follows, and the teaching of allergy developed mostly by immunologists, resulting reactivity associated mainly with the process protective. This was noted Bogomolets (1945), who linked the reactivity with the constitution and created the trend in the study of the constitution. N.N. Sirotinin (1934.1939) drew attention to the fact that in many cases is not the same reactivity with resistance.
The best example of such a state can serve as hibernation, during which resistance to various effects increases, particularly to infections, whereas reactivity decreases, also decreases immune and allergic reactivity ¬ sion.
In a number of NN Sirotinin (1934-1960) noted that the changes (secondary) reactivity (immune, allergic) formed on the background of the primary (physiological) reactivity. In turn, the primary reactivity varied depending on the phylogenetic and ontogenetic position of the animal.
The concept of reactivity become a part of medical practice, especially in the Clinic of Infectious Diseases, where distinguished hyper and anergic form of pathological process (eg, tuberculosis, etc.). The greatest use of this term is observed in the clinic, allergic diseases.
Forms reactivity
Reactivity may occur in the following forms, increased hiperergii, low hipergia and perverted dizerogy.
In pure form, the first two forms are expressed with respect to the individual systems and bodies in the whole organism can only speak of the predominance of one or another form. When giperergii often observed excitation processes at hipergii-inhibition, and parabiosis (terminology Vvedensky). Another change on the functional mobility of NE Vvedensky - isteriozis in observed at different chemical, physical (electrical accident) effects and infections.
The nervous system plays an important role in the reactivity. Therefore, all forms of changes in higher nervous activity, set of IP Pavlov and his school, however, are both forms of reactivity, as well as dominant on Ukhtomskii.
Reactivity may occur in unmodified form (initial reactivity) and modified by external and internal conditions (secondary, altered reactivity). Reactivity may be non-specific and specific, it is expressed in aneral and local forms.
Types of resistance and reactance
Types of reactivity and resistance distinguished by the development of the theory of natural immunity. Species reactivity is determined by hereditary anatomical and physiological characteristics of the representatives of the species. Reactivity and resistance related nected with sex on the basis of anatomical and physiological differences. In females reactivity changes due to the menstrual cycle scrap, pregnancy, menopause. Reactivity and resistance to some extent related to age.
As a result of immunological research has created the following types of reactivity and resistance of the body:
1. Initial reactivity and resistance corresponding still natural immunity.
2. Immunological reactivity characterizing immunological response to immunizatornoe irritation, respectively they immunologic resistance or immunity.
3. Allergic reactivity or sensitivity by sensitization. Resistance as a result of repeated exposure of antigens or antigenic substance nature (depression immunity Morgenrota, tachyphylaxis, addiction to poisons mitridatizm)
At the First All Union Conference pathophysiologists reactivity in Kazan (1950) addressed the issue of the division of reagentsion into two types: normal and pathological. The latter species occurs under the influence of the effects on the emergency Diseases hard factors. This reactivity is characterized by reduction of adaptability ailing body (AD Ado, 1962).
Antibodies.
Antibody production is characteristic only of higher animals and are specific bodies guard ¬ ism.
The mobility in the electric field serum proteins are divided into albumin and a, p, y - globulin. Antibodies with belong mainly to the fraction of gamma globulin. The word "antibody" and "gamma globulin" refers to the same substances. That is why they are now called immunoglobulins. There are currently open at least 5 types of immunoglobulins:
It is theoretically possible, and the existence and the sixth type. The total concentration of immunoglobulins in the serum of 18 mg / ml. According Perms and coworkers (1966), the different classes of immunoglobulins are produced by various cells of the lymphoid tissue. Most cells, usually draw the most common and lightweight - JgG. Immunoglobulin A few heavy Further, what immunoglobulin G.
Immunoglobulin A is found mainly in the mucous secretions of the nose and respiratory tract, and apparently provides protective properties of tissues to fight the common cold and flu germs. In all mammals, it is passed from mother to children piles milk. IgA is secreting immunoglobulins. He does not have the ability to bind complement, but good agglutinates. The number of cells synthesizing IgA in the lymphoid tissue, in a fraction of the current cell synthesizing immunoglobulin G. IgA concentration in plasma is 4 times lower than the concentration JgG.
At the same time, in biological fluids, non transudate (milk, tears, saliva, nasal secretions, exudates glands intestine, stomach), the concentration of immunoglobulin A much higher Jg G, which is a proof of education Bulina immunoglobulin A plasma cells of glands producing mentioned secrets.
It seems tempting to see the largest and heaviest of the immunoglobulins, Jg M, just as the five molecules bonded together Jg G.
For IgM characteristic that it is the first antibody secreted against foreign organisms. He urraet leadership counterattack. In place of immunoglobulin M comes immunoglobulin G, which is the most common antibodies against specific antigens threat.

The role of IgE has been elucidated recently. This antibody is effective for allergies.

Immunoglobulin D is still a mystery. It is present in small quantities. Its functions no knowledge.
With age, the concentration of all types of immunoglobulins increases and reaches a maximum at the time of puberty. Pain Most researchers believe that the main producer of antibodies, plasma cells. Antibody production by plasma cells confirmed firmed, studies using fluorescence microscopy (method Koons). In addition, it is observed that people with agammaglobuli nemiey no plasma cells in connection with which the antibodies are not produced. Removal of the spleen, the blockade of RES electronegative colloids, X-rays reduce the titer of antibodies, and the stimulation of RES function enhances the production of antibodies.
Dynamics of production of antibodies
Each animal species characteristic of antibodies specific dynamics. It depends on the dose and the nature of the antigen, the penetration into the body, the state of reactivity, etc. The antibodies are detected in the serum 3-4 days after administration of antigen on. The antibody titer increases in 1-2 weeks to stabilize, and then decreases again. Term existence of antibodies averaged 8-15 days, which indicates the continuity of the process of formation of antibodies. In the formation of antibodies distinguish between two phases:
1. Induction and
2. Phase production of antibodies.
During the induction phase (lag period, adaptive) antigen is absorbed by macrophages, splitting it to the active fragments, transfer of antigenic information predecessors antibody forming cells in the synthesis of these specific and - RNA that form ization of polypeptide chains on ribosomes, the assembly of antibody molecules and selection of the intercellular fluid. During the induction phase, the cells are biochemical and morphological changes under the influence of antigen. During this period, the antibodies in the body is not an dfistroy. Inductive phase a period of extremely high sensitivity to X-ray radiation, cortisone and other factors ¬ frames, have a depressing effect on the synthesis of antibodies. In this phase the implementation of the conversion cycle antigen, antibody production, proliferation and differentiation of the clone of lymphoid cells and the overall restructuring of reactivity.
Productive phase the phase of the release of antibodies and flow into the bloodstream.
Physiological principles of antibody
1. Law conjugacy or integrity, excitement and
inhibition (Pavlov, NE Vvedensky, AA Ukhtomsky). Unavoidable, NOSTA antibody subordination to the law due to the fact that exposure to the antigen source lymphoid tissue is replaced by high specific election excitability (reactive) resulting in subsequent impacts is insignificant doses of the same antigen in immunocompetent cells is an active process of immune stimulation.
2. The second physiological principles that are subject to
immunegenesis (for antibody production), is established ¬ fief IM Sechenov (1863) rule of "summation of stimulation." It results in an intensification of that irritation effects of, or in effect, do not identify with a single stimulation (Orbeli, 1938).

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