Study, draw and describe the microscopic specimen.

- mucoid swelling of the aorta wall (stained with toluidine blue). Pay attention to the difference in colour of unchanged regions and those with mucoid swelling. What are the substances accumulated in the region with mucoid swelling? What are their properties? Name the diseases and conditions which are accompanied by mucoid swelling. Name the results of mucoid swelling;

- hyalinosis of the spleen arteriole (stained with hematoxylin and eosin). Using low microscope magnification find the central arteries of the spleen follicule. Using high magnification study the width of the vessel wall and its lumen, the condition of internal and external tunics. Explain the mechanisms of development of hyalinosis of the spleen arteriole. Determine its outcome and significance;

- amyloidosis of the liver (stained with Congo red). Describe the localization of the amyloid, its appearance. Characterize the significance and outcome of liver amyloidosis;

-amyloidosis of the spleen (sago spleen) (stained with hematoxylin and eosin, Congo red). Pay attention to the colour and localisation of amyloid in the definite structures of the spleen and to the conditions of cellular elements of the pulp.

- obesity of the heart (fatty heart) (stained with hematoxylin and eosin). Describe the level of development of subepicardial fat layer, conditions of the adjacent muscular fibres. Name specific microscopic staining. Significance of obesity for the organism.

Study the electronograms: amyloidosis of the kidney.Pay attention to localization and structure of amyloid mass in glomerular filter, to the width of basal membrane.

Test

1)Name the types of mesenchymal dysproteinoses: a)... , b)...,

2)What is the most frequent cause of mucoid swelling?

3)Name specific histochemical staining for amyloid a)... , b)...

4)Name the types of vascular hyaline a)..., b)..., c)....

5)Give the characteristics of the morphogenetic stages of amyloidosis: a)..., b)..., c)..., d)....

6)The patient suffered from hypertension and died because of cerebral haemorrhage. Hypertrophy of the hart, haemorrhages into the brain subcortical noduli, decrease of the kidney size, microgranular surface of the kidneys have been revealed. Microscopic investigation has demonstrated changes in the
arterioles of some organs: thickened walls, narrowed lumens,
intima looking like homogenous mass of pink colour. Name
the type of degeneration in the vascular walls. What is the
process which caused it? Characterize the changes in the
kidneys.

Answers: 1) a) mucoid swelling, b) fibrinoid swelling, c) hyalinosis, d) amyloidosis.

2) hypoxia

3) a) Congo red, b) methylrosanilin chloride, c) methyl violet, d) scharlach red, e) iodine green.

4) a) simple, b) lipohyalin, c) compound hyalin.

5) a) preamyloid stage - transformation of mesenchymal elements synthesizing protein into amyloidoblasts, b) synthesis of fibrillar protein, c) aggregation of amyloid fibrils with formation of the reticulum of amyloid substance, d) formation of the compound carbohydrate-protein - amyloid.

6) hyalinosis as outcome of plasmatic infiltration, atrophy and sclerosis of nephrons, arteriolosclerotic nephrosclerosis.

Questions to control the knowledge:

l)Name morphogenetic mechanisms of development of mesenchymal degenerations.

2)Name the main causes of fibrinoid changing.

3)What pathological processes can result in hyalinosis? Enumerate the types of vascular hyalinosis.

4)Classification of amyloidosis.

5)Stages of amyloid morphogenesis. Theories of amyloid
pathogenesis.

6)The causes and types of obesity.

Terminology;

Histion, plasmatic saturation, mucoid swelling, fibrinoid swelling, hyalinosis, amyloidosis, metachromasia, plasmorrhagia, kelloid, glazed (sugar-icing) spleen, sago-like spleen, sebaceous spleen, obesity, cachexia.

Practical habits and skills

On the basis of the gained knowledge the students have to diagnose the mesenchymal degenerations and should be able to interpret them from the clinicoanatomical point of view.

Revise the word-building elements:

meso – middle; -osis – abnormal condition; -oid – resembling; -rrhagia - bursting forth; -emia - blood condition; -sclerosis – hardening; muco – mucus; fibrino – fibrin; plasmo – plasma; athero – plaque; nephro – kidney; uro - urine

Lesson № 4

Methodical instructions for students

Date: 2016-03-03; view: 1266