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Keywords: an etiology, a pathogeny, the causes of diseases, causality, etiological factors, a causal treatment, a debut of disease, physiopathology

the General etiology. A role of extreme (pathogenic) irritants, conditions and reactivities of an organism in development of pathological processes.

Key concepts

1. the General nosology (nosos - illness, logos - a science, the doctrine) - the general doctrine about illness.
2. the Etiology (aitia - the cause, logos - a science, the doctrine) - the doctrine about causality of the diseases, reflecting natural connection of an extreme irritant, conditions of environment and a reactivity of an organism.
3. the Determinism (determinare - to determine) - philosophical doctrine about objective overall natural and universal interrelation, the cause of conditionality of connatural, social and mental processes.
4. Causality - a philosophical category for notation of objective connection in a pathology from which one (cause) causes other (consequence).
5. the Extreme irritant (causative factor) - an irritant (specific or nonspecific), invoking a boring, damage or destruction of various frames of an organism (receptors, subcellular organellas, cells, a tissue and. Etc.).
6. Conditions of originating of illnesses - a category of an opportunity and impossibility to be ill, determining probability ("risk") of disease.
7. the Reactivity of an organism (re-+ activus - effective, active) - ability of an organism (CNS) to answer an extreme irritant in the certain conditions.

the General pathological value

Illness is new quality special the form of vital activity of an organism. Diseases of the person represent dialectic interaction of an extreme irritant, conditions and reactivities of an organism. Environmental factors influence the general reactivity of an organism and, first of all, on neurohumoral system which functional state determines activity and an expressiveness of protective - adaptive and compensator reactions of an organism in reply to action of extreme irritants. In dependence on the causes of illness, a reactivity of an organism and conditions in which there is a disease, the most various combinations or combinations of infringements of functions and reactive changes in cells, tissues, organs and regulating systems are frameed.

Educational elements

1.the General etiology. Causality of disease.

a - definition

b - the choronomic causes of disease

c - the intrinsic causes of disease

d - the conditions promoting development of disease

• intrinsic
• choronomic conditions

f - the conditions handicapping development of disease

• intrinsic
• choronomic conditions

g - critical analysis of some modern representations of the general etiology

• monokauzalizm
• konditsionalizm
• the theory of factors
• constitutionalism
• a genetical determinism
• ecological pessimism.

And -intrinsic conditions

Ancestral predisposition, the pathological constitution, early children's age, senile age

-choronomic conditions

Infringement of a feeding, the overwork, the transferred diseases, neurotic states, a bad nosotrophy (in case of disease).

5. The conditions handicapping development of disease

And-intrinsic conditions

• ancestral
• constitutional
• racial factors

-choronomic conditions

• a balanced diet
• the correct organization of a regimen of the working day
• occupations by physical culture
• a good nosotrophy (in case of disease).

6. A general pathology of a reactivity of an organism

a-definition

b-classification

• a biological reactivity, a heredity, a sex, age, the constitution

• phylums of the supreme nervous activity
• a functional state of a CNS
• systems of closed glands

• the allergic constitution

an age reactivity

• a reactivity at early children's age
• a reactivity in the season of a puberty
• a reactivity at senile age
• downstroke of activity of function of a CNS and closed glands

ca reactivity and a resistance of an organism

d -a reactivity and a bionomics

f -functional parameters of a reactivity of an organism

Change of functions of organs and systems of an organism at functional loads (the caused potentials, a chronaxia, physical exercises, hormonal, sugar, water and other functional trials)

Specific and nonspecific factors of immunodefence.

7. General physiopathology of a cell

a-the exogenous causes of damage of a cell

• mechanical and physical factors (high and low the temperature, ionizing radiation, beams of a solar spectrum)
• chemical factors (acids, alkalis, salts)
• biological factors (microbes, viruses, the elementary)

b-the endogenic causes of damage of a cell

• infringement of a nervous - humoral regulation
• patotrofogeny
• Hormonums
• enzymes
• biologically awake materials
• Histaminum
• a bradykinin
• patoimmunnye complexes
• genetical factors

c-the general infringements in a cell specific distresses of activity of a cell

• a dysfunction, hypo-and a hyperfunction of a cell
• generating of potentials
• reduction
• a secretion
• inkretsija

• infringement of a permeability of cellular membranes
• change of a transmembrane metabolism
• distress biopower, dezintoksikatsionnyh and biosynthetic processes
• an acidosis of damage
• nervous dystrophias
• denervatsionnyj a set of symptoms
• an atrophy, a necrobiosis, a necrosis

• stimulating action
• damaging action
• oposredovannoe action of an irritant
• infringement of oxygenous maintenance of a cell
• hypo-and a hyperoxia
• superfluous formation of free radicals of Oxygenium (superoksid a radical, a peroxide of Hydrogenium, a gidroksid-radical) infringement of mechanisms energoobrazovanija
• change of processes oxidative fosforilirovanija
• gipoergoz
• change of mechanisms of transport of energy
• infringement of use of energy
• distress of an albuminous exchange
• infringement of synthesis of proteins
• change of activity of desmoenzymes
• a role lizosomalnyh enzymes
• a denaturation, disintegration of proteins
• infringement of carbohydrate metabolism
• intensifying of disintegration and downstroke of synthesis of a glycogen
• a glycogenosis
• infringement of a lipometabolism
• intensifying of free radical reactions
• peroxide oxidation of lipids
• augmentation of formation of free radicals and hydroperoxides of lipids
• a fatty infiltration
• a fatty dystrophia
• change of a water-salt exchange
• a hyper-from and gipoosmoljarnaja dehydration
• a hyper-from and gipoosmoljarnaja an overhydratation
• infringement of the general concentration of ions Na⁺, K⁺, Ca^{2 +}, Mg^{2 +}in a cell

d -mechanisms of protection and acclimatization of a cell at damage

• a natural resistance of a cell
• gistogematicheskie barriers
• adaptive changes of functions of a cell
• hypo-and a hyperfunction of cells (nervous, endocrine, immunocompetent, etc.)
• change of a cellular metabolism
• activity of antimutation system
• elimination mutant and tumor cells
• compensator neogenesis
• cellular
• endocellular
• a hypertrophy.

8-Damaging action of mechanical factors

And - a distention and a breakage

- compression (prelum)

V-impact.

9.Damaging action of physical factors

a - hum

b - ultrasonic sound

c - an acceleration (kinetozy)

d - overloads

e - weightlessness

f - damaging action of high temperatures

g - action of low temperatures on an organism

h - damaging action of ionizing radiation.

10. Damaging action of high temperatures on an organism

a - an overheating (hyperthermia)

b - a heatstroke

c - a heliosis;

d - combustions

e - a burn shock

f - a burn disease.

11. Damaging action of low temperatures on an organism

a a hypothermia, definition

b - classification

General

regionarnaja

Superficial

Moderate

Deep

c - stages of a hypothermia

Compensator

Hypothermal

Terminal

d - an artificial hypothermia, a winter sleep

Inhibition of function of neuroendocrinal system

Decrease of consumption of Oxygenium

e - cold

f - a freezing

g - freezing.

12. Damaging action of ionizing radiation

And - influence of ionizing radiation on a cell

- action of ionizing radiation on an organism

In - a radial illness

• acute
• chronic

• distresses of functions of a CNS
• endocrine infringements

• cerebral
• medullar
• toxemic
• intestinal

13.Damaging action of beams of a solar spectrum

And - damaging action of ultra-violet beams

• a toxic lesion central nervous systems (CNS)

A reflex inhibition of a CNS

- the mechanism of damaging action of infra-red beams

• the thermal mechanism
• the reflex mechanism.

14.Mechanisms of damaging action of beams of the laser

• thermal effect
• mechanical action
• biological influence
• changes of functions of histic enzymes.

And - exogenous venenatings

• direct action of poisons
• a reflex effect of poisons

- endogenic venenatings

• an endointoxication

Uchebno-research work of students

The white mouse place in a flask. Count up number of respiratory locomotions, pay attention to behaviour of an animal and colouring of integuments (a paw, a muzzle). Then a flask occlude a ground-in fuse and determine lifetime of an animal in the closed space.

The white mouse place in a flask and put on 15 mines in a refrigeration cabinet (temperature +5 С). Then a flask occlude a ground-in fuse and determine lifetime of an animal in the closed space in conditions of a hypothermia.

The white mouse place in a flask and put on 15 mines in a thermostat (temperature +40 С). Then a flask occlude a ground-in fuse and determine lifetime - an animal in the closed space in conditions of a hyperthermia.

The white mouse subcutaneously introduce 0,12 % of solution etaminala Na at the rate of 0,1мл on 4 grammes of mass of an animal (average mass of the mouse 20г) and place in a flask. After offensive of narcotic dream, a flask occlude a ground-in fuse and determine lifetime of an animal in the closed space. The received results enter in the minutes as the table:

Pathophysiological problems

Probably, there is no range of theoretical medicine which would draw attention of scientists - physicians of all times more, than a problem of causality in a pathology. This problem and now excites representatives of different specialities (philosophers, mathematicians, physicists, chemists). In medicine, among many questions of the theory of causality, it is possible to name the main themes an interrelation of a choronomic and intrinsic course of a disease in mechanisms, the attitude of an etiology to a pathogeny, ' questions of a monoetiology, a polyetiology, causality and a biosocial determinism, in mechanisms of development of pathological processes the important value has mutual relation of pathogenic irritants with this or that part of an organism of the person which results in damage.

A.Dajte definition of an etiology

B.Privedite modern classification of the causes of disease

The history of a medical science and practice learns, that the most difficult appeared a problem what to perceive the cause.

The person during ancient times thought of why there is an illness and built the representation about the cause of his originating according to a level of the knowledge. An etiology (aitia - the cause, logos the doctrine) - the doctrine about causality of the disease, reflecting natural connection of the pathogenic factor, conditions of medium of an environment and a reactivity of an organism.

A.Objasnite value of the pathogenic factor in a course of a disease

B.Kakuju a role is played with conditions of an external environment in originating and development of pathological process?

V.Oharakterizujte value of a reactivity of an organism in mechanisms of development of diseases.

Modern representation about an etiology was generated according to basic value of a principle of a determinism, i.e. causality or causal conditionality of all natural phenomena, including illnesses of the person. The principle of causality in a pathology is absolute - in vital activity of an organism there is no process which would not be causally caused. In modern comprehension an etiology - the doctrine about causality of the diseases, reflecting natural connection of an extreme irritant of conditions of environment and a reactivity of an organism. Alongside with this view metaphysical concepts in representations about the general etiology are known also.

A.Chto such an etiology?

B.Pokazhite value of a principle of a biosocial determinism in knowledge of the general etiology. Open a role of an extreme irritant, conditions of environment and a reactivity of an organism in mechanisms of development of disease

V.Predstavte the critical characteristic to the basic metaphysical directions in the general etiology

Among foreign concepts in the doctrine about an etiology one of important monokauzalizm (causa - the cause), according to which choronomic pathogenic factor (an infection contamination, a trauma.) is the unique cause of disease.

A.Dajte definition to concept monokauzalizm

B.Kakuju a role this doctrine in development of the doctrine about an etiology has played?

One of metaphysical directions in the doctrine about the general etiology is konditsionalizm (an armour. conditio - a condition). Konditsionalizm a direction in the general etiology which asserts set of the conditions determining development of illnesses as the cause. Konditsionalnyj the mentality of the doctor does not allow it " to direct precisely on the cause of illnesses " (I.P.Pavlov).

A.Dajte definition to concept konditsionalizm

B.Kakuju a role is played with conditions of an external environment in mechanisms of development of diseases?

Infringement of an exchange by energy and the information between an organism and medium of an environment is the general basis of originating of distresses of vital activity of an organism. The problem of damage of a cell as a whole takes the important place in a modern general pathology.

At action on subcellular frames of a cell, a tissue or organs of the damaging agent (a poison, a cold, warmly, the infection contamination, ionizing radiation, etc.) descends infringement of function or frame of these formations

A.Nazovite the basic infringements of function of a cell at damage

B.Perechislite the basic infringements of cellular frames at a pathology

In mechanisms of development of pathological processes the important value has interaction of the pathogenic factor with this or that part of an organism of the person. Such interaction invokes mutual damaging and protective influence against each other. Formation of pathological process in an organism, even at action of the same damaging agent on various kinds of a material substratum can be not identical. It depends on the constitution of the person, his reactivity and a resistance.

A.Objasnite value of the constitution of the person, in a parentage of disease

B.Kakuju a role plays a reactivity of an organism in development of pathological processes?

Illness is the new (special) form of vital activity of an organism and arises at influence of some the causes which can be divided into two bunches - the choronomic and intrinsic causes.

A.Nazovete the basic choronomic causes of disease

B.Perechislite the intrinsic causes of disease

" The Conditions promoting pathogenic influence of an extreme irritant, are fallen down geological and social factors. The bionomics of environment, a climate, a state of air, water, bedrock essentially influence a case rate of the person. Social factors professional intensity, family - household, interpersonal attitudes frame congenial conditions for development of illnesses (nervous, cardiovascular, a metabolism).

A.Perechislite the choronomic conditions promoting a course of a disease.

B.Nazovite the intrinsic conditions promoting a course of a disease.

The factors influencing originating and development of illnesses, refer to as conditions of originating of illnesses. Now excrete still the conditions handicapping originating and a course of a disease which can have choronomic or intrinsic character.

A.Perechislite the choronomic conditions handicapping development of disease.

B.Nazovite the intrinsic conditions handicapping development of disease.

Action of temperature irritants, influence of a radiant energy, an electric current, a note, change of barometric pressure concerns to physical pathogenic factors. Rise in temperature of environment as the pathogenic factor, renders the general and aboriginal action on an organism.

A.Raskrojte mechanisms of development of an overheating of an organism.

B.Pokazhite mechanisms of the general influence of high temperature on an organism.

V.Objasnite pathophysiological mechanisms of aboriginal influence of high temperature on an organism.

High temperature render aboriginal (combustions) damaging action on an organism. Combustions arise from action of hot fluids, a steam, a flame, hot air, razogretyh solids. Damage of tissues arises at augmentation of their temperature up to 50 S.Neobshirnye combustions invoke only soon taking place reaction of an organism as rise in temperature, a headache. Originating of a leukocytosis, etc. At more extensive lesions serious and long infringements of the general state of the organism, determined as a burn disease are observed.

A.Dajte definition to concept a burn disease.

B.Nazovite the basic phases of a burn disease.

V.Objasnite mechanisms of development of a burn disease.

The general refrigerating an organism meets frequently as independent diseases (freezing) or concomitant pathological process at freezings, traumas, hemorrhages, serious disbolism. Refrigerating influence of medium always represents a complex of factors (the low temperature, the increased humidity, rate of locomotion of air). The hypothermia arises in cases when owing to choronomic refrigerating feedback of heat strengthens above usual limens at a normal heat production or when the heat production in an organism sharply goes down.

A.Objasnite mechanisms of medical action of a hypothermia.

B.Raskrojte mechanisms of formation of aboriginal refrigerating.

Patient В., 25 years has acted in abjointing reanimation in 45 minutes after an automobile - road trauma. The diagnosis: a serious craniocerebral trauma, a bruise of trunk departments of a brain, a shock of IV degree. A state extremely serious: the patient without consciousness, reaction of pupils to light is absent, respiration artificial, a blood pressure at entering a hg of 40/0 mm. In abjointing to the patient with the medical purpose refrigeratings (hypothermia) have applied procedure kranio-cerebral, having lowered a body temperature up to 32 and temperature of a brain up to 26 . On a background of a hypothermia have made a craniotrypesis and other medical actions. In 30 days of the patient was has written out in a satisfactory state. Without application of a hypothermia patients of such structure, as a rule, perished.

A.Objasnite mechanisms of medical effect of a cranial hypothermia at an acute hypoxia of a brain

B.Nazovite the basic degrees of a hypothermia.

Ionizing radiations (and *97; and *szlig; - particles, and *103; - Beams and X-ray) react on an organism both from choronomic, and from intrinsic sources of an irradiating (in case of penetration of radioactive materials into an organism with nutrition, water, air or through integuments).

Damaging action of various kinds of a radoactive radiation depends on their inpouring activity and, hence, from density of ionization in tissues.

A.Perechislite the basic sources of radioactive infestation also give them the pathophysiological characteristic.

B.Vskrojte mechanisms of a radiation injury of a cell. Explain mechanisms of direct action of radial energy.

Interest to studying an air hunger (hypoxia) as to one of the major pathological processes of an organism exists already about hundred years though the true role of an oxidant (Oxygenium) as the indispensable participant of processes of vital activity of the majority of biological objects became known more two hundred years ago (M.V.Lomonosov, A.Lavuazje, J.Пристли).

the Hypoxia is a pathophysiological basis of development of many morbid conditions and diseases of the person. For maintenance of normal vital activity of cells the strain of Oxygenium in an arterial blood at a level not below 80 mm of a hg is necessary, at a voltage reduction of Oxygenium in an arterial blood up to 20-30 mm of a hg vital activity of cells stops.

A.Kakoe the pathophysiological part in mechanisms of a parentage

hypoxias in the closed space is the main thing?

B.Vashe opinion on influence on flow of a hypoxia of a hypothermia?... Hyperthermias?... A narcosis?

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Keywords: an etiology, a pathogeny, the causes of diseases, pathological physiology, causality, etiological factors, a causal treatment, a debut of disease

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