INTRODUCTION TO PATHOLOGICAL ANATOMY

Pathological Anatomy is one of the most important subjects in the system of physician training. During the first years you studied Human Anatomy and Physiology. Before entering the clinic, which is a temple where an unending struggle against diseases is carried on day and night, you have to understand the essence of pathological conditions (diseases), thus, it is necessary to know pathological anatomy.

Literally pathology means the study of suffering. More specifically, Pathological Anatomy deals with the material basis of the disease and its morphology. It is impossible to understand the development and consequences of the disease without the knowledge of the changes in the organism which accompany it.

Pathological Anatomy is anatomy of an unhealthy body. The word pathological originates from a Greek word with the meaning «ill». «Pathological Anatomy» means a field of medicine dealing with the problems connected with a sick organism that is clinical features of the disease, its signs and symptoms, disturbances of physiological functions, structural changes in the organs and tissues as well as treatment and preventive measures. Thus, Pathological Anatomy is complex

knowledge about a sick person; the role of Pathological Anatomy is to study the structural changes which occur during the disease. It is closely connected with the other sciences, i.e. clinical medicine and Pathological Physiology which study the disturbances of physiological functions during the disease as well as with Microbiology, Hygiene which deal with the causes and prevention of the diseases.

Disease is a complex social and biological phenomenon occurring due to different causes in the human organism at interaction with the environment. There is no exact definition of this term but there exists a common opinion that during the disease disturbances of cellular structures and functions develop. They bring about changes in the regulatory systems which provide homeostasis, i.e. the property of the organism to adapt to the constantly changing environment. The human organism has powerful defensive and adaptive mechanisms which protect it from the disease development. That is why it is sometimes very difficult to draw a boundary between health and disease. A lot depend on the pathogenic factor influence, its duration and the whole totality of the conditions of this action, e.g. it is well known that blood clotting is a physiological process. Any injury of the vessel is accompanied by formation of a blood clot which results in arrest of the hemorrhage. On the other hand, formation of a clot in the coronary artery causes a severe disease, i.e. myocardial infarction. This example shows that a

serious and dangerous pathological process occurs on the basis of normal physiological reactions and regularities but causes a new, different from the norm pathological process with special localization. The art of treatment consists in the ability to see the new quality, i.e. disease, as well as to find the means of the fight against the disease.

Pathological Anatomy studies not only the manifestations of the disease but also the reactions of the organism aimed at the protection from the disease. Thus, Pathological Anatomy studies functional morphology, i.e. functional structure of the sick organism. Every disease is accompanied by various changes in the organs and tissues. Sometimes these changes are considerable; they are well seen during the examination with a naked eye. Such changes are observed when the disease is neglected, they are difficult to treat. As the very primary manifestations of the disease may be inconsiderable, it may seem that at the beginning of the disease structural changes do not develop, and only functional changes are present. But modern methods of investigation (electronic microscopy, luminescent microscopy, histochemical and enzyme techniques, autoradiography) allow concluding that the disease begins with the changes of the cellular structures, changes in the state of mitochondria, endoplasmic reticulum, ribosomes, lysosomes, Golgi's apparatus etc. The newest methods of study allow to investigate the structure and function

as entity. There are no functional changes which are not connected with structural ones. There are no purely functional diseases, that are diseases which are not accompanied by the changes in the cell structure.

Pathological Anatomy studies outcomes of diseases. Each disease may have different outcomes: recovery, development of the pathological state which is compensated by the organism and death (arrest of vital functions and systems of the organism, i.e. central and vegetative nervous and endocrine).

Pathological Anatomy is not limited to study of morphological changes which occur in the organism of a sick person. It uses the information about morphology to reveal the etiology and pathogenesis of the disease.