Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
164 Cards in this Set
- Front
- Back
|
Physiology
|
How the body functions normally.
|
|
|
Pathology
|
The study of disease and its causes.
|
|
|
Pathophysiology
|
The study of how diseases alter normal physiology.
|
|
|
Tachycardia
|
Low blood pressure with an accelerated pulse rate.
|
|
|
Homeostasis
|
The body's tendence to maintain a constantly balanced environment and to correct or compensate for any change that upsets the balance.
|
|
|
What are the 5 forms of cellular adaptation?
|
Atrophy
Hypertrophy Hyperplasia Metaplasia Dysplasia |
|
|
Atrophy
|
A decrease in cell size resulting from a decreased workload; the process of decreasing size and increasing efficiency.
|
|
|
Hypertrophy
|
An increase in cell size reulting from an increased workload
|
|
|
What increases durring the process of hypertrophy?
|
The size of the cell;
The cell's functional mass; and The number of organelles. |
|
|
Dilation
|
An enlargement. In reference to the heart, it is an abnormal enlargement resulting from pathology.
|
|
|
Myocardium
|
The cardiac muscle tissue of the heart.
|
|
|
Myocardial Infarction
|
Death and subsequent necrosis of the heart muscle caused by inadequate blood supply.
|
|
|
M.I.
|
Myocardial Infarction
|
|
|
AMI
|
Acute Myocardial Infarction
|
|
|
What cells are most commonly affected by hypertrophy?
|
Cells which cannot increase in number such as Heart (cardiac) cells and Kidney cells
|
|
|
Hyperplasia
|
An increase in the number of cells resulting from an increased workload; an increase in the number of cells through cell division and duplication which includes duplication of the genetic material (DNA) and the nucleus in a process called mitosis.
|
|
|
Mitosis
|
Cell division with division of the nucleus; each daughter cell contains the same number of chromosomes as the mother cell. The process by which the body grows.
|
|
|
What types of cells are capable of hyperplasia?
|
Epithelial, Glandular, and epidermal.
|
|
|
What types of cells are not capable of hyperplasia?
|
Skeletal cells, cardiac cells, and nerve tissues.
|
|
|
Metaplasia
|
Replacement of one type of cell by another type of cell that is not normal for that tissue.
|
|
|
Dysplasia
|
A change in cell size, shape, or appearance caused by an external stressor.
|
|
|
What condition does dysplasia typically lead to?
|
Malignang (cancerous) cells.
|
|
|
What are the 7 most common forms of cellular injury?
|
Hypoxia
Chemical Infectious Agent Inflammatory Reaction Physical Agent Nutritional Factors Genetic Factors |
|
|
Hypoxia
|
Oxygen deficiency.
|
|
|
Ischemia
|
A blockage in the delivery of oxygenated blood to the cells.
|
|
|
What condition is a heart attack patient suffering from?
|
Myocardial Ischemia
|
|
|
What is the most common cause of cellular injury?
|
Hypoxia
|
|
|
Anaerobic
|
Without oxygen.
|
|
|
What is intracellular metabolism in ischemic cells called?
|
Anaerobic metabolism
|
|
|
What harmful acid does anaerobic metabolism produce?
|
Lactic Acid.
|
|
|
Anaerobic metabolism produces _<_or_>_ ATP.
|
less
|
|
|
Anaerobic metabolism causes cells to swell due to an increase in what?
|
Sodium
|
|
|
Anaerobic metabolism causes cells to do what?
|
Swell
|
|
|
Infarction
|
Cellular and tissue death resulting from the release of lysosomes and digestive enzymes into the extracellular environment.
|
|
|
List some harmful chemical agents.
|
heavy metas (such as lead);
carbon monoxide; ethanol (alcohol); drugs (prescription and illegal); insecticides; cyanide (causes cell damage and death within minutes) |
|
|
Injuries to the cells cause disruption of hte cellular membrane resulting in what?
|
enxymatic reactions;
alteration of coagulation; and eventual cell death. |
|
|
What is a common cause of cellular injury?
|
Infectious, or disease-causing, agents.
|
|
|
Microorganism
|
Living things so tiny they are invisible to the naked eye.
|
|
|
Infectious Agents include:
|
Bacteria
Viruses Fungi Parasites |
|
|
Pathogen
|
A microorganism capable of producing infection or disease.
|
|
|
What are the 3 possible outcomes when a pathogen succsesfully invades the body?
|
1) it multiplies and spreads, overwhelming the body's defenses; 2) the body and the pathogen can battle to a draw producing a chronic infection; 3) the body's defenses may defeat and destroy the pathogen.
|
|
|
What factors determine the degree of damage or injury a pathogen may create?
|
Its numbers; its virulence (pathogenicity); the body's ability to contain or destroy it.
|
|
|
What 3 factors control virulence?
|
1) the pathogen's ability to invade and destroy cells; 2) its ability to produce toxins; 3) its ability to produce hypersensitivity (allergic) reactions.
|
|
|
Virulence
|
An organism's strength or ability to infect or overcome the body's defenses.
|
|
|
What kind of responses are Protective Responses
|
Immunologic and inflammatory responses.
|
|
|
Protective responses of the body can cause:
|
cellular injury and death
|
|
|
Hypersensitivity
|
Exaggerated immune response (allergy)
|
|
|
Anaphylactic (anaphylaxis)
|
Life-threatening allergic reaction (anaphylactic shock)
|
|
|
Injurious physical agents include:
|
Mechanical stresses;
Burns; Frostbite: Electrical burns; Hyperthermia/hypothermia; Atmospheric pressure changes; Ionizing radiation; Illumination; Noise |
|
|
Mechanical injuries include:
|
Blunt or penetrating trauma;
Irritation to the skin; Repetitive-motion injuries; Over-exertion back injuries. |
|
|
Atherosclerosis occurs when:
|
lipid, cholesterol, and calcium is deposited in arteries.
|
|
|
Atherosclerosis
|
A progressive, degenerative disease of the medium-sized and large arteries.
|
|
|
What is required for cellular metabolism and survival?
|
Proteins
Carbohydrates Lipids Vitamins Minerals |
|
|
Diseases caused by malnutrition and starvation include:
|
Beriberi;
Scurvey; Rickets. |
|
|
Genes
|
The basic unit of heredity composed of DNA
|
|
|
Chromosomes
|
long threadlike strands that carry molecules of DNA
|
|
|
Genetic cellular injuries can involve:
|
alterations to the nucleus or the cell membrane;
The shape of the cell; Receptors on the cell membrane; Transport mechanisms that carry substances across the cell membrane. |
|
|
What are the 2 phases of metabolism?
|
Anabolism and Catabolism
|
|
|
Anabolism
|
The constructive phase of metabolism in which cells convert nonliving substances into living cytoplasm.
|
|
|
Catabolsim
|
The destructive phase of metabolsim in which cells break down complex substances into simpler substances with release of energy.
|
|
|
What is a chief consequence of cellular injury?
|
Substances, not all of which are in the cells normally, infiltrate or accumulate in the cells to an abnormal degree.
|
|
|
What are the 3 causes of foreign substances infiltrating injured cells?
|
1) Endogenous substances (normally found in the cells) are anabolized in excess;
2) Endogenous substances are not properly catabolized; 3) Harmful exogenous substances (substances from outside the cell, usch as heavy metals, mineral dusts, or microorganisms) are taken into and remain in the cells. |
|
|
Metabolites
|
Products of catabolism
|
|
|
Phagocytes
|
Cells that have the ability to ingest other cells and substances, such as bacteria and cell debris.
|
|
|
Cellular swelling
|
Swelling of a cell caused by injury to or change in permeability of the cell membrane with resulting inability to maintain stable intra-and extracellular fluid and electrolyte levels; the most frequent result of cellular injury.
|
|
|
Fatty change
|
A result of cellular injury and swelling in which lipids (fat vesicles) invade the area of injury; occurs most commonly in the liver.
|
|
|
Apoptosis
|
Response in which an injured cell releases enzymes that engulf and destroy itself; one way the body rids itself of damaged and dead cells; only exists when the cellular injury or insult is confined to a local region.
|
|
|
Necrosis
|
cell death; always a pathological cell change.
|
|
|
What are the 4 types of necrotic cell change?
|
Coagulative
Liquefactive Caseous Fatty |
|
|
Coagulative necrosis
|
The transparent viscous albumin of the cell becomes firm and opaque, like a cooked egg white.
|
|
|
What causes coagulative necrosis (generally)? And what ordans does it affect?
|
Hypoxia which commonly occurs in the kidneys, heart, and adrenal glands.
|
|
|
Liquefactive necrosis
|
The cells become liquid and are contained in walled cysts
|
|
|
Where is liquefactive necrosis scene?
|
It is common in the ischemic death of neurons and brain cells.
|
|
|
Caseous necrosis
|
Incompletely digested cells take on a cottage-cheese-like consistency.
|
|
|
Where is caseous necrosis commonly found?
|
In tubercular lung infections.
|
|
|
Fatty Necrosis
|
Fatty acids combine with calcium, sodium, and magnesium ions to create soaps.
|
|
|
Where does fatty necrosis commonly occur?
|
In the breasts and abdominal structures.
|
|
|
Saponification
|
The production of soaps caused by fatty acids combining with calcium, sodium, and magnesium ions during fatty necrosis.
|
|
|
Gangrenous necrosis
|
tissue death over a wide area.
|
|
|
Wet gangrene
|
Results from liquefactive necrosis and usually affects internal organs.
|
|
|
Dry gangrene
|
results from coagulative necrosis and affects the skin, most commonly of the lower extremities, turnign it dry, shrunken, and black.
|
|
|
Gas Gangrene
|
The result of a bacterial infection of injured tissue, generating gas bubbles in the cells. By attacking red blood cells, gas gangrene can cause death from shock.
|
|
|
What are the 3 results of cell death?
|
Apoptosis
Necrosis Gangrenous Necrosis |
|
|
What are the 3 types of Gangrenous necrosis?
|
Dry gangrene
Wet gangrene Gas Gangrene |
|
|
What substances can accumulate in cells?
|
Water
Lipids Carbohydrates Glycogen Proteins Pigments Calcium Urate |
|
|
What are systemic signs and symptoms of cellular injury?
|
General feelings of fatigue and malaise;
Altered appetite (increased or decreased hunger); Fever associated with the inflammatory response; Increased heart rate associated with fever and pain. |
|
|
What are the 2 processes which result from cellular death?
|
apoptosis or necrosis
|
|
|
In apoptosis, what happens to destroyed cells?
|
They are cleared away and digested by phagocytes, permitting repair and regeneration.
|
|
|
What are the key differences between apoptosis and necrosis?
|
Apoptosis:
cells shrink normal bodiyl housekeeping has specificity (occurs in scattered, single cells) Necrosis: cells swell and rupture always pathological lacks specificity (will destroy injured cells and neighboring cells) |
|
|
Edema
|
excess fluid in the interstitial space; the accumulation of water in the interstitial space, caused by a disruption in the forces that normally keep net filtration at zero.
|
|
|
Interstitial Space
|
Space between cells
|
|
|
ICF
|
Intracellular Fluid: The fluid inside the body cells.
|
|
|
ECF
|
Extracellular Fluid: The fluid outside the body cells which is comprised of intravascular fluid and interstitial fluid.
|
|
|
Bldy fluids are mostly comprised of what?
|
Water
|
|
|
Intravascular Fluid
|
Part of the extracellular fluid; fluid that is part of the body, mostly plasma; fluid found within the vascular system.
|
|
|
Interstitial Fluid
|
Part of the extracellular fluid; fluid that is neither in the cells nor in the vascular system
|
|
|
Where does fluid in the interstitial space generally go?
|
it is absorbed into the lymphatic system, which returns it to the vascular system.
|
|
|
What mechanisms allow fluid to move between body compartments?
|
Osmosis and Diffusion
|
|
|
What controls the movement of water in and out of the vascular system?
|
Hydrostatic pressure (blood pressure) and the conter-effect of oncotic force exerted by the large proteins in the plasma
|
|
|
How does hydrostatic pressure affect water in capillaries?
|
it tends to force water out of the capillaries into the interstitial space.
|
|
|
What does the oncotic force exerted by the large proteins in the plasma do to water?
|
It tends to pull interstitial fluid back into the capillaries.
|
|
|
What 4 mechanisms commonly result in accumulation of water in the interstitial space?
|
1) decrease in plasma oncotic force resulting from a decrease in plasma proteins;
2) increased hydrostatic pressure, which may result from venous obstruction, thrombophlebitis, or other causes; 3) increased capillary permeability resulting from mechanisms of inflammation and immune response; 4) lymphatic channel obstruction, which can result from infection or surgical removal. |
|
|
Is Edema localized or generalized?
|
Both
|
|
|
Intravenous (IV) Therapy
|
the introducion of fluid and other substances into the venous side of the circulatory system.
|
|
|
What are the uses of IV therapy?
|
It is used to replace blood lost through hemorrhage, for electrolyte or fluid replacement, and for introduction of medications directly into the vascular system.
|
|
|
What are the blood components?
|
A Liquid portion (plasma) and the Formed Elements (blood cells)
|
|
|
Plasma
|
The liquid part of the blood
|
|
|
Erythrocytes
|
Red blood cells, which conatin hemoglobin, which transports oxygen to the cells.
|
|
|
Leukocytes
|
White blood cells, which play a key role in the immune system and inflammatory (infection-fighting) responses.
|
|
|
Thrombocytes
|
Platelets, which are important in blood clotting.
|
|
|
Hemoglobin
|
an iron-based compound that binds with oxygen and transports it to the cells.
|
|
|
What are the formed elements
|
They include red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes)
|
|
|
How many blood cells are erythrocytes?
|
more than 99%
|
|
|
What does hemoglobin acomplish?
|
It binds with oxygen in the pulmonary (lung) capillaries and transports the oxygen to the peripheral tissues where it can be unloaded and taken into the cells.
|
|
|
What determines blood viscosity (thickness)?
|
The ratio of plasma to formed elements; more formed elements = higher viscosity
|
|
|
Hematocrit
|
The percentage of the blood occupied by erythrocytes.
|
|
|
Why is whole blood the most desirable fluid for blood loss replacement?
|
1) blood contains hemoglobin which transports oxygen;
2) it is the most natural replacement. |
|
|
What kind of blood is most often used for fluid replacement?
|
Packed red blood cells
|
|
|
How is blood packaged for fluid replacement?
|
Whole blood
Packed red blood cells Fresh frozen plasma |
|
|
Does fresh frozen plasma require cross-matching?
|
No
|
|
|
What blood type is the universal donor?
|
O- (negative)
|
|
|
What are common signs and symptoms of a transfusion reaction?
|
Fever; Chills; Hives; Hypotension; Palpitations; Tachycardia; Flushing of the skin; Headaches; Loss of consciousness; Nausea; Vomitiong; Shortness of breath
|
|
|
How should you treat a transfusion reaction?
|
Immediately stop the transfusion; save the substance being transfuesed; administer rapid IV fluid infusion (to prevent renal damage); assess the patient's mental status; administer oxygen; contact medical direciton
|
|
|
What medications might medical direction order for a transfusion reaction?
|
Mannitol (Osmotrol)
Diphenhydramine (Benadryl) Furosemide (Lasix) |
|
|
What choices are used for fluid resuscitation in Hemorrhagic shock?
|
1st Choice: Whole Blood
2nd Choice: Packed RBCs 3rd Choice: Plasma or Plasma substitute 4th Choice: Lactated Ringer's or Normal Saline |
|
|
What choices are used for fluid resuscitation in shock due to plasma loss (burns)
|
1st Choice: Plasma
2nd Choice: Plasma substitute 3rd Choice: Lactated Ringer's or Normal Saline |
|
|
What choices are used for fluid resuscitation in dehydration?
|
Lactated Ringer's or Normal Saline
|
|
|
What suplimental conditions may arise after a transfusion?
|
fluid overload and congestive heart failure
|
|
|
What are the signs and symptoms of fluid overload and congestive heart failure secondary to transfusion?
|
increased dyspnea
pulmonary congestion edema altered mental status |
|
|
What do you do for a suspected fluid overload secondary to transfusion?
|
stop the infusion
start a crystalloid solution at a TKO rate administer oxygen contact medical direction |
|
|
TKO
|
To Keep Open
|
|
|
Colloids
|
substances, such as proteins or starches, consisting of large molecules or molecule aggregates that disperse evenly within a liquid without forming a true solution
|
|
|
How do colloids tend to effect the body?
|
Colloids have oncotic force (colloid osmotic pressure), which means they tend to attract water into the intravascular space from the interstitial space and the intracellular space.
|
|
|
What are 4 examples of colloids and what do they have in common?
|
Plasmanate (plasma protein fraction) is a protein-containint colloid. It's principal protein is albumin.
Salt-poor albumin contains only human albumin. Dextran is not a protein, but a large sugar molecule with osmotic properties similar to albumin. Hetastarch (Hespan), like dextran, is a sugar molecule with osmotic properties similar to protein. They all contain proteins or substances which act like proteins. |
|
|
Is Colloid replacement therapy used in the prehospital setting?
|
No
|
|
|
Albumin
|
A protein commonly present in plant and animal tissues. In the blood, albumin works to maintain blood volume and blood pressure and provides colloid osmotic pressure, which prevents plasma loss from the capillaries.
|
|
|
Crystalloids
|
Substances capable of crystallization. In solution, unlike colloids, they can diffuse through a membrane, such as a capillary wall.q
|
|
|
Tonicity
|
Solute concentration or osmotic pressure relative to the blood plasma or body cells.
|
|
|
What are the primary compounds used in prehospital IV fluid therapy?
|
Crystalloids
|
|
|
What are the key characteristics and some examples of Isotonic Solutions?
|
They have an electrolyte composition similar to the blood plasma.
Examples: Normal Saline (0.9%NaCl) and Lactated Ringer's |
|
|
What are the key characteristics and some examples of Hypertonic Solutions?
|
They have a higher solute concentration than the cells which causes a fluid shift out of the interstitial space and intracellular compartment into the intravascular space.
Examples: Plasmanate and Dextran. |
|
|
What are the key characteristics and some examples of Hypotonic Solutions?
|
Have a lower solute concentration than the cells which causes a movement of fluid from the intravascular space into the interstitial space and intracellular compartment.
Example: 5% Dextrose in water (D5W). |
|
|
What types of conditions can cause a patient to lose water more rapidly than they are losing sodium?
|
Conditions such as gastroenteritis (characterized by diarrhea, vomiting, and fever).
|
|
|
TBW
|
Total Body Water
|
|
|
What does gastroenteritis do to a patient? What can it lead to?
|
Decteased water intake and increased water loss can cause an increase in sodium levels in the serum.
This can lead to hypernatremia. |
|
|
Hypernatremia
|
Elevated sodium levels in the blood.
|
|
|
How do you tread hypernatremia?
|
Their primary need is water so hypotonic IV solutions (such as 0.45% sodium chloride) are used because it provides the needed water with a limited introduction of more sodium.
|
|
|
What is a key caution to remember when treating hypernatremia?
|
Even in cases of hypernatremia, initial fluid replacement therapy should be with an isotonic solution until adequate blood pressure and adequate tissue perfusion have been restored.
|
|
|
What are balanced salt solutions?
|
Isotonic Solutions: Solutions (such as lactated Ringer's) which have a concentration of electrolytes in similar proportions to blood plasma.
|
|
|
What solutions are most commmonly used in the prehospital setting?
|
Lactated Ringer's (Isotonic)
0.9% Sodium Chloride or Normal Saline (Isotonic) 5% Dextrose in Water (Hypotonic) |
|
|
Lactated Ringer's
|
An isotonic electrolyte solution of sodium chloride, potassium chloride, calcium chloride, and sodium lactate in water.
|
|
|
Normal Saline
|
An electrolyte solution of sodium chloride in water. It is isotonic with the extracellular fluid.
|
|
|
D5W
|
5% Dextrose in water: A hypotonic flucose solution used to keep a vein open and to supply calories necessary for cell metabolism.
|
|
|
What effect does D5W have on the body?
|
Initial: Increase circulatory volume.
Next: Glucose molecules rapidly diffuse across the vascular membrane. Overall: Water follows the glucose into the interstitial space, resulting in an increase in interstitial water. |
|
|
What controles acid-base balance?
|
hydrogen ions
|
|
|
How does cardiac arrest effect the acid-base balance?
|
Increase in hydrogen ions:
Hydrogen ions bond tobicarbonate ions; The bond creates carbonic acid; Carbonic acid breaks down into carbon dioxide and water when in the presence of carbonic anhydrase; Carbon dioxide is eliminated by the lungs; Water is eliminated by the kidneys. |
|
|
How does alkalosis relate to the acid-base balance?
|
it causes a shift to a more base related component
|
|
|
How does acidosis relate to the acid-base balance?
|
it causes a shift to a more acidic compound.
|
|
|
What are the 4 types of acid-base malfunctions?
|
Respiratory Acidosis
Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis |
|
|
Respiratory Acidosis
|
Acidity caused by abnormal retention of carbon dioxide resulting from impaired ventilation; this is caused by problems in the lungs or in the respiratory center of the brain.
|
|
|
Respiratory Alkalosis
|
Alkalinity caused by excessive elimination of carbon dioxide resulting from increased respirations; This can ocur with anxiety or following ascent to a high altitude (CO2 decreases and pH increases).
|
|
|
Metabolic Acidosis
|
Acidity caused by an increase in acid, often because of increased production of acids during metabolism or from causes such as vomiting, diarrhea, diabetes, or medication; it can result from dehydration, diabetes, and medication usage (pH decreases and CO2 remains normal).
|
|
|
Metabolic Acidosis
|
Alkalinity caused by an increase in plasma bicarbonate resulting from causes including diuresis, vomiting, or ingestion of toomuch sodium bicarbonate; usually caused by the administration of diuretics, loss of chloride ions associated with prolonged vomiting, or the overzealous administration of sodium bicarbonate (pH increases and CO2 remains normal).
|
|
|
Diuretic
|
an agent that increases urine secretion and elimination of body water.
|
