Emergency Care In The Streets: Chapter 6 Pathophysiology

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Pathophysiology

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The study of the function of the organism in the presence of suffering/disease.

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etiology

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cause of a disease process

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organelles

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Intracellular structures that carry out specific functions for the cell. They include the: ribosomes, endoplasmic reticulum (ER), Golgi complex, lysosmes, mitochondria, and nucleus.

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Ribosomes

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Contain RNA and protein and interact with other parts of the cell, joining amino acid chains together to form protein. When ribosomes attach to endoplasmic reticulum (ER), they create rough ER.

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Endoplasmic reticulum (ER)

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The network of tubules, vesicles and sacs. Rough ER is involved in build up of protein, smooth ER is involved in build up of lipids (fats).

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Golgi complex

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Near the nucleus of the cell, involved in the synthesis and packaging of various carbohydrates (sugar) and complex protein molecules such as enzymes.

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Lysosomes

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Membrane-bound vesicles that contain digestive enzymes, functioning as digestive system, eliminating waste (bacteria and organic debris) from cell.

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Mitochondria

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Small, rod-like organelles that function as the metabolic center, power house, forming adenosine triphosphate (ATP), major source of energy for the body.

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Nucleus

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Contains chromatin in the nucleoli, genetic material. A round, dense structure that contains ribonucleic acid (RNA).

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RNA

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Ribonucleic acid found within the nucleus, responsible for controlling the cellular activities.

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Tissues

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Groups of similar cells that work together for common function.

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What are the four types of tissues?

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Epithelial, connective, muscle, and nerve tissue.

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Epithelial Tissue

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Type of tissue that covers the external surfaces of the body, also lines hollow organs within the body. Funtion is protective barrier, absorption of nutrients in the intestines, secretion ie. sweat.

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endothelial cells

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The epithelial cells that line the inside of the blood vessels and regulate the flow of blood through the vessels as well as clotting of the blood.

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Connective Tissue

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Type of tissue that binds other types of tissue together. Addipose tissue is a type of connective tissue that contains large amounts of lipids/fats.

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Muscle Tissue

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Type of tissue with the ability to contract.

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Nerve tissue

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Type of tissue characterized by its ability to transmit nerve impulse, found with in the central and peripheral nervous system.

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Neurons

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The main conducting cells of the nerve tissue, and the cell body of the neuron is the site of must cellular function. Consist of dendrites and axons. Dendrites receive electrical impluse from axon and other nerve cells and conduct them toward the body, axon. Axon conduct electrical impules away form the cell body. Neurons have one axon and may have several dentrites.

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Homeostasis

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Degree of stability or equilibrium within the body. Greek words for "same" and "steady." Also called dynamic steady state. The body maintains homeostais by balancing what it takes in with what it puts out.

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Cells communication

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Cells communicate through a process called cell signaling, with the release of molecules, such as hormones, binding to proteins called receptors, located on the surface of receiving cells. This signals chemical reactions in the receiving cells that lead to a biological action. When the action is complete, the opposing system "turns off" the action through a process of feedback inhibition or negative feedback, IE. house thermostat.

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Five primary ways the body eliminate excess temp:

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Convection, conduction, radiation, evaporation, and respiration.

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Ligands

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Molecules that are either produced by the body (endogenous) or given as a drug (exogenous), and bind to a receptor leading to a reaction. In addition to meds, common ligands include hormones, neurotransmitter, and electrolytes.

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Hormones

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Substance that are formed in very small amounts in one specialized organ or group of cells and then carried to another organ or group of cells to perform a function or functions.

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Endocrine vs Exocrine hormones

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Endocrine hormones are carried to their target organ or cell group in the blood. Exocrine hormones reach their target via a specific duct that opens into the organ.

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Neurotransmitters

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Proteins that affect signals between cells of the neuron system.

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Adaptions in Cells and Tissue thought what processes? Name them

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Atrophy, Hypertrophy, Hyperplasia, Dysplasia, Metaplasia

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Atrophy

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Adaption of the cell leading to decrease in cell size due to loss of subcellular components, inturn leading to decrease size of the tissue and organ. The number of cells remain the same. IE. A casted, immobilized limb will shrink in size due to disuse atrophy.

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Hypertrophy

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Adaption of the cell leading to an increase in size of a cell due to synthesis of more subcellular components, inturn leading to an increase size of the tissue and organ. IE. The Lt ventricle of the heart may hypertrophy due to high resistance pressue from HTN.

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Dysplasia

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Adaption of the cell leading to an alteration in the size, shape, and organization of cells. IE. Commonly found in epithelial cells that have undergone irregular, atypical changes in response to chronic irritation or inflammation. Respiratory tracts of smokers producing cancer.

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Metaplasia

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Adaption of the cell leading to a reversible, cellular adaptation in which one adult cell type is replace by another adult cell type. IE. The ciliated and secretory epithelium in the airways of smokers may be replaced my squamous metaplasia.

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Total body weight of fluid is

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50% to 70%

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Two main types of body fluid are

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Intracellular 45%, and extracellular 15%

In terms of the total body water volume-as compared to body weight- ~75% of the body's fluid is intracellular, and the remaining ~25% is extracellular.

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Interstitial fluid

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The extracellular fluid surrounding tissues cells and includes cerebrospinal fluid and synovial fluid, and intravascular fluid (~4.5% of body weight), which is found within the blood vessels but outside the cells themselves.

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Osmosis

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The movement of water down its concentration gradient and across a membrane. Low to high.

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Hypertonic solution

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High solute concentration, higher osmotic pressure than the cell.
Lower to higher cell decrease in size.

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Hypotonic solution

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Low solute concentration, loser osmotic pressure than the cell.
Lower to higher cell increase in size.

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Isotonic solution

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Solutions are equal.

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Make up of plasma

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The blood is 55% plasma, plasma is 91% water with the rest plasma proteins, including albumin, globulin.

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The body's state of hydration is monitored continuously by three types of receptors:

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Osmoreceptors, Volume-sensitive receptors, and Baroreceptors.

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Osmoreceptors

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One of the three types of receptors involved in monitoring body's state of hydration. Monitor extracellular fluid osmolarity. Sensor for these receptors located primarily in the hypothalamus, When the extracellular fluid osmolarity is too high, they stimulate production of antidiuretic hormone (ADH).

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Volume-sensitive receptors

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One of the three types of receptors involved in monitoring body's state of hydration. Located in the atria, when the intravascular fluid increase, the atria are stretched, leading the release of natriuretic proteins.

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Baroreceptors

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One of the three types of receptors involved in monitoring body's state of hydration. Found primarily in the carotid artery, aorta, and kidney, sensitive to changes in blood pressure.

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Sodium and Chloride Balance

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These are very important electrolytes within the body of pH balance. Sodium in general is taken in by food and regulated primarily by the renin-angiotensin system (RAAS) and natriurectic proteins. The RAAS is a comples feed back mechanism responsible for the kidney's regulation of sodium in the body. When the sodium is present in excess they kidney excretes it, when levels are low it reabsorbs sodium.

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Fluid and Water Intake

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Average adultls takes in about 2,500 mL of water per day. 60% of this fluid by drinking, another 30% by food, and remaining 10% is byproduct of cellular metabolism.

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Fluid and Water Excretion

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Most water is lost in the form of urine ~60%, 28% is lost through skin and lungs, 6% from feces, and 6% from sweat.

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Where do most cardiac drugs work?

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Sodium-potassium pump

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Tonicity

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The tension exerted on a cell due to water movement across the cell membrane.

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Normal body pH is

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7.35 to 7.45

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pH

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Potential Hydrogen, the measurement of hydrogen ion concentration in a solution.

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Buffers

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Molecules that modulate changes in pH, maintaining the delicate acid-base balance. Includes proteins, phosphate ions, and bicarbonate.

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alkalosis vs acidosis

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Greater than 7.45 is alkalosis, less than 7.35 is acidosis.
Acidosis neurons become less excitable and CNS depression results, respiratory centers cease to function.
Alkalosis neurons become hyperexcitable, first manifest itself as sensory changes, if severe muscle twitches turn into sustained contractions that paralyze respiratory muscles.

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Metabolic acidosis

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Accumulation of abnormal acids in the blood. Body compensates for the metabolic abnormality by hyperventilating, Kussmaul respirations.
Kussmaul respirations is the deep, rapid, and labored breathing[1] associated with acidotic states, particulary diabetic ketoacidosis (DKA).

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Metabolic alkalosis

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Rarely seen in acute conditions, common in chronic conditions. Build-up of excess metabolic base or a loss of normal acid. The body will compensate by slowing ventilation.

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Respiratory acidosis

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Occurs when CO2 retention leads to increased PaCO2 levels. Situations of hypoventilation or intrinsic lung disease.

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Respiratory alkalosis

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Excess "blow off", often called hyperventilation. Many potentially serious diseases may be responsible for the increased ventilatory levels.

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List various causes of cell injury:

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hypoxia (lack of oxygen), ischemia (lack of blood supply), chemical injury, infectious injury, immunologic injury, physical damage, and inflammatory injury

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Cell Injury Manifestation

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Occurs at both the microscopic and functional levels. Common microscopic abnormalities include cell swelling, rupture of cell membranes or nuclear membrane, or breakdown of nuclear material. Often this results in a change in cell shape and function. The damage can be minor such as a fever or can be sever causing entire organ system failure.

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Viruses

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Intracellular parasites that take over the metabolic processes of the host cell and than use the cell to help them replicate.

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Apoptosis

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Normal cell death. Genetically programmed into the cell as a part of normal development. Usually die in clusters rather than random fashion. Within the cell proteins and DNA undergo controlled degradation that allows their remnants to be recycled by neighboring cells.

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Abnormal cell death

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If the injury leading to cell degeneration is sufficient intensity and duration, irreversible cell injury will lead to cell death.

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Immunologic Disorders

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Include allergies, asthma, and rheumatic fever, it is either a hyperactivity(most common) or hypoactivity of the immune system.