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161 Cards in this Set
- Front
- Back
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What is total body composition of water?
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60%
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What is intracellular composition of water?
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40%
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What is extracellular composition of water?
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20%
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What is interstitial fluid composition of water?
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15%
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What is plasma fluid composition of water?
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5%
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What is the blood volume in dogs? cats?
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9%, 6%
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Which 4 things are released when blood volume is decreased?
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symp, RAAS, vasopressin, kidneys
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Which 2 things are released when blood volume is increased?
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ANP, kidneys
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What does total tissue blood flow = ?
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(MVP-CVP)/Resistance
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What causes the RAAS stimulated? 3
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decreased delivery of sodium by SNS, decreased renal blood flow, decreased renal afferent arteriole pressure
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What does aldosterone lead to?
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water retention, thirst
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What does vasopressin lead to?
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thirst, vasoconstriction
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What mediates vasopressin? 4
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angiotensin, increased plasma osmolarity, decreased atrial stretch receptor firing, SNS
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When vasopressin acts on V1, what does it do?
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vasoconstriction, increased contractility
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When vasopressin acts on V2, what does it do?
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stimulates water reabsorption on collecting ducts of the kidneys
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What does V2 regulate?
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aquaporin 2 water channel production
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What is released when atria is stretched? ventricles when stretched?
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ANP, BNP
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What does NO cause? What is it produced by?
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vd, relaxation of smooth muscles; endothelium
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What does increased osmolality lead to? What is released?
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fluid loss; vasopressin
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What does decreased osmolality lead to? What is decreased?
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fluid gain; vasopressin
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What are the 4 types of shock?
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hypovolemic, vasodilatory, cardiogenic, obstructive
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How is vasodilatory shock treated?
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fluids, vasopressors
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How is cardiogenic shock treated?
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inotropes, diuretics, vasodilators
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What are the 4 stimulants of vomiting?
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cortical nerves, peripherial nerves, vestibular center, chemoreceptors in 4th ventricle
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What are 3 causes of regurgitation?
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motility, obstructive, weakness
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What are 2 types of obstructive or weakness-caused regurgitation?
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congenital, acquired
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What is the term for liver function that is inadequate to sustain life?
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liver failure
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What is the term for interstitial inflammation of the liver with loss of architecture, fibrosis or nodular regeneration?
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cirrhosis
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What are the 5 main jobs of the liver?
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management of energy sources, storage, absorption of fat soluble vitamins, metabolism of drugs/toxins, immunosurveilance
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What are 2 hepatocellular injuries?
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hydropic degeneration, abnormal lipid accumulation
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What can lead to hepatocyte death?
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ROIs
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What are the 2 purposes of kupffer cells?
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activate stellate cells, store transition metals
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What are hepatic stellate cells used for? Where do they live?
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vitamin A storage; space of disse
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What do stellate cells transform into when there is inflammation? what is the net result?
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myofibroblasts, fibrosis
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What liver disease is most common in cats and ponies?
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hepatic lipidosis
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What liver disease is most common in young animals?
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portovascular
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What liver disease is most common labs/bedlington terriers?
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copper storage hypatopathy
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What are the 5 main signs of liver problems?
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lethargy, abdominal distension, icterus, PU/PD, bruising
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What are the 3 reasons that the liver cannot do its job?
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abnormal blood flow, loss of mass, lipids/copper accumulation
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What are urea, glucose, albumin, bile acids, ammonia and urate used to assess?
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liver function
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Why are liver enzymes measured? 2
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cell leakage or bile stasis
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What is needed for a liver problem definitive diagnosis?
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biopsy
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What is the name for the systemic inflammatory response to a variety of clinical insults?
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SIRS
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What can be initiated by trauma, hypotension, hypoxia, pancreatitis, neoplasia or infection?
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SIRS
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What involves an excess of pro-inflammatory mediators, and not enough anti-inflammatory mediators?
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SIRS
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What is the systemic inflammatory response to infection?
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sepsis
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What are the criteria for SIRS or Sepsis?
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2 conditions with identifiable cause
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What are the underlying causes of SIRS or Sepsis?
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Fever or hyperthermia, tachycardia or bradycardia, tachypnea, neutrophilia or neutropenia, increased bands, and toxic change
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How do gram - contribute to sepsis?
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LPS binds to CD14 on MO which activates TLR4 and release of inflammatory mediators
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What 3 things can gram + have that cause sepsis?
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peptidoglycan, lipoteichoic acid, superantigens
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What can superantigens from strep cause?
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necrotizing fascitis
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Which TLR do superantigens activate?
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TLR2
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What is pancreatitis associated with in SIRS?
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IL1 and TNF
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What pro-inflammatory mediators are important in Sepsis and SIRS?
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TNF, IL1, IL6
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What anti-inflammatory mediators are important in Sepsis and SIRS?
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IL4, IL10, IL13
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Do these upregulate or downregulate inflammation: Leukotrienes, prostaglandins, thromboxanes, nitric oxide, platelet activating factor, free radicals?
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upregulate
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What is the second hit theory?
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initial events primes the immune system Than a second event occurs which can result in an excessive inflammatory response because the immune system has been already primed
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Why is it SIRS/sepsis important?
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higher level of care, worsen the patient prognosis
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What is septic shock?
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sepsis with hypotension despite adequate fluid resuscitation. Hypovolemic shock has been ruled out and you are now left with vasodilatory or cardiogenic shock
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Why can inflammatory mediators cause shock?
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increase vascular permeability, NO release, vasopressin and corticosteroids can become deficient, TNF can also lead to decreased cardiac contractility/cardiogenic shock
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What is late decompensated shock?
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Refractory septic shock - septic shock lasting longer than 1 hour with no response to IV fluids or pressors
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What bloodwork abnormalities fit with sepsis/SIRS?
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hyperglycemia, hypoglycemia, hypoalbunemia
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Why is there hyperglycemia in sepsis/SIRS?
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insulin resistance and increased glucose production.
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Why is hypoglycemia seen in sepsis/SIRS?
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consumption of glucose by bacteria
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Is the outcome better or worse when glucose is increased in sepsis/SIRS?
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worse
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What increases glucose production and can cause glucose resistance?
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Increased counter-regulatory hormones like cortisol, growth hormone, epinephrine and glucagon
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Why are increased glucose levels harmful to SIRS patients?
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increased oxidative stress, mitochondrial dysfunction and neutrophil dysfunction.
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When does hypoalbuminemia occur?
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excessive inflammation
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What is MODS?
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functional abnormalities in one or more vital organ system in patients with SIRS
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What is mortality after MODS occurs?
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50%
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What is DIC?
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initial hypercoagulation and later hypocoagulation
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What is severe sepsis?
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organ dysfunction and shock have occurred
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What are the characteristics of a Type A neuron?
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myelinated and fast
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What are the characteristics of a Type C neuron?
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unmyelinated and slow, itching sensors
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What are the 3 segments of hair?
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infundibulum, isthmus, inferior
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What are the 2 glands in the skin?
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moisture, antibacterial
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What are the secondary hairs?
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fine undercoat
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What are the primary hairs?
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coarse guard hairs
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What do the Tlyotrich hairs do?
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sensation
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What 4 animals have simple hair follicles?
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humans, large animals, pigs, rodents
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What 4 animals have compound hair follicles?
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dogs, cats, llamas, sheep
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What is the antagen phase of hair growth? What does the root look like?
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growth, square and pigmented root
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What stimulates the antagen phase of hair growth? What inhibits it?
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thyroid, glucocorticoids/estrogens
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What does the root look like in telogen?
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tapered root
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What is synchronous shedding?
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wavelike shedding
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What is mosaic shedding?
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asynchronous shedding
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What is furunculosis?
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rupture of the hair follicle
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What are the 4 skin cell types?
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keratinocytes, melanocytes, langerhans, merkels
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What are the 5 layers of the epidermis?
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Basal, Spinous, Granular, Clear, Horny
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How long does it take to get from basal to granular?
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22 days
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What are the 2 types of cells in the spinous layer?
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langerhans, keratanocytes
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What cells are in the granular layer of the epidermis?
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flattened keratanocytes
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What cells are in the clear epidermis?
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anuclear keratanocytes
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What 3 things are in the horny epidermis?
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keratanocytes, sebum, sweat
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What are the 2 bacterias that are normal on the skin?
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staph intermedium, malasezzia
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What is the purpose of the dermis?
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supplies epidermis with nutrients
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What proteins are itch receptors stimulated by?
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histaminek, leukotrienes, prostaglandins
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What is the itchiest parasite?
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sarcoptes
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What is the itchiest hypersensitivity?
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food
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What is type I HS?
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IgE, immediate histamine release
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What is type IV HS?
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CMI, delayed histamine release
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What type of neoplasia causes itchiness?
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epithelotrophic lymphoma
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What are the 2 types of alopecia that are not itchy and not puritic?
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dystrophy, hair cycle arrest
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What is dystrophic alopecia?
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congenital hypotrichosis, black hair follicle dysplasia
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What are 3 endocrine reasons for hair cycle arrest?
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hyperadrenalcorticism, hypothyroidism, diabetes
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What are 3 reasons of non-puritic inflammatory alopecia?
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demodex, dermatophytosis, pyoderma
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What are the blood supplies to mature long bones?
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principle, metaphyseal, periosteal
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What are the blood supplies to immature long bones?
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epiphyseal, metaphyseal
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What type of blood supply do fractured bones have?
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extraosseous blood supply
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What type of healing does indirect bone healing go through?
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intermediate callus formation
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Why does a bone go through indirect bone healing?
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unstable, motion, gap > 1mm, impaired vascular supply
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What are the 3 stages/times of indirect bone healing?
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inflammation (4 days), repair (2 months), remodeling (7 years)
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What 2 events happen in inflammation of indirect bone healing?
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develop fracture clot and blood supply
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What does the inflammatory fracture clot contain?
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growth factors, mast cells
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What do growth factors released in inflammation stimulate?
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antigens, bone formation
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What is the purpose of mast cells in indirect bone healing?
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vasoactive
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What happens in the repair phase of indirect bone healing?
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clots become granulation tissue by mononuclear cells and fibroblasts
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What do mesenchymal cells turn into in indirect bone repair? What do they form? where?
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chondrocytes/osteoblasts; fibrocartilage; medullary and external callus
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When is union achieved in indirect bone healing?
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fibrocartilage --> hard callus
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how long does the repair phase of bone healing last?
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2 months
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What is Wolfe's Law?
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the more a bone is used the more remodeling occurs
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What creates a convex surface? What creates a concave surface?
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convex = osteoclasts; concave = osteoblasts
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What is responsible for compression? What is responsible for tension?
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compression = osteoblasts, tension = osteoclasts
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What is direct bone healing? How long does it last?
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primary osteonal reconstruction, 6-12 months
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What type of cell is minimized in direct bone healing?
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osteoprogenitor
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When is contact direct healing utilized?
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<0.01mm, <2%strain
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What happens in contact healing?
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bone union and remodeling happen at the same time
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When is gap healing utilized?
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<1mm, <2% strain
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Which way of healing heals bone in a perpendicular direction?
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gap healing
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Where is bone healed by gap healing mechanically weak?
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fracture ends
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in gap healing, how long does it take for osteoclasts to form cutting cones?
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3-8 weeks
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Which is more stable - cancellous or cortical bone?
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cancellous
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How is cancellous bone healed?
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no callus, woven bone deposited directly on trabeculae
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When does bridging of fracture site of cancellous bone happen?
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before union or cortical shell
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What are Salter fractures?
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healing of growth plate/physeal
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how is a fractures zone of hypertrophy healed?
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continued growth of physeal cartilage
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How is fractured zone of proliferation healed?
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endochondrial ossification
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What does fracture of physeal lead to?
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prevention of normal function, premature physeal closure
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What type of healing do plates and ESF result in?
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direct (contact or gap) healing
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What type of healing do pins with wires, ESF and nails result in?
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direct and/or indirect healing
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What type of healing do casts and splints or no fixation result in?
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indirect healing
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What effect do cerclage wires and external fixator pins have on blood supply?
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no effect
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What effect do bone plates have on blood supply?
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impair outer blood supply and allow early reformation of medullary blood supply
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Do bone grafts compensate for an unstable mechanical environment?
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no
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What are the 3 indications of bone grafts?
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initial fracture repair, delayed/nonunion fractures, arthrodoses
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What is the most common type of bone graft?
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cancellous
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What are the 4 phases of cancellous bone grafting?
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inflammation, revascularization and osteoinduction, osteoconduction, mehcanical support
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How long does each phase of a cancellous bone graft last?
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hours, 2 weeks, 1 month, 4 months
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Where are cancellous bone grafts taken from?
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ilium, humerus, tibia
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What is the problem with cancellous bone grafts?
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mehcanically weak
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What is the gold standard of cancellous bone grafting?
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cancellous autogenous bone graft
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Which type of bone graft is osteogenic and osteoinductive but less osteoconductive?
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Cancellous bone graft
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What are cortical bone grafts good for?
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mehcanical support
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Where are cortical bone grafts taken from?
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rib, ulna, fibula, ilium
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Which type of bone graft is acellular so has no osteogenic properties?
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cortical bone graft
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Which type of bone grafting goes through creeping substitiution?
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cortical
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Which type of bone graft is osteogenic, osteoinductive and osteoconductive?
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cortical-cancellous
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What cells are utilized in osteogenesis?
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osteoblasts
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What happens in osteoinduction?
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recruit new mesenchymal cells
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What is osteoconduction used for?
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scaffolding
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What are the 2 problems with allographs?
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$$$, no osteogenic properties
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