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150 Cards in this Set
- Front
- Back
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pathophysiology
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physiology of altered health
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disease
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any deviation from or interruption of the normal structure or function of any part, organ, or system of the body that is manifested by a characteristic set of symptoms or signs and whose etiology, pathology, and prognosis may be known or unknown.
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etiologic factors
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causes of a disease
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pathogenesis
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how the disease process evolves
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morphology
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structure or form of cells or tissues
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morphologic changes
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changes in structure or form that are characteristic of a disease
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symptom
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subjetive complaint, dizziness
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sign
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an observable manifestation, fever
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syndrome
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compilation of signs and symptoms
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diagnosis
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designation as to the nature and cause of a health problem
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clinical course
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describes its evolution.
Acute, chronic, subacute |
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epidemiology
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study of disease in populations, looks for patterns such as age, race, dietary habits
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incidence
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the number of new cases arising in a given population during a specified time
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prevalence
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the number of people in a population who have a particular disease at a given point in time or period
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Mortality
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provide information about the trends in the health population
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morbidity
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effects an illness has on a person's life
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risk factors
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conditions suspected of contributing to the development of a disease
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natural history
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progression and projected outcome of a disease without medical intervention
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prognosis
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term used to designate the probably outcome and prospect of recovery from a disease
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evidence based practice and evidence based practice guidelines
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mechanisms that use the current best evidence to make decisions about the health care of individuals
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nucleus
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cell function, contains DNA, mRNA, rRNA, tRNA that move to the cytoplasm and carry out the actual synthesis of proteins
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cytoplasm
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contains cell's organelles and cytoskeleton
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ribosomes
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serve as sites for protein synthesis in the cell
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ER
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functions as a tubular communication system that transports substances from one part of the cell to another as the site of protein, carbs, and lipid synthesis.
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Gogli bodies
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modify materials synthesized in the ER and package them into secretory granules for transport within the cell or for export from the cell
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lysosomes
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viewed as the digestive system of the cell, contain hyrolytic enzymes that digest worn- out cell parts and foreign material
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proteasome
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digests misformed and misfolded proteins
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mitochondria
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serve as power plants for the cell because they transfer food energy into ATP, to power activities
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microtubules
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slender, stiff tubular structures that influence cell shape, provide a means of moving organelles through the cytoplasm, and effect movement of the cilia and of chromosomes during cell division
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microfilaments
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thin, threadlike cytoplasmic stuctures, include the actin and myosin filaments that participate in muscle contraction
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plasma membrane
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lipid bilayer that surrounds the cell and separates it from its surrounding external environment
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G protein- linked receptors
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rely on a class of molecules called G proteins that function as an on- off switch to convert external signals into internal signals
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Ion channel- linked
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mediated by neurotransmitters that transiently open or close ion channels formed by integral proteins in the cell membrane
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enzyme linked- receptors
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interact with certain peptide hormones, such as insulin and growth factors, and directly initiate the activity of the intracellular protein- tyrosine kinase enzyme
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Cell Cycle phases
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G0= resting phase
G1= cell begins to prepare for division through DNA and protein synthesis S (synthetic phase)= DNA replication occurs G2 (premitotic phase)= RNA and protein synthesis M = cell division occurs |
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Cell division (mitosis)
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process during which a parent cell divides into two daughter cells, each receiving an identical pair of chromosomes. It is dynamic and continuous and is divided into four stages: prophase, metaphase, anaphase, telophase
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metabolism
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process whereby carbs, fats, and proteins from the foods we eat are broken down and subsequently converted into the energy needed for cell function
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Anaerobic glycolytic pathway is in....
Aerobic pathway is in.... |
Cytoplasm
Mitochondria |
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Diffusion
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process by which substances such as ions move from an area of greater concentration or one of lesser concentration
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Facilitated Diffusion
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molecules that cannot normally pass through the cell's membrane do so with the asisitance of a carrier molecule
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Active transport
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requires the cell to expend energy in moving ions against a concentration gradient
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endocytosis
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process by which cells engulf materials from the surrounding medium
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exocytosis
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removal of large particles from the cell and is essentially the reverse of endocytosis
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ion channels
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integral transmembrane proteins that span the width of the cell membrane and are normally composed of polypeptide or protein subunits that from a gating system
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Two basic groups of ion channels exist:
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leakage channels
ligand, voltage, and mechanically gated channels |
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Two main factors that contribute to the generation of membrane potentials:
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a difference in the concentration of ions inside and outside the membrane, and the permeability of the membrane
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equilibrium or diffusion potential
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no net movement of ions occurs because the diffusion and electrical forces are exactly balanced.
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During an action potential...
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the cell membrane becomes highly permeable to sodium, causing it to depolarize and reverse its polarity, becoming positive on the inside and negative on the outside
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Epithelium
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covers and lines the body surfaces and forms the functional components of glandular structures
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Epithelial tissue is classified into 3 types according to shape of cells and number of layers present
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simple, stratified, and pseudostratified
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Epithelial tissue are held together by 3 types of intercellular junctions
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tight, adhering, and gap.
Attached to the underlying tissue by hemidesmosomes |
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Connective tissue
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supports and connects body structures, forms bones and skeletal system, joint structures, blood cells, and intercellular substances
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Connective tissue divided into 4 types
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loose or areolar, which fills body spaces and is characterized by an abundance of ground substance
adipose, which stores fat reticular, which forms the architectural framework in many structures of the body dense, regular and irregular, which forms structures such as tendons and ligaments and the dermis of the skin |
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Muscle tissues
Three types |
designed for contractility
Skeletal, cardiac, and smooth |
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Smooth muscle
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often called involuntary muscle because it contracts spontaneously or through activity of the autonomic nervous system. Sarcoplasmic reticulum is less defined and it depends on the entry of extracellular calcium ions for muscle contraction
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nervous tissue
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designed for communication purposes and includes the neurons, the supporting neural structures, and the ependymal cells that line the ventricles of the brain and the spinal canal
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extracellular fibers
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include collagen fibers, which tendons and ligaments
elastic fibers, found in large arteries and some ligaments thin reticular fibers, which are plentiful organs that are subject to a change in volume |
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Three classes of adhesion molecules that depend on extracellular calcium to function in cell adhesion:
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cadherins, which link parts of the internal cytoskeleton with the extracellular cadherin of an adjacent cell
selectins, which bind carbs present on the ligands of adjacent cells integrins, which assist in attaching epithelial cells to the underlying basement membrane |
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Ig superfamily of proteins
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calcium independent adhesion molecules that bind cells, such as those of the nervous system, together
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Cells atrophy
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reduce their size
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hypertrophy
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increase in work demands and is characterized by an increase in tissue size brought about by an increase in cell size and functional intracellular components
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hyperplasia
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an increase in the number of cells in an organ or tissue that is still capable of mitotic division
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metaplasia
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occurs in response to chronic irritation and represents the substitution of cells of a type that is better able to survive under circumstances in which a more fragile cell type might succumb
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dysplasia
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deranged cell growth of a specific tissue that results in cells that vary in size, shape, and appearance. Often a precursor for cancer
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pathologic calcification
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involves the abnormal tissue deposition of calcium salts
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dystrophic calcification
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occurs in dead or dying tissue
also a frequent cause of organ dysfunction |
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metastatic calcification
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occurs in normal tissues as the result of elevated serum calcium levels
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chemical agents can cause cell injury through several mechanisms:
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they can block enzymatic pathways, cause coagulation of tissues, or disrupt the osmotic or ionic balance of the cell
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biologic agents
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they are able to replicate and continue to produce injury
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injurious agents exert their effects largely through:
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generation of free radicals, production of cell hypoxia, or dysregulation of intracellular calcium levels
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free radicals
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partially reduce oxygen species and are important mediators of cell injury in many pathologic conditions
Important cause of cell injury in hypoxia and after exposure to radiation and certain chemical agents |
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Hypoxia can result from:
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inadequate oxygen in the air, cardiorespiratory disease, anemia, or the inability of the cells to use oxygen
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injurious agents may
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produce sublethal and reversible cellular damage or may lead to irreversible cell injury and death
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apoptosis
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controlled cell destruction and is the means by which the body removes and replaces cells that have been produced in excess, developed improperly, have genetic damage, or are worn out
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necrosis
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cell death that is characterized by cell swelling, rupture of the cell membrane, and inflammation
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neoplasm
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abnormal mass of tissue in which the growth exceeds and is uncoordinated with that of the normal tissues
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cell cycle
four phases |
process of cell growth
G1 (postmitotic phase)= during which DNA synthesis ceases while RNA and protein synthesis and cell growth take place S= phase during which DNA synthesis occurs, giving rise to two separate sets of chromosomes G2 (premitotic phase)= RNA and protein synthesis continues M = phase of cell mitosis or cell division G0= resting or quiescent phase in which nondividing cells reside |
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proliferation, process of cell division
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an inherent adaptive mechanism for cell replacement when old cells die or additional cells are needed
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differentation
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process of specialization whereby new cells acquire the structure and function of the cells they replace
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apoptosis
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form of programmed cell death that eliminates senescent cells, cells with damaged DNA, or unwanted cells.
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Stem cells
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remain quiescent until there is a need for cell replenishment, in which case they divide, producing other stem cells and cells that can carry out the functions of differentiated cells
important properties: self renewal and potency |
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Stem cells:
Self renewal |
stem cells can undergo numerous mitotic divisions while maintaining an undifferentiated state
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Stem cells:
potency |
differentiation potential of stem cells
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solid tumors
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primary tumor is initially confined to a specific organ or tissue
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hematologic cancers
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disseminated from the onset
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three ways cancer can spread:
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direct invasions and extension
seeding of cancer cells in body cavaties metastatic spread through vascular or lymphatic pathways |
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proto- oncogenes
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control cell growth and replication
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tumor suppressor genes
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growth- inhibiting regulatory genes
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Three stages of stress response
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alarm stage= activation of the sympathetic nervous system and the HPA axis
resistance stage= during which the body selects the most effective defenses exhaustion stage= physiologic resources are depleted and signs of systemic damage appear |
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immunity
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resistance to a disease that is provided by the immune system
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innate immunity
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first line of defense against microbial agents. It can distinguish between self and nonself through recognition of conserved broad patterns on microbes
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adaptive immunity
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involves humoral and cellular mechanisms that respond to a unique antigen, can amplify and sustain its responses, distinguish self from nonself, and remember the antigen to quickly produce a heightened response on subsequent encounters with the same agent
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cytokines
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soluble proteins secreted by cells of both the innate and adaptive immune systems that mediate many of the functions of these cells.
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chemokines
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cytokinds that stimulate the migration and activation of immune and inflammatory cells.
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colony- stimulating factors
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stimulate the growth and differentiation of bone marrow progenitors of immune cells.
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phagocytic leukocytes (neutrophils and macrophages)
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engulf and digest infectious agents, and NK cells, which kill microbes and foreign agents
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complement system
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primary effector systems for both innate and adaptive immune systems and consists of a group of proteins that are activated by microbes and promote inflammation and destruction of microbes
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B lymphocytes
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differentiate into plasma cells that produce antibodies and provide for the elimination of microbes on the extracellular fluid
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T lymphocytes
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differentiate into regulatory and effector cells.
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acute inflammation (self limiting)
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hemodynamic phase during which blood flow and capillary permeability are increased, and a cellular phase during which phagocytic white blood cells move into the area to engulf and degrade the inciting agent
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chronic inflammation
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prolonged and usually is caused by persistent irritants, most of which are insoluble and resistant to phagocytosis and other inflammatory mechanisms
involves presence of mononuclear cells |
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body cells are divided into types according to their ability to regenerate:
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labile cells, such as epithelial cells of the skin and GI tract
stable cells, such as those in the liver, which normally do not divide but are capable of regeneration when confronted with an appropriate stimulus permanent, fixed cells, such as nerve cells, which are unable to regenerate. |
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three phases of wound healing:
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inflammatory phase, proliferation phase, and maturational or remodeling phase
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immunodeficiency
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absolute or partial loss of the normal immune response, which places a person in a state of compromise and increases the risk for development of infections or malignant complications
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Four categories of hypersensitivity responses:
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type 1= mediated by the IgE class immunoglobulins and include anaphylactic shock
type 2= involve an antibody mediated cell destruction type 3= hypersensitivity responses, involve the formation and deposition of insoluble antigen antibody complexes, responsible for vasculitis type 4= cell mediated hypersensitivity reactions, include direct cell cytotoxicity |
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liquefaction necrosis
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cells die but catalytic enzymes not destroyed
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coagulation necrosis
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development of acidosis and subsequent denaturing of the cells enzymatic and structural proteins
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fat necrosis
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death of adipose tissues as the result of trauma or pancreatitis and the subsequent release of destructive enzymes
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caseous necrosis
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associated with TB lesions- immune mechanisms wall of dead cells and middle becomes white, soft, fragile
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dry gangrene
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form of coagulation necrosis which usually occurs in extremities due to decreased blood flow
skin wrinkles, turns black and shrinks |
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wet gangrene
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form of liquefaction necrosis due to interference of venous blood return
area is cold, swollen, black; skin is under tension, blebs forms, foul odor occurs |
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gas gangrene
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due to infection of necrotic tissue by anaerobic bacteria of clostridium family
gas bubbles form in tissues |
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wound dehiscence
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separation of the wound edges after suturing (usually 5-12 days after closing)
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normal cell
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small nucleus large cytoplasm
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malignant cell
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large nucleus small cytoplasm
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Rb gene
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codes for a large protein in the cell nucleus
"master brake" of the cell cycle Defective pRb is common in several cancers |
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P53 gene
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inhibits cell cycling, accumulates only after DNA damage and stalls cell division to allow for repair ; may signal apoptosis if cell badly damaged
more than half of all types of human tumors lack functional P53 |
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complete carcinogen
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initiate and promote
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incomplete carcinogen
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pure initiating agent
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Pharmaceutical Agents:
1. Dietheylestilbestrol (DES) 2. Estrogen 3. Alkylating agents 4. Immunosuppressive agents |
DES= increased risk of cervical cancers in children of exposed women
Estrogen= endometrial and breast cancer Alkylating agents= leukemia and lymphomas |
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Viral and chemical cancer cells have markers:
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tumor specific transplantation antigens (TSTA)
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System most responsible for immunocompetence protection?
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Natural Killer and T helper cells
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Organ tropism
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certain cancers have an affinity for metastasis to certain other organs
prostate cancer loves to go to the bone |
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Routes of metastatic spread:
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Local seeding= cancer cells are shed in the area of the primary tumor
Blood borne= most common Lymphatic spread= related to number, structure and location of lymph nodes and vessels |
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Components of the Immune System
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1. skin and mucous membranes
2. mononuclear phagocyte system 3. lymphoid system 4. bone marrow |
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Cells of the Immune Response
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Lymphoid
B lymphocyte T lymphocyte NK cells Myeloid RBCs Monocyte Granulocytes Neutrophils Eosinophils Basophils |
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Neutrophils
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circulating granulocytes
60- 80% of total WBC count mature: segmented neutrophils (segs) immature: banded neutrophils (bands) first responder to infection after skin |
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Eosinophils
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1-6% of total WBC count
primary function is to kill parasitic helminths |
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Basophils
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0-2% of total WBC count
release vasoactive substances during inflammation also involved in wound healing |
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Monocytes
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immature macrophages
5% of total WBC count |
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macrophages
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called different cells in different tissue
life span from months to years functions: phagocytosis repair of injured tissue antigen processing secretion of cytokines to help control the immune system |
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Lymphocytes:
NK cells |
innate immune cells, can kill tumor cells and virally infected cells without previous exposure
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Lymphocytes
T cells |
major cells of cell- mediated
interact with antigens; secrete cytokines that stimulate B- cell proliferation and antibody production |
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Lymphocytes
B cells |
major cells of antibody- mediated immunity
able to produce antibodies REQUIRE HELP FROM T HELPER CELLS TO RESPOND |
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Steps of inflammation:
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1. increase vascular permeability
2. recruitment and emigration of leukocytes 3. phagocytosis of antigens and debris |
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Main player in inflammation
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macrophages
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exudate
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fluid that leaks out of blood vessels, combined with neutrophils and debris from phagocytosis
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serous exudate
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low protein count, watery, usually seen with mile inflammation
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fibrinous exudate
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sticky, thick, increased protein, may have to be removed for healing to occur
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purulent exudate
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pus; sever inflammation, infection
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hemorrhagic exudate
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most sever inflammation, RBCs
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specific adaptive immunity
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capable of recognizing foreign invaders, destroying them, and retaining a memory of the encounter such that an even more effective defense will be achieved upon subsequent exposure
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major histocompatibility complex (MHC)
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cluster of genes on chromosome 6
also known as human leukocyte antigen complex displayed on the surface of body cells and mark them as "self" |
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cell mediated immunity
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T cells recognize foreign antigens displayed on the surface of cells through specialized receptors called T cell receptors
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T cells mature in....
B cells mature in... |
thymus
bone marrow Each B cell binds only one particular antigen |
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Agglutination
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antibody binds to antigen forming large insoluble complex precipitate out of body fluids
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Neutralization
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toxins bound or inactivated before they can interact with cells
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Opsonization
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foreign antigen is coated making it more recognizable to phagocytic cells
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Antibody Structure
Five classes: |
IgG= most common 75-80%; activates complement
IgM= 10%; activates complement; responsible for ABO incompatibility IgA= secretory antibody found in mucus, saliva, tears IgD= <1%, little known; thought to stimulate the B cell to mulitply IgE= <1%; helps clear parasites and prevent respiratory infections; mediates many of the hypersensitivity reactions |
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Antigenic mimicry
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virus/ other factors in environment can cause an attack
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