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181 Cards in this Set
- Front
- Back
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What is pathophysiology?
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Study of functional or physiologic changes in the body that results from disease processes
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Disease
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Deviation from the normal state of health, or from a state of wellness |
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Disease occurs when significant changes take place in the body so that ___________ cannot be maintained
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homeostasis |
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Health is defined with ________ values
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normal |
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Discussion of specific diseases must be general in nature, allowing for ____________ in the individual clinical picture |
Variations |
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Study of Pathophysiology
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Utilizes knowledge of basic anatomy and physiology because its based on the Loss of, or a change in normal structure and function. |
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Goal of medical history
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Identify any condition that could create a risk for staff or other patients Promote accurate and effective communication between all. |
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Diagnosis
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Identification of a specific disease through evaluation of signs, symptoms and various tests and measures.
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Signs
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Fever Rash Edema |
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Etiology
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The causative factors involved in a disease |
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idiopathic
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Disease of unknown etiology (cause)
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iatrogenic |
Disease or injury induced by treatment
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Predisposing factors (risk factors)
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Age Gender Occupation Lifestyle Diet |
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Pathogenesis |
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Chronic |
Long term illness |
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Acute |
Short term illness Marked signs |
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subclinical
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Pathological changes prior to awareness |
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prodromal |
patient has awareness, but signs are vague |
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Manifestation |
Clinical evidence exists |
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Lesion
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Specific local pathologic change in tissue |
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Syndrome |
collection of signs and symptoms that occur (run) together in response to a certain condition |
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Remission
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Disease manifestations subside |
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Exacerbation |
Diseases manifestations increase |
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Precipitating factor
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event or condition that triggers an episode |
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Therapy |
Treatment measures used to promote recovery |
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sequelae
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Potential unwanted outcomes |
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Convalescence |
Period of recovery and return to health |
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Prognosis |
Probability of recovery based on averages |
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Morbidity |
Disease rated within a group
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Mortality
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Relative number of deaths from a disease |
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Atrophy |
decrease in cell size and tissue mass |
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Hypertrophy
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Increase in cell size and tissue mass |
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Hyperplasia
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Increased number of cells and tissue mass |
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metaplasia |
One type of mature cell replaced by another type |
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dysplasia
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Abnormal tissue in which cells vary in size and shape, frequent mitosis and large cell nuclei |
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anaplasia
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Loss of cell differentiation
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neoplasm |
Abnormal new cell growth |
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Benign |
Does not spread |
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Malignant |
Characterized by metastasis |
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Apoptosis
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Programmed cell death. |
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Ischemic
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Cell injury or death due to lack of oxygen which reduces metabolism |
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Hypoxic |
Decreased oxygen to tissues s |
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Necrosis
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Cells undergo lysis (dissolution) release chemicals that cause inflammation |
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infarction |
Area of dead cells due to ischemic |
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Gangrene |
Area of necrotic tissue invaded by bacteria |
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Body defenses
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Defense mechanisms are used by the body to protect itself from any injurious agent |
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Non specific (general) |
Provide general defense against anything "not self" |
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Specific |
Recognizes the agent it is responding to |
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1st line of defense (non specific) |
Skin Mucous membranes Sweat |
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2nd line of defense (non specific) |
Natural killer cells Inflammation Phagocytosis Fever |
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3rd line of defense (specific) |
Immunity |
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Chemical barriers
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PH extremes in stomach lysozyme |
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Interferons
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Released by virus infected cells and bind to uninfected cells |
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Natural killer cells (2nd line of defense) |
Defends body against various viruses and cancer cells |
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Performing
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Causes cell membrane to disintegrate, destroying infected cells |
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Inflammation (2nd line of defense) |
Redness heat pain Swelling Helps prevent spread of pathogen and promotes healing |
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Phagocytosis (2nd line of defense) |
Destruction of foreign particles |
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Neutrophil |
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Monocyte |
Destroy larger particles |
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Fever
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Release interleukin-1 Endogenous pyrogen (fire maker from within) |
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Immunity (3rd line of defense) |
More directed responses are carried out by specialized lymphocytes |
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2 types of immunity
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humoral |
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(mediated immunity) |
Attach to foreign, antigen-bearing cells such as bacterial cells, and interact directly by cell to cell contact |
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B cells
(Humeral immunity) |
When stimulated, they divide to give rise to cells that differentiate into plasma cells which produce and secrete larger globular proteins called ANTIBODIES
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Body fluids carry
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Antibodies |
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movement of fluids, nutrients and gases out of capillaries is determined by
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Hydrostatic pressure
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Pressure exerted by fluids |
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Osmotic pressure |
Pressure needed to stop osmosis |
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arteriole end of capillary
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movement of fluid, lytes, O2, and nutrients out of capillary |
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venular end of capillary
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Osmotic pressure is high |
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Lymphatic system
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System where excess fluid and any proteins are recovered from the interstitial area and eventually returned to the general circulation
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Acute inflammation
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Histamine PROSTAGLANDIN |
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Permeable
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Allows plasma proteins to leak into tissue spaces |
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vasodilation
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Vascular response to injury |
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Cellular response |
(chemotaxis) |
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marginate
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Neutrophils along with monocyte and macrophages collect along the capillary wall |
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diapedesis |
Cells move through the cell wall into the interstitial space |
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Inflammatory exudates
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The fluid formed in the interstitial space in an inflamed area |
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SEROUS |
Consists primarily of fluid with small amounts of protein and white blood cells |
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Fibrinous
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Increases risk of scar tissue |
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Purulent (pus) |
Contains... Leukocytes Cellular debris Microorganisms Indicates bacterial infection |
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Abscess
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Localized pocket of purulent or pus in a solid tissue
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Hemorrhagic (bloody) |
May be present if blood vessels have been damaged |
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Chronic inflammation |
May develop following an acute episode of inflammation when the cause is not completely eradicated |
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Treatment of inflammation
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Reduces fever, anti inflammatory agent Acetaminophen (decreases fever, does not diminish inflammatory response) |
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NSAIDS Nonsteroidal Anti-inflammatory Drugs |
–Anti-inflammatory –Analgesic –Antipyretic |
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•Glucocorticoids |
–Synthetic chemicals that are related to the naturally occurring glucocorticoids (hydrocortisone), hormones produced by the adrenal cortex
–Extremely valuable in short-termtreatment •Many undesirable effects |
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RICE (inflammation treatment)
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ICE COMPRESSION ELEVATION |
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wound healing
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Regeneration Replacement |
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Resolution
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Cells recover and return to normal in a short period of time |
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Regeneration |
Occurs in damaged tissue that can still undergo mitosis |
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Replacement
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Occurs after extensive tissue damage |
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Angiogenesis
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Granulation tissue grows new capillaries |
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collagen |
The protein component of scar tissue. Formed when fibroblasts enter area
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stenosis |
Narrowing of structures
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Adhesions |
Bands of scar tissue that joint two surfaces |
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keloid
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Overgrowth of fibrous tissue |
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Burns
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Thermal (heat) or non thermal (electrical/chemical) injury to the body |
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Most burns occur in the __________
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Home |
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Burns are classified by
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Percentage of body surfaces are involved |
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Partial thickness |
Involves epidermis and part of the dermis |
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Full thickness |
Involves all skin layers and underlying tissues |
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First degree burn
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Red and painful Healing in a few days No scarring |
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Second degree burn
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Easily infected Skin gradually sloughs off and healing via regeneration |
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Third/fourth degree burns
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require skin graphs |
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Rules of nines
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Each region is a multiple of 9% |
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Rule of nine
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A woman has burns on the anterior surfaces of her right arm, chest& right leg. |
Anterior surface of right arm = 4.5 Chest = 9 Anteriorright leg = 9 Percentage of body surface areaburned is approximately: 22.5% |
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Shock |
Due to fluid and protein loss from burn wound |
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infection |
Threat because protective skin barrier has been lost |
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microbiology
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Bacteria Viruses Fungi protozoa |
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Pathogens |
Those microbes which cause disease |
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resident or normal flora
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Refers to the large variety of non pathogenic microbes normally present in diverse sites in the body such as skin, mouth, nose, pharynx, intestines and vagina |
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bacilli
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Rod shaped |
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Spirochete / Vibrios |
Spiral shaped |
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cocci
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Spherical |
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borrelia burgdorferi Agent that causes Lyme disease |
Spread from field mice and deer ticks
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diplococci
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Ex. pneumonia |
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streptococci |
Ex. Respiratory infections |
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Staphylococci |
Ex. Skin infections |
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Binary fission
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Just divides- no mitosis |
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Limiting factors to bacterial growth |
Insufficient nutrients and oxygen Effects of increased metabolic waste in the area Changes of pH or temp |
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Viruses
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Small obligate intracellular parasites that require a living host for cell replication |
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virion
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particle is extracellular |
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some viruses have an additional outer protective ________ |
Envelope |
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New viruses are ___________ usually destroying the host cell
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Released |
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Viruses may alter host cell _________________ leading to cancer (tumors)
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Chromosomes |
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Chlamydiae, rickettesiae, mycoplasmas
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Require a host to replication |
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Elementary body
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infectious |
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reticulate body |
Non infectious |
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Mycoplasma
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Common cause of pneumonia |
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fungi
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Any of a large group of organisms such as yeast, molds and mildew that can cause infections Reproduces by budding or spores |
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Single celled
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Yeasts |
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multicellular |
Molds
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Protozoa
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Eukaryotic Complex unicellular organisms that lack a cell wall Irregular shaped Usually parasites |
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helminths
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Parasitic worms |
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modes of transmission of infection
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Indirect droplet Vectors |
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Reservoir
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Person Animal Soil Food equipment |
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nosocomial infections
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Occur in health care facilities |
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pathogenicity
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The capacity of microbes to cause disease |
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Virulence |
Invasive qualities Toxicity Adherence |
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4 periods of course of infection |
Prodromal Acute Recovery |
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Incubation period |
Timebetween entrance of microbe into the body and the appearance of clinical signsof disease •May last days to months |
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Prodromal period
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Time when person feels something is wrong |
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Acute period
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infection develops and clinical manifestations peak |
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Recovery |
When signs subside |
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local signs and symptoms |
Pus SEROUS exudate |
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Systemic signs and symptoms |
Chills Fatigue Weakness Confusion |
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Blood and circulatory system provide
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Major transportation and communication network for the immune system |
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Natural immunity
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Humans are not susceptible to infections common to many other animals |
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Innate IMMUNITY |
Controlled by factors such as race |
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Primary immune response |
Occurs upon first exposure to the antigen (Antigen is recognized and processed) |
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Secondary immune response
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Immediate response |
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Naturally Acquired Active Immunity |
•Acquired through contact with disease |
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Naturally Acquired PassiveImmunity |
Acquired from antibodies obtained through placenta and mothers milk |
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Artificially Acquired Active Immunity |
–Immunization with vaccines–Boosters
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MHC
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major histocompatibility complex Essential role in the activation of the regulation of the immune response |
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MHC Molecules |
Useful in detecting changes in cell membranes altered by viruses or cancerous changes and alerting the immune system to their presence |
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tissue organ transplant rejection
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Primarily - type IV cell mediated hypersensitivity reaction
Also involves humeral response |
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Host versus graft disease
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Ex. Possible with kidney transplants |
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Graft versus host disease |
Ex. bone marrow transplant |
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hyperacute rejection
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Occurs immediately after transplantation |
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Acute rejection |
Develops after several weeks when unmatched antigens cause a reaction |
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Chronic (late) rejection |
Occurs after months or years with gradual degeneration of the blood vessels
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Hypersensitivity reactions
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stimulate an inflammatory response |
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type 1 hypersensitivity reactions
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Ex. Hay fever anaphylaxis |
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type 2 hypersensitivity reactions |
Ex ABO blood compatibility |
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type 3 hypersensitivity reactions |
Ex. Autoimmune SLE |
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type 4 hypersensitivity reactions |
ed. contact dermatitis |
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Allergic reactions
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Attach to mast cells |
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Mediators
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initiate an inflammatory response |
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Anaphylaxis shock |
Decreased BP airway obstruction Severe hypoxia |
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•Epinephrine injection (immediately) |
–Stimulates sympathetic nervoussystem •Increase BP (vasoconstriction) •Increases rate / strength ofheartbeat •Relaxes bronchiolar smooth muscle –opens airway |
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•Antihistamine drugs (useful in early stages) |
•Diphenhydramine (Benadryl) and Chlorpheniramine (Chlor-Trimenton) –Block the response of the tissuesto release histamine |
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Type II – Cytotoxic Hypersensitivity
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•Circulating IgG antibodies react with the antigen causing destruction of the cell by Releasing catalytic enzymes Phagocytosis |
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Auto immune disorders
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When sled tolerance is lost, the immune system is unable to differentiate self from foreign material |
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Serum sickness
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Systemic reaction that occurs when immune complex deposits occur in many tissues |
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Arthus reaction |
Localized inflammatory and tissue necrosis that results when and immune complex lodges in the blood vessel causing vasculitis
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Immunodeficiency
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Primary - developmental failure Secondary- acquired, due to a specific cause |
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Artificially acquired passive immunity
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Administration of immune serum (antiserum) |
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allograft
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Transplant between same species but genetically distinct |
