Test V Response To Injury

Front 1

What is the most prominent cellular injury, cause?

Back 1

Hypoxia!
no air!

Front 2

whats the diff b/t sublethal and lethal?

Back 2

sublethal alters cell function w/o causing cell death.
lethal is irreversible process that causes cell death

Front 3

how do cells adapt to sublethal injury?

Back 3

adaptations are common
its part of the disease physiologic process

Front 4

whats an example of how cells adapt to sublethal injury?

Back 4

sunburns and suntans. sublethal cell injury can be like your muscles when your leg is in a cast, musclulr atropy

Front 5

what is hypertrophy?

Back 5

increase in the size of a cell. NOT cell division. hypertrophy is NOT cell division but INCREASE in the size of the cell.Ex. remove a kidney, the OTHER kidney grows bigger
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The enlargement or overgrowth of an organ or part due to an increase in size of its constituent cells.

Front 6

again?

Back 6

increase in size of a cell, ex is a kidney that grows

Front 7

what is hyperplasia?

Back 7

increase in # of cells
Ex. reversible when the stimulus removed. ex. Liver is removed, it regenerates itself.
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breast or uterus in pregnancy. we see BOTH tropy (bigger cells & phasia (more cells))

Front 8

what is cell atropy?

Back 8

rduced size of tissue or organ (the cells itself)
Ex. aging process causes decrease in size of cells
Ex. lack of mobility like in a cast. also from decreased nutrition

Front 9

what is meta plasia?

Back 9

reversible change of a cell type into another!!!
Ex. smokers lining in lungs changing in bronki to epitherial to squamous cells.
this is an abnormal change too. A normal change is like monocytes rushing in and change to macrophages.

Front 10

Dysplasia:

abnormal Ex. ?

Back 10

Ex = cancer cells

Abnormality of development, in pathology, alteration in size, shape and organisation of adult cells.

Front 11

cause of lethal cell death?
ischaemia =
A low oxygen state usually due to obstruction of the arterial blood supply or inadequate blood flow leading to hypoxia in the tissue.

Back 11

heat
cold
radiaton
mechanical trauma
chemical injury
microbial injury
ischemic injury
neoplasitc growth
normal substances
Ex. gastric abcesses like esphophasius, uric acid

Front 12

what is cell necrosis

Back 12

death of cells w/in a living organism

Front 13

What is Anaplasia

Back 13

Anaplasia is:

<pathology, oncology> Characteristics of a cell (structure and orientation) that make it identifiable as a cancer cell and malignant.

There is lack of differentiation, which is characteristic of some tumour cells.

Front 14

whats the most commmon cause of cell damage?

Back 14

hypoxia

the lack of oxygen

Front 15

how do cells adapt to injury

some adaptations are common to adapt to injury? whats an example?

Back 15

sunburn or a even a suntan

↑ in melon

another ex. is muscle atrophy

Front 16

what is the difference b/t hypertophy and hyperplasia?

Back 16

trophy is the size of the cell like a kidney that grows larger

plasia is the # of cells increase like breasts during pregnancy. another ex. is like a cardiac cell when heart is in a certain amount of hypertension, an enlarged heart, is a result from the cells growing larger, larger cells, NOT # of cells. Ex.kidneys do this too.

Front 17

what are some examples of hyperplasia?

Back 17

liver regeneration
breast tissue

Front 18

Atrophy is a decrease in BOTH cells size and # of cells!
from what?

Back 18

lack of blood supply
aging process. both # and size
what about an arm in a cast?
immobility causes what? a ↓ in size of cell from ↓ in blood and nutrition

Front 19

Metaplasia is a cell ▲ from one type of cell to another type of cell. ex is?

Back 19

smokers lungs that ▲ from epithelial to squamous cells
Ex. when monocyctes rush to an injury site and ▲ to phagocytes.

Front 20

what is an example of NORMAL changes of cells like metaplasia?

Back 20

monocytes ▲ to phagocyctes is a normal change, ex of metaplasia
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Front 21

what is a cell that ▲ from a normal cell into an abnormal cell, what is this called?

Back 21

Dysplasia

is a change from a healthy cell to a unhealthy cell

Front 22

what is anaplasia?

Back 22

a cell that ▲ from a mature cell to an immature cell.
So, seeing immature cells is seeing a cancer develop, a malignancy.

Front 23

what cells indicate a precursor to cancer? what type of cell?

Back 23

a Dysplasia cell is an indication or precursor to cancer

Front 24

there are other things other than hypoxia that causes cell death. like heat or burns kills cells, so does cold too. Chemical or mechanical (stabbings, shootings. What natural things can cause cell death are

Back 24

a gastric absess. where cells are not where they should be which causes cell death. gastric disturbances, or uric acid in the wrong place. What about Uric acid? Gout and Kidney stones...uric acid is normal in the body but too much can cause trauma like gout

Front 25

Cell necrosis, a term we give to cells that die that are part of a living organism. A pressure ulcer is an example of cell necrosis so we debreed it.

Back 25

no response

Front 26

we talked about the inflammatory response.
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the reaction of our body to injury.

Back 26

it is not the infection.
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all infection has inflammation BUT
not all inflammation has infection.
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Front 27

Teacher made a point of neutropenia patients...Tabers says...the presence of abnormalily small # of neutrophils in the blood. what does this make a patient exposed to? (Neutrophiles are the most common form of WBCs)

Back 27

a predisposition to infection!
a neurtrophile is the first to arrive to some kind of cell damage. They are not going to be able to mount a good inflammatory response to help protect their body.

Front 28

the inflammatory response: 4 parts:
vascular response
cellular response
exudate being formed (fluids)
and what else

Back 28

the healing response!

this doens't have to be an open wound. It can be a sprain or strain. Doesn't have to be an open wound

Front 29

the vascular response.

any tissue damage, either lethal or sublethal we will see histomines released. We see vessals dialating. We see increase of blood flow so we have more pressure so the cell wall becomes more permeable, and what?

Back 29

the fluid contains proteins and ononic pressure...large molecules that will pull fluids into tissue which causes edema. moving from low to high (i think) the vascular response
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the idea here is increased cell permiablility, KEY TERM
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with vascular respones

Front 30

w/ increased blood supply to injury, remember neutrophils have a short life like 24-48 hours, they die so what then?

Back 30

dead neutrophils is left. this and other debri from the damage is what forms the exudate.

Front 31

any damaged area has a ↑ neutrophil count so we see our bone marrow increasing blood production and we can tell this by the ↑ in WBC b/c the marrow is putting so much out some are immature & we can see that and this means ...

Back 31

a bacterial infection. the bone marrow neutrophils are sometimes are immature and when we do a LAB and count immature neutrophils indicates a bacterial infection. So think a ↑ WBC think infection
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Front 32

a scab is a form of eschar. (dead matter cast off from surface of the skin)

something over a wound for protection and falls off by itself. Called Eschar. Back to cellular response...
whats second guys get to cell damage?

Back 32

monocytes are 2 guys to get there. we see phagocytes change into macrophages and have a longer life cycle, like a whole week and hang around longer, part of your immunity.

Front 33

She brought up something about what kind of pathogens would get inside our cells themselves?

Back 33

Viruses. Also fungal infection. Incress with allergy, increase with tuberance. Also increase with paracyctes.

Front 34

Exudate formation.

made up of fluids, leukocytes dead or alive, etc. We need to talk about the manifestation of inflammation. Know the 5 cardnal signs of inflammation are...

Back 34

heat
swelling
redness
pain
loss of function

Front 35

touch with back of hand and feel that heat. Loss of function, pain and swelling at the site. What would be systemic response to an injury?

Back 35

fever
leucoyctosis at the site (WBCs)
nausia
malaise
↑ pulse and fever, and resp.

Front 36

Regeneration.

some cells are able and some cells are not! what are Labile cells?

Back 36

cells that regenerate constantly. like nails, hair, GI tract, bone marrow, skin, all regenerate

Front 37

Then there are cells that divide ONLY when they are damaged. what are some examples?

Back 37

STABLE CELLS
kidney
pancrease
bone cells
liver
don't do it on a regular basis but if injured will try
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Ex. liver cells in alcoholics

Front 38

some cells NEVER regenerate!
like what?

Back 38

cardiac cells
nervous system

never regenerate so if we have a MI (myocardial infarction) those cells will never regenerate
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Front 39

The Healing Process:

the regeneration of the raw material that was damaged.
rmember we had
cell death or damage
the inflammatory response
the cell response
formation of exudate
cell regeneration (some do some dont)
then the ???

Back 39

healing process!

2 parts:

regeneration of the tissues
repair where damaged or lost cells being replaced which causes scar tissue.
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scar tissue (connective tissue) that tissue after it heals is never as strong as the orginal tissue. So this is why we never do reverse staging w/ pressure ulcer.

Front 40

A stage 4 pressure ulcer never becomes a stage 3 or stage 2 pressure ulcer sore or a stage one. A stage 4 is a healed stage 4, but never as strong.
NOW repair and more complex thing. This is about connective tissue repair. there are 3 intentions. what are they?

Back 40

primary intention
secondary intention
tertiary intention

Front 41

what is primary intention?

the wound is nice...neatly approximated like a surgical wound. min. scarring. like a paper cut. what is being well approximated mean?

Back 41

healed well. apporximated means it comes together well. scars are minimun. Its not jagged. this is a primary intention!
neat edges

Front 42

what are secondary intentions?

Back 42

jagged edges
wounds from truama
edges not approximated
more debris
scars and pus and scabs

Front 43

what do we not want with a wound ?

Back 43

the top to heal b/f the bottom heals. this is why we might have to debri wounds.

Front 44

what is a tertiary intention?

Back 44

a delayed primary healing
an old wound. maybe purposely left open on purpose to delay the healing to control infection. This is about packing a wound to get it to heal from bottom up. A badly shaped wound is this. Debriding a wound is this. If a wound is shaped to allow it to close ok but a crater wound cant be closed very well so it has to close from bottom up.

Front 45

NOW complications related to healing

hypertropic scars:
are sometimes called

Back 45

proud flesh a lay term
large not neat scars large hard suture lines. b/c less noticable over time. regresses over time

Front 46

Keloid formation scar

a certain kind of person like blacks and you do a surgical procedure and the flesh what?
(Scars that are thick, raised and discolored, usually dark brown, red or purple, are known as hypertrophic scars)

Back 46

becomes a huge scar and you cannot fix it even if you try to remove it, so blacks are prone to Keyloid scaring

Front 47

The contracture scarring
what are some examples?

Back 47

scarring from burns
scarring around joints

Front 48

Another example of proud flesh is excessive granulation and sometimes needs to be cleaned or debrided to heal. like an abdominal wound. when sutures are removed and the edges don't stay together. Its important to teach these people what?

Back 48

how to breath correctly so they don't split these wounds open.
Disheisence is a seperation of the wound.*******************
should learn to cougha and breath correctly

Front 49

anti medic are medicines to stop someone from vomiting and retching w/h puts a huge stress on abdominal wounds. This is also an issue w/ obese patients. Why is obese an issue here?

Back 49

There is no blood supply in adipose tissue so healing is harder.

Front 50

Adhesion is where healing is around abdominal organs that heal together and b/c of this there is a connection made and this is real bad from the surgical manipulation. This is why some people have surgery just for this.
Now black people again. We can not see what in their skin?

Back 50

redness in black people skin.
so you look for natural light to get on the skin to check for temperature or a feeling of the tissue, wheither its firm or foggy. Damaged skin has a soft boggy texture that says its not the same as other tissue around it. Blacks are hard to assess with this kind of injury

Front 51

the aging and injury.
our immune response isn't 100% they will not have a fever, they may not get vocal, but we will see what?

Back 51

confusion. This is a symption of infection.

Front 52

Factors that affect healing and psycosocial issues.

what about nutrition?

Back 52

we need nutrition in place, we said obese won't heal well, smoking makes it hard to heal b/c of the constriction of vessels so MDs try to make pts stop smoking b/c smoking cuts down of circulation!
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Front 53

what about drugs that have an adverse effect on healing. like what?

Back 53

cotizon will affect healing
diabetes have bad healing abilities
nausea / vomiting hinders healing b/c of stress

Front 54

there are some huge things here like people who have huge huge wounds that take years to heal! so there are psycosocial problems like how they feel about themselves. Like what?

Back 54

Keyloid formatins

Front 55

signs and symptoms review again:

Heat, pain, swelling is
fever, malaise, etc is
for geriatrics may not see typical signs but will display what?

Back 55

GERIs will display:
decreased pain
might not have fever
increased irritablility
increased incontenence
increased adjitation
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Front 56

b/c we have talked about response to injury, now our body's natural defense mechanism. like what?

Back 56

cilia in the lungs which sweeps
up and not down into our lungs

normal flora get the bad guys down

tears and sweat protect us by cleaing and pH action

our skin is moist and keeps mold from growing on it

intake muccous membrane like our skin is intact, keeps everything in

sneezing

vaginal pH

eyelashes eyebrows now hairs

stomach acid

lots of natural protection

Front 57

Urinary tract has a natural defense system? yes gravity washing! thats it for natural defense. On thing our skin does is constantly shedding which also what?

Back 57

is shedding bacteria away with it.

Front 58

The chain of infection. KNOW THIS. THE CHAIN OF INFECTION.
Why we break the chain of infection at the resoivor. where do we break that chain of infection?

Back 58

at the portal and resivor

by doing what? washing our hands.

Front 59

chain of infection Potter pp 774
host
→ infectous agent (bacteria,viruses,etc. Washing hands will break the chain here)
→ reservoir (human body)
→ portal of exit(resp, Urinary, GI, Repro, blood)
→ mode of transmission(direct(touching),indirect(sharps, dressings),(droplet, air)
→ portal of entry(same as exit)
→ back to host. so what?

Back 59

book says:
the presence of pathogen doesn't mean an infection will begin. But development of an infection occurs ina cycle that depends on the presence of all of these following things:
an infectious agent present
a reservoir or source for growth
a portal of exit from reservoir
a mode of transmission
a portal of entry to a host
a susceptible host
an infection will develop if this chain remains intact! Nureses follow infection prevention and control to break this chain so that infection will not develop

Front 60

Urinary tract has a natural defense system? yes gravity washing! thats it for natural defense. On thing our skin does is constantly shedding which also what?

Back 60

is shedding bacteria away with it.

Front 61

The chain of infection. KNOW THIS. THE CHAIN OF INFECTION.
Why we break the chain of infection at the resoivor. where do we break that chain of infection?

Back 61

at the portal and resivor

by doing what? washing our hands.

Front 62

chain of infection Potter pp 774
host → infectous agent → reservoir → portal of exit → mode of transmission → portal of entry → back to host. so what?

Back 62

book says:
the presence of pathogen doesn't mean an infection will begin. But development of an infection occurs ina cycle that depends on the presence of all of these following things:
an infectious agent present
a reservoir or source for growth
a portal of exit from reservoir
a mode of transmission
a portal of entry to a host
a susceptible host
an infection will develop if this chain remains intact! Nureses follow infection prevention and control to break this chain so that infection will not develop