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166 Cards in this Set

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The cause of disease
etiology
used to test the density of the tissue deep to the surface; can feel differences between fluid filled, air filled, and solid structures
percussion
use a stethoscope to listen to breathing, heart fxn, GI motility, and blood flow
auscultation
skin pigment changes:

pallor, lack of color can be due to decreased melanin or decreased blood flow
white
skin pigment changes:

cyanosis indicates low hemoglobin saturation in blood under the skin. can be caused by hypoxia, abnormal substances binding to hemoglobin, or cold
blue
skin pigment changes:

jaundice is caused by the accumulation of bilirubin
yellow
skin pigment changes:

hyperpigmentation is often the result of lack of cortisol production by the adrenal gland. also associated with weakness, fatigue, and weight loss
brown
Causes of cellular injury
1) Hypoxia (decrease in oxygen)

2) Physical Agents

3) Infectious Agents

4) Immunologic Reactions

5) Chemical Agents

6) Genetic Derangements

7) Nutritional Imbalances
if pathological stimulus is removed, the cells can return to normal function
reversible cellular injury
even if the pathological stimulus is removed, the cells will still die.
irreversible cellular injury
types of necrosis
1) Coagulative

2) Liquification

3) Caseous

4) Fat necrosis
cells appear white and cheesy. often associated with TB
caseous necrosis
programmed cell death
apoptosis
Symptoms include:
- acute mental confusion

- ataxia

- ophthalmoplegia
wernicke encephalopathy
occurs mainly in women; refuses to eat
anorexia nervosa
occurs mainly in women; binges and purges
bulimia nervosa
obesity is classifed as being?
20% over your normal body weight
What should you look for with someone who has bulimia nervosa?
- binging and purging

- enamel decay

- mood changes

- weight fluctuation
describes the many social, psychological, and physiological factors that causes changes within the body
stress
general emotional state of fear and apprehension with increases of physiological arousal
anxiety
presence of physical symptoms causing impairment in social/occupational functioning
somatoform disorder
__________ make up 80% of doctor's visits and are a large percent of PT patients
somatoform disorders
the study of work and the relationship between humans and the workplace
ergonomics
ergonomics deals with:
- work performance

- stress

- posture

- biomechanics

- education

- training
In the US, over ______ per year suffer some disability.
2 million people
At least ________ new cases of disease per year
390,000
In 1987, about __1__ suffered a workplace injury.....in 1995, the number reduced to __2__
1) 10 million

2) 6.5 million
What is the most common musculoskeletal injury?
Low back and upper extremity
Signs of Latex Rubber Allergy
- Dermatitis

- Hives

- Bronchospasm

- Shortness of Breath

- Wheezing
Initial response to injury involving vascular and cellular responses
acute inflammation
Signs of acute inflammation
- redness

- warmth

- edema

- pain

- loss of fxn
systemic effects of acute inflammation
- fever

- tachycardia

- hypermetabolic state

- elevated serum protein

- elevated WBC (leukocytosis)
Result of persistent injury, repeated acute inflammation, infection, etc
Chronic inflammation
chronic inflammation results in:
accumulation of lymphocytes, macrophages, fibrosis, and loss of fxn
systemic effects of chronic inflammation
- fever

- malaise

- fatigue

- leukocytosis
chronic inflammation can be detected by:
erythrocyte sedimentation rate (ESR)
MI's heal via _____
scarring
CVA's heal via ____
nerve tissue regeneration
inflammation of blood vessel walls
vasculitis
causes narrowing or occlusion of vessels resulting in ischemia
vasculitic syndromes
best known for affecting synovial tissue, but ________________ can appear anywhere
rheumatoid nodules
Can cause anemia, osteopenia, or cariac and renal problems
rheumatoid arthritis (RA)
chronic inflammatory diseas of connective tissue; can and does involve every organ system, but more prevalent and involved in cardiovascular, renal and neurological systems
systemic lupus erythematosus (SLE)
Known for having recurrent exacerbations
systemic lupus erythematosus
A diffuse connective tissue disease characterized by fibrotic, degenerative, and inflammatory changes; approximately 30% die within 5 years of onsetq
systemic sclerosis
an acute or chronic infection caused by mycobacterium tuberculosis
TB
Aging results in _______ ventilatory capacity & ____ of alveolar surface area for gas exchange
Decreased

Loss
Respiratory acidosis is due to _______
hypoventilation
Respiratory alkalosis is due to ______
hypoxemia
Hypoxemia can cause _________
respiratory alkalosis
Hypoventilation can cause _______
respiratory acidosis
this test provides data on the proportion of different types of blood cells
complete blood count (CBC)
WBC normal level
4500-11,000/mm3
RBC normal level for adult males
4.5 - 5.4 [(10^6)/mm3]
RBC normal level for adult females
4.1 - 5.1 [(10^6)/mm3]
Hematocrit levels for men
37-49%
Hematocrit levels for females
36-46%
Hemoglobin in grams per 100mL for males
13-18
Hemoglobin in grams per 100mL for females
12-16
Platelets normal values
150,000 - 400,000/mm3
common symptoms of sickel cell anemia
- fatigue

- breathlessness

- joint pain

- jaundice

- rapid heart rate

- increased susceptibility to infections

- sporadic attacks of pain in the abdomen or other areas of the body
WBC below 1,000/mm3
patient will have difficulty fighting off opportunistic infections so hygiene practices should be used
WBC above 11,000/mm3
indicates infection and a differential will be performed to determine the number of different specific forms of WBC
Low values of hemoglobin may indicate:
- blood loss

- decreased RBC production

- nutritional deficiencies

- decreased exercise tolerance
Low values of platelets may indicate:
patient at increased risk for bleeding & may limit patient's ability to exercise
Glucose normal levels
70-100 mg/dL
Chloride normal levels
101 to 111 mEq/L
CO2 (carbon dioxide) normal levels
20 to 29 mmol/L
Usually given as fasting blood sugar (FBS) where the patient has fasted for 8 hours before the test
glucose
Prevalence of diabetes
Type I - 2 million

Type II - 20 million

Gestational Diabetes - 135,000 cases per year
Prevalence of pre-diabetes
54 million
diabetes complications
- heart disease

- stroke

- high BP

- blindness

- kidney disease

- nervous system disease

- amputations
Test that measures a waste product of protein metabolism that is eliminated by the kidney.
Blood Urea Nitrogen (BUN)
a waste product of muscle metabolism that is normally cleared and excreted by the kidney
creatinine
Triglyceride normal level
<200 mg/dL
Total cholesterol
<200 mg/dL
LDL (bad cholesterol)
<100 mg/dL
HDL (good cholesterol)
> or = 60
Rhabdomyolysis
- acute, potentially fatal disease

- massive destruction of skeletal muscle cells

- MYOGLOBINEMIA

- renal failure

- death
Cardiac Serum enzymes and markers
- CK-BB

- CK-MB

- CK-MM

- LDH-1

- LDH-2
Liver and biliary serum enzymes and markers
- AST

- ALT

- LDH

- GGT (or possibly OOT, i cannot read the slide)
Normal urinalysis consists of
- color and appearance: pale yellow to amber, clear to slightly hazy

- Blood: negative

- Glucose: negative

- RBC: negative or rare

- WBC: negative or rare
Often used to measure the effectiveness of ventilation, oxygen transport, oxygen saturation, and metabolic function of critically ill patients, patients on a ventilator, and pre and post surgery
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG) lab values
pH: 7.35-7.45

PaCO2 (partial pressure of arterial carbon dioxide): 35-45 mmHg

PaO2 (partial pressure of arterial oxygen): 75-100 mmHg

O2 saturation: 96-100%
Decreases in PaC02 indicate
hyperventilation
Increases in PaC02 indicate
hypoventilation
detect the presence of bacteria in blood
blood culture
used to dectect the presence of bacteria in blood, sputum, pleural fluid, throat, and urine...(faster than blood culture)
gram stain
culture taken directly from a wound to test for presence of infection; also used in conjunction with gram stain
wound culture
lack of nutrition; decrease in size and fxn of cell
atrophy
cells age and die like every other living thing. It is a normal physiologic process distinct from disease.
biologic aging
structural alterations in cells and/or tissues that results from normal development, adaptation, or disease
morphological changes
the physiological demands that can be accomplished by a normal cell
normal cellular homeostasis
occur when excessive physiological stress or pathological processes produce morphological alterations
cellular adaptions
excessive nutrition; increase in size of cells but there are no new cells
hypertrophy
excessive growth; increase in the number of cells
hyperplasia
different growth; substitution of one type of cell for another producing a tissue that can withstand more stress
metaplasia
deranged cellular development
dysplasia
most abundant protein in the body; 30% of all protein in mammals
collagen
classical signs are:
- calor; heat

- rubor; redness

- tumor; swelling

- dolor; pain

- loss of fxn
acute inflammation
chronic, occlusive arterial disease of medium and large sized vessels
arteriosclerosis obliterans (atherosclerosis)
associated with HTN and hyperlipidemia; patients may also exhibit CAD, cerebrovascular disease, diabetes
arteriosclerosis obliterans
Pulses and color in arteriorsclerosis obliterans
Pulses: decreased or absent

Color: pale on elevation, dusky red on dependency
early stages of arteriosclerosis patients exhibit ______
intermittent claudication
late stages of arteriosclerosis obliterans patients exhibit _______
ischemia and rest pain; ulcerations and gangrene
chronic, inflammatory vascular occlusive disease of small arteries and also veins
Thromboanglitis obliterans (Buerger's Disease)
Another name for Thromboanglitis Obliterans
Buerger's Disease
commonly occurs in young males who smoke
Buerger's Disease
This disease begins distally and progresses proximally in both UE and LE
Buerger's Disease
This disease affects primarily the LE
Atherosclerosis
Patients exhibit paresthesias or pain, cyanotic cold extremity, diminshed temperature sensation, fatigue, risk of ulceration, and gangrene
Buerger's Disease
an inappropriate elevation of blood glucose levels and accelerated atherosclerosis
Diabetic Angiopathy
Neuropathy is a major problem. Neurotrophic ulcers may lead to gangrene and amputation.
Diabetic Angiopathy
episodic spasm of small arteries and arterioles
Raynaud's disease or phenomenon
abnormal vasoconstrictor reflex exacerbated by exposure to cold or emotional stress
Raynaud's
This disease usually affects females and occlusive disease is usually not a factor.
Raynaud's
distended, swollen superficial veins; tortuous in appearance
varicose veins
clot formation and acute inflammation in a superficial vein; usually in saphenous vein
Superficial vein thrombophlebitis
clot formation and acute inflammation in a deep vein
deep vein thrombophlebitis (DVT)
usually occurs in LE associated with venous stasis, hyperactivity of blood coagulation, and vascular trauma
DVT
Signs and symptoms:
- inflammation
- tenderness
- pain
- swelling
- warmth
- skin discoloration

- may be asymptomatic early
DVT
Test for DVT of calf veins
Homan's Sign
What does the Homan's Sign measure?
calf pain with dorsiflexion of the ankle
May precipitate pulmonary embolism: presents abruptly, with chest pain, and dyspnea; also diaphoresis, cough, apprehension
DVT
TX of DVT
anticoagulation therapy (Heparin)

thrombolytic agents (streptokinase)

bedrest
Chronic Venous Insufficiency (deep)

- Pain:_________________

- Pulses: ______________

- Color: _______________

- Venous Valvular Insufficiency: __________
- Pain: none to aching pain on dependency

- Pulses: normal; difficult to take with edema

- Color: normal or cyanotic on dependency

- Venous Valvular Insufficiency: from fibroelastic degeneration of valve tissue, venous dilation
Classification of Chronic Venous Insufficiency
Grade I: mild aching, minimal edema, dilated superficial veins

Grade II: increased edema, multiple dilated veins, changes in skin pigmentation

Grade III: venous claudication, severe edema, cutaneous ulceration
enlargement of nodes
lymphadenopathy
excessive accumulation of fluid due to obstruction of lymphatics
lymphedema
acute bacterial infection spreading through lymph system; usually streptococcal
acute lymphangitis
primary lymphatic diseaes is _____
congenital
acquired, due to trauma, surgery, radiation, or diseaes
secondary lymphatic disease
Latin meaning "new growth"
neoplasia
represents abnormal cellular differentiation, maturation, and control of growth. often form masses of abnormal tissue (tumors)
neoplasia
In the US, over ______ people develop some form of CA each year
1 million
In 2003, there were approximately ________ deaths due to CA
555,000
Only _______ results in more deaths per year than CA
cardiovascular disease
a new growth that is capable of invading and destroying normal tissue and capable of metastasis
malignant
to travel to a distant site in the body and begin a new area of malignant growth
metastasize
usually grow slow and do not invade surrounding tissue or spread to distant sites
benign neoplasms
a malignant neoplasm, malignant tumor
cancer
the coverings of the external and internal surfaces of the body
epithelia
the portion of the embryonic mesoderm that forms connective tissue of the body
mesenchyme
Greek for "anything poured inside"; the essential functional elements of an organ
parenchyma
the supporting tissue or matrix of an organ. the region where the blood and lymphatics vessels run.
stroma
usually designated by the suffix "oma"
benign tumors
benign epithelial neoplasms
adenomas
benign fat cell tumors
lipomas
benign fibroblast tumors
fibromas
tumor is malignant when it has this suffix
"sarcoma"
malignant tumors derived from epithelial cells
carcinomas
derived from glandular epithelia
adenocarcinomas
Malignant neoplasms derived from mesenchymal tissue are referred to as ______
sarcomas
malignant fibroblasts
fibrosarcoma
malignant cartilage
chondrosarcoma
leading cancer in men
1) prostate

2) lung and bronchus

3) colon and rectum
leading cancer in women
1) breast

2) lung and bronchus

3) colon and rectum
examples include breast CA, ovarian CA, and some colon CA
familial cancers
there is evidence of familial clustering, but there is no specific phenotype
familial cancers
single mutant gene greatly increases risk of tumor development
inherited cancer syndromes
examples include: childhood retinoblastoma, familial adenomatous polyps of the colon and neurofibromatosis
inherited cancer syndromes
Fact: cancers incidence increases with age
Fact: Significant increase in CA between ages of 55 and 74
Fact: the stomach CA rate is 7 to 8 times higher in Japan than in the US
Fact: obesity, alcohol abuse, and cigarette smoking increase risk for cancer
acquired conditions of increased cellular replication include:
- cirrhosis of the liver

- metaplasia and dysplasia of the bronchial epithelia

- chronic gastritis and ulcerative colitis

- metaplasia of the esophageal epithelia due to frequent gastric reflux
In tumors, the ________ is the area where malignant cells grow.
parenchyma
4 factors that distinguish benign from malignant
1) cytological characteristics

2) local invasion

3) rate of growth

4) metastasis