internal medicine 2
anchoring filament
attach lymphatic endothelial cells to surrounding tissues excess interstitial fluid will cause swelling which will cause the anchoring filaments to spread apart which will case the space between the cells to increase which will allow the fluid to flow into lymphatic capillaries toward a lymphangion
retinopathy
blindness due to occluded blood vessels
anterior pituitary communicates via
blood flow
lymph watershed
boundaries of territories which drain to specific lymph nodes
tumor suppressor
brake pedals of cell growth and division, stop cancer cells from growing
Charcot mononeuropathy
broke foot and continues walking on it since they can't feel the pain and continues damage foot
regional drainage
clusters that receive lymph from a particular organ/region of the body (axillary, inguinal, cervical)
hyper parathyroidism degree 2
compensatory for hypocalcemia
adrenal gland hyper
cushings
malignant nucleus
enlarged
malignant location
envasive
N cancer staging
extent of lymph node involvement
FSH
follicle growth, secrete estrogen, spermatogenesis
anterior pituitary gland - hyper
gigantism (kids) acromegaly (adults)
hyper parathyroidism degree 1
gland enlargement, so increased PTH secretion
nephropathy
glomerulus damage, so decreased filtration, albumin in urine as an early sign
pancreases produces
glucagon (alpha cells), insulin (beta cells)
if blood sugar levels are low
glucagon released
lymphatic vessels distal to proximal
initial lymphatics (lymphatic capillary and lymphangion), pre collector, collector, lymph node, lymphatic trunk, right lymphatic duct, thoracic duct
type 1 hypothyroidism
insufficient production of TSH
type I dysfunction of pancreas
insufficient production or insulin
type II dysfunction of pancreas
insufficient use of insulin
if blood sugar levels are high
insulin release
stage 3 lymphatics
irreversible, elephantitis
stage 2 lymphatics
irreversible, no change in size and symptoms with elevation of limb
stage 0 lymphatics
limb heaviness, but no increase in volume
lipidema
negative stemmers sign, symmetrical swelling of other legs
posterior pituitary communicates via
nerves
benign mestastisize?
no
adrenal gland produces medulla
norepinephrine and epinephrine
benign nucleus
normal
LH
ovulation, secretion of progesterone and estrogen
posterior pituitary gland (2)
oxytocin and ADH
ADH
retain water
pancreas issues later
retinopathy, nephropathy, neuropathy, silent MI
stage 1 lymphatics
reversible, signs and symptoms decrease with limb elevation
lymphatic territories
root areas of skin which compromise regional drainage of select node groups
pitting edema 4+
swelling 1-2x normal size
posterior pituitary gland - hyper
syndrome of inappropriate ADH
stemmers
thickened skin fold at base of second toe, (+) when the tissue can't be lifted, but can only be grasped as a lump of tissue
dynamic insufficiency
transport capacity is lower than lymph load due to overwhelmed lymphatic system --- NOT true lymphedema ex: ankle sprain
mechanical insufficiency
transport capacity is lower than normal amount of lymph load due to diseased lymphatic system ex: surgery
P53
triggers apoptosis
oxytocin
uterine contractions
grade 4 cancer
very poorly differentiated
benign level of differentiation
well differentiated
grade 1 cancer
well differentiated
thyroid cancer follicular
10-15%
thyroid cancer papillary
70-80%
lymphangitis
infection in lymphatic vessels, compliant of lymphedema
anterior pituitary gland (6)
ACTH, , TSH, LH, FSH, growth hormone, prolactin
hypothyroidism
Hashimoto
parathyroid gland produces
PTH
thyroid gland produces
T3, T4, calcitonin
oncogene
accelerate cell growth and division
adrenal gland hypo
addisons
P53 when inactive
cancer cells escape and are able to grow and divide
lymphedema
decreased transport capacity of lymph and insufficiency to carry lymph load
pitting edema 3+
deep indentation for 5-30 seconds
posterior pituitary gland - hypo
diabetes insipidus
hyperthyroidism
graves
proto oncogene
help with regulation of cell grown and division
long stretch
high pressure at rest, low pressure at movement
type 2 hypothyroidism
hormone resistance
pancreas issues acute
hypoglycemia, diabetic ketoacidosis
hypo parathyoidism
iatrogenic - acquired from complications of other medications idiopathic - autoimmune
combination insufficiency
increased lymph load and decreased transport apiary due to increase load and diseased lymphatic system ex: infection in limb that had lymph nodes removed
pitting edema 2+
indentation from finger pressure
polyneuropathy
malfunction of many nerves in peripheral area
stage 4 cancer
metastasized
adrenal gland produces cortex
mineralocorticoid, glucocorticoid, androgen
grade 2 cancer
moderately differentiated
neuropathy
mono (charot), poly, autonomic
benign location
localized
stage 1 cancer
localized in primary organ
stage 3 cancer
locally advanced
stage 2 cancer
locally advanced, increased risk of regional spread
short stretch
low pressure at rest, high pressure at movement
oncology top 3 causes of death
lung, prostate/breast, colon/rectum
anterior pituitary gland - hypo
pituitary dwarfism
four pressures that determine lymphatic flow
plasma hydrostatic pressure, tissue hydrostatic pressure, plasma colloid osmotic pressure, tissue cooled osmotic pressure
grade 3 cancer
poorly - very poorly differentiated
malignant level of differentiation
poorly differentiated
M cancer staging
presence/absence of metastasis
plasma colloidal osmotic pressure
pressure caused by plasma proteins in a capillary that creates a siphon effect to pull back fluid into capillaries
tissue colloidal osmotic pressure
pressure caused by plasma proteins in the interstitial tissues that causes movement o fluid into tissues
plasma hydrostatic pressure
pressure inside capillaries that decreases as fluid passes from arterial to venous side
tissue hydrostatic pressure
pressure of fluid in interstitial space
oncology top 3 most prevalent
prostate/breast, lung, colon/rectum
anastamoses
shared connection that allows drainage between two adjacent territories
which stretch for lymphedema
short stretch
hyper parathyroidism degree 3
side effects of dialysis
autoimmune neuropathy
silent MI
mononeuropathy
single nerve outside of brain and spinal cord diseased
T cancer staging
size of primary tumor
complete decongestive therapy
skin care, manual lymph drainage, compression bandage, exercise
pitting edema 1+
slight
la place law
small diameter - more tension, large diameter - less tension
TSH
stimulate thyroid to make T3 and T4
malignant metastasize?
yes
