N2450: Final Exam

which parasympathetic-mediated autonomic response impairment is responsible for failure to achieve erection? a. erection b. ejaculation c. emission d. detumescence

c.?

cellular response: cellular migration

movement

crypts

mucosal epithelial depressions of the colon

metastasis

occur when neoplasm are spread by distant sites often by way of the lymphatics or blood vessels 1) breaking through the basement membrane if present and extracellular matrix 2) gaining access to and circulating within the blood vessels or lymph system 3) leaving the blood vessels or lymph systems and adhering to distant tissues 4) establishing a new nutrient network at the distant tissues through a process of angiogenesis

single gene disorders

occurs at a specific, single site on the strand of DNA as a result of: -deletion -duplication -inversion -insertion -translocation

myofibril

sarcolemia: like plasma membrane helps propogate electric impulses that help initiate contractions transfer tubules: in charge for calcium intake

diagnosis: endoscope and biopsy

-gluten free diet

micronutrients

-vitamins -minerals

UTI clinical manifestations

dysuria: painful urination hematuria: painful blood -Dysuria • Urgency • Frequency • Hematuria • Cloudy (purulent) urine

1. Which phase of the cardiac action potential involves membrane potential returning to resting level? a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase 4

e. phase 4

growth hormone

excess: before puberty (gigantism) excessive skeletal growth -after puberty (acromegaly) deficit: short stature, obesity, immature facial features, delayed puberty, hypoglycemia

thyroid hormone

excess: hyper metabolism, weight loss, diarrhea, exopthalamos, anxiety, goiter deficit: hypo metabolism, weight gain, constipation, goiter, dry skin, coarse hair

parathyroid hormone

excess: hypercalcemia, excessive osteoclastic activity and bone resorption, pathologic fractures, formation of renal calculi deficit: hypocalcemia, muscle spasms, hyperreflexia, seizures, bone deformities

aldosterone (mineralocorticoids)

excess: hypertension, hypokalemia, hypernatremia, muscle weakness fatigue, polyuria, polydipsia, metabolic alkalosis deficit: weakness, nausea, anorexia, hyponatremia, hyperkalemia, dehydration, hypotension, shock, death

teratogens

substances that cause damage to developing embryos or fetuses -pathogens, drugs, alcohol, and environmental factors

tumor markers

substances that may be detected in cells or body fluids and can provide clues to the presence, extent, and treatment response of certain neoplasms

ARDS phase 5

sufficient oxygen can't cross the alveolocapillary membrane but CO2 can and is lost with every exhalation -O2 and CO2 decrease in the blood

anaphylactic reaction: treatment

symptomatic -drugs to relax bronchial smooth muscle -drugs to constrict vascular smooth muscle -limit inflammation -alberurol and into: relax bronchial muscle -any type of difficulty breathing: use epic pen if paramedics haven't arrived, use second epi pen 15 minutes after first pen use

energy

the capacity to do work

mitosis

the chromosomes in the nuclei of somatic cells of through a series of phases (prophase, pro metaphase, metaphase, anaphase, telophase) resulting in the creation of daughter cells with the same chromosome number and genetic makeup as the originals somatic cell -chromatids one of two strands newly formed during the early process of chromosome duplication is joined together by a centromere -each human somatic body cell contains 23 pairs of chromosomes or a total of 46 also known as the diploid number of chromosomes -of the total number of chromosomes, 44 are autosomes (chromosomes that aren't sex ones) and 2 are sex chromosomes

cell-mediated immunity: major histocompatibility complex (MHC)

-MHC class 1 molecules recognize CD8 cytotoxic T lymphocytes -MHC class 2 molecules recognize CD4 Th1 or Th2 helper T lymphocytes -produced by human leukocyte antigen (HLA) genes -test these for organ donors/bone marrow -little tiny molecules that recognize CD8 (self) cells -test to make sure donor cells are very similar to our own MHC

down syndrome: clinical manifestations

-Mental delay -Facial features -Cardiac defects -GI malformations -Visual and hearing impairment -Thyroid dysfunction -Leukemia

cushing syndrome: clinical manifestations

-Metabolic alterations • Obesity of trunk, face, and upper back • Glucose intolerance • Suppression of inflammation/immunity • Behavioral changes • Impaired stress response

cerebral palsy: pathophysiology classification

-Motor dysfunction type -Spastic: inability of muscles to relax -Athetoid/dyskinetic: inability to control muscle movement - Ataxic: inability to control balance and coordination • Anatomic involvement - Hemiplegia - Diplegia - Quadriplegia spastic: types that tend to be just inability of muscle to relax and can involve hemiplegia or diplegia or quadriplegia (trunk and neck) athetoid: ability to control muscle movement ataxic: control balance and coordination

infection process

-Multiple drug-resistant microbes • Globalization and spread of harmful microbes http://www.medicinenet.com/mrsa_infection/article.htm now even finding MRSA in the community where before we used to just see it in the hospital -antibiotics are becoming less effective -individual bacteria can undergo mutations making it resistant to antibiotics -using antibiotics when you can treat on your own leads to resistant -not using antibiotics when not needed -patients ask for them and they don't need them

tests of muscular function 2

-Muscle biopsy • Complex myography - Noninvasive way to gather information on the mechanical characteristics of muscle • Genetics - Molecular genetics, deoxyribonucleic acid (DNA) libraries, genetic probes, and gene localization techniques

autosomal dominant

-Mutation located on the autosome -Inheritance of a mutation involving one dominant allele results in expression of the trait picture is known pedigree 50% each time regarding inheritance of a mutation involving one dominant allele results in expression of the trait

hydrocephalus: diagnosis

-Newborn •Head circumference measurement •Transillumination •Ultrasound Child/Adult •Imaging (CT, MRI, X-ray)

ovarian cancer: clinical manifestations

-Often asymptomatic in early stages • Vague abdominal bloating • Large tumors may manifest as: - Abdominal distention - Pressure - Pain

alternative splicing

-certain species of the RNA (exons) are retained and other segments (introns) are exercised

ARDS phase 3

-as capillary permeability increases, proteins and fluids leak out, increasing interstitial osmotic pressure and causing pulmonary edema

AIDS clinical manifesations

-associated with reduced CD4 T cell count -immunosuppression -opportunistic infections -fungal infection, candida -pneumocytis carnii pneumonia -Kaposi's sarcoma: endothelial cell tumor -usually happens to people that are fairly normally healthy

cellular changes in aging

-atrophy -hypertrophy -impaired mitosis -deposition of lipids -damage from free radicals -accumulation of metabolic waste products -deposition of lipofuscin

cellular adaptation to stress

-atrophy: decrease in cell size -hypertrophy: increase in cell size -hyperplasia: increase in cell number -dysplasia: change in cell size, shape, uniformly, arrangement and structure atrophy: die off hypertrophy: like brain and heart cells metaplasia: sounds bad but not really bad dysphasia: usually a sign of cancer

neurologic response to stress

-autonomic nervous system -cerebral cortex: regulates cognitive activities such as intense focus, planning, attention, and persistence -limbic system: regulates emotional activities such as fear, anxiety, anger, and excitement, and stimulates the reticular activating system -thalamus: intensifies sensory input related to the stressor such as vision, hearing, and smell -hypothalamus: release hormones to initiate the neuroendocrine response; acts on the autonomic nervous system -reticular activating system: increases alertness and muscle tension and contributes to stimulation of autonomic nervous system

mendels laws of genetic traits

-autosomal dominant -autosomal recessive -sex-linked dominant -sex-linked recessive

genetic inheritance patterns

-autosomal dominant -autosomal recessive -sex-linked dominant -sex-linked recessive -mitochondrial gene disorders

sickle cell disease

-autosomal recessive -often linked back from ethnicity, racial groups, family integration (cousins marrying cousins) -sickle cell more common among african americans -red cells supposed to look like a disc to allow for gas exchange but the change in shape effects change in function

sickle cell disease

-autosomal recessive affecting hemoglobin in red blood cells -result of a single gene mutation that follows mendelian inheritance pattern -have hemoglobin S making the cells stiff and distorted -breaks down red blood cells

cystic fibrosis: pathophysiology

-autosomal recessive disorder -electrolyte and water transport affecting certain epithelial cells (respiratory, digestive, and reproductive lining) -mutation of the CFTR gene -mucous plugging -inflammation -infection in the lungs -respiratory failure is most common cause of death

migraine headache treatment: nonpharmacologic prevention strategies

-avoidance of triggers -regular exercise -smoking cessation -hormone level stabilization opioids do not work for headaches and we don't prescribe them for it hormone level stabilization: give them birth control and there are medicines (hormone pills) that can prevent headaches during menstruation

shock clinical manifestations

-vomiting, diarrhea, burns could all lead to dehydration -usually a bacterial infection that causes shock -cardiogenic: heart is not pumping as effectively and not moving o2, fluid in lungs because backup, decreased plasma -tachycardia, tachypnea -cool, clammy extremities; peripheral pulses -decreased arterial BP (decompensation) -cyanosis and/or pallor -restlessness, apprehension, decreased mental function -poor urinary output

cellular response: chemotaxis attraction

-wanting the cells to stick and are attracted to the epithelium and adheres and migrates out

autoimmunity diagram

-was given a donor organ, we have to suppress it to not have it recognize that it doesn't know this kind of origin -something of the same species was put into the body and rejects the response

nondisjunction

-when chromosomes fail to separate during meiosis or mitosis resulting in an unequal number of chromosomes between cells -severity depends on when it occurred: if it was right after conception it could affect all of resulting cells

generalized anxiety disorder clinical manifestations

-worry that is -excessive -uncontrolled -irrational -lasting > 6 months -includes at least 3: -restlessness -fatigue -difficulty concentrating -irritability -tension -sleep disturbance -benzo: don't let them take it longer than 3 months

forms of healing: secondary intention

-wounds heal from the bottom up -greater risk for infection and scarring -: larger wound and could not close with a suture its too wide and would form an abscess if tried to use a suture happens from the bottom up tend to be uglier scars and takes longer and greater risk for infection and scarring

generalized anxiety disorder

-you have to have it for 6 months in order to be diagnosed -anxiety disorders: a group of chronic psychiatric conditions characterized by overwhelming and irrational feelings of fear or worry -can cause physical symptoms -types -anxiety disorders -obsessive-compulsive disorders -trauma/stress-related disorders -short of breath -nausea -headache -stomach ache -palpations

MI clinical manifestations

Gender variability Chest pain (angina pectoris) or a crushing pressure, often radiating to the left arm, shoulder, or jaw Fatigue, weakness, syncope, anxiety Dizziness, shortness of breath Sweating, pallor Indigestion Nausea, vomiting females are having heart attacks at the same level in men unlike previously -heart attacks differ among women and men

ovarian cancer: pathophysiology

Genetic risk factors - Family history - BRCA-1 and BRCA-2 genes implicated - History of breast cancer • Environmental factors - Ovarian trauma, such as with monthly ovulation - Use of hormone therapy -endometrial cancer of the uterus is most common invasive cancer

stress response 2

alteration in glucose fat and alteration: get fat autonomic and hormones causing these symptoms

cellular injury and death

causes of injury -physical -mechanical -thermal -chemical

cytoskeleton

little more than what you need to know they make up the cytoskeleton

fragile X syndrome

located on the arm of the X chromosome, a nucleotide mutation in the fragile X mental retardation 1 (FMRI) gene has been identified as the molecular basis of the syndrome

hippocampus

long-term memory

twin coronal MRI studies

ones on the left are normal

alveoli: gas exchange

only one cell thick, gas exhcange takes place by diffusion, C)2 diffuses out of bloodstream and 02 diffuses in oxygen can diffuse across the same membrane through the aveolis -large surface area -very thin -moist lining (allows gases to dissolve and then diffuse -good supply of blood -good ventilation

ectopic

refers to hormone secretion from a site outside of an endocrine gland

anaplasia

refers to the loss of cell differentiation and therefore the loss of cell function

trisomy

refers to the presence of three copies of a chromosome in a cell -life determines on which specific chromosome is affected -large chromosome=no life -occurs in chromosome 21: down syndrome

ARDS treatment:

remove causative factors -administration of 100% oxygen -mechanical ventilation (we usually only use about 21% oxygen)

prostate cancer: pathophysiology 2

risk for men is 1 in 6 second leading cause of cancer death in men following lung after the age of 65 is a major risk factor black race, smoking, other nutritional factors like high intake of fats in meat and low intake of licamen and diet high in calcium tend to increase risk factors prostate epithelial cells will become malignant 5-10% of people who get prostate cancer are estimated to be closely related to a genetic factor (chromosome 1Q24 (HPC 1 gene) mutation associated with men who tend to have

infection

• A state of cellular, tissue, and organ destruction resulting from invasion of microorganisms • Penetration of 3 lines of defense • Resident flora • Pathogen - Communicable disease - Non-communicable disease could be infection of something new or normal flora being broken and micro gets passed through lines of defense -communicable: TB, common cold, strep, pneumonia, meningitis (dorms high risk) noncommunicable: ear infection

viral hepatitis pathophysiology

• Acute or chronic inflammation of the liver caused by infection with one or more hepatitis viruses • Transmitted via fecal-oral route or direct contact with blood/body fluids of infected person • Results in varying levels of hepatic necrosis

male reproductive anatomy: hormone regulation

-hypothalamic releasing hormone -gonadotropin releasing hormone (GnRH

mechanism of action of antidepressant agents

MAO can break this down and MAO inhibitors can prevent this from happening

central nervous organization: pyramidal system

-axons in descending corticospinal and corticobulbar tracts -controls voluntary movement

what mechanisms might a cell use to process and present Ag (antigen)

cell mediated on the inside of the cell

panhypopituitarism

decrease in pituitary hormones

female reproductive anatomy: ovarian progesterone

-thickens uterine lining -relaxation of smooth muscle -elevates core body temperature

urine characteristics

-total volume: 750-2,000 mL/day -color -turbidity -slight ammonia odor

central nervous organization: spinal cord

-impulse conduction: periphery and brain -reflex responses -housed in vertebral column -vertebrae is longer than spinal cord

feedback

"The modification or control of a process or system by its results of effects" • The hypothalamus is constantly receiving input in the form of neurotransmitters, chemical mediators, or injury. • Feedback can be positive or negative

glaucoma: pathophysiology

#2 leading cause of vision loss in elders -more of peripheral loss rather than central vision -vision loss due to optic nerve damage -categories -primary open angle -clogged trabecular network at the point where the iris and cornea meet -impaired aqueous humor drainage leading to increased intraocular pressure (IOP)

mitochondrial gene disorder: mitochondrial encephalomyopathy, lactic acidosis, and stroke

(MELAS) -maternally inherited condition characterized by mtDNA point mutations -affects cytochrome oxidase (COX) an enzyme important in catalyzing oxidation-reduction mitochondrial reactions in cellular respiration and the prevailing theory on the underlying mechanisms involved in MELAS is that a decrease in oxidative phosphorylation creates an imbalance between ATP production and usual, contributing to neuronal dsyfunction

bone cells

**there are 2 out of the 3 bone cells arise from mesenchymal stem (stromal) cells: osteoblasts and osteocytes osteoclasts: not from mesenchymal stem cells

altered acid-base balance: metabolic alterations in acid-base balance

- Altered bicarbonate due to the addition or loss of nonvolatile acid or base in the extracellular fluid • Reduction of HCO3-, leading to a decrease in pH • Addition of HCO3-, leading to a increase in pH - Regulation by the kidneys • Initiating events altering H+ and HCO3- levels trigger compensatory mechanisms • pH is adjusted, without affecting the underlying cause bicarbonate is a weak base leading to decrease pH lower pH goes more acidotic you get if underlying cause isnt treated, kidneys can give you time to fix the acid base balance

HAART-Associated Acidosis clinical manifestations

- Associated with severity of metabolic acidosis • Nausea, vomiting, abdominal discomfort, weight loss • Hepatic steatosis • Lactic acidosis syndrome - Hepatomegaly - Coma - Multi-organ failure fatty liver: hepatic steatosis and can diminish quality of life

pH

- Clinical measurement of acid:base ratio - how many free hydrogen ions you have in the serum of your body is how you determine level of pH -only has to do with the serum in your body -below 7.35:acidosis -above 7.45: alkaline or alkalosis -large number of hydrogen ions present in serum then low pH and vice versa

metabolic acidosis: compensatory mechanisms/treatments

- Compensatory mechanisms • Increased breathing rate and depth, hyperkalemia, increased ammonia in urine - Treatment • Correction of the primary cause • Fluid and electrolyte replacement - `Correction of pH -increased ammonia: excreting it to decrease the acidic level or increase pH in our bloodstream -ph 7.35-7.45

renal tubulopathy: treatment

- Correction of renal salt and fluid loss - Supplemental • sodium • Potassium • Calcium • Magnesium - Potassium sparing diuretics - Prostaglandin inhibitor

metabolic acidosis in parenteral nutrition

- Delivery of water, glucose or dextrose, amino acids, lipids, vitamins, minerals, electrolytes, acetate, and trace elements through the venous system - Additives • Hydrochloric and organic acids (chemical interactions) • Base (to counter solution acidity) • Metabolic acidosis may result cannot orally intake fluids and so is given through an IV give the fluid at a pH of 7.4 by adding additives into the fluid

HAART-Associated Acidosis Diagnostic Criteria

- Early recognition and treatment - Lab tests • pH • Lactate in blood • Electrolyte levels • Liver function tests

chronic pancreatitis: diagnostic criteria

- Endoscopic retrograde cholangiopancreatography (ERCP) - Serum amylase and lipase levels - Direct aspiration of pancreatic duct or duodenum

joints classification based on structure

- Fibrous • Joins bone to bone - Cartilaginous • Bones are united by a pad or disk - Synovial • Most moveable • Joint capsule, synovial membrane, joint cavity, synovial fluid, articular cartilage fibrous: very immobile-skull and where your tibia and fibula come together cartilaginous: costal cartilage in sternum, fibrocartilage disks that are located in between the bones of your spine, cartilage located between pubic bones synovial: most mobile-articular cartilage of your shoulder, joint at your elbow and between your hummerus, ulna, radius, -all synovial joints are going to contain synovial fluid

obesity: pathophysiology risk factors

- Genetics - Lifestyle (diet and exercise) - Neurologic mechanisms and hormones • Leptin, estrogen, thyroid hormone, insulin, melanocortin, ghrelin - Enzymes where you gain weight is differently from others and is genetics that decides that leptin is most important hormone leptin: secreted by fat cells and is responsible the hypothalamus to let you know that you're full estrogen: stimulates lipid movement into the fat cells in the hips and upper thighs area (why women have more fat here) lipid protein, lipases also help promote lipid storage

renal buffer system primary regulator

- H+ elimination and HCO3- conservation save bicarbonate in bloodstream and eliminate hydrogen ions with urine (yellow) cell in center is going to give up or secrete for a potassium ion

renal tubulopathy: clinical manifestations

- In utero • Excessive amniotic fluid - Infancy • Polyuria • Hypercalciuria • Prostaglandin effects - Vomiting, diarrhea, fluid/electrolyte imbalance • Metabolic alkalosis - Increased bicarbonate in the blood • Contracted extracellular fluid volume -amniotic fluid is basically urine -extracellular fluid volume: dehydration

hydrocephalus: pathophysiology

- Increased cerebrospinal fluid -can be congenital •Imbalance of fluid produced, obstructed flow and rate of absorption •Increased ventricular size • Increased intracranial pressure - Categories •Noncommunicating -CSF flow obstruction •Communicating -Impaired absorption Timing of onset •Congenital -Present during fetal life/birth •Acquired -Secondary to another disease water on the brain really large heads 125-150 ml normal but we produce 300-400 a day

renal tubulopathy: diagnosis

- Lab • Electrolytes in blood and urine • Arterial blood gasses - Anion gap - Base excess - pH • Urine specific gravity • Renal function • DNA testing -urine specific gravity high-urine is not concentrated

plasma buffer system: protein buffer system

- Largest buffering system • Intracellular proteins • Vascular proteins - Albumin - Globulins - Amphoteric • Able to function as acid or base • Can accept and donate H+ ions • Release of H+ and CO2 -is part of plasma buffer system -proteins can accept or donate hydrogen ions (amphoteric) -babies have issues with this (amphoretic)

anion gap

- Measurement of major cations and anions in plasma • Sodium: major measurable cation • Chloride and bicarbonate: major measured anions (Sodium + Potassium) - (Chloride + Bicarbonate) = Anion Gap - Indication of acid-base balance cations -anions=anion gap -normal gap is about 12 because there are still some anions in the serum -sodium bicarb:23-30 -normal anion: acidosis that could possibly be present

regulation of acid-base balance: buffer systems

- Mixing of acids and bases to resist change 1. Plasma buffer system: Reacts within seconds in response to hydrogen ion concentration 2. Respiratory buffer system: Reacts within minutes to excrete C02 through change in respiratory rate 3. Renal buffer system: Reacts within hours to days through the production, absorption and excretion of acids, bases and ions pH of 7.4 requires a ratio of bicarbonate (HCO3-) to carbonic acid (H2CO3) of 20:1 respiratory: faster we breath more CO2 exhaled renal: most important but sometimes doesn't react fast enough every one of carbonic acid youre going to have 20 particles of bicarbonate

pathogen characteristics: virus

- Obligate intracellular parasites • Converts host cellular metabolism • Production of nucleic acids and proteins encoded and controlled by virus • Rapid cellular multiplication and random proliferation • Loss of cellular function • Release of virions infecting other cells has to have a host cell to live off of -hard to kill because inside the cell and are self-limited so they usually only lasts 10 days if you have a good immune system -weak virus: 3-4 days

chronic sinusitis: treatment

- Pharmacologic: - Glucocorticoids - Antibiotics - Nonpharmacologic: - Nasal saline irrigation - Surgical -gluocoricods: decrease swelling -irrigation: using a turkey base

regulation of acid-base balance: plasma buffer system

- Primary chemical reaction • Water (H2O) • Carbon dioxide (CO2) • Carbonic acid (H2CO3) • Bicarbonate (HCO3-) H2O + CO2 (left or right arrows) H2CO3 (left or right arrows) H+ + HCO3- use catalytic enzyme to break down carbonic acid carbonic acid can also be broken down into hydrogen and bicarbonate

plasma buffer system: bicarbonate buffer system

- Primary extracellular buffer -The strong acid HCL is substituted for the weaker acid H2CO3 through a reaction with the weak base NaHCO3. -The strong base sodium hydroxide (NaOH) is substituted for the weak base NaHCO3 through a reaction with the weak acid H2CO3.

SIADH: treatment

- Remove cause • Water restriction • Isotonic or hypertonic IV fluid replacement • Pharmacologic treatment

renal tubulopathy: pathophysiology

- Salt losing tubulopathy • Metabolic alkalosis - Hypokalemia - Hypochloremia - Impaired electrolyte reabsorption • Gene mutation in renal membrane proteins • Diuretic-like effect - Inhibition of sodium and chloride reabsorption - Excretion of water - Excretion of potassium electrons going from nephrons and being reabsorbed in the blood stream -seen in babies sodium and chloride being excreted from the kidneys fetus will produce excess amount of amniotic fluid and that is urine and the fetus is swimming around fluid filled sac composed of their urine

functional fecal incontinence: clinical manifestations nonretentive incontinence

- Socially inappropriate defecation - Absence of organic disease - Absence of excessive stool and fecal retention - Symptom frequency at least once per month - Symptom duration at least 2 months -child is having inappropriate poops

HAART-Associated Acidosis treatment

- Subclinical • Transient • No treatment needed - Hyperlactatemia • Prevent the development of metabolic acidosis - Stop NRTI treatment if LAS develops - IV fluids subclinical: continue on with therapy and you'll be fine hyperlactatemia: stop NRTIs

acids

- Substances that donate hydrogen ions - Na+, K+, Ca2+ and Mg2+ -anything that gives us a hydrogen

pathogen characteristics: protozoa

- Unicellular, complex microorganisms - Motile - Lack cell wall - Transmission • Sexual contact • Consumption of contaminated food/water • Vector transmission fungus (yeast) very opportunistic -has flagella to move around places -usually sexually transmitted -vector: mosquitos, dog, stung by mite, insect, etc.

hydrocephalus: clinical manifestations

- Variable based on •Age of onset •Severity •Underlying pathology - Newborn •Increased head size •Shrill cry •Difficulty feeding Children and adults •Impaired motor and cognitive function •Incontinence why newborns get a head measurement scalp has separated suture marks lethargy decreased pulse increased temp fontanel should be closed by age 2 and posterior one closes by 2 months normally

metabolic acidosis

- pH < 7.35 - Due to a base deficit of HCO3- - Secondary to an increase in strong anions (Cl-) or increase in weak acids -Mechanisms • Increased production of nonvolatile acids: due to fasting, ketoacidosis and lactic acidosis • Decreased secretion of acids by the kidneys: leading to renal failure • Increased loss of bicarbonate: due to diarrhea, gastro-intestinal suction • Increase in Cl-: due to excessive chloride reabsorption in the kidney, sodium chloride infusion diarrhea: not reabsorbing bicarbonate in large volumes and no longer available to our bodies

metabolic alkalosis

- pH > 7.45 - Due to excess of HCO3- in blood - Mechanisms -• Decreased H+ ions • Increased HCO3- ions • Loss of Cl- ions • Caused by • Impaired excretion of excess HCO3- • Contraction of extracellular volume • Hypokalemia • Hypochloremia -exchanging potassium for hydrogen ions-hypokalemia

fatty acid and glycerol absorption

-2 steps for the conversion of dietary fats into fatty acids and glycerol -emulsification -enzymatic digestion -hydrophobic end-adheres to the lipid molecule -hydrophyllic end-comprises an outer soluble surface (where the absorption is going to happen)

facts

-25% of children will need some types of services before 18 -due to pressure on kids, kids being sheltered, -emotions can be quicker, last to hours to days -feelings: quick last a few minutes, few hours, briefer than emotions are -temperament: your steady state; your personality, what you're born with

development disorders

-8 weeks of gestation is where a lot of stuff is happening

tinea: pathophysiology

-A group of fungal infections • Transmitted via direct contact • Dermatophyte attaches to and produces thickening of keratinized cells fungal infections of the different types of skin -wrestling big contact

metabolic acidosis in parenteral nutrition treatment

-Adjustment of PN solution components and intake • HCO3- (to correct a base deficit) • Hydration • Oxygen

burn treatment

-American burn association criteria -remove source of injury and cool/rinse skin -airway, breathing, circulation -fluids, nutrition, antibiotics, analgesics -wound management may include: -hydrotherapy -skin grafting -cold water is best way to clean the burn

motor unit

-Anterior horn cell, its axon, and its muscle fiber - Axons of motor nerves branch out to innervate a specific group of muscle fibers. - Behaves as a single entity, and contracts as a whole when it receives an electrical impulse.

myoblasts

-Are the primary cells responsible for muscle growth and regeneration. • Are termed satellite cells when in a dormant state. • Once muscle is injured, satellite cells become activated to form myoblasts and assist in repair.

tests of joint function

-Arthrography - Injects dye into the joint. • Arthroscopy - Directly visualizes a joint through an arthroscope. • MRI - Produces images of body tissues through the use of electromagnetic (radio) waves. • Synovial fluid analysis - Normal fluid is sterile. - Abnormal blood (hemoarthrosis); bacteria (disease); fragments and tissue (inflammation or wear and tear) arthrography: taking imaging after dye injected MRI: shows soft tissue well

cushing syndrome: diagnostic criteria

-Cortisol levels in 24-hour urine • Imaging studies to detect tumors has diurnal effect: different times different amount of urine

addison disease: pathophysiology

-Autoimmune destruction of the adrenal cortex • Adrenal gland cannot produce glucocorticoids, mineralocorticoids, or androgens due to tumors, hemorrhage, trauma, radiation, or surgical removal • ACTH levels increase to stimulate secretion of adrenal hormones from the adrenal glands -autoimmune destruction of the layers of the adrenal cortex is the most common cause for this -destruction least to the inability of the adrenal gland to produce any glucocorticoids, mineralocorticoids, and androgens resulting in ACTH levels elevated to increase the secretion -too little glucocorticoids -adrenal glands aren't working

more tests of bone function

-Bone scanning • Dual-photon absorptiometry(DXA) • Serum bone-specific alkaline phosphatase (BAP): Marker of bone formation • Bone resorption evaluation - Urinary and serum measurements of cross-linked N- terminal telopeptides (NTx), a product of osteoclast bone resorption; specific for bone collagen alone • Urine NTx is more sensitive and specific than serum NTx. -urine is more accurate test than the serum

urine production: urinary filtrate

-Bowman's capsule through the tubule system -transport via countercurrent mechanism -reabsorpton -from filtrate to circulation -secretion -from circulation to filtrate -excreted as urine

inadequate cardiac output

-Changes in blood volume, composition, or viscosity -Impaired ventricular pumping -Structural heart defects such as valve defects that allow leaking or regurgitation of blood -Conductions defects that lead to an unresponsive heart rate and rhythm -Changes in peripheral vascular resistance excessively or significantly

Ratio of acids and bases closely regulated

-Clinical measurement: pH (7.35-7.45) - Hydrogen concentration inverse of pH -large number of hydrogen ions present in serum then low pH and vice versa

multiple sclerosis: clinical manifestations subtypes

-Clinically isolated syndrome (CIS): Initial presentation of symptoms • Relapsing-remitting (RR): periods of acute neurologic symptoms with return of neurologic function • Primary progressive: slow, chronic neurologic deterioration • Secondary progressive: Initial RR presentation followed by slow, chronic neurologic deterioration progress to other subtypes too lasts 24-48 hours and so on and then go into a remission

characteristics of hormones

-Control via the hypothalamic-pituitary axis: hormone synthesis and release is controlled by tissues and organs • Feedback (positive and negative loops): hormones listen and adjust based on negative and positive loops • Patterns: hormones exhibit predictable patterns of secretion, metabolism, and elimination • Receptor binding: to exert an effect hormones must locate and attach onto target tissues • Action on target organs and glands 1. Act on target organs to achieve an effect 2. Act on glands to produce another hormone control: they work together in communication with one another and control hormones in your body all metabolism with through they interact with broken down by the liver (hormone) sometimes we don't have to even break them down some have half-life through apoptosis can act on glands to produce another hormone

influenza clinical manifestations

-Cough • Sore throat • Nasal congestion/drainage • Shortness of breath • Chills • Fever • Body aches • Weakness • Malaise

genetic replication

-DNA gets replicated with every cell generation and does this by unraveling double strand to form a single strand with enzymes working together to make this happen and then you get a complementary strand to get a new strand of DNA

genetic code process

-DNA is transcribed by messenger RNA -taking the message of the DNA out of the nucleus into the cytoplasm where it is translated by transfer RNA - aligns bases to make specific amino acids which then go out on the ribosomes to form peptides using ribosomal RNA to end with proteins exon: transcribed and translated intron: not transcribed or translated but are important to remain consistent

addison disease: clinical manifestations

-Darker pigmentation of skin (high ACTH) • Glucocorticoid deficiency - Hypoglycemia, weakness, poor stress response, fatigue, anorexia, nausea, vomiting, weight loss, personality changes • Mineralocorticoid deficiency - Dehydration, hyponatremia, hyperkalemia, hypotension, weakness, fatigue, shock -lady again because autoimmune disease higher risk

SIADH: clinical manifestations

-Decreased urine output (concentrated) • Severity of symptoms depends on serum sodium levels - Anorexia, nausea, vomiting, headache - Irritability, disorientation, cramps, weakness - Psychosis, gait disturbances, seizures, coma pretty dark yellow pee normal sodium 135-145 too much water and not enough sodium lower sodium: more severe symptoms

treating altered hormone function

-Dependent on cause • Hormone excesses - Removal of tumor secreting ectopic hormone • Production of hormone from an alternate site • Escape of negative feedback regulation - Removal of part or all of endocrine gland - Medications that block effects of hormone • Hormone deficits - Medications that stimulate release or replace hormone -cut back thyroid gland

spinal cord injury: clinical manifestations

-Due to ischemia, hemorrhage, necrosis -Worsened by pressure from edema secondary to the primary injury -Variables • Spinal segmental level - Quadriplegia (cervical) - Paraplegia (thoracic) • Type of injury • Degree of cord transection

muscle fibers

-Each muscle fiber is a single muscle cell • Myofibrils -- Functional units of contractions • White muscle (type II fibers): Fast • Red muscle (type I fibers): Slow • Muscle membrane - Sarcolemma: Propagates impulse - Basement membrane: Maintains cell's shape

stool analysis

-Elimination patterns -Characteristics -Color -Consistency -Volume -Shape -Odor

hydrocephalus: treatment

-Establishment and maintenance of normal • CSF volumes • Intracranial pressure Ventriculoperitoneal shunt Ventriculoatrial shunt Endoscopic third ventriculostomy -ultrasounds can only be done with newborns because of their fontanels

testicular cancer: pathophysiology

-Exact cause often unknown -highly treatable and often curable common in men between 20 and 40 yrs • Alteration in chromosome 14 may be implicated • Cryptorchidism a major risk factor • Germ cell tumors -Seminomas: malignant germ cells that resemble primitive sperm cells - Nonseminomas: malignant germ cells that do not resemble primitive sperm cells and actually appear as embryonic or undifferentiated somatic (ex. skin, muscle, glands, etc. components)

cushing syndrome: pathophysiology

-Excess glucocorticoids secreted from adrenal cortex • Affects metabolic function, stress response, inflammatory and immune responses • Causes - Long-term administration of exogenous glucocorticoids (prednisone) - Tumors of the pituitary gland that stimulate excess ACTH production -tumors of the adrenal gland that stimulates excess cortisol production -ectopic production of ACTH and CRH from a tumor at a distance site such as small cell carcinoma of the lung too much: excess fat in middle, get sick more too much prenitzone

syndrome of inappropriate antidiuretic hormone (SIADH): pathophysiology

-Excess production and release of ADH -condition of excessive production and release of ADH despite changes in serum osmolality and blood volume • Most common cause:tumor secreting ectopic ADH • ADH promotes water retention intracellularly • Water accumulates in cells, altering function • Sodium is diluted in extracellular space • Result:hypotonic hyponatremia syndrome of inappropriate antidiuretic hormone too much of antidiuretic hormone(too little urine) -intracellular because low solutes compared to inside of cell which alters their function (too much water in the cells) hypotonic: amount of solute in your serum

hypothyroidism: clinical manifestations

-Fatigue, weakness, lethargy, weight gain • Cold intolerance • Constipation • Dry skin, course hair • Impaired reproduction • Impaired memory • Goiter, myxedema myxedema: swelling in the tissues but doesn't pit because of all the solute in it

acute pyelonephritis: clinical manifestations

-Fever • Costovertebral angle pain • Nausea or vomiting • Dysuria • Urinary frequency, hesitancy, or urgency • Lower abdominal pain • Blood in urine -happens from reoccurring infection

addison disease: treatment

-Fluid replacement • Pharmacologic treatment - Hydrocortisone - Oral glucocorticoid and mineralocorticoid replacement • Dietary change - Increased sodium intake due to excess sodium losses (sweating)

tests of bone function

-Gait analysis • Serum calcium and phosphorus • X-ray studies: GREAT WAY TO SHOW BREAKS BECAUSE JOINTS ARE MINERALIZED • Computed tomography (CT) - Dual-energy computed tomography (DECT) • Magnetic resonance imaging (MRI) - Magnetic resonance arthrography (MRA) • Positron-emission tomography (PET) - MRI-PET

structure and function of bones

-Gives form to the body • Supports tissues • Permits movement by providing points of attachment for muscles • Protects many vital organs • Serves as a site for blood cell formation • Plays a role in mineral and hormone homeostasis bones are developed in utero and are mostly made of cartilage because it helps the birthing process by as the baby comes out of the vagina they are able to mold to the shape to get the baby out when baby is born over time calcification begins and will bind with the cartilage so that we are able to bear weight protects heart, lungs, etc. hematopoesis happens

hypopituitarism

-Gradual onset - Fatigue - Weakness - Anorexia - Sexual dysfunction - Growth impairment - Dry skin - Constipation - Cold intolerance -generic term indicating decreased secretion of one or more pituitary hormones that could be caused from damage to the hypothalamic-pituitary axis due to infection, inflammation, tumors, degeneration, hypoxia, hemorrhage, or genetic defects that lead to problems with the production and secretion of multiple hormones

hypothalamus: releasing hormones

-Growth hormone-releasing hormone • Thyrotropin-releasing hormone • Corticotropin-releasing hormone • Gonadotropin-releasing hormone

malaria: clinical manifestations

-Headache • Shivering and chills • High fever • Excessive sweating • Cough • Fatigue • Malaise • Joint/muscle aching -tend to be anemic -low platelet counts peripheral blood smears: gold standard for malaria because you can see the parasites within the red blood cells

HAART-Associated Acidosis part 2

-Highly Active Antiretroviral Therapy (HAART)-Associated Acidosis - Nucleoside-analogue reverse transcriptase inhibitors (NRTIs) • Hyperlactatemia (lactic academia) - Elevation of lactic acid in the blood - Range of symptoms » Self-limiting subclinical episodes » Life threatening lactic acidosis NRTIs are given to HIV patients

addison disease: diagnostic criteria

-History and physical examination • Hyponatremia, hyperkalemia • Serum corticosteroid levels remain depressed after administration of ACTH give ACTH should help them secrete more glucocorticoid

UTI diagnostic criteria

-History and physical examination • Urinalysis and urine culture • Leukocyte esterase and nitrites on a dipstick -takes three days for a culture to come back don't want to wait that long

hypothyroidism: diagnostic criteria

-History and physical examination • Laboratory studies - TSH - Free T4 - Total T3 and T4 uptake - Thyroid autoantibodies - Antithyroglobulin low T4, super high TSH working so hard to stimulate this thyroid to produce more

diagnosing altered hormone function

-History and physical examination • Laboratory tests - Serum and urine hormone levels - Hormone suppression and stimulation tests - Serum electrolyte, glucose, and calcium levels • Imaging studies • Genetic testing

tinea diagnostic criteria

-History and physical examination • Microscopic examination • Fungal cultures • Wood light examination uv light: green and glows where infection is

malaria: diagnostic criteria

-History of travel to an endemic area • Physical examination • Laboratory testing - Hemoglobin level - Platelet counts - Liver function tests - Lactate dehydrogenase level - Lymphocytes - Peripheral blood smears

SIADH: diagnostic criteria

-Hyponatremia (serum sodium <135 mEq/L) • Hypotonicity (plasma osmolality <280 mOsm/kg) • Decreased urine volume • Highly concentrated urine with a high sodium content • Absence of renal, adrenal, or thyroid abnormalities water is 1.000 hypotonicity for the blood : don't have much solute in it so youre going to be closer to water

altered hormone function

-Impairment of endocrine gland • Lack of/excessive hormone synthesis • Impaired receptor binding • Impaired feedback mechanisms • Impaired cell response to hormones

bacterial meningitis: pathophysiology

-Inflammation of the meninges of the brain and spinal cord • Commonly caused by N. meningitides • Respiratory droplet transmission; mechanism for entry into CNS unknown • Bacteria proliferate in CNS • Exudate damages and obstructs CNS structures, leading to reduced oxygen to the brain more bacteria=more exudate tendency to cause septic shock and death

diabetes insipidus: pathophysiology

-Insufficient ADH • Inability to concentrate or retain water • Causes - Insufficient ADH production or secretion - Inadequate kidney response to ADH also called nephrogenic DI - Water intoxication -ingestion of extremely large volumes of fluids and decreasing ADH levels; water intoxication can sometimes be attributed to a psychiatric disturbance not enough diuretic hormone youre going to be secreting more water

sprains and strains: treatment

-PRICE for 48-72 hrs -protection -rest -ice -compression -elevation -pain control -support by compression dressing or brace infection in the bone due to staph infection because its a staph infection from outside of the body -laceration or abrasion near a joint could lead to this

multiple sclerosis: diagnostic criteria

-Pattern of signs and symptoms Imaging • MRI: scarring and plaques Neurologic function • Response to stimuli Laboratory • Immune factors Revised McDonald Criteria • >1 lesions in at least 2-4 locations • Associated with symptoms • Treatment - Disease modifying drugs immune modular drugs help slow the disease down no cure just trying to slow it down

diabetes insipidus: clinical manifestations

-Polyuria: large volume urine output • Excessive thirst • Dehydration • Shock • Death if untreated

huntington disease: clinical manifestations

-Present in all with inherited defective gene -Involuntary movements -dyskinesia -chorea -Cognitive impairment -Emotional disturbance -dyskinesia: difficulty in voluntary movement -chorea: rapid non repetitive movement of the face, trunk, and limb -usually affect people in their 40s

cerebral atrophy treatment

-Prevention -Interruption of injury process -Slowing course of disease -prevent through helmets and by keeping brain engaged (crossword)

cushing syndrome: treatment

-Remove cause of excess cortisol secretion • Gradually taper exogenous glucocorticoid medications • Surgical removal of tumors, chemotherapy, radiation -decrease prenitzone slowly

multiple sclerosis: clinical manifestations

-Secondary to slowed impulse conduction •Site specific •Variation in time course Primary signs/symptoms • Unilateral vision loss • Bowel/bladder dysfunction • Altered gain/balance • Spasticity: chronic flexed joints • Paresthesia • Slurred speech • Fatigue • Pain

testicular cancer: diagnostic criteria

-Self-testicular examination • Physical examination • Tumor markers • Imaging studies (MRI/CT/ultrasound) • Radical orchiectomy cryptochidism: undescending testicle embryonic carcinomas: resemble primitive undifferentiated embryonic tissue teratocarcinomas: a combination of embryonic carcinomas and undifferentiated tissues

bases

-Substances that accept hydrogen ions - Cl- and lactate -anything that accepts a hydrogen ion

ulcerative colitis: treatment

-Symptom management -Pharmacologic treatment -Dietary changes -Surgical treatment -no cure for this just trying to manage pain -surgical: remove part of colon (ostomy)

cell-mediated immunity part 2

-T cells originate in the bone marrow, but mature in the thymus -cytotoxic T lymphocytes: CD8 -helper T lymphocytes: CD4 -Th1 -Th2 CD8 little molecule on cytotoxic cells CD4: TH1 responsible for activate different macrophages and cytokines and promote fusion of TH2: activate b cells to produce more antibodies

positive feedback loop

-The presence of a hormone stimulates an increased production of hormone until there is an interruption of the cycle. • Positive feedback loops are less common than negative feedback loops posterior: oxytoxin makes stretching of cervix and when baby is born stretching stops

spinal cord injury: pathophysiology

-Transection of spinal cord -Damage to nerve root or myelinated tract -Impaired afferent or efferent conduction -Pathogenesis related to •Segmental level •Type of injury •Degree of cord transection Categories •Complete transection •Partial transection -Central cord -Anterior cord -Brown-Sequard syndrome

bone cells: osteocytes

-Transformed osteoblasts and reside within the lacuna - Space in hardened bone matrix • Synthesize matrix molecules - Key regulators of both bone formation and resorption -most abundant bone cell -lacuna: space in your hardened matrix

bacterial meningitis: treatment

-Vaccination - Hib - Meningococcal • Antibiotics • Corticosteroids • Fluids • Treatment of close contacts -keep in insolation for 24 hrs

tinea: clinical manifestations

-Variable depending on type(location) - Corporis (body): "ringworm" - Versicolor (skin): hypo pigmentation - Capitis (scalp): hair loss/breakage - Pedis (feet): maceration between and around toes - Cruris (groin): erythema, itching - Unguium (nails): nail thickening, discoloration ringworm is not a real worm pedis; usually from wet and soggy socks

cerebral palsy clinical manifestations

-Variable severity - Limited fine motor skills - Lack of coordination and balance - Impaired cognitive function - Speech disorder - Seizure disorder -can fall anywhere in the spectrum

influenza pathophysiology

-Viral infection of epithelial cells of airway • Respiratory droplet transmission • Infected epithelial cell necrosis • Reassortment: gradual change in genetic composition during replication in human host different type of virus every year -sometimes they guess right sometimes its mutated and is wrong

duchenne muscular dystrophy: pathophysiology

-X-linked recessive genetic inheritance -X-linked-primarily affects boys, some carrier girls are affected -a group of inherited diseases characterized by muscle tissue weakness and atrophy -9 different types -duchenne is the most common type of MD in children -disease of skeletal and heart muscle -mutation in the dystrophin gene at Xp21 affects more males because of x-linked recessive -carriers can show symptoms too

turner syndrome

-a condition named after Henry Turner -TS occurs in females when the chromosome number is altered, resulting from the loss of all or part of sex chromosome X

shock pathophysiology

-a condition of circulatory failure and impaired perfusion of vital organs -sources of impaired perfusion: -ineffective cardiac pumping: cardiogenic shock -decreased blood volume: hypovolemic shock -massive systemic vasodilation -from severe infection: septic shock -from brain or spinal cord injury: neurogenic shock -often equated with hypotension -from IgE mediated allergic reaction: anaphylactic shock

diabetes insipidus

-a condition of insufficient ADH that results in the inability of the body to concentrate or retain water -most common cause: impairment of hypothalamic osmoreceptors after trauma or surgery to a region at or near the hypothalamus

rate and volume of ventilation are regulated by:

-a functioning respiratory control center in the brain -lung receptors -chemoreceptors

undernutrition

-a lack of intake of nutrients due to: -inadequate calorie consumption -inadequate intake of vitamins minerals -problems with digestion, absorption, or distribution of nutrients in body -results in weight loss and muscle wasting -starvation (marasmus) vs protein deprivation (kwashiorkor) -decrease of all your macronutrients (marasmus)

rhabdomyosarcoma: clinical manifestations

-a lump or swelling that increases in size -bulging eye -headache -difficulty urinating or having bowel movements -blood in the urine -bleeding (nose, throat, vagina, or rectum) -common sites: head and neck=35%, genitourinary tract=22%, extremities=18%, all other sites=25% -symptoms vary depending on the site

diffusing capacity

-a measurement of carbon monoxide (CO), oxygen, or nitric oxide transfer from inspired gas to pulmonary capillary blood and reflects the volume of a gas that diffuses through the alveolar capillary membrane each minute

impaired ventilation

-a problem of blocking airflow in and out of the lungs -two major mechanisms implicated: -compression or narrowing of the airways -disruption of the neuronal transmissions needed to stimulate the mechanics of the airways

hypertension: pathophysiology

-a progressive cardiovascular syndrome detected by an election in blood pressure and/or the presence of organ damage due to persistent blood pressure elevations -primary verus secondary

hyperpituitarism

-a wide range of manifestations, depending on hormones elevated too much hormone is being released by the pituitary -know these hormones glucose intolerance: usually end up with diabetes -excess of pituitary hormone secretion

burn pathophysiology classification: full thickness

-a widespread inflammatory response -stress hyper metabolism -impaired defense mechanisms -fluid loss all the way to the subcutaneous tissue -if it goes all the way down to the muscle, it will probably hurt with the dermis area -burn over 70% of the skin in deep partial thickness burn, you can go into septic shock from losing so much fluid

crohns disease: clinical manifestations

-abdominal pain -diarrhea -malnutrition -occult blood in stool -fever -weight loss -fatigue -malnutrition because the food passes so quickly and too quickly where you can't absorb all the nutrients

diverticular disease: clinical manifestations

-abdominal pain -fever -nausea -vomiting ******rectal bleeding -left lower quadrant pain: sigmoid colon-most site where it occurs

ROP diagnostic criteria: stage 3 plus

-abnormal growth patterns with enlarged (dilation) or twisted (tortuosity) vessels -requires early treatment to prevent retinal detachment

protective structures: lymphatics

-absent -we do have little lymphatics in our brain so ignore our book

alloimmunity: graft rejection

-acceptance dependent of MHC molecules -polymorphic -polygenic -mediated by CD4 and CD8 T cells -recognize foreign alloantigens -where human rejects the graft any transplant where the host body actually does not recognize organ as self and creates a lot of antibodies an=gainst the organ and destroys it before it even beings working (10-14 days)

migraine headache treatment: pharmacologic

-acetaminophen -NSAID's -aspirin -triptans -antiemetics -ergots -CGRP receptor antagonists -anticonvulsants aspirin: adults not kids a lot of medications are trying to vasocontrict the blood vessels since they vasodilate with migranes

DMD treatments 2

-achilles tendon release -posterior spinal fusion cardiac meds: -ACE inhibitors -beta blockers -diuretics -digoxin -prednisone resp. devices: -respiratory symptoms are worse at night -noninvasive positive pressure ventilation (NIPPV) -mechanical insufflator-exsufflator (MIE) -suction

application of the concepts of alterations in immunity

-acquired immunodeficiency syndrome (AIDS) -anaphylactic reaction -systemic lupus erythematosus (SLE) -Rh isoimmunization

conduction of impulses

-action potentials stimulate cardiac contraction and relaxation -slow response -fast response -phases -rapid depolarization -early repolarization -plateau -rapid repolarization -a resting phase sinoatrial node to atrioventricular node then to bundle branches and then separate into purkinje fibers and stimulates those muscles to contract during depolarization(action potential that it creates) sodium goes in

callus formation

-activation of osteoblasts in periosteum, endosteum, and marrow -formation of subperiosteal procallus -outer surface of shaft -broken bone ends

pulmonary processes: muscle control-inspiration

-active -external intercostal muscles, diaphragm (normal) -sternocleidomastoid and scalenus (forced) muscles only act and innervated and contract when they have an inspiration relaxation techniques: sternocleidomastoid and scalenus

somatosensory modalities

-acuity -tactile -pressure -vibration -thermal -position -refers to the specific nature of the perception of various stimuli merkel's disk: movement of light objects over your skin or vibration free nerve ending: touch and pressure meissner's: highly developed senses of touch and you have a lot of these when finding discrimination-most of these are in your fingers and hands HFR: help feel movement across the skin as well pacinian: vibration and more in adipose layer ruffini's: helps with more heavy and continuous pressure

hearing screening

-acuity (decibels): the degree of hearing loss determined using this hearing measurement -frequency or pitch (hertz) -conductive: localized to the outer or middle ear and may be temporary or permanent -sensorineural: often permanent, resulting from disease, trauma, or genetic inheritance of a defect in the cochlea nerve cells (often inner ear) -mixed: refers to a combination of both sensorineural and conductive hearing loss -central auditory processing disorder: disorder involving an alteration in auditory signal processing in the brain

osteomyelitis: clinical manifestations

-acute inflammation -chronic inflammation -fever -pain -necrotic bone -immobility of the affected bone/extremity -chronic infection: older people with low immune systems

otitis media: clinical manifestations of AOM

-acute onset -middle ear effusion -inflammation -recurrent ->3 or equal to episodes in 6 months or > or equal to 4 over one year

acute pancreatitis pathophysiology continued

-acute pancreatitis as a result of gall stone obstruction

requirements of effective perfusion

-adequate ventilation and diffusion: ability to breathe in and transport oxygen across the capillaries is mandatory for effective distribution of oxygen to the tissues -intact pulmonary circulation: pulmonary circulation is required for the uptake of oxygen from inspired air -adequate blood volume and components: an expected blood volume is required to carry oxygen (on hemoglobin) and maintain blood pressure -the role of hemoglobin and oxygen saturation in the blood -adequate cardiac output: an optimal stroke volume, an optimal heart rate, and an efficient heart rhythm are needed to maximize perfusion to the tissues -intact cardiac control center in the medulla of the brain: the cardiac control center is needed to regulate heart rate and force of cardiac contractions and to detect and respond to changes in blood pressure -intact receptors: receptors play a major role in sensing changes in cardiac function and blood pressure, and they provide feedback to the cardiac control center in the brain -medulla and the pons is where control breathing -baroreceptors that are keeping track of your blood pressure and all of those have to have it to have good perfusion -located throughout the blood vessels and the heart, sense pressure changes in the arteries

osteoarthritis: pathophysiology

-affects ball and socket joints -joint effusion: fluid in the joint -common age-related disorder of synovial joints -inflammatory joint disease -loss of articular cartilage, sclerosis, of underlying bone, and formation of bone spurs (osteophytes) -also called degenerative joint disease -incidence increases with age

autosomal dominant disorders

-affects males and females equally -if one parent is heterozygous for the autosomal dominant disorder, each child has a 50% chance of inheriting the damaged gene -likely to lead to disease even heterozygous -carrier: 0% -non-carrier: 50% -huntington disease, marfan syndrome, and osteogenesis imperfecta

life expectancy

-age at which 50% of a given population is expected to survive -aging

micronutrients: vitamins functions

-aid in metabolism of macronutrients -help develop -genetic materials -hormones -collagen -nervous system tissue

what do antibodies do?

-aid with clearance and/or destruction of antigen 1) neutralization: binding to the antigen on the surface of the membranes 2) classical complement activation: antibody and antigen create a complement through opsonization 3) opsonization by coating a cell making it more appealing to macrophages and dendritic cells to attack that cell 4) antibody-dependent cell-mediated cytotoxicity: T cells that membrane and search out the antigen in the body

pulmonary structure and function

-airways -lungs -chest wall -pulmonary circulation: circulation of the blood flowing from the right side of the heart and the pulmonary artery leads to the lungs and then goes to the left side of the heart and then to the rest of the body left side: 2 lobes (has the lingua: separates the upper and lower lungs on the left side right side: 3 lobes

maternal infections during pregnancy resulting in congenital disorders of the fetus

-toxoplasmosis -other (hepatitis) -rubella -cytomegalovirus -herpes

systemic circulation

-all blood vessels with the exception of pulmonary -higher pressure than pulmonary systemic pressure in the periphery is a lot higher than the pulmonary -don't need a high pressure for diffusion to happen -motored by the left side of the heart, particularly the left ventricle which is the strongest pumping chamber

anaphylactic reaction epidemiology

-allergic reaction to insect stings -1 in 30-300 people -regional variation in type of insect food allergies -6-8% children under age 4 -2% of people aged 10 and older -drug allergies type 1 hypersensitivity reaction possibility to grow out of these type of allergies: peanuts, tree nuts, cows milk, eggs (IgE response)

structure and function of joints

-also called articulation -site where two or more bones meet/attach -provides stability and mobility to the skeleton 2 or more bones meet and attach: articulation

neurologic function in aging

-alteration in -cognitive -sensation -pain -motor responses -involve -central nervous system -somatosensory nervous system -peripheral nervous system

down syndrome: pathophysiology

-alteration in autosome number -trisomy (3 copies) of chromosome 21 -result of nondisjuncture or inherited translocation

chromosomal alterations continuous

-alteration in chromosome number -nondisjunction -mosaicism -monosomy -trisomy population cells that are normal and all the cels after that won't be normal (mosaicism)

chromosomal alterations: translocation

-alteration in chromosome structure -occurs when a large segment of DNA breaks from one chromosome and reattaches to a different chromosome

peripheral nervous system injury: motor dysfunction

-alteration of reflex circuits -causes: -neuromuscular junction abnormalities -damage in skeletal muscle fibers -spinal cord injury: damage to corticospinal system or spinal nerve roots -changes in skeletal muscle mass -excessive inhibitory or excitatory responses -coordination and proprioception -extrapyramidal disorders: structures of the basal ganglia, substantial nigra, subthalamic nucleus -neurotransmitter excess or deficiency

altered reproductive function: male manifestations

-altered hormonal balance -glandular enlargement -obstruction of urinary tract -erectile dysfunction -infection -altered proliferation -altered nervous system function

altered reproductive function: female manifestations

-altered hormonal balance -menstrual cycle -frequency -bleeding quantity -pain -dysmenorrhea:pain during menstruation -dyspareunia: pain during sex -endometriosis -infection: inflammatory response and scarring -altered proliferation -infertility

altered urinary elimination: altered neuromuscular function

-altered neuromuscular function -failure or exaggerated neural signal transduction -failure of appropriate muscle response -consequences -limited or absent ability to eliminate urine -urinary retention or incontinence

CNS injury: excitation injury

-altered neuronal tranmission -impulse frequency -impulse intensity -tranmission cascade -consequences: injury to neurons such as amino acid glutamate: main excitatory neurotransmitter in the body, active in the promotion of many higher-order functions -cellular metabolic demands transmission cascade: going up and down -increases cellular metabolic demands

altered bowel elimination: obstruction

-altered patency -blockage of structures -tumor -impaction consequences -distention -impaired motility -perforation

altered urinary elimination: altered patency

-altered patency -blockage of structures (obstruction) consequences: -blockage of urine flow -dilation of structures proximal to ostruction -stasis of urine, leading to infection -injury to renal anatomy

altered urinary elimination: altered perfusion

-altered perfusion -inadequate blood supply -focal -global -consequences -ischemia and/or infarction -pain

general manifestations of altered bowel elimination

-altered stool volume and characteristics -bleeding -melena -occult -pain -abdominal distention -anorexia, nausea, vomiting -fever

general manifestations of altered urinary elimination

-altered volume of excretion -altered excretion characteristics -bleeding -pain -distention -anorexia -nausea -vomiting -fever

altered bowel elimination altered motility

-altered water and vitamin absorption -altered storage time -risk for obstruction -consequences -constipation -diarrhea

acute respiratory distress syndrome: patho

-alveolar epithelium and vascular endothelium damage -progression from lung injury to respiratory distress within 24-48 hrs*** -severe acute inflammation and pulmonary edema without evidence of fluid overload or impaired cardiac function (has nothing to do with heart its the lungs) -atelectasis: alveolar collapse -poor lung expansion, hypoxemia, hypercapnia, acidosis -mortality rate 30%-40% from multi system organ failure in those untreated (need oxygen to function properly)

pathophysiology

-always going to talk about etiology (how does it work and what it does to the body) -diagnoses: sometimes you have to go with what you hear and see because tests don't always back you up

menopause: diagnostic criteria

-amenorrhea for at least 12 months -no single diagnostic test -treatment: -optional -pharmacologic -hormone replacement therapy (HRT) -severe symptoms requiring treatment -short-term duration -lowest effective dose -topical application (such as with a vaginal cream) to avoid systemic effects -non-pharmacologic

protein digestion

-amino acid is what actually is absorbed

neuronal communication: neurotransmitter type

-amino acids (e.g. glutamic acid and gamma-aminobutyric acid (GABA) -peptides (ex. endorphins, enkephalins, substance P) -monoamines (e.g. serotonin, dopamine, norepinephrine) -peptides are usually involved with pain -require precise control, determined in part by the neurotransmitter type, the postsynaptic receptor with affinity for binding a specific neurotransmitter and modulators of neural transmission

diffusion: effectiveness determined by:

-amount of partial pressure of the (oxygen and carbon dioxide) in the blood -solubility of the gas in the blood -carbon dioxide more soluble than oxygen therefore CO2 diffuses at a greater rate -thickness of alveolar membrane and alveolar surface area capillary membranes -proximity of capillaries to alveoli -volume of air in the alveoli arterial line better than vein pulling out some IV fluid with it and takes about 5-10 mls *CO2 is more soluble than oxygen really easy to get CO2 but harder to bring O2 in

structures of the kidney

-capsule -renal cortex -renal medulla -minor calyx -major calyx -renal pelvis

preimplantation genetic disorders

-an alternative to prenatal diagnosis and allows for identification of abnormalities before implantation -requires the use of intro vitro fertilization, embryo culture, and biopsy of the blastomere (early embryo) -risky for individuals with identified risks, including single gene defects, X-linked disorders, aneuploidy (abnormal chromosome number) and those with balanced translocation (exchange of entire chromosome segments between two different chromosomes)

graves disease: pathophysiology

-an excessive stimulation of the thyroid gland, is the most common cause of hyperthyroidism and is the most common autoimmune condition in the US -triggering event is unknown: maybe genetic and environmental -IgG antibodies bind to the TSH receptor on thymocytes (thyroid cells) and stimulate excessive thyroid hormone secretion causing a state of thyrotoxicosis -thyrotoxic crisis: thyroid storm or sudden, severe worsening of hyperthyroidism that may result in death

fibromyalgia: pharmacologic treatments

-analgesics -antidepressants -anticonvulsants -muscle relaxants

glaucoma: pathophysiology categories

-angle closure: rapid IOP from blocked aqueous humor drainage -normal tension: poor blood flow to optic nerve -optic nerve is being affected more

cervical metaplasia and dysplasia diagnostic criteria screening guidelines

-annually, until two negative results are obtained -after two negative results, 1 year apart -every 3 years for women who are sexually active -every three years for women over 20 years of age

polycystic ovarian syndrome (PCOS): clinical manifestations

-anovulation -hirsutism (abnormal growth of hair on face and body) -driven by androgens these changes can lead to obesity by insulin resistance, more fat you have the more estrogen can proliferate -acne -acanthosis nigricans -obesity from conversion of androgens to estrogen in adipose tissues -hypertension -diabetes -obstructive sleep apnea

osteomyelitis: treatment

-antibiotics -biodegradable -debridement -surgery -hyperbaric oxygen treatment

chronic gastritis: treatment

-antibiotics for chronic infectious processes -immunosuppressive drugs for autoimmune processes

type II hypersensitivity

-antibody-mediated reaction -cellbound antigen binds to IgG or IgM antibodies -cytotoxic reaction -example: autoimmune hemolytic anemia, Graves disease Rh- to Rh+ fetus -harmless substances are identified as harmful and inhibits this huge response and kills normal cells direct response from an antigen/antibody reactions, drug reactions, etc.

antigen vs antibody

-antigen (Ag): molecule capable of inducing an immune response -antibody (ab): protective protein made by B cells that recognizes 1 specific Ag -also called immunoglobulin

anaphylactic reaction: pathophysiology

-antigen exposure stimulates an IgE mediated response in previously sensitized individual -degranulation of mast cells and basophils causes local and systemic responses -dilation of vascular smooth muscle -bronchial smooth muscle constriction -increased vascular permeability -first time you eat or whatever, its not gonna happen -second time if its been long enough for antigen exposure it can have a large anaphylactic reactions -constricts: causing harder to breathe -allergen triggers b cells to make IgE antibodies -allergen binds to IgE antibodies and causes inflammatory response in anaphylactic

host defense failure

-antigenic variation: antigens is different than what your host recognizes it as happens when you have some time of antigenic variations where you arent producing different types of cells to have effect in the body -viral latency: herpes, mono, TB -immunodeficiency -defective humoral function -deficient phagocyte numbers and functional ability -altered T-cell signaling -altered cytokine production/function

UTI treatment

-antimicrobial drugs -symptomatic care -treat with antibiotics

stroke: pathophysiology

-any clinical event that leads to the impairment of cerebral circulation -acute neurologic injury that results from pathologic events such as shock, cerebral hemorrhage, ischemia, or infarction leading to the impairment of cerebral circulation -thrombotic, embolic, or hemorrhagic -inflammation, ischemia, death of neurons -cerebrovascular accident (CVA) versus transient ischemic attack (TIA)

environmental toxin injury and cardiovascular disease: clinical manifestations

-aortic aneurysm -acute myeloid leukemia -cancer -cataract -chronic lung disease -coronary heart disease -periodontitis -stroke -sudden infant death

conduction defects: dysrhythmias

-arrhythymias disturb the electrical activity of the heart and interrupt the normal sequence of atrial/ventricular activation and contraction -indicative of problems with maintaining an efficient heart rhythm -arrhythmias are caused by electrolyte disturbances and overstimulation of the heart and can originate anywhere in the heart

alterations in hearing and balance: middle ear

-barotrauma: injury resulting from the ability of the ear to equalize barometric stress -air travel and sea diving -inflammation -otitis media: infection of the middle ear -mastoiditis: bacterial infection causing inflammation of the air cells of the mastoid bone may result as a complication -otosclerosis: autosomal dominant condition represents the most common cause of chronic, progressive, conductive hearing loss -conductive hearing loss

manifestations of impaired ventilation and diffusion: local 2

-barrel chest -altered breath sounds -breathing patterns: rate and rhythm

central nervous organization: extrapyramidal system

-basal ganglia -subcortical nuclei, caudate nucleus, putamen, subthalamic nucleus, substantia nigra, globus pallidus -separate from the pyramidal motor system modules motor function, attenuating erratic motions and maintaining muscle tone and stability of the trunk -modulates motor function

otitis media: treatment

-based on accurate diagnosis -AOM versus OME -observation -OME and uncomplicated AOM -antibiotics -in AOM unresponsive to observation antibiotics (amoxicillin), analgesics -can't get better on their own and don't always give meds because antibiotic resistance if child is younger and high fever for more than 48 hours, we absolutely treat

asthma: treatment

-based on classification (global approach) -severity -frequency -monitor lung function -control environmental triggers -pharmacologic therapy -patient and family education; action plan

celiac disease: diagnostic critera

-based on clinical manifestations -lab studies -serum detection of antibodies against -endomysium -gliadin -IgA tissue transglutaminase -diagnosis confirmed with small bowel biopsy

ROP diagnostic criteria: stage 1

-based on morphology of retinal blood vessels -mildly abnormal blood vessel growth -spontaneous resolution -likely develop normal vision

neuronal communication: neuron classification

-based on neurotransmitter produced

protective structures central nervous system: cerebrospinal fluid

-bath meninges -flows from four fluid-filled interconnecting cavities of the brain known as ventricles -produced by the choroid plexus in ventricles: a structure located in the two lateral ventricle and single third and fourth ventricles of the brain -lateral (2), third (1), and fourth (1) -functions -providing a cushion for brain structures -reducing the pressure on brain structures -removing harmful substances -transporting hormones to remote sites in the brain

first line of defense

-blink reflex occurs' -lashes catch particles -tears wash particles away -enzymes in tears neutralize harmful substances -intact surrounding skin prevents entry of harmful substances -anything that you can see on the outside of your body to try to prevent microorganisms from entering ex. lashes, mucous membranes

acute sinusitis: pathophysiology

-blockage of ostia and outflow of mucus due to allergy, viruses, or other irritants -impaired clearance of mucus by cilia -altered mucus quality or quantity -cystic fibrosis

glucose and fructose absorption

-carbohydrates are the largest proportion of nutrients absorbed -complex carbs must be degraded by enzymes=monosaccharides -pancreatic amylase -brush border enzymes -glucose requires cotransport of sodium-active transport -fructose-passive diffusion

ulcerative colitis: clinical manifestations

-bloody diarrhea -rectal bleeding -abdominal pain -fever -anemia

osteosarcoma: diagnostic criteria

-bone biopsy -radiograph -CT -MRI -include the lungs d/t metastases

elements of bone tissue

-bone cells -bone matrix -calcification osteoblasts, osteoclasts, osteocytes: bone cells in the body

osteoporosis: diagnosis

-bone density -DEXA scan -T score of -1.0 to -2.5=osteopenia -T score of < -2.5=osteoporosis -bone quality -quantitative ultrasound -classification: Z score T-score: compares your results to a healthy young adult 20-35 T-score is the better score -less fair but better at detecting osteoporosis

mobility in aging

-bone mass reduction -osteopenia: comes before osteoporosis (absolutely normal) -reduces calcium in the bone and as long as it doesn't calcify worse along long bones its normal -osteoporosis: actual disease process -kyphosis -chondrocalcinosis: calcium crystals in the joint -loss of lean body mass -sarcopenia: loss of muscles

central nervous organization

-brain -lobes: separated by sulci -frontal lobe: reasoning, planning, speech, and movement -parietal lobe: perception of touch, pressure, temperature, and pain -temporal lobe: perception memory and recognition of auditory stimuli -occipital: vision -corpus callosum: the right and left hemisphere communicate with each other though a bundle of nerve fibers

central nervous system (CNS)

-brain and spinal cord

inspiration

-breathing in to acquire oxygen -unidirectional from high pressure to low pressure -intrathoracic pressure becomes more negative, pulling air in -chest cavity size changes to alter the pressure gradient -diaphragm downward -external intercostals outward

macronutrients: proteins functions

-build body tissues -muscle, bone, connective tissue -blood -cell membranes -immune factors -enzymes, hormones -transport

osteoporosis: treatment

-calcium -vitamin D -antiresorptive meds -calcitonin -bisphosphonates -hormone therapy -pro putting calcium into the bones: antiresorptive

non-verbal pain scale: FLACC

-can be for an adult thats nonverbal objective data

genetic mutations

-can happen at certain points of the gene -deletion: pass this on the child will miss large components of the genetic makeup -duplication: too much is not good and can be associated with disease translocation: loses a chunk and added onto the other chromosome

polycystic kidney

-decreases urine production

hypertension: more clinical manifestations

-cardiovascular changes: -pulmonary edema and heart failure -renal insufficiency: -poor urinary output -problems with eliminating urinary waste -hematuria -proteinuria Normal BP: <120/80 prehypertension: 120-139/80-89 stage 1: 130-139/80-89 stage 2: >140 or >90

burns pathophysiology

-cause: direct contact with excessive heat or radiation, caustic chemicals, or electricity -proteins denature when temperature exceeds 45 degrees C (113 F) -result: acute inflammatory response -burn severity is correlated with exposure type and time -over 113 degree Fahrenheit: skin starts to burn -not supposed to put your water heater above 120

CNS injury: excitation brain injury location and consequences

-cell death -loss of neurologic function -manifestations -decerebrate posturing: the result of increased extensor muscle excitability -increased extensor excitability -decorticate posturing: the result of increased flexor muscle excitability -increased flexor excitability -very very bad sign

type IV hypersensitivity

-cell-mediated hypersensitivity reaction -occur 1-3 days after antigen exposure -results in erythema and itching -examples: contact dermatitis, tuberculin (TB test) -skin type of disorder (very much) heightened immune response due to t cell mediated reactions 1) direct cell mediated cytotoxicity: occurs in cells and tissues and CD8 damages cells with recognized antigen whether harmful or not (hepatitis) 2) delayed hypersensitivity reactions: antigens react with self proteins and

hypoxia

-cells are deprived of adequate oxygen -reduced cell metabolism and function

cervical metaplasia and dysplasia: pathophysiology

-cellular adaptation of the squamous and columnar epithelial cells in the transformation zone of the cervix -area where they do pap test looking for abnormal cells -where the HPV can cause alterations in the cells

secretion

-cellular products packaged into vesicles -transport out of the cell by exocytosis secretion: bacterium goes through phagocytosis and lysosome destroys and breaks up the bacteria and goes out through exocytosis and begins inflammatory response

central atrophy

-central atrophy: cells start dying off and can cause cognitive impairments and muscoskeletal impairments and where you have cerebral atrophy can cause different kinds of impairments -use it or you lose it -crossword puzzles and other things in your older age are good to keep their brains engaged

nervous system organization

-central nervous system (CNS) -peripheral nervous system (PNS)

lymphatics

-central organs: bone marrow and thymus -peripheral organs: -spleen -lymph nodes -lymphoid tissue thymus: located in the mediastinum

application of the concepts of alterations in cells and tissues

-cerebral atrophy -cardiac hypertrophy -acromegaly -cervical metaplasia and dysplasia -environmental toxin injury and cardiovascular disease

neuronal communication: hypopolarization

-change in membrane potential of post-synaptic neuron -changes membrane potential toward the point of threshold potential (less negative) promoting the excitatory effect of propagation of the impulse or neuron firing -toward the point of threshold potential (less negative) -promoting the excitatory effect of propagation of the impulse or neuron firing

neuronal communication: hyperpolarization

-change in membrane potential of post-synaptic neuron -moving the membrane potential away from threshold (more negative) -promoting an inhibitory effect -has the opposite effect of moving the membrane potential away from threshold (more negative) promoting an inhibitory effect

cervical metaplasia

-changing of cell types as a response to environmental stressors

cellular response

-chemotaxis -cellular adherence -cellular migration -cells escaping out of the vessels and going into tissue where the damage is

rhabdomyosarcoma: treatment

-chemotherapy -surgery -radiation -intraoperative -implants

tool for characterization if pain

-children unable to read or understand

SLE pathophysiology

-chronic disease resulting from the presence of a persistent antigen -activation of B cells producing antibodies -activation of T cells promoting inflammation -systemic condition -autoantibodies targeted against the cell membrane cytoplasm and nucleus

chronic gastritis: pathophysiology

-chronic infection or autoimmune process leading to chronic inflammation -heliobacter pylori infection -gastric epithelial and mucosal cell atrophy -gastric acid production impaired -chronic use of that irritant -cells may not grow back the same way after being exposed to this irritant all the time and may not replace as well -h.plyori: asymptomatic maybe mild heartburn or indigestion

rheumatoid arthritis (RA) pathophysiology

-chronic inflammation of synovial membranes -etiology combines -genetics -triggering event -autoimmunity -synovial membranes are in your joints -don't know what gene that causes it

asthma: pathophysiology

-chronic inflammatory disorder -IgE-mediated * hypersensitivity reaction -triggers vary often environmental allergens -manifestations mediated by histamines, prostaglandins, and leukotrienes -early and late** response: immediate response: macrophages and late response: leukotriangs -usually have atopic triad: asthma, allergies, and excema

cellular changes in aging: proliferative changes

-chronic myeloproliferative disorders -polycythemia vera -primary thrombocythemia -cancer risk increase, due to: -impaired immune function -genetic mutation accumulation -prolonged carcinogen exposure -impaired DNA repair

joints

-classification based on movement - Synarthrosis • Immovable - Amphiarthrosis • Slightly movable - Diarthrosis • Freely movable synarthrosis: skull amphiarthrosis: spine diarthrosis: ankle or wrist

autism spectrum disorders: diagnostic criteria

-clinical manifestations -screening tools -DSM-5 criteria -MCHAT: given to parents and asks about their childs behaviors and their score on that is a good screening tool for more further evaluation

CNS injury: traumatic brain injury types

-closed head injury: -coup: injury to local area -contrecoup: injury in opposite area -open head injury: -exposure of brain structures -dura, meninges, brain tissue -responses: -seizure activity, concussion, contusion, hematoma, edema, skull fracture -increased intracranial pressure, respiratory depression/failure, herniation of brain stem

healing and tissue repair factors

-clotting/coagulation -chemotaxis -proteinases -proteinase inhibitors -structural matrix -adhesion molecules -growth factors proteinases: enzymes help degrade dead tissue proteinase inhibitors: prevent the breakdown of healthy tissue structural matrix: proteins that help rebuild tissue adhesion molecules: molecules that help adhere normal reproducing cells together growth factors: instigate reproduction to make new cells

fibromyalgia: treatment=nonpharmacologic

-cognitive behavioral therapy -stress reduction -gentle exercise -application of heat and cold -ultrasound -deep massage -alternative treatment

treatment of pain: nonpharmacologic

-cognitive-behavioral -relaxation -distraction -cognitive reappraisal -imagery -biofeedback -physical agents: heat and cold -transcutaneous electric nerve stimulation (TENS) -acupuncture control BP and heart rate by breathing slowly -sore muscle: heat

generalized anxiety disorder treatment

-cognitive-behavioral therapy -pharmacotherapy -selective serotonin reuptake inhibitors (SSRIs) -benzodiazepines -relaxation techniques (abdominal breathing)

more stool characteristics

-color -brown due to stercobilin (bile pigment) -reflect diet -volume -amount and frequency variable -texture -soft, moist, semi-solid

fractures: pathophysiology classifications

-complete or incomplete -open or closed -comminuted- > 2 fragments -linear: parallel to the long axis of the bone -oblique: slanted angle to the shaft -spiral: encircles the bone -transverse: straight across the bone -impacted: fracture fragments pushed into each other -pathologic: bone is weakened by disease -avulsion: fragment of bone that is attached to a ligament or tendon is detached from the bone -displaced: out of alignment -extracapsular: fragment is close to a joint -intracapsular: fragment is within a joint

ROP diagnostic criteria: stage 5

-completely detached retina -hemorrhage

stool characteristics

-components -water (100 mL) -solids (25-50g) -unabsorbed nutrients -sloughed epithelial cells -bile pigments -bacteria -fat (10%-20%) -undigested dietary fiber (30%) -inorganic solids (20%)

genetic system components: ribonucleic acid (RNA)

-composed of -sugar: ribose -phosphate backbone -nitrogenous bases -purines -adenine (A) -guanine (G) -pyrimidines -cytosine (C) -uracil (U) -usually single stranded -A-U, C-G base pair linkages with complementary DNA

nutrition in aging

-deficiencies in macro- and micronutrients -cognitive impairment -increased risk of infection -anemia -poor wound healing -prone to overdose -fecal impaction: get your hand up there and pull the shit out

genetic system components: deoxyribonucleic acid (DNA)

-composed of: -sugar: deoxyribose -phosphate backbone -nitrogenous bases -purines -adenine (A) -guanine (G) -pyrimidines -cytosine (C) -thymine (T) -double stranded -A-T, C-G base pair linkages

acromegaly: pathophysiology

-condition of cellular hyperplasia -results from excessive hormonal stimulation -pituitary growth hormone -liver insulin-like growth factor-1 (IGF-1) -leads to excessive growth -bones, cartilage, soft tissues, organs -occurs after epiphyseal plate closure

CNS injury: pressure injury of brain

-consequences secondary to closed system -cerebrospinal fluid (CSF) -increased production -decreased reabsorption -obstruction of flow -cerebral edema: altered vascular permeability -space occupying lesion: tumor papilledema: swelling of optic disk -can be a shunt and go to atrium or abdomen in kids

social determinants of health

-consider how the following impact the pathogenesis of disease: -age -gender -race -ethnicity -socioeconomic status -locate lots of mosquitos: higher incidence of viruses from mosquitos

celiac disease: clinical manifestations

-consistent with malabsorption: -weight loss -diarrhea -flatulence -steatorrhea -malodorous stool -borborygmus (loud stomach or intestinal rumbling) -abdominal bloating and pain -fatigue -nutritional deficiencies

elimination in aging: gastrointestinal

-constipation -diarrhea -fecal incontinence -fecal impaction

micronutrients: minerals functions

-constitute -bone -hemoglobin -enzymes, hormones -chemical mediators -mediate impulses -maintain fluid and acid-base balance

mast cells

-contain performed granules, but not a granulocyte -involved in defense against parasitic worms and allergic response

peripheral nervous organization: components of autonomic nervous system

-controls involuntary organ function -divisions: sympathetic (SNS) and parasympathetic (PNS) -axon fibers -preganglionic:axon fibers extending from cell bodies in either the brain or spinal cord project to an autonomic ganglion (group of nerve cell bodies) -extend from brain/spinal cord to autonomic ganglion -short in SNS; long in PNS -postganglionic: extend from autonomic ganglion to target organ -long in SNS; short in PNS

pulmonary processes: neural control

-controls rate and volume of ventilation -functioning respiratory control center in the brain stem -neurons in pons and medulla -innervate diaphragm, intercostal muscles, (normal) sternocleidomastoid and accessory muscles (forced) -autonomic nervous system -innervates lungs -promotes smooth muscle constriction (parasympathetic) or dilation (sympathetic) of conducting airways -lung receptors: epithelium and smooth muscle pons and medulla: located in our brain stem and allow for breathing -we use these neurons when we perform a forced breath as well -breathing is controlled by autonomic system

different types of shock

-deficit in one or more of these requisites cardiogenic shock: ineffective cardiac pumping hypovolemic shock: decreased blood volume massive systemic vasodilation: -septic shock: from severe infection -neurogenic shock: from brain or spinal cord injury -anaphylactic shock: from severe immunoglobulin E (IgE-mediated hypersensitivity reaction)

peripheral nervous organization: components of somatic nervous system

-coordination of body movement -reception of external stimuli -regulation of activities under conscious control -peripheral single neuron fibers transmitting -sensory impulses to CNS -motor impulses to skeletal muscles from cell bodies in brain and spinal cord -we are in control of this system

DIC treatment

-correct the underlying cause -depends on presence of hemorrhage versus thromboses -careful balancing act with a goal of proper coagulation

bone tissue: compact bone

-cortical bone - 85% of the skeleton - Highly organized, solid, and extremely strong - Haversian system two different types of bone tissue: same elements but organized very differently -haversian: cylindrical structures that are composed of cintric rings and are an organization system for compact bone

manifestations of impaired ventilation and diffusion: local

-cough -mucus production -amount -character -color -hemoptysis -dyspnea -use of accessory muscles -retractions -pursed lip breathing -orthopnea: shortness of breath -chest pain orthopnea: easier to breathe when sitting up barrel chest: restructures your airways -transverse diameter should be twice as long but it isn't in barrel chest

regulation of attention

-culturally influenced process of selectively concentrating on information -both a cognitive process and a behavior -cognitive process: where you choose to pay attention depending on whether its important to you or not

cell-mediated immunity response

-cytotoxic T lymphocytes: CD8 -helper T lymphocytes: CD4 -Th1 -Th2 t lymphocytes and cd8 and cd4 -cd4: help with immune response, detect antigens inside the cell (Th1, Th2) and recognize these antigens inside the infected cell and bring it to the surface th1-controls intracellular bacterial infections attack inside of the cell pass the cell membrane and help activate macrophages to ingest infected cells th2-help activate b cells

peripheral nervous system injury

-damage due to -trauma -pressure -outcomes -axonal degeneration: caused by necrosis in response to significant injury to the cell body or axon of the neuron -distal axonpathy (distal): occurs when the injury affects cells in distal areas of the body, such as the hands and feet -neuronopathy (cell body damage): axonal degeneration occurs because of damage to the cell body, chance for regeneration is very slim -wallerian degeneration (crushing injury): degeneration of the axon is caused by a crushing injury -manifestations: peripheral neuropathy: clinical manifestations of damage to peripheral nerves -damage to this: numbness, tingling, pain

free radical injury

-damage to cells caused by reactive oxygen species (ROS) -superoxide -hydrogen peroxide -hydroxyl radical -peroxynitrite -Free radical injury happens as a normal way of life -free radicals occur when cells have less electrons -highly reactive chemicals that can harm cells -free radicals start stealing electrons from other cells making more free radicals -causes of free radicals: UV, pollution, stress, poor nutrition -constant exposure to these can cause cancer, etc. -how we stop free radicals: antioxidants are the bodies defense mechanisms against free radicals -molecules that can safely donate an electron to a free radical to make it neutral -once free radical has stopped it can stop the chain reaction where are antioxidants: fruits, veggies, seeds, etc. essential antioxidants: vit E, vit C, beta-carotene, selenium if you don't get enough: oxidative stress only using 50% of hydrogen peroxide; 100% kills healthy cells too

neurologic function in aging: structural changes

-decrease in brain mass -enlargement of cerebral ventricles -decrease in number of neurons, dendritic processes, and synapses -decrease in myelin -altered production of neurotransmitters -don't have as many neurons as younger people do

perfusion in aging

-decreased elasticity of vascular smooth muscle -increased afterload: how hard the left ventricle has to push for it to get to capillaries of the body -when you're pumping muscle, its going to pump your heart and hard for ventricles -left ventricular wall thickness -atherosclerosis -reduced density of pulmonary capillaries -limits oxygen availability

neurologic function in aging: decrease in myelin

-decreased in serotonin, dopamine, acetylcholine

hypoxemia

-decreased oxygen in the arterial blood leading to a decrease in the partial pressure of oxygen (PaO2) -oxygen supply in arterial blood-low PaO2 in the serum

fluid and electrolyte balance in aging

-decreased total body water -body mass changes -renal function -altered sodium balance if we are replacing a lot of muscle tissue with fat tissue and fat repels water and more fat you have in your body the less water you have in your body too much water sodium goes up

macular degeneration (MD): pathophysiology

-degeneration of the fovea -central portion of the retinal macula -categories -dry (atrophic): drusen deposition -wet (exudative): choroidal neovascularization #1 cause of blindness in the elderly drusen: small yellow depositions under the macula choroidal neovascularization: new vessels are being formed right by the fovea and tend to leak and is the wet part

cardiac cycle 2

-deoxygenated blood comes oxygenated through ventilation-perfusion exchange -blood returns to heart via pulmonary vein to left atrium -blood goes through bicuspid valve to left ventricle -blood goes through aortic valve to aorta -blood enters systemic circulation

pulmonary processes: neural control-chemoreceptors

-detect gas exchange needs -PaO2, PaCO2, and pH levels in the blood and CSF -location -central -peripheral

cell-mediated immunity

-detect pathogens inside the cell where they evade antibody detection -t cells interact with and recognize antigen carrying cells -membrane surface molecules, clusters of differentiation (CD)

cell-mediated immunity response continued

-detect pathogens inside the cell where they evade antibody detection -t cells interact with and recognize antigen carrying cells -membrane surface molecules, clusters of differentiation (CD) -grab antigen and present on outside of the membrane so that CD8 cells can kill off that bad cells -hang out in the thymus until needed

chromosomal alterations

-detected by karyotype -size of the chromosomes decrease greatly from 1-22 -error in chromosome 1 will be lethal its a boy

pulmonary processes: airway resistance

-determined by diameter of conducting airway lumen -affected by viscosity and velocity of air movement how big is your trachea, airway lumens, smaller they are less air getting through asthma: constrict your airways and a lot more resistance with your airways

neuronal communication: post-synaptic receptor types/subtypes

-determines response (inhibitory/excitatory)

male reproductive anatomy: testosterone

-development and function of male reproductive organs -sperm production and maturation -protein metabolism -muscle mass promotion -skin thickness promotion -sebaceous gland activity -growth of pubic, chest, and facial hair -maturation of the larynx resulting in a deeper voice tone -driving those changes from testosterone during development

humoral immunity: active immunity

-development of antibodies to an antigen -achieved by having a specific disease of vaccine

active immunity

-development of antibodies to an antigen -achieved by having a specific disease or vaccine -active: you get sick yourself and your body naturally makes the antibodies -have it by getting a vaccination (live virus are scary because if you don't have a good interacted immune system it can make you super sick) -MMR, varicella, nasal flu -long process maybe 10-14 days to get good immunity

theories of aging

-developmental theories: not set in stone -accumulated mutations: as you are replicating your DNA over and over again each replication you have a chance of having a mutation and more mutations and more replications of mutations with yourself causing for more likely aging -immunologic: more depressed immune system when you get older and your autoimmunity is higher -antagonistic pleiotropy: cellular division -neuroendocrine: endocrine changes as you age so you don't have as much hormones as you get older

acute leukemias

-deviant blast cells replace the normal marry elements, resulting in a marked decrease in the production of functional white blood cells, RBC's, and platelets and can then move into other organs -acute lymphocytic leukemia (ALL) is the most common cancer in children where as acute myeloid leukemia (AML) are more common in adults

diagnosis and treatment of altered bowel elimination

-diagnosis -stool characteristics -radiographic testing -endoscopic testing -sigmoidoscopy, colonoscopy -treatment -underlying cause

diagnosis and treatment of altered urinary elimination

-diagnosis: -macro-and microscopic urinalysis -GFR and creatinine clearance rate -imaging studies -IV pyelogram, renal angiogram, renal ultrasound -treatment -administration of fluids (deficit) -diuretics (excess)

treatment strategies related to altered nutrition

-dietary interventions -increasing intake of particular macronutrients -taking vitamin and mineral supplements -reducing overall caloric intake -avoiding specific foods -pharmacologic interventions -exogenous digestive enzymes

neuronal impulse transmission: membrane potential

-difference in electrical charge between the inside and outside of the cell -at rest, an excitable cell is polarized -inside of the cell more negative compared to outside -when membrane potential reaches threshold, cell is committed to an action potential

diagnostic criteria: prostate cancer

-digital rectal examination -transrectal ultrasound -PSA levels -prostate biopsy: with a needly aspiration

acute gastritis: treatment

-discontinue ingestion of irritating substance -buffer or decrease production of gastric acid -take away irritant -proton pump inhibitors, antiacid, etc.

electrolytes

-dissolved particles in body fluids -electrically charged ions -positively charged cations

water function

-dissolves -maintains fluid balance -transports nutrients and waste -lubricates -maintains body temperature

pulmonary processes: compliance

-distensibility of lung tissue and chest wall -how expandable are your lungs

intraneuronal inclusions: type of neuronal injury

-distinctive structures formed in the nucleus or cytoplasm

patterns of hormone secretion, metabolism, and elimination

-diurnal patterns of secretion -cyclic patterns of secretion diurnal: daily pattern (cortisol level) increase in morning, decrease in evening and shoot back up why you are sleeping cyclic: ovulation: estrogen level goes up and down over a month and lutenizing hormone goes low and increases during ovulation

decision tree for anxiety disorders

-don't have to memorize this just know that we have this

arterial blood pressure

-don't see many structural defects because we fix them while they're a child normally

alloimmunity: graft versus host disease

-donor T lymphocytes recognize recipient as foreign -immunocompromised recipient unable to mount a defense -results in a Type IV hypersensitivity reaction -donated bone marrow doesn't recognize the body that it is refusing and the organ is ruining the body and attack entire body/cells person receiving bone marrow goes through radiation and remove disease bone marrow and replaced with donor bone marrow and the donor creates cells with the MHC from the donor cells and realizes the host is a foreign so it attacks the cells and results likely in death -happens several days after bone marrow transplant

somatosensory neuronal transmission

-dorsal root ganglia fibers -dermatome innervation -pathways -discriminative pathway -anterolateral pathway DR: part of spinal column and is a bunch of nerves together and transmission depends on whether the nerve is myelinated (more of it faster it transmits) and width of actual neuron (thicker-faster) type A: largest diameter and have lots of myelination type B: smaller of diameter than type A also myelinated but not as much so little bit slower than Type A type C: unmyelinated nerves (thinnest) and are very very slow to send signals -more type A nerves type A: alpha, beta, delta alpha and beta: very similar and work to promote inhibition of nerve impulses (inhibit pain) delta: helps us detect pressure, touch, hot and cold, hot as painful hot DI: one single hair of dorsal root ganglia and innervate at the level they separate from the spinal column -discriminative: helps discriminate touch and also spacial orientation -where you hold something and guess what it is with your eyes closed -stereognosis: ability to figure out without looking what you are holding in your hand 2 point discrimination: where you are getting touched with two things and they have to distinguish between the two different touches -anterolateral pathway: have lots of synapses so they have a slower impulse and help with pain, temp, crude touch, etc. involves both the anterior and lateral spinothalamic pathways and is characterized by multiple synapses and slow conduction acuity: how well they can locate where you are touching them with their body

chromosomes

-double-stranded DNA in cell nucleus -22 pairs of autosomes -1 pair of sex chromosomes -contain genetic information of an individual every single cell has 22 pairs of autosomes -XX for female and XY for male

MD: clinical manifestations-progression

-dry/atrophic -slow progression of symptoms -wet/exudative -rapid and severe vision loss -dark central spot don't notice it until its very progressed in dry type -wet type its quick and severe and are more likely to see a doctor

acute pancreatitis pathophysiology: caused by

-duct blockage by gallstones -excessive alcohol use -10% unknown

-sinus infection

-ducts that connect our nose and sinus cavities together and are supposed to drain where we have to blow it out or spit it out -ostia gets blocked, warm environment makes the bacteria grow and you can't clear the mucous because your ducts are clogged so nothing moves freely -cystic fibrosis: has a different kind of mucus and has thicker mucus

protective structures central nervous system: meninges

-dura mater (outer layer) -arachnoid mater (middle layer) -pia mater (inner layer) -all protect tissue surfaces containing cerebrospinal fluid

homeostasis

-dynamic balance characterized by appropriate and effective response to stimuli at the cellular level

chronic gastritis: clinical manifestations

-dyspepsia: indigestion feeling -loss of appetite -vomiting -can be asymptomatic

central nervous organizations: hemispheres

-each contain the 4 lobes of the brain -contralateral regulation of functional capacity -gyri: irregular convolutions on the surface -sulci: fissures

nephron

-each kidney contains 1.2 million nephrons -is the functional unit of the kidney 1) superficial cortical nephrons: make up 85% of all nephrons, which extend partially into the medulla 2) midcortical nephrons: have short or long loops 3) juxtamedullary nephrons: lie close to and extend deep into the medulla and are important for the process of concentrating urine; secrete renin

cerebral atrophy diagnostic criteria

-early identification of loss of function -health history -onset -duration -severity -neurologic examination -imaging studies -no cure but ways to slow it down -hold peanut butter away from some distance and it can help you determine whether they are slowing (gradually) getting Alzheimers

developmental considerations

-early life -neural tube development -neuron complement -brain development and maturation aging -neuron complement -structure -responsiveness -developing pre-frontal cortex now our age -done myelating all our own neurons by age 2 -grow from brain down

anorexia nervosa (AN) pathophysiology

-eating disorder characterized by: -inability to maintain a minimally healthy body weight -an intense fear of gaining weight -relentless dietary habits that prevent weight gain -severe body image distortions

diagnosing altered perfusion

-echocardiography -catheterization -chest x-ray -ECG -pressure measures -stress test -nuclear scanning -doppler -understand which test to use and type

otitis media with effusion (OME): pathophysiology

-effusion (fluid) in the middle ear -trapping of fluid by obstruction in the eustachian tube -not associated with infection or inflammation 3-4 months that the child could possibly get an ear infection with that fluid growing inside the ear

neuronal impulse transmission: action potential

-electrical events that travel along the entire neuron by allowing charged ions to flood through channels in the semi-permeable membrane around the nerve cell -regulated by changes in membrane potential: the difference in electrical charge between the inside and outside of the cell -polarized: when the excitable neuronal cell is at rest -the inside of the cell is more negative compared with the outside of the cell and is measured at approximately -70mV -at rest, the neuron and the surrounding space act as a capacitor, storing current, which is released during the action potential -determined at the point when voltage-gated sodium channels open -myelin prevents current from being lost as sodium ions drift away from the neuron soma to dendrites -between 70 and 80 -influx of sodium ions into the cells: depolarization by allowing potassium back into the cell pump out 3 sodiums for 2 potassium potassium channel: uses sulfate and phosphate to force sodium into the cell overall inside of the neuron: negative overall outside of the neuron: positive

celiac disease: treatment

-eliminate gluten from the diet -vitamin and mineral supplementation -pharmacologic treatments -anti-inflammatory medications -hypersensitivity-blocking medications -symptoms usually improve within 1-2 months

MI treatment

-emergency management -medical -airway, breathing, circulation -surgical -PCI, PTCA -long term treatment -pharmacologic -lifestyle modifications

chronic gastritis: diagnostic criteria

-endoscopic examination -biopsy of gastric tissue -endoscope: take camera in and look at the lining of your stomach and test it at biopsy for h. pylori

active transport

-energy is required -example: Na+/K+ active: ATP pump that pumps sodium and potassium in and out of cell -sodium: outside of cell (blood is salty) -potassium-inside

PKD clinical manifestations

-enlarged kidneys -hypertension -flank pain -altered fluid and electrolyte balance -renal calculi -diverticular disease -urinary tract infection -additional organ involvement -liver, pancreatic cysts -cardiac valvular disease -cerebral aneurysms flank pain: lower back kidney area pain additional organ involvement: not all caused by PKD but are caused by the genetic alterations in the patients that have PKD

prostate cancer: pathophysiology

-exact cause unknown, age is a major risk factor -initiatior-promoter events with genetic and environmental influences -androgens and estrogens support prostatic epithelial proliferation -more than 95% of primary prostate cancers are classified as adenocarcinomas -arise in the periphery

anaphylactic reaction pathophysiology

-exaggerated systemic immune response due to a Type 1 hypersensitivity reaction -triggers: insect stings -food allergies -drug allergies -different allergies can be insects, food, drug allergies

polycystic ovarian syndrome (PCOS): pathophysiology

-excess ovarian androgen production -cause: unknown -altered hormonal regulation -disrupts menstrual cycle -disrupts ovulation -multiple immature ovarian follicles -decreased progesterone production -increased acyclic (constant) estrogen production -anovulation -hyperinsulinemia too much androgen: also produced by the ovaries, disruption of menstrual cycle and ovulation -the primary, secondary, follicle we don't see that progressive development in PCOS we just see immature follicles cyst like -no ovulation no corpus luteum so you don't get the progesterone effects -hyperinsulinemia: high levels of insulin beyond what you need to utilize glucose and become insulin resistance and can lead to diabetes

antidiuretic hormone

-excess: fluid retention, low urine output, hyponatremia -deficit: excessive water losses through the urine, leading to nausea, vomiting, fatigue, muscle thirst, dehydration, can progress to shock twitching; can progress to convulsions and death

glucocorticoids (cortisol)

-excess: truncal obesity, moon face, buffalo hump, glucose intolerance, atrophic skin, striae, osteoporosis, psychological changes, poor wound healing, increased infections -deficit: hypoglycemia,anorexia, nausea, vomiting, fatigue, weakness, weight loss, poor stress response

chronic pancreatitis: pathophysiology

-excessive alcohol use (60-70%) -autoimmunity (10%) -unknown causes (20%) -characterized by: -duct obstruction by enzymes and proteins -ischemia: lack of oxygen to the cells -acinar cells become atrophic and fibrotic -loss of function -oxidation: cellular injury and organ damage

overnutrition

-excessive consumption of nutrients -excessive caloric intake -vitamin/mineral toxicity -toxicity with fat solubles

excessive perfusion demands

-excessive demands -poor perfusion supply

DIC clinical manifestations

-excessive hemorrhage -bruising -petechiae -epistaxis -excessive clotting -headache -weakness -seizures, coma -renal -poor urine output -renal failure -respiratory -cough -shortness of breath -respiratory distress -chest pain petechiae: blanch -purpura: pulled blood from the skin and when you push down on it it does not turn white

plasma buffer system: potassium-hydrogen exchange buffer system

-exchange of K+ and H+ -problem because it can cause hyperkalemia

menopause: pathophysiology

-expected biological stage in the female life course -complete cessation of ovarian activity -follicular exhaustion -unresponsive to anterior pituitary tropic hormones -steroid hormone deficiency -estrogen -progesterone -systemic response in estrogen-responsive cells and tissues psychologic not pathogens -cessation of menses ovarian activity (no menstrual cycles no steroid hormones) -you don't keep making follicles like the sperm so they just run out and do not respond with FSH

environmental toxin injury and cardiovascular disease: pathophysiology

-exposure to environmental chemicals leads to cardiovascular cell injury -airborne particulate matter causes oxidative damage and inflammation in heart and blood vessel cells -additive factor to cardiovascular disease

healing and tissue repair: proliferative phase

-extracellular matrix -basement membrane -supportive architectural structure -support reepithelialization -storage of growth factors -restore neuromuscular function -support development of parenchymal tissues help clean up debris and help remove necrotic tissue and restoring structural integrity and creating that matrix through proteins and help building pushes up and up and up until the scab is gone

hutchinson-gilford progeria syndrome: pathophysiology

-extremely rare hereditary disease characterized by accelerate aging -affects: skin and musculoskeletal and cardiovascular systems -caused by autosomal dominant or recessive mutations in LMNA gene -advanced paternal age is a major risk factor

vision: extraocular muscles

-eye movements -rotation -horizontal movement -six paired muscles -cranial nerves -oculomotor (III) -trochlear (IV) -abducens (VI) -movement types -saccades -pursuit -convergence/divergence -vestibular -fixation maintenance -know the nerves don't worry about movement types myopia: nearsightedness: can't see far away (you can see up close) hyperopia: farsighted: can see far away presbyopia: farsighted astigmatism: irregular curvature of cornea or lens

vision: protective eye structures

-eyelids/eyelashes -lacrimal glands -tear production -ciliary body -aqueous humor production: space between iris and the lens -trabecular network: aqueous humor reabsorption

autoimmunity

-failure to distinguish self from non-self -causes damage to specific organs or to the entire system -lupus: more generalized and all over -oversecreting cells: graves disease -some antigens look so similar like our cells and cause trouble

huntington disease: diagnostic criteria

-family and personal medical history -physical examination -mental, cognitive, and emotional evaluation -genetic testing -blood testing -CT, MRI, PET scans -probably would be able to see this in a pedigree

hypertension: pathophysiology risk factors

-family history -aging -black race -decreased nephron count -diabetes mellitus -excessive dietary sodium intake -obesity -sedentary lifestyle -nutriton -excessive alcohol intake -smoking -family history is huge -diabetes will actually change the inside of your blood vessels -increased peripheral resistance with it

PKD diagnostic criteria

-family history -genetic testing -physical exam -hypertension -imaging studies -presence of >3 kidney cysts on ultrasound -extrarenal cysts -lab confirmation of renal failure

osteoporosis: risk factors

-family history -loss of estrogen -aging -calcium, vitamin D -cigarette smoking -excessive alcohol -sedentary lifestyle

MI pathophysiology: major risk factor

-family history of CAD -hypertension and smoking -blood cholesterol levels -concurrent diabetes mellitus -high-sensitivity: C-reactive protein (CRP) -hyperhomocysteinemia: homocysteine plays a role in coagulation and high levels are toxic to endothelial cells and could promote excessive coagulation and thrombus formation -diabetes mellitus people have a higher rate of disease -CRP indicative of inflammation

fibromyalgia: clinical manifestations

-fatigue -pain -neck - elbows -shoulders -back -hips -depression may coexist

female reproductive anatomy: ovarian estrogen

-female reproductive organ development -female body fat contour distribution -breast development and skeletal growth during puberty -ovulation and support of pregnancy and lactation -cervical mucus alterations (copious, thin, watery, and more receptive to sperm) -axillary and pubic hair growth -female skin maintenance -decreased bone resorption; maintenance of bone integrity -retention of sodium and water -elevation in body temp. which is why people watch it because we know estrogen causes in increase in body temp -ovarian estrogen is the main primary reason for what happens to women when they go through pregnancy/ovulation -cervix changes and it is due to estrogen -rentention of sodium and water: why you feel bloated -there is no covering around the ovary because the ova needs to be released and be picked up by the fimbriae

anorexia nervosa pathophysiology: risk factors

-female sex -family history -introverted, obsessive, and perfectionistic personality -inability to resolve conflict -low self-esteem -family dysfunction

kinds of nephrons

-glomerulus -proximal tubule -loop of Henle -distal tubule -collecting duct

healing and tissue repair: connective tissue layer

-fibroblasts -collagen: secreted by fibroblasts -produce and replace connective tissue -excess leads to scarring -fills in gaps after removal of damaged tissues -elastin: stretching and tissue recoil -difficult to replace -glycoproteins: attachment of cells to matrix -stimulate cell function fibroblasts collagen: secreted by fibroblasts; supporting liquid that fills in the gaps; not as functional as normal tissue so it looks different elastin: more difficult to replace and thats why scars are more tight and not as stretchy

somatosensory neuronal organization

-first-order neuron -second-order neuron -third-order neuron first-order: starts at periphery and communicate information from periphery to the CNS second order: interneurons that moves up to second order neuron and brings that signal from the spinal column all the way up to the brain third order: sensory information from the thalamus to the different networks in the brain like the primary somatosensory cortex -they can even modify sensory information before they spread it along

neuronal communication

-flow of information across a synapse: information from one neuron flows to another neuron -small gap or junction separating neurons -types: electrical and chemical synapse: two nerve endings block the reuptake from happening: dopamine, norepinephrine, etc.

neuronal impulse transmission: depolarization

-flow of potassium ions out of the cell -K+ efflux returns to cell to resting membrane potential

CNS injury: ischemic brain injury location and consequences

-focal -global consequences: -tissue necrosis -inflammatory responses in a closed space

stoke clinical manifestations

-focal brain injury -abrupt onset of hemiparesis -vision loss of field deficits -dizziness, diplopia -ataxia, aphasia -sudden decrease in the level of consciousness

phases of infection

-focus on locally and systemically

regulation of attention types

-focused: noticing and responding to one specific stimulus -sustained: sustaining concentration with vigilance over time -selective: noticing and responding to a stimulus while filtering distractions -alternating: moving between tasks having different cognitive requirements -divided: responding simultaneously to multiple tasks or demands focused: on one thing sustained: keeping your focus on that one thing over time selective: choosing one focus and focus your attention on one thing and ignore the distractors alternating: two or more different brain processes (distractions) so your paying attention to one and then focus on the one divided: looking at one or another going back and forth among two or three different things but not devoting full attention to one of them -multitasking is very hard

male reproductive anatomy: anterior pituitary trophic hormones

-follicular stimulating hormone (FSH) -luteinizing hormone (LH)

digestion

-food is broken down mechanically and chemically in gastrointestinal tract and converted into absorbable components -digestive system -extracts macronutrients -absorbs digested components -forms a psychological and chemical barrier against microorganisms and other foreign materials introduced during food ingestion -so we don't get sick everytime we eat something pathogenic

perfusion

-forcing blood or other fluid to flow through a vessel and into the vascular bed of tissue to provide oxygen

central nervous organizations: brain structures

-forebrain -telencephalon -cerebral cortex -basal ganglia -hippocampus -amygdala -diencephalon -hypothalamus -thalamus -midbrain -mesencephalon -tectum -tegmentum -hindbrian -metencephalon -cerebellum -pons -myelencephalon -medulla oblongata -don't need to memorize this just know this is a way to organize the brain

prognosis

-forecast or prediction of how the individual will proceed through the disease process -recovery -morbidity -negative outcome with disease complications -impact on quality of life -recover from a stroke but have problems walking, talking, etc. -mortality -death

osteoporosis: clinical manifestations

-fractures (especially in spine and hip) -loss of cancellous bone in vertebrae -structural impairment of trabeculae -thinning and increased porosity in cortex -spinal deformity -loss of height

theories of aging: stochastic theories

-free radicals: harm the body -cumulative cellular damage that happens -somatic mutation: similar to developmental theory but has more to do with being exposed to more environmental things that causes mutations and when they replication you get more and more mutations

processes of stool elimination

-function of the gastrointestinal system -blood supplied by superior and inferior mesenteric arteries -autonomic nervous system innervation

disease

-functional impairments of cells, tissues, organs, or organ systems -often used broadly to include: -injuries -disorders -illnesses -syndromes

neuronal communication: electrical

-gap junctions -fast and direct, multidirectional -transmit impulses by passage of current-carrying ions through small openings known as gap junction -most of these gap junctions are commonly involved in the transmission of electrical impulses that lead to cardiac contractions

ASD risk factors

-gender: boys > girls -sibling with ASD -older parents: mom > 35 yrs and dad > 40 yes -genetics: 20% of children with ASD have other genetic conditions (Down syndrome, fragile X syndrome, and tuberous sclerosis)

MD clinical manifestations

-general -distortion of central vision -decreased ability to read, recognize faces, colors -blindness -central vision loss when you are focused on anything thats central vision -can't recognize faces, what you focus on is going to be blurry and eventually causes blindness

alzheimer disease: clinical manifestations

-general -global cognitive decline -behavior changes**** -eventual loss of function -severity based on stage and progression -seven stages -initial symptoms -memory loss -confusion -restlessness -mood swings -difficulty in interpreting visual information

pneumonia: clinical manifestations

-general effects -fever -chills -cough -sputum production -fatigue -loss of appetite -dyspnea -tachypnea -pleuritic pain -adventitious breath sounds -deterioration of respiratory status -impaired diffusion -hypoxia -metabolic acidosis -dehydration outcome -recovery -respiratory failure -death

otitis media: clinical manifestations

-general ones -acute ear pain -enlarged periauricular lymph nodes -rhinorrhea (runny nose) -fever -impaired hearing -perforated tympanic membrane

genetic code

-genes on specific chromosome locations provide information for the production of proteins -sequence of 3 DNA nitrogenous bases form a codon, transcribed and translated by RNA to produce a single amino acid

oncogenes

-genes that code for proteins involved in cell growth or regulation -promote unregulated cell growth and development and can also inhibit death

altered nutrition: causes

-genetic defects -ineffective mucosa -inadequate or excessive intake -excessive nutrient losses -hypermetabolic states -malabsorptive syndromes -ingestion of unsafe food and water

epigenetic inheritance

-genetic modifications due to environmental and metabolic agents -histone acetylation -DNA methylation -genomic imprinting epigenetic inheritance: how the genes turn on or off epigenetic modification: changes how the gene is expressed doesn't change the bases but it can lead to disease way genes are turned on through epigenetic processing -diet -smoking

sickle cell disease diagnostic criteria

-genetic screening -lab analysis -hemoglobin electrophoresis -determine proportion of hemoglobin types -complete blood count -urinalysis -tests of liver and kidney function -can be seen with a pedigree -only hemoglobin A is affected -fetal hemoglobin doesn't sickle

cardiac hypertrophy: diagnostic criteria

-genetic testing -hypertension -reduced exercise tolerance -ventricular arrhythmia -altered signals in the cells of the ventricle -heart murmur

PKD pathophysiology: categories

-genetic, autosomal dominant -genetic, autosomal recessive -acquired autosomal dominant: one parent to have the genetic defect in order for child to get it autosomal recessive: both parents must carry it for child to get it acquired: genetic ones usually happen at very young age and acquired ones happen later in life from either kidney damage or aging

osteoporosis: prevention

-get adequate amounts of calcium and vitamin D -engage in regular weight-bearing exercise -avoid smoking and excessive alcohol intake -talk to your doctor about bone health -have a bone density test and take meds when appropriate -walking, running, causing impact on bones would be helpful for these people

vision: treatment of alterations in vision

-glasses -contacts -patching -surgery -LASIK: surgical procedure used to treat myopia, hyperopia, and astigmatism -cataract removal -glaucoma treatment

altered bowel elimination: altered perfusion

-global -focal -consequences -ischemia and/or infarction -pain Melena: visual blood in stool occult: can't visually see it so test stool for blood

pelvic inflammatory disease: treatment

-goal: prevent complications -adhesions -ectopic pregnancy -abscess -infertility -pharmacologic -surgical -antibiotics

heart failure: treatment goals

-goals -correct cause if possible -improve cardiac output -reduce peripheral vascular resistance -improve quality of life

disseminated intravascular coagulation (DIC): pathophysiology

-going to see in ER or ICU unit -uncontrolled activation of clotting factors resulting in widespread thrombi formation, followed by depletion of coagulation factors and platelets leading to massive hemorrhage -cause: injury -initiated by endothelial injury

stress requires balance

-good thing if its in balance and keeps you motivated

aging

-gradual deterioration of a mature organism -time-dependent -irreversible changes in structure -influence response to illness

gram positive vs gram negative

-gram positive: doesn't have extra structure (one membrane layer) -gram negative: outer layer that resists dye -hard to kill off gram-neg

types of bone fractures

-greenstick: bone is bowed

cerebral palsy: pathophysiology

-group of neuromuscular disorders -cause: event during the antenatal or postnatal periods damaging upper motor neurons -problems with the control of movement 10/1/18 -brain trauma -all going to happen during infancy and birth - perinatal:20-28 days of being a newborn -affects 1 in 300 children -diagnosed at about age of 2 years because these children tend to have normal functioning and affects of the disease are smaller and not quite as obvious until a little older

schizophrenia clinical manifestations

-hallucinations: hearing voices -delusions -disorganized thoughts and speech -social withdrawal -poor hygiene -poor judgement -loss of motivation -paranoia -impairments of memory, attention, cognitive processing -memory -attention -cognitive processing

myocardial infarction (MI) pathophysiology

-happens every 40 seconds in the US -coronary artery disease a lot of inflammation in your vessels, acts as a magnet for triglycerides in your blood -inflammation attacks magnet -total occlusion of one or more coronary arteries resulting in ischemia and death of myocardial tissues -atherosclerosis is the most common cause

cellular structure: cell membrane

-have to understand how things go in and out of cells -understand that cell membrane is made up of two structures (hydrophilic head and tail that come together to meet) -not everything can get through cell membrane and theres a channel protein that helps things come in and out of the cell like glucose

burn clinical manifestations

-heat, swelling, pain, redness, loss of function -blistering occurs with deep partial burns -redness, eschar, edema, exudate, characterize full thickness burns -dead cells collect on the surface of the burn and are not helpful and must remove through surgery to get them off and have helpful cells to come so they can help repair with fluid and oxygen

cell-mediated immunity pictures

-helper T cells will tell this macrophage to kill and destroy anything present antigens

AIDS treatment

-highly active antiretroviral therapy (HAART) -suppress viral replication -delay disease progression -drugs used in combination -reduce the development of drug resistance keep changing medication they are getting and are on several drugs at the same time and slow things down but can't cure -doesn't treat the disease just slows down the process

benign prostatic hyperplasia: diagnostic criteria

-history -physical exam -prostate palpation examination -lab tests -prostate specific antigen (limited usefulness) -urinalysis -functional tests: urodynamic

migraine headache: diagnostic criteria

-history -physical examination -imaging for acute, sudden onset -MRI -CT red flags: wake up during sleep with headache, headache gets worse through time, waking up in the morning with a headache -no changes in brain structure for migranes or anything like that

major depressive disorder diagnostic criteria

-history -reported observations by friends and family -mental status examination -ruling out physical conditions -DSM-5 diagnostic criteria -onset of 5 or more symptoms persisting over a 2 week period

pelvic inflammatory disease: diagnostic criteria

-history -physical exam -laboratory -screening

anorexia nervosa diagnostic criteria

-history and physical exam -DSM-5 criteria -restricted food intake leading to low body weight -fear or avoidance of gaining weight, despite low BMI -disturbed body image -nutritional assessment -lab studies -electrocardiogram

altered reproductive function: diagnosis

-history and physical exam -diagnostic testing: labs and imaging -treatment: medication -surgery -counseling -primary pathogens being chlamydia and gonorrhea -treatment and time of treatment is super important

hutchinson-gilford progeria syndrome: diagnosis

-history and physical exam -hyaluronic acid levels -imaging studies high acid level could be a screening process bone age scan -nothing to do to prevent the disease from happening or slowing it down

osteoarthritis: diagnostic criteria

-history and physical exam -joint aspiration -radiographs -MRI

iron-deficiency anemia diagnostic criteria

-history and physical exam -lab studies -hemoglobin, hematocrit -mean corpuscular volume -mean corpuscular hemoglobin concentration -RBC indices -serum ferritin

DIC diagnostic criteria

-history and physical exam -lab tests -prothrombin time (PT) -activated partial thromboplastin time (aPTT) -platelet count -fibrinogen level -D-dimer test (CONFIRMS PATIENT IN DIC)

erectile dysfunction: diagnostic criteria

-history and physical exam -laboratory tests: hormonal measures (LH, prolactin, testosterone)

alzheimer disease: diagnosis

-history and physical exam -neurologic evaluation -mental status, communication ability, memory, comprehension, math ability, reasoning ability, balance, visual/motor coordination -imaging studies (to rule out other disease) -brain scan, MRI, CT scan -definitive diagnosis at autopsy -youll know for sure if they have alzheimer's after autopsy

sprains and strains: diagnostic criteria

-history and physical exam -radiographs -arthroscopy -arthrography

generalized anxiety disorder diagnostic criteria

-history and physical examination -rule out medical or substance-abuse problem -standardized rating scales

anaphylactic reaction: diagnostic criteria

-history and physical examination -allergy testing -prognosis: based on -symptom severity -time to treatment

environmental toxin injury and cardiovascular disease: diagnostic criteria

-history and physical examination -cardiovascular and respiratory complications -reduced exercise tolerance -difficulty breathing -blood clot -hypertension -increased heart rate -reduced cardiac output -hyperlipidemia

heart failure: diagnostic criteria

-history and physical examination -chest radiography -echocardiography -ECG -cardiac catheterization

pneumonia: diagnostic criteria

-history and physical examination -complete blood cell count -chest x-ray or thoracic CT scan -culture/sensitivity, gram stain -V/Q scan -can back up to 3 days behind the process

crohns disease: diagnostic criteria

-history and physical examination -endoscopic examination -complete blood count (anemia)

acute gastritis: diagnostic criteria

-history and physical examination -endoscopic examination -stool analysis (presence of blood in stool) -complete blood count (anemia) -endoscopic: with a camera -blood at the lower end of digestive tract: frank blood -stool-bleed at the top of GI tract and puke blood back up

SLE diagnostic criteria

-history and physical examination -lab analysis -antibodies against cell components and DNA -anti-DNA antibodies -anti-Sm antibody (smith nuclear antigen) -anti-nuclear antibody -inflammatory markers: complement (c3 and c4) -no well defined diagnostic criteria look at symptoms

stroke: diagnostic criteria

-history and physical examination -lab studies CT SCAN

acute pancreatitis: diagnostic criteria

-history and physical examination -lab testing -complete blood count, ESR, CRP -serum amylase and lipase -serum alkaline phosphatase -total bilirubin -aspartate aminotransferase (AST) -alanine aminotransferase (ALT) -harder to diagnose -CBC: something bacteria, blood loss -serum amylase and lipase (TEST QUESTION)

diabetes insipidus: diagnostic criteria

-history and physical examination -lab tests -serum solute concentration -ADH levels -urine-specific gravity -urine osmolality urine specific: low more like water because you are peeing out so much water

acromegaly: diagnostic criteria

-history and physical examination -laboratory analysis -glucose tolerance test -growth hormone -IGF-1 glucose tolerant test: give lots and lots of glucose and see what their body does with it and after you do it it will suppress your growth hormone IGF-1: usually a better way to check it because its more predictable -still high after tolerance test, you know theres an issue

cystic fibrosis: diagnostic criteria

-history and physical examination -newborn screening -sweat test -chloride concentration(chloride dysfunction in this disease) -genetic testing: CFTR mutation -chest x-ray -sputum analysis-look for pseudomonas aerogonosa*** very susceptible to this bacteria when you have cystic fibrosis

cervical metaplasia and dysplasia: diagnostic criteria

-history and physical examination -screening tests -microscopic examination of transformation zone cells -HPV screening -diagnostic tests -biopsy of cervical tissue for microscopic examination

hypertension: diagnostic criteria

-history and physical examination -serial blood pressure measurements -lab studies

laboratory and diagnostic tests

-history and physical examination pulse oximetry -visualization (x-ray, CT, MRI, nuclear V/Q scan) -pulmonary function tests -bronchoscopy -thoracentesis -lab studies: -arterial blood gas (ABG) -culture and sensitivity

otitis media: diagnostic criteria

-history of acute onset -otoscopic exam -effusion -bulging tympanic membrane -limited or absent mobility -visible air-fluid level -otorrhea: (ear canal discharge) -eardrums that need to be treated and the ones that don't is what we need to learn

ménière disease: diagnostic criteria

-history of symptoms -physical exam -auditory exam -auditory brain stem response -glycerol test -electrocochleography -electronystagmography -caloric test give them glycerol or mannitol -cochleo: send messages to the cochlea through electric impulses -caloric: warm and cold water or warm or cool air that they send into the eye and if it causes nystagmus of the eye then thats a symptom

autosomal recessive disorder

-homozygous -one homozygous and one non carrier parent -expression: none -carrier: 100% -noncarrier: 0% -since its recessive, child must be homozygous for the mutated gene to express the disease -both parents must have one copy -may be unaware that they have it because they don't see it but its in their genes -one parents is a carrier, child has a equal chance of being a carrier or completely unaffected -both parents are homozygous, all children will have the disease -one parent is homozygous and has the disease and other one doesn't, all of their children will be carries with the ability to pass on the mutate gene -happens in more specific populations -cystic fibrosis, tay-sachs disease, thalassemia, and sickle cells disease

sex-linked disorders

-homozygous -two heterozygous parents: expression-25%, carrier-50%, non-carrier-25% -paternal x link: passed to daughters only: expression-0%, carrier-100%, non carriers-0% -maternal x link: transmitted to daughters and sons -expression: 50% sons, carrier: 50% daughters, non carrier: 50% daughter and son -mutated genes located on the sex chromosomes X or Y -most on X chromosome and are recessive -more women are carriers since they have two X's -hemophilia and x-linked severe combined immunodeficiency (bubble boy disease) are X-linked disorders with females carrying the disease and men expressing the disease

altered reproductive function

-hormonal -structural -functional

meiosis

-how ova and sperm (germ cells) are produced -one cell produces four cells, each with half the number of chromosomes known as gametocytes -each parent contributes one chromosomes so child gets half from mom and dad

behavior

-how people respond and act in a given situation

application of concepts of genetics/developmental disorders

-huntington disease -sickle cell disease -down syndrome -mitochondrial encephalopathy, lactic acidosis, stroke (MELAS) -turner syndrome -fragile X syndrome -beckwith-wiedemann syndrome -neural tube defects

female reproductive anatomy: hormonal regulation

-hypothalamic releasing hormone: gonadotropin releasing hormone (GnRH) -anterior pituitary trophic hormones -follicular stimulating hormone (FSH) -lutenizing hormone (LH) -target organ -ovarian follicles -estrogen -progesterone hypothalamic: always releasing stuff -steroid hormones has a precursor called cholesterol -cholesterol is driven down a pathway by different enzymes

manifestations of impaired ventilation and diffusion: systemic

-hypoxemia -hypoxia -cyanosis: dusky or cyanotic mucous membrane color -low oxygen saturation in arterial blood -changes in arterial blood gases -mental status changes -finger clubbing: painless enlargement and flattening of the tips of fingers or toes due to chronic hypoxia -hypercapnia -inflammation -fever -malaise -leukocytosis

effects of impaired ventilation and diffusion

-hypoxemia: decreased oxygen in the arterial blood leading to a decrease in the partial pressure of oxygen (Pa02) -hypoxia -hypercapnia: refers to a state of increased carbon dioxide in the blood

burn severity

-if it involves hands, face, feet, or perineum probably need to go to the hospital

osteoporosis: pathophysiology

-imbalance in bone remodeling -favors resorption over formation -loss of bone mass -classification: -primary -secondary (hormonal and genetic causes) -short people would be more affected because they have less bone mass

type I hypersensitivity

-immediate hypersensitivity reaction -antigen-IgE antibody binding -induced release of chemical mediators from mast cells -example: seasonal allergies type 1: IgE ANTIBODY THAT BINDS TO AN ANTIGEN LIKE AN ALLERGIC REACTION -seasonal allergies, something inhaled (anaphylaxis)-eat a peanut might die has to do with allergens whether inhaled or some other form -vessels will be wide open and expansion causing swelling and edema around the throat and can die from this severe rapid fast allergen

fractures treatment

-immobilization -reduction -closed -open -traction -fixation -internal -external

type III hypersensitivity

-immune complex-mediated reaction -result of formation and deposition of immune complexes in tissue -causes acute inflammation -example: serum sickness, lupus -cannot be broken down and cause reaction like acute inflammation -lots of cellular and tissue damage as result of complement activation -damages to kidneys, organs, etc. -serum sickness: causes local itching and swelling at the injection site and have a fever for about a week

third line of defense: immune response

-immune response is activated -immune cells recognize and destroy harmful substances -adequate response: resolution -inadequate response: disease spread primary defense and secondary defense fails, you will get this response -you either get an adequate response and get better or an inadequate which causes the disease to spread

immune responses in aging

-immune senescence -diminished antigenic responses -reduced T lymphocyte function -thymus degeneration -decreased IgE-mediated hypersensitivity responses -enhanced autoimmune responses -delayed wound healing not going to have as much myelin so every transmission is slower since myelin speeds up transmissions (impulses)

food allergy

-immune system-mediated adverse reactions to food -eggs -peanuts -milk -soy -fish and shellfish -tree nuts -wheat

humoral immunity: passive immunity

-immunity transfer from host to recipient -achieved via mother-infant transfer (placenta or breast milk) or injection of antibody -exposed to varicella and give you varicella immunoglobulin and that would be passive since its donor and not your igG -sometimes vaccinations wear away and memory cells can die off and thats why you get booster doses (tetanus)

passive immunity

-immunity transfer from host to recipient -achieved via mother-infant transfer (placenta or breast milk) or injection of antibody -passive: transferred from mom to a fetus through breastmilk, placenta, injection)

retinopathy of prematurity (ROP): pathophysiology

-impaired development of retinal blood vessels -phase 1: arrested growth -phase 2: unregulated growth -hemorrhage and scarring promotes retinal detachment retina starts maturing 16-18 weeks but doesn't fully mature until birth (why prematures are at risk) -lower O2 saturation with babies in moms -O2 can harm the retina (too much)

autism spectrum disorders: clinical manifestations

-impaired social: lack of intuition, inattention to social clues, not much eye contact, not responsive to own name, cant empathize with people, very negative reaction to social stimuli -impaired verbal: delayed speech development, don't point at objects they want, echolalia (repeating words they hear) -rep.: head flaping, picking at skin, banging head, repetitively rearranging objects at certain line, very big resistance to change in normal routine -impaired social interaction -impaired verbal and nonverbal communication -repetitive pattern of movement, interests or behaviors -poor muscle tone, incoordination, or toe walking -developmental regression

manifestations of impaired ventilation and diffusion: respiratory failure

-impaired ventilation -total airway obstruction -head injury leading to severe hypoventilation -weakness or paralysis of respiratory muscles -chest wall injury -impaired matching of ventilation and perfusion -chronic obstructive pulmonary disease (COPD) -atelectasis -severe infection -impaired diffusion -pulmonary edema -acute respiratory distress syndrome

cellular structure: organelles

-in our cells are organelles -ER: network of tubules that produce fats and proteins -rough: proteins -smooth: fat (fat in face makes it smooth) GA: charge of packaging things and have them exit the cell L: small sacs of destroyers; taking particles from the cell and destroying them Per: smaller little sacs like lysosomes but have enzymes in them that have destroy free radicals -Proteo: break down bad proteins -mitochondria: powerhouse; responsible for creating ATP -nucleus:carries all your DNA material-brain of the cell tells it what to do

erectile dysfunction: clinical manifestations

-inability to achieve and maintain erection hormonal factors: hypogonadism, hypothyroidism, or adrenal cortical hormone dysfunction, resulting in inadequate hormonal "priming" of the sexual centers of the brain neurological factors: spinal cord or perineal nerve injury resulting in inadequate nerve signaling to the penile vessels psychological factors: anxiety, low self-esteem, or depression resulting in inadequate arousal vascular obstruction: hypertension, atherosclerosis, vascular obstruction, and smoking disallow blood flow to the corpora cavernosa and spongiosa, thereby preventing erection from occurring impaired veno-occlusive ability: the inability to trap blood within the corpora cavernosa certain meds: antihypertensives, can inhibit hormone and erectile dysfunction

erectile dysfunction: pathophysiology

-inability to achieve or maintain an erection sufficient for sexual performance -neural: parasympathetic stimulation (S2-4) -smooth muscle relaxation -blood trapping in the corpora cavernosa of the penis and this trapping of blood in this area depends on smooth muscle relaxation that occludes the veins and does not allow blood flow out -sympathetic stimulation: reverse parasympathetic effects -cardiovascular: blood flow into the corpora cavernosa -hormonal: androgenic activity -adrenal cortical hormone dysfunction -libido and psychological influences nitric oxide: dilates blood vessels and relaxes smooth muscles and allows it to get a erection and sustain it

heart failure: pathophysiology

-inadequacy of heart pumping so that heart fails to maintain circulation of blood -result of: -impaired cardiac functioning -excessive workload demands -left heart failure -right heart failure person who has had a heart attack or a valvular problem or structure problem

autoimmunity response

-inadequate elimination of self-reactive lymphocytes in central lymphoid tissues -altered lymphocyte ignorance -stimuli overriding the non-responsive nature of a native T lymphocyte -impaired T lymphocyte activation -failure to recognize antigen due to MHC-antigen complex interaction -release of antigens sequestered during development -close resemblance between foreign and self-antigen (molecular mimicry) -inappropriate activation of T lymphocyte receptors by super antigens -failed to recognize cells as self and create immune response to get rid of antigens

CNS injury: ischemic spinal cord injury part 2

-inadequate perfusion -impaired oxygenation -causes: occlusion of spinal blood vessels -involvement extends from primary site: 2 segments above and below

CNS injury: ischemic injury

-inadequate perfusion -impaired oxygenation -pathology -oxygen and nutrient deprivation -impaired cellular function -infarction -initiation of inflammatory response

ventilation-perfusion mismatching

-inadequate ventilation in well-perfused areas of the lungs. this occurs with conditions such as asthma, pneumonia, and pulmonary edema -inadequate perfusion in well-ventilated areas of the lungs. this occurs with vascular obstructive processes in the lungs, such as with pulmonary embolus

ADHD clinical manifestations

-inattention -hyperactivity -restlessness -impulsivity -disruptive behavior -difficulties in school oar work -difficulties in social situations

goals of inflammation

-increase blood flow to site -vascular response -increase healing cells at site -cellular response -prepare for tissue repair -can be cellular level or tissue level or organ level -can involve an invasion of microorganisms -goal is to increase blood flow to the site -an initial injury is for you to vasodilator and stop the bleeding but we aren't not talking about the immediate process we are talking about what happens after

cardiac hypertrophy pathophysiology

-increased cardiac muscle mass etiology: -excessive cardiac workload -increased functional demand -inherited genetic trait categories: -primary -secondary cardiac hypertrophy: area of heart where ventricles enlarge -heart muscles are working to hard and causes it to get bigger primary: inherited secondary: underlying condition and usually increases left ventricular

CNS injury: brain pressure injury

-increased intracranial pressure -blood flow reduction -death of brain cells -damage to brain structures -manifestations -headaches -vomiting -papilledema -mental status deterioration -treatment: shunting of CSF -osmotic diuretics -corticosteroids

generalized anxiety disorder: pathophysiology

-increased response in amygdala to anxiety-provoking events -central nervous system mediators -norepinephrine, serotonin, dopamine, GABA -genetic factors -environmental factors -mom with anxiety can make child predisposed to it

renin-angiotensin-aldosterone system

-increases systemic arterial pressure and increases sodium reabsorption -renin: enzyme is formed and stored in afferent arterioles of the juxtaglomerular apparatus -renin helps form angiotensin I (psychologically inactive) -in the presence of angiotensin-converting enzyme (ACE), angiotensin I is converted to angiotensin II -angiotensin II -stimulates the secretion of aldosterone by the adrenal cortex -is a potent vasoconstrictor -stimulates antidiuretic hormone (ADH) secretion and thirst

erectile dysfunction: treatment

-individualized based on etiology -pharmacologic -testosterone replacement -nitric oxide donors, smooth muscle relaxants -implants/devices

glaucoma clinical manifestations: acute angle closure

-induced by increased pupil dilation -eye pain -headache -nausea -blurred vision -rainbows around lights at night -damage to optic nerve leads to vision loss

vascular response induces

-induces vasodilation and increases capillary permeability -objective is to get more blood flowing to the injured area -we want more blood to the injured area because we need RBC (carry oxygen) to help rebuild tissue

complications of healing

-infection -ulceration -dehiscence -keloids -adhesions ulceration: scab drops off and a pit where the scab used to be dehiscence: smaller scab starts healing but then breaks back open when hit keloids: overproduction of scar tissue and body has an over response adhesions: things can adhere that aren't supposed to adhere

pneumonia: pathophysiology

-infectious process -bacterial -viral -respiratory droplet spread -community acquired -nosocomial -inflammation of the lungs -bronchioles -interstitial lung tissue -alveoli -consolidation -accumulation of products of inflammation

emphysema: pathophysiology

-inflammation -small airways distal to respiratory bronchioles -loss of elastic recoil -air trapping -carbon dioxide retention -hyperinflation of lungs -arterial fibrosis -etiology -smoking -environmental exposure -genetic -children can be compromised very quickly because they have really small airways compared to adult child-respiratory Emergency adult: heart emergency -marfan disease could have them develop emphysema too -air trapping and they lose their elastic recoil so their lungs get super hyperinflated

second line of defense: inflammation

-inflammatory mechanisms are activated -vasodilation and increased capillary permeability cause redness and swelling -phagocytes move in to engulf and destroy harmful substances -capillaries normally do not allow things to leak out of your body so they are usually tight but in inflammation it has to change to get things through to begin healing process -phagocytes destroy foreign invaders and dead cells

healing and tissue repair

-inflammatory phase -proliferative phase -remodeling phase

healing and tissue repair processes

-inflammatory phase: cover the wound -proliferative phase: clear debris and restore structural integrity (extracellular matrix) -remodeling phase -restore structural integrity -resolution, repair, regeneration proliferative: after the battle theres dead bodies (things near cleared up) remodeling (restore structural integrity) scar tissue is not near as stretchy as normal

phases of the cardiac action potential: phase 0 (QRS wave)

-influx of Na+ ions polarizes the cardiac membrane and generates an action potential

acute gastritis: pathophysiology

-ingestion of irritating substances and/or poor gastric perfusion results in acute inflammation of the gastric mucosa -gastric epithelial cell necrosis -gastric acid erodes underlying tissue -could be alcohol, aspirin -nice mucosa lining that protects the cells and if acid goes past the protective lining, it can cause inflammation -could end up with an ulcer

ARDS phase 1

-injury reduces blood flow to the lungs -platelets aggregate and release histamine, serotonin, and bradykinin

acute pancreatitis: pathophysiology injury to

-injury to: -acinar cells -zymogen -pancreatic duct -protective digestive feedback mechanisms

innate vs adaptive immune response

-innate: fast responses and get to the scene first attack almost anything adaptive: longer acting phase -cytokines within a day after infection will increase and adaptive immune response takes over creating killer T cells and antibodies that are targeted to a specific antigen -delayed because you have to make antibodies for specific antigens

micronutrients: minerals structure

-inorganic substances critical to cellular processes -macrominerals -sodium, potassium, calcium, phosphorus, magnesium, sulfur -microminerals -iron, zinc, fluoride, copper

iron-deficiency anemia pathophysiology

-insufficient iron stores to meet needs for red blood cell development -major causes -inadequate iron intake -chronic hemorrhage -iron malabsorpton -high iron demands

requirements for effect perfusion: intact

-intact parasympathetic and sympathetic nervous systems: the autonomic nervous system is responsible for mediating changes in the cardiovascular system based on demands -intact cardiac conduction: conduction of impulses is essential in stimulating cardiac contractility -intact coronary circulation: coronary circulation maintains perfusion to cardiac structures, enabling the heart to distribute oxygenated blood to the remainder of the body -intact systemic circulation: the coronary and systemic circulation is designed to distribute oxygenated blood to tissues and organs -adequate tissue uptake of oxygen parasympathetic: rest and digest decreasing heart rate sympathetic: flight or fight-higher heart rate and higher cardiac output (stronger) -once heart cells die we can't replace them -we can get oxygen to the tissue but if the tissue doesn't absorb the oxygen it can be an issue

intake and storage of nutrients

-intake -regulated by hypothalamuc -factors -hunger -safety -food availability -emotional and physical health -storage -adipocytes -lipids -liver -vitamins A, B12, D, E, K -iron -copper -glycogen -reduces serum cholesterol

phenylketouria: clinical manifestations

-intellectual disability -fair skin and hair -hypopigmentation of eyes -musty odor -seizure disorder air hair and skin b/c impairment of melanin not being able to metabolize it musty odor: sign of excess phenylalanine

anorexia nervosa treatment

-interdisciplinary team approach -goal: acheve and maintain a healthy weight and nutritional intake -nutritional support -gradual refeeding (gain of 1-2 pounds per week) -monitoring for complications and disturbances -psychotherapy -tends to be very long time

immune response manipulation

-interference with the responses seen in autoimmunity and hypersensitivity -control of unwanted responses -suppression of the immune response -anti-inflammatory drugs -cytotoxic drugs -bacterial and fungal derivative drugs -all three things are going to the same thing and suppress all the medications

asthma: pathophysiology 2

-intermittent or persistent airway obstruction due to: -bronchial hyper responsiveness -chronic inflammation -bronchoconstriction -excess mucous production -chronic response includes airway remodeling -breathing out is the issue sometimes not usually breathing in -is reversible

acute pancreatitis: treatment

-intravenous hydration -analgesics -surgical removal of gallstones -over time: anti inflammatory meds

regulation of attention 2

-involves different areas of the brain -reflexive attention (bottom up, RAS control) -executive processing (top down, frontal lobe) -visual attention RA: feedback from our sensory; comes from your senses and go up to your brain EP: start in brain and thinking about it and then uses your senses

vision

-involves integration of eye structures, motor control, and neural control -cornea: the clear, transparent structure that covers the exterior wall of the eye -pupil: light passes though this -iris: colored part of the eye (opening) -lens: responsible for fine-tuning of focus -ciliary muscles: contract, promoting a rounder lens shape to focus an object at close range -chambers: compartments in the eyes -retina: located over the posterior two thirds of the eye, contains photoreceptor (receptor sensitive to light) cells called rods and cones macula: the area responsible for central vision, color vision, and fine detail located in the center of the retina fovea: an area in the center of the macula is the site at which the cones are most dense

hearing

-involves integration of neural impulses and function of ear structures

humoral immunity

-involves production and activation of antibodies to specific antigens -antigen wil come into body and recognize it as non self pick it up bring it to lymph nodes and have cells that will produce antibodies -two different antibodies for two different antigens -once they bind it prevents cell from harming antigens will form a complement and tells macrophages that its time to come to destroy them

stress response

-is a specific physiological response to a nonspecific threat. •Is initiated by the central nervous system and the endocrine system. -autonomic sympathetic nervous system takes over

osteomyelitis: pathophysiology

-is usually caused by a staph infection -is often outside the body (exogenous) -open fractures, penetrating wound, surgery -can also be from a bloodborne (endogenous/hematogenous) infection -sinus infections, ear infections, dental infections -GI, GU, and respiratory tract -infection spreads under the periosteum and along the bone shaft or into the bone marrow -in adults: affects the cortex -sequestra: sections of dead bone from periosteal separation -involucrum: periosteal new bone -acute versus subacute versus chronic

sickle cell disease: clinical manifestations

-jaundice -anemia -pain -organ damage -infection -related to the proportion of HbS in the circulation -decreases life span of red blood cells (usually 90 days) but is less with sickle cell meaning we have to keep continuously making more -jaundice: happens because of the liver having to reproduce red blood cells and then make more bilirubin -spleen, kidneys, liver, brain affected -related to the percent of sickle cell hemoglobin

juxtaglomerular apparatus

-juxtaglomerular cells: these specialized cells are located around the afferent arteriole where the afferent arteriole enters the glomerulus macula densa: portion of the distal convoluted tubule with specialized sodium and chloride-sensing cells is located between the afferent and efferent arterioles -control of renal blood flow (RBF), glomerular filtration, and renin secretion occurs at this site

neurotransmission impairments

-know these neurotransmitters

neuron impulse transmission: supporting cells

-know this table -you need myelin to cover all your axons and oligodendrocytes regulate growth of myelin -microglia: macrophage (does the same thing as phagocytes) -oligodenodrocytes: responsible for the formation of multilayered myelin segments around multiple axons in the brain, promoting the speed of nerve impulse conduction in the CNS -schwann cells: produce myelin on long, single axons of the peripheral nervous system nodes of Ranvier: rich in sodium channels and are necessary to promote the movement of the nerve impulse over long distances saltatory conduction: impulses traveling down the axon jump from node to node in a stepwise fashion

osteomyelitis: diagnostic criteria

-lab data -CBC-elevated WBC's -C- reactive protein count-elevated -radiograph -radionuclide bone scan -radionuclide scanning with fluorodeoxyglucose (FDG) -PET scan -MRI -bone biopsy

osteosarcoma: pathophysiology

-lace-like pattern of bone growth -moth eaten pattern of destruction -tumor extends into adjacent soft tissue -osteoid produced by anaplastic stromal cells-atypical/abnormal cells -may contain chondroid (cartilage) and fibrinoid tissue -infiltrate and destroy normal bone tissue -infiltrate and destroy normal bone tissue -metaphyses of long bones-common site

bone tissue: spongy (cancellous bone)

-lack haversian systems -trabeculae trabeculae: plates and bars that are organized in very irregular networks patterns are determined by stress or weight bearing of the bone

vitamin and mineral deficiencies

-lack of dietary fats affects vitamin A, D, E, and K

malabsorption

-lack of movement of one or more nutrients across the gastrointestinal mucosa -causes: -problems with processing or digesting nutrients -problems with intestinal mucosa -lymphatic obstruction -vitamin K cannot be digested without guy bacteria which is problematic for infants that are born with a sterile gut

immunoglobulin (Ig) proteins

-large glycoproteins that recognize a specific Ag -membrane bound-B cell receptor (BCR) -nonmembrane bound-antibody (Ab) can be on outside of B cell and look for that specific antigen -non membrane (created by B lymphocytes and ejected out of the cell are called antibodies

water

-largest single component of body -essential for all body functions -digestion -absorption -transportation -excretion

ROP treatment

-laser treatment -cryotherapy -scleral buckle -vitrectomy

movement of blood through the circulation

-layers of the heart: -pericardium(outer covering): holds the heart in place in the chest cavity, contains receptors that assist with the regulation of blood pressure and heart rate, and forms a first line of defense against infection and inflammation -myocardium (thick muscular layer): thickness varies depending on location with the left ventricle often has the thickest area because the ventricle works harder than other heart chambers to overcome the resistance of pumping blood to the aorta and to the systemic circulation -endocardium (inner lining): forms a continuous layer of endothelium that joins the arteries and veins to the heart forming a closer circulatory system -chambers of the heart: -right and left atria -right and left ventricles pericardium: keep heart in place and make sure that your heart remains stable push heart over to the side: obstruction of the lung myocardium: your muscle tissue and where all of the work in the heart is happening endocardium: protection and follows to the great vessels (vena cava and aorta and pulmonary vessels)

ROP clinical manifestations

-leukocoria (white pupils) -nystagmus (abnormal eye movements) -stabismus (crossed eyes) -myopia (severe nearsightedness) see white instead of red on the pupils -retinopathy of prematurity: leukocoria and strabismus

cellular response with WBC's

-leukocytes -neutrophils -first responders -monocytes -macrophages: activated -platelets -erythrocytes -leukocytes: going to fight off infection, bacteria, etc. -staph and strep are always sitting on our skin and are normal flora monocytes: immature macrophages platelets: will cause scab formation and prevent bleeding erythrocytes: RBC get to the site and have hemoglobin that carries oxygen and in the healing process we need oxygen to create energy to rebuild the cells

hypothyroidism: treatment

-lifelong thyroid hormone replacement therapy

macronutrients: proteins structure

-linear chains of amino acids -broken down in digestion -absorbed into circulation -20 types of amino acids (9 essential: you cannot make them so you have to eat them)

acute gastritis: pathophysiology picture

-literally eat a whole through your stomach with acid

lymphadenitis

-local manifestation of inflammation -enlargement and inflammation of near by lymph nodes) occurs from filtering or draining harmful substances from the injury site 1) get rid of all the waste from the inflammatory response 2) help deliver WBCs to the area of inflammation what lymph nodes do: lymph node on your neck is supposed to be 1 cm -not supposed to heart, move them around your neck -pain means that there maybe an infection coming soon -usually near site of injury

local vs systemic

-local: directly at the site of injury, illness, or infection -systemic: unconfined, occurring throughout the body fever: systemic happening throughout entire body: systemic -greater than 6 months

vision: photoreceptors

-located in retina -rods: vision in dim light -cones: visual acuity -bright light -color rods tend to go away with time and makes sense why old people can't drive at night well

pulmonary processes neural control chemoreceptors: peripheral location

-located in the aorta and carotid arteries -most sensitive to oxygen levels in the arterial blood -trigger increase in ventilation in response to low oxygen levels

pulmonary processes neural control chemoreceptors: central location

-located near the respiratory control center -most sensitive to PaCO2 and pH of blood -trigger increased rate of breathing in response to elevated PaCO2 and vice versa

classifications of pain

-location -cutaneous -deep -visceral -referred quality -sharp -burning -diffuse -throbbing -stabbing duration -acute -chronic referred: gallbladder issues but shoulder hurts

neoplasms exhibit several other distinct characteristics:

-loss of cell-to-cell communication which allows further unrestricted growth of tumor cells -increased energy expenditure, which deprives unaffected cells of nutrients -increased motility and loss of cohesion/adhesion -rapid angiogenesis, which provides extensive blood flow to the tumor cells -substance secretion, which alters the metabolism and degrades neighboring unaffected cells -presence of foreign antigens on the cancer cell surface, which can trigger the immune response

vision: errors in refraction

-myopia -hyperopia -astigmatism -presbyopia

urine analysis

-macroscopic (visual inspection) -color and clarity -biochemical (urine dipstick) -pH, specific gravity, protein, glucose, ketones, nitrite, leukocyte esterase -microscopic -crystals, casts, squamous cells, white and red blood cells, bacteria

SLE symptoms

-malar rash -red, raised discoid rash -photosensitivity -oral/nasopharynx ulcers -pleuritis or pericarditis -proteinuria -seizures or psychosis -anemia, leukopenia, or thrombocytopenia -antibodies

ménière disease: treatment

-management of symptoms -regulation of body fluid -smoking cessation -stress reduction -zofran: for nausea and vomiting -salt or fluid restriction -diuretic

CNS injury: traumatic spinal cord injury

-manifestations: -pain -neurologic -level of injury -location in spinal cord -severity of injury -paresthesia -quadriplegia -diagnosis: imaging, neurologic exam, quadriplegia -treatment: stabilization, medication -paresthesia: numbness/tingling -give corticosteroids, diuretic

cystic fibrosis: treatment

-maximize ventilation and diffusion -liquefy and clear mucus -avoid/control respiratory infection -promote bronchodilation -chest physiotherapy -lung transplant -gastrointestinal

inheritance of chromosomal alterations

-may result from the loss, addition, or rearrangement of genetic materials -can be detected by assessing someone's karyotype: picture of arranged, paired, like chromosomes own order of largest to smallest

cardiac output (CO)

-measurement of heart's efficiency to pump -depends on strokes volume and heart rate -stroke volume (SV): amount of blood pumped out of 1 ventricle of heart in 1 beat -heart rate (HR): number of heartbeats in 1 minute CO=SV x HR (stroke volume x heart rate)

pulmonary structure and function: lower airway

-trachea -bronchi -bronchioles -expiratory sounds -connected other airway through the larynx

somatosensory receptor classification

-mechanoreceptor: has to do with our hearing and proprioception

taste

-mediated by chemoreceptors -taste buds -sensation types -sweet -sour -salty -bitter -savory

male reproductive anatomy: detumescence

-mediated by the autonomic nervous system sympathetic: ejaculation and this term reversal of ejaculation any hormonal issues could disrupt this or medications

phases of the cardiac action potential: phase 4

-membrane potential has returned to resting level and is ready for the next action potential TIME REQUIRED FOR PHASES ) 0-4 IS THE QT interval

types of hypersensitivity reactions

-memorize this understand category, etiology need to know what type of antibody is involved, what cells are actually activated, and understand what types of injuries can be seen

single gene trait inheritance

-mendelian pattern of predictable trait transmission -chromosome alleles -homozygous -heterozygous -allele expression -dominant -recessive

ovarian menstrual cycle: menstrual cycle

-menstrual phase: sloughing of superficial endometrium -proliferative phase: estrogen mediated endometrial growth -secretory phase: progesterone mediated endometrial glandular development -premenstrual phase: regression of estrogen/progesterone says absent: not decrease can happen other things too but that answer is the main effect

genetic regulation

-messenger RNA (mRNA) -carries the transcribed message from nucleus to cytoplasm -directs protein synthesis -transfer RNA (tRNA): selects the appropriate amino acids -carries amino acids to the ribosomal RNA -assembly of proteins -ribosomal RNA (rRNA): involves the physical structure in the cytoplasm where protein synthesis takes place when you turn a gene on and transcribes, it produces a protein in the form of an amino acid -need to have amino acids to form peptides to create genetic regulation -messenger RNA takes message from DNA in the nucleus and moves it out into the cytoplasm. once in the cytoplasm it meets with transfer RNA that is specific to an amino acid that forms peptides

hormones

-messing with pituitary, you could have issues with ovaries and testies

cellular structure: cytoskeleton

-microtubules -microfilaments -thin -intermediate -thick cytoskeleton: skeleton on inside of cell and promotes cellular structure, move, and connected to microtubules and microfilaments

otitis media: OME

-middle ear effusion without inflammation

RA clinical manifestations

-mild to debilitating -symmetrical joints -pain, stiffness -redness, heat, swelling -decreased mobility -not unilateral, happens on both sides

acute gastritis: clinical manifestation

-mild to severe abdominal pain -indigestion -loss of appetite -nausea -vomiting -too much stomach acid can damage the lining of your stomach -why people get ulcers -could cause heartburn

metabolic alterations in aging

-mineral metabolism -calcium -phosphate -magnesium -vitamin and trace mineral metabolism -acid-base metabolism

genetic replication: mitosis vs meiosis

-mitotic cell division: somatic cell division resulting in two identical daughter cells -each cell contains 23 pairs of chromosomes (diploid) -meiotic cell division -gamete sex cell division (ovum, sperm) -each cell contains 23 single chromosomes (haploid) mitosis: only occurs in autosomes because we want replication of double stranded DNA that we find in those autosomes -every time we replicate, we end up with the same 23 pairs (diploids) but is different with gametes (23 single chromosomes not double) -start with one and end of up with two identical cells -meiosis: one and end up with 4

conduction of pain sensation: modulation vs perception

-modulation: substances released during impulse transmission -slow the rate of impulse transmission -perception: sensory (somatosensory cortex) and emotional (limbic system) involvement

phagocytes

-monocytes: phagocytosis -circulate in the blood, then enter tissue to differentiate into macrophage or dendritic cell -macrophages: phagocytic cells, reside in all tissues -antigen presenting cell -dendritic cells -similar function to a macrophage -can activate naive T cells -engulf it and present it to either a B or T cell in the adaptive response -naive: T cells and B cells hang in lymphatic system and wait for macophage or dendrictice cell to present them with antigen so they can make antibodies

macronutrients: carbohydrates structure

-monosaccharides -glucose -fructose -galactose -di/oligosaccharides -sucrose -lactose -polysaccharides -starches and fiber

female reproductive anatomy: external genitalia

-mons pubis -labia majora -labia minora -clitoris -vestibule -bartholin glands

SLE (systemic lupus erythematosus)

-more common in women, compared to men -cause unknown -environmental exposure -hormonal environment -familial predisposition both innate and humoral issues; type three hypersensitivity reaction and autoimmune disease; chronic illness that results in persistent Antigen complexes which causes inflammation; 7 to 20 times more common in females may due to environmental exposure, hormonal environment and does tend to run in families so maybe pre-disposition to its autoimmunity

depression statistics

-more than 1 out of 20 americans 12 years of age and older reported current depression (moderate or severe symptoms in the past 2 weeks) -among americans 12 years of age and older; a greater percentage of females reported depression than males -almost 10% of adults 40-59 reported current depression -CDC, 2012

inherited metabolic disorders

-most often related to errors in amino acid and lipid metabolism -commonly a problem of a genetically based defect in enzyme activity -examples: -phenylketonuria (PKU) -tay-sachs disease

more DMD clinical manifestations

-physical presentation -difficulty running, jumping from a standing position, climbing stairs -frequent falls -toe walking -calf pseudohypertrophy -positive Gower's maneuver/sign -lumbar lordosis -the Duchenne timeline

peripheral nervous organization

-motor and sensory nerves -cranial nerves: 12 pairs -spinal nerves: 31 pairs -8 cervical -12 thoracic -5 lumbar -5 sacral -1 coccygeal -dermatomes: spinal nerves carry information to and from particular body regions -plexus -cervical, brachial, lumbar, sacral

elimination

-movement of feces into the rectum increases pressure and triggers the defecation reflex -the act of elimination can be voluntarily stopped -this is under control of parasympathetic nervous system

exchange of gasses between the environment and blood: ventilation

-moving air into and out of the trachea, bronchi, and lungs -conducting airways

exchange of gasses between the environment and blood: diffusion

-moving and exchanging oxygen acquired during ventilation and carbon dioxide waste across the alveolar capillary membranes -respiratory airways

absorpton

-moving nutrients from digestive tract to circulation to be used by cells -process varies depending on nutrient -carbohydrates (monosaccharides, glucose, galactose, and fructose) -proteins (amino acids) -lipids (fatty acids and glycerol)

AIDS pathophysiology: site of infection

-mucosal surfaces covered with stratified squamous epithelium -vagina, cervix, anus -dendritic cells with co-receptor CCR5 -bind HIV -transport HIV to lymphoid tissues -CD4 T lymphocytes -viral RNA transcribed to complementary DNA -integrated into host cell -rapid viral replication -many mutations -HIV is continually changing and so one medication can't change it all -endothelial cell tumor-not actively recognizing tumor cells

chronic sinusitis: pathophysiology

-multifactorial -environmental factors -persistent infection -allergens -genetic factors -metabolic abnormalities -immune deficiencies -disruption of mucociliary clearance -see page 51 for a complete list of risk factors -huge amount of sinus infections and can't find why look at immune defeciences

inheritance of polygenic disorders

-multiple alleles at different chromosome locations affect phenotype -complex interaction of multiple factors -environmental influences (height) -less predictable pattern -monosomy (turner syndrome) -trisomy (down syndrome)

multifactorial trait inheritance

-multiple alleles at different chromosome locations affect phenotype -hair color -eye color -environmental influences -skin color -height -less predictable pattern

autosomal recessive

-mutation located on the autosome -inheritance of a mutation involving two recessive alleles results in expressions of the trait -inheritance of a mutation involving one recessive allele results in carrier status for the trait -unaffected, affective, carrier depending on whether your affected or not -not going to vary by sex due to mutation located on the autosomes

central nervous organization: spinal cord white matter

-myelin-covered axons neurons -contain tracts -tissue composed primarily of myelinated axons and dendrites

chronic sinusitis: clinical manifestations

-nasal congestion -nasal and postnatal discharge -sore throat -foul breath, unpleasant taste -low grade fever -fatigue, anorexia -chronic cough -hyposmia (reduced ability to smell) -facial fullness, discomfort, pain, and headache (with polyps) -happening over 12 weeks or more

acute pancreatitis: clinical manifestations

-nausea -vomiting -anorexia -diarrhea upper abdominal pain: sudden onset -growing intensity -dull, steady ache -radiating to back

alterations in hearing and balance: inner ear

-neural dysfunction -tinnitus:ringing of the ears -sensorineural hearing loss (presbycusis) -equilibrium disruption: Ménière disease: a condition associated with severe vertigo sensorineural hearing loss, and tinnitus due to overproduction or decreased absorption of endolymph -inflammation: labyrinthitis: inflammation of the labyrinth of the inner ear, also precipitates severe vertigo and sensorineural hearing loss

hearing processes: hair cell stimulation

-neural signal transmitted to brain via acoustic cranial nerve (VIII) -midbrain relay center -dual pathways to right and left auditory cortex -puke a lot because of imbalance

protective structures

-neurocirculatory system -cerebrovascular circulation -blood brain barrier -cerebrospinal fluid we don't want our hormones to cross this blood brain barrier or viruses and bacteria because it could cause infection

alzheimer disease: pathophysiology

-neurodegenerative disorder -neurofibrillary tangles -tau protein -senile plaques -B-amyloid protein (amyloud, AB) -inflammation -neuronal atrophy -genetic and environmental factors -APP, PS1, PS2 no microtubule good structure: not going to be as strong and collapse and get tangles of neurons and not able to get the nutrients back and forth in the cells on autotopsies, people who have amyloid plaques had alzheimer's runs in the family

autism spectrum disorder (ASD) pathophysiology

-neurodevelopmental disorder -symptoms start by age 2 or 3 -earlier diagnosis the better -pollution, material infections, exposure to heavy metals and toxins and happens first 8 weeks after conception -rather heritable -prevalence: 1 in 68 (CDC, 2012) -neurodevelopmental disorder with onset in early childhood -environmental and genetic factors -changes in brain structure and function -thinning of the corpus callous, greater myelination in frontal cortex -disorganization of architecture in prefrontal cortex -looking into endocrine and immune system for answers of the cause -elevated serotonin levels, elevated lactic acid and cytokines

Attention deficit hyperactivity disorder (ADHD)

-neurodevelopmental disorder of cognitive functions, causing attention deficit, hyperactivity, and impulsiveness -genetic inheritance (75%) -environmental factors (brain infection/trauma) -changes in brain structure and function

neuronal control of BP and cardiovascular adaptation

-neurons in medulla and pons -autonomic nervous system: -sympathetic division -parasympathetic division -mechanisms regulating blood pressure -baroreceptors and chemoreceptors in arteries -renin-angiotensin system -kidneys renin-angiotensin system: in your kidneys when renin is excreted, angiotensin is converted to angiotensin I and then angiotensin 2 leads to the contraction of arteries and also stimulated the adrenal cortex to produce aldosterone (which leads to Na+ retention which keeps water in body longer causing increased BP -angiotension II and antidiuretic hormone are both vasoconstrictors epinephrine: leads to increased heart rate and also increased strength of contraction

neuronal communication: chemical

-neurotransmitter (NT) release -involve specific structures important for impulses stimulated by neurotransmitters, chemical agents affecting the function of another nearby cell or cells -carry signals between nerve cells and other excitable cells including other nerve cells and muscle cells to trigger a response in another cell -synapse structures -presynaptic terminal: release NT -contain neurotransmitters packaged in vesicles, mitochondria, and other cellular organelles -synaptic cleft: neurotransmitters released from vesicles at the synaptic cleft are then available to bring with specific receptors on the postsynaptic membrane, promoting excitation or inhibition of the postsynaptic neuron -postsynaptic membrane: NT binds to receptors -unbound NT in cleft can be taken up (reuptake) at presynaptic terminal

hutchinson-gilford progeria: treatment

-no approved therapy currently -research is underway on: -gene therapy -pharmacologic therapy supportive care: -feeding -nutritional intake -activity -joint mobility -monitoring for vascular disease -family support

huntington disease: treatment

-no cure -pharmacologic -drugs for movement and psychiatric disorders -supportive care -occupational, physical, and speech therapies -nutrition management -treatment is often to help with symptoms not cure

RA diagnostic criteria

-no definitive test -increased likelihood with positive findings -erthyrocyte sedimentation rate -c-reactive protein -rheumatoid factor (antibodies) -antinuclear antibodies -inflamed synovium -joint damage --best test is rheumatoid factor that checks for antibodies to their own cartilage in their body

cerebral palsy treatment

-no known cure -supportive treatment for signs and symptoms -pharmacologic: control seizures -reduce muscle spasms -assistive devices -enhance ability to complete activities of daily living

cervical metaplasia and dysplasia: clinical manifestations

-no signs and symptoms -risk factors -early onset sexual activity -multiple partners (>3) -exposure to human papilloma virus (HPV) -smoking -HPV can prevent cancers

pain

-nociceptive -stimulus originates outside nervous system -neurogenic or neuropathic -stimulus originates within nervous system -if our body has something painful our reflexes have us try to remove the stimuli

treatment of pain: pharmacologic

-non-narcotic analgesics -opioid analgesics -adjuvant analgesics -try not to throw medication all the time opioid: codine, hydrocodone adjuvant: neurotin

pulmonary structure and function: upper airway

-nose -mouth -oropharynx upper airway: allow air to get to the lungs: going to hear an adventitious breath sounds in upper airway: hear during inspiration -connects to the other airway through larnynx

facilitated transport

-not energy-dependent -transport proteins are needed -example: transport of hydrophilic molecules -facilitated: does not use any energy and is just a protein molecule that sits on there and passively goes to the other membrane

somatic mutation

-not inheritable -can result in polymorphism: gene occurring in more than one form -can not cause harm but could

migraine headache: pathophysiology

-not just average headache -have an ora: feel that headache coming on -very genetic -recurrent headaches -moderate-to-severe intensity -duration of 1-2 days -associated with nausea, vomiting, and sensitivity to noise and light cause: likely initiated by neurologic and biochemical events

vision: alterations in protective structures-cataracts

-nuclear -cortical -posterior sub scapular -opaque growths that come with age

metabolic alterations in aging 2

-nutrient metabolism -obesity -undernutrition -endocrine metabolism -thyroid/parathyroid -adrenal/pituitary -ovarian/testicular

diagnostic strategies related to altered nutrition

-nutritional assessment -multiple-day dietary intake recall -measurement of height, weight, BMI -lab tests -complete blood count -sedimentation rate -serum electrolytes -urinalysis and urine culture

alterations in hearing and balance: external ear

-obstruction -cerumen -mass -inflammation -otitis externa -inflammation of the skin of the external ear condition associated with pain and discomfort

menopause: clinical manifestations

-occur progressively along with degree of estrogen loss -related to loss of estrogenic effect on cells of target organs -atrophy in estrogen-stimulated tissues -subcutaneous tissue is reduced #1 heart disease in women killed

cancer

-occurs because of alteration of genes controlling cell reproduction, growth, differentiation, and death -cell is therefore allowed to grow uncontrollably and loses its ability to carry out its specific function and does not die when expected -describes highly invasive and destructive neoplasms (irreversible deviant cell clusters) and ignore the genetic controls placed on cellular proliferation and differentiation

hearing: outer ear

-pinna -external auditory/acoustic meatus

hutchinson-gilford progeria syndrome: clinical manifestations

-often appear within first year of life -alopecia -prominent scalp veins -feeding difficulties -scleroderma -wrinkled skin -loss of fat, muscle -delayed dentition -hearing loss -high pitched voice -short stature and skeletal dysphasia -incomplete sexual maturation

iron deficiency anemia clincal manifestations

-often asymptomatic -pallor of the skin and mucous membranes -fatigue, weakness, lightheadedness, syncope, headache -breathlessness, palpitations, tachycardia -brittle hair and nails, mouth sores -pica

hypertension: clinical manifestations

-often asymptomatic -when advanced, causes CND changes: -headache -new-onset blurred vision -nausea -vomiting -weakness -fatigue -confusion -mental status changes -by the time you realize whats going on the damage is usually already done

prostate cancer: clinical manifestations

-often asymptomatic -urinary symptoms later in disease -symptoms similar to BPH -paraneoplastic symptoms -metastatic spread often starts in periphery and by the time it is actually impeding urine flow its pretty well advanced symptoms are similar to benign prostatic hyperplasia so it could easily be misdiagnosed

ménière disease: clinical manifestations

-often unilateral -variable in severity -vertigo -nausea and vomiting -sensorineural hearing loss -pressure, pain -tinnitus and nystagmus can be one side or another (more common) but sometimes it can be in both -could be sometimes or could be severe and everytime you stand up you have it -nystagmus: rhymthic moving back and forth of your eyeball and you can't control it

chemical mediators (plasmin)

-one of the most important things is activation of your clotting factor first in order for the total cascade to happen and your blood to clot -activated plasmin to get the process starting to clot

micronutrients: vitamins structure

-organic substances body needs but is unable to manufacture -fat soluble -A, D, E, K -water soluble -B1, B2, B6, B12, C -know which ones are fat-soluble -you can't overdose on water-soluble -the colon is immensely unimportant when it comes to digestion and absorption -digestion and absorption is primarily in the small intestine -dont store water soluble vitamins -can overdose on fat-solubles

pathogenesis

-origination and development of illness or disease risk factors -elevated blood cholesterol level (modifiable) -elevated blood pressure (modifiable) -cigarette smoking (modifiable) -family history (no) -genetic predisposition (no) -obestiy (yes) -sedentary lifestyle (yes)

hearing processes: mechanical energy

-ossicle stimulation of cochlea

lymph cells

-plasma cells, B cells, T cells, and natural killer cells

otitis media: diagnostic criteria

-otoscopic exam -inflammation -redness/erythema of tympanic membrane -pain that interferes with activity/sleep -don't want to eat because it hurts when the jaw pops

pulmonary structure and function:pleural layers

-outer parietal -inner visceral -separated by pleural space: minimize friction -pulmonary circulation -delivery of oxygen and nutrients to lung tissue -filtration -alveolar circulation -gas exchange for systemic cells and tissues pleural: help reduce friction -nice layer of fluid in between the two pleural to decrease the friction between them alveolar: blood clots can be captured into capillaries in your lungs (deep vein thrombosis)

gametes

-ova and sperm -contain only one of the chromosome pairs known as the haploid number of cells

hearing: inner ear

-oval window -cochlea -organ of court -semicircular canals -vestibule -utricle -saccule -fluid -perilymph -endolymph

ovarian menstrual cycle

-ovarian cycle (average 28 days, range 21-40 days) -follicular phase: variable length -FSH stimulates follicle growth -estrogen rising -luteal phase: 14 days -LH surge stimulates ovulation -high progesterone and estrogen -start to see the estrogenic effect on the lining -proliferates and get thicker and the point of ovulation we get a shift of hormones (progesterone) and the effect is secretory phase(fluffy soft area) -stretchy mucus: ovulation is in place -ovary oocyte: FSH is predominantly driving this folic FSH causing it to grow producing more and more estrogen and causing the proliferate phase and then progesterone takes over predominantly during the luteal phase during ovulation -no pregnancy signifies the corpus luteum to generate and causes FSH and LH to go up and progesterone and estrogen decrease

diffusion

-oxygen and carbon dioxide are exchanged at alveolar capillary junctions -across thin membrane two major processes occur: 1) oxygen movement from alveoli to capillary for circulatory delivery to all body cells 2) carbon dioxide trying to escape the body through the lungs

oxygen diffusion and transport: oxyhemoglobin (HbO2)

-oxygen bound to hemoglobin -oxygen dissociates from plasma and binds to hemoglobin on RBCs as PaO2 increases -based on oxygen attraction to iron -4 binding sites on each hemoglobin molecule -when bound, not accessible to cells and tissues -continues until iron is saturated with oxygen -once saturation occurs, oxygen continues to diffuse and dissolve in the plasma -when its bound its not useful but when its released the cell can actually use it -how much of the hemoglobin is actually saturated (carrying 4 things of oxygen) -oxygen saturated -how much of the light is shining is the exact same color as fully saturated hemoglobin. so when you have more oxygen and more saturated hemoglobin less light passes through to the other side -not helpful: carbon monoxide

osteosarcoma: clinical manifestations

-pain -worsening -nighttime -enlarging mass -pathologic fracture

sprains and strains: clinical manifestations

-pain -soft tissue swelling -changes in tendon or ligament contour -dislocation and subluxation of bones

migraine headaches: clinical manifestations

-pain -unilateral -pulsing and throbbing -aura -visual disturbances preceding headache may be associated -prodromal symptoms -mood changes, food cravings, constipation right or left sided -pulsing: dilation of blood vessels in the brain -prodrome, aura, pain -nausea, vomiting all happen after you go through prodrome, aura, and then it starts

somatosensory system: sensations

-pain (nociception) -touch -temperature -body position (proprioception)

fibromyalgia: pathophysiology

-pain in fibrous tissue and muscles -disorder of the soft tissues and muscles -cause: none known -diagnosis of exclusion -no signs because its only what the patient says -no evidence, no inflammation, no known cause -happens in about 2% of total population -more in women than men (age 60-70) -could have some with addition groups of methylation added to DNA but not for sure -serotonin levels are decreased and low

chronic pancreatitis: treatment

-pain management -behavior modification -alcohol cessation -smoking cessation -exercise -nutrition -surgery

osteoarthritis: clinical manifestations

-pain, stiffness, enlargement of the joint, tenderness, limited motion, and deformity -joint swelling in the fingers: heberden and bouchard nodes -joint effusion: exudate or blood entering the joint

types of anxiety

-panic disorder -generalized anxiety -social anxiety -phobias -separation anxiety -medication/illness-induced anxiety generalized anxiety: worried about everything -social anxiety: no large crowds -phobias: irrational fears -separation anxiety: normal for children ages 6mons-12mons

ROP diagnostic criteria: stage 4

-partially detached retina -requires immediate treatment to save vision

pulmonary processes: muscle control-expiration

-passive -passive under normal conditions -rectus abdominus, internal intercostals (forced)

types of disease

-pathogen: disease-causing microorganism -multifactorial: having more than one cause -idiopathic: no known cause -nosocomial: caused by an infection received in a health care environment -iatrogenic: caused by medical treatment -iatrogenic (if you did have a cancer and treated with chemo and radiation and caused you to be sterile)

schizophrenia: diagnostic criteria

-patient history -reported observations by friends and family -comprehensive clinical assessment -ruling out physical conditions -at least 2 indicators (delusions, hallucinations, or disorganized speech) for at least one month, with significant impact on school, work, or home for at least 6 months

bipolar affective disorder diagnostic criteria

-patient history -reported observations by friends and family -mental status examination -ruling out physical conditions -DSM-5 diagnostic criteria -seven subtypes bipolar II: little overactivity and then spike down -they don't have as high of mania as bipolar I

ADHD diagnostic criteria

-patient history -reported observations by friends and family -mental status examination -ruling out physical conditions -DSM-5 diagnostic criteria -3 subtypes

recognizing alterations in mood, attention, and behavior

-patient history -reported observations of others -screening tools -mood disorder questionnaire -American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders -World Health Organization's ICD-10 patient history and reported observations of others are the most important in recognizing alterations in mood, attention, and behavior

theories of pain

-pattern theory:suggests that nerves transmitting pain impulses are shared with other senses -specificity theory:proposes that sensations of touch, warmth, cold, and pain involve distinct receptors and pathways unique to the specific sensation -gate control theory -intensity theory -neuromatrix theory pattern: pain impulses share neurons with other types of senses-share pathways so the pressure will cause you pain because they are sharing a pathway specificity: based on thinking that touch, warmth, cold, and pain have distinct receptors for each and believe that the pathways are unique to each sensation and each have different pathways gate control: agrees with specificity however they further that the primary afferent neurons will enter the spinal column and enter the brain and they believe that the substantial gelantinosa controls the pain impulse from that area to the brain and close that gate by sending specific impulses intensity theory: believe pain is an emotional not a sensation and results from stronger than normal stimuluses from your CNS neuromatrix: believe pain is a multidimensional experience and believe that the matrix involves a somatic, limbic, and thalmocorticol component that work together

bipolar affective disorder pathophysiology

-periods of mania and depression -genetic inheritance -impaired brain functioning -psychological, environmental, social factors -childhood abuse -harsh home environment -disruptions in relationships -so much mania they cannot sleep for a week sometimes

bipolar affective disorder clinical manifestations

-periods of mania lasting at least 1 week -elevation in mood or irritability -rapid and excessive speech -distractibility -racing thoughts -impaired judgment -impulsivity -periods of depression

neuronal injury

-permanent cells: loss of function -injury types: 1) chromatolysis: the swelling of a neuron because of injury 2) atrophy: decrease in the size of the cell (neuron) 3) neuronphagia: phagocytosis and inflammatory responses caused by a dead neuron damaging neighboring cells 4) intraneuronal inclusions: distinctive structures formed in the nucleus or cytoplasm found out that neurons can reproduce but it was so so slow -as you age, brain will decrease in size

emphysema: clinical manifestations

-persistant cough -dyspnea -wheezing -barrel chest -pursed lip breathing (make a kiss and blow air out very slowly) -barrel chest

major depressive disorder clinical manifestations

-persistent very low mood -anhedonia -feelings of worthlessness, guilt helplessness, hopelessness, and self-hatred -interruption in sleep patterns -unrelenting fatigue -changes in appetite, weight, sex drive

chronic bronchitis: pathophysiology

-persistent, productive cough lasting > 3 months for >2 consecutive years result of: -chronic inflammation and edema of airways -hyperplasia of bronchial mucous glands and smooth muscles -destruction of cilia -squamous cell metaplasia -bronchial wall thickening, fibrosis development

frontal lobe control

-personality -perception -planning

heart failure: treatment

-pharmacologic -surgery -treating underlying condition (infection, anemia) -supplemental O2 -lifestyle modifications

acute sinusitis: treatment

-pharmacologic -antibiotics -antihistamines -decongestants -nasal sprays -surgical -sinuses should look dark but won't x ray with acute sinusitis -antibiotics can be used for 21 days -decongestants and nasal sprays don't cure but make you feel better

glaucoma treatment

-pharmacologic treatment -medications that increase aqueous humor outflow and fluid levels -surgical treatment -trabeculoplasty -trabeculectomy -iridotomy

MD treatment

-pharmacologic treatment -medications that inhibit vessel growth in wet/exudative form -currently no treatment options for dry form

hypertension treatment

-pharmacologic treatments -lifestyle modifications -weight reduction -decreased alcohol, salt, saturated fat intake -increased aerobic physical activity -increased fruit and vegetable intake -smoking cessation

ménière disease treatment: pharmacologic vs surgical

-pharmacologic: diuretic therapy -antimetics surgical -ototoxicity -vestibular neurectomy -labyrinthectomy surgery can cause hearing loss very high risk vest: cut the vestibular nerve labyrinthectomy: take out the whole labyrinth

RA Treatment

-pharmacologic: drugs that induce remission -drugs that reduced inflammation -nonpharmacologic -rest/activity balance -heat/cold therapy corticosteroids: leaves you at risk for cancers, swollen moon face, etc. and lots of other side effects -hurts to move but need to move in order to keep from being so stiff

schizophrenia: treatment

-pharmacology -antipsychotics -psychological and social support don't even people they have the disease and that people are out to get them -mostly need to hospitalized because their condition is threatening to them or people around them

bone remodeling

-phase 1: activation -phase 2: resorption -phase 3: formation 1) activation of osteoclasts through RANKL and stimulate osteoclasts to reabsorb some of the bone 2) osteoblasts forming and in charge of replacing bone tissue 3) new bone material that is stronger than before

phases of the cardiac action potential: phase 1-3

-phase 2 (plateau)-calcium channels open and Ca+ ions move into cell to aid with muscle contraction -membrane undergoes repolarization as K+ ions move OUT of the cardiac membrane

renal buffer system: tubular buffer system

-phosphate -water can be catalyzed in bicarbonate acid

DMD treatment: therapies and adaptive equipment

-physical -occupational -recreation -aqua -speech -orthotic devices -customized mobility and seating -wheelchair dependent by age 12

rhabdomyosarcoma: diagnostic criteria

-physical exam and history -imaging -radiographs -CT scan -MRI -PET scan -biopsies -bone marrow aspiration -lumbar puncture

chronic sinusitis: diagnostic criteria

-physical examination (minimum 2 of 4) -anterior/posterior mucopurulent drainage -nasal obstruction -facial pain, pressure, fullness -hyposmia -computed tomography (CT) scan -white should be dark -dark represents air -mucopurulent: yellow or green pus -nasal obstruction: can't sniff out of one of the nostrils

chemical mediators: complement system

-plasma-derived -proteins involved in destroying and removing microorganisms -activation induces -opsonization -chemotaxis -activation of mast cells and basophils -cell lysis -predictable, specific sequence of responses complement system: macrophages will engulf them and eat them and will have the lymph nodes remove the wastes opsonization: neutralize bacteria so they won't be resistant to phagocytosis chemotaxis: calling more inflammatory cells to that injury site through chemicals activation of mast cells and basophils: deactivate when they are granulated

chemical mediators: clotting system

-plasma-derived -promotes coagulation through activation of clotting factors -cascade sequence -suppressed by release of anticoagulation -activated in response to injury and identification of harmful foreign materials in blood -platelets will accumulate in that area and form a protective barrier (scab) while the cell is healing underneath (primary defense) -understand that there is a sequence in order for blood to clot and every factor must happen to correctly clot

impaired ventilation and diffusion: clinical models

-pnemonia -COPD -emphysema -chronic bronchitis -asthma -cystic fibrosis -acute respiratory distress syndrome

fractures diagnostic criteria

-point tenderness -imaging -radiographs -MRI -CT

senescence

-post-maturational processes that lead to diminished homeostasis and increased vulnerability -very similar to aging but more of a broader term

etiology

-precise cause of disease -identifiable -single cause -multifactoral -unknown -idiopathic -where did it come from? -mono=single cause -breast cancer=genetic component to it, and also smokes (multifactorial) idiopathic-we have no clue we have no answers we have some guesses and theories but don't know for sure

peripheral nervous organization: sympathetic nervous system-thoracolumbar

-preganglionic neurons exit between the first thoracic vertebrae and second lumbar vertebrae -synapse with ganglia near the spinal cord -postganglionic neurons extend to organs -increased heart rate -increase heart contractility -relaxation of bronchial smooth muscles -decreased peristalsis of GI tract -constriction of anal sphincter -decreased bladder tone -constriction of urinary sphincter -flight or fight response -constriction of vascular smooth muscle -increased BP -increased respiratory rate -pupil dilation -ciliary muscle relaxation -reduced pancreas secretion -increase sweat gland secretion

peripheral nervous organization: parasympathetic nervous system-craniosacral

-preganglionic neurons exit via the cranial nerves from the midbrain and medullar and spinal nerves between S2-S4 -synapse on postganglionic neurons close to organs -postganglionic neurons extend to organs -decreased heart rate -decreased heart contractility -constriction of bronchial smooth muscles -increased peristalsis of GI tract -relaxation of anal sphincter -increased bladder tone -relaxation of urinary sphincter -pupil constriction -increased pancreas secretion -increase salivary and eye secretion -exactly opposite of other

clinical manifestations

-presenting signs and symptoms of illness signs: objective symptoms: subjective -precipitating factors: promote onset of clinical manifestations -exercise -cold weather -upper respiratory infection -stress -dust/dust miles -pollen -animal dander -mold -objective: see it, hear it (stethoscope) but not what someone is telling you fever, redness, etc. subjective: what they tell you

bipolar stats and facts

-prevalence: 4% lifetime -3:2 women to men ratio -most expensive behavioral healthcare diagnosis (lost productivity) -for every $1 spent outpatient, $1.80 is spent inpatient tendency to have ups and downs and have a lot of symptoms and causes them to not have lots of jobs

anaphylactic reaction: more treatments

-preventative -desensitization to allergen -switch IgE response to IgG response -change T cell response from Th2 to Th1 driven -bind allergen to prevent IgE-mediated response keep exposing child through allergy shots to actually thing they are allergic to so that its a less severe reaction when child is exposed

migraine headache: treatment

-prevention indicated for individuals who: -have >2 or equal to migraines each month -use pain-relieving medications > or equal to 2 times per week -experience inadequate relief from analgesic treatment -have uncommon migraines

managing degenerative changes in aging

-prevention of injury and illness -primary -secondary -screening for functional impairment -comorbid conditions -physical health -cognitive status -functional ability -social support

humoral immunity responses

-primary adaptive immune response -activation with first recognition of a specific antigen -secondary adaptive immune response -reactivation with later recognition of the same antigen

humoral immunity immune responses

-primary adaptive immune response: activation with first recognition of a specific antigen -seconday adaptive immune response: reactivation with later recognition of the same antigen igG- very strong and longterm and will take over when igM is out igM-respond very quickly but will wear down over time -recent igG high for varicella-still immune for it

treatment

-primary cause -remove obstruction and restore physical integrity of airways, lung tissues -medications -anti-inflammatory decrease inflammation and mucus -anti-microbial: treat infection -antitussive: suppress cough -decongestants: decrease congestion -bronchodilators: relax bronchial smooth muscle -surgery -supportive: -supplemental oxygen -mechanical ventilation -humidification -chest physiotherapy

forms of healing

-primary intention: wound is closed with all areas of the wound connecting and healing simultaneously -risk for infection is reduced -scarring is minimal heal by primary intention or secondary intention when you have deep cuts on the skin primary: close the wound with a suture, lining the edges of the wound up so they are even with each other so they will heal from the side to the side and from the top down

glaucoma: clinical manifestations

-primary open angle -gradual, irreversible vision loss -blind spots in field of vision -initially limited to periphery -progresses centrally -ignore the fact that they can't see in their periphery so they don't get it checked out as much as they should -like when you pass out and eyes start to go black

regurgitation

-problem of incompetence of the valve, in which it is unable to properly close, allowing reflux of blood

ventricular fibrillation

-problem of the heart ventricle vibrating instead of effectively pumping

callus ossification

-procallus osteoblasts synthesize collagen and matrix -becomes mineralized to form callus

hematoma formation

-procallus osteoblasts synthesize collagen and matrix -becomes mineralized to form callus

ventilation

-process involves both acquiring oxygen (inspiration) and removing carbon dioxide (expiration) from the blood

metabolism

-produces heat -conducts impulses -contracts muscles

huntington disease: pathophysiology

-progressive degenerative neurologic disorder with an autosomal dominant inheritance pattern -defect in Huntington gene on chromosome 4 -degeneration of the basal ganglia and cortical regions of the brain -movement, emotional, and cognitive impairment not different between boys and girls -50% probability and fatal neurologic condition -defect on hunington gene on ch.4 -repeats of CAG (glutamine); more repeats worse the symptoms and earlier the onset of symptoms of the disease will happen -more than 36 indicates huntington gene making too much to it

down syndrome treatment

-promotion of maximal independence and quality of life -early intervention of therapies -physical -speech -occupational -treatment of associated congenital disorders

neuronal impulse transmission

-propagation of neuronal impulses -development of synapses -availability of receptors -release and uptake of neurotransmitters -generation of action potentials -target organ responsiveness

macronutrients

-protein -carbohydrates -lipids

amino acid absorption

-proteolytic enzymes -active protease pepsin -pancreatic proteases -peptidases in the brush border -sodium dependent transporters-amino acid movement -small peptides do not need sodium

macronutrients: lipids functions

-provide rich energy source (adipose fat: keeps you warm) -provide support -protect organs and nerves -insulate -facilitate processes

macronutrients: carbohydrates functions

-provides energy -reduces serum cholesterol (fiber) -aids gastric motility (fiber)

bipolar affective disorder treatment

-psychotherapy -pharmacology -mood stabilizers -lithium carbonate -sodium valproate -atypical antipsychotic drugs -don't take their meds often

ADHD treatment

-psychotherapy -cognitive-behavioral therapy -behavioral therapy -pharmacology -stimulants -physical exercise -cognitive behavioral therapy first

PTSD treatment

-psychotherapy -trauma-focused cognitive behavioral therapy -eye movement desensitization and reprocessing -play therapy (for children) -pharmacology -antidepressants, benzodiazepines (anxiety), glucocorticoids (neurocellular homeostasis), anticonvulsants (impulsivity), clonidine (nightmares)

mitochondrial gene disorders

-related to energy production -matrilineal inheritance -not passed on by men -heteroplasmy

major depressive disorder treatment

-psychotherapy/counseling -antidepressant medications -selective serotonin reuptake inhibitors (SSRIs) -tricyclic antidepressants (TCSs) -monoamine oxidase inhibitors (MAOIs) -electroconvulsive therapy -alternate therapies -SSRI's: help with dopamine too

treatment options

-psychotherapy: retraining your brain: conducted with a qualified mental health professional; explores thoughts, feelings, and behaviors and seeks to improve well-being such as through cognitive-behavioral therapy, exposure therapy, etc. -pharmacotherapy: prescribed by a qualified mental health professional; drug therapy can help with management of symptoms related to alterations in mood, attention, and behavior such as with antidepressant drugs -counseling -alternative/complementary therapies: herbal remedies, acupuncture, homeopathy, and many others -individual or family support group

three critical pathways of circulation

-pulmonary: circulation through lungs provides ability to transfer oxygen from atmosphere into body -coronary: blood flow to heart muscle supports heart's work in pumping oxygenated blood to body -systemic: oxygen and nutrients are distributed to body -pulmonary system is completely opposite -pulmonary vein that goes to the heart and has oxygen -pulmonary arteries does not have blood carrying

evaluation of the inner ear

-pure tone bone conduction: hearing test by using vibration -vestibular evoked myogenic potential test -otoacoustic emission: faint sounds produced by the outer hair cells in the cochlea of the inner eary

pelvic inflammatory disease: clinical manifestations

-range in severity -asymptomatic -pain -purulent discharge -tenderness -fever, malaise

neuronal impulse transmission: depolarization

-rapid movement of sodium into the cell through sodium channels in the cell membrane -generates an electrical impulse

process of inflammation

-recognition of injury -activation of response -appropriate shutting down of response Results: repair/regeneration of injured tissue -formation of scar tissue -need to have a way to shut it down because you don't want to have chronic inflammation -as you get older, ability to heal when you were younger is really good but when you get older it gets worse

nutritional intake requirements

-recommended daily allowances (RDAs) -caloric (kcal/kg) based on: -age -gender -activity level -current BMI -pregnancy/lactation -macronutrients (mg per day) -macronutrients (%) -carbs: 45% to 65% -proteins: 10% to 35% -fats: 20% to 35% -as you get older, you need less calories -takes lots of calories to make a baby -top micronutrients

chronic inflammation

-recurrent or persistent inflammation lasting several weeks or longer -monocytes, macrophages, and lymphocytes -formation of granulomas and scarring often occur typically 6 months know what cells are there for acute inflammation (neutrophils, mast cells, basophils) and what cells are there for chronic inflammation

treatment of inflammation

-reduce blood flow -decrease swelling -block the action of chemical mediators -RICE -rest, ice, compress: decreasing the amount it can enlarge elevate: put it above your heart

protective structures: blood brain barrier

-reduced capillary permeability -selectively transports substances -tight endothelial junctions -favored transport factors -small molecular size -high lipid solubility -low electrical charge functions -protection of the brain from foreign substances -protection of the brain from hormones and neurotransmitters in the systemic circulation -protection against drastic environmental fluctuations -reduces permeability in capillaries that supply the brain and it transports substances in a selective manner because of the tight junctions in the endothelial cells lining the capillaries of the brain

altered urinary elimination: altered mobility

-reduced contraction of hollow structures -renal tubules -ureters -consequences -stasis of filtrate in tubules, urine in bladder -casts may form: risk of obstruction -altered reabsorption and secretion

elimination in aging: renal/urinary

-reduced renal blood flow -decreased GFR -reduced renal mass and nephron number -decline in proximal tubular function -reduced renin and aldosterone levels -impaired drug excretion -urinary incontinence

cerebral atrophy pathophysiology

-reduction in size of the cells in the cerebrum of the brain due to reduced stimulation or injury -progressive reduction in the size of the neurons

cushing syndrome

-refers to a condition of prolonged exposure to elevated levels of either endogenous (from the adrenal cortex or cortisol-producing tumors) or exogenous glucocorticoids (as when taking glucocorticoids drugs)

mosacicism

-refers to the combination of cells with the regular chromosome number and this with an altered number of chromosomes -effects are determined by the ratio -risk of nondisjuncture increases with parental age

differentiation

-refers to the orderly process of cellular maturation to achieve a specific function

renal system

-regulates body fluid volume/composition -eliminates metabolic wastes -synthesizes, releases, or activates hormones -regulates blood pressure kidney process -20% to 25% of cardiac output -1,000 mL blood/min

protein energy malnutrition

-related to: -marasmus-deprivation of all food -kwashiorkor-protein deprivation with adequate carbohydrate intake -starvation can last for 1 month with adequate water intake

somatosensory system

-relay sensory information from the periphery to the CNS -sensory receptors -ascending pathways -processing centers ascending: periphery up our ascending pathways to our brain to our direct processes in our brain

septic shock

-releasing endotoxins as a defense mechanism usually local, not systemic -once it enters your blood stream thats where it gets bad 25-35% good chance of getting over it septic: 60% survival rate

asthma: clinical manifestations

-remission -exacerbation -intermittent or persistent airway obstruction due to: -wheezing and tachypnea -dyspnea and coughing -chest tightness -excessive sputum production -anxiety

remissions vs exacerbations

-remission: symptom-free -exacerbations: flare of symptoms exacerbation: reoccurring (mono, rheumatoid arthritis)

RA pathophysiology

-remissions and exacerbations -initial inflammation -mild edema -accumulation of inflammatory cells -acceleration of angiogenesis -accumulation of fibrin -chronic inflammation -pannus formation -cartilage erosion -fibrosis -ankylosis in the cartilage area, it is going to be slowly replaced with fibrous tissue or scar tissue and forms pannus on the side of the joints and degranulates and is replaced with thicker cartilage making it harder to move -antibodies are destroying your cartilage possibly

name one behavior modification the nurse would recommend to a patient with pancreatitis

-remove alcohol

expiration

-removing carbon dioxide out of the body through the lungs -the diaphragm and external intercostal muscles relax -lungs compress and increase the pressure inside the airways -intrathoracic pressure more positive, promoting the passive movement of air out -removing CO2 from our bodies and our diaphragm is relaxed and forms and innervated U and our lungs are compressed and its more of a passive thing

menopause: more clinical manifestations

-reproductive tissues: -breast -ovaries -uterus -thinning vaginal walls -responsiveness to glandular tissue -libido -systemic: -skin elasticity and subcutaneous tissue reduced -body hair amount and pattern -bladder atrophy -vasomotor symptoms -sleep and mood alterations -bone demineralization -cardiovascular risk

evidence-based practice

-research findings that guide decision making -provides a framework for approaches to pathophysiology concepts in practice

bone remodeling stage

-resorption of unnecessary callus -formation of trabeculae -along lines of stress -callus is usually bigger than the fracture and shows up on x-ray

cystic fibrosis: clinical manifestations

-respiratory -infection -chronic cough -tachypnea -wheezing/crackles -hemoptysis -dyspnea -chest pain -cyanosis -barrel chest -finger clubbing gastrointestinal -meconium ileus -malabsorption -reproductive -male sterility (absence of vas deferens) -delayed secondary sexual characteristics in females -sweat abnormalities -excessive salt depletion infants: meconium ileus***-VERY FIRST SIGN AND SYMPTOM

hypercapnia

-respiratory acidosis due to carbon dioxide retention

CNS injury

-response to injury -varies to cell type -mechanisms of injury -trauma -ischemia -excitatory -pressure -depends on what the cell does -astrogliosis: astrocytes respond to local tissue injury through proliferation, forming a "glial" scar

osteoarthritis: treatment

-rest of involved joint until inflammation subsides -aerobic exercise and range-of-motion exercise -cane, crutches, or walker -weight loss, if obese -analgesic and antiinflammatory drug -magnetic bracelets and acupuncture -intraarticular injection of high-molecular weight viscosupplements, particularly hyaluronic acid -surgery: joint replacement

pneumonia: treatment

-restore optimal ventilation and diffusion -identify pathogen and target with appropriate pharmacologic treatment -supplemental oxygen

healing and tissue repair: remodeling phase

-restoring functional integrity -resolution -healing in response to mild injury -regeneration -proliferation and differentiation of labile and stable cells in more severe injury -replacement -substitution of functional permanent cells with connective tissue get you back to normal smaller the injury, more likely for full resolution regeneration: labile cells are cells that reproduce really quickly (GI tract) (bladder cells) stable cells (don't get replace quickly) liver cells, replacement: large wounds you can't always make enough cells to heal so you use scar tissue

anorexia nervosa clinical manfestations

-restricted caloric and nutrient intake -extremely thin stature -lanugo -amenorrhea -brittle hair and nails -peripheral cyanosis -dry skin -bradycardia -hypotension -hypothermia -abdominal bloating -constipation

neuronal communication: altered neuronal communication

-reuptake of neurotransmitter in the presynaptic neuron -diffusion of neurotransmitter out of the synaptic cleft -enzymatic breakdown of neurotransmitter in the synapse -postsynaptic receptor alteration that impairs neurotransmitter binding neuron is releasing neurotransmitter and diffused out and can no longer be used transmitters binding sites are damaged or not working correctly

iron-deficiency anemia treatment

-reverse the cause -increase iron intake through diet and/or supplements

benign prostatic hyperplasia: treatment

-symptom management -pharmacologic -relaxation of smooth muscle -prostate -bladder neck -arterial supply -inhibition of testosterone conversion to DTH -surgical: destruction of prostate tissue -risk for incontinence and sexual dysfunction

translocation

-ribosomes from ribosomal RNA are transported from the nucleus to the cytoplasm where many attach to the endoplasmic reticulum associate with mRNA and begin protein synthesis known as this -occurs when one large segment of DNA breaks from one chromosome and reattaches to a different chromosome often occurring in meiosis -if it become balanced, does not affect the individual because it still has the same amount of genetic material

pulmonary circulation

-right side of heart -pulmonary artery blood flowing to the lungs from the right side of the heart -swelling, extra fluid, systemic effects towards the periphery left sided heart failure: coughing, left sides heart failure -functions at a much lower pressure than the systemic circulation -blood moves slowly past the lungs to allow maximum gas exchange

cervical metaplasia and dysplasia treatment

-risk reduction -ablation: removal of superficial cells -cryosurgery -laser ablation -cold coagulation and electrocoagulation diathermy ablation -surgical excision

environmental toxin injury and cardiovascular disease: treatment

-risk reduction -symptom management -smoking cessation -pharmacologic treatment: drugs that assist with smoking cessation and management of cardiovascular complications

burn diagnostic criteria

-rule of nines -american burn associated has designated criteria for distinguishing minor, moderate, and major burns based on: -wound depth -surface area -required level of treatment -whole leg: 18% -whole head: 9% -does NOT work for kids under the age of 5

management of genetic and developmental disorders

-screening and diagnosis -prenatal screening and diagnoses -postnatal screening and diagnoses treatment strategies -assess literacy level -provide information about rates of risk -promote ability to make informed decisions -affects the cortex and basil ganglia -affects movement and motor function

major depressive disorders subtypes

-seasonal affective -postpartum -melancholic -catatonic -atypical

burn pathophysiology: deep-partial thickness

-second degree burn will cause blistering and epidermis and dermis separate and accumulation of fluid (blister)

innate immune defense

-second line of defense -granulocytes -neutrophils -basophils -eosinophils -mast cell -antigen presenting cells (APCs) -monocytes/macrophages -dendritic cells -consists of granulocytes APC-cell that goes and picks up an antigen in your body and presents it to the WBCs located in the lymph nodes which will create antibodies to that antigen antibodies-made from your body antigen-foreign, non self -early rapid response of your immune system and happens within minutes to hours when foreign invasion takes place -after hours, activation of our adaptive response occurs -cells will live in your skin and mucous membranes -APCs: cells that will pick up the antigen and engulf it and present it to the t cells and B cells in the lymphatic system -neutrophils: good at killing types of bacterial cells; most abundant in bacterial infection

male reproductive anatomy: spermatogenesis

-seminiferous tubules -maturation: movement towards lumen -transits to: epididymis -vas deferens -exits via urethra constant happens in seminiferous tubules and theres a lumen and it is where the maturing sperm leave to go on their journey to the pathway out -semen is produced by secretions of prostate glands accessory glands: seminal vesicles, prostate, Cowper's glands

neuronal impulse transmission: functional neuron types

-sensory/afferent: carry impulses from receptors to the distant targets of the brain and spinal cord (from periphery to the brain and spinal cord in the central nervous system -motor/efferent: carry signals away from the spinal cord and brain to targets in the body that regulate activity -interneuron: connect the motor and sensory neurons, transmitting signals between afferent and efferent neurons -most abundant type: interneuron -sensory runs through the afferent nervous system motor are through your efferent and going from brain and spinal cord to muscles

respiration

-series of metabolic processes that transforms fuel molecules into energy (ATP) -aerobic respiration uses oxygen to make ATP -anaerobic respiration: does not use oxygen to make ATP

allele

-series of two or more different genes occupying the same location on a specific chromosome

ROP diagnostic criteria: stage 3

-severely abnormal blood vessel growth -some develop normal vision without treatment

autism spectrum disorders: treatment

-therapies -speech -occupational -physical -cognitive-behavioral -language training 1-1 therapy training what is normal behavior 20-25 hrs per week no pharmacological therapy

pelvic inflammatory disease: pathophysiology

-sexually transmitted infection -cause of combination of sexually transmitted microorganisms inlacing chlaymydia trchomatis and neisseria gonorrhoeae -after attachment to the epithelial cells living the reproductive tract,t are offending microorganisms elicit acute inflammatory and immune responses -epithelial cells of the reproductive tract -transmission to sexual partners -acute inflammation and immune response -risk for obstruction, scar tissue

taste processes

-signal initiation -binding of dissolved substance with taste receptor -signal transmitted along facial (VII) and glossopharyngeal (IX) cranial nerves

smell processes

-signal initiation: -olfactory receptors in nasal cavities -transmitted along olfactory (I) cranial nerve -signal processing and interpretation -via ascending fibers to the olfactory bulb and olfactory cortex

taste processes 2

-signal processing: thalamus -signal interpretation: -gustatory cortex in the parietal lobe -modulated by visual, thermal, scent, and pain

communication

-signals between cells controlling cellular function and behavior ex. cells secrete proinflammatory cytokines to help induce inflammation to clear a pathogen -messages communicated by receptor-ligand binding -feedback mechanisms prevent cellular damage -cytokines: talks to other cells -receptor in the cell and ligands that go from cell to cell telling other cells

macronutrients: lipids structure

-simple lipids or fats -fatty acids, glycerol -compound lipids -phospholipids, lipoproteins, glycolipids -sterols -cholesterol, bile salts

sickle cell disease: pathophysiology

-single gene mutation with autosomal recessive inheritance -homozygous: disease phenotype -heterozygous: carrier -point mutation leading to altered structure of the beta chain of hemoglobin in red blood cells -sickled shape, known as hemoglobin A (HbS) -no difference between boys or girls -may even show some of the symptoms -one base changed in the DNA it changes the transcription and amino acids -change in beta chain confers the sickle cell trait (hemoglobinS)

conduction system of the heart

-sinoatrial node (SA) -atrioventricular (AV) node -bundle of His -right bundle branch -left bundle branch -purkinje fibers -really don't see a repolarization wave

cellular changes in aging part 2

-skin changes -increased dryness -wrinkles -varied pattern of pigmentation -decreased elasticity -hair changes -loss -graying -skin is not very elastic: tends to sag and droop -lots of hair loss for women during menopause

DMD clinical manifestations

-slow acquisition of motor milestones -18 months: start walking -age 2-3 years: somewhat clumsy -age 3-5 years: difficulty keeping up with peers -consistent pattern of weakness that varies in rate -proximal muscles weaken before distal muscles -legs weaken before arms -extensors weaken before flexors electromyography: more of a screening tool -1 in 10,000 male births will have this so we don't do regular screening unless its in their family already

major depressive disorder pathophysiology continued

-social and psychological influences -isolation -social rejection -loss or lack of significant relationships -poor family functioning -unemployment -poverty -abuse -alcohol/drug abuse -poor coping skills -low self-esteem -distorted thinking -low resilience

rhabdomyosarcoma: pathophysiology

-soft tissue sarcoma from immature mesenchymal cells -majority of cases are in children <9 years -slightly more common in males -certain genetic conditions increase the risk

acromegaly: clinical manifestations

-soft tissue swelling -altered facial features -pain and numbness in hands -voice deepening -snoring -skin changes -altered reproductive function

neuron components

-soma: (cell body) filled with cytoplasm and contains processes including the nucleus, that support the metabolic demands of the cell -dendrites: multiple, branched, extensions of the cell body that transmit impulses to the cell body -axon: carries impulses away from the cell body

peripheral nervous system (PNS)

-somatic nervous system: voluntary nervous control in skeletal muscles -voluntary nervous system in skeletal muscle -autonomic nervous system -sympathetic -parasympathetic

adaptive immunity

-specific immune response -immunologic memory -diversity -self and non-self recognition -two forms: humoral immunity and cell-mediated immunity immune system is always working to make things better but viruses are always changing things up so it makes it harder

SLE clinical manifestations

-specific to organs injured by inflammation and complex deposition -local: skin, musculoskeletal pulmonary and kidney -systemic: neurologic, pulmonary, hematologic and cardiac disease -periods of exacerbations and periods of decreased symptoms

central nervous organization: left hemisphere

-speech and language -calculations -math -logical abilities

protective structures: spinal circulation

-spinal arteries -spinal veins

sickle cell disease treatment

-symptom specific -prevention of infection -avoidance of temperature extremes -reduction in emotional and physical stress drugs: promote production of red blood cells with hemoglobin F -treatment of pain and infection trisomy of chromosome 21 as a nondisjunction instead of two pairs we have three -wide range of severity

conduction of pain sensation

-stimulation of free nerve endings -chemical, mechanical, or thermal stimuli -transduction of noxious stimuli into a nerve impulse -transmission from tissues to CNS -type A (delta) and c fibers -induction of autonomic and reflex responses

immune response manipulation: vaccines

-stimulation of immunity through antigen exposure -rapid activation of memory cells if reexposure occurs -live virus vs attenuated -if we are ever exposed we will have a huge response to remove the disease

peripheral nervous organization: reflex arc

-stimuli: received, interpreted, response induced -transmission -receptor triggered: action potential generated -sensory afferent neuron -peripheral muscle sensory response -dorsal route ganglia -dorsal and ventral horn -motor efferent neuron -synapse at neuromuscular junction -muscle fiber contractile response -represents the process by which stimuli are received and interpreted and in turn stimulate a response

pathophysiology

-study of functional changes in the body caused by injury, disorder or disease related science: -pathology -anatomy -physiology -biology -microbiology -chemistry disorder-group of cells that are not functioning correctly (genetically or hereditary usually) illness-external that you bring to your body syndrome-group of diseases processes that are usually grouped together, have very similar problems with their bodies

fibromyalgia: diagnostic criteria

-subjective findings -history of fatigue -chronic musculoskeletal pain -at least 3 months duration -at least 12 of 18 identified tender point sites -trigger points

renal tubules

-substances are reabsorbed from the filtrate or secreted into the filtrate -proximal convoluted tubule -loop of Henle -distal convoluted tubule -collecting duct -principal cells -intercalated cells

exchange of gasses between the environment and blood: perfusion

-supplying oxygenated blood to the lungs and organ systems via blood vessels

osteosarcoma: treatment

-surgery -pre and post op chemotherapy -serum alkaline phosphatase and LDH-measures response to treatment

testicular cancer: treatment

-surgery -radiation -chemotherapy

treatment of altered perfusion

-surgery: babies -pharmacologic: BP issues -pacemaker -intravenous fluids -lifestyle

cardiac hypertrophy: treatment

-surgical -pharmacologic -drugs that relax the ventricles -drugs that reduce the workload of the heart -decrease the pressure that the heart must pump against -non-pharmoacologic: activity restriction -surgically depending on the cause it is -treat with a diuretic to get the fluid out of your system

crohns disease: treatment

-symptom management -pharmacolgic treatment -dietary changes -steroids, corticosteroids -decrease the amount of fats and fibers and increase protein and carbs

PKD treatment

-symptomatic care -pain control -treatment of infection -blood pressure control -promotion of renal function -dialysis -renal transplant catheter placed in forearm and blood removed from one portal and filtered and put back into the body through the same vessel or different vessel

alzheimer disease: treatment

-symptomatic care -maximizing quality of life -promotion of general health status -pharmacologic therapy -centrally acting cholinesterase inhibitors -antidepressants -anti-anxiety agents -antipsychotics

PTSD diagnostic criteria

-symptoms present for at least 1 month -impaired functioning -no other underlying medical condition -experiencing or witnessing traumatic event -persistently reexperiencing event -avoiding stimuli associated with event -exaggerated or impaired response

cardiac cycle: diastole vs systole

-systole: contraction: forcefully move blood out of the ventricles -diastole: relaxation: allows blood to fill the ventricles systole: measuring heart pressure during contraction (usually left ventricle to rest of your body) diastole: the atria fills up with blood

damage to intestinal villi

-take small piece of intestine

sprains and strains: pathophysiology

-tendon: fibrous connective tissue, attaches muscle to bone -ligament: fibrous connective tissue, connects bones to bones in a joint -sprain: tear in a ligament -strain: tear in a tendon or muscle -healing involves an inflammatory response -growth factors are released -granulation tissue (macrophages, fibroblasts, and capillary buds) -collagen formation

selye's general adaptation syndrome

-term used to describe this neuroendocrine response and the corresponding physiology changes -Alarm stage -catecholamines and cortisol are released in response to stimulation of the sympathetic nervous system, the hypothalamic pituitary axis, and the adrenal glands -fight or flight stage - Stressor triggers the hypothalamic-pituitary-adrenal (HPA) axis. - Activation of the sympathetic nervous system (SNS). • Resistance (adaptation) stage - Begins with the actions of adrenal hormones. • Cortisol, epinephrine, and norepinephrine -cortisol levels decrease though negative feedback mechanisms and excess cortisol is helpful in early stages but later on hypercortisolism is detrimental leading to exhaustion of inflammatory and immune responses •Exhaustion stage (allostatic overload) - Occurs only if stress continues and adaptation is not successful. -characteriszes by energy depletion and degeneration of cells, tissues, organs, and organ systems -stress begins in brain stem

male reproductive anatomy

-testes -epididymis -vas deferens -seminal vesicles -prostate -penis

male reproductive anatomy: target organ

-testicular leydig cells: androgen -testicular sertoli cells: inhibit not cyclic like a women -pretty constant to result in conception -everything is the same except for target organ leydig: stimulates FSH and LH and produces androgen sertoli: produces inhibit

exchange of gasses between the environment and blood: respiration

-the aerobic use of oxygen by body cells to make energy -lungs need oxygen as well so you need really good perfusion to the lungs -respiration happens at the cellular level

partial pressure

-the collision of oxygen and carbon dioxide particles creates pressure -portion of gasses in dissolved in plasma created pressure -reported in mmHG PaO2: provides an estimate of oxygen in the blood based on pressure exerted PaCO2: provides an estimate of carbon dioxide in the blood based on pressure exerted Po2: like oxygen saturation -look at the chart little more CO2 and less O2 with deoxygenated blood look at expired air and inspired air -know deoxygenated blood and oxygenated blood numbers

altered perfusion

-the inability to adequately oxygenate tissues at the capillary level

chromatolysis: type of neuronal injury

-the swelling of a neuron because of injury

adaptive immune defense

-third line of defense -recognition and neutralization of foreign substances -specific immune response -immunologic memory -takes over from innate response and creates antibodies

ARDS phase 2

-those substances especially histamine, inflame and damage the alveolocapillary membrane, increasing capillary permeability -fluids then shift into the interstitial space

stress

-threat to homeostasis -real vs perceived -good vs bad -stressor is the stimulus that invokes the stress response -body's reaction to harmful forces (stressors) capable of disturbing homeostasis

impaired circulation: obstruction

-thrombosis: occurs in response to injury and is essential during the wound healing process (blood clot) -virchow triad: vessel wall damage, excessive clotting, and alterations in blood flow, such as turbulence or sluggish blood movement -atherosclerosis: condition of irregularly distributed lipid deposits in the inner lining, or intima, of large or medium arteries -bifurcations: regions wherein a vessel branches -aneurysms:local outpouchings caused by weakness in the vessel wall -venous stasis: occurs in veins with reduced venous return-where blood pools in the extremities -hypercoagulability -thrombocythemia: excess platelets (can be with cancer) -thromboembolus (simply an embolus) -embolus (any plug of material such as thrombi, air, neoplasms, microorganisms, or amniotic fluid that travels in the circulation and can obstruct the lumen of a vessel -infarct: area of necrosis resulting from a sudden insufficiency of arterial or venous blood supply -infarction: process of obstructing the vessel thrombosis: blood clot atherosclerosis: plaque buildup bifurcation: splitting and slows it down venous stasis: hard time bringing blood from periphery to the heart-leaky valves hyper coagulability:states where you just have environment inside your vessels that causes increase in blood clot formation and platelets thrombocythemia: high platelet count thromboembolus: when blood clot has moved infarction: anywhere of low blood supply

measurement of ventilation

-tidal volume (TV) -vital capacity (VC) -forced vital capacity (FVC) -forced expiratory volume in 1 second (FEV1) -residual volume (RV) -total lung capacity (TLC)

central nervous organization: spinal cord gray matter

-tissue -primarily composed of cell bodies -ventral horns -anterior extensions -efferent motor neurons leaving cord -dorsal horns -posterior extensions -sensory neurons receiving afferent impulses ventral horns: contain efferent motor neurons that leave the cord through the ventral roots sensory neurons DAVE -upper motor neurons: include cell bodies in the motor cortex and the axons extending to the brain stem and spinal cord -lower motor neurons: located in the ventral horns of the spinal cord -interneurons: connect UPN with LMN in the spinal cord

tissue injury

-tissue injury histamine causes all inflammatory responses and we want to shut them down ex. slamming finger in car door chemotactic mediators: tell cells to communicate PMN's polymorphic neutrophils: 1st responders and mast cells always get to the energy first -need platelets to come fast so we clot and don't bleed out

pulmonary structure and function: protective structures

-trap and remove foreign particles -hairs, turbinates, cilia -intercostal muscles, ribs, skin -mucosal lining: warms and humidifies air -irritant receptors: nose and airways -trigger sneeze/cough reflex -immune protection -mucosa, macrophages -remove injurious agents -when cilia stops mucus: mucus stays still and causes infection

diabetes insipidus: treatment

-treat cause -hydration -pharmacologic treatment -desmopression (synthetic vasopressin analog that acts as an antidiuretic)

inflammation

-triggered by tissue injury -damage, harm, or loss to the cell, tissue, organ, or organ system -can include invasion by microorganisms, cellular mutations, anoxia, and physical or chemical damage

celiac disease (gluten-sensitive enteropathy): pathophysiology

-true allergy to gluten -gluten malabsorption fue to a T-cell mediated hypersensitivity in persons with genetic predisposition -glutens: specific proteins found in -wheat -rye -oats -barley

polycystic ovarian syndrome (PCOS): diagnostic criteria

-two of the following -androgen excess -ovulatory dysfunction -polycystic ovaries -lab tests -treatment: goals -androgen suppression -management of manifestations -pharmacologic -reproductive hormonal management -metabolic management -cosmetic ovulatory dysfunction: do screening tests to see the ovaries -not an easy thing to treat -body image changes, infertility, significant for cardiovascular disease

impaired ventilation and diffusion: ventilation-perfusion (V/Q) mismatch

-two possible scenarios: 1) lung are ventilated but not perfused 2) lung is perfused but not ventilated

hearing: middle ear

-tympanic membrane -ossicles -malleus -incus -stapes -mastoid -eustachian tube

evaluation of the middle ear

-tympanometry: measures the degree of movement of the tympanic membrane to identify middle ear fluid, perforation, or cerumen blockage of the ear canal -acoustic reflex measurement: can be used to determine movement of the tympanic membrane in response to sound

hypersensitivities remember your ABCs

-type I: allergy (atopy and anaphylaxis) -type II: antibody -type III: immune complex -type IV: delayed (DTH) graves disease-actually create antibodies to your own tissue and the thyroid is destroyed

rH isoimmunization pathophysiology

-type II cytotoxic antibody-mediated reaction -direct antigen-antibody hypersensitivity reaction involving the rH antigen on red blood cells -antibodies against the rH antigen (anti-D) attack red blood cells causing hemolysis -often occurs in rH negative mothers exposed to fetal rH positive antigen -cell destruction (fetal red blood cell) -only in rh- moms -abo antigen on red blood cells or rh proteins on blood cells -if mom was rh- and father was rh+ theres a possibility of rh isoimmuniation rh- mom has never seen rh protein and crossing of blood cells through the placenta to the mom where the mom is exposed to rh+ from fetus and happens usually in delivery process and carrying antibodies to rh -first time is okay but second baby is usually worse because toy have her antibodies attacking the baby

SLE pathophysiology

-type III hypersensitivity reaction -autoimmune response -antiphospholipid, anticytoplasmis, antinuclear antibodies -persistent antigen-antibody complex depositions -involves responses by the innate and adaptive immune systems -chronic, systemic condition -depositing lots of antigen antibody complexes and causes inflammatory responses throughout the body

MD diagnostic criteria

-vision screening -ophthalmoscopic exam -leakage -bulging macula -drusen deposition new vessels are formed are not strong vessels and their cells are going to be looser and leak out: wet wet is not as common as dry not necessarily genetic

vision: manifestations and evaluation of alterations in vision

-vision screening (acuity) -near distance -far distance

alterations in brain structure: traumatic brain injury

-understand where you are going to find these types of behaviors and if a traumatic brain injury happened here what will be the effects -focus more whats on healthy

fractures clinical manifestations

-unnatural alignment (deformity) -pain -edema -muscle spasms -tenderness to touch -impaired sensation (numbness and tingling) -decreased mobility -decreased range of motion -fracture: local area -sprain: generalized pain area

central nervous organizations: spinal cord neurons

-upper motor neusons: cell bodies in motor cortex -axons extending to brain stem and spinal cord -lower motor neurons: ventral horns -interneuron: connect UMN and LMN anything that you can control: pyramidal system extrapyramidal: things that you can't control (ticks, -cauda equina: the extension of nerves in this portion of the vertebral canal

benign prostatic hyperplasia: clinical manifestations

-urethral obstruction -impeded urine flow from bladder to urinary meatus -difficulty starting flow -interuppted flow -weak stream -dribble -urgency -frequency -nocturia -flow starts and stops starts and stops urinalysis: obstruct flow and can lead to UTIs

urine removal

-urine -enters ureters via renal pelvis -propelled by ureters into bladder via peristalsis bladder filling -activates stretch receptors -signal stimulates contraction of detrusor muscle via parasympathetic cholinergic motor fibers -relaxation of internal and external urethral sphincters results in micturition

spinal cord injury: central cord syndrome

-usually caused by a hyperextension injury

female reproductive anatomy: internal genitalia

-vagina -uterus -fallopian tubes -ovaries

cardiac cycle

-venous blood returns to the heart -from head and arms via superior vena cava -from trunk and legs via inferior vena cava -blood enters right atrium -blood goes through tricuspid valve to right ventricle -blood goes through pulmonic valve to pulmonary artery and lungs

from ventilation to perfusion

-ventilation-perfusion ratio (0.8-0.9) -rate of ventilation less than perfusion -in the lower lobes: -ventilation is optimal because: -surface tension for alveoli is lowest -lungs are most easily inflated -perfusion is optimal as blood pressure allows maximal blood flow average adult human will go through about 4 L in and out per minute or air and pump out blood in heart 5 L -4/5=(0.8-0.9) -we aren't breathing as many times per minute in comparison as we are pumping through our circulation of blood -lower lobes have the best diffusion but with gravity it could be upper lobes -decent BP to get most blood through the system to get good perfusion growing

protective structures: cerebrovascular circulation

-vertebral, basilar, and carotid arteries -circle of Willis -connects vertebral and carotid circulations -jugular veins -3 arteries that supply blood to your body -important as a route of collateral circulation in case perfusion is impaired in another arterial system

balance proccesses

-vestibular function -motion from body movement -detected by hair cells in the semicircular canals, utricle and saccule -organ of Corti: contains hair cells, the receptors responsible for the neural impulse that allows hearing

vision: alterations in protective structures-conjunctivitis

-viral -bacterial: hello -allergic: watery

glaucoma: diagnostic criteria

-vision screening -visual fields -ophthalmoscopic exam -optic nerve cupping, pallor, hemorrhage -tonometry -measure intraocular pressure -do dome test where you click when you see a dot around the globe

central nervous organization: right hemisphere

-visual imagery -face recognition -music -spatial abilities

2 factors that regulate bone remodeling

1) RANKL 2) OPG:osteoprogerin: produced by osteoblasts as well and binds to RANKL so the RANKL cannot bind to osteoclasts and therefore cannot stimulate osteoclasts to break down bone

3 steps to bone formation

1) collagen synthesis 2) fiber formation 3) mineralization

stages of healing fracture

1) hematoma formation 2) callus formation 3) callus ossification 4) bone remodeling

colon cancer tumors

1) nonneoplastic polyps: not generally considered a cancer precursor) 2) neoplastic polyps (adenomatous polyps, adenomas; increased risk of developing carcinoma of the colon/rectum) 3) cancers (most often adenocarcinomas)

pathogen entry

1) pathogen gains entry 2) antigen is presented to T cell receptor via MHC 3) T cell activates 4) CD4 T cell activation helps further 5) CD8 T cell activation leads to the destruction of infected cells MHC connects to the antigen and pulls it out of the cell

neuron impulse transmission: phases of the action potential

1) resting membrane potential:membrane potential (or state of tension) inside a cell membrane measured relative to the fluid just outside in the absence of significant electrical activity 2) depolarization phase: is the result of rapid movement of sodium into the cell through sodium channels in the cell membrane and this inflow generated an electrical impulse 3) depolarization phase -RMP: more of negative charge inside more positive outside -DE:(IMPORTANT) sodium goes into the cell making it more positively charged -RE: potassium goes back out of the cell and helps polarize everything -initiated by the flow of potassium ions out of the cell and efflux of potassium ions promoted return of the cell to RMP

objectives

1. Define and use the key terms listed in this chapter. 2. Relate the development of infection to breaks in the three lines of defense. 3. Identify the ways in which microbes can become pathogens to human host cells. 4. Differentiate the basic types of microbes. 5. Determine measures to break the chain of infection at each link. 6. Identify the phases of acute infection. 7. Discuss the potential complications of acute infection. 8. Distinguish common clinical manifestations related to infection. 9. Identify laboratory and diagnostic tests relevant to infection. 10. Discuss treatment modalities effective against various types of infection. 11. Apply concepts of infection to the clinical models in this chapter.

the hypothalamic-pituitary axis

1. Hypothalamus produces a releasing hormone. - Travels to anterior pituitary and is activated to produce a trophic hormone which is released to the body to act on a target organ to secrete a final hormone that is released to the body. - Example: Thyrotropin releasing hormone - thyroid stimulating hormone - Thyroid hormone

valves of the heart

3 parts to them: -aortic: between left ventricle and aorta -mitral: 2 cusps -pulmonic, aortic, atrioventricular (bicuspid and tricuspid)

post traumatic stress disorder (PTSD) pathophysiology

50% of women experience one traumatic event in their life while men experience 60% -higher % of women will go on to develop PTSD after that event -an anxiety disorder caused by extreme traumatic events -military combat -concentration camp -violet crime -rape -abuse risk factors: -prior trauma -proximity, duration, severity -anxiety/depression -alcohol/drug abuse -family history -impaired support

1. According to the CDC what is the average life expectancy for an infant born in 2018 (average of both sexes)? a. 85.1 years b. 80.4 years c. 78.7 years d. 74.6 years

78.7 years

tuberculosis: clinical manifestations

90% of those infected are asymptomatic • In 10% with progressive primary disease: - Malaise - Weight loss - Fatigue - Anorexia - Low-grade fever - Night sweats - Severe chronic productive cough with hemoptysis (bloody sputum) - Site-specific

antibody and circle the area that recognizes antigen

two ends is where it recognizes

viral hepatitis: path. con

Acute - Inflammatory response - Kupffer cell phagocytosis - Hepatic cell regeneration • Chronic - Impaired liver function for greater than 6 months • Fulminant - Hepatic failure • Cirrhosis - End stage liver disease with inflammation and severe hepatocyte damage and altered blood flow • Carrier

viral hepatitis: pathophysiology cont

Alteration in liver functions, including - Venous blood return • Portal circulation

viral hepatitis: pathophysiology conti.

Alteration in liver functions, including - Secretion of bile - Energy metabolism - Plasma protein production - Synthesis of clotting factors - Metabolic detoxification - Metabolism of bilirubin - Vitamin and mineral metabolism

AIDS pathophysiology

Altered host defense resulting from secondary immunodeficiency. -> Infection of CD4 Helper T lymphocytes with HIV. Results in loss of cell-mediated and humoral immunity due to loss of CD4 TH1 lymphocytes. HIV: beginning stages of AIDS and starts with virus replicating in the body through a screening process (EIA test-enzyme linked amino acid ) syndrome comes after the virus replicates over a process of time prevent the virus from replicating and getting a really viral mode -virus will infect CD4 helper t lymphocytes and causes them not being able to replicate and not be helpful whatsoever and will decrease as the virus increases virus enters body through mucous membranes typically and infects the helper T cells by disabling them

rh isoimmunization: clinical manifestations

Anemia Hyperbilirubinemia Fetal effects -Kernicterus -Hearing loss -Cerebral palsy bilirubin in babies will shoot high and cause cerebral palsy, hearing loss, brain disabilities

treatment of infection

Antimicrobial drugs - Mechanism of action • Alteration of microorganism cellular structure • Disable enzymes produced by pathogens • Symptom reduction: Tylenol

UTI pathophysiology

Ascending infection of urinary tract • E. coli most common pathogen • Results in cell necrosis in urinary tract epithelium

phenylketouria: pathophysiology

Autosomal recessive disorder caused by a mutation in the PAH gene - Deficiency of the enzyme phenylalanine hydroxylase (PAH) impairs body's ability to metabolize phenylalanine - Phenylalanine accumulates in body fluids - Phenylalanine cannot be converted into - Tyrosine deficit leads to neuropsychologic issues muation in PAH gene -lots of different mutations can cause this disorder -if you have a mutation of the PAH gene then you cannot process phenylalanine into tyrosine and so it stays in the body as phenylalanine and is bad because it causes neurologic defects such as brain damage and won't know that you have it unless you test the blood and genetic history

functions of immune defense components

B cells formed in bone marrow t cells=bone marrow and mature in thymus spleen-lymphocytes will hang out in the spleen and lots of blood flowing here

humoral immunity immunoglobulins

B lymphocytes -antibodies secreted from plasma cells -IgA, IgD, IgE, IgG, IgM -memory cells -form antibodies -GAMED -igG is most proliferated and next is igA -can cause a bigger issue since theres more in the body -memory cells because they are going to see and remember which ones to kill that harm your body

beck with-wiedemann syndrome

BWS results from disordered epigenetic regulation of imprinted genes

pathogen characteristics: endotoxins vs exotoxins

Bacteria - Pathogenicity • Endotoxin release - Gram-negative bacterial cell envelope - Complex phospholipid-polysaccharide molecules - Stimulation of inflammatory mediator release • Exotoxin release - Released into surrounding tissues - Local and systemic host cell destruction/lysis » Neurotoxin » Enterotoxin » Hepatotoxin -endotoxin: able to cause inflammatory -exotoxin: in the structure of the cell membrane and can actually be released and cause local and systemic destruction -entertotoxin: toxic to GI cell

acute pyelonephritis: pathophysiology

Bacterial infection of kidneys (often E. coli) • Risk factors - Urinary obstruction (renal calculi) - Incomplete bladder emptying, causing urine stagnation - Frequent intercourse, irritating urethra - Exposure to sexually transmitted infections - Hormonal changes, reducing ureteral peristalsis -usually results in renal parechyma being scarred

prostate cancer: treatment

Based on • Tumor staging • Degree of anaplasia • Age, Health status - Surgery - Radiation - Chemotherapy - Androgen-deprivation hormone therapy: counteract the androgen - "Watchful waiting"

urinary incontinence: treatment

Behavioral strategies - Bladder training - Pelvic floor strengthening • Pharmacologic - Anticholinergic medications - Alpha adrenergic medications • Surgical - Relief of mechanical obstruction https://www.urologyhealth.org/urologic-conditions/neurogenic-bladder bladder training: holding urine at intervals insert vaginal weights and have them hold the weighted objects in their vagina to increase their muscle tone: pelvic floor strengthening alpha adrenergic: improve strengthening of bladder

bone repair

Bone heals itself - Hematoma formation • Clot forms. - Procallus formation • Produces granulation tissue. - Callus formation • Forms membranous or woven bone. - Callus replacement • Replaces the callus with lamellar bone or trabecular bone. - Remodeling • Periosteal and endosteal surfaces are remodeled to the size and shape of the bone before the injury. after bone fractures there is a clot and hematoma forms -sometimes its not exact same size and shape but its usually very very close

cancer nomenclature

Cancers are named according to the cell type of origin: -epithelial tissue = carcinomas -ductal or glandular epithelium = adenocarcinomas -connective tissue = suffix "-sarcoma" -lymphatic tissue = lymphoma -blood-forming cells = leukemias -germ line: teratomas -fingers: papillomas -stemming from chondrocytes: chondromas

hormones

Chemicals made by cells that can affect the growth and/or function of other target tissues/organs • Are involved in: - Metabolism - Growth and development - Muscle/Fat distribution - Fluid/Electrolyte balance - Sexual development - Reproduction - Stress response don't have to memorize entire table just know hormones we talk about in class and applications

ulcerative colitis: pathophysiology

Chronic inflammation begins in rectum and ascends the descending colon Continuous superficial areas of ulceration Perforation, obstruction, and massive hemorrhage can result mostly in the rectum -starts in rectum and ascends to the colon -whereever it stops its where its going to stay and not scattered like crohns

ovarian cancer: stages

Classification by tumor type - Epithelial: arise from the surface of the ovary. Serous adenocarcinoma an epithelial tumor that resembles the epithelial tissue of the fallopian tube, is most common type - Germ cell: comprise 25% of ovarian tumors but are mostly benign in adult women -can also occur in children but are more often malignant in children and young adults - Sex cord: comprise 10% of ovarian tumors and these tumors arise from primitive sex cord or connecting tissue of the developing ovary • Stages I. Limited to one or both ovaries II. Extends into pelvis III. Metastases in peritoneum outside pelvis IV. Distant metastases

bone matrix

Collagen fibers - Make up bulk of bone matrix • Proteoglycans - Large complexes of numerous polysaccharides attached to a common protein core - Strengthen bone - Play role in bone calcium deposition and calcification • Glycoproteins - Control collagen interactions that lead to fibril formation - Carbohydrate-protein complexes 35% organic matter(collagen) -65% inorganic matter (calcium and phosphate) figure B: only cartilage not mineralized figure C: completely mineralized no cartilage proteoglycans: in control of transporting calcium throughout the bone and help strengthen bone glycoproteins: help control collagen

hyperthyroidism: pathophysiology

Condition of excess thyroid hormone due to: - Excess stimulation of thyroid gland - Disease of thyroid gland - Excess production of TSH • Graves disease: most common form in U.S. - Autoimmune disorder of unknown etiology • Type II Hypersensitivity - IgG binds to TSH receptors on thyrocytes negative feedback is blocked by IgG by having an autoimmune disorder females at higher risk

hypothyroidism: pathophysiology

Congenital or acquired deficiency of thyroid hormone (TH) from: - Lack of thyroid gland development - Deficient synthesis of TH - Destruction of thyroid gland - Impaired secretion of TSH or TRH • Many potential causes such as autoimmunity, genetic defects, injury to gland, iodine deficiency doesn't affect fetus in utero because mom can produce enough problem after baby is born where they have to produce their own in babies it can cause brain damage because thyroid hormone can have a lot to do with brain development screen for it with all babies (T3 and T4)-state mandated test they can't refuse it

general manifestations of altered perfusion

Cyanosis Pain Pallor Coolness Edema Shortness of breath Impaired growth Tachycardia Tachypnea Fatigue Hypotension Hypertension Bleeding, bruising Heart murmur humans sign: formation of deep vein thrombosis also an obstructive process may manifest as tenderness in the calf when dorsiflexion of foot

objectives

Define and use the key terms listed in the chapter. • Identify features that characterize hormones. • Discuss the role of the hypothalamic-pituitary axis in regulating hormone levels. • Identify pathways for mediating cell-to-cell communication. • Describe the role of the neuroendocrine system in the stress response. • Analyze the mechanisms of impairment that can lead to altered hormonal and metabolic regulation. • Discuss common measures to diagnose and treat hormone dysfunction. • Apply concepts of altered hormonal and metabolic regulation to select clinical models.

urolithiasis: pathophysiology

Development of renal calculi (kidney stones) in the renal system - Solid masses precipitated from filtrate • Cause - Urinary stasis - Elevated urinary levels of salts, • Risk of renal tubule obstruction organic or inorganic acid solid mass that has precipitated from a filtrate by the kidneys decreased oxygenation in the cells and can result in cell death can come from urinary stasis: anytime urine slows down the process of movement in the unidirectional can cause kidney stones

spinal cord injury: diagnosis

Diagnosis - Cognitive, motor, sensory function assessment - Imaging • X-ray, CT, MRI, myelography Treatment - Immobilize - Surgical repair - Promotion of functional ability

cerebral palsy: diagnostic criteria

Diagnosis of exclusion - History - Physical exam •Neurologic exam - Motor skills - Reflexes • Developmental milestones

phenylketouria: diagnostic criteria

Diagnosis often occurs at birth as a result of routine metabolic screening (blood test) • In countries without routine newborn screening, PKU often goes undetected until severe developmental delay and intellectual disability occur • PKU=Phe levels > 1200 umol/L cannot refuse this testing blood test: heel stick about 24 hrs of age usually after child has had a couple of feedings

multiple sclerosis

Disease of the CNS and peripheral neurons - Degeneration of myelin • No known cause • Risk factors - Demographics - Genetic - Environmental -progressively demyelinating neural axons -definitely autoimmune disease -higher north in asia more risk factor maybe due to increased viral infections in geographic terms -US: 40 degrees latitude anything north if they have lived there for the first 15 years of their life -caucasian women tend to get the disease more -women of north european descent -25 years old

carbon dioxide: diffusion and transport

Dissolved in the plasma: approximately 10% of the CO2 Bound to hemoglobin: approximately 20% to 30% of the CO2 Diffused into the red blood cell as bicarbonate: approximately 60% to 70% of the CO2

urinary incontinence: pathophysiology

Enuresis - Inability to voluntarily prevent the discharge of urine • Causes - Impaired muscle contraction - Altered neural transmission - Hormonal stimulation - Mechanical factors parasympathetic and have somatic control over the sphincters so we can control when we urinate happens more to females than males 75% of women will report urinary leakage with even 50% saying occasional leakage can happen in men due to enlarged prostate gland

obesity: pathophysiology

Excessive body fat (BMI ≥30 kg/m2) • Types - Hypertrophic: adipose cells increased in size - Hypercellular: adipose cells increased in number • Highly complex, multifactorial 35% of our population as obese hypercellular: surgical resolution by gastric bypass hypertrophic: healthy diet and exercise age, environmental, genetics, gender, etc.

obesity: clinical manifestations

Excessive weight and body fat - Truncal-abdominal or gluteofemoral fat deposition • Numerous health risks - Diabetes, heart disease, hypertension, hyperlipidemia, stroke, osteoarthritis, liver disease, gall stones, poor wound healing, sleep apnea, and certain cancers

phases of acute infection

Exposure - Contact with pathogen • Incubation - Exposure through onset of signs/symptoms • Prodrome - Onset of vague, non-specific signs/symptoms • Clinicalillness - Manifestations of specific signs/symptoms • Convalescence - Waning clinical manifestations to full recovery -incubation: has to do with the type of pathogen for how long it is (you see no symptoms/signs it stops when you see them)

acute sinusitis: clinical manifestations

Facial pain over sinus regions of face increasing with straining or bending down -Fever -Nasal congestion and/or excessive nasal discharge and postnasal drainage -Persistent cough -Fatigue -headaches usually where the sinuses are -gets worse at night because everything drains and worse when you wake up because its coming back up

stool elimination process

Fecal matter entry -enters cecum via ileocecal valve Fecal matter transport -Peristalsis ---segmental movement ---mass movement -water & electrolyte removal Stool evacuation -rectal sphincter relaxation

shape of bones

Flat bones - Ribs - Scapulae • Short bones (cuboidal bones) - Wrists - Ankles • Irregular bones - Vertebrae - Mandibles - Facial bones

HAART-Associated Acidosis

Highly Active Antiretroviral Therapy (HAART)-Associated Acidosis - Treatment for infection with the human immunodeficiency virus (HIV) • Enveloped retrovirus • Infects CD4 helper T lymphocytes, dendritic cells, macrophages • Activates CD8 cytotoxic T lymphocytes and CD4 helper T lymphocytes - Kill cells infected by HIV • Loss of cell-mediated and humoral immunity due to loss of CD4 helper T lymphocytes very effective for suppressing HIV HAART activates cytotoxic cells

bacterial meningitis: diagnostic criteria

History and physical examination - Kerning sign - Brudzinski sign • Blood cultures • CSF analysis and cultures

AIDS: diagnostic criteria

History and physical exam -Risk factors -Signs and symptoms of infection Laboratory analysis -Detection of antibodies to HIV -HIV viral load -CD4 T helper lymphocyte cell counts know difference between screening test and diagnosis: if you get a positive screening for HIV then you go to actual western blot test to check -below 200 per microliter of CD4 cells are considered to have full blown AIDS

chronic bronchitis: diagnostic criteria

History and physical examination Arterial blood gases Pulmonary function tests Pulse oximetry Sputum analysis

ulcerative colitis: diagnostic criteria

History and physical examination Endoscopic examination Complete blood count (anemia) -where its located and whether or not its continuous

ARDS diagnostic criteria

History and physical examination Laboratory studies -arterial blood gases -blood cultures (to detect sepsis) Imaging studies -chest radiograph

emphysema: diagnostic criteria

History and physical examination Pulmonary function tests Chest x-ray Hypercapnia/hypoxemia -could lose up to 50% of lung capacity before you even notice symptoms

influenza diagnostic criteria

History and physical examination Rapid viral assays 35% that the flu test can say you dont have the flu but you do

viral hepatitis: diagnostic criteria

History and physical examination • Detection of viral antibodies - Anti-HAV, Anti-HBV, Anti-HDV, Anti-HEV - Core and surface antigens • HBcAG, HBeAG • HBsAG • Bilirubin - Urine, serum (blood) • Prolonged clotting time

ovarian cancer: diagnostic criteria

History and physical examination - Bimanual palpation of ovaries • Surgery -Laparoscopic /other to explore peritoneal cavity - Laparotomy to obtain tissues for analysis • Laboratory studies - Cytologic examination of ovarian epithelial cells - Serum tumor marker levels

graves disease: diagnostic criteria

History and physical examination • Laboratory tests - Serum TSH, T3, and T4 levels - Free thyroxine level and increased uptake of radioactive iodine by the thyroid gland confirm diagnosis TSH will be low t3 and t4: high iodine: soak it up (t3 and t4)

asthma: diagnostic criteria

History and physical examination (very genetic) Pulmonary function tests (5 yrs or older)-give them albuterol Laboratory studies -CBC -ABG Chest x-ray

rH isoimmunization diagnostic criteria

History and physical examination • Screening tests - Identification of anti-D antigen and antibodies • Diagnostic tests - Amniocentesis to measure bilirubin - Fetal blood sampling to determine anemia

MI diagnostic criteria

History and physical examination, Laboratory studies (cardiac enzymes), ECG Angiography, Echocardiography, Chest radiograph cardiac enzymes are really important in diagnosing heart attack, tryptonin levels, breakdown of cardiac muscles -EKG: elevated ST and prolonged Q wave -most common cause of MI: atherosclerosis

down syndrome: diagnostic criteria

History and physical examination. Prenatal diagnosis: -Nuchal translucency -Quadruple test -Anatomic anomalies -Fetal karyotype -older mothers 35 or older higher risk for down syndrome

functional fecal incontinence diagnostic criteria

History of fecal incontinence (age ≥4 years) - Pattern - Related factors - Diet history - Emotional stress - Associated symptoms • Physical exam - Rule out organic cause instead of waiting for the child to say they have to poop we do schedule toileting times around meal times or are placed on toilet every couple hours giving meralax: gentle laxative and is dissolved in water to prevent constipation: helps attract more water in the colon which looses stool

urinary incontinence: diagnostic criteria

History of incontinence patterns and triggers • Physical examination • Specialized testing - Post residual bladder volume - Urodynamic testing • Endoscopic testing - Cystoscopy post residual bladder volume: have patient pee and measure amount of pee and do ultrasound of how much residual volume is left in the bladder if you have a female patient with a hysterectomy, the scan will read the patient as a male because it doesn't detect a uterus

diverticular disease: diagnostic criteria

History of symptoms • Physical exam - Abdominal tenderness - Distention lab analysis - Bloody stools - Low hemoglobin and hematocrit indicating anemia - Complete blood count indicating infection • Imaging studies - Inflamed and/or ruptured diverticula -elevated white blood cell count: infection

receptor binding

Hormones MUST bind to a receptor in order to elicit a response -a surface receptor requires a second messenger to elicit a response from the cell and without the appropriate receptor, the hormone moves along and has no impact on that cell -cell surface -intracellular can sit and cause an enzyme or can have a direct effect on nucleus of cell and cause protein synthesis

alteration in adaptive immunity

Host defense failure Hypersensitivity Autoimmunity Alloimmunity

altered nutrition

Inadequate or excessive digestion, absorption, transportation, or metabolism of nutrients

myelomeningocele

Incomplete closure with protrusion of meninges, CSF and spinal cord/nerve roots

hydrocephalus: clinical manifestations 2

Increased intracranial pressure • Increased blood pressure • Altered heart rate • Headache • Vomiting • Decreased level of consciousness • Papilledema

general manifestations of aging

Increased mortality Biochemical composition tissue changes Progressive decrease in physiologic capacity Diminished adaptation to environmental stimuli Increased vulnerability and susceptibility to disease hypertrophy: nail thickening, thick areas of skin fat on cells makes the cells more rigid and then they are no longer able to carry out their functions: lipofuscin

metabolic acidosis in parenteral nutrition diagnostic criteria

Laboratory findings - Arterial blood gas sampling to determine pH • pH <7.35 • Decreased HCO3- levels • Decreased CO2 (respiratory compensation) - Electrolyte balance - Anion gap

pathogen characteristics: fungi

Large organisms • Nuclear membrane, cytoplasm, organelles - Forms • Unicellular: yeasts • Multicellular: molds when you take an antibiotic it kills of normal flora that competes for prevention of fungi

obesity: treatment

Lifestyle interventions - Diet - Exercise - Behavioral modification • Pharmacologic therapy • Surgery learn not to reward with food medications to suppress appetite or increase metabolism surgery: needs to have modifications to it too like exercise plans, counseling for food issues

manifestations of infection

Local: heat, incapacitation, pain, edema, redness, lymphadenitis, purulent exudate • Systemic: fever, weakness, headache, malaise, anorexia, nausea

bones

Long bones - Diaphysis • Tubular midportion - Metaphysis • Broad neck - Epiphysis • Broad end • Epiphyseal plate - Medullary (marrow) cavity - Endosteum • Connective tissue • Lines outer surface of bone marrow cavity diaphysis: main constitution of the bone epiphyseal: growth plate and is responsible for growth medullary cavity: where your bone marrow is

Major Histocompatibility Complex (MHC)

MHC class 1 molecules recognize CD8 cytotoxic T lymphocytes MHC class 2 molecules: recognize CD4 Th1 or Th2 helper T lymphocytes -produced by human leukocyte antigen (HLA) genes cytotoxic T cells: make antibody on outside of cell and mount up an army and attack this infection in the body MHC II: macrophage is engulfing microbe and presents antigen on outside of the cell and help pull that antigen and pulls it out of the cells so helper t cells can be activated to remove it

pituitary

Made up of two lobes: - Anterior • Receives signals from the hypothalamus via circulation • Under negative feedback regulation - Posterior • Direct neural connection • Not under negative feedback regulation anterior: lutenizing hormone, adrenocorticotropin, growth hormone, prolactin PL, thyroid stimulating hormone, and folicle stimulating hormone things go from the hypothalamus anterior: negative if hormone level is high we are going to prevent it from being released and vise versa posterior: positive -oxytocin, and antidiuretic hormone talking to anterior and posterior pituitary through the blood vessels and shows where it releases and where it works in the body could have two step or three step process on releasing the hormone stimulating hormone: stimulate an end organ to release the actual hormone (know there is going to be a third step) antidiuretic: conserving water-keeping water in your body and it causes more urine to be released not being absorbed anterior: sends messages from the hypothalamus to the blood vessels posterior: uses neurons

emphysema: treatment

Maintain optimal lung function in order to allow the individual to perform the desired activities of daily life Smoking cessation Pharmacologic therapy Lung volume reduction or transplant

diverticular disease: treatment

Management of symptoms • Control of infection • Bowel rest • Prevention of complications • Surgical correction of perforated diverticula clear liquid diet until symptoms resolve and some cut out and resect where the diverticula occurs

shock treatment

Medical emergency -airway, breathing, circulation treatment depends on type: -cardiogenic -hypovolemic -septic -neurogenic -anaphylactic

multiple sclerosis: pathophysiology

Microglial activation -disease of the CNS neurons and is characterized by the degeneration of myelin -degnerative disease affects CNS and peripheral nervous system -no exact cause •Inflammatory T and B lymphocytes •Macrophages •CSF IgG and IgM Chronic neurodegeneration •Axonal injury •Demyelinated plaque formation -Optic nerves -Spinal cord -Brainstem -Cerebellum -Juxtacortical and periventricular white matter

skeletal muscles

Millions of individual muscle fibers that contract and relax to facilitate movement • 75% water, 20% protein, 5% organic and inorganic compounds • More than 600 in body • 2 to 60cm long • Fusiform muscles - Elongated muscles shaped like straps • Pennate muscles - Broad, flat, and slightly fan shaped

shock diagnostic criteria

No one test is completely specific or sensitive for shock History and physical examination Laboratory studies Diagnostic testing

phenylketouria: treatment

Nutrition - Lifetime dietary management - Avoiding phenylalanine (high-protein foods) - Amino acid (tyrosine), vitamin, and mineral supplementation • Pharmacologic therapy - Sapropterin dihydrochloride take out phenylalanine from the diet resulting in boring diet no meat, no dairy, no nuts, no bread, no beans, no potatoes take high-protein supplements that are processed that do not contain phenylalanine need to make sure they are getting all their vitamins and minerals as well and avoid aspartame (diet coke) sapropterin dihydrochloride: needs more research and not good for everyone

pathogen characteristics: parasites

Obligate parasites - Require host for metabolism and reproduction • Facultative parasites - Live on host - May survive independently • i.e., helminths obligate: must be in the host to operate -uses your energy and fuel facultative: staph and strep occur naturally on our skin and survive

electrocardiogram waveforms

P wave: Depolarization of atria via sinoatrial node: atrial systole P-Q interval: Depolarization of AV node and bundle fibers QRS: Depolarization of ventricles T: Repolarization of ventricles U: Repolarization of Purkinje fibers QRS: depolarization of AV node: ventricle systole PR segment is correct: SA node QT interval: sometimes take a long time to repolarize

phenylketonuria

PKU: reason why we started newborn state screenings where we look for newborn errors with metabolism

urolithiasis: clinical manifestations

Pain - Colic • Distention of collecting system or ureter • Acute, intermittent, radiating, excruciating - Noncolic • Distention of renal calices or pelvis • Dull, deep with varying intensity pretty severe pain, very acute onset on the back side about where the kidney normally be placed and the pain has tendency to radiate down the groin to the center of the body another term for kidney pain: colic noncolic: result of distention of renal calices

infection: pathophysiology 2

Pathogen binding to a human host cell receptor • Disease caused by 1. Direct destruction of the host cell by the pathogen 2. Interference with the host cell's metabolic function 3. Exposure of the host cell to toxins produced by the pathogen -binding to a cell and causing destruction to that cell -1) why you feel so crumy when you have an infection 2) inflammation is good to get rid of bad cells and bringing immune cells to infection to treat it but having it for a long period of time is not good 3) can release endotoxins and exotoxins which can cause more cellular destruction and injury near the site of infection

pathogen characteristics: bacteria

Pathogenicity • bacterial structural properties - Independent survival - Stimulation of inflammatory response - Resistance to phagocytosis - Endospores https://www.quora.com/What-are-the-various-shapes-of-bacteria

HAART-Associated Acidosis Pathophysiology

Pathophysiology - NRTI-mediated inhibition of DNA polymerase • Mitochondrial dysfunction - Promotes the formation of lactic acid • Hyperlactatemia - Build up of lactic acid in blood • Lactic acidosis - Reduced pH < 7.35

graves disease: treatment

Pharmacologic treatment - Medications that block thyroid hormone production - Oral thyroid hormone replacement therapy • Destruction of all or part of gland with radioactive iodine • Surgical removal of all or part of gland replace thyroid gland somehow medication rest of lives can go from hyper to hypo to treat it

diverticular disease: prevention

Prevention - Dietary alterations - Lifestyle alterations - Medications • Bulk-forming laxatives • Antispasmodics eat more fiber and eat fresh fruits and veggies to decrease constipation laxatives

influenza treatment

Prevention - Handwashing - Vaccinations • Symptomatic care - Hydration - Nutrition -Analgesics • Antiviral drugs -tamiflu: decreases the rate of sickness and not good for use on children

viral hepatitis treatment

Prevention - Vaccination - Handwashing • Symptomatic care - Fluids - Rest - Analgesics - Low-fat diet • Anti-viral drugs -not a vaccine for C but one for A and B

malaria: treatment

Prevention - Avoiding mosquitoes - Using a bed net during sleep - Wearing long-sleeve clothing - Using insect repellants (with DEET) • Antimalarial drugs - Quinolines - Antifolates - Artemisinins - Antimicrobials • Antipyretics DEET: use 35% and above for adults and below for children concentration

tinea: treatment

Prevention - Proper hygiene - Avoidance of contact with those infected • Antifungal drugs - Topical - Oral topical: used except for hair scalp or tinea capitis: use orals and takes months to eradicate

tuberculosis: primary vs secondary

Primary - Initial exposure - Bacterial growth - With or without symptoms - Active infection - Primarily in the lungs • Secondary - Reactivation of the primary disease after a long period of dormancy - Can spread to other organs

bone cells: osteoblasts

Primary bone-producing cells • Produce osteocalcin • Synthesize osteoid - Nonmineralized bone matrix • Can activate osteoclasts - Need intracellular Ca++ - Cytokine receptor activator nuclear factor kappa-B ligand (RANKL) help you build bone must break down our own bone in order to release calcium to make more RANKL: important in reabsorption of bone -important for the destruction of bone cells and helps activate osteoclasts -stimulated by Vitamin D: helps them produce osteocalcin -osteoid: helps secrete RANKL and is found in your bone component

renal buffer system

Primary regulator - Circulating fixed acids (non-volatile) - Require renal buffering and excretion • H+ elimination and HCO3- conservation • Tubular buffers - Phosphate - Ammonia • Potassium-hydrogen (cation) exchange • Chloride-bicarbonate (anion) exchange volatile:breath in or out (gases) -eliminating hydrogen ions and conserving bicarbonate

regulation of acid-base balance: plasma buffer systems primary systems

Primary systems • Bicarbonate • Protein • Potassium- hydrogen exchange - Buffering of free hydrogen ions • Incorporated to reduce free H+ • Released to increase free H+ proteins can bind to acids or bases depending what the body needs potassium-hydrogen exchange: not enough hydrogen in serum you pull potassium from serum into the cell and exchange for a hydrogen ion and vice versa

pathogen characteristics

Prions - Protein particles lacking DNA and RNA Bacteria - Single-celled microorganisms - Able to reproduce outside of host cell • Aerobic: requiring oxygen for growth •Anaerobic:not requiring oxygen for growth - Types • Cocci(spheres) • Bacilli(rods) • Spirochetes(spirals) - Treatment targets lagella: helps find cells to infect and move -most are single cell -anaerobic: most are in GI tract where there isn't oxygen -example of a rod shape -positive cocci: soak up the dye and show better in microscope

viral hepatitis: clinical manifestations

Prodrome - fatigue, anorexia, low-grade fever • Icterus - jaundice, hepatomegaly, clay stools, dark urine • Recovery - improvement with residual hepatomegaly

chronic bronchitis: clinical manifestations

Productive cough, purulent sputum, dyspnea, adventitious lung sounds, hypoxemia and hypercapnia cyanosis emphysema and chronic bronchitis go hand in hand

diverticular disease: pathophysiology

Prolonged pressure on large intestine walls alters structure and function • Weakness leads to outpouching • Gastrointestinal consequences - Decreased motility - Obstruction - Impaired perfusion Diverticulum along the wall of the colon - Small sac, outpouching • Diverticula - More than one diverticulum • Diverticulitis - Diverticula infected due to fecal matter diverticulum: one anytime fecal matter can get caught in these pouches can cause infection affects only the large intestine almost 50% over 60 age are affected have problems with constipation and results in holes most people don't know until they have rectal bleeding, ischemia, infections, obstructions and happen in large areas before they realize

ARDS phase 6

Pulmonary edema worsens, and inflammation leads to fibrosis, and gas exchange is further impeded.

infection: pathogenicity

Qualities that promote the production of disease • Involves multiple factors - Virulence - Infectivity - Toxigenicity - Antigenicity - Antigenic variability - Pathogenic defense mechanisms - Coinfection - Superinfection anitgenic variability: microorganisms changing DNA to prevent antibioitcs from working very important coinfection: having two infections at the same time superinfection: primary infection causes a secondary infection

bacterial meningitis: clinical manifestations

Rapid and severe onset • Severe headache • Photophobia • Nuchal rigidity • Decreased alertness • Loss of consciousness • Changes in mental status • Vomiting • Seizures • Fever • Leukocytosis • Anorexia

maintenance of bone integrity

Remodeling - Basic multicellular units - Repair of microscopic bone injuries - Existing bone is resorbed and new bone is laid down to replace it - Three phases: • Activation of the remodeling cycle • Resorption • Formation of new bone what happens to the bones when they are injured and how we go about remodeling them anytime a bone fracture occurs, we have remodeling that takes place existed bone is resorbed by osteoclasts and repaired and new bone tissue formed by osteoblasts

functional fecal incontinence: pathophysiology

Repetitive voluntary or involuntary passage of stool in inappropriate places in children ≥4 y old • Retentive incontinence (vs. nonretentive) - Withholding feces from pain or fear of defecation • Developmental triggers - Introduction of solid foods - Toilet training - Start of school attendance >4 because typically most kids are potty trained by the age of 4 afraid of pooping again due to pain starting school because some kids only like to poop at home rather than poop at school

pathogen characteristics: transmission process

Reservoir - Infected person, animal, environment • Portal of exit - Method of microorganism passage from reservoir • Mode of transmission - Mechanism for transfer of pathogen to host - Forms • Directcontact • Droplet transmission • Airborn transmission • Vectortransmission • Portal of entry - Access point for pathogen to host • Host factors -direct: touching things host factors: how good your immune system is, are you healthy, injury of skin, etc.

impaired diffusion

Restricted transfer of oxygen and/or carbon dioxide across the alveolar capillary junction Dependent upon: -solubility and partial pressure of the gas -surface area and thickness of the membrane

functional fecal incontinence: clinical manifestations retentive incontinence

Retentive incontinence - Retentive posturing - Excessive volitional stool retention - History of hard or painful bowel movements - Presence of large fecal mass in rectum - History of passing large-diameter stool -ignoring their brains and refusing to poop -volitional stool rentention

pathogen characteristics: rickettsiae, mycoplasms, chylamadiae

Rickettsiae,Mycoplasms,Chlamydiae - Characteristics of bacteria and virus - Obligate intracellular parasites • Rickettsiae - Obligate intracellular parasite - Gram negative • Mycoplasms - Lack a cell wall - Do not enter host cell for replication • Chlamydiae - Reproduce through binary fission - Obligate intracellular parasites don't fall under bacteria or virus because they have characteristics of both very common for elders in nursing homes: chlamydiae -within 48 hours you have release and killing of the cells

rH isoimmunization treatment

Risk reduction • Prevention - Administration of rH immunoglobulin to prevent maternal sensitization to fetal rH antigen • Treatment - Exchange transfusion to replace damaged red blood cells with healthy red blood cells -treat hyperbiliruemia too

respiratory buffer system

Second system to respond to changes in pH • Regulates CO2 - Volatile gas - Measured by H2CO3 in blood • Compensatory - Unable to completely restore homeostatic pH independently - Provides additional time for renal correction

complications of acute infection

Septicemia - Spread of microorganisms into the blood - May lead to septic shock • Systemic vasodilation (often due to endotoxin) leading to poor perfusion of organs • Chronic infection - Lasts several weeks to years - Results from • Incomplete destruction of pathogen • Sub-optimal inflammatory/immune response • Incomplete treatment in your blood vessels (systemic) septicemia fluid leaks out of your vessels and don't have enough fluids and leads to septic shock such a septic shock state: meningitis

tests of muscular function

Serum creatine kinase - Is increased when muscles are diseased or damaged. • Myoglobin - Is detectable in urine with acute muscle damage. • Electromyogram(EMG) - Uses sensitive needle electrodes; the summation of action potentials of the muscle are recorded. - Helps differentiate muscle diseases (myopathy) from peripheral nerve (neuropathy) and neuromuscular junction disorders.

chronic bronchitis: treatment

Smoking cessation Pulmonary rehabilitation Pharmacologic therapy -bronchodilators -steroidal anti-inflammatory drugs -mucolytic agents Supplemental oxygen

ARDS clinical manifestations

Tachypnea Dyspnea Retractions Crackles due to fluid accumulation Restlessness, anxiety -Early stage symptoms

hypothalamus: inhibiting hormones

Somatostatin (inhibits GH and TSH) • Dopamine (inhibits prolactin)

prostate cancer: diagnostic criteria

Staging for TNM classification - T1: a clinically inapparent tumor not palpable or visible by imaging - T2: the tumor is confined to the prostate - T3: the tumor extends through the prostate capsule - T4: the tumor is fixed or invades adjacent structures other than the seminal vesicles

urolithiasis: diagnostic criteria

Subjective findings - History of pain • Imaging studies • Laboratory analyses - Urinalysis - Analysis of calculi composition hematuria: blood in urine (may not actually see with human eye) x-ray: can see kidney stones and 1st line choice due to limited cost and less exposure to radiation

urolithiasis: treatment

Supportive treatment - Pharmacologic • Pain control - Calculi removal • Increased fluid intake • Reduction of calculi size • Surgical calculi removal - Prevention • Diet with foods low in calcium oxalate give them a strainer to pee in to catch the kidney stone and to see what the stone is made of and interpret the treatment plan more fluid=more urine=more likely to flush the stone out of the system

lymphoid lineage

T lymphocytes: cytotoxic (CD8) -helper (CD4) -suppressor/regulatory B lymphocytes -differentiate into plasma cells -antibody production natural killer cells: involved in innate immune response (not antigen specific) -T cells: create antibodies on the outside of the cell membrane and go looking for where this infection is and they help with inflammatory response like cytokines and attract the different kinds of cells NK cells: generalized cell killers that will gravitate to the site by cytokines and will target foreign invaders

the endocrine system

The collective group of cells capable of secreting hormones. • Note: Cells of the endocrine system are not the only tissues capable of secreting hormones! -pancreas and thyroid - Examples: • Immune cells secrete cytokines, which act as hormones. • Neurons release neurotransmitters which act as hormones.

bone cells: osteoclasts

The major reabsorptive cells of the bone • Are activate by RANKL from ostoblasts -really important in bone healing and bone remodeling -activated by the RANKL

tuberculosis: diagnostic criteria

Tuberculin skin tests (screening) • Chest radiograph • Sputum culture • Sputum nucleic acid amplification inflame it -feel the lump: positive test

negative feedback loop

Two mechanisms: 1. Low levels of hormone stimulate additional release of hormone. 2. High levels of hormone inhibit the release of hormone things get to high: try to decrease it things get to low: stimulate to increase t3 and t4 low: increase hormones because we need more to be produced -affected by environmental and body temperature, stress, nutrition, and the presence of specific body substances

bone minerals

Two phases of mineralization 1. Initiation-formation of the initial mineral deposit 2. Growth-proliferation or accretion of additional mineral crystals on the initial mineral deposits • Calcium and phosphate → hydroxyapatite - Ca10(PO4)6(OH)2 -as these mineralizations happen is when you see bone growth

metabolic acidosis in parenteral nutrition clinical manifestations

Typical - Anorexia - Nausea - Vomiting - Weakness - Lethargy - Confusion - Coma - Vasodilation - Decreased heart rate - Flushed skin • Extreme - Coma - Seizures - Cardiac dysrhythmia

tuberculosis: treatment

Vaccinations • Transmission prevention - Isolation in private room - Negative air pressure - Droplet precautions (masks, respirators) • Antimicrobials - Isoniazid - Rifampin - Pyrazinamide - Ethambutol or streptomycin • Directly observed therapy -4-6 months of several antibiotics

general manifestations of altered nutrition

Weight loss or gain (increased body fatness) Muscle wasting and weakness Changes in skin and mucous membranes Problems with wound healing Dehydration, diarrhea, abdominal pain Fatigue Other manifestations can occur depending upon specific vitamin and mineral deficiencies

historical background: Dr. Hans Selye

Worked to discover a new sex hormone. - Injected ovarian extracts into rats - Witnessed • Enlargement of the adrenal cortex • Thymic atrophy • Development of bleeding ulcers in the stomach and duodenal lining - Witnessed these changes with many agents and called these stimuli stressors.

down syndrome

a condition characterized by alteration in chromosome number -three copies of chromosome 21

non-hodgkin lymphoma

a generic classification made up of a broad range of B-cell and T-cell malignancies within the immune system -occurs more frequently than just HL -doesn't contain Reed-sternberg cells -cause is unknown usually

hodgkin lymphoma

a malignant but potentially curable disorder of the lymphoid tissue often characterized by painless, progressive enlargement of cervical lymph nodes -characterized by the presence of multinucleate giant cells (macrophages) called Reed-sternberg cells, or mononuclear giant cells called hodgkin cells surrounded by multiple other inflammatory cells such as neutrophils, eosinophils, plasma cells, small lymphocytes 5 types: first four as classic 1) nodular sclerosing 2) mixed cellularity 3) lymphocyte depletion 4) lymphocyte rich 5) nodular lymphocyte-predominant

staging

a process of classifying the extent of spread of neoplasms and refers to the tumors size, location, lymph node involvement, and spread t=tumor size, indicates the presence and size of the primary tumor n=node (lymph) involvement and indicates the involvement of regional lymph nodes m=metastates

tumor grading

a process of differentiating the level of anaplasia depicted by the tumor

1. Depolarization involves a. the rapid movement of sodium into the cell b. the movement of potassium ions out of the cell c. movement of potassium ions into the cell d. the absence of electrical activity

a.

1. What is an electrolyte? a. Ions dissolved in fluid. b. A form of energy resulting from the existence of charged particles. c. What plants crave.

a.

1. Which best describes the reason that young children are at higher risk for acute otitis media? a. the eustachian tubes of children are shorter and straighter b. the eustachian tubes of children are longer and at an angle

a.

coup/contercoup occurs due to which type of injury mechanism a. traumatic b. pressure c. excitation d. ischemic

a.

1. An adolescent has experienced alternating weeks of depression as well as weeks of laying in bed for long periods of time for over one year. Which is the most likely diagnosis for this adolescent. a. Bipolar Depression-Type I b. Bipolar Depression-Type II c. Cyclothymic Disorder

a. you don't have to have all three for the first bullet point

increased levels of blood CO2 is indicative of: a. acidosis b. alkalosis c. none

a. acidosis -arterial blood is the most oxygenated blood * most sensitive to PaCO2 and pH of blood -if CO2 is high, you need to increase the ventilation rate

in PCOS, which hormone excess is primarily responsible for hirsutism? a. androgen b. progesterone c. estrogen d. cortisol

a. androgen

1. Most cases of progeria are due to a autosomal dominant mutation of the lamin A/C protein (LMNA), however affected individuals rarely live long enough to procreate. How is this possible? a. There is a germline mutation event . b. Both parents have a mutated copy but are unaffected c. Individuals with progeria procreate at a young age due to early puberty.

a. there is a germline mutation event -LMNA: gives structure and support to the cell nucleus and people without this has issues with every single cell

penetrance

ability of a gene to express a mutation

cervical dysplasia

abnormal growth and disordered differentiation in dividing cells -like cancer

amenorrhea

absence of menstruation

muscle contractions

actin and myosin actin: thin red lines myosin: thick dark blue components when muscle is relaxed, actin and myosin separate contraction: actin and myosin pull together to make the muscle fiber thicker and shorter

active vs passive immunity

active: antibodies or T cells are produced after either a natural exposure to an antigen or after immunization -is long lived passive: preformed antibodies or T lymphocytes are transferred from a donor to a recipient -occurs naturally or artificially -is temporary or short-lived -IV and short because your antibodies didn't make them

male reproductive anatomy: ejaculation

actual ejection of it

brain regions associated with PTSD

actual fear reaction that reactions in prefrontal cortex and amygdala and release different types of stress hormones that suppresses the hypothalamus and result is creation of neuron that affects the thalamus, etc. -tend to persist in that state longer because its hard to go back to homeostasis

acute verses chronic

acute inflammation: an expected body response to injury chronic inflammation: altered inflammatory response acute: alters your cells in your body chronic: the structure of your lungs completely changes with asthma because of your cells constantly interacting with inflammatory mediators -acute is short response while chronic changes the structure/tissue of the body

classification of otitis media

acute: need to treat effusion: don't really need to treat perforation: burst of eardrum and fluid rolls out of the ears and eardrum has ruptured takes about a week to heal and with antibiotics

PTSD clinical manifestations

adults -avoidance and suppression of thoughts/emotions -nightmares -flashbacks children -separation anxiety -crying, screaming -trembling -regression -withdrawal -disruptive behavior -inattentiveness

effects of anorexia nervosa on the body

anemic: not taking in enough iron -kidney stones: because electrolytes are messed up

movement of joints

anytime you have a ball and socket joint come together you will always have 6 possible movements

mechanisms of cell death

apoptosis: cellular suicide, programmed cell death necrosis: disorderly process associated with inflammation -apoptosis: happy death -necrosis: netosis (sad death)

coronary circulation

atherosclerosis, blocked, etc. -blood supply to the heart is very important because its a muscle and needs blood and oxygen in order to work properly -don't need to memorize all of this -considered part of the systemic circulatory network

bacterial meningitis: diagnostic criteria 2

bacteria infections are more severe than viral infection

hypothalamus

autonomic control in emotions

somatosensory processing

awareness, recognition, identification, and interpretation of stimuli -primary processing in the thalamus -processing refined in the somatosensory cortex -interpretation in the somatosensory association areas tells you what you need to do to respond to a stimuli

characteristics of bone

axial skeleton: -80 bones -skull -vertebral column -thorax appendicular skeleton -126 bones -upper and lower extremities -shoulder girdle -pelvic girdle appendicular: more responsible for movement especially for upper and lower extremities

1. A person has low sodium levels. How will the renal system respond? a. Stimulate urination b. Stimulate the renin-angiotensin-aldosterone system c. Reduce the glomerular filtration rate

b

1. A patient receives an injury to the hippocampus. What problem would you expect this patient to experience? a. Emotions b. Long-term memory c. Empathy d. Short-term memory

b.

1. Which person is the better choice for abortive (prevention) treatment for migraine headaches? a. a person who experiences relief with Ibuprofen for headaches that are twice a month b. a person who experiences 2 headaches a month that are unusual migraine headaches

b.

1. Which statement about the pathophysiology of meniere disease is true? a. Bacterial infection of the inner ear which affects the cochlea and labyrinth. b. Swelling of the membranous labyrinth in the cochlea and vestibular system of the inner ear. c. Sensorineural hearing loss from a genetic birth defect.

b.

what is an antigen (Ag)? a. a protein made by B cells in response to a foreign substance b. any substance that induces an immune response c. a protein secreted by immune cells that have an effect on other cells d. i have no idea

b.

which of the following area of the spinal cord contains 12 segments? a. cervical b. thoracic c. sacral d. lumbar

b.

1. What is the source of LH and FSH? a. Hypothalamus b. Anterior pituitary c. Posterior pituitary d. Ovary

b. LH and FSH: anterior pituitary

1. Which node is responsible for firing the initial electrical impulse to stimulate a cardiac contraction in the heart? a. Bundle of HIS b. SA node c. AV node d. Purkinje fibers

b. SA node

1. Neurons that carry sensory information to distant parts of the brain and spinal cord are called a. efferent b. afferent c. interneurons d. extraneurons

b. afferent

at what site does diffusion occur? a. nasopharynx b. alveoli c. trachea d. bronchi

b. alveoli

1. Which is a treatment for osetomyelitis? a. Immobilization. b. Antibiotics. c. Joint replacement surgery. d. Chemotherapy.

b. antibiotics best way: biodegradable so the joint can absorb the antibiotics -using pressurized methods to push oxygen through the bloodstream and to the bone: hyperbaric oxygen treatment

1. Age-related changes affecting neurologic functions include a. Increased myelin b. decreased number of neurons c. Enhanced nerve conduction d. Improved axonal repair mechanisms

b. decreased number of neurons

1. Which is the most common cause of myocardial infarction in adults? a. Hypertension b. Diabetes Mellitus c. Atherosclerosis

b. diabetes mellitus

reproductive atrophic changes in menopause is related to which hormonal deficiency? a. progesterone b. estrogen c. testosterone d. DHEA

b. estrogen

what would happen to PaO2 levels at high altitudes? a. it will increase b. it will decrease c. it will remain the same

b. it will decrease

1. Otitis media (ear infection) is located in the a. outer ear b. middle ear c. inner ear

b. middle ear

1. Which pain stimulus originates outside of the central nervous system? a. neurogenic b. nociceptive c. neuropathic

b. nociceptive

what is the primary risk factor for infertility as a consequence of pelvic inflammatory disease? a. impaired ovulation b. obstruction of fallopian tubes c. inadequate endometrial development d. anovulation

b. obstruction of fallopian tubes

1. Which cell is favored in osteoporosis? a. Osteoblasts b. Osteoclasts c. Osteocytes

b. osteoclasts

what is the site of spermatogenesis? a. vas deferens b. seminiferous tubules c. epididymis d. seminal vessicles

b. seminiferous tubules

shunting

blood movement across the chambers -direction of blood movement across chambers will go from the area of greater to less pressure

1. In which area of the kidney would you find a nephron? a. Major calyx b. Juxtaglomerular apparatus c. Medulla d. Capsule

c. medulla

1. This alteration of eye movement is often referred to as a "cross-eyed". a. nystagmus b. amblyopia c. strabismus d. myopia

c.

would pneumonia be an example of altered ventilation or diffusion? a. ventilation b. diffusion c. both ventilation and diffusion

c. both ventilation and diffusion

1. A reduction of colonic transit time can lead to which of the following conditions? a. Dehydration b. Anemia c. Constipation

c. constipation

define hypoxia a. decreased O2 in arterial blood b. decreased O2 at the cellular level c. decreased CO2 at the cellular level d. increased CO2 in the blood

c. decreased O2 at the cellular level

1. Which is the preferred initial treatment for elevated BP/pre-hypertension? a. Beta Blockers b. Diuretics c. Diet and lifestyle modification

c. diet and lifestyle modification

open vs close fractures

can't see bone but can see laceration: bone fragment popped through the skin and resided back inside the body -open: laceration or see bone -no bone poked through skin: closed -displace: out of alignment in the joint: intracapsular

cell proliferation vs apoptosis

cell proliferation: ligands comes onto the cells and tells cells to create more cells apoptosis: ligands come onto the cells and tell them to die (good when cells are old and need to make stronger better cells) -cancel allows this because it tells cells not to die when they need to

inflammatory mediators: within WBC's

cell-derived -mast cells -rapid response at the site of injury -production and immediate release of chemical mediators through degranulation -release of chemical mediators in the form of extracellular granules (grain-like particles) -cytokines, histamine, chemotactic factors, leukotrienes, prostaglandins -basophils -works through degranulation similar to mast cells --release brain-like particles (degranulation) allowing cells to become attracted to these granules

functional

cells aren't working properly could result in issues with reproductive function

depolarization vs repolarization

change in polarity in which ions shift resulting in a sudden change in voltage -fast sodium channels open, allowing a rapid influx of sodium (positively charged) ions into the cell and as the cell voltage peaks, the fast sodium channel closes and the cell moves into the early stage of repolarization repolarization: bascially a regrouping phase in which the cell membrane becomes polarized again with a positive charge on the outer and a negative change on the inner surface of the cell membrane

carbohydrate digestion

cholesterol attaches to the fiber and is excreted out of the body

Crohn Disease Pathophysiology

chronic inflammation anywhere throughout the GI tract but most commonly in small intestine -non-continuous penetrating ulcerations and fibrosis -impaired intestinal absorption and bowel obstruction can result -most common in the small intestine -involve so much inflammation and can cause adhesions where they stick together and cause disruptions in the intestinal tract -inflammatory bowel disease

example of negative feedback loop

circulating thyroid hormone levels (T3+T4) alert the hypothalamus and anterior pituitary to increase or decrease thyrotropin-releasing hormone and thyroid stimulating hormone

bone reform

close as it was before but rarely heals perfectly

crohn disease: granuloma

clusters of WBCs that form and cause erosion of the lining of the intestines -stool comes out of the abdomen -fitulas: where you are draining stool from one to the other parts of the abdomen

major sites for absorption in the GI tract

colon is absorbing water thats all

chromosomes

composed of double-stranded DNa containing threadlike sections of genes most commonly found in the nucleus

functional concepts of altered health

concept: a general idea that can be applied to similar situations functional concepts of altered health: meaningful clusters of current knowledge about human health and disease conceptual approach: applying general processes to specific diseases

endometriosis

condition involving endometrial tissue that is located outside of the uterus, can result in pelvic adhesions, distortion of pelvic structures, and dysmenorrhea

SA node

conduction system involving specialized myocardial cells -pacemaker which generate a rhythmic impulse in the atria

developmental disorders

congenital disorders -environmental factors (chemicals, hormones) -organogenesis (development of organs) -teratogens (ex. fetal alcohol syndrome) -maternal infection (TORCH) -ionizing radiation -maternal nutrition

mean arterial pressure

considered an adequate measure of systemic tissue perfusion is one-third the pulse pressure plus diastolic pressure

hypothalamic-pituitary axis

controls the synthesis and secretion of many hormones

protoncogenes

conversion from a normal gene to one that induces neoplasia depends on the mutation -important normal genes in the body with a vital role in regulating cell function -considered precursor genes in the body with a vital role in regulating cell function -point mutation -translocation -gene amplification

hypothalamic-pituirary-adrenal axis

corticotropin: is the one that is very important in stress model cortisol: negative Hypothalamus secretes corticotropin-releasing hormone (CRH) CRH acts on the pituitary gland to induce the production of adrenocorticotropic hormone (ACTH) ACTH acts on the adrenal cortex to induce the release of cortisol

atrophy: type of neuronal injury

decrease in the size of the cell (neuron)

which is/are chemical mediators derived by plasma? a. complement system b. kinin system c. clotting system d. all of the above

d.

of the following cells, which cell would be the first to arrive at an infection/injury site? a. basophil b. monocyte c. dendritic cell d. neutrophil e. eosinophil

d. -slower and takes more time -things that your body already have and produce antibodies too -takes time for the cells to go to the lymph nodes -IgG, IgM cells etc. that attack antigens

Altered nutrition can be caused by a. overnutrition b. undernutrition c. altered metabolism d. all of the above

d. all of the above

which branch of the nervous system controls inspiration? a. central nervous system b. peripheral nervous system c. strictly muscle control d. both the central and the peripheral nervous system

d. both the central and the peripheral nervous system

1. Which is a function of carbohydrates? a. insulation b. reduces serum cholesterol c. help develop genetic material d. build body tissue

d. build body tissue

1. Which is NOT a function of water in the digestive tract? a. lubrication b. dissolves food c. transports nutrients and waste d. digests food

d. digests food

1. Describe the appearance of red blood cells with iron deficiency anemia. Select all that apply. a. macrocytic b. microcytiic c. hyperchromic d. hypochromic

d. hypochromic

1. What outcome would be expected in the absence of FSH production? a. Increased progesterone levels b. Ovulation c. Shedding of the endometrium d. Inhibition of follicular development

d. inhibition of follicular development

1. What is the primary site of food absorption? a. mouth b. colon c. stomach d. small intestine

d. small intestine

point mutation

damages a single nucleotide base pair in the DNA that leads to the development of altered, unregulated proteins in somatic cells -can occur when exposed to carcinogens

hypertension

damages your blood vessels over a large period of time and leads to nutrients not getting to your organs and leading to organ damage -hereditary

ARDS phase 4

decreased blood flow and fluids in the alveoli damage surfactant and impair the cell's ability to produce more -resulting in alveoli collapse, impeding gas exchange, and decreasing lung compliance

diagnosis

determined by -clinical manifestations -tests -lab -imaging -diagnostic criteria -ICD-10 diagnoses: determined by what we see -ICD-10: diagnoses and you have to figure out what the code is so we can bill the insurance

chronic renal failure

determined by the glomerulin and filtration rate mild: GFR 60-89 mls per minute moderate: 30-59 mls per min normal: GFR: 90 mls per min severe: GFR: 15-20 mls per min renal failure: < 15 mls per min potassium levels, creatinine: all be elevated low pH, low bicarb

treatment

determined by: -pathogenesis (usually will have similar signs and symptoms) -etiology -clinical manifestations goal: eliminate or reduce the cause of disease

stroke treatment

emergency management -reduce cerebral edema and increased intracranial pressure -rehabilitation

cingulate gyrus

emotional memories -coordinates sights and smells with previous emotionally charged memories, involved in the emotional reaction to pain and impacts aggressive behavior

amygdala

emotionally charged memories -really strong emotions -senses danger, and controls persistent negative thoughts, especially fear and aggression, are active during stress, anxiety, and depression, connects with hippocampus, septal nuclei, thalamus, and prefrontal cortex

anterior cingulate cortex

empathy, impulse

population health

endemic: predictable incidence and prevalence epidemic: dramatic increase in incidence above the endemic rate pandemic: epidemic spread across continents -endemic: spread out throughout the country -epidemic: one certain area localized -pandemic: outbreaks of disease all over the place

ingestion

endocytosis: the process used to transport large substances into a cell -ex. phagocytosis, pinocytosis -pinocytosis: is just smaller matter -receptor-mediated: receptors sites and allow for particles to come inside your cell

Vascular response to inflammation

endothelial cells -form tight junction in the inner lining of blood vessels -connected to basement membrane -confines blood cells and plasma -separation from the tissues of the body -line your vessels -normally do not allow things to leak out of them and helps separate our vessels and tissues from our body

vascular response 2

facilitated by chemical mediators -potent substances in plasma and cells -responsible for clinical manifestations seen in inflammation -promotes widening and loosening of blood vessels at the site of injury -when they are released, things happen -cause increase permeability to let vessels leak out and to help promote healing

leiomyomas

fibrous tumors that may form in the uterus, distort endometrial cavity

cerebral atrophy: clinical manifestations

focal: localized to a particular region global: affecting the entire brain focal: head injury or bleed or stroke and you're going to damage or loss per of the brain global: alzheimers

transcription

forms one template of DNA and is where the transfer of genetic code from one type of nucleic acid to another -other strand serves as a complement to the strand used in this process

proliferation

generation of new, daughter cells divided from progenitor (parent) cells

tumor suppressor genes

genes that prohibit over proliferation of cells and regulate apoptosis -the genes that regulate the rate at which cells divide and die

trait inheritance

genotype -genetic make-up of an individual -phenotype: observable traits

what is the DSM-5?

gold standard for diagnosing mental disorders with patients

balance processes 2

hair cell stimulation: neural signal transmitted to the cerebellum via the vestibular branch of the acoustic cranial nerve -integrated in the vestibular nuclei -visual, somatic input -modulates eye and reflex movements newborn screening we test for hearing right before they are discharged

chromosomal translocation

have also been implicated in the activation of oncogenes -chromosome breaks, relocates, and united with another chromosome

individual health

health-illness continuum -health -perveived wholeness of body, mind and spirit (physical, emotional, psychological, spiritual well-being) -illness: state of suffering or distress health is sometimes subjective because its their opinion and decision where they think they are on the scale of health

PKD treatment 2

hemodialysis during end-stage renal taking blood from the periphery and putting it back into the same vessel into the bloodstream and if its for a long time they will put in a graft hemodialysis: usually does it every couple days takes less than an hour

impaired circulation: injury to vessels

hemorrhage: the loss of blood through the vessel wall

occult

hidden blood in the stool if the tumor is along the ascending colon

A.L., a 25-year-old Native American female, is pregnant with her second child. She was exposed to a child with chicken pox at a recent family event. A.L. has not had chicken pox, and she has not been immunized. Her 4 year old son was immunized (initial and booster) against the varicella virus that causes chicken pox.

high risk for varicella virus -chicken pox spread through airborne so breathing air can get it -low risk for child -can give varicella immunoglobulin to prevent her from it and her child -take blood sample and titer to test for antibody and varicella in her blood

stem cells

highly undifferentiated units that have the potential to divide into progenitor cells, the daughter cells, which can then mature into more differentiated unites with a specific function

paraneoplastic syndrome

hormonal, neurologic, hematologic, and chemical disturbances in the body not directly related to invasion by the primary tumor or metastasis

disjunction

how chromosomes separate during mitosis and meiosis in this process

adaptive immunity: humoral and cell-mediated immunity

humoral: B cells and circulating antibodies -causes direct inactivation of a microorganism or the activation of inflammatory mediators -protects against bacteria and viruses cell-mediated: T cells -T-cell differentiation -kills targets directly or stimulates the activity of other leukocytes -protects against viruses and cancer -t cells produced in the bone marrow and mature in thymus

benign prostatic hyperplasia: pathophysiology

hyperplasia: increase in cell size benign: not cancer -too much trophic stimulation stimulated by DTH testosterone and estrogen -problem with sexual function and urination -cause: unknown -prostate gland -located below bladder -surrounds the urethra -size of the walnut -major contributor to semen -hyperplastic enlargement -triggered by increased dihydrotesterone and estrogen -periurethral proliferation of epithelial and smooth muscle cells, stroll fibroblasts

specific antibodies

igG: kind of memory antibodies and will be produced later in an infection so that the body will recognize the particular antigen again IgG: most prevalent: most of protective activity against infection -crosses the placenta IgA: mostly in secretions -most of protective activity in body secretions IgE: most rare -mediator of many common allergic responses -defends against parasitic infections IgD: not well known -functions as one type of B-cell antigen receptor IgM: largest -first antibody produced during the initial or primary response to an antigen -levels raise, then later secondary response has IgG levels raise with this one

reed-sternberg cells

in classic HL, these cells originate in the cell components of lymph nodes following a B-lymphocyte lineage

AIDS cases

incidence is blue line -1986-2002 -prevalence: how many people are living with AIDS (green line) death: mortality rate (red line) morbidity: cannot function like they normally do more people living with aids but less people getting new diagnoses

epidemiology

incidence: rate of disease occurrence at any given time -prevalence: number or percentage of a population that is affected by a disease at a given time -incidence: 400,000 cases at any given time -1 baby out of 691 have down syndrome -prevalence: who all has the disease (more disease, more prevalence) -How to get rid of prevalence 1) cure 2) die -cure: increases prevalence because they have chronic illnesses and are more living with the disease -incidence: new cases -prevalence=incidence x (duration of disease)

burn pathophysiology classification: superficial partial-thickness

include epidermis and not to the dermis

spina bifida occulta

incomplete closure vertebrae without protrusion of the meninges spinal cord

meningocele

incomplete closure with protrusion of meninges and cerebrospinal fluid

autonomic nervous system

increases heart rate -increase blood pressure -increase respiratory rate -increase pupil dilation -increase sweating -blood flow is increased to the muscles, heart, and lungs in preparation of "fight or flight" -gastric function decreased to shunt blood to vital organs -altered blood flow, decreased oxygenation to gastric tissues, and prolonged cortisol exposure may result in stress ulcers of the gastrointestinal tract

nutrition

ingestion and use of nutrients for energy

internal vs external fixation

internal fixation: hammer nails the length of the bone and will stay in place so they don't even need a cast external: severe fractures

forced expiratory volume in 1 second (FEV1)

is the maximal amount of air that can be expired from the lungs in 1 second

forced vital capacity (FVC)

is the maximal amount of air that is exhaled from the lungs during a forced exhalation

total lung capacity (TLC)

is the total amount of air in the lungs when they are maximally expanded and is the sum of the VC and RV

residual volume (RV)

is the volume of air that remains in the lungs after maximal expiration

prefrontal cortex

judgment, decision-making -higher level skills -controls judgment decision-making and problem solving involved in emotional responses; controls amygdala during stress, involved in short-term memory and in retrieving long term memories

glaucoma

keep producing more and more fluid and fluid cannot drain because of the blockage and keeps damaging your optic disk

a comparison of common pathogens

know if they have unique structure, how they replication, toxin production, normal treatment? antivirals: don't use much because they kill the virus cells and the virus resides in our cells and kill our cells

more DMD diagnostic criteria

lab testing -elevated serum creatine kinase (CK) -10,000-50,000 -enzyme concentrated in muscle-released with muscle damage -elevated ALT & AST-released with muscle damage -muscle biopsy: absence of dystrophin -electromyography (EMG): confirms muscle disease, not specific -newborn screening, testing, and family planning -test moms who have DMD in their family history -test kids early for innovative treatments

cretinism

lack of thyroid hormone in an infant; if untreated, leads to mental retardation

signals regulating food intake and energy homeostasis

leptin produced by the fat cells to tell you that you are not hungry anymore obese/overweight people have non-functional leptin cells or too many that are easy to ignore -know leptin, ghrelin, insulin

spinal cord syndrome: brown-sequard syndrome

light purple shading

cellular components of adaptive immunity

lymphoid progenitor cells: -T lymphocytes -cytotoxic -helper -suppresor -B lymphocytes -differentiate into plasma cells -antibody production -Natural killer cells stem cell: transform several different types of cells -can either transform into common lymphoid progenitor -know the chart -carrier ones that go out and seek different types of antigens and bring them back to the lymph system where antibodies are formed (dendritic cells, macrophage, mast cell) -what cells produces the antibodies? B cells -innate: come from the common myeloid progenitor (all of the cells used in this system)

lymphomas

malignant lymphocytes or lymphoblasts (hodgkin or non-hodgkin) -developed from WBCs and lymph tissues -form solid organ tumors in the lymph tissue and later in the bone marrow

leukemia

malignant neoplasms of the blood and blood-forming organs -overproliferation and lack of differentiation in white blood cells, but could also be other cells too -replaces cells in the bone marrow with blast cells (immature proliferating neoplasms)

mitochondrial gene disorders

maternal link -transmitted to daughters and sons -expression: variable -carrier: variable -noncarrier: variable -different from the transmission of nuclear genes -men don't pass this down to children because their sperm doesn't have mitochondrial genes -mostly passed through maternal gametes (ova) and are transmitted only through female or maternal lines (matrilineal inheritance pattern) -leigh syndrome heteroplasmy: refers to the random distribution of mutant mitochondrial genes in tissues of an individual and between related individuals

sinus cavities of the skull

maxillary sinuses or frontal sinuses -babies don't really have sinus infections because they only have pea size maxillary sinuses -frontal sinuses grow after the age of 2 so thats where sinuses come -some people don't even have frontal sinuses

systemic manifestations of inflammation

may include fever, fatigue, weight loss, headache, lethargy, increased circulating leukocytes, and plasma proteins -affecting your whole body

renal buffer system: tubular buffer system-ammonia

metabolic acidosis: smelling stinky urine

reproduction

mitosis: DNA splits in half and create identical daughter cells meiosis: especially with sperm, DNA doesn't split all the way and then create further into x and y to create the sex (1 exact duplicate of what it was before) -created differentiation unlike mitosis

ROP diagnostic criteria: stage 2

moderately abnormal blood vessel growth -spontaneous resolution -likely develop normal vision

regulation of mood

mood: internal psychological state; emotions emotions: brief, quickly moving minute by minute temperament: stable representation of outlook -often referred to as one's personality

more references to joints

more bone erosion and lots of fluid in the joint and pannus that makes the joint more immovable

chronic leukemia

more gradual onset and are found commonly in middle and older adults -acquired mutations resulting in clonal B cells or hematopoietic stem cells disrupted along the differentiation pathway

acute otitis media: (AOM) pathophysiology

more kids get adults because eustachian tube is shorter and a straight shot where as in adults the eustachian tube is more an angle and longer kids: 8-10 upper respiratory infections a year -allergies, upper respiratory infections, and parents are smokers give for more snotty noses -infection in the middle ear -effusion (fluid) in middle ear creates an optimal environment for pathogen growth -associated with upper respiratory infections

sex-linked

mutation located on the sex chromosomes -gender difference in inheritance -most are linked to the X chromosome -males more likely to be affected -gender based -ignore picture A -females are generally carriers in sex linked disorders because they have 2 X's -male is affected by the second X that mom carries -what's wrong with picture A? male can't be carries either you have it or you don't

sex-linked picture

mutation located on the sex chromosomes -gender difference in inheritance -most are linked to the X chromosome -males more likely to be affected -mitochondrial: only passed by the mother because they are in the ova

immune contraction

naive: never been interacted with an antigen present to T and B cells T: tons of new cells and as time passes your immune system slows down until they meet again flu: vaccine is viral cells that are dead and cannot hurt your body and this allows activation of immune cells and you feel kinda sick from the activation of your immune system which is normal which is during clonal expansion

huntington disease (HD)

neurologic disorder caused by degeneration of the basal ganglia and cortical regions of the brain -autosomal dominant transmission (50% get it if parent has it) -caused by a defect in the huntingtin gene on chromosome 4 -results in a triplet cytosine-adenine-guanine (CAG) expansion mutation in the hunting tin (HTT) gene with an increased number of mutations associated with earlier onset of the clinical manifestations of the disease

neuronal impulse transmission: neuron components

neuron: fundamental unit of the nervous system -composed of one axon, central cell body, and a variable number of dendrites, neurons are excitable cells that contribute to the highly specialized cell function of the transmission of nerve impulses throughout the body components: -soma: cell body-contains processes supporting the metabolic demands of the cell -dendrites: multiple, branched extensions of the cell body that transmit impulses to the cell body -axon: carry impulses away from the body dendrites: can connect to cells beside it axon: can be very very long and can travel all the way through the spinal fluid turbo boosters: node of ranvier

granulocytes

neutrophils: most abundant leukocyte in circulation -also called polymorphonuclear leukocyte (PMNs) basophils: involved inflammatory and allergic responses eosinophils: involved in combating parasitic infections and allergic response --blue circle cell (basophil): really showing what degranulation looks like and is when an eosiniophil and basophil vomit out or eject certain particles that are cytotoxic to foreign invaders or even our own cells

stress hormones

norepinephrine: neurotransmitter -stress stimulates the release of CRH from the hypothalamus and then CRH stimulates the pituitary to secrete adrenocorticotropic hormone which in turn stimulates the adrenal glands to secrete cortisol cortex is outer layer, medulla is inner layer ( in charge or norepeniphre and epinephrine) and cortex is in charge of hormones catecholamines: norepinephrine, epinephrine, dopamine -triggered by the sympathetic nervous system which also acts on the adrenal glands -induce a neurologic response to receptive organs -release from presynaptic neurons -epinephrine: secreted by adrenal medulla -glucocorticoids (steroid hormone) -cortisol: needed to increase metabolism and regulate blood glucose levels for energy and also acts as a potent anti-inflammatory

fat digestion

not enough fiber: constipation

excretion

not enough water leads to constipation

common blood tests used to detect acute inflammation

not going to diagnose you 100% just general tests -more white blood cells: more infection erythrocyte sedimentation rate: putting whole blood into a test tube and persons from lab is watching blood cells fall to the ground of the tube good test for inflammatory but C-reactive protein is better ESR-not real specific

ménière disease: pathophysiology

not sure why you have more volume -labyrinth has too much endolymph and it gets enlarged -altered vestibular function -increased volume of endolymph leads to dilation of the membranous labyrinth of the inner ear -rupture of membranous labyrinth allows mixing of endolymph and perilymph

monosomy

occurs when nondisjunction results in cells with one copy of a chromosome instead of two if occurs with autosomes, no life -can have life with sex chromosomes but can lead to huge mental and physical defects -turner syndrome

cellular and systemic alterations in aging

overproduction of red blood cells and the blood could get very thick and not circulate well: polycythemia vera too many platelets which can cause clotting issues: primary thrombocythemia

example of positive feedback loop

oxytocin levels during labor and delivery increase release of additional oxytocin until the birth of the baby which decreases stretching of the cervix and the cycle is interrupted

dysmenorrhea

painful menstruation

cell-to-cell communication

paracrine: hormone producing cell and go from cell to cell with receptors on those cells -hormones are produced in a cell, secreted, and act directly on nearby receptive cells autocrine: can make hormones by itself and has receptors to communicate to make them -the same as the paracrine pathway except that the receptor cells also are secretory cells so in essence the cell is able to produce the hormone and exert an effect on itself

transport mechanisms

passive transport -diffusion: PARTICLES evening out on the concentration on each side; one more on one side going to move to the other side -osmosis: WATER is moving so that the concentration is on the same on either side -no energy required

C.J., a 19-year-old White female, has a history of hay fever, which seems to get worse during the summer months. After a weekend camping trip, she developed difficulty breathing and needed to seek care for these symptoms, which were diagnosed as an exacerbation of asthma.

patient is having bronchoconstriction patient has allergens chronic problem asthma treated with bronchodilators to open their airways

process of altered elimination

patients who are having problems with elimination often times not only are they uncomfortable physically but emotionally issues too

male reproductive anatomy: erection

penis gets enlarged by relaxation of the smooth muscles and fills it causing hardness (blood) and should be sustained until emission

blood pressure (BP)

peripheral vascular resistance: how tight are these vessel walls are they contracted or relaxed -pressure or tension of the blood within the systemic arteries -arteriosclerosis diastole: depending on remaining resistance at rest

neurons of the somatosensory system

periphery up to our somatic up to our brain-general somatic afferent neurons special somatic: helpful for us to determine where is our body and how it is moving general visceral: located around our organs and they don't really feel pain and it really is fulness and discomfort and stretch but our brain thinks of it as pain

major depressive disorder pathophysiology

pervasive and persistent low mood accompanied by low self esteem anhedonia (loss of pleasure) -biologic, psychologic, and social factors -genetic heritability (40% women, 30% men) -neurotransmitter deficiency: norepinephrine, dopamine, serotonin

neuronophagia: type of neuronal injury

phagocytosis and inflammatory responses caused by a dead neuron damaging neighboring cells

SLE treatment

pharmacologic: drugs to control inflammation -lots of anti-inflammatory drugs and immunosuppressants (more severe side effects for these)

acromegaly: treatment

pharmacologic: drugs to reduced growth hormone secretion nonpharmacologic: radiation therapy to promote death in growth hormone hyper-secreting cells surgical: removal of tumor (adenoma) causing hyper secretion of growth hormone

anaphylactic reaction: clinical manifestations

phase 1: due to short acting chemical mediators -bronchospasm: difficulty breathing -vasodilation: skin flushing -urticaria: itching -angioedema: sudden subcutaneous edema phase 2: due to later onset, longer acting substances -difficulty breathing -severe hypotension -severe edema -may result in anoxia and death -urticaria: hives -phase 2: severe bronchospasm which reoccurs and severe hypotension

acute sinusitis: diagnostic criteria

physical examination -general laboratory tests -erthyrocyte sedimentation rate (ESR) -C-reactive protein (CRP) test -white blood cell (WBC) count -sinus radiographs pretty easy to diagnose -usually lasts 7-10 days (virus) and then lasts more after (sinus

chemical mediators: kinin system

plasma-derived -source of potent vasoactive chemical mediators important in: 1) vasodilation, vasoconstriction 2) cell migration 3) pain response -amplifies inflammatory response -triggers mediators (ex. cytokines) -potent source of vasoactive chemical mediators -makes the response even bigger

depression

postpartum: 1-3 months after you have your baby depression has a lot to do with anatoneon -walking around like a zombie, going through the motions, no relationship or contact with other people:catatonic atypical: oversleeping, overeating, etc

a nursing student receives a PPB/TB test prior to entering a clinical course. this is an example of: primary prevention secondary prevention tertiary prevention

primary prevention

levels of prevention

primary prevention: prohibits a disease from occurring secondary prevention: early detection and treatment through screening tertiary prevention: treatment after disease detection primary prevention: immunizations -secondary: TB: screening method indicating whether you have the disease -tertiary: don't get worse than they already area (OT, RT)

cardiac hypertrophy primary vs secondary

primary: inherited non-sex-linked genetic trait secondary: due to an underlying condition increasing left ventricular workload -increase in left ventricular muscle mass results from an increase in myocardial cell size

stenosis

problem in which narrowing of the valve occurs making the valve unable to open adequately

gene amplification

process of altering the chromosome by accelerating the replication of genes

male reproductive anatomy: emission

process of moving sperm and semen through and ejaculation erection and emission is parasympathetic key in on process of emission

You are the parent of a 6-month-old child who is very fussy and tugging on her ears. You take her in to the clinic and are told that she has otitis media, a middle ear infection. From your reading and experience regarding infectious processes answer the following questions: 1. Outline the process that is most likely occurring in this child's body. • 2. What anatomical differences in a child would predispose to this type of infection? • 3. What are the probable sources of this infection? • 4. What would you expect for local and systemic clinical manifestations? • 5. What diagnostic tests could be used? How could you differentiate between viral or bacterial pathogens? • 6. What treatment measures would you anticipate? • 7. What would be the potential complications?

process where excess fluid has accumulated behind the middle ear ustachian tube is straight and short and when you get older it gets longer and angled whicch is why children get it more than adults -local: ear ache, lymph nodes swollen under ear -systemic:fever, generalized not hungry, anorexic -diagn: poke a needle through the tympanic membrane and collect a culture and test it but its painful so we basing diagnostic on symptoms and otoscope and they should look pearly gray but when sick you can see red inflammed fluid and bulging use antibiotics don't hear as well and damage to inner ear and middle ear and could rupture and if it does pain decreases and fluid ecaping from ear canal

select viruses and related disease conditions

rapid panel to assess which kind of virus it is RSV very common-bad common cold -bad for young kids and adults because the size of their airway is super small and inflammation can cause their airway to swell and could close commonality: mostly are droplet transmissions by sneezing, coughing, etc.

autonomy

refers to the unregulated proliferation of the neoplasm

primary immunodeficiencies

selective igA deficiency: very common and missing parts of igA and get more colds and flus and GI infections (anywhere there is a mucous membrane) -lacking a B cell

cellular response: resolution

self-limited -feedback systems down regulate the plasma proteins systems -clotting -complement -kinin inflammation: happens very quickly but it also stops very quickly

neurotransmitters regulating mood, attention, and behavior

serotonin: controls a lot of these neurotransmitters and if we can help control serotonin, we can help control all of them

sites of infection

shows all the types of microbes that love the body and where they live

familial nature of schizophrenia

sibling that has it, 9% chance of developing it 1% general population

sprains and strains

sprain: tends to be with joint strain: tends to be with tendons or muscle sprains could be worse than a break because with broken bones they are in casts while sprains you still are moving on it radiographs: see joint effusion and fractures arthroscopy : put endoscope in the joint and take a look at the joint itself arthrography: put a dye so we can see joint better in CT, MRI, etc.

pathophysiology: pneumonia histologic changes

stage 1: rapid filling of the alveolar capillaries with a frothy, serous, and blood-tinged fluid stage 2: filling of alveoli with fibrinous exudates, which appear as areas of dry, granular, dark-red lung tissue stage 3: WBCs packing into the alveoli as RBCs and epithelial cells degenerate. the pneumococcal bacteria release toxins that contribute to cell death -bacteria are opsonized by WBCs a yellow exudate forms -exudates absorbed -resolution

lung cancer stages

stage I: the cancer is located only in the lungs and has not spread to any lymph nodes stage II: cancer is in the lung and nearby lymph nodes stage III: cancer is found in the lung, and in the lymph nodes in the middle of the chest, also desired as locally advanced disease stage IV: most advanced stage of lung cancer and occurs when the cancer has spread to both lungs, to fluid in the area around the lungs, or to another part of the body such as the liver or other organs

seizure activity in the brain

starts from one area of the brain and lots of communication and spreads (Complex) simple(focalized) doesn't mitigate to all areas of the brain (more decreased or lesser symptoms)

vision: alterations in eye movement

strabismus: cross eyes amblyopia: lazy eye diplopia: double vision nystagmus: involuntary oscillation of the eye cataracts: result rom the clouding of the lens which alter vision focus by scattering the incoming light onto the retina

population health (epidemiology)

study of disease in populations provides info for: -where a disease is most widespread -who is most affected by disease -reason for disease presenting in a population -identify ways to reduce spread of disease, morbidity -means to eradicate

cell-to-cell communication: synaptic vs neuroendocrine

synaptic: travels across synaptic cleft between cells -hormones are produced in the neuron, secreted, and travel along the axon to the synapse where they are released and makeup by a nearby neurons with the appropriate receptors to exert an effect neuroendocrine: neuron cells produce hormone and entered into the blood stream -hormones are produced in a neuron, secreted, travel along the axon to the synapse, are released, are taken up into the vascular system, and travel to distant cells with the appropriate receptors to exert an effect endocrine: hormones are produced in a cell, secreted, and travel through blood vessels to distant cells, attach to receptors, and act on that cell

skeletal muscle 2

tendon is attaching from muscle to the bone and is comprised of epimysium (ultimately forms the tendon at the end of the muscle that attaches the bone fasicle: contain muscle fibers (long and thin) perimysium: in between actual fasicles endomysium: in between muscle fibers

anovulation

the absence of ovulation manifested by the excess or deficit of one or more reproductive hormones

tidal volume (TV)

the amount of air that is exhaled after passive inspiration; this is the volume of air going in and out of the lungs at rest -in adults this volume is approximately 500 mL

vital capacity (VC)

the maximal amount of air that can be moved in and out of the lungs with forced inhalation and exhalation

genomic imprinting

the mechanism that controls expression of genes based on parental origin -epigenetic phenomenon resulting in regulation of the expression of gene activity without alteration of genetic striation -result usually of DNA methylation, preventing transcription of the gene -occurs when both maternal and paternal alleles are present, with only one allele expressed ad the other imprinted allele inactive due to epigenetic silencing through DNA methylation

triplet code

three bases come together to become a single amino acid

acute vs chronic

time-dependent -acute: sudden onset, duration days to few months -chronic: gradual onset, lasts more than 6 months -chronic -less than 6 months: acute

1. Which sensation/s are the specific somatic afferent neurons responsible for? (select all that apply) a. body movement b. pain c. touch d. temperature e. position f. discomfort

touch, temperature, position

cellular functions

transportation: moving one thing to another ingestion: pulling things in the cell secretion: moving things out of the cell respiration: creating ATP to work the cell Reproduction: reproduce and ultimately die -life of a red blood cell: 90 days -neurons: never replace themselves -cardiac tissues: never replace (just grows) this is why we usually die from these problems because these cells don't reproduce

hypersensitivity

type I: (immediate) hypersensitivity reaction-overreaction to something type II: antibody-mediated hypersensitivity reaction type III: immune complex mediated reaction-formation of antibody and anti-antigen type IV: T cell mediated delayed hypersensitivity reaction -happens when body overreacts to allergens

CNS injury: traumatic spinal cord injury types and causes

types: -fractures -contusions causes: -twisting -pulling -severing -compressing -involvement extends from primary site -2 segments above and below contusion: hard hit hard blow if you have an injury in spinal column its going to affect above and below by two segments

neuronal communication: unidirectional vs arrangement

unidirectional: one way communication arrangement: contact between -axon and dendrite -axon and soma -axon and axon

nociception

unpleasant feeling or pain

urolithiasis

urate deposits in the parenchymal start occurring in the parenchymal and as the deposits collect together in the renal pelvis and is usually where most kidney stones occur

cardiac hypertrophy: clinical manifestations

variable -mild to severe -shortness of breath -syncope: fainting while exercising -impaired cardiac function -left ventricle size is larger

pathogen characteristics: virus process

virus gets into the cell -uncodes it -replicates -takes over cell protein synthesis and releases viruses to replicate to as many cells as possible -go into the cells and cause latency: virus hybernating inside your own cells and can happen for years (2 times of getting mono) -certain viruses can cause cancer too (HPV)

frank

visible blood in the still, abdominal pain, and bowel obstruction are more likely if the tumor is located along the descending colon or in the rectum

hematopoiesis occurs in the bone marrow

when fetus is in utero, the yolk sack is initially in charge of hematopoesis around fetal month 4: bone marrow takes over hematopoesis till death

mechanism of acute pain

when you have pain, slow down the impulses so it slows down the amount of pain they are going to feel -if you have experienced with that pain before you're probably going to have more pain the second time since you have already experienced it before

hyperthyroidism

work on the pituitary and pituitary will release TSH which works on the thyroid to make hormones T3 and T2 too much T4 or T3, negative feedback loop so won't release TSH low thyroid hormones: high TSH because we want more high thyroid: TSH goes low -state of excessive thyroid hormone and can result from excessive stimulation to the thyroid gland, diseases of the thyroid gland, or excess production of tSH by a pituitary adenoma

schizophrenia: pathophysiology

worse one cause worse prognosis 4 per 1,000 in people 9 out of 10 men and 2 out of 10 women will manifest the illness by age 30 no known cause if mom has flu with pregnant risk, malnurioushment of baby in utero 10% higher risk if parent has it and 40% if both have it enlarged ventricles, loss of gray and white matter, dopamine cortico activity -a psychotic mental health disorder that affects how patients perceive the world -complex interplay among: -genetics (family history) -perinatal risks -socioenvironmental triggers -changes in brain structure and function

malaria: pathophysiology

• Caused by infection with Plasmodium protozoa • Transmitted by mosquito • Incubation period of 1 month from exposure • Currently eradicated in U.S. • Worldwide, >1 million deaths per year • Common in children from sub-Saharan Africa endemic: africa, south africa, tropical places mostly in children

metabolic acidosis: manifestations

• Decreased neural activity resulting in reduced neuronal excitability • Anorexia, nausea, vomiting, weakness, lethargy, confusion, coma • Vasodilation, decreased heart rate, flushed skin coma: happens with diabetics where they eat but don't have insulin which is key to tell the cells to intake glucose

graves disease: clinical manifestations

• Goiter (enlargement of the thyroid gland) • Weight loss • Agitation • Restlessness • Sweating • Heat intolerance • Diarrhea • Tachycardia • Palpitations • Tremors • Fine hair, oily skin • Irregular menstrual cycle • Weakness • Exophthalmos: protrusion of the eyeballs exphthalamos: right behind their eyes they have excess inflammation that protude the eye ball (bulging out) and treating they don't usually go down

polycystic kidney disease (PKD) pathophysiology

• Growth of fluid-filled cysts bilaterally in kidneys - Functional tissue replaced - Reduced perfusion - Tubule obstruction result in loss of renal nephrons all of the nephrons in the kidney are replaced by cysts and you lose renal function so it results in reduced perfusion and these cysts can cause tubule obstructions -be progressive in nature and results in renal failure 500,000 US residents are in this stage due to PKD 4th leading cause of end stage renal disease

obesity: diagnostic criteria

• History and physical examination - Evaluation for comorbidities • Body mass index - Normal: 18.5 to 24.9 kg/m2 - Grade 1: Overweight: 25 to 29.9 kg/m2 - Grade 2: Obese: 30 to 39.9 kg/m2 - Grade 3: Severely obese: ≥40 kg/m2 • BMI Calculator this is talking about adults only for kids, we don't start calculating BMI until 2 years of age and when we do we plot it on a growth rate where we plot their percentiles not their actual BMI 95%=obese 85%=at risk for obese 5-85% normal weight

phenylketouria: incidence and prevalence

• Incidence: 1 in 13,500 to 1 in 19,000 • No gender differences • Increased in European whites and Native Americans • Decreased in Blacks, Hispanics, and Asians -autosomal recessive disorder

acute pyelonephritis: treatment

• Intravenous fluids • Antibiotics • Analgesics • Surgery

tuberculosis: pathophysiology

• Most prevalent and deadly infection disease worldwide • Caused by infection with Mycobacterium tuberculosis • Transmitted via inhaled airborne droplets • Humans are only known reservoir • Lungs are primary site of infection enters the lungs and forms these bodies that separate out and replicate -creates little lesions on their lungs

acute pyelonephritis: diagnostic criteria

• Presence of symptoms • Urinalysis and microscopic evaluation • Urine culture • Imaging studies

testicular cancer: clinical manifestations

• Small, painless testicular mass • Slight enlargement of testicle • Heaviness or enlargement of scrotum • Mild discomfort in testicle

alterations of musculoskeletal function

• Trauma • Inflammation • Compartment Syndrome: where muscles in small compartments get infected • Vitamin Deficiencies • Tumors • Arthritis • Endocrine Disorders

ovarian cancer: treatment

• Treatment based on stage • Surgery • Chemotherapy • Radiation

metabolic acidosis: lab findings

• pH < 7.35 • HCO3- < 24 mEq/L • Anion gap - Normal if due to increased chloride - Elevated if due to excess metabolic acids some say 23-30 some say 24-30 less than 24 of bicarb will be considered metabolic acidosis anion gap: more than 12 chloride