final Flashcards
(283 cards)
1
Q
Signs related to the specific area of the brain or spinal cord in which lesion is located
A
Local (Focal) Effects of Neurologic Dysfunction
2
Q
: Individual is aware and capable of thinking but is paralyzed and cannot communicate
A
*Locked-in syndrome
3
Q
Loss of awareness and mental capabilities, resulting from diffuse brain damage
A
Vegetative state:
4
Q
loss of consciousness or coma
A
The most serious level:
5
Q
7 General Effects of Neurologic Dysfunction
A
local effects
Level of Consciousness
Brain death
Motor Dysfunction
Sensory Deficits
Language Disorders
Dysarthria
6
Q
Cessation of brain function
Absence of brainstem reflexes or responses
Absence of spontaneous respirations when ventilator assistance is withdrawn
A
Brain death
7
Q
: Muscle tone and reflexes maybe increased
A
Hyperreflexia
8
Q
leads to immobility resulting contracture in the affected limbs
A
Spastic paralysis:
9
Q
Inability to comprehend or express language
A
Aphasia
10
Q
5 Increased Intracranial Pressure
early signs
A
Decreasing level of consciousness Decreased pupillary responses Severe headache: Vomiting, Papilledema
11
Q
6 Increased Intracranial Pressure
late signs
A
Increase pulse pressure slowing heart rate Irregular respiration Systemic vasoconstriction Ptosis (droopy eyelid Pupils dilated
12
Q
: mild traumatic brain injury (MTBI)
A
Concussion
13
Q
is a bruising of brain tissue-hematoma
A
Contusion
14
Q
___________ injury: direct injuries
A
Primary brain
15
Q
_________ injuries: caused by the development of additional injurious factors
A
Secondary
16
Q
sudden excessive movement of the brain, disrupting neurologic function and leading to loss of consciousness.
reversible
A
Concussion
17
Q
may result from a dislocation or fracture of a vertebra related to flexion, hyperextension, compression, or penetration injury
A
Spinal cord injury
18
Q
Complete loss of reflex function (skeletal, bladder, bowel, sexual function, thermal control, and autonomic control) below level of lesion
A
Spinal shock
19
Q
Result from temporary localized reduction of blood flow in the brain
Recovery occurs within 24 hours
A
Transient Ischemic Attacks (TIAs)
20
Q
Vascular Disorder Caused by
Partial occlusion of an artery, Atherosclerosis, Small embolus
Vascular spasm, Local loss of autoregulation
A
Transient Ischemic Attacks (TIAs)
21
Q
Vascular Disorder with Signs and symptoms:
The manifestations are related to the location of the ischemia
Remain conscious
Intermittent short episode of impaired function
- Repeated attacks may be a warning sign for obstruction related to atherosclerosis (CVA)
A
Transient Ischemic Attacks (TIAs)
22
Q
is defined as an acute neurologic deficit lasting more than 24 hours and caused by cerebrovascular etiology.
Brain tissue necrosis that results from lack of blood.
A
Cerebrovascular Accidents (stroke)
23
Q
__________ stroke: rupture of cerebral vessel
Long term hypertension, anticoagulant, arteriosclerosis, etc
A
Hemorrhagic
24
Q
_______ stroke: occlusion of a cerebral blood vessel
Thrombus: atheroma narrowing
Embolus: embolus lodging
Increasing age
Smoking and combination of oral contraceptives
Congenital malformation of blood vessels
A
Ischemic
25
is an infection, usually of bacterial origin, in the meninges of the CNS.
Respiratory droplets transmission
Meningitis
26
--resistance to leg extension when lying with the hip flexed
Kernig's sign
27
--neck flexion causes flexion of hip and knee
Brudzinski's sign
28
Signs and symptoms of __________
Severe headache, back pain, photophobia, and nuchal rigidity (a hyperextended, stiff neck).
Kernig's sign
Brudzinski's sign-
Meningitis
29
Localized dilation in an artery, due to weakness of the artery wall.
Often aggravated by hypertension
Cerebral Aneurysms
30
Signs and symptoms:
Initially small and asymptomatic
Loss of visual field or visual disturbances--enlarging aneurysm
Headache and photophobia, due to leak or rupture
Nuchal rigidity
Complications
Rupture: vomiting, seizures, loss of consciousness, rapidly followed by death
Cerebral Aneurysms
31
Uncontrolled, excessive discharge of neurons in the brain
Seizure:
32
: recurrent seizure
Epilepsy
33
seizure type where
(both hemispheres affected with loss of consciousness)
Absence seizures (petit mal)
Tonic-clonic (grand mal)
Generalized
34
seizure type where
(focal, reduced awareness and conscious remain)
Simple
Complex
Complications
Respiration: hypoxia, aspiration, airway obstruction, etc
Injury
Acidosis
Partial
35
Progressive demyelination of neurons in the brain, spinal cord, and cranial nerves
Onset: usually 20 to 40 years of age, common in women
Characterized by remission and exacerbation
Multiple Sclerosis (MS)
36
Pathophysiology
Inflammation-demyelination (Loss of myelin in white matter of brain or spinal cord)
Plaques: develop later, become visible
Multiple Sclerosis (MS)
37
Multiple Sclerosis (MS) 3 signs and symptoms
visual disturbance:
sensory deficits:
weakness in legs
38
Progressive degeneration in basal nuclei, mainly in the substantia nigra
decease secretion of dopamine
Parkinson’s Disease
39
____________ Parkinson’s disease
Usually develops after age 60
Primary or idiopathic
40
__________________parkinsonism caused by:
Encephalitis
Trauma (e.g., sports injury)
Vascular disease
Drug-induced (e.g., phenothiazine tranquilizers
Secondary
41
No identified cause
Progressive degenerative disease affecting upper motor neurons in the cerebral cortex and lower motor neurons in brainstem and spinal cord
Cognition unimpaired
Amyotrophic Lateral Sclerosis (ALS)
42
Sign and symptoms:
Upper extremity weakness and atrophy
Progressive muscle weakness and loss of fine motor coordination--fall
The weakness and paralysis progress throughout the body
Dysarthria, swallowing and respiration are impaired
Death usually from respiratory failure
*Hypoxia and hypercarbia, and having difficulty expelling mucous secretions
Amyotrophic Lateral Sclerosis (ALS)
43
Autoimmune disorder
Autoantibodies to acetylcholine (ACh) receptors form.
Destruction of receptor site, skeletal muscle weakness
Facial and ocular muscles usually affected first
Myasthenia Gravis
44
Signs and symptoms:
Muscle weakness in face and eyes
Edrophonium chloride (Tensilon) test
Complication:
Dysphagia and aspiration are significant problems!
Upper respiratory infections
Myasthenic crisis--respiratory impairment
Myasthenia Gravis
45
Progressive chronic disease
```
Cortical function is decreased.
Impaired cognitive skills: thinking, judgment, and learning
Memory loss
Confusion
Behavioral and personality changes
```
Dementia
46
signs and symptoms:
Vascular disease
Infections
Genetic disorders
AD is the most common form
Dementia
47
Progressive cortical atrophy
Neurofibrillary tangles, senile plagues which disrupt neural conduction
ACh deficit also occurs in the affected brain
Alzheimer’s Disease (AD)
48
______ stage: Inability to recognize family, lack of environmental awareness, incontinence, inability to function
Late
49
______ stage: gradual loss of memory and lack of concentration
Early
50
5 Types of Pain
Headache
Central pain
Neuropathic pain
Ischemic pain
Cancer-related pain
51
Pain is perceived at a site distant from the source.
Source may be difficult to determine.
pain in the left neck and arm
Due to heart attack or ischemia in the heart
Referred pain
52
Pain or another sensation such as itching or tingling occurs in some individuals, usually adults, after an amputation.
Usually does not respond to common pain therapies
May resolve within weeks to months
Phenomenon not fully understood
Phantom pain
53
is the degree of pain, either its intensity or its duration, which is endured before an individual takes some action.
Culturally related, varies among individuals
Pain tolerance
54
Level of stimulation required to elicit a pain response
Usually does not vary among individuals
Pain threshold
55
```
Inflammation
Infection
Ischemia and tissue necrosis
Stretching of tissue
Stretching of tendons, ligaments, joint capsule
Chemicals
Burns
Muscle spasm
```
Causes of Pain
56
excessive amount of fluid in the interstitial compartment, which causes a swelling or enlargement of the tissue
Edema
57
5 causes of edemas
```
Increased capillary hydrostatic pressure
Loss of plasma proteins
Obstruction of lymphatic circulation
Increased capillary permeability
bacterial toxins or large burn wounds
```
58
cause of edema where
Caused by higher blood pressure or increased blood volume
Forces increased fluid out of capillaries into tissue
Cause of pulmonary edema
Increased capillary hydrostatic pressure
59
cause of edema where
Particularly albumin
Results in decreased plasma osmotic pressure
Loss of plasma proteins
60
cause of edema where
Causes localized edema
Excessive fluid and protein not returned to general circulation
Obstruction of lymphatic circulation
61
cause of edema where
Usually causes localized edema
May result from an inflammatory response or infection
Increased capillary permeability
62
5 major symptoms of edema
Swelling
Pale or red in color
Pitting edema
Depression―“pit” remains when finger pressure is
removed
Increase in body weight
With generalized edema
Functional impairment
Restricts range of joint movement
Edematous tissue in skin is susceptible to tissue breakdown
Proper skin care
63
refers to insufficient body fluid resulting from Inadequate intake or excessive loss or both.
Dehydration
64
3 major Causes of dehydration
Vomiting and diarrhea
Excessive sweating with loss of sodium and water
Insufficient water intake in older adults or unconscious persons
65
4 major signs of dehydration
Dry mucous membranes in the mouth
Decreased skin turgor or elasticity
Lower blood pressure
Decreased mental function, confusion,
66
high sodium = high________ pressure
osmotic
67
proper amount of sodium
135 mEq/L – 145 mEq/L
68
when Serum sodium less than 135 mEq/l, sodium deficit, excessive water
Hyponatremia
69
3 main causes of Hyponatremia
Excessive water intake
Excessive sweating, vomiting, diarrhea
Diuretic drugs combined with low-salt diet
70
4 symptoms of Hyponatremia
Fatigue,
muscle cramps,
nausea,
vomiting
71
is an excessive sodium levels in the blood and extracellular fluids (> 145 mEq per liter)
Hypernatremia
72
2 causes of Hypernatremia
Ingestion of large amounts of sodium
Loss of water from the body
73
4 symptoms of Hypernatremia
Weakness
Dry, rough mucous membranes
Increased thirst
Urinary output is decreased
74
Abnormal potassium levels cause changes in____________ and are life-threatening!
cardiac conduction
75
Major intracellular cation
3.5-5mEq/L
potassium balance
76
Serum potassium less than 3.5 mEq/L
Hypokalemia
77
4 main causes of Hypokalemia
Diarrhea
Diuretic drugs
Excessive aldosterone
Decreased dietary intake
78
2 symptoms of Hypokalemia
Muscle weakness , Paresthesias―“pins and needles”(numb)
Cardiac dysrhythmias
79
Serum potassium is greater than 5 mEq/L
Hyperkalemia
80
3 causes of Hyperkalemia
Renal failure
Deficit of aldosterone; “Potassium-sparing” diuretics
Tissue injury
Leakage of intracellular potassium into extracellular fluids
81
2 symptoms of Hyperkalemia
Muscle weakness common, progresses to paralysis
Cardiac dysrhythmias, may progress to cardiac arrest
82
excess hydrogen ions (H+), decrease in serum pH
Acidosis:
83
deficit of hydrogen ions (H+), increase in serum pH
Alkalosis:
84
3 Compensation Mechanisms for pH Imbalance
Buffers
Change in respiration
Change in renal function
85
type of acidosis where Increase carbon dioxide levels
Respiratory Acidosis
86
type of acidosis where Decease in serum bicarbonate
Metabolic Acidosis
87
Excessive loss of bicarbonate ions to buffer hydrogen
Diarrhea―loss of bicarbonate from intestines
Increased use of serum bicarbonate
Renal disease or failure
are all causes of
Metabolic Acidosis
88
```
Suppressed nervous system function
Headache
Lethargy
Weakness
Confusion
Coma and death
```
are all effects of ______
acidosis
89
type of alkalosis where
Hyperventilation
Caused by anxiety, high fever, overdose of aspirin
Head injuries
Brainstem tumor
Respiratory alkalosis
90
type of alkalosis where
Increase in serum bicarbonate ion
Loss of hydrochloric acid from stomach
Hypokalemia
Excessive ingestion of antacids
Metabolic alkalosis
91
```
Increased irritability of the nervous system
Restlessness
Muscle twitching
Tingling and numbness of the fingers
Tetany
Seizures
Coma
```
are all effects of _________
Alkalosis
92
A protective mechanism and important basic concept in pathophysiology. It is the body’s nonspecific response to tissue injury.
Inflammation
93
Inflammation Disorders are named using the ending ______
itis.
94
7 Causes of Inflammation
Direct physical damage
Caustic chemicals
Ischemia or infarction
Allergic reactions
Extremes of heat or cold
Foreign bodies
Infection
95
in the steps of Inflammation
Injury to ________ and tissue cells
Release of _________ from injured cells
Bradykinin stimulates ______ receptors.
Pain causes release of _________
Bradykinin and histamine cause ________
Migration of ______ & _________ to the site of injury
Neutrophils _________ bacteria.
___________ (mature monocytes) leave the bloodstream and phagocytose microbes.
capillaries
bradykinin
pain
histamine.
capillary dilation.
neutrophils and monocyte
phagocytize
Macrophages
96
in this type of inflammaion
Process of inflammation is the same, regardless of cause.
Acute Inflammation
97
in this type of inflammaion
Timing varies with specific cause
Acute Inflammation
98
In Acute Inflammation
Chemical mediators affect blood vessels and nerves in the damaged area through what 4 ways
Vasodilation
Hyperemia—increase blood flow in the area
Increase in capillary permeability—plasma proteins to move into the interstitial space
Chemotaxis to attract cells of the immune system
99
5 Local Effects of Inflammation
Redness and warmth
Swelling (edema)
Pain
Loss of function
Exudate
100
Local Effect of Inflammation that
Caused by increased blood flow to damaged area (vasodilation)
Redness and warmth
101
Local Effect of Inflammation that
Shift of protein and fluid into the interstitial space(capillary permeability increased)
Swelling (edema)
102
Local Effect of Inflammation that
Increased pressure of fluid on nerves; release of chemical mediators (e.g., bradykinins)
Pain
103
Local Effect of Inflammation that
May develop if cells lack nutrients; edema may interfere with movement.
Loss of function
104
Local Effect of Inflammation that
Collection of interstitial fluid formed in the inflamed area.
Exudate
105
3 Systemic Effects of Inflammation
Mild fever (pyrexia)
Leukocytosis (increased white blood cells in the blood)
Increased plasma protein synthesis
106
Potential Complication of Inflammation
Follows acute episode of inflammation when the cause is not removed.
Infection ( Local / Systemic)
107
type of inflammation that
Less swelling and exudate
Chronic Inflammation
108
type of inflammation that
Presence of more lymphocytes, macrophages, and fibroblasts
Chronic Inflammation
109
type of inflammation that
Continued tissue destruction
Chronic Inflammation
110
type of inflammation that
More fibrous scar tissue
Granuloma may develop around foreign object
Chronic Inflammation
111
type of inflammation that
Potential Complications
Deep ulcers may result from severe or prolonged inflammation
Cell necrosis and lack of cell regeneration that causes erosion of the tissue
Can lead to complications such as perforation of viscera
Extensive scar tissue formation
Chronic Inflammation
112
Occur in health care facilities
Hospitals, nursing homes, physician’s offices, dental offices
10% to 15% of patients acquire an infection in the hospital because of:
Nosocomial Infections
113
Capability of a microbe to cause disease
Pathogenicity
114
Degree of pathogenicity
Virulence
115
9 Factors That Decrease Host Resistance
Age (infants and older adults)
Pregnancy
Genetic susceptibility
Immunodeficiency
Malnutrition
Chronic disease
Severe physical or emotional stress
Inflammation or trauma
Impaired inflammatory responses
116
6 host resistance
intact skin and mucous membrane
body secretions- stomach acid, tears
nonspecific phagocytosis
effective inflammatory response
absence of disease
effective immune system interferon production
117
the microbe causing the infection
Agent:
118
Environmental source such as contaminated soil
Infected person or animal
Person may carry the agent and show no signs of disease
Person or animal may show signs and symptoms of disease
Reservoir:
119
means whereby the agent leaves the reservoir
Portal of exit
120
method whereby the agent reaches a new susceptible host
Air; Water; Direct contact; Food
Mode of transmission:
121
access to new host
Portal of entry
122
Mode of Transmission that
Touching infectious lesion, sexual activity
Contact with infected blood or bodily secretions
Direct contact
123
Mode of Transmission that
Contaminated hand or food
Fomite—inanimate object
Indirect contact
124
Mode of Transmission that
Respiratory or salivary secretions are expelled from infected individual
Droplet transmission
125
Mode of Transmission that
Involve small particles from the respiratory tract, suspended in air and can travel farther than droplets
Aerosol transmission
126
Mode of Transmission that
Insect or animal is an intermediate host
Vector-borne
127
Infection Stage of Development period where
Time between entry of organism into the body and appearance of clinical signs of disease
Vary considerable with different organisms
Incubation period
128
Infection Stage of Development period where
Fatigue, loss of appetite, headache
Nonspecific—“coming down with something”
More evident in some infections than others
Prodromal period
129
Infection Stage of Development period where
Infectious disease develops fully
Acute period
130
2 local signs of infection
Pain, swelling, redness, warmth
Lymphadenopathy-swollen and tender lymph nodes
131
2 systemic signs of infection
Fever
Leukocytosis
Increase neutrophils: acute infections
Others: fatigue, weakness, headache, nausea
132
2 methods of diagnosing infection
Culture and staining techniques
Blood tests
133
blood test for diagnosing infection where
Variations in numbers of leukocytes
bacterial infection
Leukocytosis
134
blood test for diagnosing infection where
Variations in numbers of leukocytes
viral infection
Leukopenia
135
immune system cells that
Initiation of immune response, engulf foreign material
Macrophages:
136
immune system cells that
One of leukocyte from bone marrow
Lymphocytes
137
immune system cells that
destroy foreign cells, virus-infected cells, and cancer cells
Natural killer cell
138
Types of Immunity that
Antibodies or immunoglobulins are produced to protect the body.
Humoral immunity:
139
Types of Immunity that
Lymphocytes are programmed to directly destroy the invading antigens
Cell-mediated immunity (CMI):
140
2 Nonspecific defense mechanism of the immune response
Phagocytosis
Inflammation response
141
type of Immunity that
Species-specific
Natural immunity
142
type of Immunity that
Gene-specific
Related to ethnicity
Innate immunity
143
type of Immunity that
Natural exposure to antigen
Development of antibodies
Active natural immunity
144
type of Immunity that
Antigen purposefully introduced to body
Stimulation of antibody production
Immunization
Booster immunization
Active artificial immunity
145
type of Immunity that
Injection of antibodies
Short-term protection
Passive artificial immunity
146
type of Immunity that
IgG transferred from mother to fetus:
Across placenta
Through breast milk
Protection of infant for the first few months of life or until weaned
Passive natural immunity
147
type of immune response stage that
First exposure to antigen
1 to 2 weeks before antibody titer reaches efficacy
Primary response
148
type of immune response stage that
Repeat exposure to the same antigen
More rapid response, with efficacy in 1 to 3 days
Secondary response
149
Partial or total loss of one or more immune system components
Increased risk of infection and cancer
Immunodeficiency
150
in Immunodeficiency
Primary deficiencies are caused by
developmental failure
151
3 effects of Immunodeficiency
Predisposition to the development of opportunistic infections
Usually difficult to treat because of immunodeficiency
Prophylactic antimicrobial drugs may be used prior to invasive procedures.
152
type of Hypersensitivity that
—allergic reactions
IgE mediated
IgE bound to mast cells; histamine release
Against environmental antigens (allergens)
Type I hypersensitivity
153
type of Hypersensitivity that
Tissue specific
Specific cell or tissue (tissue-specific antigens) is the target of an immune response
IgG or IgM reacts with antigen on cell–complement activated
Type II: Cytotoxic Hypersensitivity
154
type of Hypersensitivity that
Immune complex mediated
Antigen combines with antibody forms immune complexes, deposited in tissue or blood vessel walls
Type III: Immune Complex Hypersensitivity
155
type of Hypersensitivity that
Cell-Mediated
Antigen binds to T-lymphocyte; sensitized lymphocyte releases lymphokines
Type IV: Cell-Mediated or Delayed Hypersensitivity
156
type of Hypersensitivity that has the effects
Immediate inflammation and pruritus
Type I hypersensitivity
157
type of Hypersensitivity that has the effects
Cell lysis and phagocytosis
Type II: Cytotoxic Hypersensitivity
158
type of Hypersensitivity that has the effects
Inflammation, tissue destruction, vasculitis
Type III: Immune Complex Hypersensitivity
159
type of Hypersensitivity that has the effects
Delayed inflammation
Type IV: Cell-Mediated or Delayed Hypersensitivity
160
2 Hypersensitivity Reaction complication
Anaphylaxis
| Anaphylactic Shock
161
3 Systemic hypersensitivity reactions
Decreased blood pressure caused by release of histamine
Airway obstruction
Severe hypoxia
162
Anemia causes a reduction in _________ transport.
oxygen
163
Basic problem with anemia is __________deficit
hemoglobin
164
5 General signs of anemia
```
Fatigue
pallor (pale face),
dyspnea
tachycardia
Decreased regeneration of epithelial cells
```
165
4 Iron Deficiency Anemia Etiology
Dietary intake of iron below minimum requirement
Chronic blood loss
Impaired duodenal absorption of iron
Severe liver disease: iron absorption/storage
166
Iron Deficiency Anemia Sign and Symptoms
Spoon shaped (concave) and ridged nails, brittle hair
General signs of anemias
Pallor, fatigue, lethargy, and CNS stimulation (hypoxia)
167
Vitamin B12 Deficiency
Pernicious Anemia:
168
Pernicious Anemia: Basic problem is lack of ______
intrinsic factor
169
Pernicious Anemia 3 Etiology
Dietary insufficiency
Malabsorption
Surgery, such as gastrectomy
170
4 Pernicious Anemia Sign and Symptoms
General signs of anemia
Tongue is typically enlarged, red, sore, and shiny.
Digestive discomfort, often with nausea and diarrhea
Feeling of pins and needles, tingling in limbs
171
Vitamin B12 is needed for the function and maintenance of
neurons.
172
Impairment or failure of bone marrow leading to loss of stem cells and pancytopenia.
Aplastic Anemia
173
5 Aplastic Anemia Etiology
Myelotoxins: Radiation, industrial chemicals, drugs
174
Aplastic Anemia 4 Sign and Symptoms
Blood counts indicate pancytopenia.
Anemia (pallor, weakness, and dyspnea)
Leukopenia (recurrent infection)
Thrombocytopenia (petechiae)
175
Genetic condition
Autosomal recessive disorder
More common in individuals of African ancestry
Sickle Cell Anemia
176
Sickle cell crisis occurs whenever _______ levels are lowered.
oxygen
177
4 Sign and symptoms : Sickle Cell Anemia
General sign of anemia (Pallor, weakness, tachycardia, dyspnea)
Severe pain because of ischemia of tissues and infarction
Jaundice--hyperbilirubinemia
**Acute symptom of vaso-occlusive/painful crisis
178
Sickle-shaped cells have shorter lifespan—anemia
Sickle cell hemoglobin leads to multiple infarctions
Abnormal hemoglobin (HbS)
Sickle Cell Anemia
179
General term for all types of arterial changes
Arteriosclerosis
180
Degenerative changes in small arteries and arterioles
Loss of elasticity
Lumen gradually narrows and may become obstructed
Cause of increased BP
Arteriosclerosis
181
3 Risk Factors for Atherosclerosis
| Nonmodifiable
Age
Gender
Genetic or familial factors
182
6 Risk Factors for Atherosclerosis
| modifiable
Obesity or diet high in cholesterol and animal fat
Cigarette smoking
Sedentary lifestyle
Diabetes mellitus
Poorly controlled hypertension
Combination of oral contraceptives and smoking
183
Occurs when there is a deficit of oxygen to meet myocardial needs
Angina Pectoris
184
3 Etiology of Angina Pectoris
Insufficient myocardial blood supply
Increased demands (tachycardia)
Precipitating factors of angina attacks
185
Sign and symptoms for what cardiovascualr disorder
Recurrent, intermittent brief episodes of substernal chest pain
Triggered by physical or emotional stress
Attacks vary in severity and duration but become more frequent and longer as disease progresses.
Angina Pectoris
186
occurs when a coronary artery is totally obstructed, leading to prolonged ischemia and cell death, or infarction, of the heart wall.
Myocardial Infarction (heart attack)
187
Common cause: atherosclerosis (thrombus)
The heart muscle becomes necrotic, and an area of injury, inflammation, and scar formation
Specific enzymes (troponin) appear in the blood
Myocardial Infarction (heart attack)
188
Signs and symptoms of this cardiovascular disorder
Pain: Sudden substernal chest pain that radiates to the left arm, shoulder, jaw, or neck is the hallmark of myocardial infarction.
Pallor and diaphoresis, nausea, dizziness and weakness, and dyspnea
Marked anxiety and fear
Hypotension
Pulse is rapid and weak as cardiac output decreases and shock develops.
Low-grade fever
Myocardial Infarction (heart attack)
189
3 complications of Myocardial Infarction
Sudden death: cardiac Dysrhythmias
Cardiogenic shock
Congestive heart failure
190
Heart is unable to pump out sufficient blood to meet metabolic demands of the body.
Congestive Heart Failure
191
3 Compensation mechanisms of Congestive Heart Failure
Increase renin aldosterone secretion
CNS response
Chamber of heart tend to dilate and cardiac muscle becomes hypertrophied
192
2 Pathophysiological effects of Congestive Heart Failure
Cardiac output or stroke volume decreases.
Backup and congestion develop
193
3 Congestive Heart Failure Etiology
Infarction
Coronary artery disease, hypertension
Pulmonary disease
194
Sign and symptoms: cardiovascular disorder
Forward effects (similar with failure on either side)
Decreased blood supply to tissues, general hypoxia
Fatigue and weakness
Dyspnea and shortness of breath
Compensation mechanisms
Tachycardia, cutaneous and visceral vasoconstriction, daytime oliguria
Congestive Heart Failure
195
signs and symptoms: cardiovascular disorder
Left ventricle doesn’t empty, backup effects of left-sided failure, pulmonary congestion
Dyspnea and orthopnea
Develop as fluid accumulates in the lungs
Cough
Associated with fluid irritating the respiratory passages
Paroxysmal nocturnal dyspnea
Indicates the presence of acute pulmonary edema
Usually develops during sleep
Excess fluid in lungs frequently leads to infections such as pneumonia.
left sided Congestive Heart Failure
196
signs and symptoms: cadiovascular disorder
Right ventricle weakens--systemic backup
Dependent edema in feet, legs, or buttocks
Increased pressure in jugular veins leads to distention.
Hepatomegaly and splenomegaly
Ascites
Complication when fluid accumulates in peritoneal cavity
Marked abdominal distention
Acute right-sided failure
Flushed face, distended neck veins, headache, visual disturbances
right sided Congestive Heart Failure
197
High blood pressure
Common
May occur in any age group
More common in individuals of African ancestry
Hypertension
198
Decreased blood flow through the kidneys, leading to increased renin, angiotensin, and aldosterone secretion
Hypertension
199
type of Hypertension that
Blood pressure consistently above 140/90 mm Hg (adjusted for age)
Increase in arteriolar vasoconstriction
Primary: Essential hypertension
200
type of Hypertension that
Decreased blood flow through the kidneys, leading to increased renin, angiotensin, and aldosterone secretion (HTN continue to increase)
Over long period of time—damage to arterial walls—decrease blood supply--Ischemia and necrosis of tissues, with loss of function
Primary: Essential hypertension
201
type of Hypertension that
The areas most frequently damaged by elevated pressure are
Kidneys, cardiovascular, brain, and retina.
Primary: Essential hypertension
202
Localized dilation and weakening of arterial wall
Develops from a defect in the medial laye
Aortic Aneurysm
203
Aortic Aneurysm etiology
Atherosclerosis, trauma, HTN
Others: syphilis and other infections, congenital defects
204
Signs and symptoms cardiovascular disorder
Frequently asymptomatic until they become large or rupture
Rupture may lead to moderate bleeding but usually causes severe hemorrhage and death.
Bruit may be heard on auscultation.
Abdominal aneurysms are sometimes detected as palpable pulsating masses with bruits (abnormal sounds).
Aortic Aneurysm
205
Obstructive lung disese where
Inherited (genetic) disorder
Seven chromosome, autosomal recessive disorder
Cystic Fibrosis
206
Obstructive lung disese where
Thick secretion, Tenacious mucus from exocrine glands
Cystic Fibrosis
207
Obstructive lung disese where
Primary effects seen in lungs and pancreas
Cystic Fibrosis
208
Obstructive lung disese where
Mucus obstructs airflow in bronchioles and small bronchi.
Permanent damage to bronchial walls
Cystic Fibrosis
209
Cystic Fibrosis Infections in the lungs are common due to what two factors
stagnant mucus is an excellent medium for bacterial to grow
Commonly caused by Pseudomonas aeruginosa and Staphylococcus aureus
210
Cystic Fibrosis effecs the Digestive tract by what 2 things
Meconium ileus in newborns
Small intestine of neonate is blocked by mucous at birth, preventing the excretion of meconium.
211
Cystic Fibrosis effecs Blockage of pancreatic ducts and bile ducts by
Malabsorption and malnutrition
212
Most conclusive test for diagnosis of Cystic Fibrosis
Sweat glands
213
5 Signs and symptoms of___________
Meconium ileus may occur at birth.
Salty skin: sweat test
Signs of malabsorption: steatorrhea, abdominal distention
Chronic cough and frequent respiratory infections
Failure to meet normal growth milestones
Cystic Fibrosis
214
type of Asthma where
Occurs in persons with hypersensitive or hyperresponsive airways
Bronchial obstruction
215
type of Asthma where
Acute episodes triggered by type I hypersensitivity reactions
Antigen react with immunoglobulin E (IgE)
Extrinsic asthma
216
type of Asthma where
Onset during adulthood
Hyperresponsive tissue in airway initiates attack.
Intrinsic asthma
217
4 Pathophysiological effects of asthma
Inflammation of the mucosa with edema
Bronchoconstriction
Increased secretion of thick mucus
Changes create obstructed airways, partial or total.
218
6 signs and symptoms of asthma
Cough, marked dyspnea, tight feeling in chest
Wheezing
thick or sticky mucus
Hypoxia, tachycardia
Respiratory alkalosis/acidosis
Severe respiratory distress/ respiratory failure
219
Breakdown of alveolar wall,
Emphysema
220
Emphysema Leads to large, permanently inflated _____ air spaces
alveolar
221
Emphysema leads to Fibrosis and thickening of the _____________
bronchial walls
222
Emphysema leads to Progressive difficulty with ________
expiration
223
Advanced emphysema and loss of tissue lead to
| what 5 things
Pneumothorax
Hypercapnia
Hypoxia becomes driving force of respiration
Frequent infections
Pulmonary hypertension and cor pulmonale may develop in late stage
224
Emphysema Etiology
Smoking or genetic factors
225
Emphysema 5 Signs and symptoms
Dyspnea
Hyperventilation with prolonged expiratory phase
Development of barrel chest
Anorexia, fatigue, and weight loss
Clubbed fingers
226
2 Emphysema Diagnostic tests
Chest radiography and pulmonary function tests
227
this leads to
Overinflation of the lungs
increased anterior-posterior diameter of thorax (barrel chest
Emphysema
228
Significant change in bronchi
Inflammation, obstruction, repeated infection, chronic coughing
Chronic Bronchitis
229
Chronic Bronchitis Etiology
Constant irritation from smoking or exposure to inhaled irritants
230
4 signs and symptoms of Chronic Bronchitis
Constant productive cough, tachypnea and shortness of breath
Frequent thick and purulent secretions
Hypoxia, cyanosis, hypercapnia---Caused by airway obstruction
Polycythemia, weight loss, signs of cor pulmonale possible
231
is secondary to a number of renal diseases as well as to a variety of systemic disorders(e.g., systemic lupus erythematosus, exposure to toxins or drugs.
The nephrotic syndrome
232
Caused by glomerular injury-abnormality in the glomerular capillaries
The nephrotic syndrome
233
defined as the presence of proteinuria, hypoalbuminemia and peripheral edema.
The nephrotic syndrome
234
The nephrotic syndrome 3 Sign and symptoms
* Marked proteinuria
* Massive edema, gain weight
* hyperlipidemia
235
Acute kidney injury (AKI), acute decline glomerular filtration rate (GFR) from baseline, with or without oliguria ( reduced urine output) /anuria (no urine output) .
Acute Renal Failure
236
3 signs and symptoms for Acute Renal Failure
.Elevated BUN/Creatinine
•Hyperkalemia
•Metabolic acidosis
237
Type of Acute Renal Failure where
: failure due to impaired renal perfusion
•Severe, prolonged circulatory shock or heart failure
Prerenal
238
Type of Acute Renal Failure where
: failure due to direct injury to renal parenchyma
* Nephrotoxins: Drugs, chemicals, or toxins
* Acute bilateral kidney diseases
:Intrinsic
239
Type of Acute Renal Failure where
: failure due to obstruction of urinary flow
* Mechanical obstruction (occasionally)
* Calculi, blood clots, tumors: block urine flow beyond kidney
Postrenal
240
Gradual irreversible destruction of the kidneys over a long period of time
* Asymptomatic in early stages
* Associated with HTN, diabetes, long-term exposure to nephrotoxins, etc.
Chronic Renal Failure
241
Pathophysiology
•Decreased renal reserve(around 60% nephrons lost)
* Decrease in GFR
* Renal insufficiency (around 75% nephrons loss)
* Decreased GFR to about 20% of normal
* End-stage renal failure (more than 90% nephrons lost)
* Negligible GFR
Chronic Renal Failure
242
5 Chronic Renal Failure signs and symptoms
Oliguria
* Electrolyte imbalance (usually hyponatremia and hyperkalemia occur)
* GFR falls, plasma creatinine increases
* metabolic acidosis
* Anemia
243
Inflammation of the liver
Cell injury results in inflammation and necrosis in the liver.
Liver is edematous and tender.
Hepatitis
244
Hepatitis cause
Idiopathic (Fatty liver), Local infection (viral hepatitis) , or Infection elsewhere in body , or chemical or drug toxicity (hepatotoxicity)
245
Type of Viral Hepatitis (P465) where
* Transmission: fecal-oral route
* No carrier or chronic state
* Vaccine available for travelers
:Hepatitis A (HAV)
246
Type of Viral Hepatitis (P465) where
* Transmission: blood and body fluid
* Carrier and Chronic
* Vaccine available, routinely given to children
* Carrier: asymptomatic but contagious
:Hepatitis B (HBV)
247
Type of Viral Hepatitis (P465) where
* Transmission: blood and body fluid
* Chronic
:Hepatitis D (HDV)
248
Type of Viral Hepatitis (P465) where
* Transmitted by oral-fecal route
* No chronic or carrier state
:Hepatitis E (HEV)
249
Type of Viral Hepatitis (P465) where
Transmission: Blood and body fluid
•Carrier and chronic
Hepatitis C (HCV)
250
Viral Hepatitis stage where
* Fatigue and malaise, Anorexia and nausea,
* General muscle aching
:Preicteric stage
251
Viral Hepatitis stage where
* Stools light in color, urine becomes darker
* Liver tender and enlarged, mild aching pain
:Icteric stage: Onset of jaundice
252
Viral Hepatitis stage where
* Reductions in signs
* Weakness persists for weeks
Posticteric stage—recovery stage
253
Progressive destruction of the liver tissue, when 80-90% of the liver has been destroyed. (Irreversible)
* Extensive diffuse fibrosis and loss of lobular organization
* Degenerative changes may be asymptomatic until disease is well advanced.
Cirrhosis
254
* Decreased removal and conjugation of bilirubin
* Decreased production of blood-clotting factors and plasma albumin
* Inadequate storage of iron and vitamin B12
* Decreased inactivation of hormones (aldosterone and estrogen)
* Decreased removal of toxic substances, such as ammonia leading to hepatic encephalopathy
* Decreased production of bile
6 Cirrhosis Losses of liver cell functions
255
inflammation of the pancreas
•Activate enzymes in the pancreas which digest the pancreatic tissue leading to massive inflammation, bleeding, and necrosis.
Acute Pancreatitis
256
3 Etiology of Pancreatitis
* Gallstones
* Alcohol abuse
* Sudden onset may follow intake of large meal or large amount of alcohol
257
3 signs and symptoms of Pancreatitis
Severe mid epigastric pain radiating to the back
* Nausea, vomiting, Low-grade fever until infection develops
* Elevated serum amylase and lipase levels
258
is an inflammation and infection in the vermiform appendix.
Appendicitis
259
2 complications of Appendicitis
* Perforation
| * Peritonitis--rigid “boardlike” abdomen
260
A mechanical disruption in the patency of GI tract, resulting in a combination of emesis, constipation, and abdominal pain.
Intestinal Obstruction
261
•Result from tumors, adhesions, hernias, other tangible obstructions
Mechanical obstructions
262
* Result from impairment of peristalsis
* Spinal cord injury
* Paralytic ileus caused by toxins or electrolyte imbalance
Functional or adynamic obstructions
263
4 signs and symptoms of Intestinal Obstruction
* Abdominal pain
* Vomiting and abdominal distention
* No stool or gas passed
* Hypovolemia and electrolyte imbalance---dehydration, weakness, confusion and shock
264
3 complications with Intestinal Obstruction
* Ischemia and necrosis
* Perforation of the necrotic segment may occur.
* Peritonitis--bacteremia, septicemia
265
Degenerative—wear and tear joint disease
Osteoarthritis
266
Articular cartilage is damaged.
Surface of cartilage becomes rough and worn
Joint space becomes narrower.
Secondary inflammation of surrounding tissue
Osteoarthritis
267
Etiology
Primary form—weight-bearing, obesity, aging
Secondary form—follows trauma or repetitive use
Genetic factors thought to play a role
Weight-bearing joints most frequently affected but finger joints also involved
Osteoarthritis
268
Signs and symptoms:
Aching pain with weight-bearing and movement
Joint movement is limited.
Predisposition to falls
Bony enlargement of distal interphalangeal joints--Heberden’s node
Crepitus
No systemic signs or changes in serum levels.
X ray evidence—joint changes
Osteoarthritis
269
Also known as gouty arthritis
Results from deposits of uric acid and crystals in the joint, causing inflammation
Common location: digital joint
Gout
270
Sign and symptoms :
Inflammation causes redness, swelling, and pain.
increase in serum uric acid levels
Risk factors:
Renal excretion is not adequate
Dietary factors: seafood, meat, and alcohol.
Others: cancer patients, obesity, insulin resistance, and hypertension
Gout
271
___________ is caused by
| Deficit of insulin or lack of response by cells to insuli
Diabetes mellitus
272
Types of Diabetes that
Absolute deficit insulin
Autoimmune destruction of beta cells in pancreas
Acute onset in children and adolescents
Type 1
273
Types of Diabetes that
Not linked to obesity
Genetic factors may play a role.
Type 1
274
Types of Diabetes that
Caused by decreased production of insulin and/or increased resistance by body cells to insulin
Onset is slow and insidious, usually in those older than 50 years
Type 2
275
Types of Diabetes that
Associated with obesity
Component of metabolic syndrome
Type 2
276
Insulin deficit results in decreased transport and use of glucose in many cells---fatigue, polyphagia
Blood glucose levels rise—hyperglycemia
Diabetes Mellitus
277
```
Progressive effects
Diabetic ketoacidosis (DKA)
```
Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC)
Diabetes Mellitus
278
Occurs in type 2 diabetes
Insidious in onset
Often occurs in older clients and assumed to be cognitive impairment
HHNK: Hyperglycemic hyperosmolar nonketotic
279
5 Diabetes: Chronic Complications
Increased incidence of atherosclerosis
Microangiopathy
Macroangiopathy
Peripheral neuropathy
infection
280
Related to autoimmune factor
Increase T3 and T4,
Hypermetabolism and increased stimulation of SNS
Toxic goiter
Exophthalmos
Hyperthyroidism (Graves’ disease)
281
Signs and symptoms:
↑ metabolic rate: loss weight, heat intolerance,
↑ Stimulate SNS: palpitation, tachycardia, restless
Hyperthyroidism
282
Etiology
Iodine deficit,
Hashimoto’s thyroiditis--Autoimmune disorder
Tumor, surgical removal or treatment of gland
Cretinism: hyposecretion of thyroid hormone during youth
Hypothyroidism
283
Signs and symptoms:
↓ metabolic rate: gain weight, cold intolerance,
↓ SNS stimulation: bradycardia, lethargic
Hypothyroidism
