Health status Flashcards
Confirm physical health status
1
Q
Anatomy:
A
The study of body structures and the relationships between these structures.
When we look at body parts that can be seen without a microscope, such as an arm or a stomach the term gross anatomy is used.
This is in contrast to use of the term microscopic anatomy when a microscope is needed to observe body structures such as cells.
2
Q
Physiology:
A
The study of the functions of the body, that is, how the body parts work.
3
Q
6 main levels of structural organisation in the human body:
A
Chemical:
Atoms are the smallest building blocks, that combine to form molecules.
Cellular:
Trillions of microscopic units known as cells are in constant motion in the body.
Tissue:
Tissues are similar types of cells with a common function that are grouped together.
Organ:
Structure composed of at least two different tissue types that perform a specific body function.
Organ System:
Groups of organs that work in unison to perform a common function.
Organism:
The combination of all the parts of the structure, working together to keep us alive.
4
Q
Eight essential functions for maintaining human life:
A
Response to stimuli Movement Growth Maintaining boundaries Reproduction Digestion Metabolism Excretion
5
Q
Eight essential functions explained:
A
Response to stimuli:
react to changes in the environment. Flinch from pain; increased respiratory rate when CO2 in blood is high.
Movement:
musculoskeletal system movement; and blood/foodstuffs/urine etc movement.
Growth:
increase in size, usually by increasing number of cells. Cell-constructing activities must occur at faster rate than cell-destroying activities. Largely directed by endocrine system.
Maintaining boundaries:
Must be able to keep “inside” distinct from “outside”. Every cell has a membrane; the human organism has the integumentary system.
Reproduction:
Cellular reproduction by cellular division. Organism reproduction by reproductive system/s
Digestion:
Breaking down food into simple molecules to be absorbed by the blood.
Metabolism:
All chemical reactions within body cells.
Breaking complex substances into simpler building blocks; making larger structures from smaller ones; using nutrients and oxygen to produce other molecules.
Depends on digestive and respiratory systems for production and cardiovascular system for distribution. Regulated by endocrine system.
Excretion:
Removing wastes from the body.
Essential of human naatomy & physiology eleventh edition
6
Q
Three important parts that make up any homeostatic control mechanism:
A
Sensory receptor:
Senses and responses to changes in the environment, such as extreme heat and cold.
Control Centre:
Receive the information, analyzes it, and decides on the appropriate response (such as shivering or sweating).
Effector:
Relays the response to the correct part of the body so that homeostasis can be maintained. This response is implemented by muscles or glands.
7
Q
Negative feedback loops:
Positive feedback loops:
A
aim to stay/move close to setpoint. (temperature regulation, both high and low temps)
amplification (fruit ripening chemicals spread; childbirth -> pressure of baby’s head on cervix causes contractions which increase pressure etc.)
Positive feedback loops = faster change
8
Q
What negative feedback mechanisms ensure that blood glucose is returned to normal levels after a sugary meal?
A
high = insulin secreted by pancreas triggers cells to store glucose and liver to store glucose as glycogen.
low = pancreas produces glucagon. converts glycogen from liver to glucose
9
Q
brachial: dorsal: cephalic: a- : afebrile:
A
arm back head without without fever
10
Q
Alternate names for planes:
Frontal:
Median:
Transverse:
Rostal: Caudal: Ipsilateral Contralateral Axial Intermediate
A
Coronal
Sagittal
Cross section
towards face/nose/beak
towards tail/tailbone
on the same side of the body (eg, both left limbs)
opposite sides of the body (eg, both arms)
around central axis (eg skeleton)
between two structures (heart intermediate to lungs)
11
Q
Anatomical position:
A
Palms forward, thumbs up
Arms by side
Feet slightly apart
12
Q
Divisions of the two body cavities:
A
Dorsal cavity divisions:
Cranial cavity and the Spinal/Vertebral cavity.
cranial cavity contains the brain and pituitary gland
spinal/vertebral cavity contains spinal cord and nerves.
Ventral cavity divisions:
Thoracic cavity, Abdominal cavity and Pelvic cavity (abdominopelvic)
The thoracic cavity is situated in the upper part of the trunk. Its boundaries are formed by a bony framework and supporting muscles. The main organs and structures are the trachea, bronchi, lungs, the heart, aorta, superior and inferior vena cava, the oesophagus, lymph nodes and the nerves.
The abdominal cavity is the largest cavity in the body and contains the stomach, small intestine and most of the large intestine, the liver, gall bladder, bile ducts, pancreas, spleen and two kidneys. Most of the abdominal cavity is occupied by the organs and glands of the digestive system. There are other structures such as the adrenal glands and numerous blood vessels and lymph vessels, nerves and lymph nodes that are found in the abdominal cavity.
The pelvic cavity extends from the lower end of the abdominal cavity and contains the sigmoid colon, rectum, anus, some loops of the small intestine, urinary bladder, lower parts of the ureters and the urethra, and in the female, and the organs of the reproductive system.
13
Q
Four quadrants and nine regions of Abdominopelvic cavity:
A
Right Upper Quadrant (RUQ)
Right Lower Quadrant (RLQ)
Left Upper Quadrant (LUQ)
Left Lower Quadrant (LLQ)
Left hypochondriac region Epigastric region Right hypochondriac region Right lumbar region Umbilical region Left lumbar region Left iliac region Hypogastric region Right iliac region
14
Q
How many cells in an adult body?
A
around 100 trillion cells, each of which have a very specific role to play.
15
Q
Three main parts of a cell:
A
Nucleus
Cytoplasm (jelly-like fluid)
Plasma membrane (or cell membrane)
16
Q
How many cells fit on the head of a pin?
A
around 10 000
17
Q
Two categories of cells:
A
Eukaryotic cells:
have organelles (including nucleus) enclosed in a membrane.
more advanced, complex cells (in plants and animals)
plant cells have cell walls, animal cells don’t.
Prokaryotic cells:
No nucleus or other organelles
have genetic material, but contained in nucleus
Single-celled organisms only. (bacteria etc)
18
Q
Organelles are:
A
organelle = “little organ”
specialised parts of the cell with unique “jobs” to perform.
Nucleus contains DNA (instructions for what cell does and how)
Chromatin = tangled, spread-out form of DNA. found inside nuclear membrane
Nucleolus produces Ribosomes, which create proteins.
Endoplasmic Reticulum: rough ER = ribosomes attached. smooth ER = no ribosomes attached.
Vesicles carry proteins etc from ER to Golgi apparatus.
Golgi body “folds” proteins into forms the body can use, and/or adds (lipids, carbs) to them.
Vacuoles: sack-like structures for storing materials.
Lysosomes (animals only) contain enzymes to break down cellular debri.
Mitochondrian = powerhouse. energy created through “cellular respiration”
Cytoskeleton maintains cell’s shape. Include microfilaments (made of protein) and microtubules.
19
Q
Cell specialisation:
A
There are many types of cell specialisation in the human body, some common specialised cells include surface skin cells, bone cells, muscle cells (including cardiac, skeletal and smooth), neurons and epithelial cells.
20
Q
(3 steps) Cellular respiration:
A
Glycolysis breaks down a 6carbon glucose molecule into 2x 3carbon pyruvic acid molecules. gives a net gain of 2 ATP molecules (body uses these as cellular energy). High energy electrons are released.
Each 3carbon pyruvic acid molecule enters the mitochondria as part of the “citric acid cycle”. 2 more ATP are created and carbon dioxide is released as a waste product. more high energy electrons released.
High energy electrons are used in the “electron transport chain”, located in mitochondrial membrane. This phase creates most of ATP. Previously-released electrons interact with a series of enzymes that store the energy from electrons in ATP molecules.
These three steps can produce up to 38 ATP molecules from one glucose molecule
21
Q
Plasma Membrane:
A
A see-through ‘skin’ or barrier that separates the cell contents from everything outside the cell (holds the cell contents together)
However, the plasma membrane (or cell membrane) also has important functions to perform related to allowing substances to get into and out of the cells - a process known as membrane transport.
Only small and uncharged particles can cross. Large or charged ones can’t.
22
Q
Diffusion:
A
the spread of particles from regions of higher concentration, to regions of lower concentration.
“Osmolarity” refers to concentration of particles per litre
23
Q
Osmosis:
A
movement of water molecules across a membrane from lower to higher solute concentration. This equalises the concentration on either side of the barrier/membrane.
“Osmotic pressure” = pressure caused by water crossing membrane.
24
Q
Tonicity:
A
The measure of the osmotic pressure gradient across a cell membrane.
Isotonic solution = one that gives same pressure inside and outside the cells. ie, a solution with equal osmolarity to cell contents. hypotonic (lower osmolarity than cell) solution can cause so much water to move into cells that they rupture
25
The study of tissues is known as:
Histology,
There are four primary tissues in the body:
Connective, epithelial, nervous, and muscle tissues.
26
Connective tissue:
Supports, connects, or separates different types of tissues and organs in the body. Connective tissue typically has cells scattered throughout an extracellular matrix of fibrous proteins and glycoproteins attached to a basement membrane
27
Epithelial tissue:
Covers the whole surface of the body. It is made up of cells closely packed and ranged in one or more layers. This tissue is specialised to form the covering or lining of all internal and external body surfaces. Also lines inner surfaces such as digestive & respiratory system lining etc.
28
Nervous tissue:
Makes up the different parts of our nervous system. The nervous tissue allows us to receive stimuli and process the information
29
Muscle tissue:
a soft tissue that composes muscles. There are three types of muscle tissue, these are cardiac, smooth and skeletal.
30
Wound healing:
Platelets from torn blood vessels work to form a mesh-like clot that prevents blood loss.
Inflammation occurs as tissue repair begins.
Mast cells release histamine that dilates blood vessels and increases blood flow to the repair site.
White blood cells (neutrophyls) and macrophages work to consume bacteria and remove damaged tissue/debris.
Fibroblasts build new tissue by secreting collagen that takes the shape of the original tissue.
During remodelling (the final phase) the tissue matures and regains its original function.
31
The adult human skeleton is made up of:
206 bones
These are living connective tissues, which is one of the four main types of tissue in the body, which require oxygen and nutrients, and the disposal of waste products in order to remain alive and functional.
32
Two subdivisions of the skeleton:
```
Axial skeleton (axis)
Appendicular skeleton (appended to axial skeleton)
```
33
articular process:
condyle:
neck:
articulation:
A projection that contacts an adjacent bone.
A large, rounded articular process.
The region of bone between the head and the shaft.
The region where adjacent bones contact each other—a joint.
34
crest:
eminence:
canal:
A prominent ridge.
A relatively small projection or bump.
A long, tunnel-like foramen, usually a passage for notable nerves or blood vessels.
35
epicondyle:
facet:
line:
A projection near to a condyle but not part of the joint.
A small, flattened articular surface.
A long, thin projection, often with a rough surface. Also known as a ridge.
36
foramen:
fossa:
malleolus:
An opening through a bone.
A broad, shallow depressed area.
One of two specific protuberances of bones in the ankle.
37
fovea:
labyrinth:
tubercle:
A small pit on the head of a bone.
A cavity within a bone.
A projection or bump with a roughened surface, generally smaller than a tuberosity.
38
meatus:
process:
diaphysis:
A short canal.
A relatively large projection or prominent bump.(gen.)
The long, relatively straight main body of a long bone; region of primary ossification. Also known as the shaft.
39
ramus:
sinus:
epiphysis:
An arm-like branch off the body of a bone.
A cavity within a cranial bone.
The end regions of a long bone; regions of secondary ossification.
40
spine:
suture:
epiphyseal plate:
A relatively long, thin projection or bump.
Articulation between cranial bones.
Also known as the growth plate or physis. In a long bone it is a thin disc of hyaline cartilage that is positioned transversely between the epiphysis and metaphysis. In the long bones of humans, the epiphyseal plate disappears by twenty years of age.
41
trochanter:
tuberosity:
head:
metaphysis:
One of two specific tuberosities located on the femur.
A projection or bump with a roughened surface.
The proximal articular end of the bone.
The region of a long bone lying between the epiphysis and diaphysis.
42
The axial skeleton:
Consists of 80 bones and is composed of six parts.
```
Face and skull bones,
Fossicles of the middle ear
Hyoid bone
Rib cage
Sternum
Vertebral column.
```
(the head and trunk of a vertebrate; or the bones of vertebrae, sacrum, ribs, and sternum)
The axial skeleton together with the appendicular skeleton forms the complete skeleton.
43
fontanelles:
"soft spots" on baby's skull
Fibrous, non-ossified connections that join the bones of the cranium to allow for the slight compression needed during vaginal delivery
44
Number of bones in the spine:
26:
```
7 cervical
12 thoracic
5 lumbar:
sacrum
coccyx
```
intervertebral disks between each (bar sacrum and coccyx)
45
rib cage:
also known as thoracic cage or bony thorax.
Twelve pairs of ribs form the walls of the bony thorax. All ribs articulate posteriorly with the thoracic vertebrae.
The "true ribs" (pairs 1-7) attach to the sternum via costal cartilages. Anatomically called vertebrosternal ribs
The false ribs are pairs 8-12. Anatomically called vertebrocondral ribs. Pairs 8-10 attach to the costal cartilage of rib 7 rather than the sternum. This section of cartilage together is called the Costal Margin.
The floating ribs (pairs 11 & 12) are also false ribs, but have no anterior attachment with the sternum. They are anatomically called vertebral ribs.
46
"slipped disc" is correctly called:
| three possible causes:
herniated disc.
Possible causes:
Drying of the discs, weakening of the ligaments of the vertebral column, and twisting forces.
47
Appendicular skeleton:
```
Bones come in all shapes and sizes, depending on where they are in the body and what they have to do. Bones are sometimes described according to their shape, for example:
Long Bone (humerous)
Flat Bone (sternum)
Short Bone (talus)
Irregular Bone (vertebra)
```
48
```
Parietal bone:
Temporal Bone :
Frontal Bone :
Occipital Bone:
Mandible:
Maxilla:
Clavicle:
Scapula:
Sternum:
(12 pairs of) Ribs:
Cervicle vertebrae:
Thoracic vertebrae:
Lumbaar vertebrae:
Sacrum:
Coccyx:
Humerus:
Radius:
Ulna:
Carpals:
Metacarpals:
Phalanges:
Pelvic girdle:
Femur:
Patella:
Tibia:
Fibula:
Tarsals:
Metatarsals:
```
```
top of skull
at temples
front of skull
back of skull
lower jaw
maxillary bone is lower front of face (down to top jaw)
runs from shoulder to sternum
shoulder blades
(manubrium, body and xiphoid process) frontal rib join.
7true (to spine) 5false ribs (3to costal cartilage, 2floating)
neck. C1-C7
chest. T1-T12
back (from below ribs) L1-L5
five vertebrae fused together (S1-S5) sits above coccyx.
tailbone. Three tiny vertebrae fused together
superior arm bone.
lateral inferior arm bone (thumb side)
medial inferior arm bone (pinky side)
wrist bones
central hand bones (through palm)
fingers and toes
hips etc
superior leg bone. largest in body
kneecap
medial leg bone
lateral leg bone
ankle bones
foot bones (between ankle and toes)
```
49
Five major functions that bones perform:
```
support
protection
movement
storage of minerals and fats
formation of blood cells.
```
50
The largest bone in the human adult:
Bone can also be called:
Two different types of bones:
The femur.
Osseous tissue.
Compact bone is dense and found mostly on the shaft of long bones. Spongy bone looks like a sponge with many open spaces.
51
Anatomy of Bone:
compact bone tissue along the long shaft and spongy bone towards the end of the bone at the joint which is capped in cartilage. The medullary cavity within the bone shaft is filled with bone marrow, which in turn is wrapped in the endosteum and then again by the periosteum. Nutrient vessels perforate the periosteum and the endostium and connect with the periosteum by way of the nutrient foramen.
52
Three types of cells that contribute to bone homeostasis:
osteoblasts (cells that form new bone),
osteoclasts (cells that break down the bone)
osteocytes (mature bone cells).
53
Osteon:
is a unit (small [cylindrical?] segment) of compact bone.
Comprised of:
Blood vessel, lymph vessel and nerve run down osteonic canal through centre;
Outside this is the matrix (osteocytes housed in lacunii) surrounded by caneliculii (network of canals that allow osteocytes to "communicate" with one another. Matrix contains osteocytes (that mature bone cells) through the centre, and osteoblasts (cells that form new bone) and osteoclasts (cells that break down damaged/old bone) towards the circumference.
Outside surface of osteon is lined with collagen.
If too much bone is broken down, not enough new bone is being formed, or the quality of the new bone is poor, it can contribute to the development of osteoporosis, particularly in older people
54
Osteoporosis:
Prevention of osteoporosis is multifaceted, however poor intake of dietary calcium and Vitamin D can play a very significant part in the development of this condition, and so an appropriate intake of these nutrients should be present in the diets of all older clients.
The structure of fragile osteoporotic bone being much less dense than normal bone tissue will mean it is important to take extra care to avoid falls in older clients who may be osteoporotic. Even a minor trip or stumble can cause a fracture in an osteoporotic patient, and an older person's bone is likely to take longer to heal than a younger person's bone.
55
Four types of fracture:
Greenstick fracture - the bone is only partially broken;
Simple fracture - the bone is neatly broken across entirely;
Open fracture - the bone is broken across entirely and displaced away from the separated half, puncturing skin;
Comminuted fracture - the bone is broken across entirely in several places.
Fracture, break, and crack all mean the same thing. One term is not more serious than another.
The description of the fracture also includes the direction it takes within the bones:
Transverse: the fracture travels across the bone;
Oblique: the fracture occurs at an angle;
Spiral: –the fracture spirals or extends down the length of the bone;
Comminuted: the fracture has more than two parts, multiple fragments are present.
56
Some medications commonly used to treat bone conditions include:
Bisphosphonates: slow down bone breakdown and is used to treat osteoporosis for example, Alendronate.
Hormone replacement therapy (HRT): These medications contain the hormone oestrogen and sometimes also progesterone. This therapy can reduce the risk of osteoporosis in women who have undergone menopause.
Calcium: Supplements may be recommended if it is not possible to obtain sufficient levels of calcium in the diet.
57
Synovial membrane:
A layer of connective tissue that lines the cavities of joints, tendon sheaths, and bursae and makes synovial fluid, which has a lubricating function.
58
Synovial fluid:
Yolk-like fluid found in the cavities of synovial joints which reduces friction between the articular cartilage of synovial joints during movement.
59
Joint Capsule:
The sac of dense fibrous tissue that surrounds the joint like a sleeve.
60
Synarthroses:
Amphiarthroses:
Diarthroses:
joints that do not allow any movement;
joints that allow a small/slight movement to happen;
freely moveable joints.
61
Three muscle types and their descriptions:
Skeletal muscle cells such as those of the deltoid muscle in the upper arm, are single, very long, cylindrical, cells with many nuclei, and they have a striped, or in medical terminology 'striated', appearance. They are known as 'voluntary' because you can choose to use them whenever you want.
Cardiac muscle cells are found in the walls of the heart and look totally different to skeletal muscle cells. Although they are striated, they are branching chains of cells that are joined together with intercalated discs to allow the spread of electrical impulses through the heart. They are involuntary muscles.
Smooth muscle cells are found in the walls of body organs such as the stomach and intestines, they are involuntary long narrow cells with one nucleus and no striations. They contract very slowly.
62
5 major properties of muscle system:
The muscular system is:
1) Excitable/irritable (capable of receiving and responding to stimulation from nerves.
2) Contractable (able to shorten upon stimulation)
3) Extensible (can be stretched without damage)
4) Elastic. (has elasticity = able to return to original length and shape after contraction/extension)
5) Adaptable (can be changed in response to how it is used. ie, hypertrophy = enlargement of muscle with increased work; atrophy = wasting away if not used.)
63
5 types of muscle movements:
Adduction: moving limb toward midline;
Abduction: moving limb away from midline;
Flexion: joint bends to decrease angle between two body parts;
Extension: straightening/extending joint to increase angle between two body parts
Rotation: moving a body part around an axis
64
```
tendon:
fascia:
Sarcolemma :
Myofibrils :
Sarcomeres :
Actin :
Aponeurosis :
```
connects muscle to bone
connects muscle to muscle
specific name for plasma membrane in muscle cells
muscle fibres = ribbon-like organelles.
contractile units chained together, to make myofibrils.
contractile protein in thin myofilaments of sarcomeres.
sheet-like connective tissue, attaches indirectly to bone, cartilage or connective tissue covering.
"essentials of human anatomy and physiology" textbk
65
Action potential. :
| Multinucleate :
```
Electrical current (by nerve impulses)to contract muscle
When mitosis (cell division) occurs without the cytoplasm dividing, it can result in multiple nucleii. common in liver.
```
"essentials of human anatomy and physiology" textbk
66
Three types of Range of Motion exercises:
Passive range of motion exercise (PROME):
the physiotherapist will move your limb along the joint range. This is often performed on patients who are unable to move their limb.
Active-assistive range of motion exercise (AAROME):
done on clients who are able to move their limb but needs assistance from the physiotherapist to complete the joint range. Sometimes, pain may limit the patient’s ability to actively complete the motion. The physiotherapist may assist the patient to complete the movement or just beyond the point of pain. The pain should not persist or worsen when motion is stopped.
In this type of ROM exercise, there is minimal assistance from the physiotherapist.
Active range of motion exercise (AROME):
Client performs the movement without physical assistance from the therapist. The physiotherapist may still verbally instruct the client on the proper execution of the exercise.
67
Other physiotherapy exercises (besides ROM):
Strengthening exercises:
Usually done on weakened muscles. It may also be done as part of the client’s general conditioning exercise program. Having normal muscle strength help prevent future injury.
When muscles are not moved for a while due to injury or immobilization (cast or brace), the muscles tend to get weak. Often, progressive strengthening exercises are included in the rehabilitation program. May start performing exercises with resistance bands then progress to weights as strength improves.
```
General conditioning exercises:
Involve a combination of exercises including range of motion, strengthening, and walking exercises to help maintain or improve your
Cardiopulmonary fitness;
Muscle and joint flexibility; and
Muscle strength.
```
Balance exercises:
For clients with balance problems. Strengthening major muscles are important for balance rehab program.
Depending on specific needs and level of fitness, client may start from where most stable.
Example: can sit without support, so may suggest that balance exercises are done using parallel bars. Once able to do them easily, start doing them without bars.
68
Five common muscular disorders:
Cramps:
An uncontrollable painful muscle spasm which can occur in any muscle but commonly occurs in the muscles of the calf and foot. Causes can include tight muscles, poor muscle tone, an imbalance in electrolytes or injury.
Muscular dystrophy:
Nine types. All are genetic diseases that lead to progressive weakness and irreversible muscle wasting.
ALS (MND):
Amyotrophic lateral sclerosis.
A disease of parts of the nervous system that control voluntary muscle movement (motor neurones). ALS usually occurs in middle age and causes weak and soft or tight and stiff muscles. As ALS progresses some muscles may become paralysed while others are unaffected although in late stage ALS most voluntary muscles are paralysed.
Myasthenia gravis:
This is an autoimmune disease that causes muscle weakness due to problems with the transmission of signals form the nerves to the muscles. This results in weak muscles that get tired quickly and which improve after rest. Symptoms start with eyes, face, and mouth (chewing/swallowing) and spread down.
```
Myositis:
Autoimmune; inflammation of the muscle tissue. This term usually relates to chronic forms of this condition which include:
Dermatomyositis
Polymyositis
Inclusion Body Myositis
Juvenile Myositis
```
69
Eversion:
Inversion:
rotating of ankle so sole of foot points outwards
| rotating ankle so sole of foot points inwards
70
pH of blood:
slightly alkaline; between 7.35 and 7.45
71
Normal blood volume of adults:
5-6 litres in males and 4-5 litres in females.
| Accounts for approximately 8% of total body weight.
72
Blood "recipe":
55% plasma
45% red blood cells
<1% white blood cells and platelets
red blood cells + white blood cells + platelets
= "formed elements". 99.9% red blood cells.
```
White blood cells:
Neutrophils 50-70%
Lymphocytes 20-30%
Monocytes 2-8%
Eosinophils 2-4%
Basophils <1%
```
73
Red blood cell contents:
These cells have very few organelles and no nucleus (anucleate) and so they are essentially bags of haemoglobin, with more than 250 million haemoglobin molecules in a single cell.
Every single one of these 250 million haemoglobin molecules has the ability to carry 4 molecules of oxygen, so a single red blood cell can potentially carry 1000 million molecules of oxygen!
In a normal, healthy adult, there are approximately 4 - 6 million Red blood cells (RBC) per square millimetre.
74
White blood cell content:
Neutrophils are the most common leukocyte. They are active phagocytes that are found at sites of acute infection
Lymphocytes represent the true immune system - they are comprised of B cells, producing antibodies and T cells that fight off viruses via direct cellular attack
Monocytes are large cells. They are active phagocytes that become macrophages - a long term 'clean up' cell that is common during chronic infections
Eosinophils fight off parasitic invaders, such as worms
Basophils are found at sites of inflammation; they release histamines and contain an anticoagulant, heparin
75
Platelets are:
not true 'cells', but irregular 'pieces' or fragments of large cells known as megakaryocytes. Platelets are anucleate (do not have a nucleus), but they play a very important role in the blood clotting process.
76
Haematopoiesis:
blood cell formation. Process differs, depending on the type of blood cell being formed.
All blood cells arise from a common stem cell, known as a haemocytoblast, found in the red bone marrow. The haemocytoblast differentiates into either lymphoid stem cells, which eventually form lymphocytes, or myeloid stem cells, which form all other types of blood cells.
Erythrocytes (red blood cells) are formed when the kidneys register decreasing levels of oxygen-carrying capacity in the blood. This stimulates the kidneys to release a hormone called erythropoietin (EPO), which stimulates the bone marrow to produce erythrocytes. This is a process known as erythropoiesis. During your career you may be involved in administering EPO intravenously to patients who lack this hormone so it's important to know what it is.
Red bone marrow is also responsible for the production of White blood cells and platelets, the formation of which is stimulated by hormones in response to environmental signals such as bacteria and toxins.
77
Three layers of blood vessel walls:
Tunica externa:
protects, reinforces and anchors the vessel to surrounding structures.
Tunica media:
controls vasoconstriction and vasodilation of the vessel.
Tunica interna:
reduces friction between the vessel walls and blood.
78
```
Ischaemic stroke:
Coronary artery disease:
Myocardial infarction:
Aortic stenosis:
Congenitive heart failure:
```
Blood clot or artery rupture in the brain.
Coronary artery narrowed by plaque = less O2 to heart
Heart attack. muscle death/weakness due to CAD^
Calcified aortic valve wont open fully; less blood flows.
Weakened heart muscle leads to tachycardia, fluid in lungs, thickened heart wall and swelling of lower limbs.
79
Peripheral Vascular disease:
Atherosclerosis:
Aortic aneurysm:
Pulmonary embolism:
lower limb artery narrowed by plaque. injure nerves etc
Cholesterol on inner artery wall=atherosclerotic plaque.
Weakened aortic artery in abdomen.bulges,can rupture
Part of DVT clot breaks and travels to pulmonary artery, cutting O2 supply to part of lungs
80
Skin excretes:
uric acid and urea via sweat
81
Skin-colour-related conditions:
Colour: Blue
Condition: Cyanosis
Cause: Poor circulation or lack of oxygen in the blood
Colour: Yellow
Condition: Jaundice
Cause: Elevated levels of bilirubin in the Blood
Colour: Black
Condition: Necrosis
Cause: Dead tissue due to injury, radiation or chemicals (e.g. toxins, bacteria and venom).
82
Two types of body membranes:
Epithelial membranes line the body cavities and body organs, and form the skin on the outer body surface
Connective tissue membranes
83
Five types of epithelial tissues:
Cuboidal: cube-shaped, specialised for secretion (eg kidney tubules, many glands)
Simple columnar: large brick-shaped. found where secretion/absorption is important (eg intestines)
Pseudostratified ciliated columnar: single layer of varied height (makes it look multilayered) (eg mucuous membrane of respiratory tract)
Stratified squamous: multilayered, constant regeneration. (eg skin and mouth lining)
Simple squamous: single thin layer of flat cells for diffusion. (eg blood vessels and air sacs in lungs)
84
Three types of epithelial membrane:
Cutaneous membrane:
The soft outer covering of vertebrates, and guards the underlying muscles, bones, ligaments, and internal organs. Relates to the skin.
Mucous membranes:
Lines all the body cavities that open to the exterior e.g. mouth, nasal passages, urinary and reproductive tracts. Despite their name, they don't all secrete mucus, but they are all moist surfaces.
Serous membranes:
Found in the three closed cavities: Pleural (lungs), peritoneal (abdominal), and pericardial (heart) cavities.
Occur in pairs, the visceral layer forms a lining around body organs, and folds outwards on itself to form a second layer, the parietal layer meaning that there is a small, potential gap in between the layers.
The potential gap between the two layers is labelled as the pleural cavity, and it contains a small amount of lubricating pleural fluid that reduces friction between the two surfaces.
Inflammation of the pleural space is known as 'Pleurisy'.
85
Connective tissue membranes:
Line the fibrous capsules that surround joints. Synovial membranes are connective tissue membranes that provide a smooth surface around some joints and secrete a lubricating fluid called synovial fluid that helps to provide cushioning for body organs during muscle activity.
86
Scleroderma:
Also known as systemic sclerosis.
Chronic connective tissue disease generally classified as one of the autoimmune rheumatic diseases.
Symptoms:
Thickening or hardening of the skin. (sclero=hard, derma=skin).
"systemic sclerosis " tells us more about the condition. It is a systemic disease (may affect many parts of the body) and sclerosis=thickening or hardening of the tissues
Scleroderma can cause serious damage to internal organs including the lungs, heart, kidneys, esophagus, and gastrointestinal tract. As such, it is often referred to as a “multi-system” disease. It can be life-threatening. Scleroderma is three to four times more prevalent in women.
Scleroderma is not contagious, infectious, cancerous or malignant.
87
Supporting Structures of the Integumentary system:
Hair, nails and sweat and oil glands.
Other than some minor protective duties of the eyebrows, eyelashes and hairs in the nose, the hair now usually plays a more cosmetic role than it did in the past when it was important for protecting against the cold. However, in some very cold climates it still has a significant function in maintaining warmth in the body.
The cutaneous glands, that is, the glands found in the skin, are exocrine glands that discharge their secretions into ducts before they are released on to the skin surface.
There are two types of cutaneous glands: sebaceous glands and sweat glands
Sebaceous glands are found all over the body. They produce sebum ('grease') which, as well as lubricating the skin, acts as an antiseptic agent, killing bacteria on contact. Sebum is produced in large quantities in adolescence, causing the skin to become oilier at this time of life, and resulting in teenage skin problems.
88
Burns:
Burns can result in damage to the cells and tissues of the body that can range from minor (but painful) through to life-threatening or fatal. Immediate loss of fluids through the damaged skin and underlying tissues can cause death, but if the patient survives the first 24 hours, infection can be fatal.
You should always seek advice from Specialist Burns Units regarding the most appropriate evidence-based treatment for serious burns, as these wounds will require specific and specialized care. Generally, these patients will be transferred to a Tertiary Hospital that has specialized facilities, resources, and personnel who are trained in best practice management of these conditions.
1st degree burn = only epidermis
2nd degree burn = epidermis and dermis
3rd degree burn = epidermis, dermis and hypodermis.
89
Pressure ulcers:
Also known as bedsores/pressure sores.
Occur when there is localised injury to the skin and/or underlying tissue usually over a bony prominence (e.g. heels, elbows, sacrum) due to the result of pressure or a combination of pressure and shearing forces. Prevention of pressure ulcers includes regular position changes, good hygiene and maintenance of skin.
```
Common locations:
Back of head and ears
Shoulders
Elbows
Lower back and buttocks
Hips
Inner knees
Heels
```
```
Signs to watch for:
discolouration
numbness
pain
itching
heat
hardness
```
90
Eczema:
Also known as atopic dermatitis.
Chronic inflammatory condition that can cause symptoms such as dryness, redness and itching. Triggers include environmental irritants (e.g. soaps) and heat and sometimes food. Skin with eczema is more prone to infections such as Staphylococcus aureus.
91
Acne:
A common skin condition which often occurs in the teenage years. Acne is caused by inflammation of the hair follicles and commonly affects the face back and chest. Treatment can include over the counter topical remedies as well as prescribed treatments such as hormonal agents (e.g. oral contraceptives), antibiotics, retinoid creams or ointments.
92
Psoriasis:
A chronic skin condition which causes dry, red, raised patches of skin covered in silvery scales (plaques). Psoriasis can also affect the joints. Treatments can include moisturisers, topical treatments and UV light.
93
Rosacea:
A common skin condition that causes redness, flushing on the face. It can be triggered by sun exposure, stress, alcohol and hot, spicy foods.
94
Integumentary System Pharmacology:
Medication vary greatly according to the condition type and severity but can include both topical and systemic medications.
Systemic medications include:
Antibiotics to treat certain types of acne
Immunosuppressants used to treat psoriasis
Topical medications include:
Corticosteroid preparations used to relieve inflammation;
Anti-infective agents such as anti-biotic or antiviral preparations.
95
cicatrix:
| actinis keratosis:
a normal scar resulting from the healing of a wound;
| a precancerous skin growth that occurs on sun-damaged skin
96
alopecia universalis:
| alopecia areata:
the total loss of hair on all parts of the body;
an autoimmune disorder that attacks the hair follicles, causing well-defined bald areas on the scalp or elsewhere on the body
97
bulla:
| alopecia capitas totalis:
large blister, usually more than 0.5 cm in diameter;
| an uncommon condition characterized by the loss of all the hair on the scalp
98
carbuncle:
anhidrosis:
a cluster of connected furuncles (boils);
| abnormal condition of lacking sweat in response to heat
99
curettage:
blepharoplasty:
the removal of material from the surface by scraping;
| the surgical reduction of the upper and lower eyelids by removing excess fat, skin, and muscle
100
cyst:
cellulitis:
abnormal sac containing gas/fluid/semisolid material;
an acute, rapidly spreading infection within the connective tissues that is characterized by malaise, swelling, warmth, and red streaks
101
diaphoresis:
chloasma:
profuse sweating;
| a pigmentation disorder characterized by brownish spots on the face
102
dysplastic nevi:
| comedo:
atypical moles that may develop into skin cancer;
| a noninfected lesion formed by the buildup of sebum and keratin in a hair follicle
103
erythroderma:
contusion:
abnormal redness of the entire skin surface;
| an injury to underlying tissues without breaking the skin and is characterized by discoloration and pain
104
granulation tissue:
| cuticle:
tissue that normally forms during healing of a wound;
a narrow band of epidermis attached to the surface of the nail just in front of the root, protecting the new keratin cells as they form
105
heparin:
debridement:
an anticoagulant released in response to an injury;
the removal of dirt, foreign objects, damaged tissue, and cellular debris from a wound to prevent infection and to promote healing
106
hidrosis:
dermatoplasty:
the production and excretion of sweat;
| the replacement of damaged skin with healthy tissue taken from a donor site on the patient's body
107
hyperhidrosis:
dermatosis:
condition of sweating in 1 area or over the whole body;
| a general term used to denote skin lesions or eruptions of any type that are not associated with inflammation
108
lipectomy:
ecchymosis:
the surgical removal of fat beneath the skin;
| a large, irregular area of purplish discoloration due to bleeding under the skin; a bruise
109
macule:
| exfoliative cytology:
a discolored, flat spot that is less than 1 cm in diameter;
| a technique in which cells are scraped from the tissue and examined under a microscope
110
Mohs surgery:
| exfoliative dermatitis:
a technique used to treat skin cancer;
| a condition in which there is widespread scaling of the skin, often with pruritus, erythroderma, and hair loss
111
necrotising fascilitis:
| furuncles:
a severe infection caused by Group A strep bacteria;
| large, tender, swollen areas caused by a staphylococcal infection around hair follicles or sebaceous glands; boils
112
nevi:
granuloma:
moles = small dark skin growths from melanocytes;
| a general term used to describe small, knot-like swellings of granulation tissue in the epidermis
113
onychocryptosis:
haematoma:
ingrown toenail. edges of nail curve in + cut into skin;
| a swelling of clotted blood trapped in the tissues, usually caused by an injury
114
onychomycosis:
ichthyosis:
a fungal infection of the nail;
| a group of hereditary disorders characterized by dry, thickened, and scaly skin
115
onychophagia:
impetigo:
nail biting or nail eating;
| a highly contagious bacterial skin infection that commonly occurs in children
116
paronychia:
keloid:
acute or chronic infection of the skin fold around a nail;
| an abnormally raised or thickened scar that expands beyond the boundaries of the incision
117
pediculosis capitis:
pediculosis corporis:
pediculosis pubis:
keratosis:
an infestation with head lice;
an infestation with body lice;
an infestation with lice in pubic hair and pubic region;
any skin growth, such as a wart or a callus, in which there is overgrowth and thickening of the skin
118
petechiae:
koilonychia:
pinpoint hemorrhages less than 2 mm in diameter;
| a malformation of the nails in which the outer surface is concave or scooped out like the bowl of a spoon
119
pruritus:
lipedema:
itching. is associated with most forms of dermatitis;
a chronic abnormal condition that is characterized by the accumulation of fat and fluid in the tissues just under the skin of the hips and legs
120
purulent:
| lupus erythematosus:
producing or containing pus;
| an autoimmune disorder characterized by a red, scaly rash on the face and upper trunk
121
seborrhea:
melanosis:
overactivity of sebaceous glands =excessive sebum;
| any condition of unusual deposits of black pigment in different parts of the body
122
seborrheic keratosis:
| miliaria:
benign skin growth that has a waxy or "pasted on" look;
an intensely itchy rash caused by blockage of the sweat glands by bacteria and dead cells; also known as heat rash and prickly heat (do not confuse with malaria)
123
strawberry hemangioma:
| onychia:
a soft, raised, dark-reddish-purple birthmark;
| an inflammation of the matrix of the nail that usually results in the loss of the nail
124
tinea:
purpura:
ringworm = fungal infection, can grow on skin/hair/nails;
| the appearance of multiple purple discolorations on the skin caused by bleeding underneath the skin
125
tinea cruris:
| pyoderma:
tinea found in the genital area; also known as jock itch;
| any acute, inflammatory, pus-forming bacterial skin infection such as impetigo
126
urticaria:
wheal:
rhinophyma:
itchy wheals caused by an allergic reaction;
a small bump that itches (ie a welt);
a condition characterized by hyperplasia (overgrowth) of the tissues of the nose and is associated with advanced rosacea; usually occurs in older men
127
xeroderma:
rhytidectomy:
excessively dry skin:
| the surgical removal of excess skin and fat around the face to eliminate wrinkles; also known as a facelift
128
seborhheic dermatitis:
an inflammation that causes scaling and itching of the upper layers of the skin or scalp
129
sleep hyperhidrosis:
the occurrence of excessive hyperhidrosis during sleep; also known as night sweats
130
tinea versicolour:
a fungal infection that causes painless, discoloured areas on the skin
131
unguis:
fingernail or toenail; the keratin plate protecting the dorsal surface of the last bone of each finger and toe
132
The digestive system consists of:
```
mouth, tongue, salivary glands and pharynx
oesophagus
liver
gall bladder
stomach
spleen
pancreas
small intestine (duodenum, jejunum, ileum)
appendix
large intestine
rectum
anal canal.
```
It takes in food, breaks it down into nutrient molecules, absorbs them into the bloodstream and then rids the body of the indigestible remains.
The alimentary canal, also called the gastrointestinal tract (GIT), is a continuous muscular tube that winds through the ventral body cavity and is open at both ends. The terminal opening is called the anus. In a cadaver, the GIT is approximately 9m long; but in a living person, it is much shorter because of its relatively constant muscle tone.
133
Chemical breakdown of food uses:
enzymes, bile and hydrochloric acid.
134
Digestive enzymes include:
Mouth:
Salivary amylase Breaks down starches into disaccharides
Stomach:
Pepsin Breaks down proteins into large peptides
```
Small intestine (from pancreas):
Amylase Continues breakdown of starch;
Trypsin Continues breakdown of protein;
Lipase Breaks down fat
```
Small intestine:
Maltase, sucrose, lactase Break down remaining disaccharides into mono saccharides;
Peptidase Breaks down dipeptides into amino acids
135
Where are most nutrients absorbed?
Jejunum and ileum absorb 95-99% of nutrients fron food.
136
Deglutition:
swallowing.
137
Symptom of gallstones:
When gallstones block the ducts leading form the gallbladder to your intestines, this may cause a sharp pain in your upper right abdomen.
138
Celiac disease:
This is where the immune system acts abnormally to gluten causing damage to the small intestine when the villi in the bowel become flattened. This causes symptoms which include diarrhoea, constipation, nausea, vomiting, fatigue and weight loss.
139
Diverticular disease:
Diverticulosis is the formation of small pouches in the bowel wall due to defects in the muscle wall. When these pouches become inflamed this is call diverticulitis. Symptoms include: abdominal pain and bloating, constipation and diarrhoea, flatulence and blood in the faeces.
140
Digestive System Pharmacology:
Anti-inflammatory drugs: used to treat the different types of inflammatory bowel disease. These may include Aminosalicylates for example, sulfasalazine.
Corticosteroids:eg. prednisolone, hydrocortisone.
Immune system suppressors: drugs used to reduce inflammation by targeting the immune response that releases the chemicals causing the inflammation.
Anti-emetics: may be used to be treat nausea and vomiting. Eg, metoclopramide, chlorpromethazine and ondansetron.
Aperients: include osmotic laxatives, softeners peristaltic stimulants. used to treat constipation.
141
Sperm and testosterone production:
The testes are the primary sex organs (gonads) of the male and consist of two oval glands located within the scrotal sac. Each testis is divided into lobules, which contain the seminiferous tubules, the site of sperm formation. The interstitial cells surrounding these tubules produce hormones called androgens, in particular, testosterone, which is needed for sperm formation. The main functions of the male reproductive system are to produce sperm and hormone testosterone.
142
Semen production:
The seminal vesicles, prostate gland and the bulbo-urethral glands produce most of the semen. Semen is a milky white secretion made up of sperm and other secretions. Semen is alkaline and therefore helps neutralize the acidity of the female vagina as well as protect the delicate sperm. Each ejaculation consists of about 2 - 5 ml of semen that contains approximately 50 - 130 million sperm in each millilitre.
143
Difficulties with prostate gland:
The prostate gland can be the cause of significant discomfort in older men when it becomes enlarged (hypertrophies) and results in difficulty with urination (dysuria) and bladder infections (cystitis). As the urethra passes through the prostate, enlargement impinges on the tube, causing narrowing or blockage.
Additionally, cancer of the prostate gland is now the third most prevalent cancer in men.
144
Female sex hormones and menstrual cycle:
Follicle stimulating hormone (FSH):
Secreted from anterior pituitary.
Stimulates follicular growth and oestrogen secretion (from the developing follicles).
Oestrogen:
Secreted from ovaries (developing follicle)
Its function is development of endometrium.
Stimulates LH secretion (follicular phase).
Inhibits LH and FSH (luteal phase).
```
Luteinising hormone (LH):
Secreted from anterior pituitary
Surge causes ovulation.
Also causes development of corpus luteum.
Stimulates progesterone secretion.
```
Progesterone:
Secreted from ovaries (corpus luteum)
Thickens the endometrium.
Inhibits LH and FSH (luteal phase).
145
Eggs survive after ovulation for:
12-24 hours. For pregnancy to occur, they need to be fertilised within this window.
146
Three stages of labour:
early labour, active labour, and delivery of the placenta and afterbirth.
147
Male reproductive system issues:
Testicular cancer:
second most common cancer in young males. The most common symptom is a painless swelling or lump in the testicle
Prostate Disease:
Also known as benign prostatic hypertrophy (BPH). This is when the prostate gland enlarges which can cause difficulty urinating, dribbling and nocturia.
Prostate cancer:
Symptoms of prostate cancer include feeling the need to urinate suddenly or frequently; difficulty urinating; painful urination; pain in lower back upper thighs or hips.
Erectile dysfunction:
Also known as ‘impotence’; this is the inability to achieve or maintain a penile erection sufficient to complete sexual activity.
Cryptorchidism:
Also known as ‘undescended testes’. This in when one or both of the testes fails to descend into the scrotum.
148
```
arche/o:
colp/o:
episi/o:
metr/o/i:
salping/o:
-atresia:
hysteratresia:
menometrorrhagia:
```
```
first, beginning;
vagina;
vulva;
uterus:
uterine/fallopian tube;
absence of normal body opening, or occlusion/closure;
closure of the uterus;
rapid flow of blood from the uterus at menstruation (and between menstrual cycles; increased amount).
```
149
```
menorrhagia:
metrorrhagia:
oligomenorrhea:
colpoperineorraphy:
colpoplasty:
colporraphy:
A and P repair:
episioperineoplasty:
episiorraphy:
hysteropexy:
sonohysterography:
vesicovaginal fistula:
stereotactic breast biopsy:
```
rapid bloodflow at menstruation (increased amount);
rapid bloodflow from uterus (btween menstrual cycles);
scanty menstrual flow (less often);
suture of the vagina and perineum;
surgical repair of the vagina;
suture of the vagina;
anterior and posterior colporrhaphy;
surgical repair of the vulva and perineum;
suture of the vulva;
surgical fixation of the uterus;
process of recording the uterus by use of sound;
abnormal opening between the bladder and vagina;
technique that combines mammography and computer assisted biopsy to obtain tissue from a breast lesion.
150
```
culdocentesis:
leukorrhea:
mastoptosis:
UAE:
TVS:
TVH:
Cx:
FBD:
SHG:
TAH/BSO:
```
```
surgical puncture: remove fluid from pouch of Douglas;
white discharge (from the vagina);
sagging breast;
uterine artery embolization;
transvaginal sonography;
total vaginal hysterectomy;
cervix;
fibrocystic breast disease;
sonohysterography;
total abdominal hysterectomy/bilateral salpingo-oophorectomy
```
151
Neurons:
highly specialised nerve cells that transmit messages (nerve impulses) from one part of the body to another. Impulses are sent from various areas in the brain, down the spinal cord and out to peripheral nerve endings, and other electrical impulses return along a similar but different pathway. Different nerves cells have different roles and their structure varies, but there are some common characteristics of all neurons.
All neurons have a cell body which contains the nucleus and one or more fibres (also called processes) that extend from the cell body. These fibres can vary in length from less than a millimetre to more than one metre. The longest ones in humans stretch from the lumbar region of the spinal column to the big toe.
152
Two types of neuron fibres:
Dendrites conduct electrical currents toward the cell body.
Axons conduct electrical currents away from the cell body.
A neuron can have hundreds of branching dendrites but usually only one axon.
Most axons are covered with a myelin sheath - a white fatty substance that protects and insulates the axon as well as helping to increase the speed of nerve impulses. Axons outside the brain and spinal cord are myelinated by Schwann cells, which are supporting cells that wrap around the axon in a tight coil.
153
There are two types of nerve cells:
Glial cells/neuroglia are supporting cells;
and
Neurons.
154
Action potentials:
Nerve impulses are conducted along a neuron by means of what is known as an action potential.
An action potential relies mainly on sodium (Na+) and potassium (K+) to change the electrical charge of a resting cell and bring about a response.
Dendrites receive signal. chain reaction in axon moves message to synapse, where the signal is transferred.
Before this process begins, neuron is polarized positive outside and negative inside.
Signal passing causes membrane to depolarise then repolarise, passing positive charges in and then back out.
Depolarising signal creates a chain reaction that passes along the axon.
At axon terminal, chemical synapses trigger release of neurotransmitters, which travel across a small space to activate another neuron or body tissue (such as muscle)
155
Peripheral nervous system (PNS):
Somatic Nervous System. Voluntary, except "Reflex loop" when signal only goes as far as spinal cord before message being sent back (ie doesn't get sent to brain).
Autonomic Nervous System: Sympathetic (fight or flight/stress) and Parasympathetic (the opposite). both are always active; together they create balance/homeostasis.
156
Cerebral hemispheres:
The two cerebral hemispheres are known collectively as the cerebrum.
Cerebrum is composed mostly of nerve fibre tracts that are whitish in colour and are known as 'white matter', as opposed to 'grey matter' which is composed of cell bodies.
The two hemispheres are divided by a large bundle of nerve fibre tracts called the corpus callosum that allow the two hemispheres to communicate with each other.
157
Diencephalon:
Situated right in the centre of the brain, and includes a lot of grey matter (i.e. cell bodies) as well as the thalamus and the hypothalamus.
The thalamus is like a relay station for sensory and motor impulses, relaying them to and from the cerebral cortex. It is also important in memory and emotion.
The hypothalamus is smaller than the thalamus and is situated below (hypo = below) and in front of the thalamus. It's the control centre for the Autonomic Nervous System and it regulates appetite, thirst, temperature, and the hormonal output of the Anterior Pituitary Gland. It also secretes Antidiuretic Hormone (ADH) and oxytocin, which is stored in the posterior pituitary gland.
158
Brain stem:
The brain stem houses the midbrain (mesencephalon), pons (part of the metencephalon), and medulla oblongata (myelencephalon). This is the posterior area of the brain that attaches to the spinal cord. It's here, at the brain stem, where information is sent back and forth between the cerebrum or cerebellum and the body. Also connects most of cranial nerves and spinal cord
159
Cerebellum:
This structure is tucked away at the bottom and back of the brain. (also divided into hemispheres)
The main functions of the cerebellum are control of balance and equilibrium, and coordination of movements. Damage to the cerebellum (for example from a stroke or a tumour) can cause the condition called ataxia, in which the person loses muscle coordination and balance.
One of the clinical tests for this condition is to ask the person to touch their finger to their nose with their eyes closed - ataxic patients are unable to do this accurately, whereas normally it is easily accomplished.
160
Cerebral cortex types:
Primary (basic motor or sensory functions)
| Association (associates different types of info for more complex processing and functions)
161
Three layers of meninges:
The meninges refer to the membranes that cover and protect the brain. The three layers of meninges (from outside in) are:
Dura mater (periosteal and meningeal sublayers)
Arachnoid mater
Pia mater.
The space between the skull and the dura mater is called the epidural space
162
CSF:
cerebrospinal fluid. cushions, protects, delivers nutrients and removes waste from the brain.
163
Average length of adult spinal cord:
~42cm long, extending from the foramen magnum of the skull to the level of the first or second lumbar vertebrae.
164
The inferior "end" of the spinal cord is called:
| The bundle of nerves exiting here is called:
```
the conus medullaris. (located just below T12)
cauda equina (because it resembles horse's tail)
```
165
Path of travel for messages from sensory receptor to brain then back to appropriate muscle:
The sensory receptor in the skin receives a message that is sent through the peripheral nerve to the big group of nerve fibres just outside the spinal column - the posterior or dorsal horn, which then sends it on to the receiving area in the brain.
The thalamus is the relay station in the brain for sensory impulses, so the impulse will be directed from there to the appropriate motor area in the cerebral cortex for action.
From here, the impulse passes down the spinal cord and out of the smaller front (or ventral) group of nerve fibres, (the anterior horn) through the peripheral nerve and on to the muscle that can move the body appropriately.
166
How fast do nerve impulses travel?
Varies with the type of impulse. Many impulses travel at around 100 metres per second, but this can rise to 350 metres per second at times.
167
Pairs of nerves in the PNS:
The 12 pairs of cranial nerves found in the head and neck. These are:
1) Olfactory nerve fibres
2) Optic nerve
3) Oculomotor nerve
4) Trochlear nerve
5) Trigeminal nerve
6) Abducens nerve
7) Facial nerve
8) Vestibulocochlear nerve
9) Glossopharyngeal nerve
10) Vagus nerve
11) Accessory nerve
12) Hypoglossal nerve
There are also 31 pairs of spinal nerves.
168
ANS:
The Autonomic Nervous System is the motor subdivision of the Peripheral Nervous System that controls automatic (involuntary) body activities and maintains the body in a homeostatic state
The Autonomic Nervous System is further divided into the sympathetic and parasympathetic nervous systems. These two divisions serve the same organs with different effects, enabling the body to maintain a homeostatic balance.
169
Sympathetic ANS:
'fight or flight' responses, with control of processes such as:
dilates pupils
inhibits saliva
relaxes bronchi
accelerates heartbeat and breathing rates
inhibits peristalsis and secretion
stimulates glucose production and release
stimulates adrenaline and noradrenaline secretion
inhibits bladder contraction
stimulates orgasm.
170
Parasympathetic ANS:
```
"rest and digest" responses, with control of processes such as:
constricts pupils
stimulates flow of saliva
constricts bronchi
slows heartbeat and breathing rates
stimulates peristalsis and secretion
stimulates bile release
contracts bladder
```
171
Spina bifida:
A group of congenital defects known as neural tube defects, which affects the formation of the spine and spinal cord.
172
Parkinson's disease:
A degenerative condition where there is a decline in the production of dopamine.
173
Alzheimer's disease:
The most common form of dementia (up to 70% of cases) where changes in the brain cause impaired memory, thought processes and behaviour.
Alzheimer’s disease can be either sporadic or familial:
Sporadic Alzheimer's disease can affect adults at any age, but usually occurs after age 65 and is the most common form of Alzheimer's disease.
Familial Alzheimer’s disease is a very rare genetic condition, caused by a mutation in one of several genes. The presence of mutated genes means that the person will eventually develop Alzheimer's disease, usually in their 40's or 50's.
Symptoms:
In the early stages the symptoms can be very subtle. However, it often begins with lapses in memory and difficulty in finding the right words for everyday objects.
Other symptoms may include:
Persistent and frequent memory difficulties, especially of recent events;
Vagueness in everyday conversation;
Apparent loss of enthusiasm for previously enjoyed activities;
Taking longer to do routine tasks;
Forgetting well-known people or places;
Inability to process questions and instructions;
Deterioration of social skills;
Emotional unpredictability
Symptoms vary and the disease progresses at a different pace according to the individual and the areas of the brain affected. A person's abilities may fluctuate from day to day, or even within the one day, becoming worse in times of stress, fatigue or ill-health.
174
CVA:
cerebrovascular accident/stroke
blocked artery =ischaemic stroke,
or bleed in the brain =haemorrhagic stroke.
175
Meningitis:
An inflammation of the meninges which can be bacterial, viral or fungal. Meningitis is potentially life threatening, and can cause death or disability in only a matter of hours.
Symptoms can be similar to those of the common flu and can develop quickly, over a matter of hours.
The main symptoms to look out for are:
fever, rash, vomiting, headache, stiff neck, sensitivity to light, and drowsiness.
The signs and symptoms do not appear in a definite order, may not occur all together, or may not appear at all.
```
Other symptoms include:
Behavioural changes
irritability
Listless, less responsive
Blank, staring expression
cold hands and feet
Pale or blotchy skin
Rash or spots that don’t fade with pressure (called purpura/petechiae) (DON'T WAIT for this,may not occur)
Rapid breathing
Seizures, fits or convulsions
Muscle, leg or joint pain
```
176
Epilepsy:
Epilepsy is a condition where repeated convulsive or not convulsive seizures occur. Not all seizures mean that the person has epilepsy.
A seizure happens when the normal alternating pattern of these electrical impulses are disrupted, causing them to rapidly fire all at once.
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Depending on where the seizure in the brain, this can cause changes in:
sensation and feeling
awareness and consciousness
behaviour
or movement
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Seizures vary greatly and can be very brief or last up to two or three minutes. Most seizures are over in less than two minutes. Some seizures are severe and some very subtle.
Roughly 50% of people have no known cause for their epilepsy. However, some known causes include:
Hhead injury such as in a car accident, trauma or serious fall;
Stroke or brain haemorrhage;
Lack of oxygen to the brain for a prolonged period (such as in birth trauma, cardiac arrest, drowning, drug overdose);
Brain infections (for example meningitis, encephalitis or brain abscess);
Brain abnormalities or malformations;
Brain tumours;
Genetic factors;
Degenerative conditions affecting the brain (such as dementia).
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Head injury:
A head injury can sometimes result in damage to the brain. Concussion is a traumatic brain injury that alters brain function and its effects can be temporary or permanent.
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5 special senses:
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Sight
Hearing
Smell
Taste
Equilibrium (balance)
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Although it is commonly thought that touch is one of the special senses, touch is more accurately a mix of the general senses that relay sensations of temperature, pressure and pain.
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Sight:
The eyes contain an incredible 70% of all the sensory receptors in the body.
An understanding of the anatomy of the eye will give you more knowledge and understanding when working with clients who have sight limitations or conditions that alter their ability to perceive objects clearly.
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Hearing:
Perceive sound by detecting vibrations and changes in the pressure of the surrounding medium through an organ such as the ear.
Sound may be heard through solid, liquid, or gaseous matter.
Hearing is achieved by mechanical waves, known as vibrations which are detected by the ear and transduced into nerve impulses that are perceived by the brain (primarily in the temporal lobe).
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Olfaction:
Sense of smell allows the perception of odours.
Thousands of olfactory receptors which have 'hairs' or cilia that protrudes from the nasal epithelium are located in the roof of the nasal canals. The cilia are bathed in a layer of mucus, and are stimulated by chemicals dissolved in this mucus and transmit impulses along the olfactory nerve, which conducts impulses to the olfactory cortex of the brain where the odour is interpreted. This part of the brain is linked to the limbic system, which is why a smell may trigger a memory e.g. smell of eucalyptus reminds some people of walking in the Australian bush and for others, it reminds them of hospitals or illness.
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Taste:
Gustation is one of the traditional senses and refers to the ability to detect the flavour of substances. Although the human tongue can identify thousands of different tastes, they are commonly grouped into five kinds - bitter, salty, sour, sweet and umami.
The ability to detect bitter-tasting substances is essentially a protective mechanism as many toxins taste bitter. Similarly, a sour taste is usually only agreeable in small amounts, again, warding off the potential to ingest harmful substances
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Equilibrium:
The semi-circular canals and the vestibule in the inner ear (the vestibular apparatus) are responsible for maintaining equilibrium in the body.
They do this with the help of fluid (perilymph and endolymph), hair cells and receptors that work together to cause impulses to be transmitted up the vestibular nerve to the cerebellum.
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Sight:
The eye has the ability to focus our vision so we can clearly see close-up objects that are less than about 3 metres away through the process of accommodation (focussing) that is achieved by contraction of the lens.
When people see close objects clearly but have trouble distinguishing more distant objects, they are said to have myopia, or near-sightedness.
When people can see distant objects clearly but have trouble focussing on near objects, they have hyperopia, or far-sightedness.
Presbyopia is a gradual age-related change in the ability to focus on nearby objects.
Correction of the way the lens diverges the light rays before entering the eye allows emmetropia, or optimal focussing of images on the retina.
As the light stimulus (now a sensory stimulus) passes from the rods and cones, bipolar cells and ganglion cells into the optic nerve, it passes through the optic chiasm where the fibres from the medial side of each eye cross over to the opposite side of the brain and travel along the optic tracts, while the fibres from the lateral side of each eye don't cross over. The optic fibre tracts pass through the thalamus (you may recall that this is the 'relay station' of the brain) to the occipital lobe of the brain where interpretation of the stimulus occurs.
Note that each eye sees a slightly different visual field - the lateral field of vision from its own side of the body, and the medial field of vision from the other eye. This phenomenon gives humans binocular vision (two-eyed vision) which allows us to see in 3D (or three-dimensionally).
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Cataracts:
the lens of the eye becomes hard and non-transparent (opaque) and looks 'milky'. This causes hazy and distorted vision, and may cause blindness if not surgically treated.
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Glaucoma:
drainage of the aqueous humour is blocked, causing a build-up of pressure in the eye with pain and eventual blindness. These patients will need eye drops instilled into the affected eye on a daily basis to minimise this pressure build-up and prevent loss of sight.
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Corneal transplant:
As the cornea has no blood supply it can be transplanted without the concern of rejection by the recipient's immune system.
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Outer ear:
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The outer (external) ear is composed of the pinna and the external auditory canal.
In the walls of the external auditory canal are glands that secrete cerumen (earwax).
Sound waves entering the external auditory canal eventually hit the tympanic membrane (eardrum) and cause it to vibrate. The eardrum separates the outer and the middle ear.
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Middle ear:
The middle ear is a small space containing the Eustachian tube and three small bones called the ossicles.
The eustachian tube connects the middle ear and the throat. The eustachian tubes purpose is to equalise the pressure on both sides of the tympanic membrane by allowing air to pass from the area of the throat into the middle ear.
The ossicles amplify sound received from the eardrum and transmit it to the oval window also known as the fenestra vestibuli.
The oval window separates the middle ear from the inner ear.
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Inner ear:
The inner ear consists of the semi-circular canals and the cochlea, which contains fluid and hair like structures.
In the cochlea, fluid carries sound waves received from the middle ear to the auditory nerve.
The auditory nerve carries the message to the brain.
The semi-circular canals are involved in balance. They sense the head's position and changes in position and send messages to the brain.
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6 steps involved in hearing:
1) Sound waves enter and travel down the external auditory canal.
2) The vibrations from the sound waves then hit the tympanic membrane (ear drum) which vibrates and transmits the vibration to the ossicles.
3) The movement of the stapes (part of the ossicles) creates pressure waves on the oval window.
4) The vibrations from the oval window move through the vestibular duct (Scala vestibule) and push on the cochlear duct membrane (Basilar membrane) causing movement of the hair cells.
5) The movement of the hair cells is converted to electrical impulses which travel along the cochlear nerve to the brain (temporal lobe).
6) Energy from the sound waves is transferred across the cochlear duct into the tympanic duct (Scala tympani) and dissipated back in to the middle ear at the round window.
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Benign Paroxysmal Positional Vertigo:
Paroxysmal = it comes in sudden, brief spells.
BPPV is a mechanical problem in the inner ear.
It occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be.
When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.
Fluid in the semi-circular canals does not normally react to gravity. However, the crystals do move with gravity, thereby moving the fluid when it normally would be still.
When the fluid moves, nerve endings in the canal are excited and send a message to the brain that the head is moving, even though it isn’t. This false information does not match with what the other ear is sensing, with what the eyes are seeing, or with what the muscles and joints are doing, and this mismatched information is perceived by the brain as a spinning sensation, or vertigo, which normally lasts less than one minute.
Between vertigo spells some people feel symptom-free, while others feel a mild sense of imbalance or disequilibrium.
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Taste and smell:
The tongue serves as an organ of taste, with taste buds scattered over its surface and concentrated toward the back of the tongue. In chewing, the tongue holds the food against the teeth; in swallowing, it moves the food back into the pharynx, and then into the oesophagus when the pressure of the tongue closes the opening of the trachea or windpipe. The tongue also acts, together with the lips, teeth, and hard palate, to form word sounds.
The receptors for taste and smell are chemoreceptors that respond to chemicals in solution. To smell a particular odour it must be volatile and it must be dissolved in the fluid coating the olfactory epithelium.
There are thousands of olfactory receptors in the roof of each nasal canal. The olfactory receptor cells are neurons that transmit impulses along the olfactory filaments to the olfactory nerve. This nerve conducts impulses to the olfactory cortex of the brain where the odour is interpreted. This part of the brain makes 'snapshots' of each smell and is intrinsically linked to the limbic system. It is this linkage that makes a smell trigger a memory.
The olfactory receptors are very sensitive, however, they tend to adapt if exposed continually to a specific smell. This is why you can often not smell your own perfume after a little while, whereas others who have not been exposed to it until you come near, will comment on its fragrance.
If you can't smell, you probably can't taste very well either as these are closely related functions.
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Different things can affect taste and smell and may include:
Medications
Gum disease
Alcohol
Smoking
Cancer treatments
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Lymphatic system:
The word lymph means 'clear water', and describes the lymphatic fluid that drains out of the tissues into the one-way lymphatic system and into the blood stream. This return of fluid to the circulatory system ensures that fluid doesn't accumulate in the tissues as oedema, as well as making sure there is adequate circulating blood volume in the body.
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Components:
cervical lymph nodes
palatine tonsil
thymus
axillary lymph nodes
right lymphatic duct
spleen
thoracic duct
cisterna chyli
inguinal lymph nodes
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Characteristics of Lymphatic Vessels:
Lymph vessels are found in all tissues except CNS, bone marrow, and tissues without blood vessels.
Large lymphatic vessels are composed of three layers (Tunica intima, tunica media, tunica adventitia).
The smallest lymphatic vessels are called lymph capillaries. Lymph capillaries are closed at their ends and have very thin walls.
The job of the lymphatic vessels and nodes is to collect the fluid that leaks out of the capillary beds and transport it back to the blood vessels. This could be around three litres each day, so you can see what an important function this has in the body.
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Anatomy of a lymph node:
Within each lymph node are numerous white blood cells such as macrophages and lymphocytes that destroy any pathogens found in the lymph fluid.
They have several afferent lymph vessels but only one efferent vessel.
capsule = outer covering
trabeculae = extensions of capsule inward to make "skeleton" of lymph node.
reticular fibres extend from trabeculae and form a net of connective tissue.
germinal centres create lymphocytes.
Lymph nodes that are swollen and painful are the result of infiltration by pathogenic micro-organisms, whereas lymph nodes that are swollen and not painful need further investigation to establish whether or not they have been infiltrated by cancer cells.
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Lymphoedema:
Blockage of the lymph nodes causing swelling.
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Lymphatic system pharmacology:
Medication for disorders of the lymphatic system varies greatly according to the condition type and severity.
If the condition is caused by infection, antibiotics may be prescribed and if cancer is the cause, treatment may involve radiotherapy or chemotherapy.
If swollen lymph nodes are caused by an autoimmune condition, treatment and medications will be determined by the underlying condition.
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Three lines of immune defence:
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Innate (non-specific) defense mechanisms:
(First line of defense):
Skin
Mucous membranes
Secretions of skin and mucous membranes
(Second line of defense):
Phagocytic cells
Natural killer cells
Antimicrobial proteins
Inflammatory response
Fever
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Adaptive (specific) defense mechanisms:
(Third line of defense):
Lymphocytes
Antibodies
Macrophages and other antigen-presenting cells
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Immune system targets:
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Pathogens:
Viruses
Bacteria
Parasites
Fungi
Protozoa/Protists
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Worn Out Cells (because they are:) :
Likely to dysfunction
Can result in cancerous cells/tumours
Mutant cells:
Abnormal cells in the body
Cellular debris:
Remains of broken-down cells
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Anaphylactic shock:
A life-threatening condition that affects about 1 in 200 people and can happen anywhere, anytime. Be sure that you are aware of the correct actions you should initiate if you suspect an anaphylactic reaction is occurring. Your observation, plus rapid appropriate action, can save a person's life
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Hypersensitivity/Allergy:
This is when an inappropriate powerful immune response occurs to an antigen (allergen) that is usually harmless. Symptoms can be mild, e.g. as in hay fever or severe as in anaphylaxis which can be life-threatening.
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Auoimmune disease:
The body attacks and damages its own tissues through overactivity. Examples of autoimmune diseases include:
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Rheumatoid arthritis
Systemic Lupus Erythematosus (Lupus)
Inflammatory Bowel Disease (IBD)
Multiple Sclerosis (MS)
Guillian-Barre Syndrome
Psoriasis
Myasthenia Gravis
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Immunodeficiency disorders:
May be primary (congenital) or Secondary (acquired). These conditions prevent the body from adequately fighting infections and diseases and can impact in different ways. There are over 250 rare congenital immunodeficiency disorders. People with an immunodeficiency disorder tend to have repeated and severe infections.
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AIDS:
Acquired Immune Deficiency Syndrome.
A secondary immunodeficiency disorder caused by the human immunodeficiency virus (HIV) which produces the enzyme reverse transcriptase inside the cells of the infected person.
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Immune System Pharmacology:
Medication for disorders of the immune system varies greatly according to the condition type and severity. Some medications used for immune disorders are:
Antibiotics
Antivirals
Antifungals
These medications are used to treat any infection caused by an immunodeficiency disorder. Note that they do not treat the actual disorder but only the infection.
Immuno-suppressants
These are used to prevent rejection of new organs following transplant, and for autoimmune disorders such as RA or nephrotic syndrome. e.g. Cyclosporine
Anti-histamines
These are used to block or reduce histamine in order to relieve allergy symptoms.
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The major processes controlled by hormones are:
Reproduction;
Growth and development;
Mobilising body defences;
Maintaining water, electrolyte and nutrient balances of the blood;
Regulation of cellular metabolism and energy balance.
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Two types of glands in endocrine system:
Endocrine:
Secretions enter interstitial flood and then the bloodstream and stay in the body such as all hormones including growth hormone, insulin and adrenaline.
Exocrine:
Secrete substances that enter ducts, these substances ultimately exit the body. These include substances such as mucus, saliva, sweat and tears.
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Hormones are:
signalling molecules produced by glands within the endocrine system. They regulate many different aspects of behaviour as well as bodily functions and processes, their correct functioning and regulation is vitally important for health and wellbeing.
Hormones are chemical substances that regulate the metabolic activity of other cells in the body.
Hormones are either amino-acid based molecules or steroids.
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The hypothalamus:
is the major integrating link between the nervous and endocrine systems. The hypothalamus releases at least nine different hormones, several of which control the release mechanisms of the pituitary gland. It also produces oxytocin and anti-diuretic hormone which are stored in the posterior pituitary gland. Oxytocin stimulates the uterus during labour and causes the letdown reflex to enable breast feeding.
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The pituary gland:
hangs by a stalk inferior to the hypothalamus and has two lobes - the anterior portion that is comprised of glandular tissue and the posterior lobe that is nervous tissue.
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Thyroid and Parathyroid glands:
The Thyroid Gland is located at the base of the throat just below the "Adam's apple".
It has two parts that are joined by a narrower central part called the Isthmus and it is responsible for producing two hormones - Thyroid Hormone and Calcitonin.
The four Parathyroid Glands are situated on the posterior (one near each corner) of the Thyroid Gland, and secrete Parathyroid Hormone or PTH.
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Goitre is caused by:
lack of iodine in the diet. causes enlarged thyroid.
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Adrenal glands:
The Adrenal Glands are situated on the superior surface of the two kidneys - one gland on each kidney. The Adrenal Glands are similar to the Pituitary Gland in that they are actually two organs in one. They have both glandular tissue (the adrenal cortex) and neural tissue (the adrenal medulla).
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Pancreas and the Pancreatic Islets:
The pancreas is situated in close proximity to the stomach and has a number of functions. It has both endocrine and exocrine functions, and is therefore known as a mixed gland.
The Pancreatic Islets, or the Islets of Langerhans are the source of the endocrine function in the pancreas, and produce two important hormones: insulin and glucagon that play an important role in the homeostasis of blood sugar levels. Insulin is the only hormone that decreases blood glucose levels and that's why it's so important in the treatment of diabetes mellitus. Glucagon is released in response to low blood glucose levels and when the body requires additional glucose such as during vigorous exercise. Glucagon stimulates the liver to break down glycogen to be released into the blood as glucose; activates glycogenesis which is the conversion of amino acids into glucose and breaks down triglycerides into fatty acids to be used a fuel by cells.
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Thymus, Pineal, and Gonads:
The thymus gland secretes thymosin, a peptide hormone that appears to 'program' T lymphocytes to commence their maturation process. What structure exactly controls the regulation of thymosin release is not yet known.
The pineal gland mostly secretes melatonin which is known as the 'sleep trigger'. Melatonin is also believed to be linked to delaying sexual maturity until physical maturity is reached.
The male and female gonads produce sex hormones. The female gonads are the ovaries which produce oestrogens and progesterone - two hormones that work together in a cyclic manner that we call the menstrual cycle. The male gonads are the testes which produce androgens (male sex hormones). Testosterone is the major androgen and is necessary for the continuous production of sperm. Hypo-secretion of gonadal hormones may result in sterility in either males or females.
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the Urinary System:
bears the primary responsibility for removing nitrogenous wastes from the blood. The kidneys filter blood and return most of the water and many solutes to the bloodstream, and the remaining water and solutes constitute urine.
Urine is excreted from each kidney through the ureter and stored in the urinary bladder until it is expelled through the urethra.
In addition to the function of excretion, the kidneys also maintain the electrolyte, acid-base and other fluid balances in the blood and therefore play an important role in homeostasis.
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Nephrons:
the filtering centres of the kidneys where waste products are filtered from the blood and urine is formed. There are over a million of these functional units in each kidney that pass the urine into collecting ducts where it is conveyed to the renal pelvis.
Nephrons are central in disease processes such as renal failure.
Proximal tubule does most of re-absorption and secretion, Loop of Henle does concentration, and the distal tubule does fine-tuning.
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Urinary tract infection:
UTIs affect more women than men and are often due to bacteria making their way from the digestive tract into the urinary system. The bacteria that causes a UTI is often Escherichia coli (E. Coli).
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Cystitis:
an infection of the bladder usually secondary to bacterial infection in the urine. Symptoms include, frequent urge to urinate, ‘burning’ pain on urination, cloudy or bloody urine, strong smelling urine and lower abdominal pain.
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Pyelonephritis:
Most cases are complications of bladder infections.
Pyelonephritis results when a UTI progresses to involve the upper urinary system (kidneys and ureters). Pyelonephritis is a potentially serious condition but is usually treatable with antibiotics.
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Urethritis:
an inflammation of the urethra commonly due to infection.
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Benign prostatic hyperplasia:
This occurs when the prostate which is located in the male reproductive system becomes enlarged due to the growth of non-cancerous cells. It can cause problems as it presses on the urethra creating a blockage or leading to urination difficulties.
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Renal Calculi:
(Kidney stones) are solid masses made of crystals and usually originate in the kidneys but can develop anywhere in the urinary tract.
Kidney stones can be made from calcium, uric acid, struvite or cysteine. Kidney stones cause severe pain called renal colic.
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Renal failure:
Kidney failure can be acute or chronic and can be life threatening. Dialysis or organ transplantation is required for very severe kidney failure.
Acute kidney failure is often short-lived, but requires treatment until kidney function returns.
Chronic kidney disease develops over time and is related to a number of risk factors, including diabetes and high blood pressure.
If chronic kidney disease is detected early, medication and lifestyle changes can increase the life of your kidneys.
Treatment options for kidney failure include dialysis, transplant or non-dialysis supportive care.
Symptoms of kidney disease:
Can be asymptomatic in early stages. Some people have no symptoms until over 90 per cent of their kidney function has gone. This is unfortunate because early detection of kidney disease and treatment is the key to preventing kidney failure.
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Symptoms of kidney disease can include:
tiredness;
loss of appetite;
difficulty sleeping;
headaches;
lack of concentration;
shortness of breath;
nausea and vomiting;
changes in the quantity and frequency of urine passed;
changes in appearance of urine or blood in the urine;
puffiness in the legs and ankles;
pain in the kidney area;
high blood pressure;
itching;
bad breath;
a metallic taste in the mouth.
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These symptoms can be caused by other conditions, but if you are in a high-risk group for kidney disease, speak with your doctor.
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Glomerulo-nephritis:
A condition affecting the kidneys that can result from infections such as a streptococcal sore throat that hasn't been properly treated, but can also result from unknown other causes. After a streptococcal sore throat, the filters in the glomerulus can sometimes become clogged with waste products from the infection and cause inflammation and ongoing kidney disease.
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four processes needed to supply the body with oxygen and dispose of carbon dioxide:
Pulmonary respiration:
This is the mechanical process called 'breathing', with volume and pressure changes in the thoracic cavity that cause gas to flow in and out of the lungs. The medical terms are 'inspiration' and 'expiration'.
External respiration:
The gas exchange that takes place in the alveoli during which the haemoglobin uploads oxygen and downloads carbon dioxide. The respiratory membrane in the alveoli is normally very thin, and presents a huge surface area for efficient gas exchange.
Respiratory gas transport:
Transportation of oxygen and carbon dioxide in the blood.
Only 1.5% of the available oxygen is able to be dissolved in plasma, so the remaining 98.5% is carried on haemoglobin, with up to four oxygen molecules bound to each molecule of haemoglobin. A small amount of carbon dioxide is dissolved in plasma or carried on haemoglobin, with about 70% transported as bicarbonate, which helps to maintain blood pH balance in the body.
Internal respiration:
Neural control of respiration is in the medulla oblongata and the pons, and nerve impulses are transmitted from these centres to the phrenic and intercostal nerves that relay the impulses to the respiratory muscles, diaphragm and external intercostal muscles.
Medications such as morphine can suppress the respiratory control centre in the brain. Large amounts of alcohol have the same effect. This suppression can cause a person to become apnoeic (a = without, pnoeic = breathing) because the nerve impulses from the medulla oblongata are no longer stimulating the muscles of respiration.
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COPD:
Chronic obstructive pulmonary disease refers to a group of lung diseases that block airflow and make breathing difficult.
COPD is a serious long-term, irreversible disease that mainly affects older people, and includes conditions such as emphysema and chronic bronchitis.
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Emphysema:
Smoking causes carbon deposits to build up in the alveoli and can be the cause of emphysema which gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath.
Smoking decreases the ability of the cilia to keep the airways clear, and eventually destroys all the cilia in the air passages (inflammatory chemicals dissolve alveolar septum) which means that smokers have much less ability to clear secretions from the lungs and have to rely solely on coughing.
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Chronic bronchitis:
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus, as well as shortness of breath, wheezing, and chest tightness.
There are two main types of bronchitis: acute and chronic. The inflamed bronchi produce a lot of mucus. This leads to cough and difficulty getting air in and out of the lungs. Inhaled medication such as Salbutamol (Ventolin) relaxes the smooth muscle in the small bronchial tubes and therefore opens up more space for air to get in and out of the lungs.
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Asthma:
a chronic inflammatory disorder of the airways. People with asthma experience episodes of wheezing, breathlessness and chest tightness due to widespread narrowing of the airways.
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Bronchiectasis:
refers to an abnormal and irreversible widening of air passages in the lungs. People with bronchiectasis are prone to infections as mucus accumulates in the airways and becomes stagnant. It has a number of causes, including COPD, cystic fibrosis, low antibody levels and infections such as tuberculosis, whooping cough and measles.
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Bronchiectasis:
refers to an abnormal and irreversible widening of air passages in the lungs. People with bronchiectasis are prone to infections as mucus accumulates in the airways and becomes stagnant.
It has a number of causes, including COPD, cystic fibrosis, low antibody levels and infections such as tuberculosis, whooping cough and measles.
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Bronchiolitis:
develops when small airways in the lungs become injured or inflamed. The passage of air is restricted, which may cause shortness of breath and coughing. Its most often caused by viral infections and is common among young children.
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Cystic Fibrosis:
CF is a genetic (inherited) disease that causes thickened sticky mucus to form in the lungs, pancreas and other organs. In the lungs, this mucus blocks the airways, causing lung damage and making breathing difficult. People with CF have a shortened life expectancy.
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Pneumonia:
an infection of the alveoli caused by bacteria, a virus or fungi.
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ARDS:
Acute respiratory distress syndrome is a rapidly progressive disease occurring in critically ill patients.
The main complication in ARDS is that fluid leaks into the lungs making breathing difficult or impossible.
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Tuberculosis:
a slowly progressing pneumonia caused by a specific bacteria called Myobacterium tuberculosis.
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Pneumothorax / Atelectasis:
Collapsed lung.
Condition affects the membranes that surround lungs.
Causes:
Injury to the lung (gunshot/knife wound, rib fracture, or certain medical procedures);
Air blisters (blebs) that break open, sending air into the space around the lung. Can result from air pressure changes (when scuba diving/travelling to high altitude);
Tall, thin people and smokers are more at risk;
Lung diseases can also increase the chance of getting a collapsed lung. These include Asthma, Chronic obstructive pulmonary disease (COPD), Cystic fibrosis, Tuberculosis, Whooping cough.
In some cases, a collapsed lung occurs without any cause. This is called a spontaneous collapsed lung.
Symptoms:
Common symptoms of a collapsed lung include
Sharp chest or shoulder pain, made worse by a deep breath or a cough
Shortness of breath
Nasal flaring (from shortness of breath)
A larger pneumothorax causes more severe symptoms, including:
Bluish color of the skin due to lack of oxygen
Chest tightness
Lightheadedness and near fainting
Easy fatigue
Rapid heart rate
Shock and collapse
Exams and tests:
listen to breathing with a stethoscope. If you have a collapsed lung, there are decreased breath sounds or no breath sounds on the affected side. You may also have low blood pressure.
Tests that may be ordered include:
Arterial blood gases and other blood tests
Chest x-ray
CT scan if other injuries or conditions are suspected
Electrocardiogram
Treatment:
A small pneumothorax may go away on its own over time. You may only need oxygen treatment and rest.
A needle may allow the air to escape from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.
If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allow the lung to re-expand. The chest tube may be left in place for several days and you may need to stay in the hospital. If a small chest tube or flutter valve is used, you may be able to go home. You will need to return to the hospital to have the tube or valve removed.
Some people with a collapsed lung need extra oxygen.
Lung surgery may be needed to treat collapsed lung or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form. This procedure is called pleurodesis.
Prognosis:
If you have a collapsed lung, you are more likely to have another one in the future if you:
Are tall and thin
Continue to smoke
Have had two collapsed lungs in the past
How well you do after having a collapsed lung depends on what caused it.
Complications:
Another collapsed lung in the future;
Shock, if there are serious injuries or infection, severe inflammation, or fluid in the lung develops.
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Respiratory System:Pharmacology:
Medication for respiratory disorders varies according to the condition type and severity but some medications commonly used to treat respiratory conditions are listed below:
Bronchodilators:
used to widen or dilate the bronchi to relieve wheezing, tightness and shortness of breath.
For example: salbutamol, ipratropium bromide, aminophylline.
Corticosteroids:
used to reduce inflammation and can be inhaled or take systemically.
For example: prednisolone, budesonide.
Decongestants:
used to relieve congestion in the nose and sinuses.
For example: ephedrine, pseudoephedrine.
Antimicrobials and Antivirals:
used to treat infections in the respiratory system.
For example: amoxicillin, clarithromycin.
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Disease can have various causes including:
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pathogens
inherited genetic conditions
trauma, toxins and other environmental hazards
nutritional factors
iatrogenic causes
degenerative changes
loss of normal control systems.
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Pathogens:
A biological agent that causes illness or disease to its host.
An infection is the multiplication of the pathogenic microbes and disease occurs when infection causes damage to the individual’s vital functions or systems.
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There are five different types of pathogen. These are:
bacteria
viruses
parasites
fungi
protozoa.
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Diseases caused by bacteria include:
food poisoning
cholera
typhoid
pertussis.
Diseases caused by viruses include:
influenza (flu)
colds
measles
mumps
rubella.
Diseases caused by parasites include:
hookworm
threadworm
scabies
head lice
Diseases caused by protozoa include:
giardiasis
toxoplasmosis
malaria.
Diseases caused by fungi include:
candidiasis
pneumocystis pneumonia (PCP)
ringworm
aspergillus
tinea pedis (Athlete’s foot).
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In order to cause an infection, pathogens must enter our bodies. The site at which they enter is known as the portal of entry. Pathogens can enter the body via:
The respiratory tract e.g. Influenza virus (Influenza);
The gastrointestinal tract e.g. Vibrio cholerae (Cholera);
The urogenital tract e.g. Escherichia coli (Cystitis);
Breaks in the surface of the skin e.g. Clostridium tetani (Tetanus).
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Inherited Genetic Conditions:
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A genetic disorder is caused by an altered gene or set of genes. There are four general groups of genetic disorders. These are:
single gene disorders
chromosome abnormalities
mitochondrial disorders
multifactorial disorders.
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Some common inherited conditions are:
Achondroplasia = Dwarfism, large head, short extremities;
Osteogenesis imperfecta = Bone fragility, deafness;
Cystic fibrosis = Chronic lung and intestinal symptoms;
Sickle cell anaemia = Fatigue, shortness of breath, delayed growth;
Haemophilia = Slow blood clotting;
Phenylketonuria = Developmental delays and intellectual disability.
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Multifactorial disorders:
do not have one single genetic cause and are caused by a combination of genetic and environmental factors. The way this occurs is not yet fully understood.
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Multifactorial disorders include the following:
hypertension;
coronary heart disease;
birth defects such as spina bifida;
diabetes;
arthritis;
osteoporosis;
asthma;
allergies;
psoriasis;
eczema;
schizophrenia;
some cancers (bowel, breast, ovarian, melanoma, prostate).
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Trauma:
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Trauma or injury can cause many chronic conditions and may affect the person for long after the injury has occurred. Some examples of these types of trauma include:
severe burns
spinal cord injury
traumatic brain injury
fractures.
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Trauma or injury can also cause emotional and psychological disorders such as:
post traumatic brain injury
depression
anxiety.
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Toxins:
Toxins are any substances that can cause disease and can be naturally occurring or man-made. Toxins can be in our food; the products we use or in the environment.
Some examples of toxic agents:
radiation for example UV light, x-rays
nicotine
animal venoms
carbon monoxide
heavy metals for example lead, mercury, arsenic
parabens for example used as preservatives in food, cosmetics and pharmaceuticals.
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Nutrition:
A healthy eating pattern is crucial to the maintenance of good health and well-being. It is essential that we have an adequate dietary intake of nutrients in order to maintain optimum homeostasis in the body.
Our bodies require the basic nutrients for cellular functions to be delivered through those products that enter our bodies from the external environment.
Healthy eating benefits almost every aspect of our health throughout our lifetime. Health problems that are linked to poor eating patterns such as heart disease, diabetes and some cancers, place an enormous burden on individuals, families and society as a whole.
Most people should be eating three main meals a day. Most people need to eat more starchy foods and more fruit and vegetables and reduce their fat intake, drink less alcohol and eat less salt. Look for labels that say food is low in fat (particularly saturated fat), low in salt and sugar.
The right amount of vitamins and nutrients can increase life expectancy by keeping the heart and body healthy and preventing many long-term illnesses. Fruit and vegetables are packed with vitamins and minerals, low in calories and high in fibre. Eating lots of fruit and vegetables keeps the heart and body healthy. They are also an ideal alternative to eating crisps and chocolate as snacks between meals.
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Hyperlipidaemia:
High cholesterol.
Cholesterol makes up the sides of every cell in your body.
High density lipoprotein = "good" cholesterol
Low density lipoprotein = "bad" cholesterol
Triglycerides = "bad" cholesterol.
Bad floats in arteries, can stick to walls and block blood supply.
Good floats in arteries and "clean", collecting bad and moving to liver for removal from the body.
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Obesity:
Approximately 63% of Australian adults are overweight or obese in 2011–12 (70% of men and 56% of women), according to the Australian Institute of Health and Welfare, with the rates having doubled in the last 20 years and continuing to rise.
In fact, being overweight and obesity (high BMI) is the second highest contributor to burden of disease in Australia, with dietary factors being the highest contributor, and smoking being the third highest (Australian Institute of Health and Welfare, 2014).
Body weight can be kept to an acceptable level through healthy eating, leading to a fitter and more active lifestyle.
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Three highest contributors to burden of disease in Australia are:
Dietary habits
Overweight and obesity
Smoking.
These are all "modifiable factors" (ie people have control over them)
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Iatrogenic Impacts:
Iatrogenesis is a term form the Greek work ‘brought forth by the healer’ and it refers to any injury or illness which occurs due to medical care. Iatrogenic impacts may be a result of error or negligence or simply due to complication caused by chance. One of the most common iatrogenic impacts is from the side effects of drugs.
Examples of iatrogenesis:
A patient in hospital acquires an infection because a healthcare worker did not wash their hands after touching the previous patient.
A surgical error such as inadvertently nicking the patient’s bowel or removing the wrong kidney.
Drug conflicts that have been documented but are unknown to the prescriber.
A rash brought on by a medication.
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Degenerative Changes:
Aging can cause degenerative changes in individual cells and in whole organs which can result in changes in function and appearance. Degeneration may also arise prematurely when structures deteriorate and cause impaired function.
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Degenerative changes can occur in all organ systems. Some examples:
Coronary artery disease
Alzheimer’s disease
Osteoporosis
Macular degeneration
Amyotrophic Lateral Sclerosis.
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Development and Causes of Cancer:
Cancer can result from abnormal growth of any of the different kinds of cells in the body, so there are more than a hundred distinct types of cancer. A tumour (also called a neoplasm) is any abnormal proliferation of cells, which may be either benign or malignant.
Benign tumours are localised and do not invade surrounding tissue whereas malignant tumours invade surrounding tissue and can spread elsewhere in the body which is a process is called metastasis.
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Oral Health Disease:
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Oral health is the absence of disease in the mouth and is important for general health and quality of life. Oral diseases and conditions include:
dental cavities,
periodontal (gum) disease,
tooth loss,
oral cancer,
oro-dental trauma, and
cleft lip and palate.
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It is important to maintain the oral health for persons who are dentate (with teeth) and also those who are edentulous (without teeth).
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1 in 2 twelve (12) year olds experienced tooth decay in their permanent teeth.
Causes:
poor nutrition,
poor dental hygiene,
smoking,
diabetes,
osteoporosis.
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Many oral diseases are preventable through good nutrition, oral hygiene, water fluoridation and education.
Oral health can affect a person’s diet and nutrition and, as a result, their overall health, and can also have a range of social impacts.
Dental problems may result in a person experiencing pain, discomfort and feelings of embarrassment. They may also choose to avoid eating some foods and taking part in certain activities. There is also evidence that chronic oral infections are associated with a range of diseases and conditions, such as heart and lung diseases, stroke, low birthweight and premature births.
https://www.aihw.gov.au/reports-statistics/health-conditions-disability-deaths/dental-oral-health/overview
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Psycho-social Health:
Psychosocial health involves both the psychological and social aspects of a person’s life, it relates to the mental, emotional, social, and spiritual aspects of what it means to be healthy.
Some studies have found psychosocial factors such as stress, hopelessness, and job control seem to be associated with physical health—particularly heart disease.
Mental health is the thinking part of psychosocial health and incorporates the values, attitudes, and beliefs of the person.
An example of a mentally healthy person includes the ability to respond to life’s challenges constructively and accept their own mistakes rather than blaming others for something unfortunate. They know when to seek help, talk to a trusted friend, and/or take time out for rest and regrouping.
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Variations from Normal Health Status:
may be due to internal or external factors. For example, a person’s temperature may be affected by internal factors such as fever due to an infection or external factors such as a hotter than normal day or a person wearing large amounts of clothing.
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Client assessment:
Assessment of a client occurs on admission and you may be involved in this process but it is important to note that assessment of a client’s health status is an ongoing process and over time you will develop the skills of observing and assessing.
Allied Health Assistants are assessing clients on a continual basis and must be observant for signs of change which can include signs of deterioration.
The current health status of a client may mean that we have to adapt or change interventions we perform. For example, a client may usually perform their physiotherapy exercises in the morning but on one occasion the client has had very little sleep due to pain; it is important for the Allied Health Assistant to recognise this and make adjustments to any interventions they perform.
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Recognising & Responding to Clinical Deterioration:
Standard 9 of the National Safety and Quality Health Service (NSQHS) Standards, covers Recognising and responding to clinical deterioration in Acute Care.
This standard was developed following evidence that warning signs of clinical deterioration are not always identified or acted on appropriately. As an Allied Health Assistant, you play an important role in recognising patient deterioration
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Allied Health Assistants obtain information regarding a client’s health status by:
Questioning the client, carer or significant other
Through observation
Through review of documentation – this could include observation charts, patient history, progress notes, medication charts etc.
Any change in a client’s condition or from their normal functioning must be reported as soon as you recognise them.
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Members of the MDT (multi-disciplinary team) may include:
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Medical:
Doctors
Specialist
Registrar
Intern
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Nursing:
Specialist nurse
Nurse Practitioner
Registered nurse
Enrolled nurse
Assistant in nursing
Nurse manager
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Allied Health:
Physiotherapist
Dietician
Speech pathologist
Social worker
Occupational therapist
Pharmacist
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Support staff:
Administration staff
Ward Clerk
Kitchen staff
Cleaning staff
Security staff
Wardsperson
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In order for the MDT (multidisciplinary team) to work effectively, the following should be considered:
1) Define roles and boundaries – Everyone needs clarity in their own role and those of other to understand where responsibilities lie.
2) Consider power dynamics – This can affect how the team works together. Think about the traditional hierarchies in healthcare and how this may impact on the power dynamics.
3) Different views – Different professionals may have different views however as an Allied Health Assistant we should always be guided by best practice.
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The appropriate person to contact:
will vary depending on the organisation in which you work and on the situation that occurs.
In most health care facilities, the most appropriate person to inform would be the Registered Nurse but may also include a supervisor or manager, medical staff or other member/s of the multidisciplinary team.
