Pathophysiology Flashcards
1
Q
Pathophysiology
A
Study of the functioning of an organism in presence of disease
2
Q
Cell
A
Basic self sustaining unit of the human body
3
Q
Three Main Parts of Cell
A
Cell Membrane
Cytoplasm
Nucleus
4
Q
Cell Membrane
A
Consists of fat and protein
-surrounds dell and protects nucleus and organelles
5
Q
Organelles
A
Functional structure within the cells cytoplasm
6
Q
Inside of Organelle
A
Ribosomes, ER, Golgi Complex, Lysosomes, Peroxisomes, Mitochondria, Nucleus
7
Q
Ribosomes
A
Contain RNA and protein
- Responsible for controlling cellular activities
- interact with other amino chains to form proteins
- when attached to ER they for, rough ER
8
Q
ER
A
Network of tubules, vesicles and sacs
- Smooth ER builds fats
- Rough builds proteins
9
Q
Golgi Complex
A
Synthesis and packaging of various carbohydrates and complex protein molecules such as enzymes
10
Q
Lysosomes
A
Membrane bound vesicles that contain digestive enzymes
-intracellular digestion that breaks down organic debris, (bacteria) that have been taken into the cell
11
Q
Peroxisomes
A
Found in high concentrations in liver and neutralize toxins such as alcohol
12
Q
Mitochondria
A
Metabolic center of cell no produce ATP, major energy source in the cell
13
Q
Nucleus
A
Contains DNA in the chromosomes and RNA
14
Q
Epithelium
A
Covers external surfaces and lines hollow organs such as intestines, blood vessels and bronchial tubes
- absorb nutrients
- secrete body substances (sweat)
15
Q
Endothelial Cells
A
Epithelial cells that line vessels
-help regulate blood flow and have a role in blood clotting
16
Q
Connective Tissue
A
Binds other types of tissue to one another
- separated by non living extracellular matrix consisting of protein fibers and fluid
- collagen main protein in fluid
- adipose tissue is a connective tissue mainly made of large amounts of lipids (fats)
- blood is connective
17
Q
Muscle Tissue
A
Characterized by ability to contract -Enclosed by fascia, envelope of fibrous material Skeletal: striated volunTary Cardiac: striated involuntary Smooth: nonstriated involuntary
18
Q
Nerve Tissue
A
Transmit nerve impulses
Central and Peripheral
19
Q
Homeostasis
A
Same and steady
20
Q
Apoptosis
A
Normal cell death in which old cells are replaced by new cells
21
Q
Cell Signaling
A
Way that the cells communicate electrochemically to each other by releasing molecules (such as hormones) that bind to protein receptors on the cell surface.
In result, a triggered chemical reaction occurs and initiates a biological reaction
22
Q
Baroreceptors
A
Respond to changes in pressure usually within heart or main arteries
23
Q
Chemoreceptors
A
Sense changes in chemical composition of the blood, especially reduced oxygen levels and elevated CO levels
24
Q
Five Primary Ways to Release Heat
A
Convection, conduction, evaporation, radiation and respiration
25
Ligand
"To tie or bind"
Are molecules that bind to receptor sites to form more complex structures
-Endogenous or Exogenous Ligands: produced by body or given into body
26
Hormones
Substances found in tiny amounts by one specialized group of cells and then carried to another organ or group of cells and then carried to another organ or group to perform regulatory functions
27
Endocrine Hormones
(Thyroid hormones and adrenal) carried to their target by the blood
28
Exocrine Hormone
Reach target by a specific duct that opens into an organ (stomach acids and perspiration)
29
Paracrine Hormones
(Histamines) diffuse through intracellular spaces to reach their target
30
Electrolytes
Dissolved mineral salts that dissociate in a solution yielding ions (sodium, potassium, clalcium, chloride)
-have important role in cell signaling and in generating the Nervous System action potential
31
Ions
Positive charge: cation
Negatively charged: anion
Body fluids are suppose to be electrically neutral
32
Atrophy
Decrease in cell size due to loss of sub cellular components which results in a decrease in the size of the organ or tissue
- actual number of cells remain unchanged but decrease in an attempt to cope with a new steady state
- coasted immobilized limb loses muscle and shrinks in size
33
Hypertrophy
Increase in the size of the cells due to synthesis of more subcellular components which creates an increase in size of a tissue or organ
-left ventricle may hypertrophy from increased pressure
34
Hyperplasia
Increase in actual number of cells in an organ or tissue usually resulting in increase in size of organ or tissue
-a callus is hyperplasia of the keratinized layer of the epidermis in response to increase friction or trauma
35
Dysplasia
Alteration of size shape and organization of cells is most often found in epithelial cells where they have undergone atypical, irregular inflammation or irritation.
-development of cervical dysplasia in women is strongly associated with exposure to certain viruses
36
Metaplasia
Reversible cellular adaptation in which one or more cell type is replaced by another adult cell type.
-the airway of smokers and cilia may be replaced by meta plastic epithelium after burned away
37
Body Weight
50-70% is fluid
38
Intracellular Fluid
75% of body weight in fluid
39
Extracellular Fluid
25% of body weight in fluid
- interstitial and intravascular
- interstitial: surrounds tissue cells and includes cerebrospinal, and synovial fluid
- intravascular: found within blood vessels but outside the cells
40
Solvent and Solute
Water and Salt
41
Passive Transport
Movement of substance by diffusion from area of high concentration to area of low concentration
42
Active Transport
Movement via transport molecules, or pumps, that require energy to move substances from an area of low concentration to area of high concentration
43
Osmosis - how water moves between ICF and EXF
Movement of a solvent from an area of low solute concentration to an area of high solute concentration through a selectively permeable membrane to equalize solute to solvent
44
Hypertonic Solution
Higher osmotic pressure due to having a higher solute concentration
45
Hypotonic Solution
Lower osmotic pressure due to having a lower solute concentration
46
Isotonic Solutions
Normal Saline e.g and lactate ringers
47
Intracellular Fluid controlled In two ways
By proteins and compounds that cannot escape and the sodium potassium pump
-most intracellular charges are negatively charged so they attract positively charged ions like potassium and because potassium is osmotically active, they can pull water into the cell. Even until it ruptures.
48
Sodium Potassium Pump
Responsible for checks and balances of water being brought in by continuously removing three sodium ions from the cell for every two potassium cells that are moved back into the cell
- if Pump is damaged due insufficient potassium, sodium accumulates and causes the cells to swell
- ATP used to make the exchange happen
49
Plasma
Makes up 55% of blood
91% water and 9% plasma proteins
-plasma proteins: albumin which maintains osmotic pressure; and fibrinogen and prothrombin which assist with clotting
50
Capillary Hydrostatic Pressure
Pushes water out of capillary into interstitial space. Cause pressures differ, more water is pushed out of arterial end and more is absorbed through venous end.
51
Tissue Colloidal Pressure
Draws fluid into the interstitial space
52
Edema
```
Occurs when excess fluid builds up in interstitial spaces
-Many causes: increased capillary hydrostatic pressure from
Allergic Reactions
Venous Obstruction
Increased vascular volume
Increase adrenocorticol hormones
Sodium retention
Pregnancy
Gravity from long sitting
```
53
ADH
Antidiuretic Hormone or "vasopressin"
54
RAAS
Renin-angiotensin-aldosterone system
- complex feedback mechanism responsible for kidneys regulation of sodium in the body
- high it is secreted, low it is reabsorbed
55
Osmoreceptors
Monitor extracellular fluid osmolarity
- located primarily in Hypothalmus
- when extrcellular osmolarity is too high they stimulate production of ADH
56
Blood Osmolarity
When increased pituitary gland secretes ADH which stimulates the kidneys to reabsorb water decreasing the osmolarity of the blood
57
Renin
Protein that released by kidneys into blood stream as a response of changes in blood pressure, blood flow, and globular filtration rate.
When renin is released, it converts plasma protein angiotensinogen to angiontensin 1.
In the lungs, angiotensin 1 is rapidly converted to angiotensin 2 by Agiontensin-Converting Enzyme.
Angiotensin 2 then stimulates sodium resorption by renal tubules and constricts renal blood vessels, slowing kidney blood flow and decreasing the glomerular filtration rate.
In result, less sodium is reabsorbed in the blood
58
RAAS
Renin + plasma protein angiotensinogin = agiontensin 1 => lungs + ACE => angiotensin 2 + renal tubules = sodium reasorption
59
Baroreceptors
Monitor hydration and are located in the carotid artery, kidneys, and aorta
60
Volume sensitive receptors
Located in the atria so when intravascular pressure increases, the atria stretches and causes a release of atrial natriuretic proteins
61
Natriuretic Proteins
Increase when the body contains too much sodium and water which inhibit the ADH and promote excretion of sodium and water by the kidneys
62
Sodium and Chloride
Where sodium goes, Chloride follows
| -together they make table salt but when in water they dissasociate
63
Tonicity
Tension exerted on a cell as a result of water movement across the cell membrane
64
Hyponatremia
Low sodium level caused by sweating, exercise, vomiting, diarrhea
65
Potassium
Major intracellular cation necessary for muscle control, regulation of all muscles, acid base balance, and maintain osmolarity in cells
- hypokalemia: from fluid loss, shifts into cells from insulin, Epi and others. Causes, muscle weakness, fatigues, muscle cramps,
- hyperkalemia: renal failure, ace inhibitors, nsaids inhibit secretion. Causes, peaked t waves can administer calcium, Albuterol, fluids, and bicarbonate
66
Calcium
98% found in bones
- provides strength and stability for collagen and ground substances.
- calcium enters through GI tract and is absorbed in the blood
- hypocalcemia: hypoparathyroidism, alcoholism, diuretic Therapy. Causes, spasm of skeletal muscles, cramps, laryngospasm, seizures, prolongation of QT interval
- hypercalcemia: excess ingestion, hyperparathyroidism, cancers. Causes, constipation and frequent urination. Give fluid of NaCl.
67
PTH
Parathyroid Hormone, regulates uptake of calcium in intestines, kidneys, and works with calcitirol to stimulate osteoclasts activity
68
Acid
Can give up hydrogen ion
- less than 7 ph
- H+
69
Base
Can accept hydrogen ion
- OH-
- greater than 7 ph
70
Acidosis
Kidneys secrete H+ and retain K+
71
Alkolosis
Kidneys secrete K+ and retain H+
72
Buffers
Molecules that modulate changes in pH by neutralizing excessive buildup of acids and bases
73
Bone Buffer
Bone acts as buffer to absorb excess acids and release calcium into the circulation
74
Strong or Weak
Depends on how it disassociates in water
75
Buffers
Proteins, phosphate ions, and bicarbonate
76
Eliminate Acid
Excess acids are given off in the form of gas from the lungs
77
Eliminate Base
Mainly give excess base off from kidneys
78
Three primary buffers
Bicarbonate in blood, respiratory, and renal system
79
Bicarbonate
Forms with H+ To from carbonic acid and disassociates in water to form carbon dioxide to be exhaled
80
Four types of OF presentations of acid base imbalance
Respiratory alkalosis/acidosis
| Metabolic alkalosis/acidosis
81
Respiratory Acidosis
Hypoventilation
Causes: Signs and Symptoms
airway obstruction. Red skin
Cardiac arrest. CNS depression
Opiate OD. Bradypnea
Drowning. Nausea vomiting
CHF
Head Injury
Chest Trauma
CO poisioning
-can cause fatal disrhythmias due to accumulation of potassium
-COPD causes acidosis over time as inhibition of gas exchange occur
82
Respiratory Alkalosis
Caused by hyperventilation
Causes: S&S:
Drug overdose, aspirin. loc
Fever. Light headed ness
BVM. Carpalpedal spasm
Hypocalcemia. Tingling face lips
Nausea Vomiting. Chest pain
Anxiety. Blurred vision
83
Metabolic Acidosis
Any acidosis not caused by respiratory
-Lactic Acidosis: anaerobic metabolism from hypoperfusion of tissues
-Ketoacidosis: develops when cells are forced to switch to use fatty acids as energy
-Acetlysalicylic OD: aspirin, 10-30g, is overdose, stimulates brain to hyperventilate and renal compensatory
-Alchoholic Keto: anti freeze and wood alcohol
Causes: vasodilation, CNS depression, headaches, hot skin, tachypnea, nausea vomiting
84
Metabolic Alkalosis
Excessive loss of acid from increased urine output or from acid in stomach
-Stomach loses acids
-Drinking large amounts of water
-Alkaline substances such as atacids
Causes: confusion, tremors and cramps, bradypnea, hypotension
85
Hypoxia Injury
Caused from air, CO, red blood cell loss, or cyanide poisoning
- when hypoxia for more than minutes, cells produce mediators that are harmful to other tissues
- free radicals produced as mediator: are missing an electron so the attack cells to find missing electron
86
Infectious Injury
Virulence: measures Disease causing ability of a microorganism
87
Bacteria
Phagocytes: white blood cells that engulf and consume foreign material such as cellular debris and microorganisms
88
Pyrogens
Released by white blood cells when they attach to a cell to destroy causing a fever
89
Apoptosis
Normal cell death
90
Necrosis
Result of morphologic changes that occur following cell death in living tissues
91
Long QT Syndrome
Cardiac conduction system abnormality characterized by prolongation of the QT interval on ECG
-Causes syncope, death
92
Gout
Abnormal accumulation of Uris acid due to a defect in metabolism
93
Kidney Stones
Small amounts of Uris acid or calcium salts that accumulates
94
Cardiogenic Shock
Occurs when heart can not circulate enough blood to maintain adequate peripheral oxygen delivery.
-Causes: MI, Large Ventricular Defect, Dysrhythmias
95
Obstructive Shock
Blood flow becomes blocked in heart or great vessels
| -Causes: tamponade, tumor, PE
96
Hypovolemia Shock
Circulating blood Volume is not enough to deliver adequate oxygen and nutrients to the body
-Causes: fluid loss, vomiting/diarrhea, blood loss
97
Distributive Shock
Wide Spread of dilation of vessels
| -Causes: anaphylactic, sepsis, neurogenic ( spinal cord injury)
98
Lymphatic system
Network of capillaries and ducts that help maintain fluid environment of the body
99
Lymph
Thin watery substance that bathes tissues of the body
100
Five Types of Leukocytes
- Basophils: histamine granules released during inflammation
- Eosinophils: damage or kill invaders and can trigger bronchospasm
- Neutrophils: most abundant ,55-70% of leukocytes, protect body against invasion, and infection. They are readily attracted to foreign antigens and eat them by phagocytosis
- Monocytes: produce macrophages which scavengers for the tissues
- Lymphocytes: mediate acquired immune response
101
Antigen
Foreign substance
102
Antibody
Binds to an antigen to hopefully destroy it
103
Cell Mediated Immune Response
Characterized by the formation of a population of lymphocytes that can attack and destroy foreign material
104
T-cell Lymphocytes
Recognize antigens and contribute to the immune response in two ways
1: by secreting cytokines that attract other cells
2: by becoming cytotoxic and killing infected or abnormal cells
105
Killer T Cells
Destroy the antigen
| Help rid the body of cells that have been infected by viruses and cells that have been transformed into cancer cells
106
Helper T Cells
Activate many immune cells
107
Suppressor T Cells
Suppress the activity of other lymphocytes so they do not destroy normal tissue
108
Memory T Cells
Remember the reaction for the next time it is needed
109
Lymphokine-producing cells
Work to damage cells, they destroy cells that have been infected by virus
110
Active Hyperemia
Causes increased vascular pressure which causes the blood vessel to expand in an inflammatory response
- when the wall expands it becomes thinner causing fluid to leak from the vessel causing edema
- results in warm to touch because the vessels dilate and are closer to the skin
111
Mast Cells
During inflammation they degranulate and release a variety of substances
-primary stimuli is trauma, chemical agents, and immunologic substances ( antigen )
112
Mast Cells cont.
Following degranulation, mast Cells release vasoactivamines which increase vascular permeability, vasodilator, and can cause bronchoconstriction, nausea, vomiting
-histamine and serotonin: released quickly
113
Prostoglandins
Mast Cells synthesize these
- comprise about 20 lipids that are composed of fatty acids.
- found in vertebra tissue and act as messengers in reproduction, inflammatory response and pain from trauma
- aspirin and nsaids inhibit prostaglandin synthesis which leads to reduced inflammation and pain
114
Coagulation System
Vital role in formation of blood clots in the body and facilitates repair
115
Coagulation cont.
Inflammation triggers the coagulation cascade initiating a series of complex reactions that encourage fibrin formation
-simultaneously the fibronolysis cascade is activated to dissolve the fibrin and create fibrin split products
116
Fibrin
Is the protein that bonds to form the fibrous compound of a blood clot
117
Kinin System
Leads to formation of The vasoactive protein bradykinin from kallikrein.
Kallikarein found in plasma, urine, and tissue inactive but when active can cause dilation, change BP, modulate salt and water excretion by kidneys
118
Polymorphonuclear Neutrophils
Inflammatory cells that involve both an intravascular and extravascular phase
119
Intravascular
Move to the sides of blood vessels and attach to endothelial cells
120
Extravascular
Leukocytes move to the site of inflammation and kill organism
121
Margination
Loss of fluid from blood vessels into inflamed or infected tissue gives blood remaining in vessels more viscosity which slows the flow of blood and produces stasis
122
Activaton
Mediators of inflammation trigger the appearance of selectins which stimulates bone marrow to produce more WBC and increase Leukocytes count
123
Adhesion
PMN's attach to endothelial cells by selections and integrins
124
Transmigration
The pmn's permeate the vessel wall, passing into interstitial spaces
125
Chemotaxis
PMN's move toward inflammation
126
Hypersensitivity
Response of the body to any substance to which a patient has increased sensitivity
127
Allergy
Hypersensitivity reaction to presence of an allergen
128
Autoimmunity
Production of antibodies or T cells that work against the tissues of ones own body producing hypersensitivity reactions or autoimmune diseases
129
Isoimmunity
Formation of T cells in response to others tissues
| -seen with rejection of t cells
130
Rh Factor
Antigen present in the red blood cells of about 85% of population
Must be Rh positive or negative to receive that type of blood along with ABO
131
Type A
Contains type A surface antigens and plasma containing B antibodies
132
Type B
Contains type B surface antigens and plasma containing A antibodies
133
Type O
Have neither A or B surface antigens but have type A and B antibodies
134
Stress
General Adaptation Syndrome
135
Stage 1
Alarm:
| Release catecholamines
136
Stage 2
Resistance:
Body adapts to release of catecholamines by releasing corticosteroids hormones that increase the blood glucose and maintain blood pressure
-Glucocorticoid and Mineralcorticoid
Body also increases metabolism to compensate
137
Stage 3
Exhaustion:
| Adrenal Glands become depleted giminishing level of glucose resulting in mental and physical exhaustion
138
Hypothalamic-adrenal-pituitary axis
Major part of the neuron doctrine system that controls reaction to stress
