Chapter 5 Study and Book Questions Flashcards
Explain why a cast placed around a fractured leg in which extensive tissue damage has occurred might be too tight after 24 hours.
Inflammation related to tissue damage causes increasing edema for at least 48 hours under the rigid, non-expandable cast.
b. Explain why such a cast might become loose in 3 weeks.
inflammation has subsided and muscle atrophy has occurred because of immobility.
List specific reasons why the inflammatory response is considered a body defense mechanism.
Pain and visible redness provide warning of tissue injury. Increased fluid at the site dilutes any toxic material. Fibrin mesh and leukocytes localize (wall off) the causative agent. Migration of phagocytic cells, leukocytes, and antibodies (globulins) to the area combat or destroy the agent, and remove debris in preparation for healing.
Explain the rationale for each of the following with acute inflammation: (i) warmth, (ii) fever.
Warmth results from vasodilation and increased blood flow to the area; fever is caused by the release of pyrogens from WBCs.
State three systemic signs of inflammation.
Low-grade fever occurs with increased WBCs, malaise, anorexia, and headache.
Explain why leukocytosis, a differential count, and elevated ESR are useful data but are of limited value.
They confirm the presence of inflammation in the body but do not define the specific cause or location of the problem. In some cases, a differential count is helpful.
. Explain how acute inflammation predisposes to the development of infection.
The increased permeability may permit leakage or penetration of toxins or bacteria (e.g., through the intestinal wall). Any necrosis breaks the barrier, allowing microbes to invade. The edema or increased interstitial fluid may impair arterial flow to an area, leading to ischemia and decreased access of leukocytes to the site. The exudate provides a nutritious medium for organisms to reproduce.
Classify each as inflammation or infection: (i) sunburn, (ii) skin rash under adhesive tape, (iii) common cold, (iv) red, swollen eye with purulent exudate.
b. Inflammation accompanies i and ii; infection is associated with iii and iv.
How does the presence of thick, cloudy, yellowish fluid in the peritoneal cavity differ from the normal state?
Normal fluid should be watery, clear, and colorless.
Thick yellowish fluid often indicates the presence of a bacterial infection (peritonitis).
If a large volume of fluid has shifted from the blood into the peritoneal cavity, how would this affect blood volume and hematocrit?
Blood volume would be low (hypovolemia), and the hematocrit level would be elevated.
Explain how acute inflammation impairs the movement of a joint.
Excessive fluid in the joint cavity and surrounding tissues prevents further stretching of the tissues, such as ligaments, tendons, and skin, as required for movement.
Explain two mechanisms used to increase body temperature as a fever develops.
The body attempts to increase body temperature through shiver-increased skeletal muscle activity, peripheral vasoconstriction, and decreased blood flow and heat loss.
. Why might a client be advised to avoid taking ASA a few days before extensive oral surgery (eg, multiple tooth extractions)?
Aspirin (acetylsalicylic acid [ASA]) interferes with blood clotting (prevents platelet adhesion).
Explain why a young child taking prednisone (glucocorticoid) for chronic kidney inflammation is at high risk for infection and might need prophylactic antibiotics.
Prednisone decreases the immune response, causes atrophy of lymphoid tissue, decreases the number of leukocytes, and suppresses the inflammatory response, thus decreasing resistance to infection.
When part of the heart muscle dies, how does it heal?
Heart muscle heals through scar tissue. Cardiac muscle does not regenerate.
How would the new tissue affect the strength of the heart contraction?
Scar tissue is nonfunctional and therefore cannot contract; thus, heart contractions would be weaker.
Suggest several reasons why healing is slow in the elderly.
Circulation may be impaired, decreasing the supply of oxygen and nutrients to the site. The metabolic rate is decreased, slowing protein synthesis and cell mitosis. Other pathological conditions may interfere with the supply of nutrients or oxygen. The immune response is decreased, predisposing the person to infection and delaying healing.
Explain how scar tissue could affect the function of the following:
a. small intestine
b. brain
c. cornea of the eye
d. mouth
e. lungs (try to find more than one point!)
a. Small intestine—scar tissue may cause obstruction by stenosis as it shrinks, or adhesions may twist or pull on a loop of the intestine.
b. Brain—scar tissue is nonfunctional and can block conduction pathways or interfere with the flow of blood or CSF.
c. Cornea—scar tissue is not transparent and therefore blocks the passage of light rays, impairing vision.
d. Mouth—contractures may develop, preventing normal opening and movement of the mouth, affecting eating, speech, and facial expression.
e. Lungs—the bronchi or bronchioles may be narrowed, reducing airflow, and adhesions may impede movement and expansion of the pleural membranes. Because scar tissue is nonelastic, large amounts of it impair expansion and recoil of the lungs. Scar tissue interferes with blood flow.
Explain the reason for pain and redness accompanying a burn.
Pain—chemical mediators irritate nerves; edema results from increased capillary permeability; erythema occurs because of increased blood in the area.
Explain three reasons why protein levels in the body are low after a major burn.
Over the long term, lower protein levels occur, with protein shifts into tissue and loss in exudates. In addition, protein is in increased demand for repair, but anorexia results in decreased intake, further lowering protein levels.
Explain why immediate neutralization or removal of a chemical spilled on the hand minimizes burn injury
It removes damaging chemicals and prevents penetration into the deeper layers of the skin.
Describe some of the factors that would promote rapid healing of this burn
Good nutrition (including protein and vitamins), promotion of circulation, warmth, and avoidance of secondary infection would promote rapid healing.
