clinical connections Flashcards
skin grafts
transfer of a patch of healthy skin taken from a donor site to cover wound
autologous skin transplantation
if the skin damage is so great, a self-donation procedure…for severely burned patients a small amount of epidermis is removed and keratinocytes are cultured to create sheets of skin
apigraft and transite skin graftsare grown where and from what
grown in laboratory from the foreskins of circumcised infants
what provides clues for diagnosing certain conditions
colour of skin and mucous membrane
cyanosis
due to lack of oxygen, skin appears bluish
jaundice
buildup of bilirubin in blood, yellowish appearance to the skin and whites of eyes..liver issue
erythema
redness of skin caused by engorgment of capillaries in the dermis with blood due to skin injury, exposure to heat, infection, inflammation, allergic reaction
pallor
paleness of skin…shock or anemia
chemotherapy-what is it, what does it interupt, what loses stuff
treatment of disease, usually cancer, using chemical substances or drugs
-chemotherapeutic agents interrupt the life cycle of rapidly dividing cancer cells
-hair loss, 15% stay in resting state so it stays
acne
inflammation of sebaceous glands that usually beings at puberty, when the sebaceous glands are stimulated by androgens
where does acne occur
in sebaceous follicles that have been colonized by bacteria
transdermal (transcutaneous) drug administration
enables a drug contained within an adhesive skin patch to pass through the epidermis and into the blood vessels of the dermis
transdermal (transcutaneous) drug administration examples and what it does
-nitroglycerin- prevention of angina pectoris…chest pain with heart disease
- scopolamine…motion sickness
- estradiol…estrogen replacement therapy during menopause
- ethinyl estradiol and norelgestromin in contraceptive patches
- nicotine to help stop smoking
- fentanyl- relieve severe pain in cancer patients
bone scan-how is it administered, what indicates abnormlities, why is it important to do, what does it do
intravenous
figures out the amount of blood flow to bone
darker or lighter areas indicated abnormalities
standard test for bone density screening….important for females for checking for osteoporosis
bone scan-darker areas
hot spots
indicate bone cancer, abnormal healing of fractures, abnormal bone growth…areas of increased metabolism…increased blood flow
bone scan- lighter areas
cold spots….decreased metabolism absorbs less radioactive tracer due to decreased blood flow
degenerative bone disease, decalcified bone, fractures, bone infections, paget’s disease, rheumatoid arthritis
orthodontics
dentistry that focuses on the prevention and correction of poorly aligned teeth…osteoclasts and osteoblasts remodel the sockets so teeth align properly
giantism
oversecretion of growth hormone during childhood
dwarfism and 2 types
small stature…under 4 feet 10 inches
2 types: proportionate and disproportionate dwarfism
proportionate dwarfism
all parts are small but proportionate to eachother
hyposecretion of GH and condition called pituitary dwarfism…can be treated until epiphyseal plate closure
disproportionate dwarfism
some parts are normal, others are small
achondroplasia…conversion of hyaline cartilage to bone is abnormal and long bones stop growing in childhood
achondroplastic dwarfism-disproportionate
short stature but normal head and trunk size
temporomandibular joint syndrome
improperly aligned teeth, grinding or clenching teeth, trauma to head and neck or arthritis
-dull pain around ear, tenderness of jaw muscles, clicking/popping noise when opening or closing mouth
celft palate
incomplete fusion of the palatine bones, failure to unite maxillary bones during week 10-12 of embryonic development
surgical fix 12-18 months of age
cleft lip
split in upper lip
surgical fix after the first few weeks after birth
what vitamin decreases the incidence of cleft palate and cleft lip
folic acid (vitamin b)
sinusitis-caused, what is it, treatment
inflammation of the mucous membrane of one or more paranasal sinuses
-caused by microbial infection(virus, bacteria, fungus), allergic reactions, nasal polyps, deviated nasal septum
-treatments: decongestant sprays/drops, oral decongestants, nasal corticosteroids, antibiotics, analgesics, warm compresses, surgery
caudal anesthesia
relieves pain during labour, injected in the lower portion of the spinal cord
- acts of sacral and coccygeal nerves injected through sacral hiatus
most common chest injury and how do they happen, why cant they be bound by bandages
rib fractures
direct blows…impact of steering wheels, falls and crushing injuries to chest
-would casue pneumonia that would results from lack of proper lung ventilation
what is one of the most common broken bones, how does it happen, how to treat
fractured clavicle
- mechanical force transmitted from upper limb to clavicle, a blow to the superior part of anterior thorax
- figure 8 sling to immobilize arm
carpal tunnel syndrome-what is it, causes what
narrowing of carpal tunnel, median nerve is compressed
causes pain, numbness, tingling, weakness in hand
pelvimetry what is it, what gets planned if too small
measurement of the size of the inlet and outlet of the birth canal by ultrasonography or physical examination.
cesarean section is planned if too small for birth of baby
patellofemoral stress syndrome, known as, what is it. causes
runner knee
normal tracking does not occur, patella tracks laterally, superiorly and inferiorly, increased pressure on the joint so aching or tenderness around or under patella happens
-causes: walking, running, jogging on same side of road, running on hills, running long distance, knock-knee (anatomical deformity)
shin splints-what, cause
soreness or pain along the tibia
inflammation of the periosteum due to repeated tugging of attached muscles and tendons-walking, running up and down hills
flatfoot-what, causes, can cause
medial longitudinal arch decreases or falls
-causes: excessive weight, postural abnormalities, weakened supporting tissues, genetic predisposition
-can cause inflammation of deep fascia…plantar fasciitis, Achilles tendinitis, shin splints, stress fractures, bunions, calluses
where is the needle inserted in a spinal tap, what does it take and why position the patient like that
-subarachnoid space
- withdraws cerebrospinal fluid for diagnostic purposes
- patient lies on their side with vertebral column flexed so that theres easy access to the subarachnoid space without the risk of damaging the spinal cord
what can cause a reflex to be absent or abnormal
damage or disease anywhere along the reflex arc
what does the absence of a patellar reflex indicate
damage of the sensory or motor neurons, spinal cord injury in lumbar region
what does the absence of a normal pupillary light reflex indicate
brain damage or injury
how are somatic reflexes tested for
tapping or stroking the body surface
hydrocephalus- what is it, what intervention is needed, occurs when
elevated csf pressure due to an excess csf accumulation in the ventricles
- surgeons need to add a shunt
-occurs: after head injury, meningitis, subarachnoid hemorrhage. needs immediate intervention and is life threatening
injury to medulla
can be fatal-blow to the back of the head or upper neck
nonfatal- paralysis, loss of sensation for opposite side of the body, irregularities in breathing or heart rhythm
- alcohol overdose also suppresses medullary rhythmically area and may results in death
ataxia-what is it and how can it occur
damage to cerebellum that results in a loss of ability to coordinate muscular movements
-can occur as a result of a degenerative disease (multiple sclerosis, parkinsons), trauma, brian, tumors, genetic factors, side effects of bipolar disorder meds
chronic traumatic encephalopathy-what is it, with who, symptoms
progressive, degenerative brain disorder caused by concussions and other repeated head injuries…common in hockey, football players and boxers
symptoms: memory loss, confusion, impulsive or erratic behaviour, impaired judgment, depression, paranoia, agression, difficulty with motor and balance skills
most common brain disorder
cerebrovascular accident (CVA) aka stroke or brain accident
what causes cerebrovascular accident
death of brain cells due to lack of oxygen
ischemic stroke
type of stroke that kills brain cells due to a blood clot and is 85% of all strokes
hemorrhagic stroke
15% of all strokes
leaky or ruptured vessel, overtreatment of anticoagulants and weak spots in blood vessels (aneurysms) cause this type of stroke
brain cells without oxygen for 4-6 mins die at a rate of about
1,900,000 per minute
the longer a stroke goes untreated
the greater potential for more brain damage and disability
signs of a stroke
weakness or paralysis on one side of body, trouble speaking/understanding, visual problems, headache
treatment for an ischemic stroke
meds that dissolve clots or prevent the formation of new ones: aspirin, heparin, clot-dissolving drug called tissue plasminogen activator
- remove plaque from carotid arteries
- placing stents in arterioles
treatment for hemorrhagic stroke
meds that dissolve/prevent clots and procedures that repair weakened/rupture blood vessels
what is a transient ischemic attack (TIA)
ministroke
blood clot that blocks the blood supply to the brain usually due to atherosclerosis
aphasia
injury to the language areas of the cerebral cortex, an inability to use or comprehend words
damage to the broca’s speech area results in
nonfluent aphasia…inability to form words
damage to Wernicke’s area results in
fluent aphasia…characterized by faulty understanding of spoken or written words
flaccid paralysis
damage or disease of lower motor neurons on the same side of body
spastic paralysis- what is it and what happens
injury or disease of upper motor neurons in the cerebral cortex removes the inhibitory influences of some of these neurons on lower motor neurons on opposite side of body
-muscle tone increased, reflexes are exaggerated and pathological reflexes appear
cardiopulmonary resuscitation
-emergency procedure for establishing a normal heartbeat and rate of breathing
- after calling 911, chest compressions should be administered
- 100 chest compressions per minute
-saves 20% more lives than the standard method(chest compression and mouth to mouth)
coronary artery disease
effects of the accumulation of atherosclerotic plaques in coronary arteries which leads to a decrease in blood flow to the myocardium
CAD- atherosclerosis
progressive disease characterized by the formation in the walls of large and medium-sized artery lesions called atherosclerotic plaques
-LDLs promote production of atherosclerosis
CAD: c-reactive proteins CRP
proteins produced by the liver or present in blood in an inactive form that are converted to an active form during inflammation.
direct role in production of atherosclerosis by promoting uptake of LDLs by macrophages
lipoprotein-CAD
LDL like particle that binds to epithelial cells, macrophages and blood platelets, may promote the proliferation of smooth muscle fibers and inhibits breakdown of blood clots
fibrinogen-CAD
glycoprotein involved in blood clotting that may help regulate cellular proliferation, vasoconstriction and platelet aggregation
homocysteine
amino acid that may induce blood vessel damage by promoting platelets aggregation and smooth muscle proliferation
coronary artery bypass grafting (CABG)
surgical procedure in which a blood vessel from another part of the body is attached to a coronary artery to bypass an area of blockage
nonsurgical procedure used to treat CAD
percutaneous transluminal coronary angioplasty (PTCA). uses balloon catheter and places a shent via catheter
stenosis- heart valve disorder
narrowing of a heart valve opening that restricts blood flow
insufficiency or incompetence
failure of a valve to close completely
mitral insufficency
scar formation or a congenital defect causes narrowing of the mitral valve
mitral valve prolapse
backflow of blood from the left ventricle into the left atrium
aortic stenosis
aortic valve is narrowed
aortic insufficiency
backflow of blood from the aorta into the left ventricle
reperfusion
the reestablishment of blood flow after a blockage of the coronary artery
free radical
have unpaired electrons, unstable and highly reactive
artificial pacemaker
normal heart rhythm can be restored and maintained by surgically implanting device that sends out small electrical currents to stimulate the heart to contract
heart murmur- what is it, what does it indicate
abnormal sound consisting of a clicking, rushing, gurgling noise that is heard before, between or after the normal heart sounds
-often indicate a valve disorder
congestive heart failure (CHF)
heart is a failing pump
-causes: coronary artery disease, long-term high blood pressure, myocardial infarction, valve disorders
pulmonary edema-chf
fluid accumulation in the lungs that can lead to suffocation
peripheral edema- chf
swelling in the feet and ankles
varicose veins
leaky venous valves that cause veins to be dilated and twisted in appearance
-varicose veins in anal canal are hemorroids
- bleeding esophageal varices are life threatening…from chronic liver disease
treatment for varicose veins
elastic stockings…for mild symptoms
sclerotherapy…injection damages tunica interna by producing a harmless superficial thrombophlebitis (inflammation involving a blood clot)
radiofrequency endovenous occlusion-heat up and close off varicose veins
laser occlusion- laser shuts veins
stripping- surgical procedure where veins are removed
baroreceptor reflexes
counteract things ex if you stand up too quickly and theres a drop in your blood pressure then it counteracts this
peritonitis
acute inflammation of peritoneum, results from surgical wounds in abdominal wall or perforation/rupture of abdominal organs bc contain microbes
gastroesophageal reflux disease (GERD)
when the lower esophageal sphincter doesn’t close fully and the stomach refluxes up and hcl irriates the esophageal wall…heartburn
vomiting-what, can lead to
forcible expulsion of the contents of the upper GI tract through the mouth
-alkalosis (higher than normal blood ph), dehydration, damage to esophagus and teeth
pancreatic cancer-why is it nearly always fatal and who does it effect mostly
-symptoms don’t appear until the cancer reaches a severe stage and has metastasized
- males over 50
gallstones
bile containing insufficient bile salts or lecithin or excessive cholesterol and it crystallizes
if you have a history of gallstones what procedure is necessary and why
cholecystectomy-removes gallbladder and contents
liver function test- what, monitors what
blood tests designed to determine the presence of certain chemicals (enzymes and proteins) released by liver cells
-monitors: liver damage/disease
lactose intolerance-what is a concern that they arent getting enough of
people who lack the enzyme lactase and cant breakdown disaccharide lactose
-calcium and vitamin d
kidney transplant-what, recieves, careful of, takes
- transfer of a kidney from a living donor cadaver to a recipient whose kidney(s) no longer function
- receives one because kidney can maintain sufficient renal function with just one
- must be careful about signs of infections, rejection and must take immunosuppressive drugs fro the rest of their life
oliguria-why and what
when glomerular filtration slows
daily output of urine is 50-250ml
anuria-why and what
when glomerular filtration slows
urine output is less than 50ml
glucosuria-what is it, what causes it
glucose remains in urine
- diabetes mellitus-blood glucose level is far above normal because of insulin deficiency
polyuria-what is it, accompanies, symptom of
excessive excretion of urine
accompanies glucosuria
symptom of diabetes
diuretics
substances that slow reabsorption of water by the kidneys and cause diuresis, an elevated urine flow rate
- caffeine, alcohol
diabetes insipidus
ADH (antidiuretic hormone)
secretion is inadequate and person pees up to 20L of dilute urine daily
hemodialysis-when is it necessary, what is it, what machine used, what is the leading cause of renal failure, how long and how often
when a person’s kidneys can only function at 10-15% of their capacity
process that removes wastes and excess fluids from the blood and restores electrolyte balance in order to maintain homeostasis
-leading cause of renal failure: diabetes
- kidney dialysis machine
3-5 hours, 3 times per week
what does a kidney dialysis machine do
monitors blood flow, blood pressure, fluid volume, vital info
dialyzer
artificial kidney, equivalent to nephrons
removes wastes and excess fluid and restores the proper balance of electrolytes in the blood
peritoneal dialysis - what is it, how often, where does stuff flow to
procedure that uses the lining of the abdominal cavity called the peritoneum as the selectively permeable membrane
- wastes and excess fluid and electrolytes flow from blood to dialysate
-4-6 times per day
cystoscopy- what is it, what does it find
direct examination of the mucosa of the urethra and urinary bladder and prostate in males
-finds urinary problems ex cancer and infections and figure out how big an obstruction is
urinary incontinence-what is it, who is more likely to develop this, most common type
a lack of voluntary control over micturition
-smokers are twice as likely to develop this
- stress incontinence-physical stress ex pregnancy, laughing, straining, lifting heavy objects etc
