E2-Immune System-Horners Syndrome Flashcards
1
Q
what is an innate cell
A
non specific from birth
monocytes, neutrophils, basophils, mast cells, natural killer cells
2
Q
what are adaptive cells
A
acquire following exposure
remember foreign invaders
B and T cells/lymphocytes
3
Q
what are macrophages and dendritic cells
A
innate and adaptive cells
4
Q
where do stem cells occur and what do they generate
A
bone marrow
immune cells
5
Q
what are neutrophils
A
predominantly leukocyte or WBC
1st cells to arrive
phagocytosis
6
Q
what are monocytes and macrophages
A
long lived
monocytes mature into macrophages
filter pus/bacteria from neutrophils and kill larger pathogens
7
Q
what are eosinophils
A
next cells to participate
handle larger invading pathogens
8
Q
what do eosinophils release
A
histamine- vasodilator to improve circulation
9
Q
what are B lymphocytes
A
produce antibodies in reaction to antigens or foreign bodies
10
Q
what are T lymphocytes
A
stimulate B lymphocytes that are directly kill infected host cells
11
Q
what are presenting antigens
A
they present antigens to T lymphocytes to ingest/digest pathogens
12
Q
what are natural killer cells
A
large lymphocytes
directly kill cells infected by pathogens
activate macrophages
13
Q
what is our first line of defense
A
innate cells
resolve most threats
external/internal defenses
14
Q
what are our external defenses
A
physical, chemical, and mechanical barriers that limit host penetration
skin, mucus, coughing, sneezing, stomach acid, etc
15
Q
what are our internal defenses
A
soluble factors- modify cell behavior and enhance inflammatory response
innate cells and components from birth
16
Q
what is our 2nd line of defense
A
inflammatory response
vascular response and plasma protein systems
17
Q
what is the vascular response
A
activated at time of injury or exposure
series of vascular and cellular activities
possibly start a fever
natural killer cells
18
Q
what is the plasma protein systems
A
clotting to control bleeding
kinin
19
Q
what is kinin
A
produces vasodilation and vascular permeability
makes debris/pathogen vulnerable to phagocytosis
20
Q
what is the 3rd line of defense
A
adaptive immunity
21
Q
what is adaptive immunity
A
acquired and reactive
characterized by specificity and memory of a pathogen- B/T cells
days to weeks to respond
develops throughout life
responds with exposure
22
Q
what is active immunity
A
concept of most vaccinations using a harmless virus to produce a secondary immune response with antibodies and memories
23
Q
what is passive immunity
A
passing of antibodies through birth/breast feeding but is only temporary due to lack of memory cells
24
Q
what is cell mediated immunity
A
not involving antibodies but instead cells like WBCs and B and T cells that can kill antigens
25
what are the phases of the immune response
recognition phase
amplification phase
effector phase
termination phase
memory
26
what factors negatively affect immunity
aging
hormonal imbalances
environment pollution
trauma or illnesses
inadequate sleep
lack of exercise
stress
dysfunctional gut
27
how does exercise affect immunology
enhanced or suppressed
moderate intensity is beneficial
overtraining without adequate recovery can impair immunity
28
what is a primary immunodeficiency disease
genetic defect involving T cells, B cells, or lymphoid tissues
29
what is secondary immunodeficiency
results from an underlying disease or factor that depresses or blocks the immune response
most common
30
what is acquired immunodeficiency syndrome (AIDS)
massive destruction of the immune system by HIV
31
what is AIDS patho
HIV depletes T lymphocytes along with other immunity cells
very high mutation rate
32
what are the S&S of AIDS
constitutional S&S
distal peripheral neuropathy, balance/gait deficits, myalgia and arthralgia, bone degradation
integumentary breakdown
lipodystrophic syndrome
33
what conditions can increase morbidity and mortality in AIDS
cardiopulmonary
34
what is lipodystrophic syndrome
central fat accumulation in neck and trunk but a decrease in extremities
35
what are the PT implications for AIDS
unrestricted with usual benefits for initial asymptomatic HIV
more limited with symptomatic and advanced HIV= less beneficial
36
What is chronic fatigue syndrome
Immune dysfunction syndrome characterized by unexplained fatigue >4 months limiting ADLs
37
What are the risk factors for chronic fatigue syndrome
Minority females with lower socioeconomic status
Immune deficits
Traumatic events
Poorly managed stress
Abnormal neuroendocrine function
38
What are the S&S of chronic fatigue syndrome
Varied
Overwhelming fatigue
Muscle pain and weakness
Forgetfulness
Hypotension that worsens through the day
39
What are the PT implications of chronic fatigue syndrome
Lifestyle management for stress, sleep, diet, actively levels
Gentle graded exercise
40
What is hypersensitivity disorder
Inaccurate response of the immune system
No response the first time, but occurs 2nd exposure
41
What is type 1 hypersensitivity disorder
Immediate type
Seasonal or food allergy
Anaphylactic or severe
42
What is type 2 hypersensitivity
Tissue or organ specific
Autoimmune condition- tissue and it’s cell function are diminished
Antibody binds to antigen on tissue or cell surface
43
What is type 3 hypersensitivity
Immune complex mediated
Antibody binding to antigen and then released in circulation
Systemic lupus erythematosus attacks immune tissue throughout the body
Tissue but not organ specific
44
What is type 4 hypersensitivity
Cell mediated immunity
Only hypersensitivity not involving antibodies
T lymphocytes are present and kill target cells it does not recognize
Graft rejection, RA, MS, diabetes, contact allergen
45
What is autoimmune diseases and RF
Can’t distinguish body from non self
Genetic
Hormonal
Environment
Infections
46
What are the S&S of autoimmune diseases
GI S&S
Gradual onset
Inflammation
Swollen lymph nodes
Affects more than 1 area of body
Emotional changes
47
What are PT implications of autoimmune diseases
Infection control
Exercise prescription
Nutritional guidance
Sleep health
Corticosteroids medications
48
What are the side effects for corticosteroid medications in PT setting
Bone loss
More susceptible to fx, osteoporosis, avascular necrosis
Offset ideally with WB and resistance exercises
Avoid jt mobilization
Decrease healing
Increase susceptibility to infection
49
what are the RF and S&S for lupus
primarily young women and minorities
all systems maybe involved
50
what are the PT implications for lupus
protection with bracing/assistive devices
energy conservation
monitor symptoms
gentle and regular exercise
51
what is spondyloarthropathies or spondyloarthritides
group of diverse autoinflammatory conditions that affect the spine more than extremity jts
52
what are the common features of spondyloarthropathies or spondyloarthritides
gradual onset
> 30 minutes of P! after prolonged positions
chronic inflammation of axial skeleton
extraarticular involvement- eyes, skin, GI tract, renal and cardiac
53
what are the RF for sjogren syndrome
postmenopausal women
54
what is the patho of sjogren syndrome
exocrine glands, mainly salivary and lacrimal glands destruction
55
what are the S&S of sjogren syndrome and the hallmark
spondyloarthritide S&S
peripheral neuropathy due to vasculitis
fatigue
sleep disturbance
DRY EYES AND MOUTH
56
what is fibromylagia
chronic widespread myalgia
57
what are the RF of fibromyalgia
women
20-55 yrs
minimal fitness levels
58
what can trigger fibromylagia
prolonged anxiety and stress
trauma
rapid steroid withdrawal
thyroid disorders
infections
59
what is the patho of fibromyalgia
misprocessing of pain with sensitization and nociplastic pain
micro spasms of muscles - impaired circulation and fatigue
hypothalmic pituitary adrenal gland dysfunction - response to stress
60
how does the ANS respond to fibromyalgia
hyperactive flight or fight
hypoactive parasympathetic
increase of immune cells
61
how does pain affect immune system
more cells = more release of pain neurotransmitters = same nociplastic pain response
62
what are the results for test and measures with fibromyalgia
all imaging and blood tests are negative
Dx by exclusion
63
how would we treat fibromyalgia
pt education and exercise prescription
64
what is the MET for fibromyalgia
low to moderate global aerobic and resistance exercise
2-3x/wk
60-90 min
> or = to 13 weeks
65
what are PT implications for fibromyalgia
nutritional guidance
stress management
minimal benefits
66
what is multiple sclerosis
chronic and progressive neurodegenerative disorder of the CNS
67
what is MS RF
white females between 20-50 years
autoimmune response
genetic link
68
what is MS patho
demyelination
block neural transmission
69
What are the S&S of MS
specific to CNS involvement
exacerbations and remissions
FATIGUE
optic neuritis
70
what is the 1st S&S to be manifested with MS
optic neuritis
71
what gives a sudden transient shock pain to the face
trigeminal neuralgia
72
what are the neuromusculoskeletal S&S
abnormal speech or swallowing
incoordination and muscle tone
bowel and bladder
sexual dysfunction
73
what are the S&S found in the scan for MS
resisted testing with multiple jt weakness
neuro tests - UMN findings
74
what special tests can be done to confirm MS
balance
central vertigo
lhermitte sign
75
what is our course of Rx for MS
urgent referral
76
what is the etiology of CVA
ischemic and hemorrhagic
77
what is the leading cause of long term disability
CVA
78
what are the nonmodifiable RF for CVA
age
african americans
women
79
what are the modifiable RF for CVA
CV disease and HTN
diabetes
lifestyle
80
what is CVA
disrupted blood flow to the brain
81
what are the S&S of CVA
all SUDDEN onset
multisegmental hemi face
visual disturbance
speech and swallowing impaired
severe headache
unexplained dizziness or falls
82
what is found in scan for CVA
resisted testing with multiple jt weakness
neuro tests - UMN findings, hyperreflexive/clonus
83
what is our course of Rx for CVA
EMERGENCY
84
what can cause posterior circulation compromise
CVA
patho jt instability
atherosclerosis - ICA
sudden arterial dissection
tumors
VBI
presyncope
85
what artery supplies the trigeminal n
basilar
86
what are the 5 D's And 3 N's
dysphagia
dysarthria
diplopia
dizziness
drop attacks
Ataxia - incoordination
headache
nausea
nystagmus
numbness
87
what is our course of Rx for posterior circulation compromise
emergency
88
what is presyncope dizziness
near fainting and lightheadedness without the spinning
89
what can cause presyncope dizziness
stress or medications (cardiovascular)
90
what are the S&S of dizziness presyncope
generalized weakness
giddiness
pallor
5 D and 3 N
91
what is our course of Rx for dizziness presyncope
emergency
92
what is vertigo
the illusion of spinning or rotary motion
93
what is peripheral vertigo
BPPV
crystals become from free floating in semicircular canals
94
what is primary central vertigo
CVA or tumor
95
what is secondary vertigo
trauma creating brain injury
infection
demyelination
migraine
96
what is central vertigo patho
due to ischemia to cerebellum, brainstem, vestibular
97
what are the S&S of peripheral vertigo
severe nausea
greater spinning primarily with horizontal nystagmus
worse with head movements
hearing loss
refer to vestibular PT
98
what are S&S of central vertigo
UMN signs including 5 D and 3 N
severe perception with linear perception
vertical nystagmus
occurs at rest
severe imbalance
emergency
99
what is BPPV
most common type of peripheral vertigo
100
why is central vertigo an emergency referral
due to ischemia to cerebellum, brainstem, and vestibular neclei
101
what is dysequilibrium
unsteadiness without illusion of spinning
102
what are the 3 primary systems affected during dysequilibrium
proprioception
vestibular
visual
103
what can cause dysequilibrium
brain degeneration
aging
neuromusculoskeletal diseases
104
what do we do for dysequilibrium
assess/treat any MSK condition to improve somatosensory function and balance triad
potential urgent referral for vestibular or vision
105
what is non specific dizziness
may be due to psychophysiological or cervical origins
106
how can psychophysiological cause dizziness
vasoconstriction with SNS response
107
what are the S&S for psychophysiological dizziness
motion sickness
giddiness
feeling removed from the body
sensation of floating
subjective postural balance with normal balance tests
108
what is the Rx for psychophysiological dizziness
urgent referral to psych
109
what can cause cervicogenic dizziness
C2-3 dysfunction
abnormal afferent signals from neck to trigeminal nucleus
110
what is the S&S for cervicogenic dizziness
dizziness with neck motion
head and face parasympathetic symptoms
no illusion of spinning or nystagmus
111
what is cervical myelopathy
slow gradual and often progressive compression on cord
112
what can cause cervical myelopathy
lax and buckling lig flavum
ARJC
ARDC
vertebral body collapse
113
what are S&S of cervical myelopathy
multiple directions of weak and painful resisted testing
wide based gait
incoordination
Cooks CPR +
114
how do we treat cervical myelopathy
emergency referral with immobilization
115
what is meningitis
infection leading to inflammation of the brain and spinal cord meningeal membrane
116
what can meningitis cause that can affect the cord
scar tissue that restricts CSF that can lead to hydrocephalus or decreased blood flow leading to a stroke
117
what are the typical S&S for meningitis
constitutional S&S (fever and N&V)
neck pain and stiffness
photophobia
HA
118
what are the S&S for intracranial pressure
altered mental status
cranial n deficits
seizures
motion of bending over, lying down, lifting heavy weight
119
what are the S&S of viral meningitis
infection and GI
120
what are the S&S of bacterial meningitis
infection and respiratory
121
what test to rule out meningitis
jolt accentuation of HA test
HA worsened by neck RT (2-3 turns in a sec)
122
what test to rule in meningiits
Kernig- low back and posterior thigh pain combined with hip flexion and knee ext
Brudzinski- neck flexion produces hip and knee flexion
123
how do we treat meningitis
emergency referral
124
where can the brain tumor come from
lung- most common
breast and skin
125
what can the brain tumor do
compression of cerebral tissue
at times erosion of bone with growth
edema and intracranial pressure
126
what are the S&S for brain tumor
cancer S&S
HA increased with activity (looking down, coughing, straining, exercise)
ataxia
diplopia
painful eye motion
tinnitus
seizures
speech impairment
127
what causes horners syndrome
pancoast tumor in apical of lung that compresses the sympathetic ganglion at cervicothoracic junction
128
what does the the compression of the sympathetic ganglion in horners syndrome cause
interruption of sympathetic n supply to the eye
129
what are the S&S of horners syndrome
unilateral
ptosis
lack of face sweating
sunken eyeball
miosis
possibly pain at top of shoulder
