Exam 1 Flashcards
How does cells response to injury ?
- Atrophy: decrease in size
- Hypertrophy: Increase in size
- Hyperplasia: Increase in #’s
- Metaplasia: Replacement in cell type thats more durable
- Dysplasia: abnormal dividing of cells
- Neoplasia: No longer function/appear like normal
What are the Diagnostic Process?
Subjective
Objective
Assessment
Plan
What is the subjective phase?
- Gather information from the PT and history.
Example: - Discomfort: pain, dull ache/numbness/tingling
- Function: Difficulty swallowing/opening chewing
- Textural Changes: Dry/rough/swelling
- Location: Where
- Periodocity : association: constant/intermittent
What is the objective phase ?
- observerable and measureable by palpation/visusal/ percussion
Example:
- Soft tissue changes: color/ consistency/ size
- Hard tissue changes: Size and shape
What are the characteristics to describe lesions?
- Location
- Size and shape
- Color
- Description
- Duration/history
What is pathology?
The study of the nature of disease.
Which includes: etiology
Pathogenesis
Phathophysiology
Prognosis
What is disease?
Injury that results in structural or functional changes
Assessment phase is ?
It develops a DIFFERENTIAL diagnosis
Determine a DEFINITIVE diagnosis
What are the biopsy PROCEDURES?
Incisional - take a part of lesion for diagnosis
Excisional- take the entire lesion, for diagnosis and treatment
Needle- insert needle and aspirate some cells done with deeper tissue like organs
Cytological smear- takes sloughed or scraped surface epithelium
Brush biopsy- takes just the epithelium
Planning phase
- Treatment provided based on diagnosis
- Treatment strategies: no treatment
Surgical removal
Pharmacological agents
Behavioral modification
Psychiatric therapy
Referral to specialist or others
What is injury ?
Alteration causing tissue damage
What are the protection measures for injury?
- Physical barrier
- Antibacterial activity of enzymes
- flushing action of saliva
- stomach acid
- cilla and mucous defends airway
What are the different types of inflammatory response ?
- Acute and chronic
- local and systemic
- nonspecific response
What are the clinical signs of inflammation?
- redness
- swelling
- heat
- loss of function
- pain
What are the microscopic events of inflammation?
- Injury
- Constriction of microcirculation
- Dilation of microcirculation
- Increase in permeability of the microcirculation
- Transudate
- increase blood viscosity
- Decreased blodd flow through the microcirculation
- Margination
- Emigration
- WBC ingest foreign and dead material
- Exudate formation
What is exudate?
Fluid, protein, and dead or injuried cells.
What are the 4 types of exudate?
- Serous
- Purulent
- Mucinous
- Fibrinous
What is serous exudate?
- it is plasma and proteins
- It is associated with mild injury
- What is purulent exudate ?
- It is WBCs, tissue, debris
- associated with acute inflammation
- found in abcess and fistulas
What is chemical mediators?
Amplify inflammatory response
What are some systemic manifestations of inflammation?
- Fever
- Leukocystis (increase in WBC count)
- Lymphadenopathy
- Elevated C-reactive protein
What are the types of chemical mediators?
- Histamine- Mast cells
- Serotonin- act like histamine released from platelets
- kinin System- Bradykinin acts like histamine, causes pain
- Fibrinolytic system- plasmin activates clotting and kinin system
- Prostaglandis and leukotrienes- Dilation, pain and produces mmps ( breaks down collagen)
- Cytokines- 1,6,8 TNA (continue movement of WBC)
what is actue inflammation made up of?
- neutrophils (effective against bacteria and fungi)
- Eosinophis (hypersensitivity)
What is chronic inflammation made up of?
- Macrophages
- Lymphocytes
- Fibroblasts
- Endothelial cells
What is the process of healing and repair?
- Clot formation
- Macrophages
What are the different types of healing?
- Primary
- Secondary
- Tertiary
What are the factors that affecting healing?
- Systemic factors
- Local factors
What are the systemic factors that affect healing?
- Age
- Nutritional status
- Immune status
- Smoking
What are the local factors that affect healing?
- Secondary infection
- Tissue necrosis
- Poor Blood supply
What is Fibrous repair ?
Repair with scaring
eg. Keloid
What does the immune system do?
- Defends against specific target: Antigen - nonself protein ( bacteria viruses, parasites)
- macrophages present antigen to lymphocyte then it travels to injury seeking them out.
What are the two lymphocyte?
B and T cells
What are lymphocytes?
principle cells of immune system
Where are lymphocytes located?
- lymph nodes
- Spleen
- Bone marrow
What are B-cells?
Effective against bacteria and viruses
What are the two types of B-cells?
- Plasma- make antibodies only live a few days
- Memory cells- React quickly if antigen appears again
How long does it take to build up enough antibodies to neutralize antigen?
2-3 weeks
What are the 5 types of Immunoglobulins?
- IgG
- IgA
- IgM
- IgE and IgD
GAMED
IgG
- 75%
- Can cross placenta
- Long term immunity
- In tissue and in circulation
- Small molecule
IgA
- 15%
- In saliva, tears, GI tract, Breastmilk, repiratory tract.
- Protects from inhaled and ingested antigens
IgM
- 10%
- Form quickly after antigen challenge
- quick and short term protection
- large molecule
- replaced by IgG
IgD and IgE
- less than 1%
- Dont circulate, IgD serves as receptor.
- IgE binds to recept on mast cells during allergic reactions
What is immune complex ?
- Antigens and antibody
- renders antigen inactive
What cant immune complex interact with?
infected host cells- T-cells
What are T-Cells?
- recognize and attack specific antigen
- modulate B-cell antibody production
- produces t memory cells
What is cell mediate response?
- delayed immunity
- react only to antigens presented to them
- Take longer than B-cell reaction
What is humoral response?
reacting with freely circulating antigens
What is Immunopathology
An inappropriate immune response to an infection
What is hypersensitivity
Exagerated response to allergens cause tissue destruction.
- can be considered harmless antigens
What are the three types of immunopathology ?
- Hypersensitivity (allergic reactions)
- Autoimmune diseases
- Immunodeficiency (quality/quantity deficiency of WBC)
What are the 4 types of hypersensitivty reaction?
- I. Immediate
- II. Antibody mediated
- III. Immune complex mediated
- IV. Delayed
What is immediate (anaphylactic) hypersenitivity ?
- Occurs in minutes
- Production if IgE antibodies
- Histamine is releases- dilation of vessels constriction of bronchioles
What are examples of immediate hypersensitivity ?
Hayfever
Asthma
Anaphylaxis
Urticaria (hives)
Angiodema (swelling under skin)
Pruritus (itching)
Immediate Hypersensitivity
Urticaria (Hives)
What is Antibody Mediated (cytotoxic) Hypersensitivity?
- “mistaken identity”
- Response against harmless cells
What are examples of Antibody mediated response?
Blood Transfusions
Hemolytic disease of newborn
Certain drug reactions