exam 3 Flashcards
primary minerals in bone
Calcium, phosphorus, magnesium
collagen
- the protein that makes up cartilage
- gives bone tensile strength
ground substace
gelatinous material that is a medium between bone and blood vessels
transforming growth factor
initiates and commits precursor cells into osteoblasts (bone formation)
osteoblasts
- bone forming
- synthesize collagen and proteoglycans
- once function is complete, they become osteocytes
proteoglycans
complexes of polysaccharides that strengthen bone by forming compression resistant networks between collagen
osteocytes
- bone maintaining
- coordinate osteoblast and osteoclast activity
osteoclasts
- bone resorbing
- remodelers of bone
- contain lysosomes with hydrolytic enzymes
sarcomere function
part of myofibril where muscle contraction is initiated
sarcomere composed of?
actin (thin)
myosin (thick)
titin
nebulin
**converts chemical energy into movement
ions involved in muscle contraction?
calcium directly controls contraction
K
Na
Ryandine receptors
regulate calcium release within the muscle tissue rapidly
isometric
static or holding contraction
muscle contracts without limb movement
isotonic
lengthening or shortening contraction
muscle contracts with limb movement
tendons attach..?
ligaments attach..?
tendons- muscle to bone
ligaments- bone to bone
Renal capsule
tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat
comminuted fracture
bone breaks into more than 2 fragments
greenstick fracture
perforates one cortex and splinters the spongy bone
torus fracture
cortex buckles but does not break
to diagnose RA
4 or more of the following
- morning joint stiffness at least 1 hour
- 3 or more joints
- hand joints
- symmetric arthritis
- rheumatoid nodules
- abnormal serum RF
- radiographic changes
osteoarthritis
age related inflammatory joint disease of synovial joints
osteoarthritis characterized by
- loss of articular cartilage
- sclerosis of underlying bone
- thickening of joint capsule
- formation of bone spurs (osteophytes)
osteomalacia patho and manifestations
- deficiency of vitamin D lowers the absorption of calcium from the intestines
- vertebral collapse, bone malformation, waddling gait
bone healing phases
inflammatory- hematoma forms
repair- calus forms
remodeling- callus resorbed; trabeculae formed
syndactyly
webbed fingers
vestigial tabs
extra digit
metatarsus adductus
forefoot adduction
can be mild to severe
talipes equinovarus
“clubfoot”
- malformation of lower leg, ankle, and foot
- plantar flexed foot, inverted heel, and adducted forefoot
Creatinine
provides a good estimate of GFR; only one blood sample is required in addition to a 24-hour volume of urine.
BUN
varies as a result of altered protein intake and protein catabolism; poor measure of GFR; better indicator for hydration status; *increases with dehydration and kidney failure
normal is 10-20 mg/dl
Urine specific gravity/pH
SG= 1.016-1.022
pH=5-6.5
Casts in urine
- accumulation of cellular precipitates
- indication of the type of disease the kidney is experiencing
WBCs in urine
normally none is present, but presence of WBCs indicates infection
Renal Capsule
tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat
Renal cortex
outer layer of each kidney
contains all of the glomeruli, most of the proximal tubules, and some segments of the distal tubules
Renal medulla
inner part of the kidney that contains tubules and the collecting duct
consists of regions called the pyramids
Minor calyx
apexes of the pyramids project into a cup-shaped cavity that join together to form a major calyx
Major calyx
joins to form the renal pelvis
Renin-angiotensin-aldosterone system (RAAS)
Increases systemic arterial pressure, increases sodium reabsorption
Pyelonephritis
acute or chronic
- infection of the ureter, renal pelvis, and/or renal parenchyma
- flank pain, fever, chills, CVA tenderness, purulent urine
- chronic leads to scarring of the kidneys- inflammation and fibrosis leads to CKD
Hemolytic uremic syndrome
- most common cause of renal failure in children under 4
- associated with bacterial, viral, or endotoxin agents
- arterioles of the glomerulus become swollen and occluded with clots-damage RBCs as they pass into circ.
- decreased GFR, hematuria, proteinuria
- spleen removes damaged RBCs from circulation- causing acute hemolytic anemia
- preceded by a prodromal GI illness with diarrhea
Nephrotic syndrome
- filtering units of the kidney are damaged, results in proteinuria, hypoalbuminemia, hyperlipidemia, edema
- primary vs secondary causes
- s/s: periorbital edema, malnourishment, immunocompromised
Glomerulonephritis
acute, chronic, poststreptococcal glomerulonephritis
-proliferation and inflammation of the glomeruli are secondary to immune mechanism
Ectopic kidneys
failure to ascend from the pelvis to the abdomen
Hypospadias
urethral meatus is located on the ventral side or undersurface of the penis
Epispadias
urethral opening is on the dorsal side of the penis
Renal aplasia
kidneys are absent, do not develop. can be seen on ultrasounds
Hypoplastic kidney
- small with a decreased number of nephrons
- are unilateral or bilateral
- occurrence may be incidental or occur in families
Renal agenesis
- absence of 1 or both kidneys
- unilateral- usually the left kidney is absent
- remaining kidney hypertrophies
- can lead a normal, healthy life
Potter syndrome (bilateral renal agenesis)
- rare disorder that is incompatible with life
- facial anomalies include wide set eyes, parrot beak nose, low set ears, receding chin
Polycystic kidney disease (PKD)
- cyst formation and obstruction, accompanied by the destruction of renal parenchyma, interstitial fibrosis, and loss of functional nephrons
- can be autosomal dominant or recessive
Seminiferous tubules
coiled ducts in the testes, consists of 80% of bulk of testicular volume, site of sperm production (spermatogenesis)
Epididymis
comma-shaped structure that curves over the posterior portion of each testis; structural function is to conduct sperm from the efferent tubules to the vas deferens.
Vas deferens
duct with multiple layers and powerful peristalsis that transports sperm towards the urethra
Testes function
produce gametes (sperm) and produce sex hormones (androgens and testosterone)
Female sex hormones
estrogen and progesterone (main hormone of pregnancy)
Male sex hormones
testosterone, FSH, LH
External female genitalia
mons pubis, labia majora, labia minora, clitoris, vestibule, perineum
Vagina
elastic fibromuscular canal, layers, self cleaning, acidic environment for cleaning and protection, contains lactobacillus acidophilus
Uterus
hollow, pear-shaped organ, fundus, corpus, isthmus, cervix
Fallopian tubes
uterine tubes, conduct ova from spaces around ovaries to uterus
- if fertilized, the ovum (then called a blastocyst) implants itself in the endometrial layer of the uterine wall
- if not fertilized, the ovum breaks down within 12-24 hours
Ovaries
are the primary female reproductive organs, secrete female sex hormones (estrogen and progesterone), develop and release female gametes
-ovulation: the release of an ovum
Menstrual cycle
- menarche: first menstruation
- menopause: cessation of flow
phases: menstruation, follicular phase, ovulation, and luteal phase.
normal RBC value
4.2-6.2 million
normal value WBC
5-10 thousand
normal value platelet
140k-340k
Syphylis
caused by treponema pallidum, which is a corkscrew shaped anaerobic bacteria that can infect any body tissue and becomes systemic shortly after infection; on the increase with men doin the nasty with other men
normal value Hct
36-43%
normal value MVC
81-96 fL (size, -cytic)
normal value MCHC
31-37 g/L (color, -chromic)
normal value RDW
11.5-15% (width of RBC; will be normal in chronic diseases)
normal value reticulocyte
1-2%
neutrophils
- ingest and destroy microorganisms
- serve as phagocytes in early inflammation
eosinophils
- Type 1 allergic reaction
- asthma
- atopic issues
- parasitic infections
basophils
- secrete histamine
- exoparasites
macrophages
“first responders” to infection
initiate wound healing and tissue remodeling
monocytes
precursor to macrophages and dendritic cells
what goes up in bacterial infections?
lymph
what goes up in viruses?
neutrophils
extramedullary hematopoiesis
- blood cell production in tissues other than the bone marrow in adults
- usually a sign of disease (pernicious anemia, sickle cell, thalassemia, etc.)
megaloblastic (or megocytic) anemias?
- pernicious anemia (B12 deficiency)
- folate deficiency anemia
-DNA synthesis is defective
conditions that increase the risk of pernicious anemia?
- genetics/endocrine disorders
- gastrectomy, ileal resection, tapeworms
- chronic gastritis and H. pylori
- PPI’s
folate deficiency anemia is most commonly found in what individuals?
alcoholics and malnourished
microcytic, hypochromic anemias
- iron deficiency anemia
- thalassemia
RDW in IDA vs. thalassemia
RDW increased in IDA
RDW normal in thalassemia
manifestations of IDA
fatigue, weak, SOB
pale earlobes, palms, conjunctiva
brittle, ridged, spoon shaped nails (koilonychia)
burning mouth, agranular stomatitis
hemolytic anemia manifestations
- may be asymptomatic
- jaundice
- aplastic crisis
- splenomegaly
- erythroid hyperplasia (abnormal increase in # of erythrocytes)
what levels are low in IDA and thalassemia hemogram?
HbG and MVC
polycythemia vera
- overproduction of RBC’s frequently with increased levels of WBC’s and platelets
- acquired mutation of JAK2
etiology of infectious mono
- viral infection of B lymphocytes
- commonly caused by EBV
acute leukemia
presence of undifferentiated or immature cells (usuall blast); short survival
chronic leukemia
cell is mature, but does not function properly
ALL (acute lymphoblastic leukemia)
most common in kids
Philadelphia chromosome
AML
mutation in receptor tyrosine kinase FLT3
most common adult leukemia
down syndrome increases risk
CML
polycythemia vera
philadelphia chromosome
CLL
affects monoclonal B lymphocytes
adults >50 usually
lymphadenopathy is most common finding, but typically asymptomatic at diagnosis
G6PD deficiency manifestations
icterus neonatorum- jaundice (from stressful deliver) acute hemolytic anemia pallor dark urine back pain between hemolytic episodes: no anemia erythrocyte survival is normal
pathophysiology of sickle cell
- presence of abnormal hemoglobin (Hb S)
- RBC’s solidify and stretch into an elongated sickle shape
- can alter blood pH
vasoocclusive crisis
“pain crisis”
- sickling in microcirculation
- painful, symmetric
- hand-foot syndrome
aplastic crisis
transient cessation in RBC production occurs as a result of viral infection
HSV1 /HSV2
not a reportable disease, recurrent infections/outbreaks mostly with type 2, risk of transmission even during latent periods
**neonatal herpes is potentially fatal (need to do c section)
Gonorrhea
infection by neisseria gonorrhoeae, transmitted by contact with infected epithelium (dirty sex), can be asymptomatic but can also exhibit dysuria, increased discharge, abnormal menses, or dyspareunia.
Chlamydia
Most common STI in the US; caused by chlamydia trachomatis; gram-negative bacteria
Syphyllis
caused by treponema pallidum, which is a corkscrew shaped anaerobic bacteria that can infect any body tissue and becomes systemic shortly after infection; on the increase with men doin the nasty with other men
Stages of syphlis
a. ) Primary-12 days to 12 weeks; hard chancre is formed
b. ) Secondary-6 weeks post chancre, fever, malaise, joint pain, skin rash (brown on hands)- goes away, remains dormant
c. ) Latent- infection present, but pt is asymptomatic
d. ) Tertiary- most severe stage; formation of gummas, destructive systemic manifestations, neurosyphilis
Phimosis
inability to retract foreskin from the glans of the penis; frequently caused by poor hygiene
Paraphimosis
inability to replace or cover the glans with the foreskin; frequently caused by poor hygiene
Menopause
cessation of ovulation; reduced production of estrogen, and increased production of LH and FSH
Primary amenorrhea
failure of menarche and the absence of menstruation by 14 years old without the development of secondary sex characteristics or by age 16 regardless of presence of secondary sex characteristics
Secondary amenorrhea
pregnancy (main cause) dramatic weight loss malnutrition or excessive exercise hypothyroidism PCOS
Cervical cancer
almost exclusively caused by cervical HPV infection, with early detection and treatment prognosis is excellent; do a pap smear getting cells from the cervical os or transformation zone
Endometriosis
functioning endometrial tissue implants outside the uterus, responds to hormone fluctuations of the menstrual cycle; scar tissue causes infertility
Polycystic ovarian syndrome (PCOS)
a hormone disorder causing enlarged ovaries with small cysts on the outer edges; leading cause of infertility in the US; 2/3= little to no ovulation, elevated androgens, or polycystic ovaries
