Exam 4: Ch. 21-23, 25-27 Flashcards
1
Q
largest organ in the body
A
liver
2
Q
4 functions of liver
A
- metabolism (carbohydrates, protein, and fat)
- synthesis (proteins, clotting factors)
- storage (vitamin b12)
- detoxification and excretion
3
Q
the liver has a double blood supply. what does this mean?
A
there is a portal vein and a hepatic artery that supply the liver
4
Q
portal vein
A
supplies liver with 75% of its blood, is rich in nutrients, low in oxygen
5
Q
hepatic artery
A
supplies liver with 25% of its blood, is high in oxygen and low in nutrients
6
Q
bile
A
aqueous solution with various dissolved substances (conjugated bilirubin, bile salts, cholesterol, minerals)
7
Q
where does bile come from?
A
RBC break down, iron is reused, and iron-free heme pigment or bilirubin is excreted in the bile
8
Q
is bile always present?
A
yes, small quantities are always present
9
Q
lecithin
A
lipid that also functions as a detergent, is also present in bile
10
Q
where is bile stored?
A
gallbladder, it is released into the duodenum to help with digestion
11
Q
3 manifestations of liver injury
A
cell necrosis, fatty change, and mixed necrosis and fatty change
12
Q
4 common types of liver injury
A
viral hepatitis, fatty liver, alcoholic liver disease (hepatitis), cirrhosis
13
Q
does hepatitis A contain DNA or RNA?
A
RNA
14
Q
incubation period of hepatitis A
A
2-6 weeks
15
Q
transmission methods of hepatitis A
A
person to person contact, and fecal contamination of food or water
16
Q
is there prevention for hepatitis A?
A
vaccine, and immune globulin given after exposure to the virus
17
Q
does hepatitis B contain DNA or RNA?
A
DNA
18
Q
incubation period of hepatitis B
A
6 weeks to 4 months
19
Q
transmission of hepatitis B
A
blood or bodily fluids
20
Q
how is hepatitis B diagnosed?
A
with an antigen-antibody test
- infected people are HBsAg positive and lack anti-HBs
- immune people have anti-HBs
21
Q
can hepatitis B be carried?
A
yes, 10% of those infected become carriers
22
Q
is there prevention for hepatitis B?
A
vaccine, and immune globulin given after exposure to the virus
23
Q
which type of hepatitis is seen the most in the US?
A
hepatitis C
24
Q
does hepatitis C contain DNA or RNA?
A
RNA
25
transmission of hepatitis C
blood and bodily fluid
26
how is hepatitis C diagnosed?
with an antigen-antibody test
- infected people have the virus present and an active infection
- if anti HCVs are detected it does not confer immunity
27
can hepatitis C be carried?
yes, 75% of those infected become carriers
28
is there prevention for hepatitis C?
no
29
who is at risk for hepatitis C?
IV drug users, people that received transfusions before 1992, healthcare workers exposed to blood or bodily fluids
30
does hepatitis D contain DNA or RNA?
RNA
31
what makes hepatitis D different from other types?
it is a small and defective virus that can't produce its own virus coat, so it can only infect people that have hepatitis B
32
what are most of the cases of hepatitis D in the US from?
sharing used needles
33
does hepatitis E contain DNA or RNA?
RNA
34
transmission of hepatitis E
oral-fecal contact, and contaminated water
35
is there prevention for hepatitis E?
no
36
fatty liver
fat accumulates as a result of liver injury, common in heavy drinkers and alcoholics, and damage is reversible
37
alcoholic liver disease
group of structural and functional changes in the liver resulting from excessive alcohol consumption
38
severity of alcoholic liver disease depends on what?
amount and duration of alcohol consumption
39
3 stages of progression of alcoholic liver disease
1. alcoholic fatty liver-mild
2. alcoholic hepatitis-degenerative changes and necrosis of liver cells
3. alcoholic cirrhosis-diffuse scarring, disturbed liver function
40
cirrhosis
scarring of the liver from any cause with derangement of liver function and regeneration
-can result from any liver injury
41
manifestations of cirrhosis
liver failure, portal hypertension, ascites
42
ascites
accumulation of fluid in peritoneal cavity
43
portal-systemic anastomoses
procedure where portal vein is connected to systemic vein in the liver to control varices
44
varices
dilated veins as a result of portal hypertension
45
transjugular intrahepatic portosystemic shunt
a shunt is placed between hepatic and portal vein branches so the blood can bypass the cirrhotic liver
46
hepatic encephalopathy
deterioration of brain function characterized by confusion, disorientation, and eventually coma
47
what causes hepatic encephalopathy?
accumulation of toxic substances (ammonia, bacterial decomposition products) in blood that are usually detoxified and excreted by the liver
48
primary biliary cirrhosis
autoimmune disease that attacks the intrahepatic bile duct, this can lead to liver failure and require a liver transplant
49
secondary biliary cirrhosis
obstruction of large extra hepatic bile ducts (from gallstone, carcinoma), treated by reliving or bypassing the obstruction
50
Reye syndrome
virus that causes liver and brain damage, and aspirin is thought to increase the effects of this
51
characteristics of Reye syndrome
affects mainly infants and children, manifests with fatty liver and dysfunction, cerebral edema
52
cholelithiasis
gallstone formation in the bladder
53
cholelithiasis is highest in:
women, especially those who have had several children, use oral contraceptives, and that are obese
54
complications of cholelithiasis
biliary colic (pain) if the stone gets into ducts (common and cystic obstruction)
55
common duct obstruction
gallstone obstructs the common bile duct, causes obstructive jaundice
56
cystic duct obstruction
gallstone obstructs the cystic duct, doesn't cause jaundice but acute cholecystitis may occur
57
cholecystectomy
surgical removal of gallbladder, used to treat cholelithiasis
58
cholecystitis
inflammation of the gallbladder, gallstone obstructing the cystic duct or the neck of the gallbladder can cause this
59
benign adenoma
uncommon liver tumor, occur in women that take contraceptive pills
60
primary carcinoma of the liver
uncommon in US and Canada but common in Asia and Africa because of high incidence of hepatitis B carriers
61
metastatic liver carcinoma
common in developed countries, spreads from primary sites such as the GI tract, lung, and breast
62
jaundice
yellow discoloration of skin and sclera (whites of eyes) from accumulation of bile pigment in tissues
63
cause of hemolytic jaundice
increased breakdown of red blood cells, bilirubin released
64
cause of hepatocellular jaundice
liver injury impairs the conjugation of bilirubin, it builds up
65
cause of obstructive jaundice
bile duct obstructed by tumor or gallstone, impairing delivery of bile into duodenum
66
liver biopsy
needle inserted through abdominal skin directly into the liver to determine the cause of liver disease or evaluate extent of liver cell damage
67
individuals at risk for developing hepatitis C include the following except:
a. intranasal cocaine users
b. healthcare personnel exposed to blood and body fluids
c. intravenous drug users
d. children born to mothers who test HCV positive
e. children's daycare personnel
a. intranasal cocaine users
| hepatitis C is transmitted through blood and bodily fluids, options b-e all involve blood and bodily fluids
68
what does it mean to say the pancreas is both an endocrine and exocrine gland?
it secretes pancreatic juice into the duodenum (exocrine) and secretes insulin discharge directly into the bloodstream (endocrine)
69
Islets of Langerhans
small clusters of cells scattered throughout the endocrine tissue of the pancreas, responsible for secreting glucagon, insulin, and somatostatin
70
alpha cells
make up some pancreatic islets, secrete glucagon which raises blood glucose
71
beta cells
make up some pancreatic islets, secrete insulin which lowers blood glucose
72
delta cells
make up some pancreatic islets, secrete somatostatin which inhibits secretion of glucagon and insulin both
73
acute pancreatitis
pancreatic juices escape from the ducts into the pancreatic tissues, causing destruction and hemorrhaging. this happens because pancreatic juices continue to be secreted despite an obstruction, building up pressure causing the ducts to rupture
74
predisposing factors to acute pancreatitis
gallbladder disease/stones--gallstones can obstruct the pancreatic duct, causing rupture
excessive alcohol consumption--stimulates pancreatic secretions, and induces spasms in the pancreatic sphincter that results in high pressure
75
clinical manifestations of acute pancreatitis
severe abdominal pain, seriously ill, and high mortality rate
76
chronic pancreatitis
repeated episodes of mild inflammation of the pancreas, and each episode destroys some tissue which is replaced by scar tissue
77
manifestations of chronic pancreatitis
difficulty digesting and absorbing nutrients, not enough pancreatic tissue to produce enzymes, destroyed pancreatic islets can lead to diabetes
78
cystic fibrosis
hereditary disease that mainly manifests in infancy and childhood that involves mutation of CF gene on chromosome 7
79
mortality rate of cystic fibrosis
over 50% die before age 32
80
pathogenesis (how it develops) of cystic fibrosis
defective transport of chloride, sodium, and water across the cell membrane, and deficient electrolytes and water in mucus. mucus gets too think and obstructs pancreatic ducts, bronchi, bronchioles, and bile ducts
81
obstruction of pancreatic ducts causes:
atrophy and fibrosis
82
obstruction of bronchi causes:
lung injury
83
obstruction of biliary ducts causes:
liver scarring, nothing can get to liver so tissue dies and is replaced by scar tissue
84
treatment of cystic fibrosis
pills with pancreatic enzymes to compensate for lack of, treatment of pulmonary bacterial infections to preserve lung function, and eventual lung transplant
85
diabetes mellitus
two types, very common, and manifests as hyperglycemia (increased blood glucose)
86
type 1 diabetes
insulin deficiency, occurs primarily in children and young adults
87
type 2 diabetes
body doesn't respond to insulin, most common type, mostly adult onset but increasing in obese children
88
what causes type 1 diabetes
damage to pancreatic islets leading to reduction or absence of insulin secretion
89
diabetic ketosis (ketoacidosis)
complication of type 1 diabetes, overproduction of ketone bodies
90
what causes type 2 diabetes
insulin secretion is normal or increased, but the tissues don't respond correctly, and pancreas can't increase insulin output to compensate
91
hyperosmolar nonketotic coma
complication of type 2 diabetes, blood sugar increases 10-20x normal value, and there is no ketosis. coma due to hyperosmolarity (water moves out of cells, cells dehydrated)
92
prediabetes
number of insulin-producing beta cells is beginning to decline, and provides an indication that weight loss, exercise, and healthy eating habits are needed or diabetes will occur
93
pharmacologic treatment for prediabetes
a-glucosidase inhibitors: improve glucose tolerance
94
pregnancy-associated diabetes
high level of placental hormones cause pregnant woman to be less responsive to insulin, and those that can't secrete more develop gestational diabetes. usually relents after birth
95
metabolic syndrome
group of conditions identified in person with impaired glucose tolerance that can progress to diabetes
96
complications of metabolic syndrome
obesity, insulin resistance (diabetes), blood-lipid abnormalities, hypertension
97
insulin
influences carbohydrate, protein, and fat metabolism; its main stimulus for release is high blood glucose (it lowers blood sugar)
98
insulin promotes:
- glucose entry into cells
- utilization of glucose as energy
- storage of glucose as glycogen
- conversion of glucose into triglycerides
- storage of triglycerides as fat
99
ketone bodies
created when glucose is absorbed but not used, body uses fat as energy which is broken down into fatty acid and glycerol. fatty acid broken into acetyl-CoA, which are converted into ketone bodies
100
ketosis
accumulation of ketone bodies in blood and excreted in urine with water and electrolytes
101
hyperglycemia
elevated blood glucose, can come from other conditions that impair glucose usage such as chronic pancreatic disease, endocrine diseases, certain drugs
102
treatment of type 1 diabetes
diet, insulin injections with custom dosage to keep blood glucose controlled
103
treatment of type 2 diabetes
weight reduction and diet usually helps alone, if not then oral hypoglycemic drugs are used
104
how diabetes is monitored
frequent periodic measurements of blood glucose, urine tests to detect glucose in urine, and measuring glycosylated hemoglobin
105
too much insulin causes what?
large drop in glucose leading to insulin shock
106
why is vigorous exercise bad for a diabetic patient taking insulin?
with high physical activity there is high glucose utilization, this means there will be more insulin in the blood, and too much insulin leads to insulin shock
107
glycosylated hemoglobin
excess glucose molecules attach permanently to RBC, that circulate in the body. concentration of these is proportional to glucose levels for past 6-12 weeks
108
in normal people, what percent of hemoglobin is glycosylated?
6%
109
in people with well and poorly controlled diabetes, what percent of hemoglobin is glycosylated?
7% in well controlled, 8% in poorly controlled
110
carcinoma of the pancreas
usually develops in the head of the pancreas, blocking the common bile duct and causing obstructive jaundice
111
islet cell tumors
usually benign, produce hyperinsulinism (too much insulin) and hypoglycemia (too little blood glucose)
112
insulin performs all of the following functions except:
a. promotes entry of amino acids into the cells
b. promotes storage of glucose in muscle and liver cells
c. promotes entry and absorption of glucose into cells for energy use
d. promotes breakdown of fat
e. lowers blood glucose
d. promotes breakdown of fat
| insulin does promote amino acid entry, glucose usage and storage, and lowers blood sugar.
113
function of gastrointestinal tract
digestion and absorption of food
114
components of gastrointestinal tract
oral cavity, esophagus, stomach, small/large intestines, anus
115
how does cleft lip/palate develop?
when the two tissues that fuse at the midline experience maldevelopment
116
what kind of inheritance pattern does cleft lip/palate have?
multifactorial inheritance
117
when can cleft lip be surgically corrected?
soon after birth
118
when can cleft palate be surgically corrected?
when the child is 1-2 years old, followed by speech therapy to correct nasal speech
119
what is surgical correction of cleft lip and cleft palate called?
cheiloplasty
120
two types of teeth
temporary/deciduous (20) and permanent (32)
121
dental plaque
sticky film on teeth that forms with bacteria in the oral cavity mix with saliva
122
caries
tooth decay that forms as a result of plaque mixed with the action of bacteria
123
dental cavity
loss of tooth structure from bacterial action
124
gingivitis
inflammation of the gums due to masses of bacteria/debris accumulating around base of teeth
125
periodontal disease
inflammation of the gums extends to the tissues that support teeth, and form small pockets of infection between teeth and gums
126
stomatitis
inflammation of the oral cavity
127
causes of stomatitis
irritants such as alcohol, tobacco, and hot/spicy foods
| infectious agents such as herpes virus, fungus, and bacteria
128
carcinoma of the oral cavity
develops in the squamous epithelium, and can be in the lips, cheek, tongue, palate, and back of throat
129
esophagus
muscular tube that extends from pharynx to stomach, with sphincters at both ends
130
upper esophageal sphincter
sphincter at the top of the esophagus that opens to allow passage of swallowed food
131
lower gastroesophageal/cardiac sphincter
sphincter between esophagus and stomach that opens to allow passage of food into the stomach
132
what causes esophageal diseases?
failure of cardiac sphincter to function properly (GERD), tears in esophageal lining, esophageal obstruction
133
symptoms of esophageal disease
dysphagia (difficulty swallowing), substernal discomfort, inability to swallow, regurgitation of food into trachea, choking
134
two major disturbances of cardiac sphincter
cardiospasm and incompetent cardiac sphincter
135
cardiospasm
cardiac sphincter fails to open properly, esophagus becomes dilated proximal to sphincter, treated by period stretching of sphincter or surgery
136
incompetent cardiac sphincter
sphincter doesn't close properly, allowing gastric juices to leak into the esophagus
137
complications of incompetent cardiac sphincter
reflux esophagitis, ulceration and scarring, and Barrett's esophagus
138
what can obstruct the esophagus?
carcinoma, tumor that narrows lumen and infiltrates tissues and trachea, food impaction, and stricture (scar tissue)
139
acute gastritis
inflammation of the gastric lining
140
how do NSAIDS cause acute gastritis?
they inhibit the COX enzyme. COX protects gastric mucosa and mediates inflammation. if COX is inhibited then inflammation is not controlled
141
how can alcohol cause acute gastritis?
it is a gastric irritant because it stimulates gastric acid secretion
142
H. pylori
small, curved gram negative organisms that colonize the surface of gastric mucosa, and they produce a substance that decomposes urea into ammonia which allows these organisms to flourish
143
H. pylori gastritis
when these organisms flourish they produce enzymes that break down mucus layer. it is common and increases with age, and spreads via person to person contact and fecal-oral route
144
H. pylori gastritis carries an increased risk of what?
gastric carcinoma and malignant lymphoma
145
peptic ulcer
develops when increased acid secretions and digestive enzymes causes mucus digestion and injury, commonly found in distal stomach or proximal duodenum
146
complications of peptic ulcers
hemorrhage, perforation, peritonitis, obstruction from scarring
147
treatment of peptic ulcers
antacids-block acid secretion
antibiotics-destroy H. pylori that cause mucus injury
surgery if needed
148
manifestations of stomach carcinoma
vague upper abdominal discomfort and iron-deficiency anemia (chronic blood loss)
149
diagnosis of stomach carcinoma
biopsy by means of gastroscopy
150
treatment of stomach carcinoma
surgical resection of affected part, surrounding tissue, and lymph nodes
151
prognosis of stomach carcinoma
relatively poor, often far advanced when diagnosed
152
acute enteritis
common intestinal infection that is short in duration. causes nausea, vomiting, abdominal discomfort, loose stools
153
chronic enteritis
less common intestinal infection, longer, and more difficult to treat
154
Crohn's disease (regional enteritis)
chronic inflammation and ulceration of mucosa, bowel wall thickens and scars, which must be treated with drugs and surgical resection
155
ulcerative colitis
inflammation in large intestines and rectum that usually begins in the rectal mucosa and spreads throughout the entire colon
156
complications of ulcerative colitis
bleeding, bloody stool, perforation, and colon cancer
157
treatment of ulcerative colitis
antibiotics and corticosteroids for flare-ups, immunosuppressive drugs, surgical resection
158
antibiotic-associated colitis
antibiotics destroy intestinal flora, causing diarrhea, abdominal pain, and fever
159
diagnosis of antibiotic associated colitis
stool culture to look for a toxin in stool
160
treatment of antibiotic-associated colitis
stop antibiotic treatment and give a drug that increases intestinal motility
161
appendicitis
most common inflammatory lesion of the bowel, caused when secretions of the appendix drain poorly and bacteria invade the appendix wall causing inflammation
162
manifestations of appendicitis
generalized abdominal pain localizing in right lower quadrant with rebound tenderness and rigidity
163
treatment of appendicitis
surgical resection of the appendix
164
Meckel's diverticulum
out pouching at the distal ileum and usually asymptomatic, but can become infected causing similar complications to acute appendicitis
165
food intolerance
causes crampy abdominal pain, distention, flatulence, loose stools
166
lactose intolerance
unable to digest lactose into glucose and galactose for absorption due to lactase deficiency, and the lactose builds up and increases pressure of bowel
167
gluten intolerance (Celiac disease)
body can't tolerate gluten, causes chronic diarrhea impairing absorption of fats and nutrients and weight loss
168
gluten
protein in wheat, rye, barley, and imparts elasticity to bread dough
169
diagnosis of gluten intolerance
clinical features and biopsy of intestinal mucosa
170
treatment of gluten intolerance
gluten-free diet
171
irritable bowel syndrome
crampy abdominal discomfort, loud grilling bowel sounds, and disturbed bowel function without structural or biochemical abnormalities
172
how to diagnose irritable bowel syndrome
by exclusion-rule out infections, food intolerance, and inflammatory conditions
173
cause of obesity
any caloric intake that exceeds requirements is stored as adipose tissue and weight is gained-or endocrine or metabolic disturbances
174
what percentage of Americans are obese
60%
175
obesity carries a higher incidence of what?
diabetes, hypertension, cardiovascular disease and many other diseases
176
treatment of obesity
reduction in food intake, increase in activity, or surgical interventions such as gastric bypass and gastric banding for those that can't reduce food intake
177
anorexia nervosa
false perception of fatness, with continual weight reduction by food restriction and excessive exercise. medical and psychological treatment needed
178
bulimia nervosa
repeated episodes of binge eating followed by purging, that leads to dental problems, metabolic alkalosis, and electrolyte disturbances. can tear mucosa in esophagus due to purging
179
cause of chronic malnutrition
intake of nutrients is insufficient to satisfy the body's needs (inadequate food, poor distribution, or natural disaster, or inability to use food efficiently)
180
people at risk for chronic malnutrition
people that experience parental neglect or lose weight rapidly
181
tolerable body weight percentage loss?
5-10%, 30% can be fatal
182
what role does alcohol play in chronic malnutrition?
it is very high in calories and has no nutrients-has 7 calories per gram
183
diverticulosis
outpouching (diverticula) of mucosa through weak areas in muscular wall of large intestine, commonly seen in the sigmoid colon
184
diverticulitis
inflammation incited by bits of fecal material trapped within outpouchings
185
complications of diverticulitis
inflammation, perforation, bleedings, scarring, abscess
186
difference between diverticulosis and diverticulitis
diverticulosis is just the out pouching on the intestines, diverticulitis is when those outpouchings become inflamed and irritated
187
intestinal obstructions
conditions blocking normal passage of intestinal contents that is always considered a serious condition. the severity depends on the location of obstruction, completeness of obstruction, and interference with blood supply
188
high intestinal obstruction causes:
severe cramps abdominal pain and vomiting with loss of water and electrolytes
189
low intestinal obstruction causes:
less acute symptoms with mild, crampy abdominal pain and distention of abdomen (enlargement)
190
common causes of intestinal obstruction
hernia, tumor, volvulus
191
adhesions
adhesive bands of connective tissue that may cause loop of bowel to twist and cause an obstruction proximal to the adhesion
192
hernia
protrusion of loop of bowel through a small opening in the abdominal wall, that pushes through peritoneum to form hernial sac
193
inguinal hernia
common in men, loop of small bowel protrudes through a week area in inguinal ring and descends downward into the scrotum
194
umbilical hernia
loop of bowel protrudes into umbilicus through defect in the abdominal wall
195
femoral hernia
loop of intestine extends under inguinal ligament along course of femoral vessels into the groin
196
reducible hernia
herniated loop of bowel that can be pushed back into the abdominal cavity
197
incarcerated hernia
hernia that cannot be pushed back
198
strangulated hernia
loop of bowel is tightly constricted obstructing blood supply to herniated bowel, requires prompt surgical intervention
199
volvulus
rotary twisting of bowel impairing blood supply
200
intussusception
telescoping of a bowel segment into an adjacent segment, from vigorous peristalsis or tumor
201
mesenteric thrombosis
clot that blocks blood flow in a mesenteric vein-one of two veins that drains blood from intestines that can cause bowel infarction
202
benign pedunculate polyps
tumors of the colon, the tips can erode causing bleeding, must be removed by colonoscopy
203
carcinoma of colon
can be in cecum and right half of colon, or left half of colon
204
carcinoma in cecum and right half of colon
doesn't cause obstruction because veins are larger in this area, but the tumor can ulcerate and bleed, and leads to chronic iron-deficiency anemia
205
carcinoma in left half of colon
causes obstruction and symptoms of lower intestinal obstruction
206
imperforate anus
congenital anomaly where the colon doesn't develop a normal anal opening-two types
1. rectum and anus normally form but with no anal orifice-easily treated by incising tissue
2. entire distal rectum fails to develop-harder to treat
207
hemorrhoids
varicose veins of hemorrhoidal venous plexus that drains rectum and anus
208
what predisposes to hemorrhoid development?
constipation and straining
209
what relieves hemorrhoids?
diet high in fiber and rich in fruits and vegetables, medications such as stool softeners and rectal ointment, and surgery
210
internal hemorrhoids
hemorrhoids in veins of lower rectum, may erode and bleed or become thrombosed
211
external hemorrhoids
hemorrhoids in veins of anal canal and perianal skin, may become thrombosed and caused discomfort
212
what diagnoses GI disease
endoscopic procedures, radiologic examination
213
endoscopic procedures
directly visualize and biopsy abnormal areas such as esophagus, stomach, intestines
214
radiologic examination
examines areas that can't be visualized endoscopically, evaluates motility problems, identifies location and extent of disease
215
a 45 year old patient has a large right-sided colon carcinoma with iron deficiency anemia. the anemia is most likely due to:
a. impaired absorption of nutrients due to tumor
b. chronic blood loss from ulcerated tumor surface
c. poor appetite
d. metastases to the liver
e. obstruction of colon by tumor
b. chronic blood loss from ulcerated tumor surface
| right sided tumors do not obstruct, veins are large enough, but tumor can ulcerate and bleed
216
major endocrine glands
pituitary, thyroid, parathyroid, adrenal cortex, pancreatic islets
217
endocrine disorders
hypersecretion or hyposecretion
218
pituitary gland
suspended by stalk from hypothalamus at base of brain that secretes tropic hormones that regulate other endocrine glands
219
pituitary gland (anterior lobe) hormones
growth hormones, prolactin, thyroid stimulating hormone, follicle stimulating hormone
220
pituitary gland (posterior lobe) hormones
antidiuretic hormone (concentrated urine), oxytocin (uterine contractions)
221
panhypopituitarism
anterior lobe fails to secrete all hormones
222
pituitary dwarfism
deficiency of growth hormone that causes retarded growth and development
223
diabetes insipidus
failure of posterior lobe to secrete antidiuretic hormone, or failure of kidney to respond to it, can't absorb water
224
growth hormone overproduction
causes gigantism in children, acromegaly in adults, and visual disturbances
225
prolactin overproduction
result of small pituitary adenoma, that causes amenorrhea (ceased periods) and galactorrhea (milk secretion from non pregnant breasts)
226
functional pituitary tumors
produce hormones that cause clinical manifestations
227
nonfunctional pituitary tumors
do not produce hormones but exert other effects
228
many pituitary endocrine disturbances caused by:
anterior lobe pituitary tumors
229
treatment of pituitary tumors
determined by type, size, and hormone produced-drugs to suppress growth, and surgical resection though the nasal cavity
230
thyroid gland
two lateral lobes connected by isthmus, composed of thyroid follicles that produce and store hormones. regulated by thyroid stimulating hormone
231
what do thyroid glands do
controls rate of metabolic processes, and regulates normal growth and development
232
hyperthyroidism
toxic goiter, causes rapid pulse, increased metabolism, hyperactive reflexes, diarrhea, warm moist skin
233
hypothyroidism
slow pulse, decreased metabolism, sluggish reflexes, constipation, cold dry skin
234
nontoxic goiter
thyroid gland enlarges to increase hormone secretion
235
treatment of nontoxic goiter
administer thyroid hormone, may need surgical removal
236
chronic thyroiditis (Hashimoto thyroiditis)
autoantibody destroys thyroid tissue, results in hypothyroidism
237
radiation for thyroid tumors
increases incidence of benign and malignant thyroid tumors after the latent period of 5-10 years, most are well-differentiated and easily treated
238
parathyroid glands
regulate calcium levels, it is supposed to be in equilibrium with calcium level in the bone
239
low blood calcium
causes tetany (increased neuromuscular excitability causing muscle spasms)
240
high blood calcium
causes lowered neuromuscular excitability, causing less muscle movements
241
hyperparathyroidism
from hormone secreting parathyroid adenoma that causes hypercalcemia (high blood calcium), renal calculi, and calcium deposit in tissues
242
treatment of hyperparathyroidism
removal of the adenoma that is causing the symptoms
243
hypoparathyroidism
usually from accidental removal of parathyroid glands, causing hypocalcemia (low blood calcium), and neuromuscular excitability and tetany
244
treatment of hypoparathyroidism
raise the calcium levels with a high calcium diet and vitamin D supplements
245
adrenal cortex
paired glands above the kidneys that secrete glucocorticoids, aldosterone, and sex hormones
246
overproduction of aldosterone
caused by aldosterone producing tumor of adrenal cortex, causing high sodium, blood volume, blood pressure, and low potassium
247
overproduction of adrenal sex hormones
from sex hormone producing tumors and congenital adrenal hyperplasia (lack of enzyme needed for glands to produce necessary hormones)
248
adrenal medulla
produces catecholamines that stimulate sympathetic nervous system (norepinephrine and epinephrine)
249
pheochromocytoma
increased secretion of catecholamines (norepinephrine and epinephrine), that can cause cerebral hemorrhage from hypertension
250
Addison's disease
adrenal cortical dysfunction where all steroid hormones are deficient, autoimmune disorder
251
glucocorticoid deficiency
causes hypoglycemia (low blood sugar)
252
mineralocorticoid deficiency
causes low blood volume and low blood pressure
253
hyper pigmentation
results from increased adrenocorticotropic hormone (ACTH)
254
Cushing disease
excessive production of adrenal corticosteroids (glucocorticoid or mineralocorticoid), treated by tumor removal
255
glucocorticoid excess
causes disturbed carbohydrate, fat, and protein metabolism
256
mineralocorticoid excess
causes high blood volume and high blood pressure
257
function of gonads
production of germ cells and sex hormones, controlled by gonadotropic hormones of pituitary gland follicle stimulating hormone and luteinizing hormone
258
nonendocrine tumors
secrete ectopic hormones that mimic the actions of the true hormones, usually produced by malignant tumors, and commonly seen on lungs, pancreas, kidneys, connective tissues
259
CNS
central nervous system, brain and spinal cord
260
meninges
surrounding membranes of brain and spinal cord, contains neurons and neuroglia, sensory/afferent nerves, and motor/efferent nerves
261
sensory nerves
afferent nerves, transmits impulses toward the nervous system (away from muscles)
262
motor nerves
efferent nerves, transmits impulses away from the nervous system (towards muscles)
263
3 meninges
dura-firm, outer covering
arachnoid-middle (contains CSF in subarachnoid space)
pie-thin, inner membrane
264
subarachnoid space
space between the arachnoid and pia meninges that contains cerebrospinal fluid
265
how many ventricles (cavities) does that brain have?
4
266
where does the arterial blood supply of the brain come from?
large vessels that enter the base of the skull, and join to form arterial circle at the base of the brain
267
where does the venous blood supply of the brain go?
from the brain into large venous sinuses in dura, and drain into the jugular veins
268
forebrain develops what part of the brain?
cerebral hemispheres and diencephalon
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voluntary motor activity is controlled by..?
nerve impulses that originate in motor neurons of cerebral cortex (pyramidal system)
270
involuntary motor activity is controlled by what?
the extrapyramidal system
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flaccid muscle paralysis
motor neurons are destroyed by disease, the reflex arc responsible for muscle tone is interrupted, and muscle is deprived of innervation (nerves)
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spastic muscle paralysis
the reflex arc responsible for tone is not disturbed, but cortical neurons (in cerebral cortex) stop voluntary control, resulting in increased muscle tone
273
cerebral injury
large blood vessels on cerebrum (brain surface) may be torn, resulting in epidural, subdural, or subarachnoid hemorrhage
274
anencephaly
neural tube defect in which the brain and cranial cavity fails to develop normally
275
spina bifida
neural tube defect in which the meninges bulge out from the spine, causes alpha-fetoprotein to leak from fetal blood into amniotic fluid
276
congenital hydrocephalus
from congenital obstruction of aqueduct or absence of openings in 4th ventricle, the head enlarges as the ventricles dilate because cranial structures are not fused
277
acquired hydrocephalus
obstruction of cerebrospinal fluid by a tumor or adhesion blocking the opening of the 4th ventricle, where the ventricles dilate but the head does not enlarge because cranial structures are fused
278
stroke
cerebrovascular accident-injury to brain tissue from disturbance of blood supply to the brain
279
cerebral thrombosis
most common type of stroke, where a thrombus forms in a cerebral artery narrowed by arteriosclerosis
280
cerebral embolus
blockage of cerebral artery by a fragment of a blood clot from the heart or from arteriosclerotic plaque
281
cerebral hemorrhage
most serious type of stroke, usually from rupture of a cerebral artery in someone with hypertension
282
what is the most serious type of stroke?
cerebral hemorrhage
283
what is the most common type of stroke?
cerebral thrombosis
284
predisposing factors to a stroke
1. thrombus formed on wall of left ventricle next to a healing myocardial infarction
2. thrombus formed on rough surface of diseased mitral or aortic valve
3. small thrombus in left atrium of someone with atrial fibrillation
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ischemic infarct
infarct of brain tissue where no blood leaks into the brain
286
hemorrhagic infarct
infarct of brain tissue into which blood leaks
287
arteriosclerosis of extracranial arteries
sclerosis of a major artery from aorta that supplies the brain, can narrow the lumen and reduce cerebral blood flow
288
common site of arteriosclerosis of extracranial arteries
carotid artery in neck
289
diagnosis of a stroke
cerebral angiogram, CT scan, and MRI
290
a CT scan can do what for cerebral infarcts and hemorrhages?
it can distinguish between a cerebral infarct from a cerebral hemorrhage
291
transient ischemic attack
TIA, brief episodes of neurologic dysfunction from plaque in carotid artery forming an embolus that reduces blood flow to the brain, 1/3 of patients eventually suffer a stroke
292
treatment of transient ischemic attack
endarterectomy (surgical removal of part of the inner lining of an artery) or medical therapy
293
cerebral aneurysm
congenital aneurysm of the circle of Willis, caused by a congenital weakness that allows the arterial lining to protrude and rupture, causing subarachnoid hemorrhage which is treated by surgically blocking the aneurysm
294
arteriosclerotic aneurysm
cerebral artery dilates and compresses adjacent tissue, but rupturing is not common
295
meningitis
infection affecting the meninges
296
encephalitis
infection of the brain tissue
297
meningoencephalitis
infection affecting both meninges and brain tissue
298
three types of infections
bacterial, fungal, and viral
299
viral infections that affect the CNS
measles, mumps, herpes simplex, intestinal and respiratory viruses
300
manifestations of viral infections that affect the CNS
systemic symptoms, aseptic meningitis (serious inflammation of meninges), encephalitis, and spinal fluid abnormalities
301
arboviruses
virus responsible for causing meningitis and encephalitis and it is transmitted by mosquitoes (West Nile is a type of encephalitis)
302
Creutzfeldt-Jakob disease
also known as mad cow disease, caused by a small protein particle produced by gene mutation--cows became infected from animal feed mixed with infected sheep tissue, and then humans eat the infected beef
303
alzheimer disease
progressive mental deterioration and emotional disturbances, and has no specific treatment but drugs can temporarily improve function
304
multiple sclerosis
autoimmune disease in generally predisposed individual, caused by demyelination of nerve fibers and glial scarring, but can be initiated by a viral infection in a genetically predisposed person
305
manifestations of multiple sclerosis
activated T lymphocytes, monocytes target myelin proteins and destroy the myelin sheaths
306
parkinson disease
usually has an unknown cause, but manifests as progressive loss of neurons, rigidity of voluntary muscles, and tremors
307
treatment of parkinson disease
can induce stem cells to produce more dopamine to treat the disease, because one of the characteristics is decreased dopamine
308
huntington disease
progressive hereditary autosomal dominant disease, is uncommon but well-known
309
manifestations of huntington disease
progressive mental deterioration, jerky movements. begins between age 30-50, and usually fatal within 15-20 years
310
treatment of huntington disease
no way to stop progression but some drugs can ease symptoms
311
degenerative disease of motor neurons
affects upper and lower motor neurons, causes weakness, paralysis, and respiratory problems. ALS is a big example
312
ALS
amyotrophic lateral sclerosis. it affects both upper and lower motor neurons, causing flaccid paralysis of muscles and respiratory problems (loss of muscle tone and nerves)
313
tumors of peripheral nerves
- usually solitary and develop from Schwann cells
- neuromas usually involve the acoustic nerve and are difficult to treat surgically
- multiple tumors occur in multiple neurofibromatosis
314
multiple neurofibromatosis
transmitted as the dominant trait, causing disfiguring skin nodules, thickened patches of skin, and hyperpigmentation
315
brain tumors
metastatic tumors are more common that primary tumors
316
primary brain tumors
glioma, astrocytoma, oligodendroglioma, lymphoma
317
glioma
mostly poor prognosis with deep location in the brain, treated by surgery, radiation, and chemo
318
spinal cord tumors
same kinds of tumors that arise in the brain, but they can extend from the vertebrae to compress or invade the spinal cord
319
peripheral nerve injury
caused by traumatic injury (crush injury, lacerations, etc) or nerve entrapment (commonly the median nerve and may require surgical release)
320
polyneuritis
sensory and motor dysfunction in hands and feet
321
Guillain Barré syndrome
patchy demyelination of nerves and nerve roots with mild inflammation, this is an autoimmune reaction to myelin. causes progressive weakness followed by complete recovery
322
neurologic manifestations of HIV
acute viral meningitis, AIDS encephalopathy, polyneuritis
323
AIDS related tumors
primary tumor that metastasizes to nervous system, a primary tumor of the brain may occur, and usually responds poorly to treatment
324
which statement is TRUE regarding stroke?
a. paralysis on right side of body results from stroke in right cerebral hemisphere
b. flaccid paralysis occurs from a brain injury that damages lower motor neurons
c. spastic paralysis occurs from brain injury that damages lower motor neurons
d. smoking and oral contraceptives in women have no impact on stroke risk
e. cerebral embolism is most serious type of stroke and is frequently fatal
b. flaccid paralysis occurs from brain injury that damages lower motor neurons
because flaccid paralysis is the only type of paralysis that results from lower motor neuron damage
325
structure of bones
cortex (outer layer of compact bone), trabecular (inner spongy layer), and bone marrow (spaces between trabecular, fat and blood-forming tissue)
326
bone is what type of tissue?
connective-composed of dense connective tissue framework with calcium phosphate salts, and is continuously broken down and reformed
327
3 types of cells in bone
osteoblasts, osteocytes, osteoclasts
328
3 types of joints
fibrous joint (non moving), cartilaginous joint (some moving) and synovial joint (freely moving)
329
intramembranous bone formation
mesoderm transformed into osteoblasts that are converted into bone
330
endochondral bone formation
cartilage model is converted into bone
331
achondroplasia
congenital faulty endochondral bone formation, where there is impaired growth of extremities and skull bone formation. causes dwarfism with short limbs
332
osteogenesis imperfecta
congenital malformation where all bones are thin and delicate and easily broken. presents with malformation of fingers and toes, polydactyly, can have multiple fractures at birth
333
congenital clubfoot (talipes)
multifactorial inheritance pattern, and treated with manipulation and casts to make the foot grow normally
334
congenital hip dislocation
multifactorial inheritance pattern, more common in females, where the acetabulum is too shallow and the femoral head is displaced out of socket. treated with manipulation and casts
335
rheumatoid arthritis
systemic disease that affects connective tissues especially in the joints, and produces chronic inflammation and thickening of synovial membrane-autoimmune
336
rheumatoid factor
autoantibody in blood and synovial tissues produced by B lymphocytes directed against a person's own gamma globulin
337
rheumatoid arthritis usually affects what joints?
small joints of hands and feet
338
rheumatoid arthritis usually affects what age and gender?
young men and middle aged women
339
osteoarthritis
"wear and tear" degeneration of weight bearing joints, causing degeneration of articular cartilage covering bones. normal aging process and seen more in older adults
340
gout
disorder of purine metabolism where the product (uric acid) precipitates as crystals in joint fluid causing pain and swelling
341
urate nephropathy
urate deposits plug tubules and damage the kidneys from an excess of uric acid
342
simple fracture
bone is broken cleanly into two pieces
343
comminuted fracture
bone is shattered
344
compound fracture
the bone breaks the skin
345
pathologic fracture
fracture through a diseased area in the bone
346
treatment of a bone fracture
open reduction (internal fixation of a bone-steel plate, screws, etc) and closed reduction (plaster cast)
347
osteomyelitis
infection of bone and adjacent marrow cavity as a result of bacteria that get into the bone by direct implantation from conditions that expose to direct infection such as trauma or surgery
348
manifestations of osteomyelitis
fever, local pain, tendernedd
349
diagnosis and treatment of osteomyelitis
x-rays used to show changes in bone, and treated with antibiotics and possibly surgery
350
tumors of the bone are usually:
metastatic tumors from the prostate, breasts, and other organs
351
multiple myeloma
growth of abnormal cells in the plasma cells
352
primary malignant bone tumors
unusual, chondrosarcoma (cartilage) and osteosarcoma (bone forming cells)
353
osteoporosis
generalized thinning and demineralization of the entire skeletal system-"porous bones," and is most common in postmenopausal women because estrogen loss accelerates the rate at which osteoclasts break down bones
354
avascular necrosis
interference in blood supply to the epiphysis of bones that results in necrosis and degeneration at the ends of bone. caused by disturbance of blood supply and causes local pain and disability
355
common sites of avascular necrosis
femoral head, tibial tubercle, articular surface of femoral condyle
356
intervertebral disks
fibrocartilaginous cushions interposed between adjacent vertebral bodies that function as shock absorbers
357
curves of the vertebral column
cervical (forward, 7), thoracic (backward, 12), lumbar (forward, 5), and sacral (backward, 5)
358
scoliosis
abnormal lateral (sideways) curvature of the spin that occurs in 4% of the population. one shoulder is higher than the other and the pelvis is tilted
359
intervertebral disk disease
progressive wear and tear degeneration, and part of the disk is herniated. treated with surgery
360
manifestation of intervertebral disk disease
sudden onset of back pain radiating down the leg
361
diagnosis of intervertebral disk disease
CT scan or myelogram
362
manubrium
upper portion of the sternum
363
how do the ribs connect to the rest of the skeletal system?
they articulate posteriorly (in the back) to the thoracic vertebrae 1-12 and anteriorly (in the front) to the sternum, except ribs 11 and 12
364
pectus excavatum
the lower 2/3 of the sternum is displaced posteriorly (it caves in), caused by unbalanced costal cartilage growth and if severe can compromise cardiac and pulmonary function
365
pectus carinatum
part of the sternum projects outward, opposite of pectus excavated
366
Marfan syndrome
connective tissue disease-gene mutation leads to excessive growth in height, long thin fingers and toes, and chest wall abnormalities, usually pectus excavatum
367
myoneural junction
communication between a nerve and a muscle
368
how does a muscle contraction work?
nerve stimulation releases acetylcholine that crosses myoneural junction and attaches to receptors on surface of muscle fibers and initiates the contraction, which causes myofilaments to slide together
369
myositis
muscle inflammation, can be localized or generalized
370
localized myositis is usually caused by:
muscle injury or overexertion
371
generalized myositis is usually caused by:
systemic disease, or widespread degeneration and inflammation of skeletal muscle
372
dermatomyositis
type of polymyositis associated with swelling and inflammation of skin
373
polymyositis
chronic illness featuring progressive muscle weakness and inflammation with periods of increased symptoms, called flares or relapses, and minimal or no symptoms, known as remissions
374
progressive muscular atrophy
rare disease characterized by progressive degeneration of skeletal muscle, secondary to motor nerve cell degeneration
375
muscular dystrophy
primary muscle degeneration
376
myasthenia gravis
chronic disease characterized by abnormal fatiguability of voluntary muscles due to myoneural junction abnormality-autoimmune dbseasewith antibodies that fight acetylcholine receptors
377
the most common type of arthritis is osteoarthritis or rheumatoid arthritis?
osteoarthritis
378
arthritis pain that begins in one joint is usually characteristic of:
a. rheumatoid arthritis
b. osteoarthritis
b. osteoarthritis
379
joint pain accompanied by redness, swelling, warmth, and tenderness is usually characteristic of:
a. rheumatoid arthritis
b. osteoarthritis
a. rheumatoid arthritis
380
which arthritis affects only joints and not internal organs?
osteoarthritis
381
which type of arthritis affects weight-bearing joints?
osteoarthritis
382
which type of arthritis affects small joints of the hands and feet?
rheumatoid arthritis
