LO5 Flashcards
what is the role of the nervous system?
the nervous system receives, transmits and responds to information from the external environment and from the body’s internal environment, through a collection of nerve cells.
what are the 5 components of the nervous system?
- the central nervous system
- spinal cord
- autonomic system
- somatic nervous system
- peripheral nervous system
what is the structure and function of the central nervous system?
the CNS is the control centre for the body.
it consists of the brain and spinal cord.
the spinal cord connects to the brain by long lines of individual nerve cells, to every area in the body.
what is the structure and function of the spinal cord?
the spinal cord is protected by specialised bones called vertebrae.
these bones have a hollow centre through which the spinal cord runs.
it transmits information to and from the brain through structures called nerves.
what is the structure and function of the autonomic system?
the autonomic system controls and regulates processes such as heart rate and gut movements (peristalsis).
these actions are automatic - unconsciously controlled.
what is the structure and function of the somatic nervous system?
sensory nerves transmit information from the senses to the brain.
motor nerves transmit information to the muscles from the brain.
the sensory and motor nerve pathways work together, for example when picking something up.
what is the structure and function of the peripheral nervous system?
all the nerves outside of the CNS make up the peripheral nervous system.
it relays information from the brain and spinal cord to the rest of the body, and the reverse information from the body to the brain and spinal cord.
peripheral nerves include autonomic, sensory and motor nerves.
what is the definition of nerves?
cells called neurones, which make up our nervous system.
nerves are specialised cells, they carry messages from one part of the body to another as tiny electrical signals.
these messages are known as nerve impulses.
what are the 10 parts of the brain?
frontal lobe
parietal lobe
limbic lobe
occipital lobe
pineal gland
medulla
cerebellum
corpus callosum
hypothalamus
pituitary gland
what is the structure and function of the cerebral cortex?
the cerebral cortex is the wrinkly, outermost layer of the brain, responsible for thinking and processing sensory information from the body.
there are 4 lobes, each responsible for processing different types of information.
it is made of tightly packed neurons.
what is the structure and function of the cerebellum?
positioned at the back of the skull.
co-ordinates and regulates muscle activity, such as walking and writing.
it is also involved in the control of muscles to maintain balance.
what is the structure and function of the frontal lobes?
carry out higher level mental processes such as thinking, decision making and planning.
what is the structure and function of the corpus callosum?
a bridge of nerve tissue that connects the 2 halves of the brain and enables communication between the two.
what is the structure and function of the hypothalamus?
responsible for the maintenance of body temperature.
it also regulates appetite and thirst.
what is the structure and function of the medulla?
automatically carries out and regulates life-sustaining functions such as breathing, swallowing and heart rate
what is the structure and function of meninges?
3 layers of membranes surrounding the brain and spinal cord.
they provide a barrier from the rest of the body and act as protection from infection.
what is the structure and function of a neuron?
neurons are specialised nerve cells that transmit electrical impulses (information) from one part of the body to another.
what are the 3 main sections of a neuron?
axon
dendron (dendrites)
myelin sheath
what is the structure and function of an axon?
axons are the long thread-like part of a nerve cell, along which impulses are conducted away from the cell body to other cells.
there is only one per neuron.
what is the structure and function of a dendron (dendrite)?
dendrons are short, branched structures on the neuron that receive electrical impulses and carry them towards the cell body.
there can be as many as 1000 per neuron.
what is the structure and function of myelin sheath?
the myelin sheath is a fatty white substance that surrounds the axon.
it forms a protective, insulating layer and enables electrical impusles to transmit quickly and efficiently along the nerve cells.
what are the 3 sections of a synapse?
pre-synaptic neuron
synaptic cleft
post-synaptic neuron
what is the function of a synapse?
to transfer electrical activity (information) from one cell to another.
how does a synapse work?
an electrical impulse travels along an axon.
this triggers the pre-synaptic neuron to release chemical messengers called neurotransmitters.
the neurotransmitters diffuse across the synapse.
they then bind with receptors on the post-synaptic membrane and then the information has been received.
what is the endocrine system?
the endocrine system is made up of glands that secrete hormones that regulate metabolism, reproduction, growth and sleep.
what are the 9 main parts of the endocrine system?
pineal gland
hypothalamus
pituitary gland
thymus gland
pancreas
ovaries
testes
adrenal gland
thyroid gland
what is the function of the pancreas in the endocrine system?
the pancreas is a gland situated near the stomach that produces insulin.
Insulin is needed to control glucose (blood sugar) levels in the body
what is the function of the pituitary gland in the endocrine system?
it is located at the base of the brain and is the master gland that regulates all the other endocrine glands.
what is the function of the adrenal gland in the endocrine system?
there are 2 adrenal glands, one situated above each kidney.
they produce adrenaline which is the fight or flight hormone.
this is released into the bloodstream as a response to a threat and prepares the body to fight or run by raising the heart and breathing rates.
what is the function of the thyroid gland in the endocrine system?
it is located in the lower front part of the neck.
the thyroid produces thyroxine, which affects growth and sustains metabolism (how the body functions)
what is the function of the reproductive glands in the endocrine system?
the ovaries and testes are the source of sex hormones.
testosterone in males affects male characteristics such as sexual development, growth of facial hair and changes at puberty, as well as sperm production.
in female, the ovaries produces oestrogen and progesterone as well as eggs. These hormones control breast growth and reproductive functions such as menstruation and pregnancy.
what are the 8 part of the kidney?
cortex
medulla
renal artery
renal vein
calyx
ureters
bladder
urethra
what is the cortex?
the outer layer of the kidney, where ultrafiltration occurs.
what is the medulla?
inner region, contains thousands of nephrons
what is the renal artery?
supplies kidney with blood from the heart. Branch directly from the aorta
what is the renal vein?
carries blood that has been filtered by the kidney
what is the calyx?
chambers through which urine passes.
it is the fibrous white region which collects urine and passes it on to the ureters
what is the ureter?
tube that carries urine from the kidney to the bladder
what is the bladder?
stores urine
what is the urethra?
urine passes out of the body through this
how do the kidneys work?
blood travels into the kidney through the renal artery.
waste products are filtered out and nutrients absorbed.
the balance of water in the body is regulated.
the renal vein takes blood away.
waste products in urine move down to the bladder.
what are the 5 main functions of the kidneys?
ultrafiltration
reabsorption
osmoregulation
removal of waste - urea
regulation of water
what is the structure and function of a nephron?
nephrons consist of a ball formed of small capillaries called a glomerulus and a small tube called a renal tubule.
the kidney nephron is a complicated twisting tube, divided into special regions that help remove poisonous wastes from the blood, as well as helping to control water, salt, pH and blood pressure levels.
there are approximately 1 million nephrons per kidney, each containing a glomerulus, bowman’s capsule, loop of henle, proximal tubule, distal tubule and collecting ducts.
what is the role of the glomerulus?
at the beginning of the nephron is the glomerulus, a network of capillaries that performs the first step of filtering blood using diffusion.
diffusion is the movement of molecules from an area of high concentration to an area of low concentration. This is allowed by the capillaries being one cell thick.
what is the role of the Bowman’s capsule?
Fluids from the blood in the glomerulus are collected in the Bowman’s capsule and further processed along the nephron to form urine. This process is known as ultrafiltration.
how does ultrafiltration occur?
The process of ultrafiltration occurs in the Bowman’s capsule.
During ultrafiltration, protein and red blood cells remain in the glomerulus. These products are not found in the urine of a healthy person.
Blood is filtered in the kidney under high pressure.
Plasma is forced out through the capillary walls into the Bowman’s capsule. This also removes waste.
The nephron peforms the job of filtration and fluid balance.
Although glucose is removed from the blood during ultrafiltration, it is always reabsorbed.
People with uncontrolled diabetes will lose glucose in urine if their blood glucose levels reach a high threshold.
how is urea removed from the body?
urea is a toxic waste product produced in the liver as a product of deamination.
deamination is the breakdown of amino acids, which are the building blocks of proteins and found in many foods. This forms ammonia, but the liver converts it to a less toxic chemical called urea.
urea passes into the blood and travels to the kidney.
it is removed through urination.
what is osmoregulation and reabsorption?
osmoregulation - water input and water output should be kept constant despite internal and external changes. It is important for all body functions that salt and water levels remain constant.
water input comes from food and drink.
water output occurs through breathing, sweating and in urination.
selective reabsorption is where the kidneys only reabsorb the products that the body needs such as water, glucose and ions.
the reabsorption of salt and glucose happens in the proximal tubule (both), and distal tubules (salts).
most water is reabsorbed in the loop of Henle.
the kidneys can conserve water levels if you are dehydrated. They can also make urine more dilute to expel excess water if necessary.
Loss of water increases the concentration of the blood, and if left uncorrected could result in our cells losing water by osmosis, as water diffuses into the plasma.
the hypothalamus in the brain detects the rise in blood concentration and it sends impulses to the pituitary gland, leading to the release of ADH.
ADH travels to target cells in the walls of the kidneys collecting ducts and all over the body.
A specialised blood supply keeps the medulla region salty, by removing salt from urine in the loop of Henle.
what is the liver?
largest internal organ
located in the upper abdomen
cleanses the blood and aids digestion by secreting bile.
what are the 3 main functions of the liver?
deamination
detoxification
production of bile
what is deamination?
the breakdown of amino acids from proteins.
our body uses part of the amino acids to make chemicals it can store like glucose and fat.
deamination results in the production of ammonia, which is a toxic waste.
ammonia is converted into urea which is a slightly less toxic chemical.
urea is transported in the blood and removed by the kidney in urine.
what is detoxification?
the liver transforms substances such as ammonia, metabolic waste, drugs and chemicals so they can be excreted.
the first step uses enzymes and oxygen to burn toxins, especially fatty ones.
the second detox step combines toxins with amino acids so they can be removed from the liver through bile or urine.
the liver converts ammonia produced by deamination into urea, a less toxic waste. The urea is transported in the blood and removed by the kidney in the urine.
the liver breaks down alcohol, removing it from the blood.
the liver breaks down drugs such as paracetamol.
what is production of bile?
bile is produced by the liver as a result of the breakdown of red blood cells.
bile is a digestive juice that helps the body absorb fat through emulsification into the bloodstream.
it is a thick, yellow-green substance stored in the gallbladder until it is needed by the digestive system, specifically the duodenum.
what is homeostasis?
the maintenance of a constant internal environment.
the conditions in the body must be very carefully controlled if the body is to function effectively.
the nervous system and hormones are responsible for this.
what are some examples of conditions that need to be controlled?
the concentration of carbon dioxide in the blood.
body temperature maintained at 37 degrees as enzymes work best at this temperature.
blood sugar levels controlled by the release and storage of glucose, which in turn is controlled by insulin.
water content, to protect cells by preventing too much water entering or leaving.
what is negative feedback?
the mechanism used to achieve homeostasis.
if the level of something rises, control systems reduce it again.
if the level of something falls, control systems raise it again.
how do negative feedback mechanisms work?
- conditions in body change from set point
- change detected
- corrective mechanisms activated
- conditions returned to set point
- correction made
how does homeostasis regulate blood glucose?
- concentration of blood glucose increases above the norm after a meal
- too much glucose in the blood - negative feedback from the pancreas
- pancreas secretes more insulin - pancreas is the effector
- liver and muscles convert excess glucose to glycogen and store it,
- concentration of blood glucose returns to normal
what is a stroke?
a stroke is a serious life-threatening medical condition that happens when the blood supply to part of the brain is cut off.
strokes are a medical emergency and urgent treatment is essential.
the sooner a person receives treatment for a stroke, the less damage is likely to happen.
what are the 2 types of stroke?
Ischaemic
Haemorragic
what is a Ischaemic stroke?
the most common type
occur when a blood clot blocks the flow of blood and oxygen to the brain.
the clots form in areas where arteries are narrowed and become blocked over time due to the build up of fatty deposits known as plaques.
what is a Haemorragic stroke?
also known as cerebral haemorrhages.
occur when a blood vessel within the skull ruptures and bleeds into and around the brain, leading to damaged cells.
what happens to the brain when it is starved of oxygen?
blood flow to an area of the brain is cut off.
therefore oxygen is prevented from getting to the brain.
brain cells then die due to a lack of oxygen.
abilities controlled by that area of the brain are lost.
what happens when there is a bleed on the brain?
blood spills into or around the brain and creates swelling and pressure, damaging cells and tissues in the brain.
bleeding causes brain cells to die and the affected part of the brain stops working correctly.
causes of Ischaemic strokes
- age as arteries naturally narrow
- smoking
- hypertension
- obesity
- high cholesterol levels
- diabetes
- excessive alcohol intake
- atrial fibrillation which is a type of irregular heartbeat. This can cause blood clots in the heart that break up and become lodged in the blood vessels supplying the brain.
causes of Haemorrhagic strokes
- high blood pressure which weakens the arteries in the brain and makes them prone to split or rupture.
some factors that can increase the risk of high blood pressure include:
- obesity
- excessive amounts of alcohol
- smoking
- a lack of exercise
- stress
haemorrhagic strokes can also occur as a results of the rupture of a balloon-like expansion of a blood vessel (brain aneurysm) or abnormally formed blood vessels in the brain.
symptoms of strokes
face - may have dropped on one side
arms - the person with suspected stroke may not be able to lift both arms and keep them there
speech - may become slurred or not be able to talk at all
dizziness
confusion
problems with balance and co-ordination
difficulty swallowing
a sudden, severe headache
how are strokes diagnosed?
usually diagnosed by carrying out physical tests and studying images of the brain produced during a scan.
blood tests to determine cholesterol and blood sugar levels.
checking pulse for an irregular heartbeat.
blood pressure measurements.
treatments for strokes
MEDICATION:
- alteplase - dissolves blood clots and restores blood flow.
- aspirin - an antiplatelet that reduces the chance of another clot forming if taken regularly.
- Warfarin - an anticoagulant for long term use, it prevents clots forming.
- Beta-blockers - used to treat high blood pressure.
- Statins - used to lower cholesterol levels.
SURGERY:
- Thrombectomy - removes blood clots and restores blood flow to the brain.
- Stents - used to open narrow arteries.
SUPPORTIVE TREATMENTS:
- Feeding tubes - if having difficulty swallowing.
- Mobility aids - walking aids, bath rail, bed rail, rise and recline chairs.
- Physiotherapy - helping the patient relearn simple motor activities such as walking, sitting, standing, lying down and the process of switching from one type of movement to another.
care needs for stroke
- emotional support/counselling from charities and support groups, family and friends.
- medical intervention - regular check ups
- bathing/dressing aids
- furniture adaptations and kitchen aids - electronic equipment, electronic chairs/beds
- mobility aids - walking frames/sticks
- personal alarms for emergency care when trip or fall.
- adapted telephones - larger numbers, speaker, voice activated.
- home help, residential care, family support
lifestyle impacts/ADLs for stroke
- speech, hearing and sight problems/restrictions.
- loss of memory (short or long term).
- co-ordination and balance problems
- mobility restrictions/paralysis of limbs and face
- swallowing complications - leading to chest infections
- social life/relationships impacted
- mental health effects - isolation, lack of independence, disempowerment, fear of repeat stroke, depression at lack of improvement.
what is multiple sclerosis?
an autoimmune condition
the immune system attacks the myelin sheath in the brain and/or spinal cord.
this causes the myelin sheath to become inflamed in patches.
this disrupts the messages travelling along the nerves which leads to the signs and symptoms of MS.
When the inflammation clears, scarring is left behind on the myelin sheath, this can eventually lead to permanent damage to the underlying nerves.
causes of MS
It is thought MS is caused partly by genes and partly by outside factors.
There is a 2-3% chance of developing it if you are related to someone with the condition.
people who smoke are twice as likely to develop MS as non-smokers.
Viral infections may trigger the immune system and lead to MS.
Low vitamin D levels may play a part in the condition, but it is not clear if vitamin D supplements can help prevent MS.
Symptoms of MS
Symptoms are unpredictable and some develop and worsen over time, whilst others come and go.
Fatigue
Difficulty walking - mobility problems
Numbness and tingling
Muscle spasms, stiffness and weakness
Vision problems
Balance and Co-ordination problems
Pain
Problems with thinking, learning and planning
Depression and anxiety
Sexual problems
Bladder/Bowel problems
Speech and swallowing difficulties.
Most people with MS only experience a few symptoms.
what are relapses? MS
Periods when symptoms get worse
what are remission?
periods when symptoms improve or disappear
diagnosis for MS
MRI Scan
- a painless scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.
- it can show whether there is any damage or scarring of the myelin sheath in the brain and spinal cord. Finding this can help confirm a diagnosis.
Blood Tests
- performed to rule out other causes of symptoms
monitoring of MS
Blood tests
- monitor blood cell counts if you are on disease modifying drugs.
Discussions with MS nurse and neurologist
- MS nurses are the main point of contact
- They offer information, support and clinical advice.
- They have a good understanding of the sort of problems and concerns you may experience when living with MS.
- They can refer you to other appropriate services if they feel it would be helpful.
- They can also liaise with the GP and other HSC professionals involved.
- Neurologists will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show if nerves are damaged.
treatments for MS
There is no cure so only the symptoms can be treated.
Disease Modifying Drugs
- Used for reducing relapses, reducing the number of brain lesions and slowing the progression of losing physical ability.
Steroids
- Short course of high dose steroids used
- only used if symptoms of relapse are causing significant problems such as impacting eyesight or walking.
- Can help symptoms of relapse improve more quickly.
- However, taking steroids does not have any impact of the ultimate level of recovery from a relapse or the long term course of your MS.
Physiotherapy
- Helps maintain mobility
care needs for MS
- emotional support/counselling from charities and support groups, family and friends.
- medical intervention - regular check ups
- bathing/dressing aids
- furniture adaptations and kitchen aids - electronic equipment, electronic chairs/beds
- mobility aids - walking frames/sticks
- personal alarms for emergency care when trip or fall.
- adapted telephones - larger numbers, speaker, voice activated.
- home help, residential care, family support
Lifestyle impacts of MS
- Fatigue - affects ability to do basic daily activities
- Vision problems
- Muscle spasms and stiffness - pain/restricted movement, uncontrolled muscle movements
- muscle weakness and balance problems - reduced mobility
- nerve pain - neuropathic- can cause intensive skin burning and sensitivity
- memory, thinking and learning issues - work productivity issues, education impacts, communication problems.
- bladder and bowel control loss
- speech and swallowing complications - weight loss, chest infections
- emotional/social effects
what is type 1 diabetes?
an autoimmune condition
the body’s immune system attacks and destroys the cells that produce insulin.
it cannot be prevented or cured
the pancreas does not produce enough insulin
causes of type 1 diabetes
having a relative with diabetes is a risk factor
symptoms of type 1 diabetes
abnormal thirst and dry mouth
frequent urination
lack of energy, fatigue
blurred vision
constant hunger
sudden weight loss
bed wetting
what is type 2 diabetes?
occurs when the body’s production of insulin is insufficient to control glucose levels. The body can also develop insulin resistance.
this means that glucose stays in the blood and is not used as fuel for energy. Untreated, this can cause organ damage.
Causes of type 2 diabetes
being overweight/obese - it has been found that fat around the abdomen releases chemicals that can upset the body’s cardiovascular and metabolic systems
genetics
ageing - gain weight and exercise less as get older
inactivity
symptoms of type 2 diabetes
excessive thirst and dry mouth
frequent and abundant urination
lack of energy, extreme tiredness
blurred vision
recurrent fungal infections, frequent episodes of thrush
slow healing wounds
tingling or numbness in hands and feet
what are long term complications of diabetes?
vision loss
blindness
kidney failure
lower-limb amputation
What is insulin?
a hormone produced by the pancreas, a large gland found behind the stomach.
insulin controls the body’s glucose levels by moving glucose from the blood into the body’s cells where it is converted into energy.
monitoring of diabetes
Frequent blood tests to monitor glucose levels
Attend diabetic eye screening because of the risk of diabetic retinopathy.
treatment of diabetes
Type 1:
- Insulin injections required multiple times a day for rest of life
- Stem cell therapy to replace non functioning pancreatic cells.
Type 2:
- Healthy diet
-Regular exercise
- Weight loss and control
- Possibly insulin as needed
- Can be prevented through lifestyle modifications
care needs for diabetes
- healthy diet
- weight loss
- reduce alcohol intake
- increase exercise
- stop smoking
- informing friends/colleagues about situation and what to do if a hypoglycaemic episode occurs.
- having emergency supply of sugar/biscuits if hypoglycaemic.
- need to maintain blood glucose levels at set target to avoid vascular damage.
- eye tests to avoid retinopathy
- home blood pressure monitoring
- regular foot check for neuropathy
lifestyle impacts of diabetes
- psychological impact
- embarrassment
- long term complications
- regular insulin injections
- loss of eyesight due to retinopathy - unable to drive
- blood vessel damage resulting in limb amputations with potential effect on mobility and independent living.
- kidney damage and strokes resulting in hospitalisation and potentially life changing consequences.
- give up work
- loss of speech
- all lifestyle changes require commitment, will power and effort, as well as being time consuming.
what is nephrotic syndrome?
a condition that causes the kidneys to leak large amounts of protein into the urine. This can lead to a range of problems, including swelling of body tissues and a greater chance of catching infections.
A loss of protein through the kidneys (proteinuria) is due to an increase in permeability of the glomerulus.
This leads to low protein levels in the blood (hypoalbuminemia) which causes water to be drawn into the soft tissues resulting in oedema.
symptoms of nephrotic syndrome
swelling of body tissues - puffy eyelids, swelling of legs, ankles, feet and lower abdomen.
high levels of urine being passed
foamy urine
a greater chance of catching infections due to the loss of protein antibodies.
weight gain due to retaining too much fluid.
tiredness
loss of appetite
blood clots, as proteins that help prevent clots are passed out with the urine.
causes of nephrotic syndrome
autoimmune disease - the body over reacts to another condition and attacks the glomerulus and bowmans capsule in the kidney.
These conditions can include diabetes, sickle cell anaemia, HIV, hepatitis or syphilis.
It can also occur as a result of certain cancers such as leukaemia.
Congenital nephrotic syndrome is usually caused by an inherited faulty gene.
diagnosis of nephrotic syndrome
usually first diagnosed in children aged 2-5 years.
can usually be diagnosed after dipping a dipstick into a urine sample. If there are large amounts of protein, there will be a colour change on the stick.
A blood test showing a low level of a protein called albumin will confirm the diagnosis.
Monitoring of nephrotic syndrome
urine needs to be monitored daily with a dipstick to check for relapses
treatment of nephrotic syndrome
the main treatment used is steroids. This reduces the immune response and inflammation.
Diuretic tablets - reduce water retention by increasing the amount of urine produced.
Reducing salt in the diet to prevent water and oedema.
Vaccinations to prevent infections.
ACE inhibitors - reduce high blood pressure caused by fluid imbalance.
Immunosuppresant drugs - reduce immune response.
Removal of kidneys - depend on dialysis until transplant
Kidney transplant - matching donor availability, use of anti-rejection drugs
Albumin infusion - most of the protein type lost, used if symptoms are severe.
care needs for nephrotic syndrome
parental support - daily urine test, specific diets, medicating, hospital trips, appointments, emotional support during treatment.
Emotional - counsellor/social care worker
school tutor to help with missed education
care post kidney transplant
vaccines to avoid risk of infections
lifestyle impacts of nephrotic syndrome
pain
emotional impact on kids - isolation, lack of understanding from peers, missed school time and activities
long hospital stays
daily urine tests and medication
regular blood tests and albumin infusions - fear
poor growth and weight gain - long term effects on organ functions - brain, heart, muscles, bones.
what is liver cirrhosis? (alcohol-related liver disease)
cirrhosis is scarring of the liver caused by long term liver damage.
the scare tissue prevents the liver working properly.
cirrhosis can eventually lead to liver failure, which can be fatal. It usually takes years for the condition to reach this stage and treatment can help slow its progression.
what is haemochromatosis?
a faulty gene allows the body to absorb excess amounts of iron from food.
as a result, iron builds up over time and is usually deposited in the liver, pancreas, joints, heart or endocrine glands.
what is non-alcoholic fatty liver disease?
a build up of fat in the liver cells.
the liver can become inflamed, leading over time to scar tissue forming around the liver and nearby blood vessels.
this leads to cirrhosis and eventually liver failure.
it is usually seen in people who are overweight and having high levels of fat in the liver is usually associated with an increased risk of serious health problems such as diabetes, high blood pressure and kidney disease.
symptoms of liver cirrhosis
nausea - because the liver cannot process toxins as effectively
weight loss - body can’t process nutrients as effectively
vomiting blood - swollen veins in oesophagus and stomach
loss of appetite - because of the nausea and build up of toxins
jaundice - bilirubin cannot be moved through the liver and bile ducts quickly enough so it builds up in the blood and is deposited in the skin.
swelling of legs, ankles, feet, abdomen - increased pressure in the portal vein can cause fluid to accumulate in the legs and abdomen.
very itchy skin - higher levels of bile salt building up under the skin.
confusion and memory problems - the liver isn’t able to clear toxins from the blood as well, the toxins can then build up on the brain and cause confusion and difficulty concentrating.
insomnia - higher melatonin levels throughout the day and delayed onset of melatonin peaking during the night
causes of liver cirrhosis
alcohol misuse - regularly drinking large amounts of alcohol in a short time or drinking more than the recommended limits over many years.
a long term infection with hepatitis C
Obesity is a cause of non-alcoholic fatty liver disease as the liver becomes inflamed as a result of a build up of excess fat.
diagnosis of liver cirrhosis
If your GP suspects cirrhosis, they will check medical history and carry out a physical examination to look for signs of long term liver disease.
This can include a series of tests to confirm the diagnosis.
Blood tests
Scans - ultrasound, CT, MRI
Liver biopsy - a fine needle is used to remove a sample of liver cells so they can be examined under a microscope.
Endoscopy - a thin, flexible tube with a light and camera at the end ( an endoscope) is passed down the throat into the stomach. Images of the oesophagus and stomach can show swollen veins which are a sign of cirrhosis.
monitoring liver cirrhosis
receiving blood tests
treatment for liver cirrhosis
There is no cure but it is possible to manage the symptoms and any complications and slow its progression.
Treating the underlying cause, such as using anti-viral medication to treat a hepatitis C infection, can stop cirrhosis getting worse.
Lifestyle changes - cut down/stop drinking alcohol as it damages liver cells
aim for a healthy weight to avoid a build up of fat in and around the liver
If your liver is severely scarred, it can stop functioning and in this case, a liver transplant is the only treatment option.
A living donor liver transplant is a surgical procedure where a portion of the liver from a healthy living person is removed and placed into someone whose liver is no longer working properly.
The donors remaining liver regrows and returns to its normal size, volume and capacity within a couple of months after the surgery.
At the same time, the transported liver portion grow and restores normal liver functions in the recipient.
care needs for liver cirrhosis
support for symptoms of condition
hypertension care - medication, low salt diet
diuretics of fluid retention
healthy meals
support with substance abuse
lifestyle impacts of liver cirrhosis
major lifestyle changes needed - difficult to stick to and overcome addiction
lack of energy - affects daily activities
tiredness
jaundice
swelling of legs
side effects of medication
loss of independence
itchy skin
waiting for transplant/surgery
requiring care from family and friends
memory loss and confusion
can lead to:
work issues
problems with exercise
inability to perform personal care
becoming housebound
eat a healthier diet
frustration
depression
insomnia
guilt
changes in diet - can’t go out to eat with family/friends
inability to work - no contact with colleagues
stop drinking - can’t go out with friends
general impacts on lifestyle and care needs of control and regulatory system malfunctions
- side effects of medications or treatments
- regular check ups and monitoring appointments to attend
- waiting for or recovering from surgery
- dietary changes
- stopping drinking and smoking
- may become housebound if mobility is lost
- home adaptations - handrails to cope with limited mobility
- loss of independence due to needing assistance
- problems with walking and driving - may affect ability to work, may have to change jobs or stop working
- feeling tired, angry or stressed about treatment, care needs or prognosis
- emotional and social effects - depression, not going out socially or taking part in hobbies or sport.
evaluation of medication - stroke
+ alteplase help prevent blood clots and restores blood flow
+ regular aspirin reduces the chance of another clot forming
+ beta-blockers reduce high blood pressure
+ statins lower cholesterol levels
+ reduce risk of blood clots and cerebral haemorrhages
+ non surgical method
- daily use of anti-blood clotting medications may make small wounds bleed for longer
- medications aren’t always effective
- alteplase is not effective 4+ hours after a stroke
- important to identify which type of stoke has occurred before treating as the wrong treatment could cause further complications
evaluation of surgery (thrombectomy) - stroke
+ removes blood clots and restores blood flow to the brain
+ more effective than medication
- surgical risks - infection, bleeding etc
- potential damage to major blood vessels
- blood clot may not be accessible with surgical tools
evaluation of steroid medication - MS
+ reduce nerve inflammation
+ help relieve symptoms
+ treat relapses
+ accessible
+ stronger than painkillers
- increased risk of infection as steroids suppress the immune system
- side effects can increase after long term usage
- can’t be used for too long
- can impact blood circulation
evaluation of disease-modifying therapies - MS
+ helps to decrease the number of relapses
+ slows progression of disease
+ reduces severity of relapses
- not effective for everyone
- side effects - depression, liver failure
evaluation of physiotherapy and other aids - MS
+ help improve quality of life and empowers individuals
+ everyday life made easier by adaptations
- regular appointments impact work
- can only help improve to an extent as there is no real cure
- exercises can cause pain
evaluation of monitoring blood glucose levels - diabetes
+ helps to manage condition
+ prevents high/low levels
- painful
- time consuming
- cost of resources
evaluation of insulin injects/pumps- diabetes
+ immediate effect as it enters blood stream
+ can take out with you
+ cost efficient
+ little action required
+ can administer themselves
- can cause redness, swelling and changes in skin texture
- constipation
- pump attached to you at all times
- pump tubes can become blocked
- pumps aren’t available to everyone
evaluation of metformin - diabetes
+ lowers glucose levels by reducing the amount of glucose produced by the liver
+ 1 tablet a day
+ inexpensive
- intestinal effect
- Vit B12 deficiency
- may affect renal function so needs to be monitored
evaluation of healthy eating and regular exercise - diabetes
+ maintain healthy weight
+ reduced blood pressure
- hard to keep up
- struggle to afford and prep healthy food
- may struggle to find time to exercise
evaluation of diuretic tablets - nephrotic syndrome
+ reduce the build up of fluids by increasing the amount of urine produced
+ accessible
- general side effects - headache, dizziness
- unbalanced electrolytes
- need the toilet more often
evaluation of albumin infusions - nephrotic syndrome
+ prevents further deterioration of renal function
+ quick acting as administered into bloodstream
+ anti-inflammatory
- only used when critically ill
- mild reactions - fever, nausea
- may have allergic reaction
evaluation of dialysis - nephrotic syndrome
+ allows toxins and waste substances to be removed from the blood
+ used when waiting for kidney transplant
- can take up to 6 hours
- need time off work
- may have to travel to get it
- regular appointments
evaluation of steroid medication - nephrotic syndrome
+ most common treatment
+ accessible
- need to take a minimum of a 4 week course, followed by a smaller dose every other day for 4 more weeks
- can have significant side effects
evaluation of a kidney transplant - nephrotic syndrome
+ increases life expectancy
+ no need for dialysis
+ increased energy levels
- major operation - risk of bleeding and infections
- kidney may be rejected
- have to use immunosuppresants
- not always a successful procedure
evaluation of lifestyle changes - liver cirrhosis
+ doesn’t require medical intervention for healthy eating, exercise etc
+ has other health benefits
+ prevents progression of the disease
- requires willpower
- may require further support
- hard to stop drinking alcohol
evaluation of liver transplant - liver cirrhosis
+ increased life expectancy
+ can return to normal life
- major operation - risks such as bleeding and jaundice
- bile duct complications
- have to take immunosuppresants
- may be rejected
- may need further surgery
