Pathophysiology Exam 1 Flashcards
General information from Powerpoints. Refer to disease templates for disease questions for disease questions.
Anatomic Organization
cells - basic building blocks
tissues
organs
organ systems
Cellular components
Plasma membrane
Organelles
Cytoplasm
Nucleus
Cytoskeleton
Plasma Membrane
semi-permeable with hydrophilic heads and hydrophobic tails
Organelles
tiny structures in cell
Golgi apparatus
packages and secretes substance produced by ER out of cell
Lysosomes
digest debris in cell
Peroxisomes
has enzymes that neutralize free radicals
Mitochondria
Produces ATP
Cytoplasm
everything in cell except nucleus
nucleus
the brain
cytoskeleton
framework of proteins that contribute to the shape of the cell
Name 6 cellular functions
- Transportation
- Ingestion
- Secretion
- Respiration
- Communication
- Reproduction
Name and explain the 3 categories of Transport Mechanisms
- Passive transport
- No energy
- From [high] to [low]
- Diffusion: Particle movement
- Osmosis: water movement
- Facilitated transport
* Still Passive= no energy
* Needs transport protein - Active transport
* Requires Energy
* Movement AGAINST the gradient
Define Ingestion and name 3 different types
Ingesting substances into the cytoplasm
- Endocytosis
Used to transport large substances into cells- Pinocytosis
*Contents of small liquid-
containing vesicles - Phagocytosis
*Large particles, such as
cells, bacteria, and cell
components
- Pinocytosis
Secretion
*Cellular products packaged into vesicles
*Transport out of the cell by exocytosis
*golgi works with ER to package and secrete
Define Respiration and name 2 types
(basically how the cell makes energy/ ATP)
Series of metabolic processes that transforms fuel molecules into energy and waste products
*Aerobic
Produces ATP using oxygen
*Anaerobic
Produces ATP without using oxygen
Communication
*Signals between cells controlling cellular function and behavior
*Messages communicated by receptor–ligand binding
*Feedback mechanisms prevent cellular damage
Reproduction
Cellular division under genetic control
*Mitosis - identical replication *Meiosis - makes something new
Cellular differentiation directs the development of specific cell types
Cellular Response to Stress
*preventcell/tissue harm
- Cells undergo adaptation torespond to stressors
*Cell injury/death whenadaptation fails
*Once stressor is removed,adaptation stops
*Cells adapt to increased work demands by changing in:
- Size
- Number
- Form
Cerebral Atrophy
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Cardiac hypertrophy
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Acromegaly
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Cervical Metaplasia and Dysplasia
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Atrophy
decrease in cell size
Hypertrophy
increase in cellsize
Hyperplasia
increase in numberof cells
Metaplasia
replacementof adult cells
Dysplasia
deranged cellgrowth
Mechanisms of death and causes of injury
Apoptosis - response to trigger! (cell suicide)
Necrosis - b/c of injury, irreversible, affects organelles/tissues
- Causes of injury
Physical
Mechanical
Thermal
Chemical
Migraine
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Which level of neuron carries sensory impulses to the thalamus?
Second-Order Neuron
What are the two Pain Pathways?
Discriminative & Anterolateral Pathways
Fibromyalgia
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Meniere Disease
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Otitis Media
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Alterations in Protective Eye Structures:
Glaucoma
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Alterations in Protective Eye Structures:
Macular Degeneration
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
The senses of hearing and balance are maximized by …
the function of the external ear and internal ear structures.
Alterations in vision can be induced by multiple causes, including …
damage to eye structures, motor dysfunction, and impaired neural conduction
Errors of Refraction
*name 9
Refraction-bending of light
Myopia-Nearsightedness
Hyperopia-Farsightedness
Astigmatism-irregular curvature of the cornea
Presbyopia-farsightedness-inability of the ciliary muscles & lens to accommodate for near vision
Strabismus-cross eye
Amblyopia-lazy eye
Diplopia-double vision
Nystagmus-involuntary eye
movement (brainstem or cerebellar lesions, Meniere disease, Multiple Sclerosis, Drug or Alcohol Toxicity
Refraction
bending of light
Diplopia
double vision
Amblyopia
lazy eye
Strabismus
cross eye
Nystagmus
involuntary eye movement (brainstem or cerebellar lesions, Meniere disease, Multiple Sclerosis, Drug or Alcohol Toxicity
Astigmatism
irregular curvature of the cornea
Myopia
Nearsightedness
True or False? The structures of the eye are protected by both physical and chemical barriers.
True
Extraocular muscles are responsible for …
the rotation, horizontal, and vertical movement of the eyes.
Evaluation of Pain
*How is it achieved?
*Careful evaluation of pain is achieved upon physical exam
*Pain is subjective
*Using the pneumonic “COLDSPA”
*Pain Measurement Scale
Review pain measurement scale
Define Referred Pain and give an example
*Perceived at a site different from its point of origin
*Results from the network of sensory nerves that supply many different tissues
Example: during a myocardial infraction pain may be felt in arm rather than the heart.
Phantom Limb Pain
Definition
Treatment
Sensation
*pain from limb that is no longer there.
*Tingling, squeezing, heaviness, burning, cramping, or shooting pain
*Multiple theories including neuromatrix
*Treatment includes TENS, hypnosis, relaxation training, sympathetic blocks
Treatment of Pain
- Pain relief (ANALGESIA) is the goal for pain treatment
- Non-pharmacologic interventions first before OTC & narcotics (ex. pacifiers, swaddling, rocking, music therapy, other distractors.
- Controlling pain to allow individuals to perform ADL’s
- Pediatric clients have a complex behavioral, physiologic and biochemical response and requires special considerations with pain management.
Non-Narcotic Analgesics
(Pain relief)
Aspirin and other NSAIDS
* reduce inflammation
Acetaminophen
* not anti-inflammatory
* Be mindful of administration in the elderly, liver and kidney disease
Types of Pain
Acute - usually diagnosed and treated. Comes quickly and resolves quickly (1-3 months)
Chronic - often associated with a disease. Lasts several months or longer (3-6+ months)
Classification of Pain
Location
- cutaneous, deep, referred, visceral
Quality (feeling)
- sharp, burning, throbbing
Duration
- acute vs. chronic
Pain can be objective or subjective. True or False
True
Headaches
*Caused by several conditions’ primary vs secondary
Can Indicate serious disorders such as meningitis, brain tumor, cerebral aneurysm, post-trauma, traumatic brain injury
*Diagnosis and classification is determined by a comprehensive H & P
(refer to powerpoint picture and textbook as well)
Characterization of Pain
Nociceptive - may cause tissue damage and include pressure, sharp objects, electric current or heat/cold applied to the skin. NOCICEPTIVE pathways are composed of first, second, third order neurons.
Neuropathic - direct injury or dysfunction of sensory axons of peripheral or central nerves
Nociceptors
Focused on Pain & Itch
Refer to powerpoint image
Dorsal Root Ganglia-Fiber Types
- Type A fibers are myelinated, the largest size fiber, and have the fastest rate of conduction. (Fast pain)
- Type B fibers are myelinated and transmit from cutaneous and subcutaneous receptors.
- Type C fibers are unmyelinated and have the smallest diameter and slowest rate of conduction. (slow pain)
NEUROMETER
tests involvement of specific nerve fibers, allowing for a more comprehensive assessment of sensory function.
Pain Pathways
Discriminative Pathway: used for the rapid transmission of sensory information such as discriminative touch (used for spatial orientation)
Anterolateral Pathway: Involves both the anterior & lateral spinothalamic pathways that provides transmission of sensory information. (slow conduction)
Use textbook
First-Order neurons
Carry Receptive endingsto Spinal Cord
*Detect stimuli that threatens the integrity of innervated tissues
*Carries sensory information from the periphery to the Central Nervous System (CNS)
Second-Order neurons
Carry sensory impulse to brain
*Relays information from the spinal cord and travels to the thalamus
Third-Order neurons
Carry Sensory Impulse to the Cortex
*Communicates sensory information from the thalamus to the cerebral cortex
*Processes pain information to the brain
Somatosensory System
(Central Nervous System )
Pain is transmitted by the somatosensory system along with sensations of pain, touch, temperature and body position
Mechanoreceptors
Touch, Sound, Balance
*The external stimuli are usually in the form of touch, pressure, stretching, sound waves, and motion.
Chemoreceptors
special nerve cells or receptors that sense changes in the chemical composition of the blood.
Anterolateral pathway
*Paleospinothalamic tract (slower)
*Diffuse, aching, unpleasant sensation
*Seen with chronic and visceral pain
*Associated with the mood-altering (emotions) and attention-narrowing effect of pain
*Can influence hypothalamic functions and > HR >BP
*Travels through small unmyelinated C fibers
*Activates the reticular activating system (controls sleep/wake cycles)
Somatosensory information is sequentially transmitted:
1st order, 2nd order and 3rd order neurons.
Somatosensory information includes…
touch, temperature, body position and PAIN.
Color vision is determined by
the combination of cones
*absence of cones -> color blindness
Visual Structures and Function
Eye consist of the cornea, retina, pupil, iris, lens, aqueous humor, vitreous humor, ciliary muscles and photoreceptors
*sight is achieved when light is reflected into the cornea
Cochlea
responsible for neural impulse that allows hearing
Balancing Processes:
Semicircular canals and vestibule (vestibular apparatus)
detect head position and acceleration, maintaining body position and stable visual fields
Barotrauma
Changes in atmospheric pressure, or injury resulting from the inability of the ear to equalize barometric stress.
ex. air travel and sea diving
Pain Theories:
Specificity
specific receptors (nociceptors) that detect and then transmit info to the brain for interpretation.
Pain Theories:
Pattern
Group of theories that propose that pain receptors share pathways with other sensory receptors.
Pain Theories:
Gate control
Peripheral receptors generate impulses along the afferent neurons and enter the spinal cord serving as a gate regulating the transmission of impulses.
Pain Theories:
Neuromatrix
The brain (thalamus, limbic, spinal) identifies pain and there are multiple dimensions and determinants of pain, including stress, attention, culture, expectation, personality, and genetics
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Diabetes Insipidus (DI)
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Hyperthyroidism
*Graves Disease
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Hypothyroidism
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Cushing syndrome
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Addison disease
- patho
- risk factors
- signs/symptoms,
- diagnostics
- treatment
*nursing actions
Refer to concept map!
Characteristics of Hormones
*CONTROL via the hypothalamic–pituitary axis
*FEEDBACK (positive and negative loops)
*PATTERNS of hormone secretion, metabolism, elimination
*RECEPTOR binding
*ACTION on target organs and glands
Mediating Cell-to-Cell Communication:
Paracrine pathway
hormones produces in cell, secreted. and act directly on nearby receptive cells
Mediating Cell-to-Cell Communication:
Autocrine pathway
similar to paracrine, but receptor cells are also secretory cells, so cell can produce and exert effect on itself
Mediating Cell-to-Cell Communication:
Endocrine pathway
involves hormones traveling through blood to find a receptor site and bind there
Mediating Cell-to-Cell Communication:
Synaptic pathway
stays in nervous system
Mediating Cell-to-Cell Communication:
Neuroendocrine pathway
starts in nervous system and ends in blood
General Adaptation Syndrome
Name the 3 stages
- Alarm stage
- Resistance stage - if you cannot maintain this stage then it’ll lead to the exhaustion stage
- Exhaustion stage - prolonged long-term stress leads to this stage (burnout and fatigue are signs)
Refer to textbook for more information!!
Stress Response
*Neurologic response
(in central nervous system)
Name 6!
*Autonomic system - heart rate, BP, resp., pupils dilate, sweating
*Cerebral cortex - regulates cognitive activities (focus, planning, attention, and persistence)
*Limbic system - regulates emotions like fear, anxiety, anger, excitement
*Thalamus - intensifies sensory input related to stressor like vision, hearing and smell
*Hypothalamus
*Reticular activating system
Stress Response
*Hormonal response
Name 4-7!
- Corticotropin-releasing hormone
*ACTH
*Cortisol
*Catecholamines
- Epinephrine
- Norepinephrine
- Dopamine
Refer to textbook
Treating Altered Hormone Function
Dependent on cause!
- Hormone excesses
- Removal of tumor
- Removal of part or all of endocrine gland
- Medications that block effects of
hormone
*Hormone deficits
- Medications that stimulate release or
replace hormone
How would you diagnose altered hormone function?
*History and physical
examination
*Laboratory tests
- Serum and urine
hormone levels
- Hormone
suppression and
stimulation tests
- Serum electrolyte,
glucose, and
calcium levels
*Imaging studies
*Genetic testing
Hypopituitarism
a rare condition in which the pituitary gland doesn’t make one or more hormones or doesn’t make enough hormones
Hyperpituitarism
an excessive secretion or production of one or more of the hormones produced by the pituitary gland
General Manifestations of Hypopituitarism
- Gradual onset
- Fatigue
- Weakness
- Anorexia
- Sexual dysfunction
- Growth impairment
- Dry skin
- Constipation
- Cold intolerance
General Manifestations of Antidiuretic hormone
*excess and deficit
*excess
- fluid retention
- hyponatremia
*deficit
- excessive water loss
General Manifestations of thyroid hormone
*excess and deficit
*excess
- weight loss
- hypermetabolism
- proptosis
*deficit
- weight gain
- dry skin
- constipation
General Manifestations of parathyroid hormone
*excess and deficit
*excess
- hypercalcemia
- formation of renal calculi
- excessive osteoclastic activity and bone resorption
*deficit
- hypocalcemia
- muscle spasms
- bone deformities
General Manifestations of Mineralocorticoids (aldosterone)
*excess and deficit
*excess
- hypertension
- hypernatremia (high sodium)
- hypokalemia
*deficit
- hypotension
- hyponatremia
- hypokalemia (low potassium)
Another term for cortisol
glucocorticoids
Hearing Evaluation
*hearing loss can be quantified using decibels (dB). The frequency or pitch of the sound in hertz (Hz)
- Minimal hearing loss: 16 to 25 dB
- Mild hearing loss: 26 to 40 dB
- Moderate hearing loss: 41 to 55 dB
- Moderate to severe hearing loss: 56 to 70 dB
- Severe hearing loss: 71 to 90 dB
- Profound hearing loss: 91 dB or more
Hyperopia
Farsightedness
Presbyopia
farsightedness-inability of the ciliary muscles & lens to accommodate for near vision