Pathophysiology 2
Terms
undefined, object
copy deck
- Define pathology
- The study of disease and its causes
- Define pathophysiology
- The study of how diseases alter normal physiology
- What are the 5 types of cellular adaptation?
-
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia - Define atrophy
- A decrease in cell size resulting from a decreased workload
- Define hypertrophy
- An increase in cell size resulting from an increased workload
- Define hyperplasia
- An increase in number of cells resulting from an increased workload
- Define metaplasia
- Replacement of one type of cell by another type of cell that is not normal for that tissue
- Define dysplasia
- A change in cell size, shape, or appearance caused by an external stressor.
- Define hypoxia
- Oxygen deficiency
- Define ischemia
- A blockage in the delivery of oxygenated blood to the cells
- Define pathogen
- A microorganism capable of producing infection or disease
- Define anabolism
- The constructive phase of metabolism in which cells convert nonliving substances into living cytoplasm
- Define catabolism
- The destructive phase of metabolism in which cells break down complex substances into simpler substances with release of energy
- Define cellular swelling
- Swelling of a cell caused by injury to or change in permeability of the cell membrane with resulting inability to maintain stable intra- and extracellular fluid and electrolyte levels.
- Define fatty change
- A result of cellular injury and swellig in which lipids (fat vesicles) invade the area of injury; occurs most commonly in the liver.
- Define apoptosis
- Response in which an injured cell releases enzymes that engulf and destroy itself; one way the body rids itself of damaged and dead cells; "cellular suicide"
- Define decrosis
- Cell death; a pathological change. There are four types, coagulative, liquefactive, caseous, and fatty.
- Define edema
- Excess fluid in the interstitial space
- Define colloids
- Substances that consist of large molecules or molecule aggregates that disperse evenly within a liquid withoutforming a true solution
- Define albumin
- A protein commonly found in plant and animal tissue. In the blood it works to maintain blood pressure and provide colloid osmotic pressure (oncotic force), which prevents plasma loss from the capillaries
- Define crystalloids
- Substances capable of crystallization. In solution, unlike colloids, they can diffuse through a membrane. Also known as salt solutions.
- Define resipratory acidosis
- Acidity caused abnormal retention of carbon dioxide resulting from impared ventilation
- Define respiratory alkalosis
- Alkalinity caused by excessive elimination of carbon dioxide resulting from increased respirations
- Define metabolic acidosis
- acidity caused by an increase in acid, often because of increased production of acids during metabolism or from causes such as vomiting, diarrhea, diabetes, or medication.
- Define metabolic alkalosis
- Alkalinity caused by an increase in plasme bicarbonate resulting from causes including diuresis, vomiting, or ingestion of too much sodium bicarbonate.
- A person experiencing metabolic acidosis will have and increase or decrease in pH?
- Decrease
- When the brain recognizes a decrease in pH, what will happen to respirations to compensate?
- Respirations will increase
- If a hypertonic solution is administered, what is likely to happen to RBC's?
- They will crenate because water will move from the cell to the extracellular fluid.
- What will happen to a RBC if an isotonic solution is administered?
- Nothing. Because the solution is isotonic (iso meaning same) there is no movement of water and the cell will neither crenate of swell.
- Water will move in which direction in response to administration to hypotonic solutions?
- Water will move into the cell causing it to swell.
- What is the treatment for a person experiencing respiratory acidosis?
- Improve ventilation.
- What is appropriate treatment of a person in respiratory alkalosis?
- Emotional support. Alkalosis occurs because the person is excessively eliminating CO2 because of the increase in respirations. With emotional support and coaching, the person is often able to reduce RR.
- How many chromosomes do somatic cells (all cells with the exception of sex cells) contain?
- 46. Sex cells contain 23.
- What is the difference between Type I diabetes and Type II?
- Type I is more affected by genetics ans is more severe. In Type I the pancreas produces no, or almost no insulin and people must take insulin daily. Type II can be controlled by diet and is a problem with the insulin response receptors response, and not production itself.
- Define hemophelia
- A bleeding disorder that is caused by a genetic clotting factor deficiency.
- True or false: Obesity has been linked, or defined as a cause for, diseases such as HTN, heart disease, and vascular disease.
- True.
- Define perfusion
- The constatnt and necessary passage of blood through the body's tissues.
- Define hypoperfusion
- Inadequate perfusion of body tissues. Also called shock.
- Hyporerfusion is almost always a result of what?
- Inadequate cardiac output.
- What are the causes of hypoperfusion dealing with the heart (pump)?
-
Inadequate preload
Inadequate cardiac contractile strength
Inadequate heat rate
Excessive afterload - Term used to indicate there is not enough blood coming into the right atria for various reasons prior to contraction.
- Inadequate preload
- Term used to describe when perephrial blood flow is too high and left ventricle is not pumping enough blood out.
- Excessive afterload
- What is the cause of hypoperfusion dealing with the blood (fluid)?
- Hypovolemia, abnormally low circulating blood volume.
- What are the causes of hypoperfusion dealing with the vessels (container)?
-
Dilated vessels without change in fluid volume (inadequate systemic vascular resistance)
Leak in the vessels - What are the two characteristics of impared cellular metabolism in shock?
- Impared use of oxygen and glucose
- What is the primary energy source for cells?
- Glucose
- Define glycolysis
- The breakdown of glucose
- During the first stage of glycolysis, which is ______________, pyruvic acid is produced.
- anerobic
- What is prodced by the anerobic, or first, stage of glycolysis?
- Pyruvic acid
- The second stage of glycolysis, which is aerobic, causes pyruvic acid to break down into _______________, ___________, and ______________. This is a process known as the Krebs or citric acid cycle.
- carbon dioxide, water, energy
- True or false: By itself the process of glycolysis is an ineffective utilization of glucose because very little energy is produced.
- True. There is very little energy produced during glycolysis, or the first phase of glucose metabolism. During shock, or other conditions where cells are not adequately oxygenated, only the first stage is completed and the pyruvic acid degrades into lactic acid.
- Define aerobic metabolism
- The second stage of metabolism requiring oxygen to break down glucose. Yields a high amount of energy.
- Define anaerobic metabolism
- The first stage of metabolism of glucose where oxygen is not needed. Produces pyruvic acid and yields very little energy.
- Define glycogenolysis
- Converting glycogen into glucose (Glycogen is branched chains of glucose. Glycogenolysis, therefore is just breaking the chains. Literally means "new sugar making").
- What are the stages of shock?
-
Compensated
Decompensated (progressive)
Irreversible - During the process of compensation, the sympathetic nervous system stimulates the adrenal gland to secrete what two catecholamines?
- Epinephrine and norepinephrine
-
Epinephrine and norepinephrine cause
a(n) ________________ in hear rate, cardiac contractile strength and arteriolar _____________, all of which serve to elevate the blood pressure. - increase, constriction
- The renin-angiotensin system, a compensatory mechanism in maintaning adequate blood pressure, is activated by what?
- A fall in blood pressure.
- Renin is released from ______________ into the systemic circulation.
- the kidneys
- Together renin and angiotensin produce what?
- Angiotensin I
- Briefly describe the renin-angiotensin system for compensation.
- Activated by a drop in BP. Renin is released by the kidneys which acts on angiotensin to make angiotensin I. AI is converted to angiotensin II by an enzyme from the lungs called angiotensin converting enzyme (ACE). AII causes vasoconstriction and the release of aldesteron, a hormone secreted by the adrenal gland, that stimulates the kidneys to reabsorb sodium, and, subsequently water.
- __________ ___________ ___________ is secreated by the pituitary gland which causes the kidneys to reabsorb water, creating an additive effect to aldesterone.
- Anti-diuretic hormone (ADH)
- The spleen is capable of storing over ______ mL of blood, and can expel up to _______ mL in the venous circulation, increasing blood volume, preload, cardiac output, and BP in response to a sudden drop in BP.
- 300, 200
- What are the compensatory mechanisms for shock?
-
Compensation - the release of epi and norepi
Renin-angiotensin system
The spleen - ability to give up blood reserve to increase circulating blood volume - Define compensated shock
- The early stage of shock during which the body's compensatory mechanisms are able to maintain normal perfusion.
- Define decompensated shock (progressive shock)
- Advanced stages of shock when the body's compensatory mechanisms are no longer able to maintain normal perfusion.
- What are the types of shock?
-
Cardiogenic, Hypovolemic, Neurogenic, Anaphalactic, and Septic
Also can be classified as Cardiogenic, Hypovolemic, Obstructive (anything that causes a block in perfusion, and Distributive (neurogenic, anaphalactic and septic together) - Define irreversible shock
- Shock that has pregressed so far that no medical intervention can reverse the condition and death is inevitable.
- Define cardiogenic shock
- Shock caused by insufficient cardiac output; the inability of the heart to pump enough blood to perfuse all parts of the body.
- Most patients with cardiogenic shock will have a ___________ blood pressure.
- normal; some patients may be hypovolemic due to excessive use of prescribed diuretics, severe diaphoresis, or the effects of vasodilatory drugs.
- What is the major difference between cardiogenic and any other type of shock?
- The presence of pulomary edema in cardiogenic shock.
- What are s/s you can expect to see in a person who is in cardiogenic shock?
- Difficulty breathing, pulmonary edema, lung sounds may be diminished, may hear wheezes, crackles, or rales as fluid levels rise, productive cough with white- or pink-tinged foamy sputum and cyanosis
- What is proper treatment for cardiogenic shock?
- Assure airway is open, assist with ventilations if necessary, O2, IV TKO, EKG, keep pt warm, elevate pts head and shoulders