Patho week notes
Patho week notes NURB 340
Popular in Pathophysiology
verified elite notetaker
Popular in NURSING
This 10 page Class Notes was uploaded by Kelsey Forbeck on Sunday September 25, 2016. The Class Notes belongs to NURB 340 at University of Indianapolis taught by Moore in Fall 2016. Since its upload, it has received 14 views. For similar materials see Pathophysiology in NURSING at University of Indianapolis.
Reviews for Patho week notes
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 09/25/16
NURB 340: Pathophysiology Exam 2 Altered Cellular and Tissue Biology Cellular Adaptation o Our cells learn to adapt to the environment o EX: Uterus enlarges during pregnancy o Atrophy Defined: A decrease or shrinking in the size of the cells Atrophy can affect any organ EX: Wearing a cast makes your arm weaker and gets smaller It is reversible! Atrophy is caused by disuse, insufficient blood flow, malnourished, or something is going on in endocrine Seen most in skeletal system, heart, secondary sex organs, and the brain o Hypertrophy Defined: Increase in the size of the cell resulting in enlarged tissue mass Caused by an increase workload Physical example: Think of a body builder, they increase workload and make muscles bigger Pathologic example: Heart gets enlarged when it has to work too hard o Hyperplasia Defined: Increase the number of cells that result in enlarged tissue mass Can be a compensatory mechanism to meet increased demands Can be pathologic due to hormone imbalance EX: Uterus increases cells to hold baby Hyperplasia can put us at risk for cancer o Dysplasia Defined: Cells vary in shape and size Nuclei in cell are present Rate of mitosis (cell division) is increase Dysplasia can result from chronic irritation, infection, or precancerous change EX: Pap smear. They are looking for dysplasia o Metaplasia Defined: When one mature cell type is replaced by a different mature cell type A response to chronic inflammation or irritation EX: Smokers irritate respiratory tract so new respiratory cells replace old ones to deal with irritation. There is no cilia on them now so no protection. The new cells will be able to endure the change or stress better. Change may result from a Vitamin A deficit General Mechanism Of Cell Injury o Hypoxic injury: MOST COMMON Defined: Lack of sufficient oxygen within the cells is the most common cause of cellular injury AKA ISCHEMIA Hypoxia can be caused by reduced amount of oxygen in the air, loss of hemoglobin, decreased production of RBC’s, disease of the respiratory and cardiovascular systems and poisoning of the oxidative enzymes (cytochromes) within the cells. An example of the poison could be carbon monoxide. EX of hypoxic injury is those with heart problems Ischemia reperfusion is clearing the blockage o Free radicals and reactive oxygen species injury Defined: Cellular injury induced by free radicals especially reactive oxygen species causes oxidative stress Difficult to control and initiate chain reaction Occur in chemical and radiation injury, ischemia reperfusion injury, cellular aging, and microbial killing by phagocytes o Chemical injury or Toxic Caused by endogenous factors (inside the body) or exogenous factors Common endogenous factors: Genetically determined metabolic errors (birth defects) Gross malformation Hypersensitivity reactions Common exogenous factors: Alcohol, lead, carbon monoxide Drugs that alter cellular function o Chemotherapeutic agents o Immunosuppressive drugs o Chemical agents Over the counter and prescribed drugs Leading cause of child poisoning is medications Air pollutants, insecticides, and herbicides can cause cellular problems Drug addictions and over dose Acetaminophen (Tylenol) MOST COMMON CAUSE OF POSIONING WORLD WIDE Lead Carbon monoxide Odorless, colorless, and most hidden kind Will turn cherry red and complain of headache, giddiness, chest pain, ringing in the ear. Ethanol (alcohol) Primary choice of mind-altering drug in the U.S. Fetal alcohol syndrome may occur Mercury Found in old thermometers and fillings o Unintentional and intentional Injury Death from injury more common in men than women Unintentional death is the leading cause of death for people ages 1-34 Intentional (suicide/homicide) Ranks between 2 nd and 4 in the same age group EX: strangulation and chemical exficulants o Infectious injury Viral, fungal, protozoa, and bacterial agents can cause cell injury or death The effect integrity of the cells and cell membrane Intervene with cell synthesis, producing mutant cells Human immunodiffiency virus alters the cell when the virus is replicated in the cell’s RNA o Immunologic and Inflammatory Injury Cell membranes injured by direct contact with cellular or chemical components of the immune and inflammatory responses Complement cascade is responsible for many of the membrane alterations during immunologic alterations Manifestations of Cellular Injury o Accumulations Intracellular accumulations of abnormal amounts of various substances Cellular accumulation also known as infiltrates Normal substances: water, proteins, lipids carbohydrates Abnormal substances: endo or exogenous- can be toxic or harmless o Cellular Swelling Most common change Caused by the shift of extracellular water into the cells Reversible and considered sub lethal First sign of cellular injury Associated with high fever, hyperkalemia, and certain infections o Lipids and Carbs Can accumulate throughout the body but lots of them are found in spleen, liver, and CNS If there is an excess then we may have Tay-Ssachs disease, Niemann, and Gaucher disease Disease known as mucopolysaccharidoses carbs are in excess Most common site of intracellular lipid accumulation is liver cells Most common cause is alcohol abuse Other cause includes diabetes, protein malnutrition, and toxins. Anorexia, and obesity The livers outward appearance is yellow and grey Excess carbs can cause fogginess of the lens o Glycogen Intracellular accumulation of glycogen Seen in certain genetic diseases called glycogen storage diseases and disorders of glucose and glycogen metabolism DIABETES is the most common glycogen accumulation disorder o Proteins Accumulation of proteins damage cells in two ways 1. Metabolites (enzymes) released from lysosomes can damage cellular organelles 2. Excess protein in the cytoplasm disrupts organelle function and intracellular communication Several types of renal disorders cause excessive secretion of protein in the urine (proteinuria) o Pigments Can normal or abnormal Can be endogenous or exogenous Most common is carbon (coal dust) Air pollutant in urban areas The accumulation blackens lung tissues and involved lymph nodes o Melanin Accumulates in epithelial cells of the skin and retina Important as it protects the skin again long exposure to sunlight Considered an essential factor in the prevention of skin cancer UV light stimulates the synthesis of melanin A decrease in melanin production occurs in the inherited disorder call albinism o Hemoproteins Most important of the normal endogenous pigments Hemoprotein accumulations due to excessive storage of iron Hemosiderosis is a condition in which excess iron is stored as hemosiderin in the cells of many organs and tissues-associated with liver and pancreatic cell damage Bilirubin is a normal yellow to green pigment Excess bilirubin within cells and tissues causes jaundice or yellowing of the skin o Calcium Salts can accumulate in both injured and dead tissue Damage occurs when calcium salts cluster and harden interfering with normal cellular structure and function Dystrophic calcification occurs in dying and dead tissues in areas of necrosis Miasmatic calcification consists of mineral deposits that occur in undamaged normal tissues as a result of hypercalcemia Hyprcalciemia also may occur in advanced renal failure with phosphate retention Calcification on heart sounds make hard for the valves to open and close causing murmurs and whooshing sounds Center of tumors can calcify o Urate (uric acid) End produce of purine catabolism because of the absence of the enzyme urate oxidase. Accumulation of urate results in hyperuricemia and the deposits of sodium urate crystals in the tissues, leading to painful disorders called gout Disorders include: acute arthritis, chronic gouty arthritis, and nephritis Chronic hyperuricemia results in the deposition of urate in tissues, cell injury, and inflammation Allopurinol combats the elevate levels. o Systemic manifestations of cellular injury General sense of fatigue and malaise Loss of well being Altered appetite Fever Cellular Death o Not all cell injury ends in death o Injury can irreversible so they end up being forced to die o Necrosis Defined: When a whole group of cells dies The process of cell death varies under the cause of the damage Liquid necrosis: Dead cells liquefy EX: Brain cells infected Coagulated necrosis Cells maintain some sort of form after death o EX: Myocardial infarction Fat necrosis Fatty tissue is broken down into its components of fatty acids Caseous necrosis Thick yellowish cheese substance formed EX: TB Infarction Area of dead cells If a lot die then there could be significant functional loss Scar tissue replaces dead tissue Gangrene Area of necrotic tissue that has been invaded by bacteria Bacteria cause a media for more microorganisms Can be wet or dry Needs to be removed surgically o Apoptosis (dropping off) Distinct type of cell death that differs from necrosis Cells need to die, otherwise endless cell proliferation would lead to gigantic bodies A low rate of apoptosis can permit survival of abnormal cells EX: mutates cells increase risk of cancer Defective apoptosis may not eliminate lymphocytes that react against host tissue leading to autoimmune diseases Excessive apoptosis is known to occur in several neurogenertal diseases, from ischemia injury (MI stroke) and from death of virus infected cells. Aging and Altered Cellular and Tissue Biology o This is a normal process o Life expectancy Is the average number of years of life remaining at a given age, however, it does not include quality of life Birth to death o Theories of aging Degenerative extracellular changes Binding of collagen, structural alterations of fascia, tendons, ligaments, bones, and joints. Cellular aging Atrophy, decreased function and loss of cells Tissue and systemic aging Progressive stiffness or rigidity Fragility Vulnerable to falls, functional decline, disability, disease and death. Somatic Death o You’re dead (entire person) o No circulation or breathing o Algor Mortis Defined: Postmortem reduction of body temperature Falls gradually after death Then more rapidly After 24 hours body temperature equals that of the environment o Livor Morties Defined: Gravity causes blood to settle in the most dependent, or lowest tissues which causes deep purple discoloration Incisions at this point wont bleed The skin loses elasticity and transparency o Rigor Mortis Defined: Within 6 hours after death, acidic compounds accumulate within in the muscles and muscle suffering develops Smaller muscles are affected first (such as jaw) Within 12-14 hours the entire body is completely rigid Body starts to diminish within 36-62 hours
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'