NURS 631 Advanced Pathophysiology Mid Term Study Guide 2020 | NURS631 Advanced Pathophysiology - Grand Canyon

NURS 631 Advanced Pathophysiology Mid Term Study Guide 2020 Topics to review for Midterm NUR 631 Advanced Pathophysiology Action potential Membrane Action Potential  Resting Neuron = - 70 MV/ (Threshold for action potential is -55) Action potential happens when internal cell reaches about -55mv/ all or nothing phenomena/ Strength of action potential is always same what changes is the frequency and conduction speed ( conduction speed is slower to glands, blood vessels. (Axon with large diameter increased conduction due to less resistance, PNS myelin sheaths are formed by Schwann cells wrapping themselves around the axon. These cell don’t touch each other and creates a gap called NODES OF RANVIER that makes salutary (Leap) conduction making current to run through axon faster. CNS oligodendrocytes wrap around the axons and lacks nodes of Ranvier. ) (1) Resting neuron are in – negative charge inside the cell and + charge extracellular (2) Sodium is in extracellular with + charge and potassium is intracellular bonded d with negative protein with + charge (3) Electrochemical gradient is created by Sodium Potassium pumps creating negative charge inside the cells and positive charge in extracellular. Sodium potassium pumps are all along the axons that exchanges 3 sodium in the cell for 2 potassium outside the cell. (4) Ion channels: - most are voltage-gated channels that open closes and reopens to changes in membrane potentials. Sodium channel opens @ -55 MV (5) Ligand-Gated Channels: - opens with neurotransmitter latched on to receptors like hormones or serotonin (6) Mechanical gated channels: - opens in response to the physical stretching of the membrane and Sodium gets in the cell. (7) Action potential depolarization: - All ions channels are closed at resting membrane voltage - 70mv. Depolarization of neuron has to happen for those voltage channels to open. An environmental stimulus opens mechanical channels which makes Sodium (NA+) to get in the cell changing charge inside the cell increases from -70. Threshold for action potential is -55mv. It is all or nothing phenomena. Stimulus that causes -55 of depolarization is false alarms nothing happens. (8) @-55mv gated sodium channel opens which rushes plenty of sodium on the cell causing depolarization which activates the sodium get next to it conducting this current in axon. Cell massive depolarization can go all the way up to +40 mv (which stays same for each action potential). This is action potential in action. This change in current kicks biological change down the axon. As soon as depolarization under way the process repolarization occurs where voltage gated potassium ions open letting K+ ( potassium ) flow out in extracellular space. This can cause membrane to first go hyperpolarized at about -75 before voltage channel closes and sodium potassium pumps take over. (9) When the Ion channels are open in membrane it cannot respond to any other stimulus. Does not matter how strong of stimulus it is. This is called Refractory Period. (10) Refractory period: - The first phase of this period from depolarization to repolarization is called absolute refractory period and it makes sure each action potential is unique in its own and all or nothing event. The second phase immediately follows the first one that spans from repolarization and back to resting potential is called the relative refractory period Atrophy (p. 50) – decrease or shrinkage in cellular size, can lead to the entire organ shrinking and atrophying – can affect any organ (most common in skeletal, heart, secondary sex and brain). Physiologic atrophy – with early development – thymus gland undergoes physiological atrophy during childhood Pathologic atrophy – results of decreased workload, use, pressure, blood supply, nutrition, hormonal simulation, and nervous stimulation. Examples are individuals not moving in bed, resulting in skeletal muscle atrophy (disuse atrophy) Hyperplasia: (p.51) (increase in cell numbers) mechanism is increased cellular divisions, secondary to prolonged and severe injury. a. loss of epithelial cells and cells in the letter number and kidney triggers DNA synthesis and mitotic division b. 2 types of normal or physiologic hyperplasia i. Compensatory hyperplasia- adaptive mechanism, certain organ to regenerate (Liver- hepatocytes) (70% of liver removal can regenerate completely in 2 weeks), HGF (Hepatocyte growth factor) is mediator in vitro of liver regeneration. Other growth factors that increases hepatic cell regeneration are transforming growth factor- alpha (TGF—alpha), epidermal growth factor (EGF), Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). 1. Compensatory hyperplasia occurs in epidermal, intestinal epithelia, hepatocytes, bone marrow and fibroblasts. Some type off hyperplasia is noted in bone, cartilage and smooth muscles – Example- callus, wound healing as part of inflammation process a. For example, removal of part of the liver leads to hyperplasia of the remaining liver cells to compensate for the loss. Even with removal of 70% of the liver regeneration is completed in about two weeks. ii. Hormonal Hyperplasia (p. 53): occurs in estrogen dependent organs- uterus and breast, fertilizing ovum (Uterus enlarges as result of hyperplasia and hypertrophy) 1. For Example: after ovulation estrogen stimulates the intermediate term to grow in thinking for the reception of fertilized ovum. If pregnancy occurs hormonal hypoplasia as well as height for trophy enables the uterus to enlarge. iii. Pathologic Hyperplasia: is the abnormal proliferation of normal cells and can occur in response to excessive hormonal stimulations or the effects of growth factors on target cells 1. Pathological hyperplasia- due to excessive hormonal stimulation or effect of growth factor. (Hyperplastic cells have enlargement of the nucleus, clumping of chromatin and presence of one or more nucleoli). a. For Example: the most common example is pathologic hyperplasia of the endometrium, which is caused by an imbalance between estrogen and progesterone one secretion with the over secretion of estrogen. Pathologic endometrial hyperplasia, which causes excessive menstrual bleeding is under the influence of regular growth inhibition controls. If these controls fail, hyperplastic endometrial cells can undergo malignant transformation. b. Example- Endometrium (Caused by imbalance between progesterone and estrogen secretion and over secretion of estrogen). If regulating growth- inhibiting control fails endometrial cells can undergo malignant transformation. Anaplasia – loss of cellular differentiation, irregularities of the size and shape of the nucleus and the loss of normal tissue structure. (p364) Dysplasia (p. 53) – abnormal changes in the size, shape and organization of mature cells. (atypical hyperplasia), occurs in epithelial tissue of the cervix, respiratory tract – considered mild, moderate severe and can be reversible. Pulmonary tuberculosis - infectious bacterial disease characterized by the growth of nodules (tubercles) in the tissues, especially the lungs. Capillary hydrostatic (p. 105) facilitates the outward movement of water from the capillary to the interstitial space.