EXam 1 review Pathophysiology

Chapter 2 What is Pathology? The study and diagnosis of the disease through examination of organs, tissues, cells and body fluids What is Physiology? The study of the mechanical physical and biochemical functions of living organisms What is Pathophysiology? THE SUUDY OF ABNORMALITIES IN PHYSIOLOGIC FUNCTIONG OF LIVING BEINGS What is the framework for Pathophysiology? Etiology – The study of the causes or reasons for phenomena, identification of the cause factors disease Pathogenesis- The development or the evolution. How did the disease actually evolve? Begin? Manifestations? Clinical Manifestations- They are observed signs of the disease EX: increase in WBC Implications/Treatments- An understanding of the etiology, pathophysiology and pathogenesis, determine what will help. What treatment? Homeostasis & Allostasis What is Homeostasis? Remaining stable, set point, equilibrium, systems are in balance What is Allostasis? Ability to successfully adapt to challenges. A dynamic process trhat maintains or reestablishes homeostasis Stress and Disease - Hans Selye- the pioneer in the study of stress and disease, described stages of adaptation to a stressful event: Alarm :Hypothalamus Activates corticotropin, fight or flight response as the result of stressful stimulus. Internal/external HPA- Hypothalamus Pituitary Adrenal Axis Resistance: Activity of the nervous and endocrine system in returning the body to homeostasis. Hypothalamus secretes corticotropin releasing hormone CRH. Activates Anterior Pituitary Secretes ACTH Adrenocorticotropic Hormone Recovery OR Exhaustion: Where the body can no longer return to homeostasis, Allostatic Overload “wear and tear on the body” Stress as a Concept 1. Reactions to stress vary depending upon 1. Genetic constitution 2. Gender 3. Past experiences 4. Cultural influences 5. Developmental stage 2. 6 Age. Conditions or situations that increase the likelihood of encountering a stressor. Mediators of Stress and Adaptation Hormones Catecholamines Norepinephrine, Epinephrine Adrenocortical Steroids Cortisol, Aldosterone Neurohormonal Mediators  Endorphins  Sex Hormones  Growth Hormone  Adaptation, Coping & Illness  Individual Stress Response Effects of Stress Response Influenced by Allostatic overload  Leads to various illnesses and disorders, both physical and emotional  Chemical mediators form the stress response contribute to various illnesses: Cortisol, catecholamines, cytokines. CH 3 Cell Structure and Function Cellular Metabolism- is the biochemical process whereby foodstuffs are used to provide cellular energy and biomolecules. Cellular metabolism includes two separate and opposite phases: anabolism and catabolism. Anabolism refers to energy-using metabolic processes or pathways that result in the synthesis of complex molecules such as fats. Catabolism refers to the energy-releasing breakdown of nutrient sources such as glucose to provide ATP to the cell. All living cells must continually perform essential cellular functions such as movement, ion transport, and synthesis of macromolecules. ATP serves as the “energy currency” of the cell Glycolysis- The catabolic process of energy production begins with the intestinal digestion of foodstuffs into small molecules: proteins into amino acids, polysaccharides into simple sugars (monosaccharides), and fats into fatty acids and glycerol. - glycolysis is an important provider of ATP under anaerobic conditions because oxygen is not required. Thus ATP production by glycolysis becomes important during conditions of reduced cellular oxygenation Citric Acid Cycle (Krebs Cycle) Ten enzymatic steps are required glycolysis to break glucose into two 3-carbon pyruvate molecules. A net gain of two ATP molecules is achieved. KNOW KREBS CYCLE process Chapter 24 Fluid & Electrolyte Homeostasis & Imbalances Body Fluids • Body fluid flows in arteries, veins, and lymph vessels • They are secreted into specialized compartments- • Joints • Cerebral Ventricle • Intestinal Lumen Fluid Excretion • Fluid excretion normally occurs through the urinary tract, bowels, lungs and skin. • Visible Sweat • Exhaling • Fecal excretion Fluid Loss through Abnormal Routes • Emesis • Tubes in the GI tract or other body cavities • Hemorrhage • Drainage from fistulas, wounds, or open skin • Paracentesis VOLUME DEFICIT ETIOLOGY CAUSED BY REMOVAL OF A SODIUM CONTAINING FLUID FROM THE BODY Weight loss of 2.2 lbs. CLINICAL MANIFESTATIONS • Sudden Weight Loss • Postural blood pressure decrease with increase heart rate • Flat neck veins • Lightheadedness • Dizziness • Syncope • Oliguria (Small volume of concentrated urine • Decreased skin tugor • Dry Mucus Membranes • Hard Stools • Soft sunken eyeballs • Longitudinal furrows in the tongue Volume excess ETIOLOGY • -CAUSED BY ADDITION OR RETINTION OF ISOTONIC SALINE EXCESS • -EXCESSIVE SECRETION OF HORMONE ALDOSTERONE-CAUSES KIDNEY TO RETAIN SALINE • Weight GAIN of 2.2 lbs. CLINICAL MANIFESTATIONS • Bounding Pulse • Crackles in lungs • Neck vein distension • Dyspnea • Orthopenea (SOB when lying down) • Sudden weight gain • Edema Body fluid concentration imbalances • Imbalances are disorders of concentration and not the amount of extracellular fluid. Also called water imbalances *See Handout* • SODIUM- 135 – 145 mEq/L Hyponatremia • Water Intoxication • Etiology-Gain of relatively more water than salt Hypernatremia- • Clinical Dehydration • Etiology- ECF fluid contains relatively too little water for sodium ions present. • Clinical dehydration • Etiology- Combination of two fluid disorders: Extracellular Volume deficit and hypernatremia. • Too small a volume of fluid in the Extracellular compartment (vascular and interstitial) and the body fluids are too concentrated. Vomiting and Diarrhea Clinical Manifestations- • Postural blood pressure decrease with increase in heart rate • Lightheadedness • Dizziness • Syncope on standing • Flat neck veins • Decreased skin turgor Dry oral mucus membranes • Hard stools • Sunken eyeballs • Longitudinal furrows in the tongue • Thirst • Increased Serum Sodium Concentration • Confusion, lethargy • Coma • Hypovolemic Shock • Oliguria