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WHAT IS PATHOPHYSIOLOGY?

Disease: An interruption, cessation or disorder in the function of a body. Pathophysiology: Is the study of disease processes that alter normal human physiology. Definitions Etiology/Etiologic Factor: Disease causing factor/agent. The agent that triggers the disease process. Ex: Bio.(Virus, Bacteria) Physical (trauma, burns) Chemicals (poison, alcohol). Pathogenesis: cellular and tissue responses to an etiologic agent. (prior to onset of disease) Definitions Clinical Manifestations Signs: Objective (ex. Swollen, fever, difficulty breathing, pain) Symptoms: Subjective (ex. Numbness, tingling, malaise) Syndrome: Compilation of S/S that are indicative of a specific disease process. Definitions Diagnosis Diagnosis: Designation of cause to a disease process. (Hx, P/E, Diag. Tests) Diag. Tests: Reliability: Repeated gives same results Validity: Extent to which it measures what it is intended to measure Sensitivity: True positive result Specificity: True negative result Idiopathic: Unknown cause.

Definitions Clinical Course Acute: Severe but self limiting Subacute: Intermediate between acute and chronic Chronic: Long term, continuous or exacerbations Pre-Clinical: No s/s but eventually will Sub-Clinical: No s/s and will not develop Carrier State: Harbors an organism

Epidemiology Epidemiology: Study of disease in a population Incidence: Number of new cases in pop. during specific time period. Prevalence: Number of people in a pop. that have the disease at a given time point. Mortality: Number of deaths caused by a disease. Morbidity: Effects illness has on the person BASIC CONCEPTS OF PHYSIOLOGY


Cells

Cell Structure & Cell Types Movement Across the Membrane Energy Production Cell Reproduction Protein Synthesis

The cell is the smallest functional unit that an organism can be divided into and retain the characteristics necessary for life. Cell Membrane Plasma membrane, semipermeable structure Phospholipids, glycolipids, cholesterol, carbohydrates and proteins. Encloses the cell Provides intra/extra cellular communication Transports materials Maintains electrical activity that powers cell function Hydrophilic: water-soluble Hydrophobic: water-insoluble Nucleus Enclosed by the nuclear membrane

Control center for cell Contains chromatin Contains nucleolus Contains genetic material

Eukaryotic Cells: Contain Nucleus Prokaryotic Cells: No nucleus

INTERNAL CELL STRUCTURE Cytoplasm Colloidal solution: H2O, Electrolytes, proteins, fats, and glycogen.

Work of cell takes place

Contains the essential organelles for the cell Organelles Ribosomes: Site for protein synthesis. Endoplasmic Reticulum: Provides transport and communication within the cell. sER: No ribosomes, protein synthesis of plasma cells. rER: Yes ribosomes, no protein synthesis, synthesis of lipids, reg. Ca, detoxification. Mitochondria: powerhouse of cell, aerobic metabolism converts organic compounds into energy. CELLUALR TRANSPORT Simple Diffusion: movement of particles or molecules in order to reach a uniform concentration. Facilitated Diffusion: requires the a transport protein. Osmosis: Movement of H2O from an area of lower to an area of higher concentration of particles. Endocytosis: Process of engulfing surrounding materials. Pinocytosis: Cell drinking. Phagocytosis: Cell eating. Exocytosis: Secretion into extracellular space Active Transport: Use of energy to move ions across an electrical or chemical gradient. Energy Metabolism Energy Metabolism: Process of converting fats, proteins and carbohydrates into energy. Catabolism: Breakdown of stored nutrients.

Anabolism: Forms complex molecules

ENERGY PRODUCTION

ATP: Carrier for cellular energy.

Conversion of ATP to ADP and AMP causes the release of energy.

ENERGY PRODUCTION Glycolysis: Anaerobic (no 02) process of liberating energy by the breakdown of glucose. Occurs in cytoplasm, end product is lactic acid, 2 ATP. Citric Acid/Krebs Cycle: Aerobic (02) process, occurs inside mitochondria, end product is carbon dioxide and hydrogen atoms, 2 ATP Electron Transport Chain: Inner mitochondrial membrane, end product H2O, 36 ATP THE NA & K PUMP

Transports Na ions out of the cell and potassium ions into the

cell. The concentration of Na and K is different both inside and outside the cell. NA & K PUMP The difference in concentrations creates an electrical gradient which stimulates the cell. It also maintains the volume inside the cell.

CELLULAR REPRODUCTION To reproduce, a cell has to replicate its genetic material and then split in two. Liver, bone marrow, and gut cells undergo frequent replication and mitosis. CELLULAR REPRODUCTION Nerve cells and cardiac muscle cells only replicate or divide during fetal development or in the neonatal period. PROTEIN SYNTHESIS Protein synthesis occurs when sections of DNA are turned on, which causes the cell to make a certain protein.

Sections of DNA that turn on and in different cells are called genes. TYPES OF CELLS

Epithelial Cells Connective Tissues Cells Muscle Cells Nerve Cells

PATHOPHYSIOLOGIC CONCEPTS Atrophy: Decrease in cell size.

Hypertrophy: Increase in cell size. Hyperplasia: Increase in the number of cells

Metaplasia: Reversible change in adult cell. Can predispose to cancer. Dysplasia: Precursor for cancer, changes in cell growth and arrangement of the cell. Cell Injury:

Cell death: Cellular Adaptation HYPOXIA

Decreased concentration of O2 in the blood. Oxygen is carried by the protein hemoglobin.

When cells are hypoxic, they can no longer maintain cellular function. HYPOXIA No Na-K pump: sodium accumulates within the cell and pressure inside the cell increases, drawing water inside the cell and the cell swells up. Lactic acid is produced and causes cellular damage.

HYPOXIA

The effects of hypoxia can be reversed if O2 is returned to the If the cells burst, they die.

cell.

Cell death can be measured by >levels of intracellular enzymes in the circ. TEMPERATURE EXTREMES AND RADIATION Can cause cell injury or death Burns Hypothermia Ionizing Radiation destroys cell membranes

MICROORGANISMS Bacteria, viruses, mycoplasmas, rickettsiae, chlamydiae, fungi, protozoa. MICROORGANISMS Destroy cells directly or release a toxin.

Clinical manifestations of infection depend on the specific agent involved, the site of infection, and the initial state of health. Cellular Injury Reversible Irreversible Cellular Injury Cellular Injury Mechanisms Chemical injury Carbon tetrachloride Lead Carbon monoxide Ethanol Mercury Social or street drugs Unintentional and Intentional Injuries Blunt force injuries

Application of mechanical energy to the body resulting in the tearing, shearing, or crushing of tissues Contusion vs. hematoma Abrasion Laceration Fractures Unintentional and Intentional Injuries Sharp injuries Incised wounds Stab wounds Puncture wounds Chopping wounds Unintentional and Intentional Injuries Unintentional and Intentional Injuries Gunshot Wounds Infectious Injury Pathogenicity of a microorganism

Disease-producing potential Invasion and destruction Toxin production Production of hypersensitivity reactions Manifestations of Cellular Injury Cellular Death Necrosis Sum of cellular changes after local cell death and the process of cellular autodigestion Necrosis Gangrenous necrosis Death of tissue from severe hypoxic injury Dry vs. wet gangrene Gas gangrene Clostridium Gangrenous Necrosis Apoptosis Programmed cellular death

Physiologic vs. pathologic Apoptosis vs. Necrosis Aging

Cellular aging Atrophy, decreased function, and loss of cells Tissue and systemic aging Progressive stiffness and rigidity Sarcopenia Frailty Mobility, balance, muscle strength, motor activity, cognition, nutrition, endurance, falls, fractures, and bone density

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