Pathology-Exam 1

• continuum where wellness is on one end and illness is at the other
• --reflects biological, psychological, spritual and sociological state
• --dynamic process of interactions between an individual and internal and external environment

a sickness or deviation from a healthy state

a biological or psychological alteration resulting in malfunction of body organ or system

• minorities less likley to receive health care
• racial and ethnic minorities less likely to receive health care

• education to address discrimination, biases, and stereotypes
• cross cultural education
• standardized data collection
• treat everyone fairly

• Angioplast
• CABG
• Mammograms
• Hip fracture repair
• African American are 2.5X more likely to get orchiectomy
• After hip fracture, decreased PT for African Americans in actue and skilled nursing facilities
• Medicare and Medicaid patients less likely to get PT/OT for a hip fracture repair

• Culture
• Gerneration
• Socioeconomic status
• Adverse childhood experiences
• Smoking and tobacco use
• Alcohol and substance abuse
• Stress

multiple practice pattersn associated with risk factor reduction and prevention of disorder and disease

• perception of health
• compliance with therapy
• language barriers
• physical contact

• Matures
• --passive and accept treatment recommended
• Baby Boomers
• --question authority
• Generation X & Y
• --consumers, often seek a second opinion

• greatest influence on health
• decreased SES have more health problems
• decreased SES have activity limitaions 2^o disease 3X more
• decreased SES have a lack of health care/access delays/postponed treatments

• prevention and screening to promote health and reduce chronic disease
• --cardiovascular and integumentary 2^o to decreased activity level
• --behavior modification for physical activity
• --build endurance tolerance

• Ischemia
• Infections agents
• Immune reactions
• Genetic factors
• Nutritional factors
• Physical factors
• Chemical factors

• altered blood flow
• below the minimum needed for cell homeostasis and metabolic function

• bacteria
• viruses
• --both are responsible for majority of infections

• Allergies
• --mild reactions - runny nose, watery eyes
• --moderate reactions - hypoxia 2^o bronchoconstruction
• --anaphylaxic shock - whole body allergic response
• --autoimmune disorders - reacts and destroys normal body tissue

• alterations in structure or number of chromosomes
• single mutation of genes that cause change in amount of proteins
• multiple gene mutations interacting with environmental factors

• deficiencies in essential amino acdids interfere with protein synthesis, which is required for cell replication
• --deficiency of Iron - anemic
• --deficiency of Vitamin C - scurvey
• --deficiency of Vitamin D - rickets

• trauma (MVA) - leading killer in US
• extremes in physical agents
• --cell death due to burn or freezing (ice crystals)
• --irradation of cells

• toxic substances
• --directly injure cells
• *heavy metals: mercury, chemo drugs
• --indirectly injure through metabolic transformations
• *carbon tetrachloride, acetominophen are inert but must be metabolized to cause cell damage

• mild reaction - runny nose, watery eyes
• moderate reaction - hypoxia 2^o bronchoconstriction

• A whole body reaction
• circulatory collapse
• multiple symptoms

• abdominal pain/cramping
• abnormal (high-pitched) breathing
• anxiety
• confusion
• cough
• diarhea
• difficulty breathing
• difficulty swallowing
• slurred speech
• fainting/light headed
• hives/itchiness
• nasla congestion
• naseau/vomiting
• palpitations
• skin redness
• wheezing

• reacts to and destroys normal body tissue
• can affect more than one tissue type

• genetic
• --alteration in structure or number of chromosomes
• --single mutation of genes that cause changes in amount or funtion of proteins
• --multiple gene mutations that interact with environmental factors
• nutritional
• --deficiencies in essential amino acids

• physical
• --trauma
• --extremes in physical agents
• mechanical
• --applied load exceeds failure tolerance of tissue
• ~rate of load
• ~compression
• ~direction
• chemical
• --directly injure cells
• --indirectly injure through metabolic transformation

• fibronectin
• protectoglycans
• elastin
• collagen

• inflammatory- 1st few days
• proliferative - day 2 - 3 weeks
• remodeling - 3rd week - closure

• Innate - natural or native
• Acquired - adaptive or specific

• natural or native
• first line of defense
• consists of all immune defenses that lack immunologicl memory
• responses remain unchanged
• does not distinguish between different invaders (bacteria vs. virus)

• Humoral
• Cell-mediated

• adaptive or specific
• recognizes and destroys invaders and prevents proliferation of mutant cells
• has memory so subsequesnt invasions result in quick response

• a response
• antibodies pressent in body fluids (saliva, blood, vaginal secretions)
• effective against free0floating organisms
• B lymphocytes (B-cells) circulate in extracellular fluid

• specific cells (T-lymphocytes) recognize hidden organisms
• --search and destroy bacteria and viruses
• reponsible for rejection of transplanted tissue
• basis for many skin tests (TB, allergies)
• cellular immunity cannont be transferred

• Innate
• --phagocytic cells
• --inflammatory mediator-releasing cells
• --natural killer cells
• Acquired
• --B lymphocytes
• --T lymphocytes

• phagocytic cells
• --neutrophiles, monocytes, macrophages
• --ingest microorganisms and foreign particles
• inflammatory-mediated cells
• --basophils, mast cells, eosinophil
• --assist immune cells by coating invading organisns so they can be phagocytosed
• natural killer cells
• --large granular lymphocytes
• --function to kill:
• ~viruses, other intracellular microbe-infected cells, tumor cells

viruses, other intracellular microbe-infected cells, tumor cells

• cells involved with acquired immunity
• --immunoglogulin-related immunity
• --part of humoral immunity
• --originate and mature within bone
• --float in extracelluar fluid
• --coated with immunoglobulin
• --each B-cell has a receptor that recognizes specific anitigen
• --becomes plasma cell and memory B-cell
• --secretes specific antibody
• --memory cells circulate for about 1 year
• --responsible for rapid and strong response

• cells involved with acquired immunity
• part of cell mediated immunity
• originate in bone, mature in thymus
• consistanly circulating in blood and lymph
• recognizes hidden organisms
• --all viruses, some bacteria
• interacts with antigen, now as active lymphocyte, produces Helper T cells and cytotoxins. T-cells to recognize and destroy virally infected cells
• also help natural killer cells kill infected cells

• nutrition
• environmental pollution
• chemical exposure
• trauma
• medications
• splenectomy
• burns
• stress
• SES
• sleep

• immune response of GI tract and host defense
• reduction of normal bacteria
• deficits in calories, proteins and vitamins
• ~decrease in T-cell function (Vitamin A, E, and Zinc)

• may suppress blood cell formation in bone marrow
• induce inappropriate immunologic responses
• affect (depress) B and T-cell function

• surgery and anesthesia can suppress T and B cell function up to one month post-op
• invasivenature of surgery increases exposure to pathogens
• splenectomy results in depressed humoral response against encapsulated bacteria

• drepress immune function
• acute stress triggers myocardial ischemia, platelet function, ovarian dysfunction, increased blood viscosity
• prolonged stress can lead to other responses

increased susceptibility to severe bacterial infections

• musculoskeletal
• neuromuscular
• cardiopulmonary
• integumentary
• other symptoms

• provide pain relief
• improve appetite
• reduce muscle atrophy
• inprove quality of life
• regulare boweels
• improve function
• enhance immune function

• allergies
• exaggerated or inappropriate immune response
• immediate - reaction in minutes
• late-phase - hours/days after
• delayed - symptoms come several days later

• immediate hypersensitivity reaction
• allergic disorder
• ~anaphylaxis
• ~allergic rhinitis, uticaria, extrinsic asthma

• cytotoxin reactions to self-antigens
• sees own tissues as foreign
• cell membranes are disrupted and destroyed

• immune complex disease
• normally, immune complexes are gone
• deposited into tissues near smll blood vessels
• ~begin acute inflammation and local tissue injury
• affects skin, joints, kidneys, pleura and pericardium

• cell mediated hypersensitivity
• delayped response after sensitaization to an allergen
• cell by cell response

• body unable to discern self from nonself
• organ-specific and non-organ specific
• affects skin, joints, organs and systems

a chronic inflammatory autoimmune disorder

• Musculoskeletal - arthralgia and arthritis
• Integumentary - cutaneous lesions
• Cardio - dyspnea, pleuritis
• Treatment - symptomatic relief

• chronic muscle pain syndrome
• most common musculoseletal disorder
• muscle pain = major symptom

• Ring Worm
• Athlete's Foot

• Impetigo
• MRSA

• Warts
• Chicken Pox/Shingles
• Fifth disease
• Hand, Foot, Mouth
• Measles
• Molluscm Contagiosum
• Roseola (sixth disease)
• Rubella

• Common cold
• Influenza
• Croup
• Strep Throat
• Scarlet Fever
• Tuberculosis
• Whooping cough

• Cytomegalovirus
• TORCH
• Hepatitis A
• Hepatitis B
• Mononucleosis
• Bacterial Meningitis
• Mumps
• Conjunctivitis
• Otitis Media
• Lyme Disease

• Lice
• Scabies
• Bed bugs

itchy, red, scaling patches. Usualoy round with raised and scaly borders. May be on scalp and body. Roughly dime sized

Mild scaling with or without redness and itching in the warm, moist areas between the toes. Maceration and fissuring possible

Pustular rash, cellulites, very itchy. Lesions frequently on the face. Fluidy

• Staph skin infection: red, swollen and painful area on the skin
• Skin abscess: with pus or other fluids from the site. With or w/o odor

rough- surfaced, round, firm and may be yellow, grey brown or black

itchy pustular patch, fever, malaise. Rash starts on scalp, then trunk, then extremities

symmetric or maculopapular rash

fever with small blisters on the hands and feet and oral ulcers