What are the 6 specific stages of acute illness we talked about in class?
- Physical Symptoms
- Cognitive Awareness
- Emotional Response
- Assumption of sick role
- Recovery or rehab.
What are the 3 characteristics of chronic illness we talked about?
- Permanent impairment of disability
- Residual physical or cognitive disability
- Need for special rehab or long term care
There are many factors for indicating health. Name ten.
- 1.Physical activity
- 2. Overweight/obese
- 3. Tobacco use
- 4. Susbstance abuse
- 5. Sexual behavior
- 6. Mental health
- 7. Injury/violence
- 8. Environmental quality
- 9. Immunization
- 10. Access to health care. (this is the one we can help the most with)
What are some of the causes of cellular aging?
- Wear and tear
- Antioxidant damage to DNA
- Genetically predetermined
Ischemia doesn't directly cause cell injury, describe the sequence to arrive at cell injury via ischemia.
Clot-ischemia-hypoxia-lessATP-accumulation of ions-swelling-rupture
How do infectious agents cause cell damage?
- Bacteria-release endotoxins and exotoxins
- Virus- Directly: RNA viruses disrupt function of plasma membrane and ion transport and cause rupture of cell. Indirectly: They integrate themselves in the cellular genome, make copies of themselves and cause the host cell to be tagged and destroyed by T-cells
How can an immune system attack cause cell damage?
Antibodies attach to the tagged cell. There is activation of the complement system and the inflammatory cells.
how would a genetic problem affect cell health?
By changing the genome, cell production would be altered. This would directly affect the cells function, and usually result in its destruction.
Discuss the affect of nutrition, chemical, and physical damage to a cell.
- Nutrition-if cells lack nutrition they will die.
- Chemical- injury to cells directly, pH and antioxidants
- Physical- Temperature, electricity, trauma, radiation
What are the cellular adaptions made by cells that are undergoing chronic trauma?
- Atrophy-decrease in size
- Hypertrophy-increase in size
- Hyperplasia-increase in number
- Metaplasia-change in cell
- Dysplasia-increase in different cells
What are some changes that a cell can't really adapt to?
Damage to the cell nucleus, mitochondria, lysosomes, and ruputre of the cell membrane.
The coordinated reaction of body tissue to cell injury and cell death that involves vascular, humeral, neurlogical, and cellular responses.
What happens to a vessel wall during acute inflammation?
- If wall injury: small arteries contrict d/t neural reflex. Surrounding blood increases in pressure. Flow slows and you get clots.
- If no wall injury: Vasodialation occurs. Hydrostatic pressure rises. Transudate leaves vessels and enters the area.
What is the reaction of leukocytes during acute inflammation? What do the leukocytes do?
- Margination: The binding of Leukocytes to the margins of the vessel do to the slowing of blood and increase in adhesive glycoprotiens.
- Diapedesis: Chemoactic agents cause migration from intravascular to extravascular locations.
- Leukocytes release enzymes and toxic substances to kill, they phagocytoses, and release growth factor to induce healing.
What do we call the hyperplasi of leukocytes in the lymph nodes?
What doe we call the inflammation of lymphatics
What are the major chemical mediators of inflammation?
- Histamine: Endothelial contraction and vasodialation, bronchoconstriction
- Platelet activating factor: induces aggregation and infiltration of leukocytes
- Cytokines: local-stimulates margination, activates fibroblasts, chondrocytes, osteoclasts. Systemic-induces fever, increase metabolism, causes hypotension
Which systems are part of the protein protease system?
- Blood coagulation system: Hageman-Prothrombin-thrombin-fibrinogen-fibrin
- Fibrinolytic systems: Hageman-Plasminogen-plasmin
- Kinin system: Hageman-bradykinin-pain and vasodilation
- Complement system: Chemical activation- Vasodilation,chemoactic agent, Opsonization, MAC
Steps in phagocytosis.
Opsonization-binding to leukocytes-invagination d/t calcium influx-incapsulation-digestion(pus/purulence)
Characteristics of chronic inflammation.
- Accumulation of specific leukocytes (macrophages and lymphocytes) and plasma cells
- Granulation tissues, endothelial cells and fibroblasts
If I had tissues in the process of healing and fibroblasts where present to stimulate the ECM, what other chemicals would be present?
Fibronectin, proteoglycans and elastin, collagenh
What is tissue regeneration?
What is tissue Repair?
What do keloids cause?
What happens in the brain?
- Regeneration: When the perenchymal cells experience regrowth
- Repair: Formation of scare tissue
- Keloids: hypertrophic deposition of collagen
- Brain: permanent, no regeneration, no fibroblast for scar tissue, so there are holes. no collagen. astrocytes form glail scars.
What is the first line of defense?
The innate immune system. Non-specific, non-adaptive. Skin and inflammatory response. Macrophages responding to any pathogens, not specific ones.
What do we know about acquired immunity?
- Specific antigen = specific response
- Humeral and cell mediated components
- Active v. Passive
What are the main Leukocytes used by innate immunity?
- NK cells -
- Neutrophils - PMN cells
- Monocytes - become macrophages
B-Cells bind with antigens. Very rapid. Can be passively transmitted.
Helper t-cells. 75% of t cells. Stimulate b cells to make more antibodies. The antibodies will bind with antigens to help the innate leukocytes, like the macrophages other T-cells and NK cells kill them.
How is the brain linked to the immune system?
Via the Autonomic nervous system and the neuroendocrine outflow via the pituitary. May explain how stress and emotion cna modify a person capacity to cope with infection or cancer and influence autoimmune disease.
What is an iatrogenic Immunodeficiency?
- One that occurs from a physicians actions.
- Cytotoxic drugs, Corticosteroids, cyclosporine, Radiation Splenectomy
Levels of HIV infection?
- Asymptomatic: CD4>500cells/mm3 (unresticted exercise)
- Early Symptomatic stage: CD4=200-500 cells/mm3 (Cytomegalovirus, Pneumocysti carinii pneumonia)
- HIV advances CD4<200 cells/mm3
- Normal=600-1200 cells/mm3
- 40,000 new infections/year
- 50%-drugs use, 41% MSM 20-49