Patho Topic 12

General Adaptation Syndrome (Selye)

Enlargement of adrenal cortex

Atrophy of thymus gland and other lymphoid organs

Bleeding Ulcers

Stress stimulates release of coritsol

Cortisol supresses immune system

Fight or Flight- Blood is redirected from stomach and over time the lack of blood causes damage

• Stage 1- Alarm Fight or Flight- CNS aroused body's defenses are mobilized
• Stage 2- Restistance Body selects most effective defenses
• Stage 3- Exhaustion Burn out- cont. stress breaks down compensatory mech. Triad manifestations occur

Stressor initiates the disturbance and causes chemical or physical change in body The body then adapts

The body responding to psychological stressors

Body mounts response in anticipation of physical action

Stressor > CNS > Hypothalamus > release of corticotropine releasing factor>stimulates secretion of cortisol

Produced in Hypothalamus

Induces secretion of ACTH from anterior pituitary

ACTH stimulation secretion of coritsol

Stimulation of gluconeogenses (making glucose from non-carbs)

Affects protein metabolism

Affects Lipid metabolism

Immunosuppressant

Epinephrine- works on liver and skelatal muscle- opens blood vessels to skelatal muscle

Norepinephrine- constricts blood vessels causes sweating and hairs to stand up

diminish perception of pain and help surpress stress response

initially have stress GH goes increases

long term stress GH decreases

increase in response to stress. can alter the affects of immune cells

Responsible for contractions and emotion and bonding with baby. It's calming

Central Nervous System

froceful emptying of stomach and intestinal contents through the mouth.

• Nausea
• Retching
• Projectile

subjective experience associated with many different conditions. usually precedes vomiting

strong involuntary effort to vomit.

Spontaneous vomiting not preceded by nausea or retching due to direct stinulation of vomiting center

• Osmotic diarrhea
• Secretory Diarrhea
• Motility Diarrhea

nonabsorbable substances in the intstine causes water to be drawn to the lumen by osmosis causing large volume diarrhea

Something in the intstine that is drawing water to it

large volume diarrhea caused by excessive muscosal secretion of fluid and electrolytes most of cause by toxins released by C.diff or ecoli

if something triggers things to move more quickly through the intestines there is less time to absorb water. Causes recetion of SI, surgival bypass, diabetic neuropathy

unhealthy dietary and bowl habits combined with inadequate exercise and low fulid intake

frank bleeding from the rectum

presence of blood in the vomitus

slow chronic blood loss that results in iron deficiency anemia

difficulty swallowing

Mechanical obstruction of esophagus

impairment of esophagealy motility

neural or musular interference with sawllowing (Example MS)

loss of esophageal peristalisis and failure of lower esophageal sphincter to relax leading to distension

protrusion of upper stomach through diaphragm into thorax

tummy slides into thoracic cavity through hiatus

Causes: congenitally short esophagus, trauma, weakinging of diaphram muscles at the gas. junction

greater curvature of tummy herniates through 2nd opening in diaphragm and lies alongside the esophagus

protrusion of intestine through weakness in abdominal wall

telescoping of one part of intstine into another

twisting of instestine

inflammed herniations of mucosa

loss of peristalic activity

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• Too high bilirubin in blood from:
• Increased RBC destruction
• Decreased conjigated bilirubing
• Obstuction of bile flow

Yellowed skin and sclera

accumulation of fluid in peritoneal cavity

• increased resistance to flow in pirtal venous system
• Thombosis, compresseion to to cancer, rt sided hear failure impedes out flow, alcoholic cirrhosis is major cause because of fibrous liver

vomiting of blood, splenomegly, ascites

Altered brain function in response to liver dysfuncation

accumulation of neurotoxins including amonia because liver can't detoxify blood

% of peeps with a portosystemic shunt get it because nothing does to liver so no filtration

slowed speech and thought, impaired memory, concentraion, attention, flapping tremor, restlessness, coma

ulcers, gastritis

injury of mucosal barrier from drugs or checmicals Alcohol

H Pylorie

Cause-lactases deficiency- which inhibits the breakdown of lactose into monosaccharides and prevents absorption

Diarrhea

to help absorb fat and fat soluble vitamins ADEK

When there is a definciancy there is poor absorption which leads to increased fat in stool leading to diarrhea

Chronic reoccurant intestinal syptoms with no physical problems

abdominal pain, diarreah constipation or alternating diarreah/constipation, gas and bloating

Psychological stress and tx is stress management

inflammation of small and large intestine

abdominal pain, diarrhea, abdonminal mass, small instestine malabsorbsion, skip lesions

Chronic inflamation that causes ulcer in colon and rectum

abdomincal pain, darrhea, bloody stools, no skip lesions

Symptoms of the flu, comes on suddenly, referred pain about the belly button

• decreased heart rate
• constipation
• hypothermia
• malnutrition
• pitted teeth
• cachexia (wasting)

Poor appetite, sweating, fatigue, body aches, fever, nausea, vomiting, green-tinted foamy urine, clay-colored stools and jaundice are typical signs

Fecal-oral

urine, seman, tears, patenteral

NOT AIRBORNE

• Parenteral
• semen, saliva

urine, breast milkd other secreations

NOT AIRBORNE OR FECAL-ORAL

Type C

gall stone formation

bile that is supersaturation with cholestrol

abdonminal pain and jaundice are cardnial signs

aggregates of substances in the bile

cause- alcohol abuse, smoking increases risk

man- intermittent abdominal pain with usually intensifies after a meal

bruising produced by force of impact, the smaller the area of impact the greater the severity of injury.

MOST COMMON IN FRONTAL LOBE

Rebound injury.

Hit your head brain sloshes forward then sloshes back and injury to back too

Artierial more serious

usually caused by head injury in which skull is fractures. Artierial bleed which means serious

as hematoma accumulates, HA of increasing severity, vomiting, drowsiness, confusion, seizure and hemiparesis

most often due to tearing of bridging vein

Subdural space gradually fills with blood and herniation can result

shearing forces tramatized small blood cessels. Hematoma expands - increases intracranial pressure with compression of breain tissues

sudden rapidly progressive decreased leversl of consciousness with pupil dilation Posturing

Transient Ischemic Attack

thrombotic particles that cause a temporary blockage of circulation.

Warning sign that the person is at risk for stroke

• most common causes are hypertension
• ruptured aneurysms or anteriovenous malformation and hemorrhage assoc. with bleeding disorders

Hypertenstion=aneurysm=rupture=bleeding=fatal

Clot- Thromblitic Agent to break up clot

Hypertension- Get blood pressure down

• Left hemiplegia or hemiparesis
• Spatial-Perceptual deficits
• Poor Judgement
• Distractibility
• denial of deficits of affected side
• left visual field defect

• Right sided hemiplegia or hemiparesis
• slow and cautious behavior
• right visual field defect
• expressive, receptive or global dysphasia
• Frustration
• Speech problems

hemorrhagic stroke

Bacterial meningitis treated with appropriate antibiotic therapy and other supportive measures.

Viral meningitis is managed pharmacologically with antiviral drugs and steroids.

Spine is forced backwards

Blow to chin or face like falling down stairs

Spine bend forward passed normal

Hit from back of the head

Blow to top of head or land on head and the spine is compressed

Diving

Rupture of supporting ligemints of spinal cord

Sports injury

• C1-C2
• Less stbility

because of rib cage protection has more stability

• Lose function below injury.
• Loss of normal activity- reflex function of skeletal muscle, bladder, bowel, sexual funcation autonomic control.

If you don't have intervation can't keep blood vessel constricted

• red
• hot
• decreased blood pressure
• heart can't adjust because it's not geting signal from nervous syetem
• Risk for hypothermia because of dilated vessels

Paroxysmal Hypertension- Pressure highest below injury

Pounding HA- reduced blood flow to brain

• Blurred VA
• Sweating about level of injury
• Flushing of face and neck
• Nasel Congestion
• Bradycardia
• Nausea
• Pupil Dilation

Most common cause- Foley cath gets plugged

uncompensated cardio response to stimulation of SNS

Mosquitoes, herpes simplex 1 complications of systemic viral disease (polio, rabies mono)

nerve cell degeneration and increased ICP

Grave muscle weakness.

weakness of fatigability of voluntary muscles

ocular movements, respiration. gacial expression, swallowing and chewing

weakness of skeletal muscles

Ptosis of lids and difficulty closing eyes

expressionless face

weak voice

dysphagia

inability to hold head up or close mouth

drooling

Drugs stoping immune response

thymectomy may be performed

Basial ganglia are not functioning well the excitatory areas become overactive and inhibitory areas become under active

• Muscle Rigidity
• Tremors
• Akinesia
• Postural difficulty
• Mask like face
• Mental Depression

Autonomic symptoms---constipation, drooling, dysphagia

The etiology still unclears

Characterized by wiespread patches of myelin destruction of the CNS

still unclear alrhough thought to be auto-ammune in natures (a cell mediated immunologic reaction directed at the peripheral nerves)