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What are the functions of the lymphatic system?
- Provides immunity
- Phagocytizes foreign and abnormal cells
- Collects interstitial fluid and returnsit to the blood stream
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What's the name of the cells that are marrow derived and are produced in the thymus?
Hint: they control the immune responses.
- t-cells
- they sense the difference in cells of the body that have been invaded by any foreign substance ( a living virus, bacteria, parasite ect.)
-
What is humoral immunity?
involves the antibodies produced by B-cells
-
What is cellular immunity?
Involves attacks on "invaders" by the cells themselves.
-
What are Peyer Patches?
- Small, raised areas of lymph tissure on the mucosa of the small intestine.
- They consist of many clusteredlyphoid nodules, and they serve the intestinal tract.
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Name the Lymph Nodes.
- 1. Submental
- 2. Submandibular
- 3. Retropharyngeal (tonsilar)
- 4. Preauricular
- 5.Postauricular
- 6. Occipital
- 7. Deep Cervical
- 8. Supraclavicular/Infraclavicular
- 9. Anterior Cervical/ Posterior Cervical
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Where do the following lymphatics drain:
Cervial nodes
Axillary nodes
Epitrochlear nodes
Inguinal nodes
- Cervial nodes: drain the head and neck
- Axillary nodes: drain the breast and upper arm
- Epitrochlear nodes: drain the hand and lower arm
- Inguinal nodes: drain most of the lower extremity, the external genitalia and the anterior abdominal wall.
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List some changes in the lymphatic system as the client ages.
- The number of lymph nodes may diminish
- Node size may decrease
- Nodes are more likely to be fibrotic and fatty ( a contributing factor in an impaired abilityto resist infection)
-
What are some characteristics of a lymph node?
- Usually occur in groups
- Nodes are numerous and tiny
- They defend against the invasion of microorganisms
- Nodes aid in the maturation of lymphocytes and monocytes
- Superficial nodes are located in subcutaneous connective tissue and are readily accesible to inspection and palpation.provide earliest clues to presence of infection and malignancy
- Deeper nodes lie beneath the fascia of muscles and within various body cavities
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What are the 7 bones of the head?
- 2 Frontal
- 2 Parietal
- 2 Temporal
- Occupital
-
What are the 8 facial bones?
- Nasal
- Frontal
- Lacrimal
- Sphenoid
- Ethmoid
- Zygomatic
- Maxillary
- Mandible
-
What are 2 physical changes in the head that generally occur with older adults?
- Hypo-pigmintation (gray hair)
- Hair shaft becomes thinner (hair loss)
-
In the neck what is formed by the medial border of the sternocleidomastoid muscles, the mandible, and the midline?
Anterior triangle
-
In the neck, what is formed by the trapezius and sternocleidomastoid muscles and the clavicle?
Posterior triangle
-
What are some of nasal functions?
- Air passageway
- Humidifier
- Smell
- Filter
- Resonance of laryngeal sound
-
Know Nasal Anatomy
- Note that:
- -the floor of the nose is formed by hard and soft palate
- -the internal nose is divided by the septum into 2 anterior cavities (the vestibules)
- -the lateral walls of the nose are formed by turbinates (curved bony structured covered by vascular mucous membrane) thatrun horizontally and protude into the nasal cavity.
-
- Frontal Sinuses
- Ethmoidal Cells
- Superior Nasal Concha
- Maxillary Sinus
- Nasal Septum
- Inferior Nasal Concha
- Nasolacrimal Duct (on right side)
-
What are some of the changes of the nose that can occur with aging?
- Nose elongates
- Muscus membranes may dry
- Decreased olfactory functions and ability to distinguish specific odors
-
What are the functions of the mouth and oropharynx?
- Emission of air for vocalization and non-nasal expiration
- Passageway for food, liquid, and saliva, either swallowed or vomites
- Initiation of digestion by masticating solid foods and by salivary secretions
- Identification of taste
-
How many teeth should an adult generally have?
32 permanent teeth
-
What structures are included in the anatomy of the mouth and oropharynx?
- mouth:
- -teeth
- -hard palate
- -tongue ( dorsal{taste buds} and ventral)
- -3 pairs of salivary glands ( submandibular, sublingual, and parotid{stenson's duct})
- oropharynx:
- -soft palate (uvula)
- -anterior pillar
- -posterior pillar
- -tonsils
- -posterior pharyngeal wall
- -epiglottis
-
What separates the mouth and the oropharynx?
- the anterior and posterior tonsillar pillars on each side.
- the tonsils, lying in the cavity between these pillars, have crypts that collect cell debris and particles.
-
What are some changes in the mouth that can occur with age?
- Decreased elasticity in lips ("pursed lips")
- Gums/mucosa paler
- Decrease in saliva production
- Gums recede slightly
- Tooth color more yellow
- Decrease in taste sensation
- Not able to chew as well
-
An S shaped pathway in the ear composed of cartilage covered with skin
-
An air-filled cavity in the temporal bone in the ear.
Middle ear.
-
In ear, A membranous, curved cavity inside a bony labyrinth consisting of the vestibule, semicircular canals, and cochlea.
Functions: Hearing and balance transmits sound impulses via CN VIII
Inner Ear
-
A coiled structure in the ear containing the organ of Corti.
Cochlea
-
What are the 3 levels of hearing?
- Peripheral- Sound waves enter ear canal and strike membrane.
- Brain Stem- Vibration stimulates hair cells of the organ of Corti. As hair cells bend turn vibrations into electric impulse. Electric impulse travels to brain via CN 8. Locates sound's directions: R or L.
- Cerebral Cortex- Interprets sound's meaning. Begins to make appropriate response
-
Vibrations of TM to inner ear structures?
Air conduction
-
Vibration of bone directly to inner ear structures.
- Bone Conduction
- Hint: both air and bone conductions activate cochlea which transmits to CN VIII.
-
What hearing test tests bone conduction?
- Weber
- normal is equal bilaterally
-
What hearing test compares AC to BC?
- Rinne
- AC greater than BC= normal
-
What is the mechanical dysfunction in the external ear of middle ear?
- Conductive loss
- -also if foreign object in canal, perforated TM, or otosclerosis and can still hear if sound is loud enough.
-
What is Sensorineural Loss?
- Damage to cochlear, CN VII or auditory area of cerebral cortex
- -can have sensorineural loss if there is an inner ear disease, ototoxic drugs
-
What is the loss of high frequency sound due to aging?
Presbycusis
-
What is the Romberg Test?
- Tests for CN VIII
- Have patient stand with arms at sides and eyes open then closed. watch for exaggerated swaying.
-
What are some changes that are common in the ear as aging occurs?
- Pinna increases in width and length
- Hair growth may increase
- Skin may become dry and less elastic
- Cerumen becomes drier
- TM more rigid
- Decreased discrimination of pitch and acuity
-
Inflammation in the middle ear, associated with middle ear effusion(fluid) that becomes infected by bacteria organisms
Otitis Media
-
A disorder of progressive hearing loss.
Meniere Disease
-
The illusion of rotational movement by a client, often due to a disorder of the inner ear.
Vertigo
-
- On Left:
- Upper eyelid
- Palpebral fissure
- Lateral canthus
- Lower eyelid
- On Right:
- Pupil
- Iris
- Sclera
- Medial Canthus
- Caruncle
- Limbus
-
Trochlear
- CN IV
- eyes down and towards nose
-
Abducens
- CN VI
- eyes lateral and toward ear
-
-
Tough protective outer layer. Part of the refracting media of the eye. Bends incoming light rays so they will be focused.
Sclera
-
Transparent front part of the eye that covers the iris, pupil and anterior chamber and provides most of an eye's optical power.
- Cornea
- Hint: together with the lens, the cornea helps refract light and consequently helps the eye to focus.
-
What is the space between the cornea and iris filled with Agueous Humor which delivers nutrients to surrounding tissue.
Anterior Chamber
-
What is the layer of blood vessels between the retina and sclera
Choroid
-
When vision shift from far object to near object, pupils constrict to bring object into focus. What cranial nerve controls this?
CN III
-
Nearsighted
- Myopia
- Can't see things far away
-
Farsighted
- Hperopia
- Can't see things that are close
-
Decreased accomodation with aging
- Presbyopia
- Needs to move objects farther away to see it
-
Confrontation test?
- pt. covers one eye and you cover yours.
- move hand foward from behind to front in four directions.
- pt. tells you when they can see your hand. each time.
- repeart for other eye.
-
What are some changes that may occur in the eye with age?
- Lids may droop
- Dry eyes due to decreased tearing
- Cornea may cloud
- Loss of peripheral vision
- Lipid accumulation causes white-ray circle around eye
- decrease in ability to distinguish between pastels and like colors.
-
What is the large opening where brain and spinal cord become continuous?
Foramen
-
What is the name of the entrance/exit of the spinal neres and blood vessels?
Foramina
-
Outer fibrous layer, supports occipital and temporal lobes and separates cerebral hemispheres from brain stem
Dura mater
-
Fibrous, elastic membrane that covers folds and fissures of brain
Arachnoid
-
Inner layer which contains lots of blood vessels which supply the brain.
Pia mater
-
What is Cerebral Spinal Fluid (CSF)?
- Colorless, odorless fluid which contains glucose, electrolytes, O2 and H2O
- Provides cushion for the brain and spinal cord
- Removes waste products
- Provides nutrition to the brain
- Maintains normal intracranial
-
-
What are some characteristics of the brain?
- Composed of cerebral cortex,cerebellum, diencephalon and brain stem
- Made of grey and white matter
- Blood supply by crotid, vertebral and basilar arteries.
-
Found at the base of brain to provide back up for arterial blood flow
Cirlce of Willis
-
What are some characteristics of the cerebral cortex?
- Center for human's highest functions
- Governs thought, memory,reasoning, sensationand voluntary movement
- 2 hemispheres with 4 lobes
- Lobes control function for the opposite side of the body
-
Contains primary voluntary motor cortex and is concerned with personality, behavior, emotions and higher intellectual functions.
- Frontal lobes
- Hint: Broca's area (for motor speech) if damaged can get expressive aphasia.
-
Primary center for sensation.
Processes sensory input: touch, position, sense shape and consistency of objects.
Parietal Lobe
-
Primary visial receptor center.
Responsible for recieving and interpreting visual information
Occipital Lobe
-
Primary auditory reception are in the brain.
Contains interpretive area where auditory, visual and somatic input are integrated into thought and memory.
Temporal Lobe
-
Wernicke's Area
- Associated with language comprehension
- Damage to this area get a receptive aphasia. Hears sound but has no meaning.
-
Main relay station for the nervous system
Thalamus
-
Major control for many vital functions- heart rate, BP, sleep center, pituitarygland regulation, coordinator of autonomic nervous system and emotional status.
Hypothalamus
-
Contains pineal gland for growth and sexual development.
Epithalamus
-
Pain of extrapyramidal system of ANS & basal ganglia.
Subthalamus
-
Bands of gray matter buried deep in teh cerebral hemispheres
Basal Ganglia
-
Coiled structure located under the occipital lobe.
Concerned with motor coordination of voluntary movements equilibrium and muscle tone.
- Cerebellum
- Hint: does not initiate movement, but coordinates and smoothes it. Assess for balance. Romberg Test CN VII
-
Cranial nerves 3 and 4 originate here
- Midbrain
- Hint: anterior part of the brain.
-
Cranial nerves 5-8 start here
- Pons
- Hint: contains ascending and descending fiber tracts.
-
Cranial nerves 9-12 originate here
- Medulla
- Hint: continuation of spinal cord. contains ascending and descending tracts and vital autonomic centers for respirations, heart and GI function.
-
What system is involves in short term memory and helps to mediate visceral and behavioral responses to emotions such as fear, affection, and aggression.
- Limbic System
- Hint: on medial surface of each cerebral hemisphere.
-
What do sensory pathways do?
Monitors conscious sensations, internal organ functions, body positions reflexes.
-
Contains sensory fibers that transmit sensations, pain, temperature and light touch.
Spinothalmic Tract.
-
Posterior Columns
- Conduct sensations of position, vibrations
- -Stereogenesis: tactile recognition of object
- -Proprioception: you know without looking where your body parts are in relation to space.
-
What are the 2 motor pathways?
- Corticospinal Tracts: originate inmotor cortexand travel to brain stem. Mediate voluntary movement
- Extrapyramidal Tract: maintainmuscle tone and control gross automatic body movements such as walking
-
What diseases are related with Uppper Motor Neurons?
- CVA, MS, Cerebral Palsy
- Hint: Located completely within CNS
-
What diseases are related to Lower Motor Neurons?
- Polio, ALS
- Hint: located mostly in PNS
-
What makes up Spinal Nerves?
- Consists of 31 pairs
- -8 cervical
- -12 thoracic
- -5 lumbar
- -5 sacral
- -1 coccygeal
-
Relfex Arc
- Sensory impulse which synapses immediatly with a motor neuron within the spinal column.
- Basic defense mechanism of nervouse system
- Involuntary
-
Fight or Flight response
- Sympathetic
- Hint: increases heart rate, BP, vasoconstricts peripheral blood vessels.
-
Controls "Vegatative function" that conserves energy
- Parasympathetic
- Hint: decreases BP, respiration, heart rate.
-
CN I
- Olfactory
- Test: Sniff test
-
CN II
- Optic
- Test: Snellen, Jager(confrontation)
-
CN III
- Oculomotor
- Test: Pupil's constriction, convergence/accomodations( finger to nose), PERL
-
CN IV
- Trochlear
- Test: EOM( extraocular movements) or 6 cardinal fields of gaze.
-
CN V
- Trigeminal
- Test: Cottom wisp(sensory) and feel masseter muscles(motor)( clench jaw)
-
CN VI
- Abducens
- Test: EOM and 6 cardinal fields of gaze
-
CN VII
- Facial
- Test: facial expressions(motor). discriminate taste(sensory)
-
CN VIII
- Acoustic (vestibulocochlear)
- Test: compare air to bone conduction, Weber and Rinne
-
CN IX
- Glossopharyngeal
- Test: "ah" and gag reflex
-
CN X
- Vagus
- Test: "ah" and gag reflex
-
CN XI
- Spinal Accessory
- Test: Shrug and with resistance, turning of head and with resistance
-
CN XII
- Hypoglossal
- Test: stick out tongue,push tongue against cheek. check for strength.
-
What is the degree of balance between nutrient intakeand nutrient requirements?
Nutrition
-
How is Optimal Nutritional Status achieved?
when the sufficient nutrients are consumed to support day to day body needs and any increased metabolic demands due to growth.
-
Process by which the digest proteins, fats, carbohydrates, vitamins, minerals and water are actively and passively transported through the intestinal mucosa into the blood or lymphatic circulation.
Absorption
-
A complex chemical process that occurs in the cells to allow for energy use & cellular growth and repair.
Metabolism
-
Builds tissue, produces antibodies, replaces blood cells, and repairs tissue.
Building blocks for every living cell. Regulates fluid balance and regulates acid-base balance.
- Proteins
- Hint: 4 kilocalories per gram
-
Nutrient that provides energy.
2 types: Simple and complex.
- Carbohydrates
- Hint: 4 kilocalories per gram.
-
Negative Nitrogen Balance
- More nitrogen is excreted than what is taken in.
- Hint: Nitrogen is excreted when amino acids are broken down.
-
Fats
- Function:
- - cellular transport
- -Insulation and protection of vital organs
- -Energy storage in adipose tissue
- -Vitamin absorption and transport of fat-soluble vitamins
- Hint: 9 kilocalories per gram
-
Difference between saturated fats and unsaturated fats?
- saturated fats: all points on chain have a hydrgen atom
- unsaturated fats: at least one point not filled with a hydrogen atom
-
What are Lipoproteins?
- Lipids containing protein
- produces in the liver
- HDL vs. LDL(remember HDL is good or "happy :)")
-
What is emulsification?
Breaking down fats into smaller droplets and placing these droplets in solution.
-
What is the function of vitamins?
- Organic compounds that are essential to the body in small amounts for growth, development, maintenance and reproduction.
- They do not supply energy but assist in the use of energy nutrients.
-
Inorganic substances found in nearly all body tissues and fluids.
- Minerals
- Hint: they help to build body tissue,regulate enzyme metabolism, and transmission of nerve impulses & contractility of muscles.
-
What can happen if you have a calcium deficiency and why is calcium important?
- Fragile bones, cardiac& neurological irregularities.
- Calcium: nervous stimulation, muscle contractions, blood clotting.99% in bone and teeth.
- Hint: macro mineral
-
What can happen is you have phosphorus deficiency and why is phosphorus important?
- Electrolyte abnormalities, osteromalacia
- Phosphorus: transport of fats, protein synthesis-need vitamin D to absorb and use.
- Hint: macro mineral
-
What can happen if you have magnesium deficiency and why is magnesium important?
- Can affect virtually every organ system of the body.
- Affects smooth and skeletal muscle
- Magnesium: transmits nerve impulses, muscle contraction, 60% in bone and teeth.
- Hint: macro mineral
-
What can happen if you have iron deficiency and why is iron important?
- Anemia, Cheilosis, pallor.
- Iron: found mostly in hemoglobin, needed for energy, and RBC production.
- Hint: Micromineral
-
What can happen if you have iodine deficiency and why is iodine important?
- Goiter
- Iodine: forms thyroxinefor energy metabolism
- Hint: Micromineral
-
What can happen if you have zinc deficiency and why is zinc important?
- growth retardation and altered taste
- Zinc: taste, protein synthesis, transfer of CO2
- Hint: Micromineral
-
What provides turgor to body tissue and is a medium for all chemical reactions?
- Water
- Hint: maintains stable body temperature. drinking 2.5 L is recommended per day
-
Arthropometrics
- skinfold measurement.
- measures SQ tissue not muscle
-
Biochemical Test
Tests for: CBC, Glucose, Cholesterol & Triglycerides, Albumin and Iron.
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