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NURS 241 exam 1
pathophys, stress/adap, Injury, inflamm. genet/congen disorders musculoskeletal
99
Nursing
Undergraduate 2
08/31/2012

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Term
PATHOGENESIS
Definition

-sequence of cellular & tissue events that take place from time of initial contact w/ an etiologic agent until expression of disease

-etiology; results in structural/functional abnormalities and clinical manifestations-development or evolution of a disease -

Term
ETIOLOGY or ETIOLOGICAL FACTORS
Definition

-the cause of disease (genetic, infective, immune, injuries, etc) for path chart.. -Risk factors -Precipitating factors -Arrange info into logical grouping

Term
IDIOPATHIC
Definition
of unknown etiology
Term
IATROGENIC
Definition
-caused unintentionally by medical therapy; tx causes problem
Term
NOSOCOMIAL
Definition
disease originating or acquired in a hospital/institution
Term
SIGN
Definition

-objective, observable, measurable evidence of a disease/health alteration; Everything you can see

-Phys. exam, observations, lab data, diagnostic testing

Term
SYMPTOM
Definition
subjective evidence (feelings, thoughts) of a disease/health alteration Subjective complaint by the person with the disorder
Term
COMPENSATORY MECHANISM
Definition
an attempt by the body to make up for a defect, alteration, or loss of capacity
Term
COMPLICATION
Definition

-secondary disease or injury that develops during or follows a primary disease

-unexpected;new disease states caused by the disease or tx.

Term
PROGNOSIS
Definition
educated prediction of the expected outcome of a disease or injury
Term
MORBIDITY
Definition

-frequency of disability (interference with a person's normal phys, mental, or emotional function)within a population

-effects an illness has on a person's life; incidence, persistence & long-term consequences of disease

Term
MORTALITY
Definition

-frequency of deaths within a population # of persons dying per year/number of persons in population

-provides info about trends in the health of a population

Term
PREVALENCE
Definition
number of new and old cases of a disease in a given population. # of ppl in a pop. that have a particular disease (i.e. cases per 100)
Term
INCIDENCE
Definition
number of newly diagnosed cases of a disease in a given population
Term
ACUTE DISEASE
Definition
a condition with relatively sudden onset and short duration; sharp or severe
Term
CHRONIC DISEASE
Definition
disease that lasts for a long time, usually years
Term
ADAPTATION
Definition
the process by which living organisms adjust or change in response to a wide variety of environmental forces and stressors in order to survive
Term
ATROPHY
Definition
decrease in cell size, decrease in O2 consumption, less mitoch., reversible
Term
HYPERTROPHY
Definition

increase in cell size

incr. functioning tissue mass

Term
HYPERPLASIA
Definition
increase cell number by cells that are able to undergo mitotic division
Term
METAPLASIA
Definition
reversible chge. 1 adult cell type (epithelial or mesenchymal) replaced by another adult cell type. change in form
Term
DYSPLASIA
Definition
deranged cell growth varying in size, shape and organization
Term
DISEASE
Definition
interruption of, or alteration in body functions and/or structures. In _____, the body's normal adaptive mechanisms are often overwhelmed.
Term
Categories of Structural Changes due to Disease
Definition
*Genetic or Developmental- alterations caused by genetic makeup of individual or due to changes in utero. from congenital abnormalities to diseases assoc. to inherited tendencies *Hyperplasias & Neoplasms- diseases characterizedby increases in cell population *Acquired injuries & Inflammatory- alterations caused by internal or external agents that destroy cells or cause the body to injure itself by means of inflammatory process.
Term
Etiology of disease: EXTERNAL CAUSE (EXOGENOUS)
Definition

physical injury- trauma, electricity, pressure, heat/cold, ionizing radiation,burns, radiation.

chemical injury- poisons, drug rxns, ETOH(alcohol)

microbiological injury- bacteria, viruses, fungi, rickettsia, etc

Term
Etiology of Disease: INTERNAL CAUSES (ENDOGENOUS)
Definition

Vascular- obstruction, bleeding, altered flow

Immunologic- immune deficiency, allergy, autoimmune process Metabolic- abnormal metabolism or deficiency of lipids, carbs, protein, minerals, vitamins, fluids

Term
How can the alterations in body function and/or structure caused by the etiological agent and the body's response to the agent be detected?
Definition
Through clinical manifestations (signs & symptoms) and through lab/diagnostic test findings
Term
LEADING CAUSES OF DEATH IN U.S.
Definition

1)Heart disease
2)Cancer

3)Stroke

4)Accidents

5)Obstructive lung disease

Term
FREQUENCY OF ACUTE DISEASE
Definition

1. Respiratory illnesses

2. Injuries

3. Other infections

Term
PREVALENCE OF CHRONIC DISEASES
Definition

1. Arthritis

2. Hearing impairment

3. Hypertension

4. Heart disease

5. Visual impairment

6. Chronic bronchitis

7. Asthma

8. Diabetes

Term
What is the greatest skill you must acquire to succeed? Who determines your grades?
Definition
Self discipline! YOU! (me)
Term
HOMEOSTASIS
Definition
-Ability to maintain stable state of the body
Term
RISK FACTORS
Definition
Multiple factors that predispose to a particular disease
Term
What is the the etiologic agent and the risk factors for HIV infection?
Definition

- virus

- blood & body fluid exposure, sexual contact, needle sharing, tattoos, etc.

Term
What factors affect Pathogenesis?
Definition
*Time *Quantity *Location *Morphologic changes
Term
MORPHOLOGY
Definition
the structure or form of cells or tissues. changes both gross anatomic and microscopic changes and lesions
Term
Compare Etiology and Pathogenesis
Definition

etiology describes what sets the disease process in motion

pathogenesis is how the disease process evolves

Term
CONGENITAL
Definition
conditions that are present at birth
Term
ACQUIRED
Definition
defects occur after birth
Term
SEQUELA ; SEQUELAE
Definition

-the expected outcome of a certain situation

-impairments following or caused by the disease

Term
What two ways can signs & symptoms originate from?
Definition
Either related to the primary disorder or the body's attempt to COMPENSATE for altered function/pathologic condition
Term
RELIABILITY
Definition
the extent to which a repeated observation gives the same result
Term
VALIDITY
Definition

The extent to which a measurement tool measures what it is intended to measure

Term
SENSITIVITY
Definition

The proportion of people with a disease that are positive (true positive)

Term
SPECIFICITY
Definition

The proportion of people without a disease that are negative (true negative)

Term
FACTORS DERIVED BY USING EPIDEMIOLOGIC METHODS
Definition

-How disease is spread

-How to control disease

-How to prevent disease

-How to eliminate

Term
What is the leading cause of death in 1900, today, and why?
Definition

Heart disease because

Term
FRAMINGHAM HEART STUDY
Definition
For over 50 years, educating patients on heart health. Looks at twelve different risk calculators to inform patients on age of heart physiologically vs. actual heart age. helps people to make change that will help them in 20-30 years to come
Term
Nurse's Health Study at Brigham & Women's Hospital
Definition
Teaching affiliate of Harvard Medical School in Boston. one of the nation's leading transplant centers, performing heart, lung, kidney, and heart-lung transplant surgery, as well as bone marrow transplantation. nationally recognized for clinical and research excellence in cardiovascular medicine, neurosciences, arthritis and rheumatic disorders, orthopedics and cancer
Term
NATURAL HISTORY
Definition
progression and projected outcome of a disease without medical intervention
Term
What is the difference in physiological response to stress between you and a cave man? What about behavioral response?
Definition

A1: Nothing.

A2: Different. ppl get stressed sitting down where as cave men would release that E thru running. --> So, now we have more pathophysiological conditions

Term
STRESS
Definition

-Any physical, emotional, social, or other factor that requires the body to respond or change

-Causes activation of neuroendocrine and immune systems -General adaptation response

Term
Who was Walter Cannon and Hans Selye?
Definition

-W.C. "Fight or flight" and homeostasis(physiological systems oppose change)

-H.S.-stress

Term
HPA AXIS
Definition
Hypothalamic pituitary adrenal axis- homeostatic interactions betw. 3 organs that controls rxns to stress, blood levels of cortisol or sleep-wake cycles & regulates processes such as digestions, immune sys., mood, sexuality, E use. part of neuroendocrine system & limbic -Corticotropic Releasing factor (CRF) -->SNS: arousal, anxiety, vigilance(insomnia)- mediated by catecholamines -->suppresses digestion, reproduction, etc. (fight or flight)
Term
CATECHOLAMINES
Definition
any of a group of sympathomimetic amines (including dopamine, epinephrine, and norepinephrine) - important role in the body's physiological response to stress. Their release at sympathetic nerve endings increases the rate and force of muscular contraction of the heart, constricts peripheral blood vessels(incr. BP),etc
Term
GENERAL ADAPTATION SYNDROME
Definition

-aka generalized stress response -coritcotropin-releasing hormone (CRH)production -Anti-diuretic hormone release -SNS activation (activates all stress response) -Renin-angiotensin-aldosterone pathway activation (incr. high BP)

Term
CORTISOL (HPA axis)
Definition

-a major "stress hormone" - help regulate stress response -diverts metabolism from building tissues to supplying energy for dealing with the stress -causes signs and symptoms of chronic stress Chain: Hypothalamus-->CRH-->anterior pituitary-->ACTH-->Adrenal cortex-->cortisol--> alters glucose, fat, and protein metabolism AND suppresses inflammatory and immune responses

Term
CORTISOL RELEASE CAUSES
Definition
*Incr. blood glucose *Stronger sympathetic system effect on heart rate *decr. in nonessential E-using activities like: Hormone production(metabolic rate&reproductive functns decr.), bone formation, and R & WBC production(immune system becomes depressed)
Term
ANTIDIURETIC HORMONE (ADH)
Definition
-AKA vasopressin -causes vasocostriction -makes kidneys reabsorb water from urine to blood
Term
SYMPATHETIC SYSTEM
Definition
"fight or flight" response -rapid response to trauma and emergency -Epinephrine (adrenalin) and norepinephrine (noradrenalin) both released -both attach to adrenergic receptors on cells chain: Pain,fear,low BP-->hypothalamus-->SNS activated--> SNS neurons-->Norepinephrine-->adrenal medulla-->Epinephrine released into blood -BP restored -reduction in blood flow to skin, guts, kidneys -skin becomes pale -decrease in urine production and GI activity
Term
What does norepinephrine and epinephrine do to the heart and blood vessels?
Definition

heart- incr. HR, incr. heart strength--> incr. BP

blood vessels-vasoconstriction in skin, guts, kidneys -->incr. BP

Term
What does biological and psychosocial stress each lead to?
Definition

Each other. biological stress to psychosocial psychosocial stress to biological biological ex: trauma, car accident, illness psychosocial ex. loss & lack of support

Term

What influences BEHAVIOR during times of stress?

Definition

Neuroendocrine Control Systems

Term
ADAPTIVE CAPABILITIES
Definition

*Hardiness (genetically wired differently for rxns/adaptations: ex. someone could instantly cry from sad news, another could have no expression at all) *Health status (one could already be sick with a lot of other things or not) *Psychosocial factors *Experience and past learning *Time available for adaptation *Genetic Factors *Age *Nutrition *Physiologic reserves *Sleep

Term
During times of stress, what are the immune effects of increased cortisol?
Definition

-Immunosupression: *infections *cancer- breakdown of immune system by kicking out good stuff that should really be kicking out bad stuff *Autoimmune diseases

Term
NEUROENDOCRINOLOGY OF STRESS EX: DECR. SLEEP
Definition
Decreased sleep leads to reduced anorexigenic hormone leptin & elevated ghrelin -> stimulates hunger(esp. for carbs ie sugar) for E to fight off what is prohibiting sleep in stone age(fight or flight)-> obesity
Term
FACTORS AFFECTING ADAPTATION TO STRESSORS
Definition
*Health status *Psychosocial resources *Rapidity with which the need to adapt occurs *Availability of adaptive responses *Ability of body to select the best appropriate response
Term
COPING WITH STRESS
Definition
*Physiological adaptation *Cognitive coping *Social support
Term
BIOLOGICAL EFFECTS ON STRESS
Definition

1)Cardiovascular system --Hypertension, MI, Stroke (not enough perfusion to the brain) 2)GI and hepatobiliary systems --Inflammation, Ulceration, Diabetes 3)Immune system --Cancer, infections

Term
PSYCHOLOGICAL EFFECTS ON STRESS
Definition
*Depression
*Anxiety
*Low self esteem
*Social isolation
*Physical illness
Term
How do stresses affect normal cell function?
Definition
A) cells must make adaptive changes in order to maintain function

B)When maintaining function is unattainable, injury occurs which either turns into maladaptive changes or cell death
Term
CELLULAR ADAPTATION
Definition
Allows the stressed tissue to survive or maintain function

-thru atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia
Term
AGENTS OF CELL INJURY
Definition
-Oxygen deficiency
-Trauma
-Infectious, immune
-Chemical
-Radiation
-Nutritional
Term
How do stresses damage cells?
Definition
-direct damage to proteins, membranes, DNA
-ATP depletion
-Free radical formation
-Increased intracellular calcium
Term
APOPTOSIS
Definition
-programmed cell death
-triggered by decr. survival signals or activation of death pathways
-->role of p53 in monitoring cell damage
-Activation of caspases
-enzymatic degradation of intracellular structures
-Neat & tidy, no release of intracellular components
Term
PATH CHARTING
Definition
-strategy for learning pathophysiology
-results in a concise, informative chart diagramming the etiology, physiological alterations, and clinical manifestations of a specific disease or injury.
-Column 1: Etiology vs. risk factors
-Column 2: Structural/Functional Alterations
-Column 3: Clinical manifestations- signs and symptoms
Term
STRUCTURAL/FUNCTIONAL ALTERATIONS (path chart)
Definition
-description of changes at the cellular, tissue, organ, and system level
-arrange in chronological sequence-start w/ what happens 1st; finish w/ complications
-Link alterations with etiologies in column 1, where possible
Term
PSYCHONEUROIMMUNOLOGY
Definition
-PNI
-study of the effects of mental and neurological status of the immune system

-interaction of behavioral, neural, & endocrine factors and function of immune system
Term
STRESS RESPONSE
Definition
-neuroendocrine control system that mediate the physical, emotional, and behavioral reactions to stressors
-2 factors that determine severity:
1)properties of stressor
2)condition of person being stressed
Term
HPA AXIS PROCESS
Definition
1) CRF(sm. peptide hormone-CRH)is secreted by hypothalamus that triggers pituitary to secrete.
2)Pituitary secretes Adrenocorticotropic hormone (ACTH)then triggering adrenal gland to secrete
3)Adrenal gland secretes mainly cortisol
4)Cortisol suppresses CRF & ACTH in negative feedback

-->Increase release -> immunosuppression
Term
EPIGENETICS
Definition
study of inherited changes in phenotype or gene expression cause by changes in DNA sequence
Term
GENETIC CONTROL OF CELL FUNCTION
Definition
-Genetic info is embedded in stable DNA molecule and is needed to control structure & function
-Every cell in the body has the same genetic info but uses different portions of the info
-To produce proteins to help control cell function, DNA must be: 1) transcribed of its code to assemble protein onto mRNA 2) mRNA code translated to assemble protein onto rRNA in cytoplasm 3)AAs, via tRNA is delivered to rRNA to synthesize the proteins
Term
CHROMOSOMES
Definition
-small intracellular structures arranged in pairs; one member of the pair is from dad, one member from mom. contain most genetic info.
Term
GENES
Definition
-biological units of heredity, self-producing, and located at specific position(locus) on a particular chromosome.
Term
CELL REPRODUCTION
Definition
2 types of cell division:
meiosis and mitosis
Term
CELL CYCLE
Definition
S phase, occurring toward the end of interphase, in which DNA is synthesized; the G2 phase, a relatively quiescent period; the M phase, consisting of the four phases of mitosis; and the G1 phase of interphase, which lasts until the S phase of the next cycle.
Term
PATTERNS OF INHERITANCE
Definition
-Single gene- only 1 pair of genes involved in transmission of info.

-Codominance- when both members(alleles) are expressed fully in a heterozygote

-multifactorial- multiple alleles at different loci affect outcome
Term
STRESSOR
Definition
events or environmental agents responsible for initiating stress response. endogenous or exogenous
Term
ADAPTIVE CAPACITY
Definition
The factors affecting the ability to adapt include:
-Nutrition
-Hardiness
-psychosocial factors
-sleep-wake cycles
-genetic endowment & age
-physiological reserve
-rapidity with which need for adaptation occurs
Term
ALLELE
Definition
-gene pair, 1 inherited from father, 1 from mother
Term
RECESSIVE AND DOMINANT
Definition
recessive- both members code for the trait/trait expressed only in Homozygote

dominant- trait expressed in Heterozygote, only one member of gene pair codes for trait
Term
MULTIFACTORIAL INHERITANCE DISORDERS
Definition
an unknown amount of gene mutations involved that doesn't follow mendelian inheritance.

3 patterns:
-congenital malformations involve single organ or tissue from same embryonic developmental field
-incr. in # of preganancies = incr. in severity of children w/ same or similar defects as the first
-The more distant the family member, risk for the disease decr.
Term
TRANSLOCATION
Definition
simultaneous breaks in 2 chromosomes from different pairs, with exchange of chromosome parts

-no genetic info lost IF it is balance reciprocal
Term
NONDISJUNCTION
Definition
failure of the chromosomes to separate during oogenesis or spermatogenesis. results in aneuploidy (abnormal chromosome #) can happen to autosomes and sex chromosomes
Term
GENOME
Definition
complete haploid set of chromosomes with its associated genes
-genetic makeup of cell, composed of DNA
Term
CARRIER
Definition
A person who has a genetic defect but does not develop any symptoms or signs of the defect. The carrier's offspring may inherit the defect and develop the associated disorder.
Term
MUTATION
Definition
biochemical event such as nucleotide change, deletion or insertion that produces a new allele
Term
KARYOTYPE
Definition
total chromosomal characteristics of a cell; arranged from biggest to smallest
Term
How does dry gangrene turn into wet/moist?
Definition
If bacteria invades
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