Pathophysiology Chapter 1 – What is Pathophysiology



Pathophysiology Chapter 1 – What is Pathophysiology?I. What is Pathophysiology?A. Study of structural and functional changes related to disease processesB. Health and disease1. unable to maintain homeostasis causing significant changes in body2. disease results3. disease – deviation from the norm4. effects of specific disease depend on: a. changes at microscopic level - cellularb. changes at gross level - tissue/organ/system affected (actual focus of pathophysiology)c. cause of disease (tumor, infection, genetic defect, etc.)C. Study of Pathophysiology1. need knowledge of basic AP2. need knowledge of disease preventiona. to develop better prevention programs (vaccines)b. to develop better screening programs (genetic testing, blood pressure testing, etc.)c. based on factors such as causes, predisposing factors, and incidence of specific disease3. student awareness of: complexity of diseases, difficulties in diagnosis/treatment, etc.D. A medical historyE. New developments1. need constant updating2. important organizations: WHO, CDC, and United States Public Health ServiceF. Discussion of disease process1. occurrence2. diagnosis/identification 3. etiology or cause4. pathological changes in cell/tissue/organ5. signs/symptoms6. prognosisII. Language of PathophysiologyA. Terms used in discussion of disease1. biopsy – excision of small amts. of living tissue2. autopsy – examination after death – gross and microscopic with lab tests on tissue/fluids3. diagnosis – identification of disease4. etiology – cause of disease5. idiopathic – unknown cause of disease6 iatrogenic – disease caused by treatment, procedure, or error7. predisposing factors – tendencies that promote development of a disease in person8. prevention – vaccines, dietary or lifestyle modifications, removal of harmful materials, cessation of harmful activities.B. Terms used in describing the characteristics of a particular diseaseI. pathogenesis – how disease begins and progresses2. onset of diseasea. acute – sudden and obvious b. insidious – gradual , vague and very mild symptoms3. acute - short term illness, develops quickly4. chronic – disease develops gradually and long term causing more damage with acute episodes5. subclinical – pathologic changes occur – no symptoms occur for long time if at all6. Initial latent stage – no clinical signs yet observed – incubation period 7. Incubation period – time between exposure and onset of symptoms8. Prodromal period – early in development of disease, but symptoms general9. Manifestations – clinical evidence (signs, symptoms) of diseasea. local – found at site of problem (swelling, redness, etc.)b. systemic – general indicators of illness (fever)10. Signs – objective indicators of disease – obvious to others (rash)11. Symptoms – subjective feelings (nausea, pain)12. Lesion – specific local change in tissue (blister, pimple)13. Syndrome – collection of signs and symptoms14. Diagnostic tests – laboratory tests that assist in diagnosis of specific disease15. Remission – manifestations subside16. Exacerbation – manifestations increase17. Precipitating factor – condition that triggers an acute episode18. Complications – new secondary or additional problems after original diseases begins19. Therapy – treatment measures used to promote recovery or slow progress of disease20. Sequelae – potential unwanted outcomes of primary condition (paralysis from stroke)21. Convalescence – period of recovery and return to normal healthy state22. Prognosis – probability or likelihood for recovery – based on averages23. Morbidity - indicates the disease rates within a group24. Mortality – indicate relative # of deaths resulting from a particular disease25. Epidemiology – science of tracking the pattern or occurrence of disease26. Epidemics – many cases of infectious disease within given area27. Pandemics – involve high # of cases in several regions or world28. Occurrence – tracked by 2 factorsa. incidence - # of new cases in a given pop. within a stated time pd.b. prevalence - # of new and old or existing cases within a specific pop. and time pd.29. Communicable – disease can be spread 30. Notifiable/reportable – certain diseases must be reported by doctor to specific authorities – done to protect public health (HIV/AIDS)IV. Introduction to cellular changesA. Terms used for common cellular adaptations1. atrophy – decrease in size of cells resulting in reduced tissue mass2. hypertrophy – increase in size of individual cells resulting in enlarged tissue mass3. hyperplasia – increase in # of cells resulting in enlarged tissue mass4. metaplasia – one mature cell type replaced by different mature cell type5. dysplasia a. cells in tissue vary in size and shape, with large nuclei and high rate of mitosisb. causes: irritation, infection, or precancerous change6. anaplasia a. cells undifferentiated and have variable nuclei and cell structureb. numerous mitotic figures (cells)c. associated with malignancyd. basis for grading tumor7. neoplasm – “new growth” – a tumora. malignant - cancerb. benignB. Cell Damage and Necrosis1. apoptosis – programmed cell death – natural2. how cells are injureda. ischemia-most common injury-results in hypoxia- oxygen deficit- interference with ATP production- ATP decrease- loss of sodium pump/increase of sodium ions within cell- cell rupture- anaerobic respiration occurs- pH decreaseb. physical agents, excessive heat or cold, radiation exposure-impair blood supply-affect metabolic processes-alter DNA-create toxins in cell-exogenous/endogenous factors alter cell permeability and/or form free radicals which damage cell componentsc. mechanical damaged. chemical toxins or foreign substancese. microorganismsf. abnormal metabolites accumulate in cellsg. nutritional deficitsh. fluid or electrolyte imbalance3. 2 stages of cell damagea. initial – causes alteration in metabolic reactions – loss of cell functionb. morphologic changes in cell and nucleus – result in cell deathc. lysis-lysosomal enzymes released into tissues-inflammation results, more cell damage, more enzymes released, etc.4. necrosisa. liquefaction necrosis – ulcer/cavity formedb. coagulative necrosis – proteins denaturedc. fat necrosis – fatty tissue broken down into fatty acidsd. caseous necrosis – thick yellowish cheesy substance forms in tissuee. infarction – cells die due to lack of oxygenf. gangrene – dry or wet5. cell death occurs at different ratesa. dependent on type of cellb. brain death = somatic death ................
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