Patho Patho Patho Patho

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Patho Patho Patho Patho
2013-08-18 12:23:16

exam 4
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  1. How to detect where hormone disorders are coming from
    • tertiary - from the hypothalamus
    • secondary - from the pituitary
    • primary - from the gland
  2. growth hormone causes
    more protein uptake and synthesis, less glucose uptake, and an increase in fat breakdown
  3. Growth hormone is inhibited by
    Increased glucose levels, free fatty acid release, obesity, and cortiso
  4. How hormones are eliminated
    can be eliminated intact or inactivatedcan be taken up then destroyedcan be destroyed in the liver and passed out in the bile
  5. Dwarfism
    GH deficiencybody is in proportioncan be treated with GH therapy
  6. Lack of Nurture
    Failure to thrive
  7. Achondroplasia
    • can occur by itself with no prior family history
    • risk increases with father's age
    • can be an autosomal dominant trait
    • most are spontaneous

    • longs bones do not develop
    • fibula become overly long
    • head disproportionately large
  8. Hormone classifications
    based on structure, peptides, amines, and steroids
  9. sex hormones released in adolescence
    causes bones to stop growing by replacing cartilage with calcium and phospahate
  10. Down-regulation
    the cell makes less hormone receptors
  11. What is the most common control mechanism for regulation?
    negative feedback
  12. Growth hormone is stimulated by
    hypoglycemia, fasting, starvation, stress
  13. IGF 1
    ⇩ adipose tissue, decreases glucose uptake in cells

    stimulates protein synthesis and makes the body retain carbohydrates, blood glucose will rise
  14. Cholesterol (steroids)
    derived from cholesterolsecreted by gonads, adrenal cortex and placentaonce synthesized, passed directly into the bloodstream, they are not stored
  15. four common dwarfism
    • Achondroplasia
    • Turner Syndrome
    • Pituitary
    • Lack of nurture
  16. Turner's Syndrome
    Chromosomal abnormality, occurs only in femalesone X chromosome is either missing or defective
  17. Amino acids (amines)
    derived from Tyrisinesecreted from thyroid and adrenal medullastored as granules in the cytoplasm
  18. Proteins (peptides)
    majority of hormoneswater soluableexcreted from pituitary, parathyroid, heart, stomach, liver, kidneys
  19. Growth hormones causes what?
    an increase in size and number in cells
  20. Up-regulation
    the cell makes more hormone receptors
  21. how are peptides stored?
    as secretory granules until they are released into the blood
  22. How growth hormone is released
    released by anterior pituitaryreacts to hypothalamus releasing growth hormone releasing hormone
  23. Dwarfism
    • GH deficiency
    • body is in proportion
    • can be treated with GH therapy
  24. What does the hypothalamus regulate?
    temperature, hunger, mood, release of hormones, sex drive, sleep, thirst
  25. Functions of growth hormone
    ⇧ bone length and thickness by depositing cartilage to the end of the bones
  26. Growth hormone deficiency
    • idiopathic - lacks hypothalamic GHRH
    • pituitary tumors/agenesis - can't produce GH
    • Laron-type dwarfism - hereditary defect in IGF production
  27. Endocrine versus exocrine
    Endocrine pancreas releases hormones into the bld stream (**where insulin is secreted)

    exocrine releases digestive juices
  28. 3 of the 4 cells of the pancreas that we are concerned with
    • alpha
    • beta
    • delta
  29. alpha cells secrete what?
    glucagon - used to break down glycogen
  30. beta cells secrete what?
    insulin and amylin
  31. delta cells secrete what?
  32. glucose can not get into cells easily without what?
  33. amylin does what?
    slows glucose absorption in small intestine; suppresses glucagon secretion

    happens via active transport
  34. somatostatin
    decreases GI activity; suppresses glucagon and insulin secretion
  35. Glucagon:
    • Glucagon: stimulates the liver to release stored glucose
    • Glycogenolysis-break down of glycogen into glucose
    • Gluconeogenesis-creation of glucose from fats and proteins
  36. Insulin:
    increases cells ability to take up glucose from the blood
  37. insulin levels:
    highest and lowest levels of the day

    highest level of glucagon during the day?
    • Insulin
    • High= while eating
    • Low= when you wake up

    Gluca= Highest when you wake up
  38. What does insulin do to the body?
    • Inc. transport of glucose into ms
    • Dec. gluconeogenesis
    • Inc. transport of fatty acids into adipose Inc. active transport of amino acids into cells.
    • Dec. protein breakdown
  39. application example:
    what happens when we lack insulin:
    1.Blood glucose levels?
    2.Blood amino acid levels?
    3.Blood pH?
    4.Intracellular fat levels?
    5.Intracellular protein levels?Cell growth?
    • 1. inc b/c not transport into cells
    • 2. inc b/c source of energy
    • 3. dec. b/c acidic from increased amino acids
    • 4. and 5. decrease b/c broken down as energy
  40. ***once diabetes starts, it is a life long disease with no cure

    it is controllable though
    ***once diabetes starts, it is a life long disease with no cureit

    is controllable though
  41. *Type 1 diabetes*
    • common in childhood
    • autoimmune process
    • body attacks its own pancreas
    • **REQUIRES insulin injection to sustain life

    **Beta cell destruction
  42. Type 2 diabetes
    • most common (90%), Adult onset
    • **Inc. glucoe and insulin resistance
    • **Diagnosed by blood glucose levels
    • Pancreas is not producing enough insulin OR body won't respond to insulin

    **combination of beta cell dysfunction and insulin resistance
  43. Which type on insulin can be given through an IV?
  44. Diagnostic criteria of diabetes:
    fasting blood glucose level
    • s= casual bld glucose >200mg/dL on 2 different occasions**
    • f= glucose >126mg/dL
    • t= drink the fasting solution and take bld test after 2 hrs >200mg/dL
    • h= HbgA1C >7%
  45. gestational diabetes
    • fetus grows too fast for pancreas and it's unable to compensate
    • baby pancreas takes over for both baby and mom causing the baby to get big in the womb
  46. ketoacidosis (DKA)
    • associated with Type 1 diabetes
    • inadequate insulin the results in increased acids and fats in the blood that we can measure

    Pt's smell fruity and have severe dehydration
  47. treatment of Pt with DKA
    • REGULAR insulin and fluid replacement (hypotonic solution, then switch to iso)
    • Check electrolyte levels throughout
  48. pathogenesis of type 2:
    • p= impaired insulin secretion
    • i= carbohydrate absorption
    • L= increased basal hepatic glucose production
    • m= decreased insulin-stimulated glucose uptake
  49. Hyperglycemic, Hyperosmolar State (HHS)
    • Type 2 diabetes
    • used to be called Hyperglycemic, Hyperosmolar Non-ketotic coma
    • ***do no develop DKA
    • Polyuresis
  50. simply, what makes DM bad?
    it causes vascular and neuro problems, which happen (especially in type 2) before diabetes is ever diagnosed
  51. DM complication examples:
    macro and microvascular
    autonomic and sensory neuro
    • macro= MI, stroke
    • micro= retinopathy

    • auto= GI and bladder dysfunction
    • sensory= parethesias (hypersensitivity)
  52. 3 acute complication of diabetes
    • hypoglycemia (which is more dangerous that hyper)
    • somogyi (type of hypo)
    • dawn effect (also type of hypo)
  53. somogyi as an acute complication of daibetes
    • "rebound hypoglycemia"
    • liver is still working ok
    • liver over-produces bld sugar when it detects low bld levels
    • usually happens during the night
  54. dawn effect as an acute complication of daibetes
    • nothing Pt does to cause this
    • cortisol and growth hormone release affect glucose levels

    Tx= wake them up and give insulin between 5-9 AM
  55. 3 things that cause/affect foot ulcers
    • neuropathy
    • vascular disease
    • infections
  56. # of amputations per year b/c of neglect
  57. 2 types of diabetic neuropathy
    • somatic
    • autonomic
  58. somatic neuropathy
    hypersensitivity to light touch is one S & Sx
  59. autonomic neuropathy
    impaired motility of GI tract --> similar to IBS S & Sx
  60. Just because we get older...
    it does not mean that we stop enjoying sex!

    giggity giggity!
  61. what do nerve cells produce to maintain osmolar balance?
    intracellular osmoles
  62. 4 types of insulin
    • rapid acting
    • intermediate acting
    • long acting
    • continuous infusion pump
  63. rapid acting insulin
    • w/n 15 min
    • peaks 30-45
    • gone in 2 hours
  64. continuous infusion pump (regular insulin)
    • "short acting"
    • w/n 30 mins
    • peaks 1-2 hrs
    • gone 6-8 hrs
  65. Intermediate acting insulin
    • w/n 60-90 min
    • peaks 8 hrs
    • gone 18-24 hrs

    most common is NPH
  66. Long Acting insulin
    • w/n almost immediately, but subtle
    • does not peak at all (continuous base line for hours)

    best given at night
  67. metabolic sydrome
    • not quite diabetes, more of a precursor to diabetes
    • "apple belly" abdominal obesity
    • inc. triglycerides
    • insulin resistance

    puts pressure on the liver
  68. 5 functions of the nervous system
    • control skeletal muscle movement
    • regulate cardiac and smooth muscle
    • reception, integration, and perception of sensory
    • intelligence, anticipation, and judgement
    • adjusts to ever-changing environment
  69. what is one of the most important function of a CNS support cell?
  70. 4 supporting cells of the CNS
    • oligodendroglia
    • astroglia
    • microglia
    • ependymal
  71. oligodendroglia cells
    • form myelin in CNS
    • link bld vessels to cns
  72. astroglia cells
    intercellular ion transport system (messaging)
  73. Microglia cells
  74. Ependymal cells
    produce CSF
  75. 2 support cells of the PNS
    • Schwann
    • Satellite
  76. schwann
    satellite cells
    sch= layers of myelin around axons

    sat= separate nv cells from supporting tissue
  77. Epinureum
    outter most layer of the entire PNS
  78. 2 things that nervous system requires?
    • oxygen***
    • glucose***

    nerve cells can not store glucose, so they need a constant supply
  79. 2 types of synaptic transmission
    • electrical
    • chemical - require specific membrane structures
  80. what part of the neuron is most often damaged in a neuropathy?
    the synapse
  81. 3 things that neurons secrete
    • neurotransmitters
    • neuromodulators
    • neurotrophic factors
  82. 3 neurotransmitters

    • amino acids
    • peptides
    • monoamines

    ***GABA= mediates most inhibitions on the CNS
  83. neuromodulator
    bind to receptors and change their response to neurotransmitters
  84. what element is associated with Excitatory Post-synaptic pathway?
  85. what element is associated with Inhibitory Post-synaptic pathway?
  86. 2 spinal nerve roots in every spinal segment?
    • dorsal root
    • ventral root
  87. dorsal root
    • **Afferent
    • **Sensory
    • **Ascending
  88. Ventral roots
    • **Efferent
    • **Motor
    • **Descending
  89. what type of feedback is the spinal reflex?
    negative feedback
  90. reflexs
    rapid and automatic response to a specific stimuli

    ***occur with predictability and little variability
  91. 2 types of motor reflex
    • withdrawl
    • myptatic/stretch reflex
  92. 12 cranial nerves mnemonic
    Oh, Oh, Oh, Tiny Tits And Furry Vaginas Give Victor A Hardon
  93. Vagus Nerve
    CN X (10)

    intervate the somatosensory feeling, motor and autonomic functions of the digestion, respiration, and cardiac systems
  94. trigeminal nerve
    CN V(5)

    intervate somatosensory for the face, head, and chewing muscles
  95. meninges
    system of membrane that envelope and protect the entire nervous system
  96. pia matter
    innermost layer of the meninges that actually sits on the spinal cord and nerves

    **contains the blood supply
  97. what is missing in the blood brain barrier?
    NO proteins or peptides
  98. adrenergic vs. cholinergic neurotransmitters
    • a= sympathetic NS
    •  = primary are Epi, Norepi, dopamine
    •  = **Excitatory 

    • c= parasympathetic NS
    •  = primary is Acetylcholine
    •  = **Inhibitory
  99. Beta 1
    heart and BP

  100. Beta 2
    • lungs and respiration
    • tend to relax ans smooth muscles
    • also make liver release glucose into bld and make muscles break glucose down for energy

    • *we like to 2 Breath with 2 Betas*
    • *dilation*
  101. what does Alpha 1 and Beta 1 have in common?
    they are both adrenergic/excitatory
  102. alpha 2
    • turn off digestive tract
    • inhibit further norepi release
  103. general somatic Afferent neuron receptor location and sensation
    L= wide distribution

    S= pain, touch, temperature
  104. special somatic Afferent neuron receptor location and sensation
    L= muscles, tendons, joints

    S= position and body movement
  105. general visceral Afferent neuron receptor location and sensation
    L= visceral structures

    S= fullness and discomfort
  106. perception of senses depends on what?>
    **the number of receptors and transmission through thalamus to the cerebral cortex
  107. first order of neuro in somatic sensation
    detect sensation
  108. sencond order of neuro in somatic sensation
    in the spinal cord

    transmit message to the brain
  109. third order of neuro in somatic sensation
    are in the brain

    carry message from thalamus to cortex

    **highest quantity of neurons
  110. transmission of sensation of pain
    from the 2nd-order neurons along the anterolateral system in the spinal cord
  111. relationship between neuron numbers and their order
    the amount of neurons increase with their order

    1st < 2nd < 3rd
  112. what term is used to describe pain in the nerve itself?
    neuropathic pain
  113. nociception
    pain outside the body, in an organ, or just outside the nerve itself (where the pain originates) 

    **activates C-nerve fibers
  114. transduction
    convert pain signal into action potentials
  115. transmission
    actually sending the pain action potentials
  116. pereption
    awarness and interpretation
  117. modulation
    control of pain
  118. 2 pain neurotransmitter
    • glutamate
    • substance P
  119. glutamate
    • excitatory neurotransmitter
    • acts instantly w/n milliseconds
    • confined to immediate area
  120. Substance P
    • acts slower --> seconds to minutes
    • lasts longer
    • diffuse to other areas
    • **prolongs and enhances glutamate
  121. 2 pain nerve fibers
    • A-delta
    • C Fibers
  122. A-delta fibers respond to what?

    fast pain, sharp and stabbing
  123. c- fibers respond to what?
    Substance P

    slow, dull, aching
  124. types of pain 1-4
    • cutaneous= sharp, burning
    • deep somatic= bones/muscles/tendons (dull)
    • visceral= organs
    • referred= originates at a visceral site
  125. acute pain
    • sudden
    • self limiting
    • <6 months
  126. chronic pain
    • persistent
    • >6 months
  127. hyperpathia
    continued stimulation causes pain
  128. paresthesias
    pins and needles sensation of diabetic neuropathy
  129. dysesthesias
    • partial loss of sensation
    • distorted
  130. hypalgesia
    reduced pain sensation
  131. analgesia
    absence of pain

    **the sensation of pain, NOT the source of pain
  132. allodynia
  133. how can inflammation cause neuropathic pain?
    pain is from swelling that puts pressure on surrounding structures
  134. 4 types of headaches
    • migraine
    • cluster
    • tension
    • chronic daily
  135. migraine headache
    • only one side hurts and it is felt with the pulse
    • people may have an aura or warning that it is coming on
    • **recurent, moderate-severe that last days
  136. what can we do for migraines?
    • ASA
    • NSAIDS
    • anti-emetics
    • beta-blockers
  137. cluster headaches

    • episodic with remission
    • 15min-4 hrs. 7-8 times a day
    • can be from 7days to a year
    • retro-orbital pain (behind the eye)

    Tx= Ca channel blockers
  138. Tension headache

    • nonpharmalogical interventions work well
    • ASA
    • NSAIDS
    • antihistamines
  139. Chronic Daily headache treatment
    **reduce or eliminate other medications and caffeine
  140. two parts of the Primary Motor Cortex
    • Premotor
    • Supplementary
  141. Premotor cortex
    • programmed patterned
    • coordinated movement
    • posture and positioning
  142. Supplementary
    planning and initiation of complex, skillful movements
  143. any injury or what not can result in loss of muscle tone
    any injury or what not can result in loss of muscle tone
  144. 4 alterations in muscle tone
    • hypotonia
    • hypertonia
    • rigidity
    • clonus
  145. hypotonia
    weakness to flaccid paralysis
  146. hypertonia
    spasticity where person can't relax
  147. rigidity
    increased resistance to movement
  148. clonus
    ***rythmic contraction and alt. relaxation of a limb that occur with upper motor neuron lesions such as spinal nerve injury
  149. tetany
    • very prolonged contraction of skeletal muscles only
    • will result in contraction of muscles that become fatigued 
  150. 1. -plega
    2. paralysis
    3. paresis
    4. mono
    5. hemi
    6. di or para
    7. qaudri or tetra
    • 1. paralysis
    • 2. loss of movement
    • 3. weakness
    • 4. one limb
    • 5. both limbs on one side
    • 6. top or bottom half of body
    • 7. all four limbs
  151. ipsi vs. contralateral
    I= same side

    C= opposite side
  152. motor unit
    the neurons and the muscle fibers that they intervate
  153. upper vs. lower motor neurons
    • U= in the brain and spinal cord
    •  = ****associated with spastic neuropathy

    L= send axons out of the ventral horn of the spinal cord to the PNS
  154. Upper neuron damage
    • weakness and loss of voluntary control
    • often the result of a stroke: rehab can take months to years

    *spasticity results
  155. Lower neuron damage
    neurons that directly intervate muscles are damaged

  156. Primary lesion spinal cord injury
  157. Secondary lesion spinal cord injury
    damage to surrounding tissues

    *Small chance to get some neuron sensation back
  158. level of injury for spinal cord injury
    the lowest point on cord where there is a decrease of feeling (sesnory level) and/or decrease in movement (motor level)

    ex: this person is a T-4
  159. Tetraplegia
    usually C1-T1

    **loss of head, neck, shoulders, arms, upper chest
  160. paraplegia
    • usually T5-S5
    • chest, stomach, hips, legs and feet
  161. the higher the spinal cord injury vs. the lower the injury is
    higher= lose more feeling and function

    lower= lose less feeling and function

  162. spinal cord cut off for upper and lower motor neuron injury
    • T12-L1 
    • above or below determines 
  163. complete vs incomplete injury
    sensation or motor in EITHER the S4, S5, or anal area
  164. spasms are not a sign of recovery from spinal cord injury

    if it is not voluntarily repeated, then that is spacisity
    spasms are not a sign of recovery from spinal cord injury

    if it is not voluntarily repeated, then that is spacisity
  165. 3 types of Partial Spinal cord injury
    • central cord syndrome
    • anterior cord syndrome
    • Brown-Sequard syndrome
  166. central cord syndrome
    • arms affected more than legs
    • Usually happens in the Cervical regiono
  167. anterior cord syndrome
    • motor functions affected
    • touch and sensory NOT affected
  168. Brown-Sequard
    • damage to 1 side of the cord
    • Motor loss on SAME side of injury (ipsilateral)
    • pain/temp sensation loss on OPPOSITE side (contralateral)
  169. Treatment of spinal cord injury
    **1st is to stabilize Pt.
  170. Autonomic Dysreflexia
    • hyper-sympathetic response
    • is a neurological emergency

    interesting symptom: Only sweat above the site of injury
  171. mononeuropathies
    damage to one peripheral nerve

    **Back pain is most often mono
  172. Polyneuropthies
    damage to many peripheral nerves

    Guillian-Barre syndrom
  173. Guillian-Barre syndrom
    • Idiopathic
    • ***Injury ascends bottom up
    • Can be reversed
  174. Parkinson's

    S & Sx
    • Degeneration of Dopamine receptors of Basal Ganglion
    • *pt. can stop walking until you kick their heels

    • S= rigidity
    • tremor
    • loss of posture (muscle tone)
    • bradykinesia
    • dementia
    • ANS
  175. Treatment for Parkinson's
    • Inc. levels of Dopamine in brain
    • (Dopamine does not cross Bld Brain Barrier)

    give Levadopa combined with carbidopa, a precursor to dopamine
  176. 3 things that make up the intracranial pressure?
    • H2O is cells
    • CSF
    • blood volume

    if tissue swells, other 2 will try to compensate
  177. high Mean Arterial Pressure can cause what?
    brain ischemia
  178. Treatment of a cranial hernia
    decrease cranial pressure
  179. what type of vomit is associated with ICP?

  180. what score indicates coma on the Glasgow coma scale?
  181. 2 types of abnormal posturing
    decorticate = arms are crossed like and "O"

    • extensor or decerebrate = arms are extended
    •   = from brain stem injury
  182. ischemic stroke
    • sudden occlusion of cerebral artery
    • can be a recovery

    most often associated with arthrosclerosis, and hypercoagability states
  183. hemorrhagic stroke
    rupture of blood vessel

    most often fatal b/c of rapid increase of ICP

    **direct result of spontaneous rupture of a cerebral bld vessel into the brain tissue
  184. 3 types of hematoma (brain bleed)
    • epidural= talk and die
    • subdural= venous-ish
    • subarachnoid= arterial-ish
  185. epidural hematoma
    • from trauma
    • b/w skull and dura
    • can relieve pressure via surgery
  186. subdural hematoma
    • b/w dura and arachnoid membrane
    • involves veins, so bleeding is slower
  187. subarachnoid hematoma
    • b/w arachnoid membrane and pia mater
    • arterial, so bleed quicker

    • from aneurysms usually
    • can have a re-bleed which is most often fatal
    • NO blood thinners, even Aspirin
  188. dyssomnia vs parasomnia
    D= inability to fall and stay asleep

    P= undesirable phenomena such as sleep walking
  189. When does sleep apnea occur?
    during REM sleep (cycle 5)
  190. some signs associated with REM sleep
    • increase BP, resp., and heart rate
    • vivid dreaming
    • etc.
  191. obtructive sleep apnea
    • obstruction of the pharynx that occurs during the REM cycle
    • unable to increase respiration rate because in the REM cycle
  192. sleep apnea simply defined
    interrupted sleep caused by disordered breathing
  193. 1st and 2nd treatment for obstructive sleep apnea
    • 1st= weight loss
    • 2nd= rid alcohol and sedatives
  194. hyperopia vs myopia
    H= the eyeball has lengthened and the person is farsighted

    M= the eyeball has shortened and this person is near sighted  (I only see Myself in Myopia)
  195. what is the leading cause of blindness across the world?
    Ketatits= inflammation of the cornea
  196. glaucoma
    • imbalance between aqueous humor production and drainage, increasing pressure
    • Inc. pressure and cause Optic Nerve damage.
  197. which is congenital?
    Angle-closure or Open-angle Glaucoma?
    angle-closure is seen in younger peeps
  198. presbyopia
    when an old guy moves the newspaper backward and forward to read it

    lens thickens and becomes less elastic
  199. what causes cataracts?
    proteins clumping in the lens of the eye.

    smoking bad... mmkay
  200. retinopathy

    *w/ diabetics
    • damage to small retinal blood vessels
    • bleeding can cause the retina to detach

    **Diabetics need tight glycemic control to prevent this
  201. retinal detachment
    • ret seperates from the choroid blood vessels, breaking them
    • this causes a lack of bld and O2, stops fuctioning, and loss of vision
    • caused by retinopathies, trauma, botched surgery, and inflammation
    • Pt. needs to lay PRONE after corrective surgery to keep retina in proper place
  202. age related macular degeneration
    • loss of central vision as well as visual acuity
    • **responsible for the majority of vision loss as we age
    • causes= smoking, poor nutrition, heredity
  203. problems with pressure in the middle ear
    • patent and/or obstructed Eustachian tube
    • acute otis medias= fluid in middle ear. can cause scaring and loss of hearing
  204. problems with adhesions between ossicles
    • adhesive otitis media
    • otosclerosis= hereditary, formation of more spongy bone
    •   =preventing proper vibration perception
    •   =***identified 1st by the whisper test
    •   = ***Causes Early hearing loss
  205. Meniere’s disease
    • It affects balance and hearing loss
    • don't know the cause
    • combination of vertigo, visual changes, headaches, tinnitus (constant noise)
    • try to keep their environment quiet b/c they have trouble with space perception and vertigo

    a chronic inner ear syndrome marked by attacks of vertigo, progressive deafness, tinnitus, and a sensation of fullness in the ears. The condition usually appears in persons between ages 40 and 50. The cause is unknown, but the disease process appears to destroy the hair cells within the cochlea." S/Sx include severe vertigo, tinnitus, and sensorineural hearing loss
  206. primary functions of the skeletal system 1-3
    • support tissue
    • support CNS structures
    • participate in formation of new blood cells
  207. shoulder and hip...
    appendicular or axial skeleton?
  208. bone remoldeling is controled by what 2 hormones?
    calcitonin and PTH
  209. osteoblasts
    **express surface receptors that bind hormones (Vit. D) to help build bone
  210. function of PTH in bone building/reabsorption
    Stimulate osteoclasts to release Ca+ from bone when serum levels drop to low
  211. Calcium and Phosphate have an inverse relationship
    Calcium and Phosphate have an inverse relationship
  212. actions of Vit. D on bone management
    • inc. intestinal Ca absorption
    • inc. renal secretion of P
    • inc. bone resorption and formation
  213. actions of Calcitonin
    • dec. blood calcium levels
    • ***dec. bone resorption
    • released by thyroid when Ca is high
    • inhibits osteoCLASTS
  214. synovial fluid
    • lubricates the joint
    • should be clear, pale-yellow
    • consistency of egg white
    • very slippery
    • should not clot nor have granules in it
  215. red bone marrow in adults
    • ribs
    • vertebrae
    • sternum
    • illium
  216. sprain vs strain
    sprain= injury to ligaments

    strains= injury to muscles
  217. treatment for sprain

    • Rest
    • Ice
    • Compression
    • Elevation
  218. sublexation
    partial joint dislocation
  219. how are fractures named?
    by their appearance on an X-Ray
  220. fractures:
    • T= single strait line, completely through the bone
    • O= single line, diagonal, completely through the bone
    • S= sign of abuse, twisted bone
    • C= shattered
    • S= a piece of the bone has come away (large piece, not shrapnel)
    • B= a chuck of bone, not completely through
    • I= bone pushes up against itself
  221. S & Sx of bone fractures
    • numbness
    • loss of function
    • muscle spasms
    • bruising
    • edema
    • pain
  222. purpose of treating a bone fracture
    preserve and restore function
  223. ** life-threatening complications of fractures
    compartment syndrome= increased pressure in a very limited space. inflam process cause increase swelling, crushing blood vessels, leading to necrosis

    yellow bone marrow can release fat as emboli into the blood stream
  224. osteoporosis

    important treatment
    • metabolic disorder with rate of bone resorption accelerates while bone deposition decreases
    • loss of bone mass
    • associated with lazy lifestyle

    Tx= weight baring exercise to prevent muscle atrophy and enhance osteoblasts
  225. osteomalacia
    • **defective mineralization w/o loss of bone matrix
    • *Doesn't cause breakdown like porosis
    • "bone softening"
    • Calcium and/or phosphate deficiency will cause this
    • Diet is important
  226. rheumatoid arthritis
    • Autoimmune disorder
    • *systemic, chronic, progressive, autoimmune disease that involves inflamm of synovial membrane
    • leads to Pannus (abnormal joints)
    • all major joints of the body are involved, bilaterally
  227. Lupus (SLE)
    • systemic inflammation
    • autoimmune disease
    • skin lesions (butterfly rash)
  228. why is SLE associate with skeletal system?
    • It can cause Arthralgia= pain in joint and/or muscles
    •  = ***1st symptoms of SLE is joint/muscle pain


    Arthritis= inflammation

    Pt. with SLE can have both
  229. osteoarthritis
    • most common form of arthritis
    • "wear and tear"
    • *unilateral
    • from injury to weight baring joints
    • starts with destruction of cartilage

    *NOT systemic like rheumatoid arthritis
  230. Epidermis includes what 3 things?
    • hair
    • nails
    • glands
  231. Wheal
    • like mosqutio bite
    • contained borders, raised area on skin
    • can be red, but is not always red
  232. pustule
    • filled with pus
    • acne, impetigo
  233. papule
    palpable solid mass
  234. nodule
    deeper and firmer than papule
  235. how contagious is impetigo?
    still very contagious no matter how long they are on antibiotics
  236. 3 A's of shingles
    • Anti-depressants
    • Antivirals
    • Analgesics 
  237. 1st degree burn
    • superficial partial thickness burn
    • pink, NO blisters
    • heal in 3-10 days with no intervention
  238. 2nd degree burn
    • partial thickness burn affecting epidermis and dermis
    • red, painful, moist, formed Blisters
    • important to keep blisters intact

    can also be full-thickness burn
  239. 3rd degree burn
    full thickness that continues into the subQ, muscles, bone, and bld vessels

    NO pain in the area
  240. sun burn is what classification?
    can be 1st and 2nd
  241. complications of burn
    • depend on the severity and level of burn
    • can cause hypovolemia

    IV fluids can lead to hypervolemia

    ****most severe complications of 3rd degree burn is decrease in circulating bld volume from plasma seepage into interstitial spaces from the damaged bld vessels which result in a systemic vasoconstriction
  242. 4 things that contribute to pressure ulcers
    • pressure
    • shear= capillaries ripping away for the skin (underlying)
    • friction= like rug burn
    • moisture
  243. stage 4 ulcers will NEVER upgrade to a 3,2, or 1 even when it heals
    stage 4 ulcers will NEVER upgrade to a 3,2, or 1 even when it heals