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hypertrophy
Increase in cell size and in amount of functioning tissue Cells increase oxygen consumption & cellular functions Physiologic Pathologic Compensatory TERM 2
hyperplasia
DEFINITION 2 Increase in number of cells of organ or tissue with cells that are capable of mitotic division Stimuli that induce hyperplasia may be: Physiologic Hormonal Compensatory Pathologic TERM 3
metaplasia
DEFINITION 3 Reversible replacement of one cell type by another adult cell type Occurs from chronic irritation & inflammation TERM 4
atrophy
DEFINITION 4 A decrease in cell size Reduce oxygen consumption & other cellular functions Causes Disuse Denervation Loss of endocrine stimulation Inadequate nutrition Ischemia (decreased blood flow) TERM 5
dysplasia
DEFINITION 5 Deranged cell growth resulting in change of cells size, shape, & organization May return to normal if trigger is removed Concern that can implicate cancer precursor (neoplasia)
neoplasia (malignancy)
a cellular growth that is no longer responding to normal regulator processes usually because of a mutationdisease is associated with this uncontrolled growthcancer's key features include rapid, uncontrolled proliferation and a loss of differentiation TERM 7
cellular adaptation
DEFINITION 7 Alteration that enables cells to maintain a steady state despite adverse conditions Survival depends on changes in size or shape without affecting function Stimulus causing change affects whether the adaptation is normal or abnormal TERM 8
cell injury: physical agents
DEFINITION 8 Mechanical forces (bodily impact) Extremes of temperature Heat/cold extremes damage cell organelles, cell enzymes Electrical injuries Extensive tissue injury, neural & cardiac impulse damage TERM 9
cell injury: chemical agents
DEFINITION 9 Drugs capable of directly or indirectly damaging tissues Lead in environment and absorbed though GI tract or lungs Consequences of Toxicity Inactivates enzymes & interferes with nerve transmission & brain development Major systems targeted RBCs, GI tract, kidneys, nervous Anemia: cardinal sign TERM 10
Radiation Biologic agents & Nutritional
imbalances
DEFINITION 10 All are external sources that can cause cell injury
gangrene
Large mass of tissue undergoes necrosis TERM 17
dry gangrene
DEFINITION 17 Slow spread Produces line of demarcation between dead and healthy tissue Part becomes dry & shrinks; skin wrinkles Color changes to dark brown/black TERM 18
wet gangrene
DEFINITION 18 Rapid tissue destruction No line of demarcation Cold, swollen, pulseless Skin moist, black, & taut Blebs form on surface, liquefaction occurs Bacteria causes foul odor Affects internal organs or extremities TERM 19
gas gangrene
DEFINITION 19 Clostridium bacteria produces toxin that dissolves cell membranes causing: Muscle cell death Massive spreading edema RBC hemolysis hemolytic anemia Renal failure Bubbles of hydrogen sulfide gas from muscle tissue Serious & potentially fatal; amputation usually required TERM 20
cell injury: injurious
agents
DEFINITION 20 These two forms involve abnormal calcium deposit: Dystrophic occurs in dead or dying tissue Metastatic occurs in normal tissue, large calcium deposits (Padgetts disease and boney cancer lesions)
cell injury: intracellular
accumulations
Substances that build-up inside cell & cannot be used or eliminated (3 types) Normal Build-up fat with increased cholesterol levels Abnormal endogenous (inside the organ body) productsOccur genetic disorders such as Tay-Sachs diseaseJaundice from increase bilirubin or fat from alcoholic liver Exogenous (outside the organ body)Environmental agents such as coal dust, asbestos TERM 22
reversible cell injury
DEFINITION 22 Impairs cellular function Two Patterns in Cell Cellular swelling Impairment of Na/K pump usually from hypoxic cell injury Fatty changes Intracellular accumulation of fat; liver susceptible, kidney, heart TERM 23
intracellular fluid
DEFINITION 23 ICFThe cytosol or intracellular fluid is the liquid found inside cells. It is separated into compartments by membranes.2/ of the body's fluid TERM 24
extracellular fluid
DEFINITION 24 ECFFluid found outside of the cells, about 1/3 of the body's fluidCan be further divided into:interstitial (about 80% of ECF) - is NOT inside a vessel, almost everywhere else intravascular (about 20% of ECF) - found inside blood vessels TERM 25
transcellular fluid
DEFINITION 25 exists in other spaces, CSF (cerebrospinal fluid, lymph system, GI tract, in the joint spaces, peritoneal (inside abdominal cavity), pericardial (sack around the heart), pleural fluid (allows for breathing)smallest component of ECF
oncotic pressure
Oncotic pressure, or colloid osmotic pressure, is a form of osmotic pressure exerted by proteins in blood plasma that usually tends to pull water into the circulatory system. TERM 32
hypertonic solutions (3% saline)
DEFINITION 32 Area surrounding the cell has higher solute concentration, cell has lower solute concentration. Fluid leaves cell to dissolve solutes outside. Cells shrink when exposed to hypertonic solutions. TERM 33
hypotonic solutions (0.45% saline)
DEFINITION 33 Area surrounding cell has lower solute concentration, cell has higher concentration. Fluid enters cell to dissolve solutes inside. Cells expand when exposed to hypotonic solutions. TERM 34
isotonic solutions (0.9% saline)
DEFINITION 34 Have concentrations of solutes equal to those in the intravascular compartment. Because of these solute concentrations, isotonic solutions allow fluid to move equally between compartments. Cells do not change when exposed to isotonic solutions. TERM 35
osmolality
DEFINITION 35 Total number of dissolved particles per liter of fluid
tonicity
Tonicity is a measure of the osmotic pressure gradient of two solutions separated by a semipermeable membrane.Tonicity is often used to describe the cell's response to an external solution. The three classifications of tonicity are:IsotonicHypotonicHypertonic TERM 37
ADH antidiuretic hormone
DEFINITION 37 This hormone is a vasoconstrictor and inhibitor of water secretion. It regulates fluid volume by controlling water losses in the urine. Released in times of decreased fluid volume and increased osmolality (more dissolved particles in fluid). It promotes reabsorption of water into the blood from the renal tubules. ADH is secreted when: Increase plasma osmolality or Decrease in blood volume (B/P drops) TERM 38
renin-angiotensin-aldosterone system (RAAS)
DEFINITION 38 reninangiotensinaldosterone system (RAAS) is a hormone system that regulates blood pressure and water (fluid) balance. renal blood flow renin secreted by kidneys with levels of angiotensin II excessive vasoconstriction & aldosterone & ADH TERM 39
edema
DEFINITION 39 Significant fluid increases in the interstitial space. A problem of fluid distribution, not necessarily of fluid overload. Edema results when hydrostatic & osmotic forces favor fluid moving from the intravascular to the interstitial space. OCCURS WHEN HYDROSTATIC FORCES ARE GREATER THAN OSMOTIC FORCES. (pressure is pushing excessive amounts of fluid out of the capillaries into the interstitial space). 2 to 3 L excess fluid to produce detectable edema TERM 40
causes of edema (part 1)
DEFINITION 40 Increased capillary permeability: Inflammation and immune responses; Allergic reactions, Trauma (burns or crushing injuries), Neoplastic disease Decreased capillary oncotic (capillary osmotic) pressure: Decrease plasma albumin production (liver disease/malnutrition), Renal glomerular diseases; Liver Cirrhosis, Hemorrhage, burns, serous open wound drainage
hypernatremia, >145 mEq/L (high sodium)
Causes: Acute gain in sodium, Inappropriate administration of hypertonic saline solution, Over-secretion of aldosterone Net loss of water, due to: Fever, Respiratory infections, Profuse sweating, Diarrhea, Polyuria, Diabetes Clinical Manifestations: Thirst, Dry mucous membranes, Muscle twitching, Hyperreflexia, Pulmonary edema CNS Symptoms: headache, seizures TERM 47
hyponatremia (low sodium)
DEFINITION 47 Occurs from: Sodium loss, Water gain, Insufficient sodium intake Causes: vomiting, diarrhea, fistulas, NG suctioning, wound drainage, excessive sweating, burns, salt losing, diuretics SIADH, adrenal insufficiency Clinical Manifestations: Depressed reflexes, Muscle cramps, CNS symptoms: lethargy, confusion, seizures, coma TERM 48
chloride
DEFINITION 48 Major anion in ECF, Cl- Provides electroneutrality Passive transport & follows active transport of sodium Concentration of chloride can vary inversely with changes in concentration of bicarbonate (HCO3-) NORMAL BODY RANGE: 95 TO 105 mEq/L TERM 49
potassium
DEFINITION 49 Essential for lifeMajor cation in ICF, K+ Regulates normal cellular functions: ICF osmolality Electrical conduction - maintains the resting membrane potential Metabolism - deposits glycogen in liver & skeletal muscle cells NORMAL BODY RANGE: 3.5 TO 5 mEq/L TERM 50
potassium balance regulated by:
DEFINITION 50 Kidney: 90% reabsorbed by the proximal tubule and loop of Henle Aldosterone: Stimulates release of potassium into the urine Increases secretion of potassium from sweat glands Insulin: Promotes the movement of potassium into liver and muscle cells Changes in pH: Drawn to exchange hydrogen ions (H+) to maintain balance of cations across cell membrane
hyperkalemia, pt 1 (high
potassium)
Causes: Decreased renal elimination Increased intake Burns; extensive surgery Trauma; massive crush injuries Insulin deficits (DKA) Decrease secretion of aldosterone>5.0 mEq/L TERM 52
hyperkalemia, pt 2 (high
potassium)
DEFINITION 52 Clinical Manifestations: Arrhythmias *** Cardiac arrest Muscle weakness Parasthesias Flaccid paralysis (late) Heart waves will have a peaked T wave (that is as high as the QRS wave) TERM 53
hypokalemia, pt 1 (low
potassium)
DEFINITION 53 Causes: Renal Disorders Vomiting, Diarrhea Intestinal drainage tubes Laxative abuse Diuretics Deficient Intake<3. mEq/L TERM 54
hypokalemia, pt 2 (low
potassium)
DEFINITION 54 Clinical Manifestations: Arrhythmias**** Weak irregular pulse Weakness, confusion Muscle cramps Paralysis TERM 55
hematopoiesis
DEFINITION 55 the process of blood formation it occurs primarily in the bone marrow
leukopenia
Leukopenia is a decrease in the number of white blood cells (leukocytes) found in the blood, which places individuals at increased risk of infection.NORMAL WBC RANGE IN BODY: 5,000 TO 10, TERM 62
neutropenia, pt
DEFINITION 62 Neutropenia is a granulocyte disorder characterized by an abnormally low number of neutrophils. <1, neutrophilsWith fewer of these first responders, the body is poorly equipped to fight infections. Etiology: Ineffective production Excessive removal of neutrophils TERM 63
neutropenia, pt
DEFINITION 63 Causes : Acute infections or severe prolonged infections (demand higher than production) Congenital Neutropenia Bone marrow disorders; aplastic anemia, Radiation Immunosuppressants; chemotherapy, Overgrowth neoplastic cells; leukemias or spleen destruction Manifestations: Depend on severity and cause Infections are common Malaise, chills, fever, weakness, fatigue, decreased WBC count TERM 64
blood cell development from bone marrow
stem cells
DEFINITION 64 Blood cells develop from hematopoietic stem cells and are formed in the bone marrow through the highly regulated process of hematopoiesis. Hematopoietic stem cells are capable of transforming into red blood cells, white blood cells, and platelets. These stem cells can be found circulating in the blood and bone marrow in people of all ages, as well as in the umbilical cords of newborn babies TERM 65
agranulocytosis
DEFINITION 65 Agranulocytosis (virtual absence of neutrophils): < 200 cells/L
"shift to the left"
In Acute Infection there is an increase immature neutrophils (bands) More and more immature cells are sent to fight an acute infection and the shift to the left indicates an increase in YOUNG WBC that don't have multi-lobed nuclei. Young WBC nuclei are much larger TERM 67
Hodgkin's disease, pt
DEFINITION 67 Pathology: Solid tumors derived from neoplastic lymphoid tissue Specialized form of lymphoma age 20-40 Start upper body lymph nodes Abnormal presence of B lymphocyte Reed-Sternberg cell Etiology: Unknown, Inflammatory reactions to infectious agent, EBV TERM 68
"shift to the right"
DEFINITION 68 In Chronic or resolved infection increases mature segmented neutrophils (segs) TERM 69
Hodgkin's disease, pt
DEFINITION 69 Clinical Manifestions:Painless enlargement of a node or group of nodes Mediastinal mass is frequent Chest discomfort, cough, dyspnea Fever, weight loss, night sweats, pruritis Lab: thrombycytosis, leukocytosis, eosinophilia, alkaline phosphatase TERM 70
Non-Hodgkin's lymphoma, pt
DEFINITION 70 Pathology: Solid tumors derived from neoplastic lymphoid tissue More common than Hodgkin Lymphoma Malignant transformation T or B cells in peripheral lymphoid with spread to liver, spleen & bone marrow Etiology (causes): Unknown, viral suspected in some forms; exposure to carcinogens
multiple myeloma, pt
Clinical Manifestations: Bone pain Pathologic fractures Formation of plasmacytomas in bone/soft tissue Prone to infections; decrease humoral response Hypercalcemia caused by increased bone resorption TERM 77
hemostasis
DEFINITION 77 Hemostasis or haemostasis") is a process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). TERM 78
stages of hemostasis
DEFINITION 78 Stage 1 Vessel spasm Stage 2 Formation of Platelet Plug Stage 3 Blood coagulation Stage 4 Clot retraction Stage 5 Clot dissolution Normal: sealing blood vessel to prevent blood loss & hemorrhage Abnormal: inappropriate blood clotting or insufficient to stop flow of blood (bleeding) TERM 79
vessel spasm
DEFINITION 79 Initiated by endothelial injury Spasm constricts vessel & blood flow Transient event: lasts 1 minute Thromboxane A (TXA2) released from platelets, add to endothelial vasoconstriction TERM 80
formation of platelet plug
DEFINITION 80 Exposed collagen & injured tissue initiate platelets to injured vessel wall Platelets adhere (requires vWF) & aggregate to damaged vessel wall become activated change from smooth disks to spiny spheres (requires vWF) linking platelets to exposed surface collagen receptors After adhesion TXA2 & ADP stimulate platelet aggregation (progressive accumulation of platelets) mediated by secretion of contents of platelet granules Activation of coagulation pathway stabilizes platelet plug
blood coagulation
Process by which blood forms clotsProcess results from activation of pathways: intrinsic & extrinsic Stepwise process: Results in fibrin clot Terminal steps of both pathways result: Activation & conversion of prothrombin thrombin then thrombin converts fibrinogen fibrin Calcium required in many steps of the clotting process Activates (7) vitamin K dependent clotting factors in cascade TERM 82
clot
retraction
DEFINITION 82 Clot retraction is the "shrinking" of a blood clot over a number of daysRequires large number of platelets failure indicates low platelet count Occurs within 20 60 minutes after clot formation Actin & myosin in platelet squeezes serum from clot, shrinks it & joins edges of injured blood vessel TERM 83
clot dissolution or lysis
DEFINITION 83 Process of sequence of steps controlled by activators and inhibitors Fibrinolysis Begins after clot formation Allows blood flow to be reestablished & tissue repair to occur tPA from injured tissue converts plasminogen plasmin which digests fibrin & dissolves clot TERM 84
hypercoagulability states
DEFINITION 84 Clot Formation: Increased Platelet Function Increase # thrombocytosis 1,000,000/mm3 Any condition causing: Disturbances in flow Endothelial damage Results in platelet adhesion with clot formation called thrombus TERM 85
hypercoagulability states
DEFINITION 85 Increased Clotting Activity : Inherited Disorders Acquired Disorders Prolonged bed rest; immobilization Post-surgery; trauma Cancer; Myocardial infarction; HF Oral contraceptives; pregnancy
thrombocytopenia
Decrease circulating number < 100,000/mL Causes: Decrease platelet production Increased platelets pooling in spleen Decreased platelet survival due to destruction (immune or non-immune mechanisms) Drug-induced Certain sulfa-drugs TERM 92
thrombocytopathia
DEFINITION 92 Impaired platelet function Causes: Inherited adhesion disorders Acquired defects from drugsAspirin (ASA) ASA inhibits synthesis of TXA2NSAID TERM 93
hemophilia A hereditary bleeding disorder
DEFINITION 93 Hemophilia AFactor VIII deficiency X-linked recessive disorder in males Deficiency of Factor VIII in circulation determines severity of disease Clinical Manifestations Petechiae, bruising skin, hematuria Bleeding in soft tissues, GI tract Bleeding in muscles and joints TERM 94
von Wildenbrand disease hereditary bleeding
disorder
DEFINITION 94 Most common hereditary bleeding disorder Transmitted as autosomal trait caused by deficiency of or defect in vWF Various Types Clinical Manifestations Abnormal bleeding Bruising Excessive menstrual flow Bleeding from nose, gums, GI tract TERM 95
(DIC)disseminated intravascular coagulation,
pt 1
DEFINITION 95 Complication of another condition: (life-threatening, not primary disease) Obstetrical disorders; Massive trauma Shock; infection; malignant cancer Bleeding and thrombotic disorder: Leads to intravascular thrombus formation Depletes platelets Consumption of coagulation/clotting factors
disseminated intravascular coagulation, pt
Characterized by widespread coagulation & bleeding in vascular space Activated by tissue trauma or inflammatory response Promotes widespread intravascular fibrin deposition Causes micro- thrombi to develop leads to vessel occlusion causing tissue and organ ischemia/hypoxia & necrosis Blocks blood supply to vital organs leads to multi-organ failure
