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ALTERED CELLULAR AND TISSUE BIOLOGY

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					ALTERED CELLULAR AND TISSUE BIOLOGY (www.wisc-online.edu)


LEARNING OUTCOMES
   Determine the relationship between the study of pathophysiology and nursing
     practice
   Discuss the adaptive and maladaptive responses associated with tissue injury
   Id cell and systemic responses related to cell and tissue injury
   Describe


WHY PATHOPHYSIOLOGY?

To be more comfortable

      Definition
      Importance
      Definition of terms
      Relationship to nursing practice

TERMINOLOGY
   Risk factors = potential to develop a disease
   Precipitating factor = trigger (dust for asthma)
   Nosocomial = dz when exposed to hc environment
         o Iatrogenic = dz as a result of a medical intervention
   Clinical manifestations
         o Sign vs. symptom = objective vs. subjective
         o Syndrome = collection of symptoms
         o Local vs. systemic
   Remission vs. exacerbation = lessening or disappearance vs. worsening or
     reappearance of the symptoms
   Paresis = weakness
   Plegia = paralysis


CONCEPT 1: CELLULAR ADAPTATION
   Adaptation is necessary for survival of the cell
   Atrophy = smaller cells
       o Lack of O2
       o Lack of stimulation
   Hypertrophy = larger than normal cell SIZE
       o Increase in stimulation, workload
       o Could be physiologic (normal) or pathologic(abnormal)
   Hyperplasia = increase in NUMBER of cells
       o Physiologic or pathologic in origin
      Metaplasia = replacement of one cell type by another; could be cancer precursors
      Dysplasia = atypical hyperplasia; could be a cancer precursors
      Key is to remove the stimuli causing these abnormalities

CONCEPT 2: CELL INJURY
   On the way to cell death, there is cell injury

      Injurious stimuli:
           o Hypoxia
           o Chemicals and free radicals
           o Infectious agents
           o Physical and mechanical factors
           o Immunologic reactions
           o Genetics
           o Nutritional imbalances
      Hypoxia = Lack of oxygen
           o Pulmonary conditions
           o Poor circulation
           o Infection = lack of aerobic metabolism
           o Toxic exposure
           o Asphyxiation
           o Abnormal RBC condition (eg. Sickle cell anemia)
      Cell injury is reversible until a certain state of acidosis
           o Acidosis needs to be corrected, otherwise the cells become irreversibly
               injured
      Example : MI
           o Chest pain
                    Release of factors signaling brain to send pain signal
           o Diaphoresis
                    ANS stress response
           o Radiating pain to L arm/jaw
                    Lack/decrease of blood flow to the left side of the body
           o Flu symptoms in women
           o Indigestion in elderly and women
           o Dyspnea
      Everything can be traced back to the cellular level
      Chemical agents
           o Lead
                    Affects kidney
                    Affects brain
                    Anemia
           o Carbon monoxide
                    Affinity is 300X more than oxygen
           o Ethanol
      Physical agents
           o Temperature = hyper vs. hypothermic
                Hypothermia = freezing of cells caused by cold temperature
      o Atmospheric pressure
      o Ionizing radiation
                Penetrating vs. non-penetrating
      o Illumination
                Sunlight – uv rays
      o Noise
   Mechanical
      o Abrasion = scrape
      o Laceration = ripping of the skin
      o Avulsion = skin comes off
      o Stab wound = deeper than it is longer
                Difficult to assess b/c depth is unknown
      o GSW
                Close range
                Intermediate
                Indeterminate
   More injurious stimuli
   Manifestations of cellular injury
      o Cellular swelling
                Disruption of na/k pump
      o Glycogen and lipid deposits
                Diabetes
      o Pigmentation
                Hemosiderosis = too much iron/discoloration
      o Calcium accumulation
                Atherosclerosis
      o Protein accumulation
                Proteinuria
      o Urate accumulation
                Gouty arthritis – accumulation of uric acid
      o Systemic manifestations
                Cellular problems manifest systemically
                Fever, malaise, inc wbc

CONCEPT 3: CELLULAR DEATH

       Necrosis = dead tissue
           o Necrosis vs. apoptosis
           o Dry vs. wet necrosis
                    Dry = clear line of demarcation b/w healthy and necrotic tissue

				
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posted:11/15/2011
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