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Pathophysiology Intro
Pathophysiology Intro
445
Health Care
Undergraduate 2
08/24/2008

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Term
Pathophysiology
Definition
the study of the underlying changes in body physiology that result from disease or injury
Term
Pathology
Definition
the investigation of structural alterations in cells, tissues, and organs, which can help identify the cause of a particular disease
Term
pathogenesis
Definition
the pattern of tissue changes associated with the development of disease
Term
Etiology
Definition
the study of the cause of disease
Term
idiopathic
Definition
Diseases that have no identifiable cause
Term
iatrogenic
Definition
Diseases that occur as a result of medical treatment
Term
nosocomial
Definition
Diseases that are acquired as a consequence of being in a hospital environment
Term
diagnosis
Definition
the naming or identification of a disease
Term
prognosis
Definition
the expected outcome of a disease
Term
acute disease
Definition
the sudden appearance of signs and symptoms that last only a short time
Term
chronic disease
Definition
disease which develops more slowly and the signs and symptoms last for a long time, perhaps for a lifetime
Term
remissions
Definition
periods when symptoms disappear or diminish significantly
Term
exacerbations
Definition
periods when the symptoms become worse or more severe
Term
complication
Definition
the onset of a disease in a person who is already coping with another existing disease
Term
sequelae
Definition
unwanted outcomes of having a disease or are the result of treatment, trauma, such as paralysis resulting from a stroke or severe scarring resulting from a burn
Term
clinical manifestations
Definition
signs and symptoms or evidence of disease
Term
signs
Definition
objective alterations that can be observed or measured by another person, measures of bodily functions such as pulse rate, blood pressure, body temperature, or white blood cell count, Some are local such as redness or swelling and others are systemic such as fever, CAN BE LOCAL OR SYSTEMIC
Term
symptoms
Definition
subjective experiences reported by the person with disease, such as pain, nausea, or shortness of breath.
Term
prodromal period
Definition
is the time of a disease during which a person experiences vague symptoms such as fatigue or loss of appetite before the onset of specific signs and symptoms (PRODROMAL PERIOD AND INSIDIOUS SYMPTOMS CAN BE LUMPED TOGETHER.)
Term
insidious symptoms
Definition
vague or nonspecific feelings and an awareness that there is a change within the body (PRODROMAL PERIOD AND INSIDIOUS SYMPTOMS CAN BE LUMPED TOGETHER.)
Term
latent period
Definition
a time during which no symptoms are readily apparent in the affected person, but the disease is nevertheless present in the body; an example is the incubation phase of an infection or the early growth phase of a tumor
Term
syndrome
Definition
a group of symptoms that occur together and may be caused by several interrelated problems or a specific disease. (EX: HODGKIN'S LYMPHOMA HAS MANY SYMPTOMS.)
Term
disorder
Definition
an abnormality of function; this term also can refer to an illness or a particular problem such as a bleeding disorder
Term
epidemiology
Definition
the study of tracking patterns or disease occurrence and transmission among populations and by geographic areas (STUDIES HAVE SHOWN THAT DIABETES IS PREVALENT IN THE HISPANIC POPULATION.)
Term
incidence
Definition
the number of new cases of a disease occurring in a specific period
Term
prevalence
Definition
the number of existing cases of a disease within a population during a specific period
Term
Risk factors, also known as predisposing factors
Definition
increase the probability that disease will occur
Term
precipitating factor
Definition
a condition or event that does cause a pathologic event or disorder
Term
Most frequently occurring neuro disorder
Definition
stroke
Term
Leading cause of disability in U.S. (paresis and paralysis)
Definition
stroke
Term
Stroke risk factors (7)
Definition
Arterial HTN,
Diabetes,
Lipoprotein-a presence (testable),
Polycythemia and Thrombocythemia (>600,000) which thickens blood,
Smoking which constricts vessels, Impaired cardiac function – quivering atrium, Non-rheumatic atrial fibrillation
Term
Classifications of strokes according to patho (4)
Definition
Global hypoperfusion (shock) (death can follow quickly), Ischemia: Thrombotic or Embolic (blood clot or air or other bubble, not DVT) comes from carotid artery or heart, Hemorrhage
Term
Ischemic Stroke: Thrombotic is common with what two disease processes?
Definition
artherosclerosis and inflammatory disease (arthritis) (damage to arterial walls)
Term
Ischemic Stroke: Thrombotic is a thrombus where?
Definition
intercranial vessels
Term
3rd most common cause of CVA
Definition
Hemorrhagic Stroke
Term
Fragments that break from thrombus (air, fat, tumors) formed outside the brain in the heart, aorta, and carotid
Definition
Ischemic Stoke: Embolic
Term
Risk factors for Ischemic Stoke: Embolic (5)
Definition
Atrial fibrillation,
endocarditis,
MI,
Rheumatic heart disease,
valvular prostheses
Term
Risk factors for Hemorrhagic stroke (5)
Definition
anticoagulation disorders,
bleeding into tumor,
HTN,
ruptured aneurysms,
vascular malformation,
Term
CVA signs and symptoms - 16
Definition
agnosia (decreased sensory interpretation),
aphasia (cva left hemisphere),
apraxia (decreased learned movements),
decreased cough and swallow reflex,
emotional lability (uncontrolled crying and crisis state),
Headache,
hemiparesis or hemiplegia,
hypertension,
hyperthermia,
incontinence,
mental changes (confusion, memory impairment, disorientation),
perceptual defects (cva right hemisphere),
resp problems (decreased neuro muscle control),
seizures,
visual changes (Homonymous hemianopsia or Horner's syndrome: half blindness),
vomiting,
Term
focal neurologic signs and symptoms (4)
Definition
language disorder,
paralysis,
reflex changes
sensory loss,
Term
TIA signs and symptoms (6)
Definition
confusion,
dysarthria,
syncope,
temporary vision changes,
transient hemiparesis,
vertigo,
Term
Stroke that has lesions less than 1 cm in size, pure motor and sensory deficits, associated with smoking, DM, and HTN
Definition
Lacunar stroke
Term
two main bacterias responsible for bacterial meningitis
Definition
Neisseria meningitidis and Streptococcus pneumoniae
Term
infected areas in bacterial meningitis
Definition
pia mater and arachnoid, the subarachnoid space, the ventricular system, and the CSF
Term
signs and symptoms of bacterial meningitis (9)
Definition
Fever, tachycardia, chills, petechial rash,
Throbbing HA, photophobia, nuchal rigidity (covering of brain is inflammed – extremely painful to put chin to chest),
decreased LOC, cranial nerve palsies, focal deficits,
Term
viral meningitis point of infection
Definition
meninges only - membranes which envelops the central nervous system, dura mater, arachnoid mater, pia mater.
Term
contagion in viral meningitis
Definition
enteroviral viruses,mumps, herpes simplex I
Term
symptoms of viral meningitis(3)
Definition
mild generalized headache, photophobia, neck stiffness
Term
contagions of fungal meningitis
Definition
cryptococcosis, aspergillosis
Term
Does fungal meningitis develop quickly?
Definition
No, slow, chronic, and insiduous
Term
fungal meningitis symptom
Definition
dementia
Term
types of meningitis
Definition
bacterial, fungal, viral, parasitic, toxic
Term
Multiple sclerosis: destruction of the _______ ___________ ________
Definition
CNS myelin sheath
Term
MS spares the __________ nervous system
Definition
peripheral
Term
MS: onset of __ to __ years
Definition
20-50
Term
MS: Male to female ratio
Definition
1:2
Term
leading cause of neuro disability in EARLY adulthood
Definition
Multiple sclerosis
Term
Are MS sufferers always symptomatic?
Definition
No, exacerbations and remissions occur.
Term
What are the MS manifestations dependant on?
Definition
Location and extent of lesion
Term
Common symptoms of MS (19, only about 5-6 categories, though)
Definition

Optic nerve, optic neuritis (cloudiness), diplopia, blurred vision, nystagmus,

tinnitus, decreased hearing,

urinary retention, spastic bladder, constipation, dysarthria(speech)/dysphagia(swallowing),

muscle strength, gait/coordination, balance, muscle spasticity, ataxia, acute paresthesias, leads to paralysis,

Term
Myasthenia Gravis: autoimmune disorder caused by antibodies against ________ receptors, which affect the ________ junction
Definition
acetylcholine, neuromuscular
Term
symptoms of Myastenia Gravis
Definition
Progressive muscle fatigue,
drooping head,
diploplia of eyes,
affects muscles of mouth and throat,
comes without warning, causing difficulty swallowing , HIGH-PITCHED VOICE, and decreased energy that improves with rest. The body literally attacks itself.
Term
Acute pain classifications
Definition
Somatic: Pain with a cause; superficial, Sharp, well-localized, dull, aching
Visceral: Pain in internal organs, abdomen, skeleton, Poorly localized, associated with n/v, hypotension, restlessness, ~ shock
Referred: Present in an area removed or distant from point of origin
Term
Autonomic Dysreflexia Patho
Definition
•Sensory receptors below level of cord lesion are stimulated
• The intact nervous system then responds with arteriolar spasm increasing blood pressure
• Baroreceptors in cerebral, carotid sinus, and aorta stimulate PNS (r/t HTN)
• Heart rate decreases, but visceral and peripheral vessels do not dilate r/t blocked impulses
Term
Acute Pain experience
Definition
Event
Term
Chronic Pain experience
Definition
A situation; state of existence
Term
Acute pain source
Definition
External agent or internal disease, injury or inflammation
Term
Chronic pain source
Definition
Unknown; if known, treatment is prolonged or ineffective
Term
Acute pain onset
Definition
Usually sudden
Term
Chronic pain onset
Definition
May be sudden or develop insidiously
Term
Acute Pain duration
Definition
Transient (up to 6 months); usually of short duration
Resolves with treatment and healing.
Term
Chronic Pain duration
Definition
Prolonged (6 months to years)
Term
acute pain identification
Definition
Painful and nonpainful areas generally well identified
Term
chronic pain identification
Definition
Painful and nonpainful areas less easily differentiated; change in sensations becomes more difficult to evaluate
Term
Acute pain clinical signs
Definition
Typical response pattern with more visible signs
Anxiety and emotional distress common
Term
Chronic pain clinical signs
Definition
Response patterns vary; fewer overt signs (adaptation)
Can interfere with sleep, productivity and quality of life
Term
acute pain significance
Definition
Significant (informs person something is wrong); protective
Term
chronic pain significance
Definition
Person looks for significance
Term
acute pain pattern
Definition
Self-limiting or readily corrected
Term
chronic pain pattern
Definition
Continuous(persistent) or intermittent; intensity may vary or remain constant
Term
acute pain course
Definition
Suffering usually decreases over time
Term
chronic pain course
Definition
Suffering usually increases over time
Term
acute pain action
Definition
Leads to actions to relieve pain
Term
chronic pain action
Definition
Leads to actions to modify pain experience
Term
acute pain prognosis
Definition
Likelihood of eventual complete relief
Term
chronic pain prognosis
Definition
Complete relief usually not possible
Term
chronic pain physiologic adaptations
Definition
Normal heart rate, BP, respiratory rate
Term
Negative chronic pain physiologic responses
Definition
Depression, difficulty sleeping, eating, preoccupation with pain, social-cultural influence
Term
Strabismus
Definition
Deviation of one eye while focusing on an object
Term
amblyopia
Definition
Reduced vision in affected eye
Term
dioplia
Definition
Double vision, primary symptom of strabismus
Term
Nystagmus
Definition
Involuntary unilateral or bilateral rhythmic movement of the eyes
Caused by imbalanced reflex activity of inner ear etc.
Term
Glasgow coma scale
Definition
– 15 point scale
Assesses level of consciousness
Three areas: eye opening; motor response; verbal response
Most critical clinical index of nervous system function
Term
levels of altered consciousness
Definition
Confusion-Loss of ability to think rapidly and clearly; impaired judgment and decision making
Disorientation-Beginning loss of consciousness; disorientation to time followed by disorientation to place and impaired memory; lost last is recognition of self
Lethargy-Limited spontaneous movement or speech; easy arousal with normal speech or touch; may or may not be oriented to time, place, or person
Obtundation-Mild to moderate reduction in arousal (awakeness) with limited response to the environment; falls asleep unless stimulated verbally or tactilely; answers questions with minimum response
Stupor-A condition of deep sleep or unresponsiveness from which the person may be aroused or caused to open eyes only by vigorous and repeated stimulation; response is often withdrawal or grabbing at stimulus
Coma-No verbal response to the external environment or to any stimuli, noxious stimuli such as deep pain or suctioning do not yield motor movement
Light coma-Associated with purposeful movement on stimulation
Coma-Associated with nonpurposeful movement only on stimulation
Deep coma-Associated with unresponsiveness or no response to any stimulus
Term
Why is the rate, rhythm and pattern of breathing important?
Definition
Helps evaluate level of brain dysfunction and coma
Term
The LOC is regulated by _______ _______ ______ in response to changes in ______
Definition
lower brain stem, PaCO2
Term
Cheyne-stokes breathing pattern is a ventilatory response to ____ and is characterized by _____ breaths and periods of _____ that grow _____. Also called the death ______. Caused by:
Definition
CO2, deep, apnea, longer, rattle
Bilateral dysfunction of the deep cerebral or diencephalic structures, seen with supratentorial injury and metabolically induced coma states
Term
Why are pupillary changes important?
Definition
The pupillary reflex is adjacent to the brain stem and is indicative of brain stem activity and dysfunction level. The pupil are also indicative of drug alterations.
Term
Pupils: Dysfunction of the tectum of the midbrain looks like this:
Definition
Large fixed hippus
Term
Pupils: A pontine dysfunction looks like this:
Definition
pinpoint pupils
Term
Pupils: midbrain dysfunction looks like this:
Definition
midposition and fixed pupils
Term
pupils: dysfunction of the third cranial nerve looks like this:
Definition
sluggish, dilated and fixed pupils
Term
pupils: diencephalic dysfunction looks like this:
Definition
small and reactive pupils
Term
pupils: normal pupils look like this:
Definition
small, reactive and REGULAR
Term
Normal Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes turn together (conjugate) to side opposite from turn of head.
Term
Abnormal Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes do not turn in conjugate manner (dysconjugate or asymmetric movement).
Term
Absent Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes do not turn as head position changes.
Term
Normal Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes turn together (conjugate) to ear where pain is induced.
Term
Abnormal Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes do not turn in conjugate manner to ear where pain is induced (dysconjugate or asymmetric movement).
Term
Absent Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes do not turn to ear where pain is induced.
Term
What are the two tests for Oculomotor Response?
Definition
Dolls eyes phenomenon (Oculocephalic reflex response) and Caloric Ice Water Test (Oculovestibular reflex response)
Term
What are the pathologic reflexes (4) and when should they disappear?
Definition
They should disappear at 24 months and only reappear with brain dysfunction. They are the grasp reflex, the snout reflex, the palmomental reflex and the suck reflex.
Term
What are the seven criteria for brain death?
Definition
1 Completion of all appropriate and therapeutic procedures

2 Unresponsive coma (no motor or reflex movements)

3 No spontaneous respiration

4 No ocular responses to head turning or caloric stimulation; dilated, fixed pupils

5 Isoelectric (flat) EEG (electrocerebral silence)

6 Persistence of these signs for 30 minutes to 1 hour and for 6 hours after onset of coma and apnea

7 Confirming test indicating absence of cerebral circulation (optional)
Term
Is recovery possible with brain death?
Definition
No
Term
Is there homeostasis with brain death?
Definition
No
Term
Is coma reversible with cerebral death?
Definition
No
Term
Is brain damage reversible with cerebral death?
Definition
No
Term
Is homeostasis intact with cerebral death?
Definition
Yes
Term
Brain death has occurred when there is no evidence of function above the __________—that is, in the cerebral hemispheres or brain stem—for an extended period. The abnormality of brain function must result from _____ or known ______ disease and must not be caused by a ______ drug, ______ poisoning, or ____thermia. An __________, or flat, ________________ (EEG) (electrocerebral silence) for _ to __ hours in a person who is not hypothermic and has not ingested depressant drugs indicates brain death.
Definition
foramen magnum, structural, metabolic, depressant, alcohol, hypothermia, isoelectric, electroencephalogram, 6 to 12
Term
The three types of dysphagia
Definition
Expressive, Receptive, and Transcortial
Term
Expressive dysphagia
Non______; cannot find _____
Difficulty _______
Definition
Expressive
Nonfluent; cannot find words
Difficulty writing
Term
Receptive dysphagia
Fluent; __________ ____________words
Unable to monitor language for ____________
Speech may be _________________
Definition
Receptive
Fluent; meaningless inappropriate words
Unable to monitor language for correctness
Speech may be incomprehensible
Term
Transcortical dysphagia
Echolalia – ______ another's words
Inability to ____ and _____
Impaired _________
Definition
Transcortical dysphagia
Echolalia – repeat another's words
Inability to read and write
Impaired comprehension
Term
Leading cause of severe cognitive dysfunction in older adults
Definition
Alzheimer's disease
Term
risk for AD increases with ________
Definition
age
Term
AD has a diagnosis of ___________
Definition
exclusion
Term
what is the diagnostic criteria for AD?
Definition
neurofibrillary tangles (and amyloid containing neuritic plaques)
Term
What causes cortical atrophy in AD?
Definition
Loss of neurons, particularly in the parietal and temporal lobes
Term
What is another name for cortical atrophy?
Definition
Senile plaques
Term
The loss of neurotransmitter stimulation by ____________ ______________ is thought to be responsible for AD.
Definition
The loss of neurotransmitter stimulation by choline acetyltransferase is thought to be responsible for AD.
Term
Where are neurofibrillary tangles?
Definition
Inside the neuron
Term
What causes a neurofibrillary tangle?
Definition
Tau proteins in the neuron become distorted and twisted.
Term
How long does stage 1 AD last and what are the symptoms?
Definition
2-4 years, memory loss, subtle personality changes, disorientation to time and place
Term
What is another name for stage 2 AD and what are the symptoms and duration?
Definition
The confusion stage,
impaired cognition restlessness, agitation, wandering, SUNDOWNER'S SYNDROME, repetitive behavior,
lasts several years
Term
What' another name for stage 3 AD and what are the symptoms and duration?
Definition
The terminal stage,
emaciation, inability to communicate, bowel and bladder incontinence, seizures,
lasts 1-2 years
Term
Should you attempt to reorient a patient with AD?
Definition
No
Term
What is the first visible sign of Parkinson Disease?
Definition
tremor
Term
Parkinson disease is a ___________ disorder of the _____ ______.
Definition
Parkinson disease is a degeneration disorder of the basal ganglia.
Term
Parkinson disease is characterized by a progressive destruction of the ______________ pathway.
Definition
Parkinson disease is characterized by a progressive destruction of the nigrostriatal pathway. (gray matter)
Term
Parkinson disease is characterized by a decrease in the concentration of ________.
Definition
Parkinson disease is characterized by a decrease in the concentration of dopamine.
Term
Cardinal manifestations of PD include _______ (rhythmic altenation flexion and contraction), _______ (resistance to movement throughout full ROM), ___wheel motions (most evident during _______ joint movement), _____kinesia, ____ rolling, uncontrolled __________ caused by ANS, salivation, ___________ gait, _____ steps, _________ posture. Dementia occurs __% of the time with PD patients.
Definition
Cardinal manifestations of PD include tremors (rhythmic altenation flexion and contraction), rigidity (resistance to movement throughout full ROM), cogwheel motions (most evident during passive joint movement), bradykinesia, pill rolling, uncontrolled sweating caused by ANS, salivation, shuffling gait, short steps, stooped posture. Dementia occurs 20% of the time with PD patients.
Term
hemiparesis
Definition
weakness on one side of the body (left or right)
Term
hemiplegia
Definition
Paralysis on one side of the body (left or right)
Term
diplegia
Definition
paralysis of both upper or lower extremities
Term
paraplegia
Definition
paralysis of both lower extremities
Term
quadriplegia
Definition
paralysis of all four extremities
Term
Bone healing steps in order (5):
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down.
Term
Bone Healing
A: _______ at broken ends of the bone with subsequent ________ formation.
B: ____________ of hematoma into fibrous _______. (inflammatory)
C: Invasion of osteo______, lengthening of ________ strands, and deposition of _______.
D: ______ formation; new bone is built up as osteo_______ destroy ____ bone.
E: __________ is accomplished as excess ______ is reabsorbed and __________ bone is laid down.
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down.
Term
subluxation
Definition
incomplete or partial dislocation of a joint, partial loss of opposing bone surface
Term
Delayed union
Union that does not occur for _ to _ months after injury (or _ to __)
Definition
Delayed union
Union that does not occur for 8 to 9 months after injury (6-12)
Term
Malunion
Healing of bone with incorrect _________ ________
Definition
Malunion
Healing of bone with incorrect anatomic position
Term
Nonunion
Failure of bone ends to ____ __________
Definition
Nonunion
Failure of bone ends to grow together
Term
Dislocation
Temporary ____________ of one or more bones in a _____ with entire loss of _______
Definition
Dislocation
Temporary displacement of one or more bones in a joint with entire loss of contact
Term
When is dislocation most prevalent (age)?
Definition
<20
Term
Dislocation is associated with what other alteration in MS function?
Definition
fracture
Term
What complication is possible with dislocation?
Definition
Disruption of circulation leading to ischemia and permanent disability.
Term
Strain
Definition
Tear in tendon (ties muscle to bone), associated with sports injuries
Term
Sprain
Definition
Tear in ligament (ties bone to cartilage)
Term
Avulsion
Definition
Complete separation from tendon or ligament from the bone
Term
Signs and symptoms of strains, sprains, and avulsions:
Definition
Pain, soft tissue swelling, change ligament or tendon contour, dislocation or subluxation of bone,
decreased mobility, instability, weakness
Term
Tendonitis
Definition
inflammation of the tendon (like achilles tendonitis)
Term
epicondylitis
Definition
Inflammation of tendon where it attaches to a bone at its origin
(Humerus, radius, ulna, knee)
* lateral epicondylitis, also known as tennis elbow
* medial epicondylitis, also known as golfer's elbow
Term
bursitis
Definition
Inflammation of small sac that lines synovial membranes. Localized; tenderness, pain with activity. Common sites are: * Prepatellar bursitis, "housemaid's knee",
* Trochanteric bursitis giving hip pain,
* Olecranon bursitis characterised by pain and swelling in the elbow, and
* Subacromial bursitis, which gives shoulder pain.
Term
osteoporosis affects __% of people age __ and older
Definition
55,50
Term
In osteoporosis the _________ cycle is disrupted, which means that ___ bone is reabsorbed ________ than ___ bone is formed.
Definition
In osteoporosis the modeling cycle is disrupted, which means that old bone is reabsorbed faster than new bone is formed.
Term
Genetic risk factors for osteoporosis include:
Definition
Family history of osteoporosis
White race
Increased age
Female sex
Term
T/F: Even though age is a risk factor for osteoporosis it is not a disease of aging.
Definition
True
Term
Hormonal and metabolic risk factors for osteoporosis include:
Definition
Early menopause (natural or surgical)
Late menarche
Nulliparity (never pregnant)
Obesity (increased pressure on bone tissue)
Hypogonadism
Cushing syndrome
Weight below healthy range
Acidosis
Term
Anthropometric risk factors for osteoporosis include:
Definition
Small stature
Fair or pale skinned
Thin build
Term
Diet risk factors for osteoporosis include:
Definition
Low dietary calcium and vitamin D
Low endogenous magnesium
Excessive protein
Excessive sodium intake
High caffeine intake – high metabolism, increased excretion
Anorexia
Malabsorption
Term
Lifestyle risk factors for osteoporosis include:
Definition
Sedentary
Smoker
Alcohol consumption (excessive)
Term
Concurrent risk factors for osteoporosis include:
Definition
Hyperparathyroidism - pulls the calcium out of the bone
Term
Illness and trauma risk factors for osteoporosis include:
Definition
Renal insufficiency, hypocalciuria, extra calcium becomes uremic frost
Rheumatoid arthritis’
Spinal cord injury
Systemic lupus
Term
Liver diseases as risks for osteoporosis:
Definition
Marrow disease (myeloma, mastocytosis, thalassemia)
Term
WHO=______ Health ____________, BMD=____ ____ Density.
Definition
WHO=World Health Organization, BMD=Bone Mass Density.
Term
The WHO defines bones density as normal if it is greater that ___ mg/cm2, ostepenia if between ___ and ___ mg/cm2, and osteoporosis if less than ___ mg/cm2.
Definition
The WHO defines bones density as normal if it is greater that 833 mg/cm2, ostepenia if between 833 and 648 mg/cm2, and osteoporosis if less than 648 mg/cm2.
Term
Osteoporosis is a impairment of the structural integrity of ___________ bone.
Definition
Osteoporosis is a impairment of the structural integrity of trabecular bone.
Term
Common s/s of osteoporosis
Definition
Pain, bone deformity, kyphosis, fractures (distal radius, ribs, vertebrae, neck of femur)
Term
Complications of osteoporosis include:
Definition
fat or pulmonary embolism, pneumonia, hemorrhage, shock
Term
Osteomylelitis is a ____________ bone disease caused by ________, ______, _________, and _______.
Definition
Osteomylelitis is a infectious bone disease caused by bacteria, fungi, parasites, and viruses.
Term
What are 3 contributors to osteomyelitis?
Definition
Multiple microscopic channels in bone tissue, microcirculation vulnerable to damage, limited capacity to replace bone destroyed by infection.
Term
What are the two types of osteomyelitis?
Definition
Exogenous (open fractures, penetrating wounds, surgery) and endogenous osteomyelitis (staph through cutaneous, sinus, ear, dental or other primary infection sources)
Term
Clinical manifestations of osteomyelitis vary with ___, ________, ________, and ______ of infection.
Definition
Clinical manifestations of osteomyelitis vary with age, location, organism, and length of infection.
Term
Acute osteomyelitis infections involve the _____________ response.
Definition
Acute osteomyelitis infections involve the inflammatory response.
Term
With chronic osteomyelitis, symptoms are _____, including _____, malaise, ________, weight ____, and ____.
Definition
With chronic osteomyelitis, symptoms are vague, including fever, malaise, anorexia, weight loss, and pain.
Term
Osteoarthritis is a ____________ disease with loss of _________ cartilage in ________ joints. It occurs > age __. ________ are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as _______.
Pathologic characteristics are erosion of _________ cartilage, _________ of bone underneath cartilage, formation of bone _____ (osteo______).
Definition
Osteoarthritis is a degenerative disease with loss of articular cartilage in synovial joints. It occurs > age 40. Athletes are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as trauma.
Pathologic characteristics are erosion of articular cartilage, sclerosis of bone underneath cartilage, formation of bone spurs (osteophytes).
Term
Commonly affected joints by osteoarthritis:
Definition
Hand, wrist, neck, hip, knees, ankles, feet
Term
T/F Aging is an important associated factor in osteoarthritis.
Definition
True
Term
Clinical s/s of osteoarthritis include nothing (asymptomatic), ____ in one or more joints, especially _____ ________ joints, pain at _____, and pares______.
Definition
Clinical s/s of osteoarthritis include nothing (asymptomatic), pain in one or more joints, especially weight bearing joints, pain at night, and paresthesia.
Term
Risk factors for osteoarthritis include:
Definition
Risk factors for osteoarthritis include trauma, sprains, strains, joints dislocations, etc. Also long term mechanical stress caused by athletics, ballet dancing, or repetitive physical tasks. Inflammation of the joint structures is a risk factor. Joint instability from damage to supporting structures is a risk factor. Diabetic neuropathy is a risk factor. Other risk factors include Congenital or acquired skeletal deformities, hematologic or endocrine disorders including hemophilia and hyperparathyroidism, and the use of certain drugs like colchicine, indmethacin and steroids (stimulates collagen digesting enzymes in the synovial membrane).
Term
___________ Arthritis is a systemic autoimmune disease.
Definition
Rheumatoid Arthritis is a systemic autoimmune disease.
Term
Rheumatoid Arthritis is characterized by a chronic inflammation of __________ tissue (primarily joints).
Definition
Rheumatoid Arthritis is characterized by a chronic inflammation of connective tissue (primarily joints).
Term
The cause of rheumatoid arthritis is _______, however it is believed to be genetic with ____________, _________, and ______________ factors.
Definition
The cause of rheumatoid arthritis is unknown, however it is believed to be genetic with environmental, hormonal, and reproductive factors.
Term
In rheumatoid arthritis the ___________ become activated, degrading surface layers of _________ cartilage. _________ also cause chondrocytes to attack cartilage. ________ digests nearby cartilage.
Definition
In rheumatoid arthritis the neutrophils become activated, degrading surface layers of articular cartilage. Cytokines also cause chondrocytes to attack cartilage. Synovium digests nearby cartilage.
Term
Increased intracranial pressure (ICP)
Normal: _ to __ mm Hg
Causes
_____ growth, _____, excess ___, h_______ge, brain a______m
Clinical
Subtle and t______t; episodic con______n, ____lessness, _____iness, slight p_________ and b_______g changes
Decreased levels of a________, ________ pulse pressure, b__________dia, pupils small and s____ish
Cerebral hypoxia and a_______s
Prolonged effect
Brain h_______tion, d_____
Definition
Increased intracranial pressure (ICP)
Normal: 5 to 15 mm Hg
Causes
Tumor growth, edema, excess CSF, hemorrhage, brain aneurysm
Clinical
Subtle and transient; episodic confusion, restlessness, drowsiness, slight pupillary and breathing changes
Decreased levels of arousal, widened pulse pressure, bradycardia, pupils small and sluggish
Cerebral hypoxia and acidosis
Prolonged effect
Brain herniation, death
Term
Which cerebral edema is the most important clinically?
Definition
Vasogenic edema
Term
What causes vasogenic edema?
Definition
increased permeability of capillary endothelium after injury
Term
What are the 4 types of cerebral edema?
Definition
ischemic, vasogenic, cytotoxic, and interstitial
Term
Ischemic cerebral edema is actually what two types of cerebral edema?
Definition
Vasogenic and cytotoxic
Term
Paget disease is a state of __creased metabolic activity with abnormal and excessive bone __________ (resorption & formation). The accelerated remodeling e_____es and s____ns affected bones.
Most commonly affected bones include the v________, s___l, s_c___, st_____, p____s, f___r. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often a______matic, as_______cal skull; A__ (_______ ______ ______), d_____ia; s______ d______ (d/t pressure on brain)
Impaired m____/m_____ function, d___ness, atrophy _____ nerve, ____ache is common.
Definition
Paget disease is a state of increased metabolic activity with abnormal and excessive bone remodeling (resorption & formation). The accelerated remodeling enlarges and softens affected bones.
Most commonly affected bones include the vertebrae, skull, sacrum, sternum, pelvis, femur. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often asymptomatic, asymmetrical skull; AMS (altered mental status), dementia; sensory deficit (d/t pressure on brain)
Impaired motor/muscle function, deafness, atrophy optic nerve, headache is common.
Term
Gout is an ___________ response in relation to ____ acid production or excretion. The result is _____uric____
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in _________ tissue. Clinical s/s are joint and organ involvement including acute joint p___ or “_____ ar______s” and r____ stones. M______ium u____ crystals deposit in subcutaneous tissue as well and are called T____ (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to p______ metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process.
Definition
Gout is an inflammatory response in relation to uric acid production or excretion. The result is hyperuricemia
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in connective tissue. Clinical s/s are joint and organ involvement including acute joint pain or “Gouty arthritis” and renal stones. Monosodium urate crystals deposit in subcutaneous tissue as well and are called Tophi (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to purine metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process.
Term
What is the most common site of gouty arthritis?
Definition
The Great Toe
Term
Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the _________. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in Mc_____ disease (muscle myophosphorylase deficiency) and m_______t _____thermia. The contracture is usually temporary if the underlying pathology is reversed.
Definition
Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the sarcolemma. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in McArdle disease (muscle myophosphorylase deficiency) and malignant hyperthermia. The contracture is usually temporary if the underlying pathology is reversed.
Term
A pathologic contracture is a permanent muscle shortening caused by muscle s____ or w___ness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as m________ d________ (see p. 1079) and C______ _______ ______ (C__) injury. Contractures also may develop secondary to ____ tissue contraction in the flexor tissues of a joint, for example, contracture of b___ed tissues in the antecubital area of the forearm leading to a flexion contracture.
Definition
A pathologic contracture is a permanent muscle shortening caused by muscle spasm or weakness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as muscular dystrophy (see p. 1079) and central nervous system (CNS) injury. Contractures also may develop secondary to scar tissue contraction in the flexor tissues of a joint, for example, contracture of burned tissues in the antecubital area of the forearm leading to a flexion contracture.
Term
The term disuse atrophy describes the p_____logic reduction in normal size of muscle fibers after prolonged inactivity from b__ ____, t_____ (c___ing), or l___l n____ damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of _% per day.
Definition
The term disuse atrophy describes the pathologic reduction in normal size of muscle fibers after prolonged inactivity from bed rest, trauma (casting), or local nerve damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of 3% per day.
Term
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and t____r points. Increased sensitivity to touch (i.e., tender points), the __sence of systemic or localized inflammation, and the presence of f______e and non_______tive sleep are common. Because the symptoms are v___e, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: F__like v___l illness, Chronic f______e s______e, H__ infection, L___ disease, Physical tr____, Persistent s____s, Chronic s___p disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are _ pairs (__ total) of tender points for diagnostic classification of fibromyalgia. People describe the pain as b_____g or g___ing. F___gue is profound. There is a strong association (50%) between fibromyalgia, R_______d phenomenon, and irritable b___l syndrome.
Definition
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and tender points. Increased sensitivity to touch (i.e., tender points), the absence of systemic or localized inflammation, and the presence of fatigue and nonrestorative sleep are common. Because the symptoms are vague, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: Flulike viral illness, Chronic fatigue syndrome, Human immunodeficiency virus (HIV) infection, Lyme disease, Physical trauma, Persistent stress, Chronic sleep disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are 9 pairs (18) of tender points for diagnostic classification of fibromyalgia. People describe the pain as burning or gnawing. Fatigue is profound. There is a strong association (50%) between fibromyalgia, Raynaud phenomenon, and irritable bowel syndrome.
Term
What type of seizure am I? Musculature stiffens, then intense jerking as trunk and extremities undergo rhythmic contraction and relaxation. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Simple
Term
What type of seizure am I? Seizure activity that occurs with impairment of consciousness. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Complex
Term
What type of seizure am I? Partial onset evolving to generalized tonic-clonic seizures. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Secondary Generalized
Term
What type of seizure am I? Brief loss of consciousness with minimal or no loss of muscle tone; may experience 20 or more episodes a day lasting approximately 5-10 seconds each; may have minor movement, such as lip smacking, twitching of eyelids.
Definition
Generalized seizure: Absence
Term
What type of seizure am I? Sudden, brief contractures of a muscle or group of muscles.
Definition
Generalized seizure: Myoclonic
Term
What type of seizure am I? Alternating contraction and relaxation of muscles.
Definition
Generalized seizure: Clonic
Term
What type of seizure am I? Musculature stiffens, then intense jerking as trunk and extremities undergo rhythmic contraction and relaxation.
Definition
Generalized seizure: Tonic-Clonic
Term
What type of seizure am I? Sudden, momentary loss of muscle tone; drop attacks, likelihood of injury.
Definition
Generalized seizure: Atonic
Term
Seizure terminology: A partial seizure experienced as a peculiar sensation preceding the onset of generalized seizure that may take the form of gustatory, visual, or auditory experience or a feeling of dizziness, numbness, or just “a funny feeling”.
Definition
Aura
Term
Seizure terminology: Early clinical manifestations, such as malaise, headache, or a sense of depression, that may occur hours to a few days before the onset of a seizure.
Definition
Prodroma
Term
Seizure terminology: A state of muscle contraction in which there is excessive muscle tone.
Definition
Tonic
Term
Seizure terminology: A state of alternating contraction and relaxation of muscles.
Definition
Clonic
Term
Seizure terminology: The time period immediately following the cessation of seizure activity.
Definition
Postictal Phase
Term
Agnosia is a defect of pattern re_____tion—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in A_________ D________.
Definition
Agnosia is a defect of pattern recognition—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in Alzheimer's Disease.
Term
Is the loss of vision reversible with Macular Degeneration?
Definition
No
Term
What are the risk factors for Macular Degeneration?
Definition
Hypertension, cigarette smoking, and diabetes mellitus are risk factors for Macular Degeneration.
Term
Onset of macular degeneration
Definition
>60 years
Term
Types of macular degeneration
Definition
atrophic or dry and neovascular or wet
Term
Symptoms of atrophic/dry macular degeneration:
Definition
Limited night vision; difficulty reading
Term
Symptoms of neovascular/wet macular degeneration:
Definition
Leakage of blood or serum; retinal detachment; fibrovascular scarring; loss of photoreceptors
Term
Accomodation
Definition
Accommodation
Changes in thickness of the lens
Needed for clear vision
Presbyopia
Age related loss of accommodation; ocular lens becomes larger, firmer and less elastic
Term
Refraction
Definition
Refraction – most common visual problems
Myopia – nearsighted
Hyperopia – farsighted
Astigmatism – unequal curvature of cornea
Term
Color blindness
Definition
Color blindness
Inherited trait; cannot distinguish between red and green
Affects males
Term
Conductive hearing loss
Definition
Conductive hearing loss
Impaired form outer to inner ear
Causes: impacted cerumen; foreign body, tumor
Clinical: diminished hearing and soft speaking voice
Term
Sensorineural hearing loss
Definition
Sensorineural hearing loss
Impairment of the organ of Corti or its central connections
Presbycusis
Most common form
Atrophy of the basal end of organ of Corti
Term
Otitis externa
Definition
Otitis externa
Most common infection of outer ear
Pseudomonas, E. Coli, Staph
Occurs after prolonged exposure to moisture
Clinical
Swelling and clear purulent drainage; obstruction of ear canal
Term
Otitis media
Definition
Otitis media
Most common infection of children and infants
Strep, Haemophilus, Moraxella catarrhalis
Clinical
Pain, fever, irritability, inflamed tympanic membrane, fluid in middle ear
Term
Hyposmia
Definition
Hyposmia – impaired sense of smell
Term
Anosmia
Definition
Anosmia – complete loss of smell
Term
Olfactory hallucinations
Definition
Olfactory hallucinations
Smelling odors not present
Term
Parosmia
Definition
Parosmia – abnormal/ perverted sense of smell
Term
Hypogeusia
Definition
Hypogeusia: decreased taste sensation
Term
Ageusia
Definition
Ageusia - Absence of taste
Term
Parageusia
Definition
Parageusia - Substances possess an unpleasant flavor
Term
Temperature regulation in the elderly is compromised because: Elderly
blood c_________n is poor, structural/ functional s___ changes, decreased h__t-p____cing activities, decreased s____ring response, decreased meta___ic rate, decrease t____t and n____tion,
decreased p___pheral s___ation to h__t and c__d.
Definition
Temperature regulation in the elderly is compromised because: Elderly
blood circulation is poor, structural/ functional skin changes, decreased heat-producing activities, decreased shivering response, decreased metabolic rate, decrease thirst and nutrition,
decreased peripheral sensation to heat and cold.
Term
Intraocular pressure should be between __ to __ mm Hg.
Definition
Intraocular pressure should be between 12 to 20 mm Hg.
Term
Intraocular pressure over 20 mm Hg is __________.
Definition
Glaucoma
Term
Three types of glaucoma
Definition
Open angle, Angle closure, Congenital
Term
Which type of glaucoma is the leading cause of blindness, has few preliminary symptoms, is inherited, and involves an obstruction of aqueous humor?
Definition
Open angle glaucoma
Term
Which type of glaucoma involves a displacement of iris toward cornea, and is characterized by acute pain and visual disturbances?
Definition
Narrow or closed angle glaucoma
Term
Which type of glaucoma is neither open or closed and is associated with other anomolies?
Definition
Congenital glaucoma
Term
Is the loss of vision reversible with Macular Degeneration?
Definition
No
Term
What are the risk factors for Macular Degeneration?
Definition
Hypertension, cigarette smoking, and diabetes mellitus are risk factors for Macular Degeneration.
Term
Onset of macular degeneration
Definition
>60 years
Term
Types of macular degeneration
Definition
atrophic or dry and neovascular or wet
Term
Symptoms of atrophic/dry macular degeneration:
Definition
Limited night vision; difficulty reading
Term
Symptoms of neovascular/wet macular degeneration:
Definition
Leakage of blood or serum; retinal detachment; fibrovascular scarring; loss of photoreceptors
Term
Acute pain classifications
Definition
Somatic: Pain with a cause; superficial, Sharp, well-localized, dull, aching
Visceral: Pain in internal organs, abdomen, skeleton, Poorly localized, associated with n/v, hypotension, restlessness, ~ shock
Referred: Present in an area removed or distant from point of origin
Term
Acute Pain experience
Definition
Event
Term
Chronic Pain experience
Definition
A situation; state of existence
Term
Acute pain source
Definition
External agent or internal disease, injury or inflammation
Term
Chronic pain source
Definition
Unknown; if known, treatment is prolonged or ineffective
Term
Acute pain onset
Definition
Usually sudden
Term
Chronic pain onset
Definition
May be sudden or develop insidiously
Term
Acute Pain duration
Definition
Transient (up to 6 months); usually of short duration
Resolves with treatment and healing.
Term
Chronic Pain duration
Definition
Prolonged (6 months to years)
Term
acute pain identification
Definition
Painful and nonpainful areas generally well identified
Term
chronic pain identification
Definition
Painful and nonpainful areas less easily differentiated; change in sensations becomes more difficult to evaluate
Term
Acute pain clinical signs
Definition
Typical response pattern with more visible signs
Anxiety and emotional distress common
Term
Chronic pain clinical signs
Definition
Response patterns vary; fewer overt signs (adaptation)
Can interfere with sleep, productivity and quality of life
Term
acute pain significance
Definition
Significant (informs person something is wrong); protective
Term
chronic pain significance
Definition
Person looks for significance
Term
acute pain pattern
Definition
Self-limiting or readily corrected
Term
chronic pain pattern
Definition
Continuous(persistent) or intermittent; intensity may vary or remain constant
Term
acute pain course
Definition
Suffering usually decreases over time
Term
chronic pain course
Definition
Suffering usually increases over time
Term
acute pain action
Definition
Leads to actions to relieve pain
Term
chronic pain action
Definition
Leads to actions to modify pain experience
Term
acute pain prognosis
Definition
Likelihood of eventual complete relief
Term
chronic pain prognosis
Definition
Complete relief usually not possible
Term
chronic pain physiologic adaptations
Definition
Normal heart rate, BP, respiratory rate
Term
Negative chronic pain physiologic responses
Definition
Depression, difficulty sleeping, eating, preoccupation with pain, social-cultural influence
Term
Strabismus
Definition
Deviation of one eye while focusing on an object
Term
amblyopia
Definition
Reduced vision in affected eye
Term
dioplia
Definition
Double vision, primary symptom of strabismus
Term
Nystagmus
Definition
Involuntary unilateral or bilateral rhythmic movement of the eyes
Caused by imbalanced reflex activity of inner ear etc.
Term
Glasgow coma scale
Definition
– 15 point scale
Assesses level of consciousness
Three areas: eye opening; motor response; verbal response
Most critical clinical index of nervous system function
Term
levels of altered consciousness
Definition
Confusion-Loss of ability to think rapidly and clearly; impaired judgment and decision making
Disorientation-Beginning loss of consciousness; disorientation to time followed by disorientation to place and impaired memory; lost last is recognition of self
Lethargy-Limited spontaneous movement or speech; easy arousal with normal speech or touch; may or may not be oriented to time, place, or person
Obtundation-Mild to moderate reduction in arousal (awakeness) with limited response to the environment; falls asleep unless stimulated verbally or tactilely; answers questions with minimum response
Stupor-A condition of deep sleep or unresponsiveness from which the person may be aroused or caused to open eyes only by vigorous and repeated stimulation; response is often withdrawal or grabbing at stimulus
Coma-No verbal response to the external environment or to any stimuli, noxious stimuli such as deep pain or suctioning do not yield motor movement
Light coma-Associated with purposeful movement on stimulation
Coma-Associated with nonpurposeful movement only on stimulation
Deep coma-Associated with unresponsiveness or no response to any stimulus
Term
Why is the rate, rhythm and pattern of breathing important?
Definition
Helps evaluate level of brain dysfunction and coma
Term
The LOC is regulated by _______ _______ ______ in response to changes in ______
Definition
lower brain stem, PaCO2
Term
Cheyne-stokes breathing pattern is a ventilatory response to ____ and is characterized by _____ breaths and periods of _____ that grow _____. Also called the death ______. Caused by:
Definition
CO2, deep, apnea, longer, rattle
Bilateral dysfunction of the deep cerebral or diencephalic structures, seen with supratentorial injury and metabolically induced coma states
Term
Why are pupillary changes important?
Definition
The pupillary reflex is adjacent to the brain stem and is indicative of brain stem activity and dysfunction level. The pupil are also indicative of drug alterations.
Term
Pupils: Dysfunction of the tectum of the midbrain looks like this:
Definition
Large fixed hippus
Term
Pupils: A pontine dysfunction looks like this:
Definition
pinpoint pupils
Term
Pupils: midbrain dysfunction looks like this:
Definition
midposition and fixed pupils
Term
pupils: dysfunction of the third cranial nerve looks like this:
Definition
sluggish, dilated and fixed pupils
Term
pupils: diencephalic dysfunction looks like this:
Definition
small and reactive pupils
Term
pupils: normal pupils look like this:
Definition
small, reactive and REGULAR
Term
Normal Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes turn together (conjugate) to side opposite from turn of head.
Term
Abnormal Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes do not turn in conjugate manner (dysconjugate or asymmetric movement).
Term
Absent Oculocephalic Reflex Response (Dolls eyes Phenomenon test)
Definition
eyes do not turn as head position changes.
Term
Normal Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes turn together (conjugate) to ear where pain is induced.
Term
Abnormal Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes do not turn in conjugate manner to ear where pain is induced (dysconjugate or asymmetric movement).
Term
Absent Oculovestibular Reflex (Caloric Ice Water test)
Definition
eyes do not turn to ear where pain is induced.
Term
What are the two tests for Oculomotor Response?
Definition
Dolls eyes phenomenon (Oculocephalic reflex response) and Caloric Ice Water Test (Oculovestibular reflex response)
Term
What are the pathologic reflexes (4) and when should they disappear?
Definition
They should disappear at 24 months and only reappear with brain dysfunction. They are the grasp reflex, the snout reflex, the palmomental reflex and the suck reflex.
Term
What are the seven criteria for brain death?
Definition
1 Completion of all appropriate and therapeutic procedures

2 Unresponsive coma (no motor or reflex movements)

3 No spontaneous respiration

4 No ocular responses to head turning or caloric stimulation; dilated, fixed pupils

5 Isoelectric (flat) EEG (electrocerebral silence)

6 Persistence of these signs for 30 minutes to 1 hour and for 6 hours after onset of coma and apnea

7 Confirming test indicating absence of cerebral circulation (optional)
Term
Is recovery possible with brain death?
Definition
No
Term
Is there homeostasis with brain death?
Definition
No
Term
Is coma reversible with cerebral death?
Definition
No
Term
Is brain damage reversible with cerebral death?
Definition
No
Term
Is homeostasis intact with cerebral death?
Definition
Yes
Term
Brain death has occurred when there is no evidence of function above the __________—that is, in the cerebral hemispheres or brain stem—for an extended period. The abnormality of brain function must result from _____ or known ______ disease and must not be caused by a ______ drug, ______ poisoning, or ____thermia. An __________, or flat, ________________ (EEG) (electrocerebral silence) for _ to __ hours in a person who is not hypothermic and has not ingested depressant drugs indicates brain death.
Definition
foramen magnum, structural, metabolic, depressant, alcohol, hypothermia, isoelectric, electroencephalogram, 6 to 12
Term
The three types of dysphagia
Definition
Expressive, Receptive, and Transcortial
Term
Expressive dysphagia
Non______; cannot find _____
Difficulty _______
Definition
Expressive
Nonfluent; cannot find words
Difficulty writing
Term
Receptive dysphagia
Fluent; __________ ____________words
Unable to monitor language for ____________
Speech may be _________________
Definition
Receptive
Fluent; meaningless inappropriate words
Unable to monitor language for correctness
Speech may be incomprehensible
Term
Transcortical dysphagia
Echolalia – ______ another's words
Inability to ____ and _____
Impaired _________
Definition
Transcortical dysphagia
Echolalia – repeat another's words
Inability to read and write
Impaired comprehension
Term
Leading cause of severe cognitive dysfunction in older adults
Definition
Alzheimer's disease
Term
risk for AD increases with ________
Definition
age
Term
AD has a diagnosis of ___________
Definition
exclusion
Term
what is the diagnostic criteria for AD?
Definition
neurofibrillary tangles (and amyloid containing neuritic plaques)
Term
What causes cortical atrophy in AD?
Definition
Loss of neurons, particularly in the parietal and temporal lobes
Term
What is another name for cortical atrophy?
Definition
Senile plaques
Term
The loss of neurotransmitter stimulation by ____________ ______________ is thought to be responsible for AD.
Definition
The loss of neurotransmitter stimulation by choline acetyltransferase is thought to be responsible for AD.
Term
Where are neurofibrillary tangles?
Definition
Inside the neuron
Term
What causes a neurofibrillary tangle?
Definition
Tau proteins in the neuron become distorted and twisted.
Term
How long does stage 1 AD last and what are the symptoms?
Definition
2-4 years, memory loss, subtle personality changes, disorientation to time and place
Term
What is another name for stage 2 AD and what are the symptoms and duration?
Definition
The confusion stage,
impaired cognition restlessness, agitation, wandering, SUNDOWNER'S SYNDROME, repetitive behavior,
lasts several years
Term
What' another name for stage 3 AD and what are the symptoms and duration?
Definition
The terminal stage,
emaciation, inability to communicate, bowel and bladder incontinence, seizures,
lasts 1-2 years
Term
Should you attempt to reorient a patient with AD?
Definition
No
Term
What is the first visible sign of Parkinson Disease?
Definition
tremor
Term
Parkinson disease is a ___________ disorder of the _____ ______.
Definition
Parkinson disease is a degeneration disorder of the basal ganglia.
Term
Parkinson disease is characterized by a progressive destruction of the ______________ pathway.
Definition
Parkinson disease is characterized by a progressive destruction of the nigrostriatal pathway. (gray matter)
Term
Parkinson disease is characterized by a decrease in the concentration of ________.
Definition
Parkinson disease is characterized by a decrease in the concentration of dopamine.
Term
Cardinal manifestations of PD include _______ (rhythmic altenation flexion and contraction), _______ (resistance to movement throughout full ROM), ___wheel motions (most evident during _______ joint movement), _____kinesia, ____ rolling, uncontrolled __________ caused by ANS, salivation, ___________ gait, _____ steps, _________ posture. Dementia occurs __% of the time with PD patients.
Definition
Cardinal manifestations of PD include tremors (rhythmic altenation flexion and contraction), rigidity (resistance to movement throughout full ROM), cogwheel motions (most evident during passive joint movement), bradykinesia, pill rolling, uncontrolled sweating caused by ANS, salivation, shuffling gait, short steps, stooped posture. Dementia occurs 20% of the time with PD patients.
Term
hemiparesis
Definition
weakness on one side of the body (left or right)
Term
hemiplegia
Definition
Paralysis on one side of the body (left or right)
Term
diplegia
Definition
paralysis of both upper or lower extremities
Term
paraplegia
Definition
paralysis of both lower extremities
Term
quadriplegia
Definition
paralysis of all four extremities
Term
Increased intracranial pressure (ICP)
Normal: _ to __ mm Hg
Causes
_____ growth, _____, excess ___, h_______ge, brain a______m
Clinical
Subtle and t______t; episodic con______n, ____lessness, _____iness, slight p_________ and b_______g changes
Decreased levels of a________, ________ pulse pressure, b__________dia, pupils small and s____ish
Cerebral hypoxia and a_______s
Prolonged effect
Brain h_______tion, d_____
Definition
Increased intracranial pressure (ICP)
Normal: 5 to 15 mm Hg
Causes
Tumor growth, edema, excess CSF, hemorrhage, brain aneurysm
Clinical
Subtle and transient; episodic confusion, restlessness, drowsiness, slight pupillary and breathing changes
Decreased levels of arousal, widened pulse pressure, bradycardia, pupils small and sluggish
Cerebral hypoxia and acidosis
Prolonged effect
Brain herniation, death
Term
Which cerebral edema is the most important clinically?
Definition
Vasogenic edema
Term
What causes vasogenic edema?
Definition
increased permeability of capillary endothelium after injury
Term
What are the 4 types of cerebral edema?
Definition
ischemic, vasogenic, cytotoxic, and interstitial
Term
Ischemic cerebral edema is actually what two types of cerebral edema?
Definition
Vasogenic and cytotoxic
Term
What type of seizure am I? Musculature stiffens, then intense jerking as trunk and extremities undergo rhythmic contraction and relaxation. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Simple
Term
What type of seizure am I? Seizure activity that occurs with impairment of consciousness. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Complex
Term
What type of seizure am I? Partial onset evolving to generalized tonic-clonic seizures. Seizure activity that begins and usually is limited to one part of the left or right hemisphere.
Definition
Partial seizure: Secondary Generalized
Term
What type of seizure am I? Brief loss of consciousness with minimal or no loss of muscle tone; may experience 20 or more episodes a day lasting approximately 5-10 seconds each; may have minor movement, such as lip smacking, twitching of eyelids.
Definition
Generalized seizure: Absence
Term
What type of seizure am I? Sudden, brief contractures of a muscle or group of muscles.
Definition
Generalized seizure: Myoclonic
Term
What type of seizure am I? Alternating contraction and relaxation of muscles.
Definition
Generalized seizure: Clonic
Term
What type of seizure am I? Musculature stiffens, then intense jerking as trunk and extremities undergo rhythmic contraction and relaxation.
Definition
Generalized seizure: Tonic-Clonic
Term
What type of seizure am I? Sudden, momentary loss of muscle tone; drop attacks, likelihood of injury.
Definition
Generalized seizure: Atonic
Term
Seizure terminology: A partial seizure experienced as a peculiar sensation preceding the onset of generalized seizure that may take the form of gustatory, visual, or auditory experience or a feeling of dizziness, numbness, or just “a funny feeling”.
Definition
Aura
Term
Seizure terminology: Early clinical manifestations, such as malaise, headache, or a sense of depression, that may occur hours to a few days before the onset of a seizure.
Definition
Prodroma
Term
Seizure terminology: A state of muscle contraction in which there is excessive muscle tone.
Definition
Tonic
Term
Seizure terminology: A state of alternating contraction and relaxation of muscles.
Definition
Clonic
Term
Seizure terminology: The time period immediately following the cessation of seizure activity.
Definition
Postictal Phase
Term
Agnosia is a defect of pattern re_____tion—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in A_________ D________.
Definition
Agnosia is a defect of pattern recognition—a failure to recognize the form and nature of objects. For example, someone with agnosia might try to use a shoe to brush their teeth. Common in Alzheimer's Disease.
Term
Most frequently occurring neuro disorder
Definition
stroke
Term
Leading cause of disability in U.S. (paresis and paralysis)
Definition
stroke
Term
Stroke risk factors (7)
Definition
Arterial HTN,
Diabetes,
Lipoprotein-a presence (testable),
Polycythemia and Thrombocythemia (>600,000) which thickens blood,
Smoking which constricts vessels, Impaired cardiac function – quivering atrium, Non-rheumatic atrial fibrillation
Term
Classifications of strokes according to patho (4)
Definition
Global hypoperfusion (shock) (death can follow quickly), Ischemia: Thrombotic or Embolic (blood clot or air or other bubble, not DVT) comes from carotid artery or heart, Hemorrhage
Term
Ischemic Stroke: Thrombotic is common with what two disease processes?
Definition
artherosclerosis and inflammatory disease (arthritis) (damage to arterial walls)
Term
Ischemic Stroke: Thrombotic is a thrombus where?
Definition
intercranial vessels
Term
3rd most common cause of CVA
Definition
Hemorrhagic Stroke
Term
Fragments that break from thrombus (air, fat, tumors) formed outside the brain in the heart, aorta, and carotid
Definition
Ischemic Stoke: Embolic
Term
Risk factors for Ischemic Stoke: Embolic (5)
Definition
Atrial fibrillation,
endocarditis,
MI,
Rheumatic heart disease,
valvular prostheses
Term
Risk factors for Hemorrhagic stroke (5)
Definition
anticoagulation disorders,
bleeding into tumor,
HTN,
ruptured aneurysms,
vascular malformation,
Term
CVA signs and symptoms - 16
Definition
agnosia (decreased sensory interpretation),
aphasia (cva left hemisphere),
apraxia (decreased learned movements),
decreased cough and swallow reflex,
emotional lability (uncontrolled crying and crisis state),
Headache,
hemiparesis or hemiplegia,
hypertension,
hyperthermia,
incontinence,
mental changes (confusion, memory impairment, disorientation),
perceptual defects (cva right hemisphere),
resp problems (decreased neuro muscle control),
seizures,
visual changes (Homonymous hemianopsia or Horner's syndrome: half blindness),
vomiting,
Term
focal neurologic signs and symptoms (4)
Definition
language disorder,
paralysis,
reflex changes
sensory loss,
Term
TIA signs and symptoms (6)
Definition
confusion,
dysarthria,
syncope,
temporary vision changes,
transient hemiparesis,
vertigo,
Term
Stroke that has lesions less than 1 cm in size, pure motor and sensory deficits, associated with smoking, DM, and HTN
Definition
Lacunar stroke
Term
two main bacterias responsible for bacterial meningitis
Definition
Neisseria meningitidis and Streptococcus pneumoniae
Term
infected areas in bacterial meningitis
Definition
pia mater and arachnoid, the subarachnoid space, the ventricular system, and the CSF
Term
signs and symptoms of bacterial meningitis (9)
Definition
Fever, tachycardia, chills, petechial rash,
Throbbing HA, photophobia, nuchal rigidity (covering of brain is inflammed – extremely painful to put chin to chest),
decreased LOC, cranial nerve palsies, focal deficits,
Term
viral meningitis point of infection
Definition
meninges only - membranes which envelops the central nervous system, dura mater, arachnoid mater, pia mater.
Term
contagion in viral meningitis
Definition
enteroviral viruses,mumps, herpes simplex I
Term
symptoms of viral meningitis(3)
Definition
mild generalized headache, photophobia, neck stiffness
Term
contagions of fungal meningitis
Definition
cryptococcosis, aspergillosis
Term
Does fungal meningitis develop quickly?
Definition
No, slow, chronic, and insiduous
Term
fungal meningitis symptom
Definition
dementia
Term
types of meningitis
Definition
bacterial, fungal, viral, parasitic, toxic
Term
Multiple sclerosis: destruction of the _______ ___________ ________
Definition
CNS myelin sheath
Term
MS spares the __________ nervous system
Definition
peripheral
Term
MS: onset of __ to __ years
Definition
20-50
Term
MS: Male to female ratio
Definition
1:2
Term
leading cause of neuro disability in EARLY adulthood
Definition
Multiple sclerosis
Term
Are MS sufferers always symptomatic?
Definition
No, exacerbations and remissions occur.
Term
What are the MS manifestations dependant on?
Definition
Location and extent of lesion
Term
Common symptoms of MS (19, only about 5-6 categories, though)
Definition

Optic nerve, optic neuritis (cloudiness), diplopia, blurred vision, nystagmus,

tinnitus, decreased hearing,

urinary retention, spastic bladder, constipation, dysarthria(speech)/dysphagia(swallowing),

muscle strength, gait/coordination, balance, muscle spasticity, ataxia, acute paresthesias, leads to paralysis,

Term
Myasthenia Gravis: autoimmune disorder caused by antibodies against ________ receptors, which affect the ________ junction
Definition
acetylcholine, neuromuscular
Term
symptoms of Myastenia Gravis
Definition
Progressive muscle fatigue,
drooping head,
diploplia of eyes,
affects muscles of mouth and throat,
comes without warning, causing difficulty swallowing , HIGH-PITCHED VOICE, and decreased energy that improves with rest. The body literally attacks itself.
Term
Autonomic Dysreflexia Patho
Definition
•Sensory receptors below level of cord lesion are stimulated
• The intact nervous system then responds with arteriolar spasm increasing blood pressure
• Baroreceptors in cerebral, carotid sinus, and aorta stimulate PNS (r/t HTN)
• Heart rate decreases, but visceral and peripheral vessels do not dilate r/t blocked impulses
Term
Bone healing steps in order (5):
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down.
Term
Bone Healing
A: _______ at broken ends of the bone with subsequent ________ formation.
B: ____________ of hematoma into fibrous _______. (inflammatory)
C: Invasion of osteo______, lengthening of ________ strands, and deposition of _______.
D: ______ formation; new bone is built up as osteo_______ destroy ____ bone.
E: __________ is accomplished as excess ______ is reabsorbed and __________ bone is laid down.
Definition
A: Bleeding at broken ends of the bone with subsequent hematoma formation.
B: Organization of hematoma into fibrous network. (inflammatory)
C: Invasion of osteoblasts, lengthening of collagen strands, and deposition of calcium.
D: Callus formation; new bone is built up as osteoclasts destroy dead bone.
E: Remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down.
Term
subluxation
Definition
incomplete or partial dislocation of a joint, partial loss of opposing bone surface
Term
Delayed union
Union that does not occur for _ to _ months after injury (or _ to __)
Definition
Delayed union
Union that does not occur for 8 to 9 months after injury (6-12)
Term
Malunion
Healing of bone with incorrect _________ ________
Definition
Malunion
Healing of bone with incorrect anatomic position
Term
Nonunion
Failure of bone ends to ____ __________
Definition
Nonunion
Failure of bone ends to grow together
Term
Dislocation
Temporary ____________ of one or more bones in a _____ with entire loss of _______
Definition
Dislocation
Temporary displacement of one or more bones in a joint with entire loss of contact
Term
When is dislocation most prevalent (age)?
Definition
<20
Term
Dislocation is associated with what other alteration in MS function?
Definition
fracture
Term
What complication is possible with dislocation?
Definition
Disruption of circulation leading to ischemia and permanent disability.
Term
Strain
Definition
Tear in tendon (ties muscle to bone), associated with sports injuries
Term
Sprain
Definition
Tear in ligament (ties bone to cartilage)
Term
Avulsion
Definition
Complete separation from tendon or ligament from the bone
Term
Signs and symptoms of strains, sprains, and avulsions:
Definition
Pain, soft tissue swelling, change ligament or tendon contour, dislocation or subluxation of bone,
decreased mobility, instability, weakness
Term
Tendonitis
Definition
inflammation of the tendon (like achilles tendonitis)
Term
epicondylitis - Inflammation of t_____ where it attaches to a b___ at its o___in
(H_____s, r____s, u___, k___)
Definition
epicondylitis - Inflammation of tendon where it attaches to a bone at its origin
(Humerus, radius, ulna, knee)
Term
bursitis
Definition
Inflammation of small sac that lines synovial membranes. Localized; tenderness, pain with activity. Common sites are: * Prepatellar bursitis, "housemaid's knee",
* Trochanteric bursitis giving hip pain,
* Olecranon bursitis characterised by pain and swelling in the elbow, and
* Subacromial bursitis, which gives shoulder pain.
Term
osteoporosis affects __% of people age __ and older
Definition
55,50
Term
In osteoporosis the _________ cycle is disrupted, which means that ___ bone is reabsorbed ________ than ___ bone is formed.
Definition
In osteoporosis the modeling cycle is disrupted, which means that old bone is reabsorbed faster than new bone is formed.
Term
Genetic risk factors for osteoporosis include:
Definition
Family history of osteoporosis
White race
Increased age
Female sex
Term
T/F: Even though age is a risk factor for osteoporosis it is not a disease of aging.
Definition
True
Term
Hormonal and metabolic risk factors for osteoporosis include:
Definition
Early menopause (natural or surgical)
Late menarche
Nulliparity (never pregnant)
Obesity (increased pressure on bone tissue)
Hypogonadism
Cushing syndrome
Weight below healthy range
Acidosis
Term
Anthropometric risk factors for osteoporosis include:
Definition
Small stature
Fair or pale skinned
Thin build
Term
Diet risk factors for osteoporosis include:
Definition
Low dietary calcium and vitamin D
Low endogenous magnesium
Excessive protein
Excessive sodium intake
High caffeine intake – high metabolism, increased excretion
Anorexia
Malabsorption
Term
Lifestyle risk factors for osteoporosis include:
Definition
Sedentary
Smoker
Alcohol consumption (excessive)
Term
Concurrent risk factors for osteoporosis include:
Definition
Hyperparathyroidism - pulls the calcium out of the bone
Term
Illness and trauma risk factors for osteoporosis include: R____ insufficiency, h___calciuria (extra calcium becomes uremic frost), ____________ arthritis, S______ c___ injury, S_________ lupus.
Definition
Illness and trauma risk factors for osteoporosis include: Renal insufficiency, hypocalciuria (extra calcium becomes uremic frost), Rheumatoid arthritis, Spinal cord injury, Systemic lupus.
Systemic lupus
Term
Liver diseases as risks for osteoporosis:
Definition
Marrow disease (myeloma, mastocytosis, thalassemia)
Term
WHO=______ Health ____________, BMD=____ ____ Density.
Definition
WHO=World Health Organization, BMD=Bone Mass Density.
Term
The WHO defines bones density as normal if it is greater that ___ mg/cm2, ostepenia if between ___ and ___ mg/cm2, and osteoporosis if less than ___ mg/cm2.
Definition
The WHO defines bones density as normal if it is greater that 833 mg/cm2, ostepenia if between 833 and 648 mg/cm2, and osteoporosis if less than 648 mg/cm2.
Term
Osteoporosis is a impairment of the structural integrity of ___________ bone.
Definition
Osteoporosis is a impairment of the structural integrity of trabecular bone.
Term
Common s/s of osteoporosis
Definition
Pain, bone deformity, kyphosis, fractures (distal radius, ribs, vertebrae, neck of femur)
Term
Complications of osteoporosis include:
Definition
fat or pulmonary embolism, pneumonia, hemorrhage, shock
Term
Osteomylelitis is a ____________ bone disease caused by ________, ______, _________, and _______.
Definition
Osteomylelitis is a infectious bone disease caused by bacteria, fungi, parasites, and viruses.
Term
What are 3 contributors to osteomyelitis?
Definition
Multiple microscopic channels in bone tissue, microcirculation vulnerable to damage, limited capacity to replace bone destroyed by infection.
Term
What are the two types of osteomyelitis?
Definition
Exogenous (open fractures, penetrating wounds, surgery) and endogenous osteomyelitis (staph through cutaneous, sinus, ear, dental or other primary infection sources)
Term
Clinical manifestations of osteomyelitis vary with ___, ________, ________, and ______ of infection.
Definition
Clinical manifestations of osteomyelitis vary with age, location, organism, and length of infection.
Term
Acute osteomyelitis infections involve the _____________ response.
Definition
Acute osteomyelitis infections involve the inflammatory response.
Term
With chronic osteomyelitis, symptoms are _____, including _____, malaise, ________, weight ____, and ____.
Definition
With chronic osteomyelitis, symptoms are vague, including fever, malaise, anorexia, weight loss, and pain.
Term
Osteoarthritis is a ____________ disease with loss of _________ cartilage in ________ joints. It occurs > age __. ________ are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as _______.
Pathologic characteristics are erosion of _________ cartilage, _________ of bone underneath cartilage, formation of bone _____ (osteo______).
Definition
Osteoarthritis is a degenerative disease with loss of articular cartilage in synovial joints. It occurs > age 40. Athletes are at risk. Idiopathic is primary cause. Secondary causes are associated with known risk factors such as trauma.
Pathologic characteristics are erosion of articular cartilage, sclerosis of bone underneath cartilage, formation of bone spurs (osteophytes).
Term
Commonly affected joints by osteoarthritis:
Definition
Hand, wrist, neck, hip, knees, ankles, feet
Term
T/F Aging is an important associated factor in osteoarthritis.
Definition
True
Term
Clinical s/s of osteoarthritis include nothing (asymptomatic), ____ in one or more joints, especially _____ ________ joints, pain at _____, and pares______.
Definition
Clinical s/s of osteoarthritis include nothing (asymptomatic), pain in one or more joints, especially weight bearing joints, pain at night, and paresthesia.
Term
Risk factors for osteoarthritis include:
Definition
Risk factors for osteoarthritis include trauma, sprains, strains, joints dislocations, etc. Also long term mechanical stress caused by athletics, ballet dancing, or repetitive physical tasks. Inflammation of the joint structures is a risk factor. Joint instability from damage to supporting structures is a risk factor. Diabetic neuropathy is a risk factor. Other risk factors include Congenital or acquired skeletal deformities, hematologic or endocrine disorders including hemophilia and hyperparathyroidism, and the use of certain drugs like colchicine, indmethacin and steroids (stimulates collagen digesting enzymes in the synovial membrane).
Term
___________ Arthritis is a systemic autoimmune disease.
Definition
Rheumatoid Arthritis is a systemic autoimmune disease.
Term
Rheumatoid Arthritis is characterized by a chronic inflammation of __________ tissue (primarily joints).
Definition
Rheumatoid Arthritis is characterized by a chronic inflammation of connective tissue (primarily joints).
Term
The cause of rheumatoid arthritis is _______, however it is believed to be genetic with ____________, _________, and ______________ factors.
Definition
The cause of rheumatoid arthritis is unknown, however it is believed to be genetic with environmental, hormonal, and reproductive factors.
Term
In rheumatoid arthritis the ___________ become activated, degrading surface layers of _________ cartilage. _________ also cause chondrocytes to attack cartilage. ________ digests nearby cartilage.
Definition
In rheumatoid arthritis the neutrophils become activated, degrading surface layers of articular cartilage. Cytokines also cause chondrocytes to attack cartilage. Synovium digests nearby cartilage.
Term
Paget disease is a state of __creased metabolic activity with abnormal and excessive bone __________ (resorption & formation). The accelerated remodeling e_____es and s____ns affected bones.
Most commonly affected bones include the v________, s___l, s_c___, st_____, p____s, f___r. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often a______matic, as_______cal skull; A__ (_______ ______ ______), d_____ia; s______ d______ (d/t pressure on brain)
Impaired m____/m_____ function, d___ness, atrophy _____ nerve, ____ache is common.
Definition
Paget disease is a state of increased metabolic activity with abnormal and excessive bone remodeling (resorption & formation). The accelerated remodeling enlarges and softens affected bones.
Most commonly affected bones include the vertebrae, skull, sacrum, sternum, pelvis, femur. The cause is unknown; however there is a strong genetic component. Clinical s/s include: often asymptomatic, asymmetrical skull; AMS (altered mental status), dementia; sensory deficit (d/t pressure on brain)
Impaired motor/muscle function, deafness, atrophy optic nerve, headache is common.
Term
Gout is an ___________ response in relation to ____ acid production or excretion. The result is _____uric____
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in _________ tissue. Clinical s/s are joint and organ involvement including acute joint p___ or “_____ ar______s” and r____ stones. M______ium u____ crystals deposit in subcutaneous tissue as well and are called T____ (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to p______ metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process.
Definition
Gout is an inflammatory response in relation to uric acid production or excretion. The result is hyperuricemia
High concentrations of uric acid crystallize (insoluble precipitates),
and are deposited in connective tissue. Clinical s/s are joint and organ involvement including acute joint pain or “Gouty arthritis” and renal stones. Monosodium urate crystals deposit in subcutaneous tissue as well and are called Tophi (white nodules). Crystal deposits in kidneys or renal stones lead to renal failure. The patho is linked to purine metabolism. Uric acid is the breakdown product. Monosodium urate crystals stimulate and perpetuate the inflammatory process.
Term
What is the most common site of gouty arthritis?
Definition
The Great Toe
Term
Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the _________. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in Mc_____ disease (muscle myophosphorylase deficiency) and m_______t _____thermia. The contracture is usually temporary if the underlying pathology is reversed.
Definition
Contractures can be pathologic or physiologic. A physiologic muscle contracture occurs in the absence of a muscle action potential in the sarcolemma. Muscle shortening is explained on the basis of failure of the calcium pump in the presence of plentiful adenosine triphosphate (ATP). A physiologic contracture is seen in McArdle disease (muscle myophosphorylase deficiency) and malignant hyperthermia. The contracture is usually temporary if the underlying pathology is reversed.
Term
A pathologic contracture is a permanent muscle shortening caused by muscle s____ or w___ness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as m________ d________ (see p. 1079) and C______ _______ ______ (C__) injury. Contractures also may develop secondary to ____ tissue contraction in the flexor tissues of a joint, for example, contracture of b___ed tissues in the antecubital area of the forearm leading to a flexion contracture.
Definition
A pathologic contracture is a permanent muscle shortening caused by muscle spasm or weakness. Heel cord (Achilles tendon) contractures are examples of pathologic contractures. They are associated with plentiful ATP and occur in spite of a normal action potential. The most common form of contracture is seen in conditions such as muscular dystrophy (see p. 1079) and central nervous system (CNS) injury. Contractures also may develop secondary to scar tissue contraction in the flexor tissues of a joint, for example, contracture of burned tissues in the antecubital area of the forearm leading to a flexion contracture.
Term
The term disuse atrophy describes the p_____logic reduction in normal size of muscle fibers after prolonged inactivity from b__ ____, t_____ (c___ing), or l___l n____ damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of _% per day.
Definition
The term disuse atrophy describes the pathologic reduction in normal size of muscle fibers after prolonged inactivity from bed rest, trauma (casting), or local nerve damage. The normal individual on bed rest loses muscle strength from baseline levels at a rate of 3% per day.
Term
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and t____r points. Increased sensitivity to touch (i.e., tender points), the __sence of systemic or localized inflammation, and the presence of f______e and non_______tive sleep are common. Because the symptoms are v___e, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: F__like v___l illness, Chronic f______e s______e, H__ infection, L___ disease, Physical tr____, Persistent s____s, Chronic s___p disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are _ pairs (__ total) of tender points for diagnostic classification of fibromyalgia. People describe the pain as b_____g or g___ing. F___gue is profound. There is a strong association (50%) between fibromyalgia, R_______d phenomenon, and irritable b___l syndrome.
Definition
Fibromyalgia is a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and tender points. Increased sensitivity to touch (i.e., tender points), the absence of systemic or localized inflammation, and the presence of fatigue and nonrestorative sleep are common. Because the symptoms are vague, fibromyalgia has often been misdiagnosed or completely dismissed by clinicians.
The most common precipitating factors include the following: Flulike viral illness, Chronic fatigue syndrome, Human immunodeficiency virus (HIV) infection, Lyme disease, Physical trauma, Persistent stress, Chronic sleep disturbance.
The prominent symptom of fibromyalgia is diffuse, chronic pain. There are 9 pairs (18) of tender points for diagnostic classification of fibromyalgia. People describe the pain as burning or gnawing. Fatigue is profound. There is a strong association (50%) between fibromyalgia, Raynaud phenomenon, and irritable bowel syndrome.
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