MRIS 210 chapter 1

Health

Physical, mental, and social well-being

Disease-

Deviation from the normal state of homeostasis
(maintain stable internal environment regardless of external changes – bp pulse, lab data)

Normal” values occur within a range of values and may vary depending on technology used for measurement

age, physical activity, gender, genetics, environment,

seven steps to health

nonsmoker, eat 5-10 veggies, be physically active, protect from sun, follow cancer screening guidelines, follow health and safety guidelines at home, visit dentist or doctor if nay changes in health

what is the primary focus of health care

prevention

Maintaining routine
vaccination programs, Participation in screening
programs, Community health programs, Regular routine doctor
visits

primary prevention

protect healthy people from developing a disease or experiencing an injury. (education about good nutrition, dangers of tobacco, immunizations, controlling potential hazards at home/work)

secondary prevention

interventions after illness has been diagnosed. Goal is to halt/ slow progress of disease in early stages (provide suitable modified work for injured workers)

tertiary prevention

helping people manage complicated,
long-term health problems such as diabetes, heart disease, cancer, and chronic musculoskeletal pain. Prevent further deterioration and maximize quality of life
(cardiac or stroke rehab, chronic pain management programs, patient support
groups)

medical history

This information is essential to identify any impact health care activities might have on a patient’s condition, or how a patient’s illness might complicate care

include: current and prior illnesses, Allergies, Hospitalizations,Treatment, Specific difficulties
Any type of therapy or drugs, Prescription, Nonprescription
herbal items, including food supplements

gross level

Organ or system level visually view by the naked eye

microscopic level

Cellular level visible only when magnified by lenses in a microscope

biopsy

Excision of small amounts of living tissue surgical specimens. Establishing the cause of disease (pathology reports)

Autopsy (Necropsy)

Examination of the body and organs after death

Differential Diagnosis-

identification of a specific disease through evaluation of signs and symptoms, laboratory tests

diagnosis

identification of specific disease

etiology

study of disease

cause

causative factors in a particular disease

idiopathic

unknown cause

iatrogenic

condition caused by the treatment of the disease (tx, procedure or error may cause disease)

predisposing factor

Tendencies that promote development of a disease in an individual

pathogenesis

Development of the disease sequence of events leading from cause to biochemical, morphological (visible) and or functional abnormalities to manifestations of disease

acute disease

a short-term illness that develops quickly marked sign short term rapid onset

chronic disease

Often milder, develops gradually,
persists for a long time often a lifetime

subclinical state

in some conditions in which pathologic changes occur but the patient exhibits no obvious manifestations, perhaps because of the great reserve capacity of some organs.

Pathologic
changes, no obvious manifestations

latent state

in which no clinical signs are evident, characterizes some diseases

No symptoms or clinical signs evident

incubation period

time between exposure to the microorganism and the onset of signs or symptom

prodromal period

Early development of a disease
(increase in number of infections where
immune system reacts to infectious
agents)
• Signs nonspecific or absent

manifestation

Signs and symptoms of disease

syndrome

collection of signs and symptoms, often affecting more than one organ, that usually occur together in response to a certain condition.

remission

Manifestations of the disease subside or are absent

Precipitating factor

Condition that triggers an acute episode (stressors or
events that promote onset of illness – conflict

Complications

New secondary or additional problems after the original disease begins

Therapy

Treatment measures to promote recovery or slow the progress of a disease

Sequelae

Unwanted outcomes of primary condition
(postpoliomyelitis conditions such as new weakness, fatigue, pain

Convalescence

Period of recovery

Prognosis

Probability for recovery or for other outcome

Rehabilitation

Maximizing function of diseased tissues

Epidemiology

Science of identifying the causative factors and tracking the pattern or occurrence of disease

Morbidity

Indicates the number of people
with a disease within a group

Mortality

Indicates the number of deaths
resulting from a particular disease
within a group(the number of
deaths per 100,000 per year by a
specific disease Example: Breast
Cancer)

Leukocytosis-

increase of leukocytes (WBCs) in the blood

Necrosis-

death of cells or tissue in a localized area

Ischemia-

localized hypoxia due to poor blood flow (holding
back blood)

Nosocomial Infection-

hospital acquired infection

Epidemics

Occur when a higher than expected number of cases of an infectious disease occur within a given area

Pandemics

Involve a higher number of cases in many regions of the globe

signs and symptoms also known as

manifestations

Signs-

manifestations noted by observation ex:
swelling, redness, fever, rash

Symptoms-

subjective complaint so stated by the
patient ex. Pain, dizziness, nausea

Remission-

S&S goes away or lesson

Exacerbation (Relapse)-

S&S return and they may be
worse

Palliative Care-

supportive care to make the patientcomfortable

incidence

Number of new cases in a given population within a specified time period

Prevalence

Number of new and old or existing cases in a
specific population within a specified time period

Communicable diseases

Infections that can spread from one person to another

Notifiable or reportable diseases

Diseases that must be reported by the physician
because of infectiousness, severity or frequency ofoccurrence. Reported to certain designated
authorities (COVID, TB, Polio)

Atrophy

Decrease in the size of cells
Results in reduced tissue mass (reduced use of tissue leads to shrinkage of skeletal muscle when limb in cast for weeks)

Hypertrophy

Increase in cell size
Results in enlarged tissue mass (enlarged heart muscle from increased demands, muscular dystrophy)

Hyperplasia

Increased number of cells Results in enlarged tissue mass (from hormonal imbalance; compensatory mechanism to meet increased demands) Ex.
Goiter

Metaplasia

Mature cell type is replaced by a different mature cell type. (may
result from vitamin A deficiency; may be adaptive mechanism, but
could lead to other problems Example: Callus)

Dysplasia

Cells vary in size and shape within a tissue. (result of chronic
infection or precancerous change) (ex. Routine screening tests for
atypical cells such as the Pap smear)

Anaplasia

Undifferentiated cells, with variable nuclear and cell structures
(seen in most malignant tumors, used for grading aggressiveness
of tumor)

neoplasia

“New growth”―commonly called tumor – benign and malignant

Apoptosis

Refers to programmed cell death, dead skin
 Normal occurrence in the body (may increase when cell
development is abnormal, cells are injured or aged)

Ischemia

Deficit of oxygen in the cells (caused by radiation, physical
agents, tearing of tissue, chemicals, bacteria, viruses,
nutritional deficits, electrolyte imbalance) (Due to
circulatory obstruction)

Hypoxia

Reduced oxygen in tissues (interferes with energy production, loss of sodium pump at cellular level

Physical damage to cell

Excessive heat or cold
 Radiation exposure

Chemical toxins

Exogenous: from environment Endogenous: from inside the body

Mechanical damage

Pressure or tearing of tissue

other factors for cell damage

Microorganisms- Bacteria and viruses, for example
Abnormal metabolites (small molecules)
 Genetic disorders
 Inborn errors/alterations of metabolism (chemicalprocesses that help to maintain life)
Nutritional deficits
Imbalance of fluids or electrolytes

Necrosis:

group of cells die

Liquefaction necrosis

Dead cells liquefy because of release of cell enzymes
 Occurs when brain tissue dies or ulcer develops in infected area

Coagulative necrosis

Cell proteins are altered or denatured― coagulation
 Occurs in MI due to lack of oxygen causing cell death

Fat necrosis

Fatty tissue broken down into fatty acids and may increase inflammation

caseous necrosis

Form of coagulation necrosis where
 Thick, yellowish, “cheesy” substance forms
 TB is an example

infarction

Area of dead cells as a result of oxygen deprivation
• After tissues dies, replaced by tissue regeneration from nearby similar cells or connective tissue or
scar tissue
• Ex. When part of the heart muscle is infarcted or dies, that area can no longer contract to pump
blood

gangrene

Area of necrotic tissue (lack of blood supply) that
has been invaded by bacteria
• Necrotic tissue is medium for infection
• Dry – caused by coagulative necrosis where tissue
dries, shrinks, wrinkles and turns brown and black
• Wet – microbes, no gas, skin will be moist, black
and under tension, odor, cold, swollen and
pulseless
• Gas- generally anaerobic gas producing micros,
usually results from trauma, dirt, debris, bacteria
causes immediate death of cells
• Usually removed surgically – amputation to prevent
spread of infection

Congenital Conditions-

defects present at birth

Acquired defects-

those defects that occur by events after birth

Morphology-

structure or form of cells or tissues

Histology-

Study of cells and tissues

Lesion-

pathologic or traumatic discontinuity of a tissue or organ

EDEMA-

EXCESSIVE FLUID IN THE INTERSTITIAL
COMPARTMENT, WHICH CAUSES SWELLING INCLUDING THE CELLS

buffer system

SUBSTANCE THAT INCREASES AMOUNT OF ACID OR ALKALI NECESSARY TO PRODUCE A UNIT CHANGE IN PH
• BICARBONATE – MAINTAINS BALANCE BETWEEN SODIUM BICARBONATE–CARBON DIOXIDE IONS AND DETERMINES PH
• CONTROLLED BY THE RESPIRATORY SYSTEM AND KIDNEYS

OTHER BUFFERING SYSTEMS:

PHOSPHATE
• HEMOGLOBIN
• PROTEIN

compensation

CCURS TO BALANCE THE RELATIVE
PROPORTION OF HYDROGEN IONS AND BICARBONATE
IONS IN CIRCULATION:
• BUFFERS
• CHANGE IN RESPIRATION
• CHANGE IN RENAL FUNCTION

COMPENSATION LIMITED, USUALLY SHORT TERM
DOES NOT REMOVE THE CAUSE OF IMBALANCE

DECOMPENSATION

CAUSATIVE PROBLEM BECOMES MORE SEVERE
• ADDITIONAL PROBLEMS OCCUR
• COMPENSATION MECHANISMS ARE EXCEEDED OR FAIL
• REQUIRES INTERVENTION TO MAINTAIN HOMEOSTASIS
• LIFE-THREATENING – DYSPNEA, VENOUS ENGORGEMENT,
CYANOSIS, EDEMA

ACID-BASE IMBALANCE

IS ESSENTIAL TO HOMEOSTASIS
BECAUSE CELL ENZYMES CAN FUNCTION ONLY WITHIN A VERY NARROW PH RANGE

normal ph range

7.35-7.45

PH BELOW 7.4 CAUSES ACIDOSIS
PH ABOVE 7.4 CAUSES ALKALOSIS

when does death occur in ph

6.8 or above 7.8

treatment of imbalances

TREATMENT OF UNDERLYING CAUSE
• IMMEDIATE CORRECTIVE MEASURES TO INCLUDE FLUID AND ELECTROLYTE REPLACEMENT OR REMOVAL
( CAUTION IS REQUIRED WHEN ADJUSTING FLUID LEVELS TO ENSURE APPROPRIATE ELECTROLYTE BALANCE.)
ADDITION OF BICARBONATE TO THE BLOOD TO REVERSEACIDOSIS
• MODIFICATION OF DIET TO MAINTAIN BETTER ELECTROLYTE BALANCE