med term exam 3

blood

• Body tissue composed of formed elements suspended in plasma

• Formed elements:

  • Erythrocytes

  • Leukocytes 

  • Platelets

• Plasma

  • Water 

  • Proteins

  • Gases, nutrients, salts, others

• Formed in red bone marrow (hematopoiesis): skull, ribs, sternum, pelvis, long bones 

  • Stem cells: undifferentiated cells

  • Cells remain in bone marrow until fully matured

• Form of connective tissue

erythrocytes

(red blood cells)

• Contain hemoglobin: iron complexes, allows for transport of respiratory gases, causes red color

• Biconcave disk

• Most numerous

• Erythropoiesis: maturation of rbc, expels nucleus & organelles

leukocytes

• (white blood cells)

  • Protection & defense

  • Aids in tissue repair

  • Phagocytosis: uptake of foreign particles

  • Can migrate through walls/fenestrations of capillaries into tissue spaces (diapedesis)

  • 5 types

    • Neutrophils: phagocytosis - once it uptakes foreign particle, dies

    • Eosinophils: sign of parasites, allergies

    • Basophils: inflammation

    • Monocytes: can phagocytize (minor), becomes macrophage (large immune cell to fight in

    • Lymphocytes: antigen - marked for memory

  • -phils: contain granules

  • -cytes: agranule

thrombocytes

• (platelets)

  • Not true cells: fragments

  • Hemostasis: control bleeding, formation of clots/coagulation (example of positive feedback)

lymphatic system

• Drains excess interstitial fluid from tissue spaces & returns it to the blood

• Works closely with immune system, maintains the cells that defend the body

• Lymph nodes: blood vessels drain in & out, cleanse fluid

• Lymph vessels

  • Lymph capillaries: create mesh w/ regular capillaries

• Helper organs: tonsils, thymus, spleen (maturation of white blood cells)

• Lymph fluid: carries monocytes & lymphocytes (major cells of lymphatic system)

immune system

• Protects body against disease-causing organisms

• 2 types:

  • Innate: present at birth

    • Skin, tears, saliva, stomach acid

    • Protects w/o specificity

  • Acquired: develops through life w/ encounters w/ foreigners substances

    • Humoral immunity: orchestrated by B lymphocytes

    • Cellular immunity: orchestrated by T lymphocytes

    • Creates memory of pathogen:

      • Can be created naturally through exposure to pathogen, or through vaccinations

• Characteristics of the acquired immune response:

  • Recognition: ability to know what belongs to the body & what is foreign/harmful

  • Specificity: ability to “custom make” defenses unique to each pathogen

  • Memory: ability to recall how the pathogen was destroyed & repeat it with each subsequent exposure

iron-deficiency anemia

• Decrease in red blood cells caused by insufficient iron in the diet

• Large, central paleness (pallor) in RBC under microscope

• Most common anemia in US

• Common in adolescents & premenopausal women

• Signs & symptoms

  • Extreme fatigue

  • Cold hands & feet

  • Headaches

• Treatment

  • Depends on severity & cause

  • Oral or parenteral (intramuscular or IV) iron supplements

  • Dietary modifications

  • Red cell transfusions

pernicious anemia

• Caused by inadequate levels of vitamin B12 needed for red blood cell development

• Common result of insufficient amount of intrinsic factor needed for vB12 absorption

• Characteristic formation of large, abnormal rbc (macrocytes)

• Signs & symptoms

  • Weakness, nausea, vomiting

  • Inflammation of nerves (neuritis)

  • Muscular incoordination

  • Lightheadedness & impaired memory

• Treatment

  • Vitamin B12 injections

  • Dietary changes (inc. in red meats & liver)

  • Possibly lifelong treatment

sickle cell anemia

• Hereditary

• rbc have abnormal, sickle shape that prevents smooth passage through blood vessels

• Signs & symptoms

  • Pain crises (mainly in arms, legs, abdomen) due to impaired circulation

    • Triggered by infections, stress, extremes in temperature

  • Affects many body systems & organs

  • Jaundice in sclera

• Treatment

  • Analgesics: medications to relieve pain

  • Hydration

  • Regular blood transfusions (can help decrease severity)

  • Bone marrow transplant (severe cases)

leukemia

• Oncology: study of cancer

• 5 classes of blood cancers:

  • Leukemia: blood & bone marrow

  • Myoloma: plasma cells

  • Lymphoma: lymph system, lymphocytes

• Malignancy of the bone marrow

• Proliferation (rapid growth) of white blood cells - unable to carry on their normal function

  • Causes crowding of rbc & platelets - leads to anemia, bruising, & bleeding problems

• Both acute (sudden onset, blastic blood cells, life threatening) & chronic (ongoing, signs & symptoms slow to develop)

• Signs & symptoms

  • Splenomegaly, hepatomegaly, lymphadenopathy

  • Fatigue, malaise (general feeling of illness/discomfort), easy bruising, exercise intolerance

  • Night sweats & joint pain

  • Some can be asymptomatic until late in disease

• Treatment

  • Depends on type & stage

  • Chemotherapy

  • Bone marrow transplants

lymphedema

• Abnormal accumulation of fluid within tissues

• Common in arms & legs

• Causes:

  • blockage of lymph channels

  • Most common: mastectomy w/ removal of underarm lymph nodes

  • injury (trauma), radiation therapy, surgery, skin infections, tumors

• Can lead to fibrosis (excessive accumulation of fibrous tissue (scar tissue), leads to loss of function) & inflammation of tissues

• Signs & symptoms

  • Generalized swelling of arm/leg - can occur after surgery when chain of lymph nodes has been removed

  • Insufficient drainage of tissue fluid - leads to edema

• Treatment

  • Compression (multilayered bandages) - limits swelling & promotes lymph drainage

  • Manual lymph drainage

  • Elevation

  • Range of motion exercises

karposi sarcoma

• Malignancy of connective tissue (especially cells that line lymph & blood vessels)

• Affected areas develop tumors/blotches (lesions)

• Can invade organs (lungs, intestines, liver) - life threatening

• Closely associated with HIV - considered “AIDS defining condition”

• Signs & symptoms

  • Purple/red/brown lesions on skin/mucus membranes

    • Appear on lower extremities

    • Spread to upper body/face

    • mucous membranes of mouth/throat - sometimes internal organs

  • Weight loss - caused by pain by eating due to lesions in mouth/throat

  • Dyspnea when found in lungs

• Treatment

  • Depends on stage & degree of metastasis

  • Radiation therapy, chemotherapy, surgery, immunotherapy

  • Palliative treatment & good oral hygiene

systemic lupus erythematosus (SLE)

• Autoimmune disease

• Development of autoantibodies that attack skin, joints, & other organs

• Mild to life threatening

• Pattern of “flares” & remissions

• More common in women than men

• Signs & symptoms

  • Fatigue, joint pain, anemia

  • Abnormal blood clotting & edema

  • Butterfly shaped rash over nose & cheeks

  • Sensitivity to light & sun

• Treatment

  • Anti-inflammatories - joint pain/stiffness

  • Corticosteroids - minimize immune response

  • Antimalarial medications - skin & joint problems

  • Steroid cream - rashes

  • Anticlotting agents - if blood clotting occurs

thrombocytopenia

• Deficiency in number of circulating platelets

• Most common cause of hemorrhagic disorders

• Serious threat to hemostasis - platelets vital for coagulation

• Signs & symptoms

  • Bruising

  • Bleeding from nose/gums

  • Prolonged bleeding after injury

  • Petechiae

• Treatment

  • Treat underlying cause of platelet deficiency

  • Whole blood transfusions

  • Packed rbc transfusions

  • Platelet transfusions

Disseminated intravascular coagulation (DIC)

• Abnormal activation of proteins involved in blood coagulation

• Blood clots form in small vessels - cuts off blood supply to tissues

• Exhaustion of clotting proteins - leads to profuse bleeding

• Causes

  • Infection

  • Severe trauma

  • Inflammation

  • Cancer

• Signs & symptoms

  • Bruising

  • Bleeding from mucosal tissues

  • Thrombus formation that can affect kidneys & liver & lead to organ failure

  • Hypotension

  • Petichiae

• Treatment

  • Treat underlying cause (possible resolution of DIC)

  • Anticoagulant therapy

  • Transfusions

  • Platelet transfusion

antibody

(immunoglobulin) protein produced by B cells that protects against substances (antigens) that are potentially harmful to the body

antigen

substance recognized by the immune system that will cause the production of antibodies

cytokine

substance that initiates, inhibits, increases/decreases activity in other cells

immunocompetent

ability of immune system to respond to presence of antigen

autoimmunity

inability of immune system to accurately differentiate “self” from “non-self” - attacks its own cells

autoantibody

abnormal immune substance directed at one/more of individual’s cells or tissues until they are destroyed

apheresis

• Used to separate particular component of blood

• Channels blood through device that collects component & remainder of blood is returned back to the patient

• Types

  • Plasmapheresis

    • Specialized type of apheresis

    • Removal of plasma portion of blood

    • Used in autoimmune diseases (removes autoantibodies - plasma component is responsible for autoimmune symptoms)

    • Used in treatment for autoimmune diseases

      • Myasthenia gravis, multiple sclerosis, muscular dystrophy

  • Leukapheresis

  • Plateletpheresis

  • Stem cell harvest

blood transfusion

• Intravenous transfer of whole blood, blood cells, or plasma 

• Treatment for anemia

• Life saving procedure for severe blood loss

• Two types

  • Autologous: transfusion of own blood

  • Homologous (allogenic): transfusion from compatible donor

bone marrow trans pant

• Procedure to replace damaged/destroyed bone marrow cells w/ healthy cells

• Stem cells used for development of all types of blood cells

• Used for treatment of:

  • Leukemia, multiple myeloma, serious anemia, some autoimmune diseases

• Immunosuppressant treatment before transplantation to decrease chance of rejection (but increases chance of infections)

• Complications

  • Graph-versus-host disease (GVHD): donor cells attack recipient 

  • Graft failure

bone marrow aspiration

Withdrawal of bone marrow for microscopic evaluation (usually from pelvic bone, rarely from sternum)

sentinel node excision

• sentinel node- first node that drains from tumor site

  • Removal of this node - most likely to contain cancer cells

• If cancer cells not found in sentinel node, regional nodes are commonly not removed

lymphangiography

process of recording lymph vessels

lymphadenotomy

surgical incision of lymph gland

lymphadenectomy

removal of lymph gland

hemoglobinometer

instrument to measure hemoglobin

lymphangioplasty

surgical repair of lymph vessel

splenopexy

surgical fixation of spleen

tonsillotomy

incision of tonsils

splenorrhaphy

suture of the spleen

thymolysis

destruction of the thymus

blood/lymphatic/immune system pharmacology

• Anticoagulants: prevents blood from clotting, inactivates some clotting factors

• Antifibrinolytics: prevents blood clots from breaking down too early - blocks enzyme that dissolves fibrin

• Antiretrovirals: stops virus from making copies (common treatment in HIV)

• Immunosuppressants: reduces strength of the body’s immune system

• Thrombolytics: dissolves blood clots

muscle

• 3 types: 

  • Skeletal: striated, voluntary movement

  • Smooth: involuntary movement

  • Cardiac: only found in heart, propels blood through vascular system, striated, involuntary

• Help with posture

• Contribute to homeostasis for heat (shivering)

• Protection: cover/layer on top of organs

skeleton

• 2 divisions:

  • Axial: skull, spinal column, rib cage

  • Appendicular: arms & legs

• Skeletal framework: supports & protects body

• Stores calcium & other minerals

• Produces blood cells within bone marrow

bones

• Functions

  • Framework to support & protect the body

  • Point of attachment w/ muscles

  • Joint ligaments hold bones together closely

    • Flexible bands of fibrous tissue

  • Stores calcium & other minerals

  • Produce blood cells within bone marrow

• Joint: where 2 bones come together

• Ligaments: flexible bands of fibrous connective tissue that holds bones together at the joint

• 4 types

  • Short: cube shaped, ex. carpal/tarsal bones

  • Irregular: complex shape, ex. spinal vertebrae, ossicles in ear

  • Flat: broad surface, flat bone, ex. skull bones, shoulderblade, sternum

  • Long: well defined shape, ex. Femur, radius/ulna, humerus

    • Epiphysis: end of bone

    • Diaphysis: middle of bone, shaft

costochondritis

inflammation of ribs & cartilage

Pelvimetry

act of measuring the pelvis

Myosarcoma

malignant tumor of connective tissue & muscle

Osteoclast

cell that breaks down bone

Subcostal

pertaining to under/below the ribs

Sternocostal

pertaining to the sternum & ribs

Calcaneodynia

pain in the calcaneum (heel bone)

Osteoporosis

porous bone

Myoma

tumor (composed) of muscle

Arthrodesis

binding, fixation (of bone or joint)

Myorrhexis

rupture of muscle

Ankylosis

abnormal condition of being stiff, bent, or crooked

Myasthenia

weakness or debility of muscle

Chondromalacia

softening of cartilage

Arthroscopy

visual examination of a joint

spinal stenosis

• Narrowing of one/more spaces within the spine (as bones break down they change shape (due to age/disuse)

• Results in nerve compression or pinched nerve

• Common sites: cervical & lumbar area (lumbar area seen first - due to weight/gravity)

• Causes:

  • Develops slowly over time - age related changes 

  • (ex. osteoarthritis, thickened ligaments, herniated discs)

• Symptoms

  • Back pain

  • Leg numbness

  • Weakness

  • Leaning forward (relieves pressure on nerve - allows more space in spinal column)

• Treatment

  • (mild-moderate)

    • Physical therapy

    • Anti-inflammatory medications

  • (surgical - when conservative treatments are not effective)

    • Foraminotomy: enlarge nerve exit space to relieve pressure - relief in pain & numbness

bunion

(hallux valgus)

• Deformity characterized by lateral deviation of great toe

• Commonly caused by ill-fitting shoes

• Signs & symptoms

  • Tissues surrounding joint become red, swollen, tender

  • Corn or callus may develop where 1st & 2nd toe overlap

  • Limited movement of big toe

• Treatment

  • Nonsurgical

    • Wide toed shoes

    • Anti inflammatory meds

    • Shoe inserts

    • Padding, taping, splinting

  • Surgical

    • Bunionectomy to remove tissue & realign bones

ganglion cyst

• Fluid filled sac arising from joint capsules or tendons

• Commonly occurs in wrist, hand, foot

• Signs & symptoms

  • Pain (or not)

  • Bone spur (osteophyte) - common in cysts at the far joint of the finger

• Treatment

  • Can resolve spontaneously

  • Corticosteroids

  • Needle aspiration of fluid

  • Gangliectomy to remove ganglion

fracture

• Break or crack in a bone

• 8 types

  • Closed (simple): break w/ no external skin wound

  • Open (compound): break w/ external wound - piece of bone protruding through the skin

  • Complicated: broken bone injures internal organ (ex. lung)

  • Comminuted: bone broken/splintered into pieces

  • Impacted: end of broken bone wedged into interior of other bone

  • Incomplete: fracture doesn't go through whole bone

  • Greenstick: break where bone is partially bent & split - occurs commonly in children or in people who have rickets (soft bones)

  • Colles: break in lower end of radius - commonly occurs when wrist is extended to break a fall

• Signs & symptoms

  • Pain

  • Swelling, bruising

  • Specific signs & symptoms dependent on cause

    • Trauma, crushing, pathological (cancer, osteoporosis)

• Treatment

  • Realignment of broken bone ends (reduction)

    • Closed reduction: manipulating bones through the skin, then immobilization/fixation using casts, slings, taping

    • Open reduction: realignment through surgical opening, then internal/external immobilization/fixation using wires, plates, rods, screws, pins (internal fixation)

  • Analgesics or muscle relaxants to ease pain

  • Possibly no treatment (ex. rib fractures, sanya)

herniated disk

• protrusion/herniation of nucleus pulposus (gelatinous material at center of intervertebral disk) between 2 vertebrae

• Aka prolapsed disk

• Signs & symptoms

  • Depend on site of herniation

  • Severe back pain, worsens w/ motion

  • Paresthesia (numbness)/restricted mobility of neck

  • Intensifying pain w/ coughing, sneezing, bending

  • Dull ache progressing to severe pain - sciatic involvement

• Treatment

  • Bed rest (cautious activity)

  • Alternating application of heat/cold

  • Muscle relaxants, salicylates (help w/ pain/inflammation, tylenol), analgesics (help w/ pain)

  • Traction of lower extremities & back brace

  • Laminectomy if other treatment is unsuccessful

  • Spinal fusion possible to stabilize spine

rheumatoid arthritis

• Chronic, progressive, systemic inflammatory disease

• Affects synovial membranes of joints

• Possibly cartilage destruction, bone erosion, joint deformity

• congestion/edema of synovial membrane & joint

• Immobility of joints

• Common in women, 23-35

• Atrophy of muscles, bones, & skin adjacent to affected joint

• Signs & symptoms

  • Joint pain & stiffness

  • Crippling deformities

• Treatment

  • Reduce inflammation & pain, preserve joint function, prevent joint deformity

  • NSAIDs, physical therapy, orthopedic measures for less severe cases

  • Surgery to reduce pain & improve mobility

osteomyelitis

• acute/chronic infection of bone-forming tissue

• Disease progression

  • Beginning infection

  • Blocked blood flow in area of infection

  • Death of bone at infection site, continued pus formation

• Signs & symptoms

  • Acute

    • Fever

    • Local signs of inflammations (tenderness, redness, heat, pain, swelling)

  • Chronic

    • Ulceration

    • Drainage

    • Localized pain

• Treatment

  • Eliminate infection

  • Long-term antibiotic therapy

  • Surgical drainage to remove pus & necrotic bone tissue

  • Tissue & bone grafts (if necessary to restore blood flow to site)

gout

• Systemic connective tissue disorder

• Chronic disorder of uric acid metabolism

• More common in middle aged-older men

• Signs & symptoms

  • One+ severely inflamed joints as result of buildup of uric acid crystals

  • Swollen joint, hot, painful to touch

  • Typically occurs in small joints

  • Common in great toe joint

• Treatment

  • Drug therapy (1st)

    • NSAIDs - reduce inflammatory response to urate crystals

    • Meds taken until joint inflammation subsides

  • heat/cold

  • Analgesics (help w/ pain)

  • Control of uric acid formation w/ low-purine diet

Muscular dystrophy

group of hereditary diseases characterized by progressive degeneration of muscles, leading to increased weakness & debilitation (ex. Duchenne muscular dystrophy, most common)

necrosis

localized tissue death that occurs in groups of cells in response to disease/injury

Spondylolisthesis

forward slipping of one vertebra onto the one below it w/ predisposing factors including spondylosis, degeneration, & birth defects (ex. spina bifida)

Osteoporosis

abnormal bone-density loss w/ increased porosity, causing brittle bones & increased risk of fracture, occurs most commonly in postmenopausal women or sedentary/immobilized people

Talipes

deformity of the foot & ankle (usually congenital), foot is twisted & relatively fixed in abnormal position

Total hip arthroplasty

replacement of femoral head & & acetabulum w/ prosthesis that are fastened to the bone

Amputation

partial or complete removal of extremity, result of trauma or circulatory disease

Arthrocentesis

puncture of joint space using needle to remove accumulated fluid

Laminectomy

excision of posterior arch of a vertebra

Arthroscopy

visual examination of interior of joint via endoscope through small incision, allows for repair/removal of joint tissue

Myelography

radiography of spinal cord after injection of contrast medium, used to identify & study spinal distortions caused by tumors, cysts, herniated intervertebral disks

Rheumatoid factor

blood test used to detect presence of rheumatoid factor - antibody present in patients w/ rheumatoid arthritis

musculoskeletal pharmacology

• Bone reabsorption inhibitors: slow/block the breakdown of bone tissue

• Gold salts: gold containing drugs

• NSAIDs: drugs that relieve pain, reduce inflammation, lower fevers, decrease blood clotting

• Salicylates: aka aspirin

• Skeletal muscle relaxants: drugs to reduce muscle tension or spasms

functions of urinary system

• Regulation of extracellular fluid

• Remove waste products (nitrogenous waste - toxic) from plasma

• (kidneys) Secretes erythropoietin - acts on bone marrow to create blood cells

kidneys

• Bean shaped organ located in lumbar region of the back

• Right sits lower than left

• 2 regions

  • Renal cortex (outer region)

  • Renal medulla (inner region)

• Retroperitoneal: outside of cavity, behind peritoneum

ureters

• Vessels for carrying urine from kidneys → urinary bladder

• Smooth muscle: peristaltic waves moves liquid

  • Helps prevent regurgitation

bladder

• Hollow, muscular sac (smooth muscle)

• Temporary reservoir for urine

• Rugae: folds that expand as bladder fills

• Trigone: triangular area, where most problems w/ urinary system occurs

urethra

• Tube that carries urine from urinary bladder → outside

• Urination or voiding

• Different in length between women (short) vs men (longer)

  • Shorter length causes more chances for infection

• Urinary meatus: opening at end of urethra

nephron

• Microscopic functional unit of the kidney

• Forms urine in renal corpuscles & tubules by process of filtration, reabsorption, & secretion

• Renal corpuscle

  • Beginning of urine formation

  • Complete spherical initial unit, 2 parts:

    • Glomerulus - tuft of blood capillaries, lets water, ions, & sm wastes pass through

    • Bowman capsule - sac that encloses the glomerulus, captures filtered fluid & funnels it to proximal convoluted tubule

• Renal tubule

  • proximal convoluted tubule → loop of Henle (where majority of electrolytes are being exchanged) → distal tubule → collecting tube

Cystoscope

instrument to examine the bladder

Pyelitis

inflammation of the renal pelvis

Ureterectasis

expansion of the ureter

Urethrostenosis

stricture of the urethra

Meatotomy

incision of the meatus

Lithotripsy

crushing of a stone

Glomerulonephritis

inflammation of the glomerulus & kidney

Nephropexy

fixation of a kidney

Albuminoid

resembling albumin

Polyuria

excessive urination

Oliguria

scanty (less than normal) urine

Urolith

stone in the urinary tract

Nephrocele

hernia or swelling of the kidney

Ureterography

process of recording the ureter

Urogram

record of the urinary tract

Glomerulopathy

disease of the glomerulus

Pyelopathy

disease of the renal pelvis

Nephroma

tumor of the kidney

Hematuria

urine w/ blood