clinical pathophysiology midterm

what does the motor function assessment test for?

• muscle strength

• muscle size

• muscle tone

• spinal reflex activity

• coordination of movement

what is esotropia?

what is exotropia?

what is hypertropia?

what is hypotropia?

what is penicillin?

• treat streptococcal and staphylococcal infections, syphilis and gonorrhea

• side effects: GI issues like nausea, vomiting, diarrhea, and abdominal pain

what are cephalosporins?

• treat a variety of issues including urinary tract and respiratory tract infections

• caution: may be contraindicated for people with allergies to penicillin

what are aminoglycosides?

• treat infection with gram-negative bacteria

• ex: gentamicin and tobramycin

• adverse effects: ototoxicity and nephrotoxicity

what are tetracyclines?

• treat various infections

• contraindicated for pregnancy people and children under age 8

what are macrolides?

• treat mild to moderate respiratory infections

• ex: azithromycin

• contraindicated for people who are lactating or who have hepatic dysfunction

what are fluoroquinolones?

• treat gram-negative and gram-positive infections of the urinary and respiratory tracts

• adverse reactions: tendon rupture and CNS effects

what are examples of isolation precautions?

• contact

• droplet

• airborne

what are analgesics (a pharmacological treatment)?

• drugs that act on the nervous system to decrease or eliminate pain without inducing loss of consciousness

• do not cure the underlying cause

• enable a person to achieve mobility after surgery, when exercises such as coughing or deep breathing may be required

what is neuropathic pain?

a type of chronic pain caused by nerve damage, often described as burning, stabbing, or tingling

what is neuralgia?

sharp, sudden pain along the path of a nerve, usually due to nerve irritation or damage

what is phantom limb pain?

sensations or pain felt in a limb that has been amputated, as if it is still present

what is the spinal cord?

function: transmits signals between the brain and body; controls reflexes

structure: a long, cylindrical structure extending from the brainstem to the lower back

role in neural function: involved in basic motor control and sensation; damage can lead to paralysis or loss of sensation

what is the brain stem?

function: regulates essential life functions such as heart rate, breathing, and swallowing

structure: includes the midbrain, pons, and medulla oblongata

role in neural function: acts as a communication pathway between the brain and spinal cord; controls autonomic functions, and manages reflexes

what is the motor cortex?

function: responsible for voluntary movement control

structure: located in the frontal lobe, specifically in the precentral gyrus

role in neural function: sends signals to the muscles to produce voluntary movements. damage can lead to motor impairments or paralysis

what is the cerebellum?

function: coordinates movement and maintains balance

structure: located at the back of the brain, below the occipital lobes

role in neural function: fine-tunes motor activity and ensures smooth, coordinated movements. damage can cause ataxia (loss of coordination)

what is muscle atrophy?

a skeletal muscle disorder that causes the weakening or shrinking of muscles due to disuse, injury, or disease

what is muscular dystrophy?

a skeletal muscle disorder where a group of genetic disorders causing progressive muscle weakness and degeneration

what is carpal tunnel syndrome?

a skeletal muscle disorder

caused by a compression of the median nerve in the wrist

leads to pain, numbness, and tingling in the hand

what is Guillain-Barre syndrome?

a skeletal muscle disorder

rare neurological disorder where the immune system attacks the peripheral nerves

leading to muscle weakness and paralysis

what is a herniated intervertebral disk?

a skeletal muscle disorder

condition where a disk in the spine ruptures or slips

causing pain and nerve compression

what is Parkinson’s disease?

a skeletal muscle disorder

a neurodegenerative disorder characterized by tremors, rigidity, and bradykinesia due to the loss of dopamine-producing cells in the brain

what happens during a cervical injury?

paralysis below neck (level of injury)

• quadriplegia: 4 limbs paralyzed

  • quad=4; diplegia=sounds like paralyzed

• breathing impaired - life threatening

  • happens to a lot of sports figures

what happens during a thoracic injury?

trunk of body

• paraplegic ( 2 legs)

• legs, pelvic organs

what happens during a lumbar injury?

legs and leaky bladder

what are examples of disruption of the autonomic nervous system function?

• vasovagal response

• autonomic dysreflexia

• postural hypotension

what is vasovagal response?

a sudden drop in heart rate and blood pressure

leading to fainting, often triggered by stress, pain, or standing up too quickly

what is autonomic dysreflexia?

a potentially life-threatening condition in individuals with spinal cord injuries

causing a dangerously high spike in blood pressure due to overstimulation of the autonomic nervous system

what is postural hypotension?

a condition where blood pressure drops significantly when standing up from a sitting or lying position

leading to dizziness or fainting

what is the Glasglow coma scale’s eye response?

this relates to how awake and alert you are

• spontaneous - 4

• to sound - 3

• to pain - 2

• no response - 1

what is the Glasglow coma scale’s verbal response?

this tests how well certain brain abilities work, including thinking, memory, attention span and awareness of your surroundings

• oriented - 5

• confused - 4

• coherent single words - 3

• sounds - 2

• no response - 1

what is the Glasglow coma scale’s motor response?

this part is about how well your brain can control muscle movement. it can also show if there are any issues with connections between you brain and the rest of your body

• obeys commands - 6

• moves to localized stimulation or pain - 5

• withdrawal response to pain - 4

• abnormal flexion - 3

• abnormal extension - 2

• no response - 1

what is a ischemic stroke?

results from blockage (clot)

what is a hemorrhagic stroke?

involves bleeding into/around the brain. associated with a higher mortality rate, more immediately dangerous due to increased ICP

what is conductive hearing loss?

hearing loss caused by problems in the outer or middle ear that prevent sound waves from reaching the inner ear

what is sensorineural hearing loss?

hearing loss due to damage to the inner ear (cochlea) or auditory nerve pathways

what is impacted cerumen?

accumulation of cerumen that causes a blockage in the ear canal

causes: overproduction of cerumen, use of cotton swabs, narrow ear canals, or hearing aids

symptoms:

• hearing loss

• ear fullness or pressure

• earache

• tinnitus (ringing in the ear)

• dizziness or balance issues

management:

• removal by a healthcare provider (avoid cotton swabs)

• over-the-counter ear drops

• irrigations

what is otitis externa (aka swimmer’s ear)?

infection or inflammation of the external auditory canal, often due to bacteria or fungi

causes:

• water exposure (swimming, bathing)

• mechanical injury (scratching, use of cotton swabs)

• allergies or skin conditions (eczema, psoriasis)

symptoms:

• itching in the ear canal

• pain or tenderness, especially when touching the ear or pulling the earlobe

• redness or swelling in the ear canal

• discharge (clear, yellow, or pus-like)

management:

• ear drops (antibiotic or antifungal)

• pain relief (acetaminophen or ibuprofen)

• avoid water exposure or scratching

what is barotrauma?

ear pain or damage resulting from rapid changes in air pressure or imbalances between the middle ear and the atmosphere

causes:

• rapid ascent or descent (airplane, scuba diving)

• Eustachian tube dysfunction

symptoms:

• pain or discomfort in the ear

• hearing loss

• fullness or pressure

• possible ear bleeding or rupture of the eardrum

management:

• prevention: yawning, swallowing, chewing gum

• use of nasal decongestants prior to flying or diving

• if rupture occurs, seeks medical attention for possible ear drop treatment or antibiotics

what is otosclerosis?

a disease of the bone of the otic capsule that causes the formation of new spongy bone around the stapes and oval window

causes:

• genetic factors (familial patterns)

• more common in women and may worsen during pregnancy

symptoms:

• gradual hearing loss, particularly in low frequencies

• tinnitus

• difficulty hearing in noisy environments

managements:

• hearing aids to amplify sound

• surgery (stapedectomy, removal of the affected bone)

• in some cases, a prosthetic device to replace the stapes

what is the impact of hearing loss on language development?

even mild or unilateral hearing loss can affect a young child’s language development, with 1 to 3 babies per 1,000 born with permanent hearing loss

what causes hearing impairment in children?

it can be conductive or sensorineural. genetic causes contribute to about 50% of sensorineural hearing loss

what are postnatal causes for hearing loss in children?

after birth, sensorineural hearing loss can be caused by infections like bacterial meningitis or sepsis, toxins (e.g., ototoxic drugs), or trauma. congenital cytomegalovirus is a leading cause of hearing loss in newborns

what are screening and interventions for hearing loss in children?

the AAP recommend universal screening for all infants before 1 month of age, with intervention by 6 months. children with risk factors for delayed hearing loss should receive ongoing monitoring, and a developmental and speech evaluation is needed once hearing loss is identified

what is presbycusis?

refers to age-related degenerative hearing loss, affecting approximately 45% of individuals aged 65+

• it’s a common social and health issue due to its high prevalence

characteristics: the hearing loss is gradual, bilateral, and typically involves high-frequency loss. it leads to difficulty in understanding speech, especially in noisy environments, and challenges with sound localization

causes and symptoms: likely results from a combination of aging, auditory stress, trauma, and otologic diseases. a common complaint is difficulty understanding speech rather than the inability to hear, especially for high-frequency sounds like beepers or alarms

screening and treatment: annual screening is recommended for older adults, typically using the question, “do you have a hearing problem?” hearing aids, lipreading, and assistive devices are effective treatments. Cochlear implants are recommended for severe hearing loss unresponsive to hearing aids

what does posture “A” mean?

patient is alive

1. plantar flexed

2. flexed

3. pronated

4. extended

5. abducted

what does posture “B” mean?

patient is dead

6. plantar flexed

7. internally rotated

8. flexed

9. flexed

10. adducted

what is intraocular pressure?

the fluid pressure inside the eye, which helps maintain its shape and is important for proper eye function

what is glaucoma?

a group of eye conditions that cause damage to the optic nerve, often associated with high intraocular pressure, leading to vision loss

what is primary open-angle?

The most common form of glaucoma, when the eye’s drainage canals become clogged over time, causing gradual vision loss without noticeable symptoms

what is angle-closure?

a type of glaucoma where the iris is pushed forward blocking the drainage angle and causing a sudden increase in intraocular pressure, leading to acute pain and vision loss

• sudden glaucoma

what is amblyopia?

a condition where one eye has poor vision due to abnormal visual development, even though the eye itself appears around

LAZY EYE

treatment: patches; eye drops

can lead to this if strabismus is left untreated

what is nystagmus?

involuntary, rhythmic oscillations or jerking of the eyes, which can be horizontal, vertical, or rotary

• common in people with albinism

what is strabismus?

a condition where the eyes are not properly aligned, causing them to point in different directions (e.g., one eye may turn inward, outward, upward, and downward)

• one eye is straying away

• CROSS-EYED

treatment: patches over the strong eye to make the weak eye to work on muscles

what is myopia?

nearsightedness; eyeball too long

what is astigmatism?

Nonuniform curvature of the refractive medium with regard to the horizontal and vertical planes

the result of an asymmetric bowing of the cornea, or defects in the cornea, lens, or the retina

what is hyperopia?

farsightedness; eyeball is too short, the image is theoretically focused posterior to (behind) the retina

what is the Romberg test?

oldest sensory tests used to demonstrate disorders of static vestibular function

POSITIVE: bad—swaying w/ eyes opened or closed

NEGATIVE: good—no swaying

what is tinnitus?

is the perception of abnormal ear or head noises that are not produced by an external stimulus… RINGING

causes:

• impacted cerumen— benign cause

• noise-induced hearing loss

• presbycusis

• hypertension

• atherosclerosis

• head injury

• cochlear or labyrinthine

diagnosis:

• audiological exam

• physical exam

• MRI or CT scan

management:

• white noise therapy

• cognitive hearing therapy

• stress management

what is peripheral vestibular apparatus?

contained in the bony labyrinth of the inner ear

• detects movement and maintains balance

what is vertigo?

Disorders of vestibular function in which an illusion of motion occurs

• frequently describe a sensation of spinning, “to-and-fro” motion, or falling.

• dizziness or spinning

what is motion sickness?

form of normal physiologic vertigo. It is caused by repeated rhythmic stimulation of the vestibular system, such as that encountered in car, air, or boat travel

• conflicting sensory input

• brain sends mismatch signals from hearing and sight

what is meniere disease?

disorder of the inner ear because of distention of the endolymphatic compartment of the inner ear.

symptoms include hearing loss, vertigo, and tinnitus.

What is the normal WBC?

4,500-11,000

what is the normal hemoglobin count?

11-18 g/dL

what is the normal hematocrit percentage in women?

36-44%

what is the normal hematocrit percentage in men?

41-50%

what is the normal platelet count?

150,000-450,000

What is the complete blood count (CBC)?

RBC, WBC, hemoglobin, hematocrit, and platelets

• hemoglobin and hematocrit: H&H blood tests are often performed to rule out anemia

what is the importance of type & screening?

identifies patient’s blood type and presence of antibodies (follow facility policy)

what is blood type?

the patient’s RBC are types for their ABO and Rh (D) blood type

what are antibodies?

the patient’s plasma is screened for the presence of ______ that could cause transfusion reaction

what are the steps to adverse reactions?

• start administration slowly (approximately 2-3 mL/min for the first 15 minutes)

• stay with the patient for the first 15 minutes of transfusion

• assess that patient at least every 30 minutes for adverse reactions

• stop the blood transfusion if you suspect a reaction. quickly replace the blood tubing with a new administration set primed with normal saline for IV infusion

• initiate an infusion of normal saline for IV at a keep open rate, usually 40 mL/hr. obtain vital signs. notify the healthcare team and the blood bank/transfusion service

what is anemia?

a condition where there is a deficiency of RBC or hemoglobin, leading to fatigue and weakness; also released in decreased oxygen delivery to tissue

symptoms: fatigue, weakness, pale skin, dizziness, shortness of breath, and cold hands/feet

causes: iron deficiency, vitamin B12 deficiency, chronic disease, blood loss, or genetic factors

treatment: iron supplements, vitamin B12 injections, medications for underlying causes, or blood transfusions

visual: diaphragm comparing normal red blood cells with those seen in anemia

what is sickle cell disease?

a genetic disorder where RBC become abnormally shaped (crescent or sickle-shaped), causing blockages in blood flow and pain

symptoms: pain episodes (crises), anemia fatigue, frequent infections, delayed growth in children

causes: inherited from both parents, leading to abnormal hemoglobin (HbS)

treatment: pain management, blood transfusions, hydroxyurea, and in some cases, stem cell transplant

visual: a comparison of normal red blood cells versus sickle-shaped cells

what is thalassemia?

a genetic blood disorder characterized by the reduced production of hemoglobin, leading to anemia

symptoms: fatigue, weakness, pale skin, slow growth in children, bone deformities, and enlarged spleen or liver

causes: mutations in the genes responsible for hemoglobin production

treatment: blood transfusion, iron chelation therapy, folic acid supplements, and stem cell transplant

visual: diaphragm of red blood cells showing abnormalities

what is polycythemia?

a condition where there is an overproduction of RBC, which can increase the risk of blood clots

symptoms: headache, dizziness, itching (especially after a hot shower), fatigue, and redness in the skin

causes: primary (polycythemia vera) or secondary due to chronic low oxygen levels, such as in lung disease

treatment: phlebotomy (removal of blood), medications to reduce blood thickness, and treatment of underlying conditions

visual: a blood smear showing increased RBC count

what is neutropenia?

a condition characterized by low levels of neutrophils, increasing the risk of infections

symptoms: increased susceptibility

causes: can result from chemotherapy, certain medications, bone marrow disorder, or autoimmune diseases

treatment: depends on the cause, including antibiotics, growth factors, and sometimes a bone marrow transplant

visual: a diaphragm of a blood cell with neutrophil levels compared to normal and low counts

what are non-hodgkin lymphomas (NHL)?

a group of cancers that originate in the lymphatic system, affecting WBC

symptoms: swollen lymph nodes, fever, weight loss, night sweats, fatigue

causes: genetics, infections (e.g., epstein-barr virus), or weakened immune systems

treatment: chemotherapy, radiation, immunotherapy, or stem cell transplant

visual: lymph node image highlights tumor development

what is leukemia?

cancers of the bone marrow and blood, leading to the overproduction of abnormal WBC

types: acute and chronic, including acute lymphoblastic leukemia (ALL) and chronic myelogenous leukemia (CML)

symptoms: fatigue, frequent infections, easy bruising, weight loss, and swollen lymph nodes

treatment: chemotherapy, radiation, bone marrow transplant, targeted therapies

visual: a blood smear showing leukemia cells

what is multiple myeloma?

a cancer of plasma cells in the bone marrow, which leads to the overproduction of abnormal blood cells

symptoms: bone pain, fatigue, kidney problems, frequent infections, and anemia

causes: unknown, but certain genetic factors, age, ad family history may play a role

treatment: chemotherapy, stem cell transplants, immunotherapy, and targeted therapies

visual: diaphragm of plasma cells in the bone marrow showing abnormal growth

what does a high GCS score mean?

13/15-15/15

indicates an awake, alert, oriented person

what does a moderate GCS score mean?

9/15-12/15

needs attention

what does a low GCS score mean?

<8/15

considered comatose

what is the glasglow coma scale used for?

Used as part of a neurological exam

• where you might have a decrease in how conscious you are

  • includes injury-related conditions like concussions and traumatic brain injuries

also help with conditions that don’t involve injuries

• hypoglycemia, poisoning, or after a seizure

what is contact precaution?

used to prevent diseases from spreading after touching a patient or objects in the patient’s room

wear gown and gloves

ex:

• clostridium difficle (c. diff)

• methicillin-resistant staphylococcus aureus (mrsa)

• respiratory syncytial virus (rsv)

• scabies

what is droplet precaution?

used to to help keep individuals safe from diseases that spread through particles that come out of the mouth during talking or coughing, or from drainage from the nose

wear a surgical mask and eye protection

ex:

• influenza

• mumps

• pertussis (whooping cough)

• rubella

what is airborne precaution?

used to keep individuals safe from diseases that spread through the air from person to person

wear a surgical mask

ex:

• tuberculosis (tb)

• measles

• varicella (chickenpox)

• covid-19