Pathophysiology Week 1: Cell Injury, Fluids/Electrolytes, Inflammation & Wound Healing

Vocabulary practice flashcards covering clinical judgment frameworks (ADPIE, ABCDE), cellular adaptations and injuries (Chapter 2), fluid and electrolyte balance (Chapter 7), and inflammation and wound healing mechanisms (Chapter 9).

Assessment (ADPIE)

The first step of the nursing process involving the gathering of data (vitals, history, physical exam); always occurs before taking action unless there is an immediate life threat.

Diagnosis/Analysis (ADPIE)

The second step of the nursing process where collected data is grouped together to identify the patient's problem.

Planning (ADPIE)

The third step of the nursing process where a specific, measurable goal is established (e.g., raising oxygen saturation from $88\%$ to $>90\%$).

Implementation (ADPIE)

The fourth step of the nursing process where the planned nursing intervention is actually performed.

Evaluation (ADPIE)

The final step of the nursing process where the effectiveness of an intervention is reassessed (e.g., rechecking pain level 30 minutes after medication administration).

Airway (ABCDE)

The highest medical priority in the ABCDE framework, assessing for any physical obstruction in the respiratory pathway (e.g., neck swelling with wheezing).

Breathing (ABCDE)

The second priority in ABCDE, evaluating whether ventilation is adequate (e.g., identifying fast, shallow breathing or inability to speak full sentences).

Circulation (ABCDE)

The third priority in ABCDE, assessing peripheral perfusion and blood flow (e.g., checking for color changes and weak pulses in a limb).

Disability (ABCDE)

The fourth priority in ABCDE, evaluating neurological status (e.g., checking for sudden slurred speech or confusion).

Exposure (ABCDE)

The fifth priority in ABCDE, protecting the patient from environmental conditions and managing bodily temperature issues (e.g., severe sunburn with fever).

Pathophysiology

The study of the altered physiological processes and functional changes that occur in the body as a result of disease.

Etiology

The underlying cause or origin of a disease or medical condition.

Manifestations

The objective signs and subjective symptoms associated with a specific disease process.

Pathogenesis

The step-by-step mechanism and clinical sequence through which a disease develops and progresses.

Remission

A period during a chronic illness when disease symptoms lessen or temporarily disappear.

Exacerbation

A temporary flare-up or severe increase in the intensity of disease symptoms.

Morbidity

The degree of illness, disability, or physiological impairment caused by a specific disease.

Mortality

The death rate or frequency of death resulting from a disease within a population.

Incidence

The rate of newly diagnosed cases of a disease within a specified time period.

Prevalence

The total number of active, existing cases of a disease in a given population at a specific time.

Atrophy

A reversible cellular adaptation where cells decrease in size due to disuse or reduced workload (e.g., skeletal muscle shrinking in a cast).

Hypertrophy

A cellular adaptation where individual cells increase in physical size, leading to enlarged organ mass (e.g., muscle growth in weightlifters).

Physiological Hypertrophy

Beneficial cellular enlargement accompanied by adequate blood supply and vascular growth, such as heart enlargement in trained athletes.

Pathological Hypertrophy

Harmful cellular enlargement without a corresponding increase in blood vessel supply, leading to ischemic stress (e.g., cardiac enlargement due to chronic high blood pressure).

Hyperplasia

A cellular adaptation marked by an increase in the total number of cells in a tissue or organ (e.g., breast tissue proliferation during pregnancy).

Metaplasia

A cellular adaptation in which one mature, delicate cell type is replaced by a different, tougher cell type better suited to withstand chronic irritation (e.g., esophageal lining changes from chronic GERD).

Dysplasia

Disorganized, atypical, and abnormal cellular growth in size, shape, and organization; acts as a precancerous warning sign (e.g., cervical changes on a Pap smear).

Neoplasia

Uncontrolled, uncoordinated new cellular growth forming a tumor; can be classified as benign or malignant.

Benign Neoplasm

A non-cancerous mass of cells that exhibits localized growth and does not invade surrounding tissue or metastasize to distant sites.

Malignant Neoplasm

A cancerous, poorly differentiated tumor capable of invasive growth, tissue destruction, and distant metastasis.

Hypoxic Injury

Cellular damage caused by reduced oxygen availability; recognized as the single most common cause of cellular injury overall.

Free Radicals

Unstable oxygen-containing molecules with unpaired electrons that react destructively with cellular membranes and structures.

Apoptosis

Programmed, clean cellular suicide that removes damaged or unnecessary cells without releasing contents or causing inflammation; can be physiological or pathological.

Necrosis

Unplanned cell death resulting from severe, overwhelming lethal injury; always triggers an inflammatory response and is always pathological.

Gangrene

A condition occurring when necrotic tissue becomes infected by saprophytic bacteria that thrive on decaying biological material.

Atherosclerosis

Plaque accumulation inside arterial walls initiated by endothelial injury due to hypertension, hyperglycemia, smoking, or elevated cholesterol.

Intracellular Fluid (ICF)

The fluid contained inside all body cells, accounting for approximately $40\%$ of total body weight.

Extracellular Fluid (ECF)

The fluid residing outside of cells, accounting for approximately $20\%$ of total body weight, consisting of interstitial, intravascular, and transcellular compartments.

Interstitial Fluid

The specific component of extracellular fluid that bathes and surrounds the tissue cells.

Intravascular Fluid

The fluid portion of extracellular fluid found within blood vessels, primarily consisting of blood plasma.

Transcellular Fluid

Specialized extracellular fluid contained within epithelial-lined body spaces, such as peritoneal, pleural, or pericardial cavities.

Third Spacing

The abnormal sequestration and trapping of extracellular fluid into transcellular spaces where it cannot easily exchange with the rest of the ECF (e.g., ascites).

Hydrostatic Pressure

The mechanical pushing force generated by heart pumping that forces fluid out of the blood vessels into surrounding tissue spaces.

Osmotic Pressure

The pulling force exerted by solute particles (primarily plasma albumin and sodium) that draws fluid back into the vascular system.

Osmoreceptors

Sensory neurons located in the hypothalamus that detect hyperosmolality in the blood, triggering thirst and anti-diuretic hormone (ADH) release to retain water.

Renin-Angiotensin-Aldosterone System (RAAS)

A neurohormonal compensatory pathway activated by low blood volume/pressure that acts across the kidneys, liver, lungs, and adrenal glands to retain sodium and water, raising blood pressure.

Natriuretic Peptides

Hormones (ANP from the atria, BNP from the ventricles) released in response to cardiac stretch from fluid overload that direct the kidneys to excrete sodium and water.

Brain Natriuretic Peptide (BNP)

A peptide hormone secreted by stretch-overloaded cardiac ventricles, utilized as the primary diagnostic blood biomarker to diagnose and track heart failure.

Edema

Excessive accumulation of fluid in the interstitial tissue space, caused by increased hydrostatic pressure, decreased oncotic pressure, increased capillary permeability, or lymphatic obstruction.

Hypotonic Solution

An intravenous solution with a lower solute concentration than body fluids, causing fluid to shift out of the vascular space into cells (can precipitate cerebral edema if overused).

Hypertonic Solution

An intravenous solution with a higher solute concentration than body fluids, drawing fluid out of cells into the intravascular space (used therapeutically to treat cerebral edema).

Hyponatremia

A serum sodium level below $135\,\text{mEq/L}$, resulting in cellular swelling, neurological confusion, muscle twitching, and risk of seizures.

Hypernatremia

A serum sodium level above $145\,\text{mEq/L}$, resulting in cellular dehydration, shrinking, and fluid balance disturbances.

Hypokalemia

A serum potassium level below $3.5\,\text{mEq/L}$, frequently caused by diuretic therapy or GI fluid losses, leading to muscle cramps, anorexia, and cardiac arrhythmias.

Hyperkalemia

A serum potassium level above $5.0\,\text{mEq/L}$ (or $5.2\,\text{mEq/L}$), commonly caused by renal failure, presenting with paresthesias, muscle weakness, severe ECG changes, and risk of fatal cardiac arrest.

Chvostek’s Sign

An indicator of hypocalcemia demonstrated by facial twitching upon tapping the facial nerve over the parotid gland.

Trousseau’s Sign

An indicator of hypocalcemia demonstrated by involuntary carpal spasm of the hand induced by inflating a blood pressure cuff above systolic pressure for several minutes.

Chemotaxis

The chemical signaling process that directs and attracts white blood cells toward the site of tissue injury or inflammation.

Leukocytosis

An elevated white blood cell count in the systemic circulation, commonly seen as part of the systemic inflammatory response.

Granuloma

A localized, nodular wall composed of aggregated macrophages and lymphocytes formed during chronic inflammation to isolate persistent pathogens (e.g., in tuberculosis).

Primary Intention Healing

Wound healing occurring in clean injuries with closely approximated edges (e.g., surgical incisions), yielding rapid healing and minimal scarring.

Secondary Intention Healing

Wound healing in large tissue defects with unapproximated edges, requiring extensive granulation tissue formation and resulting in significant scarring.

Tertiary Intention Healing

Delayed primary wound closure where a heavily contaminated or swollen wound is left open to drain before surgical closure, often requiring skin grafts.

Dehiscence

A surgical wound complication where previously closed wound margins separate or burst open.

Evisceration

A life-threatening surgical complication where internal abdominal organs protrude through a dehisced wound site.

Keloid

An excessive, hyperplastic scar growth that extends beyond the boundaries of the original tissue injury.

Contracture

The tightening and shortening of fibrous scar tissue, leading to restricted joint mobility and anatomical deformity.

Stricture

An abnormal narrowing or constriction of a hollow internal organ or passage (e.g., esophagus) due to scar formation.

Fistula

An abnormal passage or tract formed between two internal organs, or between an internal organ and the external body surface.

Adhesion

Inflexible internal bands of fibrous scar tissue that unnaturally bind adjacent visceral organs or structures together.