The beginning of Medicine

Where is considered the cradle of modern Western medicine

Greece

Greek Medicine revolved around what

Four humors

What did Greece Medicine move from practice wise

Moved from Supernatural causes to observation and logical thinking

What are the four humors

blood, phlegm, yellow bile, black bile

Did the Greeks test theories

No autopsies, just observation

What was Imhotep known for?

Physician to the pharaoh and pyramid builder

What were the two nicknames Imhotep had?

“The one who comes in peace“ and “Shepard of the Anus”

What was Hippocrates known for?

founded a school of physicians, the Hippocratic oath, four humors

What was significant about the Edwin Smith Papyrus

earliest known writing on medicine

Who was speculated to be the original author of the Edwin Smith Papyrus

Imhotep

What was Celsus most notable for

Identified the cardinal signs of inflammation

What did Celsus Write

De Medicina

What are the four cardinal signs of inflammation?

• Redness

• Heat

• Swelling

• Pain

What was most notable about Galen?

writings guided medicine for 1500 years

What is a notable contribution of Galen regarding arteries, urine, and spinal cord

• first to describe arteries are filled with blood instead of pneuma

• urine is produced by kidneys

• spinal cord and spinal nerves control muscle function

What is a notable contribution of Galen regarding the heart, brain and, nerves

• The heart is the origin of blood vessels

• The brain is the origin of nerves

• Sensory nerves are different from motor nerves

Why did Galen get some facts incorrect?

Galen studied monkeys

What was noteworthy about Leonardo da Vinci?

learned about the functions of muscles, bones, and tendons, from human dissection

What was noteworthy about William Harvey

discovered that blood is moved through the body by the heart

What book did William Harvey write

De Motu Cordis et Sanguinis

What is noteworthy about Rudolf Virchow

introduced the concept of cellular pathology

What was Rudolf Virchow’s main point

diseases result from alterations within cells and tissues using microscopic observation

What is Virchow’s node

enlarged left supraclavicular lymph node as an early sign of gastric cancer

What is Rudolf Virchow’s nickname

Father of Modern Pathology

Virchow is credited with what two things

• First recognizing leukemia

• discovering pulmonary thromboembolism

Define Human Diseases

undesired deviations from the norm

What are signs

Can be detected by tests: Fever, blood pressure, bleeding

What are symptoms

reported by pt, cannot be measured: pain, drowsiness, vertigo

What are some ways diseases can have genetic predisposition

chromosomal alterations, gene mutations

What are some ways diseases are acquired

infection, trauma, degenerative

What are some ways diseases can be seen by eye

jaundice, bleeding

What are some ways diseases are only visible with medical tests, imaging

pigment or inclusions visible in cells by microscope, protein in urine, COVID-19, flu protein in nasal swab

What are the four pillars to understanding disease

• Disease etiology

• Pathogenesis

• Lesion

• Functional Changes

What is disease etiology

the cause of a disease

What is Pathogenesis

the disease process

What is lesion

structural/morphological changes in affected tissues

What is functional changes

impaired function of an organ system, clinical manifestation

What are five ways to recognize diseases

• Reported by patient

• Gross examination

• Histologic examination

• Lab examination

• Specialized examinations

Examples of pt reported dx

nausea, pain

Examples of gross examination

physical examination, autopsy

What are histologic examinations

alterations are visible by microscope

What is gross examination

The lesion is visible to the naked eye

What are examples of laboratory examinations

blood tests, urine sample, DNA test

What are examples of Specialized examinations

X-ray, ultrasound, endoscopy, MRI

What is the fifth sign of acute inflammation that Galen added

impaired function

What is Rubor

redness

What is Tumor

swelling

What is Calor

heat

What is Dolor

pain

What humors are affected at the first stage of acute inflammation

Rubor and Calor

What humors are affected at the second stage of acute inflammation

Rubor, Calor, Dolor, Tumor

What humors are affected at the third stage of acute inflammation

Rubor, Calor, Dolor, Tumor, Functio Laesa

What is function laesa

impaired function

What humors are affected at the fourth stage of acute inflammation

Dolor, tumor, functio laesa

When is the first stage of acute inflammation?

0-4 hours

When is the second stage of acute inflammation?

4-48 hours

When is the third stage of acute inflammation?

24-96 hours

When is the fourth stage of acute inflammation?

> 96 hours

what happens in the first stage of acute inflammation

preformed factors: antibodies, complement, serum factors, vasoactive factors

what happens in the second stage of acute inflammation

influx of neutrophils: kill bacteria

what happens in the third stage of acute inflammation

influx of macrophages: remove debris

what happens in the fourth stage of acute inflammation

adaptive immunity, T-lymphocytes are activated and migrate to inflammatory site