med term exam 2

structure of integumentary system

• epidermis: avascular

  • stratum corneum: largest layer of epidermis

    • thicker in “thick skin” areas

  • basal layer: bottom layer of epidermis

    • gives rise to new cells

    • contains melanocytes: melanin protects from UV radiation

• dermal papillae: helps attachment of dermis to epidermis, creates fingerprints

• dermis:

  • aka “hypodermis” “corium”

  • below epidermis

  • vascular & living tissue

• subcutaneous tissue: below dermis, adipose tissue

• accessory organs:

  • glands:

    • sebaceous: oil - sebum

    • sudoriferous: sweat

  • hair

  • nails

functions of integumentary system

• covers & protects from pathogens/other harmful substances

• produces secretions from sweat/oil glands

• provides nerve endings for sensations (heat, cold, pressure, touch)

• regulate body temperature (from sweating)

• synthesizes vitamin D

• color - melanocytes produced in basal layer

skin lesions

doesn’t have to be something wrong, just describing thing on skin

primary

• flat lesions

  • macule: flat, pigmented, <1cm

    • ex. freckle, flat mole

• elevated lesions

  • solid

    • papule: solid, elevated, <1cm, can be same color or different color from the skin

      • ex. Wart, pimple, ringworm, psoriasis, eczema

    • nodule: palpable, larger & deeper than papule (0.6-2 cm), extends into dermis

      • ex. benign/malignant tumor

    • tumor: solid, elevated, >2cm, extends into dermis & subcutaneous tissue

      • ex. lipoma

    • wheal: elevated, firm, round, localized skin edema (swelling), varies in size shape & color, paler in the center than edges, itching

      • ex. hives, insect bites

  • fluid filled

    • vesicle: elevated, fluid filled, <0.5 cm

      • ex. poison ivy, shingles, chicken pox

    • pustule: small, raised, contains pus, usually <1 cm

      • ex. acne, furuncle, scabies

    • bulla: vesicle or blister >1 cm

      • ex. 2nd degree burns, poison ivy

secondary

• excoriations: linear scratch marks or traumatized abrasions of the epidermis

  • ex. scratches, abrasions, chemical/thermal burns

• fissure: small slit or cracklike sore, extends into dermis, can be caused by continuous inflammation and drying

• ulcer: open sore or lesion, extends into dermis, usually heals w/ scarring

  • ex. pressure sore, basal cell carcinoma

burns

3 classifications:

• 1st degree: change in color of skin, superficial

• 2nd degree: blisters, burns into upper layer of dermis

• 3rd degree: charring, through dermis, sometimes into hyperdermis & bone, worry about infection (barrier loss), water loss

caused by UV, hot objects, chemical burns, electrical burns

rule of 9s: used to estimate burn percentage to determine appropriate treatment

skin cancer

basal cell carcinoma: usually localized

squamous cell carcinoma:

• if caught early = localized

• exposure to UV

• radiation therapy causes, exposed to carcinogens

malignant carcinoma:

• high death rate

• if not caught early, spreads easily

• UV main cause

keloid

thickened scar that forms after surgical incision or injury

firm, raised, often purplish-red

laser therapy: help flatten scar & fade color

• might need more than one treatments (keloids can be resistant)

basal cell carcinoma

most common type of skin cancer

arises in basal cell layer of epidermis

flesh colored or brown (later stage)

slow growing & destructive

rarely metastasizes (moves to another part of the body), but is invasive

occurs mostly in blond, fair-skinned individuals

signs & symptoms:

• tumor mainly seen in sun exposed parts of the body (face)

• can also occur in other parts of the body not exposed to sun

• pearly white/waxy bump, often w/ visible blood vessels

• bump can bleed, develop crust, form deep depression

treatment:

• goal: completely eradicate lesions

• type of treatment determined by size, shape, location, & invasiveness

• curettage & electrodesiccation (go in & kill cells)

• cryotherapy & laser therapy

• chemotherapeutic drugs (less likely)

• surgical excision (90% of cases)

• irradiation or chemosurgery

abscess

• Localized collection of pus at the infection site (characteristically a staphylococcal infection)

• Most common sites on hairy parts of the body exposed to irritation, pressure, friction, or moisture

• Two types:

  • Furuncle (or boil): abscess in a hair follicle & adjacent subcutaneous tissue

  • Carbuncle: several furuncles developing in adjoining hair follicles w/ multiple drainage sinuses

• Signs & symptoms:

  • Affected portion of skin possibly extremely tender, painful, & swollen

  • Abscess possibly enlarged, softened, open, discharging pus & necrotic material

  • Erythema & edema possibly persisting at the site for days-weeks

  • Possibly accompanied by mild fever

• Treatment:

  • Cleaning infected area w/ soap & water

  • Applying hot, wet compress to area to promote vasodilation & drainage from lesions

  • Administering topical antibiotics

  • Incision & drainage (I&D): possibly necessary after lesion matured

psoriasis

• Chronic, noninfectious, inflammatory skin disease

• Circumscribed (round) red patches covered by thick, dry, silvery, adherent scales

• Epidermal cells produced 6-9x faster than normal

• family history is common

• May begin at any age

  • Condition possibly severe if onset is in childhood

• Signs & symptoms:

  • Excessive development of the basal layer of the skin

  • Affective areas typically appear dry, cracked, & encrusted

  • Buildup of skin composed of living & dead tissue

  • Pruritus: itching, common complaint

  • Common sites: scalp, knees, elbows, umbilicus, genitalia

• Treatment:

  • Depends on type, disease extent, effect on patient

  • Palliative only - no cure

  • Topical application of medications: coal tar, vitamin D, corticosteroid drugs, wet dressings

  • Ultraviolet (UV) treatment

  • Sebaceous (oil)

  • Exposure amount depends on condition, pigmentation, & susceptibility to burning

  • UVB light (natural sunlight to the point of minimal erythema)

  • UVA light from artificial source

  • Excimer laser - more powerful form of UVB light therapy to eliminate plaques & control scaling & inflammation

acne vulgaris

• Inflammatory skin disease of sebaceous glands & hair follicles

  • Hair follicles are openings in the skin which allow opportunities for bacteria to enter

• Appearance of: comedos (blackheads/whiteheads), papules (solid elevations <1cm), pustules (raised areas of skin filled w/ pus)

• Most commonly on face, chest, back, shoulders

• Caused by hormone change (but can happen at any time), stress, external irritants

• Underlying cause of genetic predisposition

• Signs & symptoms:

  • Acne plug commonly appears first as:

    • Open comedo (blackhead) or closed comedo (whitehead)

    • Color of comedo is caused by melanin produced by follicle, not dirt

  • Eventual enlargement & rupture or leak of plug - spreads contents to dermis

    • Results in inflammation & acne pustules/papules

    • Development of scars if chronic irritation continues

• Treatment:

  • Goals: reduce bacteria count, decrease sebaceous gland activity, prevention of inflammation of follicle

  • Topical antibacterial solution, orally administered antibiotics, or both

  • Skin kept clean & dry

scabies

• Contagious - results of infestation of itch mite

• Transmitted by direct skin-to-skin contact & prolonged contact w/ infected clothing, bedding, small animals

• Signs & symptoms:

  • Asymptomatic while parasite multiplies

  • Parasite burrows causing short, wavy, brownish-black lines

  • Itching & rash

  • Lesions caused by scratching, makes it harder to diagnose

  • Commonly between fingers, in axillae, on waist, wrists, elbows, nipples, buttocks, & genitalia

• Treatment:

  • Topical scabicide (cream/lotion) for chemical disinfection

    • Applies all over body in order to kill all the mites

  • Antipruritics & oral antihistamines to reduce itching

impetigo

• Common, contagious, superficial skin infection

• Fluid filled blister, becomes pustular, ruptures & forms yellow crust

  • Vesicle: small, fluid filled blister

  • Bulla: large, fluid filled blister

• Signs & symptoms

  • Lesions - start as macules, vesicles, & pustules

  • Rupture of primary lesion, leaves honey colored liquid

  • Hardening of liquid leaves yellow crust

  • Can occur anywhere, but common near mouth, nose, neck, extremities

  • Possible erythema w/ ulcerations & scarring

• Treatment

  • Topical antibiotics, oral antibiotics, or both

  • Cleansing of lesions

  • Good hygiene to prevent spread

debridement

removal of foreign material from dead/damaged tissue

mohs surgery

removal of thin layers of skin cancer, tumors w/ irregular shapes & depths

microscopic examination of each layer

repetition of procedure until no cancerous cells remain

skin graft

skin transplantation

allograft:

• other, differing (other person)

• often temporary

• opt for autograft when possible

• aka homograft

autograft:

• self, own

• permanent, usually not rejected

synthetic:

• artificial, mesh

• helps wound healing while skin grows back

xenograft:

• foreign (other species)

• typically transplant of dermis, temporary

• aka heterograft

scratch (prick) skin test

scrape skin, place allergen, see results

intradermal allergy skin test

inject small amounts of allergen into skin, observation for reaction

biopsy

tissue sample removed for microscopic examination

Integumentary Pharmacology

• Antibiotics: stop bacteria from multiplying

• Antifungals: places where skin holds onto moisture attracts fungi (under nails, between toes, groin)

• Antipuritics: relieves/prevents/stop itching

• Corticosteroids: helps inflammation

oral cavity

1.

where digestion starts

teeth: mechanical digestion, mastication

• enamel, dentin (structure), pulp (inner most), gingiva (gums)

• contains nerve endings

salivary glands: chemical digestion

after food leaves mouth, now bolus

pharynx

2.

throat

uvula

epiglottis: flap of cartilage, closes trachea when swallowing

esophagus

3.

muscular transport tube

stomach

4.

food reservoir

mechanical & chemical digestion

sphincters:

• esophageal sphincter: prevents reflux into esophagus

• pyloric sphincter: prevents leakage into intestines

smooth muscle churns: longitudinal, circular, oblique

portions of stomach:

• cardia

• fundus

• corpus

• pylorus

rugae: finger-like projections, folds, allows for greater surface area

after bolus leaves stomach, now chyme

small intestine

5.

20ft

main place we take in nutrients

segments:

• duodenum

• jejunum

• ileum

villi: finger-like projections, increases surface area, catches/traps chyme to absorb nutrients into bloodstream

ileocecal valve: allows anything left in small intestine into large intestine

large intestine

6.

5ft

sections:

• cecum

• colon:

  • ascending

• hepatic flexure

  • transverse

• splenic flexure

  • descending

  • sigmoid

• rectum

• anus

purpose is to reabsorb water

feces

appendix: offshoot of large intestines

accessory organs

secrete enzymes & promote digestion

liver

• aids in digestion

• stores vitamins

• regulates blood glucose

• detoxes chemicals

• creates blood proteins (ex. albumin, prothrombin)

• destroys old erythrocytes

• produces bile: digests fats

  • bile salts & cholesterol

    • breaks down & emulsifies fats

• 2 ducts:

  • left hepatic duct

  • right hepatic duct

    • merges into common hepatic duct

gallbladder

• stores bile

• releases stored bile to digest

• cystic duct

pancreas

• releases digestive enzymes & insulin

• endocrine function: secretes into bloodstream (insulin)

• exocrine function: secretes into duct (digestive enzymes)

• pancreatic duct

intussusception

one part of intestines slides into another, causing intestinal blockage, can cut off blood supply

• Rare, but serious

• Usually occurs in infants/young children

• Typically occurs in small intestine/junction between terminal ileum & cecum

• Signs & symptoms:Intense crying,vomiting,lethargy,bloody jelly-like stool

• Diagnosis: abdominal ultrasound (imaging test)

• Treatment: nonsurgical: contrast enema (both diagnose & treat)

  • If fails/intestine damaged/signs of complications: surgery required

appendicitis

inflammation of appendix

• Usually results from obstruction/infection caused by fecalith (hard mass of fecal matter), foreign body, bacteria

• Signs & symptoms: 

  • Pain, usually localized to right lower quadrant

    • Sudden, spontaneous relief indicates ruptured appendix

  • Fever, discomfort, diarrhea, constipation, tachycardia

• Treatment:

  • Appendectomy: surgery within 48hrs of first symptoms, delay could result in rupture

diverticulitis

acute inflammation of diverticulae (small pouches in the large intestine)

• Diverticulosis: presence of diverticulae w/o inflammation 

• Signs & symptoms:

  • Varies in intensity & duration

  • Bowel changes, alternating between constipation & diarrhea

  • LLQ tenderness & pain

  • Bleeding, weakness, fever, fatigue, anemia

  • Possible rupture, leading to peritonitis

• Treatment:

  • Focus on clearing inflammation & infection, resting colon, preventing/minimizing complications

  • IV antibiotics

  • Few days w/o food or drink (to help rest colon)

  • Colon resection for severe cases, temporary colostomy while colon heals

cholelithiasis & choledocholithiasis

• formation/presence of gallstones within gallbladder or bile ducts

  • Signs & symptoms: 

    • Possibly asymptomatic

    • “Attack”: biliary colic, caused from bile duct obstruction

    • URQ pain, radiates to shoulder & back

    • Nausea & vomiting

    • Ingestion of large/fatty meals

  • Treatment:

    • Nonsurgical: if asymptomatic

      • Extracorporeal shock-wave lithotripsy

      • Dissolution of cholesterol-based stones through bile acid therapy

        • Inhibits synthesis & secretion of cholesterol within liver, alters composition of bile

        • Existing stones can be decreased in size or dissolve entirely

    • Surgical: 

      • Laparoscopic cholecystectomy (for cholelithiasis) - minimally invasive

        • Most common

      • Choledocholithotomy (for choledocholithiasis)

        • Incision into common bile duct to remove stones

anastomosis

connection between 2 vessels, surgical joining of 2 ducts/blood vessels/bowel segments to allow flow from one to the other

ascites

abnormal accumulation of fluid in peritoneal cavity

borborygmus

audible abdominal sound caused by passage of gas through liquid contents of intestine

cachexia

state of ill-health, malnutrition, & wasting that can occur in many chronic diseases, malignancies, & infections

dysentery

diarrhea containing blood & mucus, resulting from inflammation of walls of gastrointestinal tract, especially the colon

volvulus

twisting of bowel on itself, causing obstruction

Bariatric surgery

Surgical alteration of stomach as treatment for morbid obesity

Arises from accumulation of excess weight, resulting in health problems

colostomy

Excision of diseased part of colon & creation of new opening in abdominal wall - fecal flow is diverted to a colostomy bag

Permanent or temporary

Performed as treatment for cancer or diverticulitis

Polypectomy

Excision of small, tumor-like benign growths (polyps) that project from mucus membrane surface

Endoscopy

Visual examination of interior of organs & cavities w/ specialized lighted instrument called an endoscope

Endoscopes named for organ, cavity, or canal being examined

Colonoscopy

Examination of entire length of colon

Examination of only the lower third of the colon is: sigmoidoscopy

Barium enema

X-ray of rectum & colon following administration of barium sulfate into rectum

Barium swallow

X-ray of esophagus, stomach, & small intestine following oral administration of barium sulfate

Ultrasonography (US)

High-frequency sound waves (ultrasound) directed at soft tissue to produce image on a monitor of internal body structures

Stool guaiac

Lab test that detects presence of hidden blood in feces

Stool culture

Lab test that identifies microorganisms/parasites present in feces that cause gastrointestinal infection

Digestive Pharmacology

• Antacids: counteract/neutralize acidity, usually in stomach

• Antidiarrheals: control loose stools & relieve diarrhea

• Antiemetics: control nausea & vomiting

• Laxatives: treat constipation

upper respiratory tract

• Nose: where respiration begins

  • Nasal cavity: mucus membrane, cilia (hairs) trap substances, heats & moistens air

  • Cartilage mostly

• Pharynx: (throat)

  • Nasopharynx, oropharynx, laryngopharynx

  • Adenoids (pharyngeal tonsils, palatine tonsils - oropharynx) - trap bacteria

• Larynx: (voice box), vocal cords

  • Epiglottis: closes trachea when swallowing

• Trachea: (windpipe), rings of cartilage for structure to keep tube open

lower respiratory tract

• Bronchi: trachea separates into right & left bronchus

  • Also contains rings of cartilage

  • Branch into smaller bronchioles (make up bronchial tree)

    • Branch further into alveoli: sacs for O₂/CO₂ exchange

• Contains cilia (in trachea & bronchi) to filter

• Moves air over largest surface area as quickly as possible

• Composed of smooth muscle to allow for contraction/expansion

• Diaphragm: 

  • Contracts to flatten & increase volume of thoracic cavity to cause pressure difference to expand lungs

  • Relaxes to push air out

steps of respiration

1. Pulmonary ventilation: movement of air in/out of lungs

2. External respiration: exchange of gas (O₂/CO₂) through alveoli & surrounding capillaries

3. Gas transport: cardiovascular system carries O₂ from lungs to tissues & CO₂ back to the lungs

4. Internal respiration: exchange of gas between bloodstream & cells/tissues of the body

Bronchopneumonia

• Pneumonia: bacterial infection of the lungs

• Most common (mostly in young children, elderly, & immunocompromised) 

• Affects bronchi & alveoli

• Symptoms: cough, fever, shortness of breath, chest pain, fatigue

• Diagnosis: high white blood count on CBC, patchy infiltrates in lower lobes of lungs (spots of abnormal fluid/pus/cells spread unevenly), audible crackles in lower lungs & increased respiratory rate

• Treatment: oral antibiotics, rest

COPD

• chronic obstructive pulmonary disease

• Long-term lung condition, blocks airflow & makes it difficult to breathe

• Umbrella term for progressive lung diseases that cause permanent damage to airways:

  • Emphysema:

    • Decreased alveolar elasticity

    • Alveoli unable to fully contract (no troubles w/ expansion tho)

    • Signs & symptoms:

      • associated w/ long-term/heavy smoking

      • “Barrel chest”: result of trapped air in lungs

      • Difficulty breathing, shortness of breath

      • Easier to breathe sitting upright/standing

    • Treatment:

      • Bronchodilators: relax/widen air passages

      • Inhaled steroids

      • Antibiotics (if acute bronchitis/pneumonia develops)

      • Supplemental oxygen therapy

  • Asthma:

    • Spasms of smooth muscles in bronchial passages

    • Attacks are sudden & violent (paroxysms)

    • Triggers: allergens, irritants, exercise, cold, stress

    • Signs & symptoms: wheezing, dyspnea, coughing w/ large amounts of mucus secretions

    • Treatment: 

      • Avoidance of triggers

      • Mucolytics to loosen mucus

      • Bronchodilators to relax smooth muscles

      • Hospitalization for uncontrolled/severe

  • Chronic bronchitis:

    • Inflammation of bronchial passages

    • Commonly caused by constant irritation (smoke, pollution, dust, chemical exposure)

    • Other causes: viral & bacterial infections

    • Signs & symptoms: productive cough, chest discomfort, morning “smoker’s” cough

    • Treatment: 

      • Refrain from tobacco use

      • Antibiotics for bacterial causes

      • Inhalers w/ various medications depending on cause

      • Respiratory therapy

Pulmonary embolism

• Foreign object that travels through bloodstream & gets lodged in the vessels of the lungs (clot, air, fat)

• Signs & symptoms:

  • shortness of breath

  • Chest pain

  • Hemoptysis (coughing blood)

  • Edema

  • Acrocyanosis (fingers/toes turning blue)

  • Finger clubbing (fingertips bulge, nail curves)

• Treatment:

  • Anticoagulant therapy

  • Thrombolytics (clot busters)

  • Insertion of small filters to remove embolism from bloodstream

  • Surgical embolectomy

• Most commonly formed in legs

sleep apnea

• Breathing at night stops/starts repeatedly

• Accompanied by loud snoring

• More common in males/older adults

• 3 forms:

  • Obstructive: throat muscles relax bc of obstruction of airway (ex. soft palate or obesity)

  • Central: brain doesn't send proper signals to muscles that control breathing

  • Complex: combination of obstructive and central

• Signs & symptoms:

  • Long pauses between periods of regular breathing

  • Snoring

• Treatment:

  • Continuous positive airway pressure (CPAP) to keep airway open

  • Tonsillectomy & adenoidectomy (T&A)

  • Uvulopalatopharyngoplasty (UPP)

  • Apnea monitor

lung cancer

• Occurs in trachea, bronchi, alveoli

• Leading cancer killer

• Initial stages are asymptomatic

• Commonly metastasizes to surrounding tissue

• Signs & symptoms:

  • Chronic cough & wheezing

  • Chest pain, dyspnea

  • Hemoptysis

  • Risk factors: chemical exposure, smoking

• 2 types:

  • Non-small cell cancer (NSLC)

  • Small cell lung cancer (SCLC) aka oat cell cancer

• Treatment:

  • Surgery

  • Radiation therapy

  • Chemotherapy

  • Combination

Atelectasis

collapsed/airless condition of the lungs

Consolidation

process of becoming solid (describing an engorged lung)

Coryza

acute inflammation of the nasal mucosa accompanied by profuse nasal discharge, aka rhinitis or a cold

Epistaxis

bleeding from the nose, aka nosebleed, nasal hemorrhage, rhinorrhagia

Rhonchi

abnormal respiratory sound resembling snoring, caused by blockage in larger airways

Stridor

high-pitched sound during inspiration, can indicate serious airway obstruction

Endotracheal intubation

• Tube placed through mouth into pharynx, larynx, & trachea

• Used to establish open airway

  • Administration of medications

  • Facilitate breathing in anesthetized patient

Tracheostomy

• Surgical opening into trachea through neck

• Performed to bypass obstruction, clean/remove secretions, deliver oxygen, treat breathing disorders

Lavage

• Irrigation of paranasal sinuses to remove mucus/pus from sinuses

Postural drainage

• Body positioned so gravity helps remove secretions from lung/bronchi

Polysomnography

• Tests sleep cycles for patients w/ sleep disorders

• Records brain waves (EEGs), electrical activity of muscles, eye movements, respiratory rate, blood pressure, oxygen saturation, & heart rhythm

• Helps differentiate between sleep disorders: sleep apnea, sleep walking, teeth grinding, hypersomnia

Pneumonectomy

• Surgical procedure to remove lung/portion of lung

• 4 types:

  • Wedge resection

    • Removal of small wedge-shape section of lobe of the lung

    • Performed for biopsy or for small tumors

  • Segmental resection

    • Removal of larger part of lobe, but not entire lobe

  • Lobectomy

    • Removal of entire lobe of lung

    • Bilobectomy: removal of 2 lobes

  • Pneumonectomy

    • Removal of entire lung

    • Open chest procedure (thoracotomy) 

Septoplasty

• Correction of deviated nasal septum (dividing partition separating right & left nostrils)

• Difficulty breathing caused by deviation of septum can impede airflow

• Removal of cartilage or bone usually required to restore normal nasal breathing

Laryngectomy

• Removal of all/part of larynx

• Results in separation of airway from mouth, nose, & esophagus

• Patient breathes through tracheostomy

Bronchoscopy

• Specialized endoscope (bronchoscope) inserted through mouth/nose

• Enables examination of larynx, trachea, bronchi, & bronchioles

• Enables tissue biopsy & removal of obstruction

• Aids in other diagnostic & therapeutic procedures

Continuous positive airway pressure (CPAP)

• Pump that forces air through mask to keep air passages open, especially in sleep apnea

Throat culture

• Identifies microbe (bacteria/fungus) causing throat infection

Thoracentesis

• Removal of fluid from pleural space for diagnostic/therapeutic purposes

Aerosol therapy

• metered-dose inhalers (MDIs) deliver specific amount of aerosolized medication

• Most common delivery method for COPD

• Nebulized mist treatments (NMTs) deliver medications as fine mist directly into lungs when patient inhales

  • Effective for infants, small children, & those who can't use inhalers

Arterial blood gas (ABG)

• Measures amount of oxygen & carbon dioxide, & pH balance in blood sample from artery

Magnetic resonance imaging (MRI)

• Uses strong magnets & radio waves to create detailed images of organs & soft tissues in the body

Pulmonary function tests (PFTs)

• Breathing exam that measures how well lungs take in air, hold air, move air out, & transfer oxygen into blood

Sweat test

• Measures amount of chloride (salt) in sweat to primarily diagnose/rule out cystic fibrosis

Helical CT (HCT)

• X-ray tube rotates continuously around patient to create complete 3D image

Bronchoscopy

visual examination of bronchi

Thoracentesis, thoracocentesis

surgical puncture of chest

Tracheostomy

 forming opening in trachea

Laryngoscopy

visual examination of larynx

Laryngoscope

instrument for examining the larynx

Tracheotomy

incision of the trachea

Radiography

process of recording radiation/x-ray

Oximetry

act of measuring oxygen

Spirometry

act of measuring breathing

Respiratory Pharmacology

• Bronchodilators: drugs used to increase airflow by dilating constricted airways of bronchioles & bronchi

• Corticosteroids: act on immune system by blocking substances that trigger allergic & inflammatory actions

• Decongestants: constrict blood vessels of nasal passages, causing swollen tissues to shrink

• Antitussives: relieve/suppress coughing by blocking cough reflex in medulla of the brain

heart

• Muscular pump

• Layers:

  • Endocardium: inner lining of the heart

  • Myocardium: muscular part of the wall

  • Epicardium: top layer of heart, visceral layer

  • Pericardium: sac enclosing the heart

    • Pericardial cavity: holds pericardial fluid that resists friction when the heart contracts

• Propels blood to transport respiratory gases, nutrients, & waste

• Circulates blood to the lungs for gas exchange

  • Right side: pulmonary circulation - sends blood to lungs for O₂

  • Left side: systemic circulation - sends blood to body

• Chambers:

  • Right atria: receives deoxygenated blood from vena cava

  • Left atria: receives oxygenated blood from lungs

  • Right ventricle: pumps blood to lungs for oxygenation (pulmonary circulation)

  • Left ventricle: pumps blood through aorta to body (systemic circulation)

• Valves: prevents regurgitation of blood

  • Tricuspid valve: right ventricle - right atrium

  • bicuspid/mitral valve: left ventricle - left atrium

  • Pulmonic valve: pulmonary artery - right ventricle

  • Aortic valve: aorta - left ventricle

blood vessels

• Arteries

  • Carry oxygenated blood away from the heart

  • Except pulmonary artery that carries deoxygenated blood away from the heart to the lungs to become oxygenated

  • 3 layers:

    • Tunica externa: connective tissue, provides strength

    • Tunica media: smooth muscle, determines size of lumen (contracts & relaxes/vasoconstriction & vasodilation)

    • Tunica intima: thin, endothelial cells

• Capillaries

  • Connect arteries and veins

  • Monolayer of epithelial cells to allow for exchange of gas, nutrients, & waste

  • Small size allows for slower blood flow to give time to allow for exchange

• Veins

  • Carries deoxygenated blood to the heart

  • Except for pulmonary vein which carries oxygenated blood back to the heart from the lungs for distribution throughout the body

  • Contains valves to help the return of blood - helps work against gravity

  • Contraction of muscles helps move blood

Heart failure

• Inability of the heart to pump sufficient blood to meet metabolic needs of the body

• Common causes:

  • Coronary artery disease

  • Hypertension

  • Diabetes

  • Obesity

• congestive heart failure

  • Specific type of heart failure that occurs when blood returning to the heart backs up

  • Causes fluid to accumulate in the lungs (pulmonary edema)

  • Additional fluid can accumulate in the liver, abdomen, & lower extremities

Arteriosclerosis

• Progressive, degenerative disease of the arteries

• Commonly caused by buildup of fatty plaque (atheroma)

• Commonly affects coronary & carotid arteries

• Causes wall weakness, loss of elasticity, & blood clot formation

• Signs & symptoms:

  • Depends on location

    • Carotid artery: stroke symptoms, vision problems, dizziness, confusion, headaches

    • Coronary artery: chest pain, shortness of breath, palpitations, weakness, nausea

    • Peripheral arteries of the legs: muscle cramping, pain triggered by walking, can be asymptomatic

• Treatment: 

  • Pharmacological:

    • Decrease blood cholesterol level

    • Control blood clotting

  • Surgical

    • Endarterectomy

    • Vascular bypass surgery

    • Stenting

Coronary artery disease

• Any disorder of the coronary arteries that affects their ability to deliver blood to the myocardium

• Partial occlusion: distal tissues become ischemic, compromises heart function

• total/almost total occlusion: death of distal tissues (infarction/necrosis)

• Most commonly caused by arteriosclerosis

• Possible blood-clot formation or rupture caused by plaque

• Risk factors:

  • Smoking

  • Stress

  • Physical inactivity

  • family history

  • Diabetes

  • Obesity

  • Elevated blood cholesterol

• Signs & symptoms:

  • Chest pain

  • Shortness of breath

  • Diaphoresis (abnormal sweating)

  • Pallor (paleness)

• Treatment: 

  • lifestyle changes:

    • Quit smoking

    • Low fat diet

    • Regular exercise

    • Weight & stress management

  • Pharmacological:

    • Control of chest pain, hypertension, & triglyceride levels

    • Anticoagulant therapy

  • Surgical intervention:

    • Percutaneous transluminal coronary angioplasty

    • Coronary artery bypass graft

Aneurysm

• Local dilation of an artery

• Can cause thrombus formation, hemorrhage from rupture, or ischemia

• Commonly located in aorta of abdomen or chest & brain

• 3 main types

  • Fusiform (spindle shaped)

  • Saccular (sac shaped)

  • Dissecting (separated layers of vessel wall)

• Signs & symptoms:

  • Possibly asymptomatic

  • Pulsating middle & upper abdominal mass (in slender patient)

  • mild/severe weakness

  • Sweating

  • Tachycardia

  • Hypotension

• Treatment:

  • Depends on location, size, likelihood of rupture

  • Aortic aneurysm

    • Endovascular stent - graft surgery

    • Open surgical treatment - placement of synthetic or stent graft

  • Brain aneurysm

    • Only for cases w/ high rupture risk

vericose veins

• Twisted, enlarged veins caused by blood pooling in veins - especially in legs

  • Pressure on valves from blood overcoming gravity on its way back to the heart

  • Valves weaken & become incompetent

• Common locations:

  • Lower legs

  • Esophagus (esophageal varices)

  • Rectum (hemorrhoids)

• Signs & symptoms:

  • Engorged, twisted veins of the legs

  • Pain

  • Edema

  • Skin ulcers

  • Burning sensation

  • Itching

• Treatment:

  • Lifestyle changes:

    • Avoiding long periods of standing

    • Elevating legs as much as possible

    • Wearing compression stockings

  • Surgery:

    • Sclerotherapy

    • Laser ablation

    • Radiofrequency ablation

Arrhythmia

inability of the heart to maintain a normal sinus rhythm, aka dysrhythmia

Embolus

mass of undissolved matter (foreign object, gas, tissue, thrombus) circulating in the blood until it becomes lodged in a vessel

Hypertension

in adults, persistently elevated blood pressure that exceeds <140mm/<90mm (either/or)

Infarct

area of tissue that undergoes necrosis following cessation of blood supply