advanced patho bonus

Page 1: Overview of Systems Review

• Advanced Pathophysiology

• Musculoskeletal System Review

  Integumentary System Review

• Neurology System Review

  • Cranial Nerves

  • Stroke

  • Headache/Migraine

Page 2: Musculoskeletal Physiology

• Bone Cells:

  • Osteoblasts:

    • Bone forming cells.

    • Synthesize osteoid (un-mineralized bone matrix) turning into mature bone.

  • Osteoclasts:

    • Bone resorbing cells.

    • Secrete HCl and protease enzymes to dissolve bone minerals.

    • Resting phase when not resorbing.

  • Osteocytes:

    • Bone maintaining cells.

    • Coordinate osteoblast and osteoclast functions and respond to PTH.

• Compact vs. Spongy Bone:

  • Compact Bone:

    • Strong, solid; main structure of the skeleton containing Haversian systems.

  • Spongy Bone:

    • Contains red marrow, lacks Haversian systems; consists of trabeculae.

• Ground Substance Importance:

  • Facilitates diffusion between blood vessels and bone.

• Diaphysis Contains:

  • Yellow marrow.

• Bone Remodeling & Repair Basics:

  • Phases: Activation, resorption, new bone formation.

  • Final step in bone formation: Mineralization.

Page 3: Joint Classifications

• Movement Based:

  • Synarthrosis: Immovable joints.

  • Amphiarthrosis: Slightly movable joints.

  • Diarthrosis: Freely movable joints.

• Structure Based:

  • Fibrous Joints:

    • Connected by dense fibrous tissue (e.g., sutures in skull).

  • Cartilaginous Joints:

    • Pad/disk of fibrocartilage or hyaline cartilage (e.g., symphysis pubis).

  • Synovial Joints:

    • Complex, include synovial fluid for lubrication.

• Articular Cartilage:

  • Reduces friction in joints, slow regeneration after injury.

• Muscle Fiber Types:

  • Myofibrils as the functional units of contraction.

  • White Muscle (Type II): Fast fibers.

  • Red Muscle (Type I): Slow fibers.

Page 4: Muscle Contraction Basics

• Muscle Membrane Components:

  • Sarcolemma: Spreads impulse.

  • Basement Membrane: Maintains cell shape.

• Muscle Contraction Phases:

  • Excitation: AP triggers Ca2+ release via Ryanodine receptors (RyRs).

  • Coupling: Ca2+ allows actin to bind myosin.

  • Contraction: Muscle shortening via cross-bridge formation.

  • Relaxation: Cross-bridge detachment and lengthening of sarcomeres.

• Types of Contraction:

  • Isometric: Muscle length constant; tension increases.

  • Isotonic: Muscle length changes while maintaining tension.

• Bone/ Muscle Attachments:

  • Ligaments connect bone to bone; tendons connect muscle to bone.

Page 5: Aging of Musculoskeletal System

• Bones:

  • Loss of density, stiffness, brittleness, and strength.

• Joints:

  • Decreased flexibility and increased fragility.

• Muscles:

  • Sarcopenia, loss of strength/bulk, decreased metabolic rate.

• Exercise Benefits:

  • Improves strength, balance, and mobility; lowers fall risks.

Page 6: Fractures and Healing Phases

• Types of Fractures:

  • Complete: Broken all the way through.

  • Incomplete: Still in 1 piece (e.g., greenstick common in children).

  • Comminuted: More than two fragments.

  • Linear, Oblique, Spiral, Transverse, and Stress Fractures.

• Fracture Healing Phases:

  • Inflammatory Phase: Formation of hematoma within 3-4 days.

  • Repair Phase: Granulation tissue forms.

  • Remodeling Phase: Callus is reabsorbed, new healthy bone forms.

Page 7: Injuries and Conditions

• Support Structure Injuries:

  • Dislocation: Temporary bone displacement from a joint.

  • Subluxation: Partial joint contact loss.

  • Sprains and Strains: Injuries to ligaments and tendons, respectively.

• Tendinopathy Types:

  • Epicondylitis: Inflammation at tendon insertion points (e.g., tennis elbow).

  • Tendinitis and Tendinosis: Inflammation and degeneration of tendon.

  • Bursitis: Inflammation of bursa sacs due to repetitive trauma or infection.

Page 8: Muscular Pathology

• Myositis Ossificans:

  • Calcification in muscle due to injury, leading to "rider’s bone."

• Rhabdomyolysis:

  • Muscle breakdown leads to myoglobin released into the bloodstream.

  • Symptoms include muscle pain, dark urine.

• Compartment Syndrome:

  • Increased pressure in a muscle compartment leading to potential ischemia.

  • Symptoms include the "5 P's": pain, paresthesia, pallor, pulselessness, paralysis.

Page 9: Osteoporosis and Bone Conditions

• Osteoporosis:

  • Characterized by low bone density; imbalance in resorption and formation.

• RANKL System:

  • RANKL inhibits apoptosis of osteoclasts, leading to increased bone resorption.

• Osteomalacia:

  • Soft bones due to inadequate mineralization from vitamin D deficiency.

• Osteomyelitis:

  • Bone infection presenting with fever, pain, necrosis.

Page 10: Paget Disease & Joint Disease

• Paget Disease:

  • Excessive bone remodeling leading to enlarged, soft bones.

• Inflammatory vs. Noninflammatory Joint Disease:

  • Noninflammatory: No synovial inflammation and normal fluid.

  • Inflammatory: Synovial membrane damage present.

Page 11: Tumors and Arthritis

• Bone Tumors:

  • Tumors can arise from various tissues (e.g., osteosarcoma, chondrosarcoma).

• Arthritis Types:

  • Osteoarthritis: Noninflammatory degenerative condition.

  • Rheumatoid Arthritis: Autoimmune condition leading to systemic joint inflammation.

Page 12: Skin Injuries and Conditions

• Acne:

  • Common conditions like acne vulgaris and rosacea.

• Dermatitis:

  • Includes allergic, irritant contact dermatitis, and stasis dermatitis.

• Psoriasis vs. Pityriasis:

  • Psoriasis is an autoimmune condition characterized by thick, silvery lesions.

Page 13: Aging Skin and Lesions

• Aging Changes:

  • Thinner, drier skin; reduced sensory perception.

• Primary vs. Secondary Lesions:

  • Understand variations like nodules, papules, and cysts.

Page 14: Pressure Ulcers and Inflammation

• Pressure Ulcers:

  • Stages of ulcers from non-blanchable erythema to full tissue loss.

• Pruritus:

  • Pathological itching, mediated by specific nerve fibers.

Page 15: Infections and Autoimmune Conditions

• Bacterial and Viral Infections:

  • Examples include folliculitis and shingles; common skin concerns.

Page 16: Neuroanatomy Overview

• Nervous Cell Types:

  • Neurons and neuroglial cells, including astrocytes for support.

• Brain and Spinal Cord Functions:

  • Interaction between CNS and PNS; maintain functions through intricate networks.

Page 17: Pain Mechanisms and Types

• Pain Pathways:

  • Differentiate between acute somatic and visceral pain types.

• Chronic and Neuropathic Pain:

  • Presence of ongoing pain linked to nerve damage, with specific symptoms.

Page 18: Brain Injury Types

• Focal vs. Diffuse Brain Injuries:

  • Differentiate types of concussions and traumatic brain injuries.

Page 19: Vascular Events

• CVA Types and Mechanisms:

  • Thrombotic, embolic, and hemorrhagic strokes; identification of stroke types.

Page 20: Headache Types

• Migrant vs. Tension-Type:

  • Differentiate headaches based on etiology and presenting features.

Page 21: CNS Infections

• Meningitis Types:

  • Overview of bacterial, viral, and fungal forms with characteristics.

Page 22: Alzheimer's and Neurodegeneration

• Alzheimer's Pathophysiology:

  • Understand the amyloid hypothesis; clinical presentation differentiation.

Page 23: Traumatic Brain Injuries

• Herniation Syndromes:

  • Understand risks and manifestations from brain tissue displacement.

Page 24: Central Nervous System Overview

• Understanding the CNS:

  • Anatomy of spinal cord and functions of major brain regions.

Page 25: Peripheral Nervous System Functions

• Neuroanatomy of Pain:

  • Pain pathways and how sensory signals are transmitted to the CNS.

Page 26: Nervous System Structure

• Functional Structure:

  • Differentiate between voluntary and involuntary control structures.

Page 27: Blood Brain Barrier Role

• Protection and Permeability:

  • Components of the barrier and critical factors affecting its integrity.

Page 28: Neuromuscular Pathway Understanding

• Peripheral Nervous System Functionalities:

  • Overview of pain signal transport and responses through the PNS.

Page 29: Hydrocephalus Understanding

• CSF Flow and Hydrocephalus Types:

  • Identifying distinct forms based on causes and mechanism.