Advanced Pathophysiology
Musculoskeletal System Review
Integumentary System Review
Neurology System Review
Cranial Nerves
Stroke
Headache/Migraine
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Aging Changes:
Thinner, drier skin; reduced sensory perception.
Primary vs. Secondary Lesions:
Understand variations like nodules, papules, and cysts.
Pressure Ulcers:
Stages of ulcers from non-blanchable erythema to full tissue loss.
Pruritus:
Pathological itching, mediated by specific nerve fibers.
Bacterial and Viral Infections:
Examples include folliculitis and shingles; common skin concerns.
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.
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.
Focal vs. Diffuse Brain Injuries:
Differentiate types of concussions and traumatic brain injuries.
CVA Types and Mechanisms:
Thrombotic, embolic, and hemorrhagic strokes; identification of stroke types.
Migrant vs. Tension-Type:
Differentiate headaches based on etiology and presenting features.
Meningitis Types:
Overview of bacterial, viral, and fungal forms with characteristics.
Alzheimer's Pathophysiology:
Understand the amyloid hypothesis; clinical presentation differentiation.
Herniation Syndromes:
Understand risks and manifestations from brain tissue displacement.
Understanding the CNS:
Anatomy of spinal cord and functions of major brain regions.
Neuroanatomy of Pain:
Pain pathways and how sensory signals are transmitted to the CNS.
Functional Structure:
Differentiate between voluntary and involuntary control structures.
Protection and Permeability:
Components of the barrier and critical factors affecting its integrity.
Peripheral Nervous System Functionalities:
Overview of pain signal transport and responses through the PNS.
CSF Flow and Hydrocephalus Types:
Identifying distinct forms based on causes and mechanism.