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.

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