Pathology Flashcards

Pathology

Objectives

• Define key terms related to pathology.
• Analyze models of health and illness.
• Determine the four aspects of the biopsychosocial model of pain.
• Clarify the genetic aspects of health and illness.
• Explain the lifestyle factors that affect health.
• Describe health promotion and disease prevention and physical therapy practice implications.
• Assess epigenetics and implications for PT practice.
• Compare and contrast the increased health risks with obesity and physical therapist practice implications.
• Define stress and describe the impact of stress on the organism.
• Define and describe various psychiatric disorders.
• Discuss the impact of these disorders on the provision of healthcare services to the patient/client.
• Describe the role of the physical therapist in addressing the needs of the patient/client with these disorders.

Terms and Definitions

• Disease: Biologic/Psychologic changes leading to organ or system malfunction. Biomedical condition(s) causing disturbances in normal health. Objective changes that can occur without a person being aware of the illness.
• Illness: Perception/response of a person to not being well. Includes biologic, personal, interpersonal, & cultural reactions to disease. A person can feel ill without obvious pathologic process identified.

Illness Types

• Acute: Rapid onset & short duration, usually self-limiting, and responds to specific treatment.
• Subacute: Time course between acute & chronic, present for more than a few days but less than several months.
• Chronic:
  • Permanent impairment or disability.
  • Residual physical or cognitive disability.
  • Need for rehabilitation and/or long-term medical management.

Incidence and Prevalence

• Incidence: Measurement of the number of new cases of a disease during a particular period of time.Measures rate of occurrence of disease which leads to calculating to probability (risk) of being diagnosed with a disease during a given period of time.
• Prevalence: Refers to the total number of cases of a disease in a population during a specific time period. References how widespread a disease has become & Indicates impact of disease on population, including length of time disease has been encountered & old/new cases.

Etiology, Clinical Manifestations, Morbidity, Premorbidity, and Comorbidity

• Etiology: Cause(s) of a disease or condition.
• Clinical Manifestations:
  • Symptoms (subjective).
  • Sign (Objective).
• Morbidity: Diseased state or symptom.
• Premorbidity: State of function prior to disease.
• Comorbidity: More than one disease at the same time.

Mortality

• Mortality: Death.
• Mortality rate: Number of deaths due to disease/total population.
  • Taken according to age, sex, area, type of disease.
  • Several types: infant, perinatal, child, maternal, crude, standardized, & age-specific

Disability (WHO Definition)

• Physical and/or cognitive condition that limits a person’s movements, senses, or activities.
  • Impairments: problems in body function/structure.
  • Activity limitations: Difficulty in executing a task/action.
  • Participation restrictions: Difficulty with involvement in life situations.

Health Promotion and Disease Prevention

• Health Promotion: Built on the principles of self-responsibility, nutritional awareness, stress reduction and management, and physical fitness.
• Disease Prevention: More cost-effective than treating disease.
  • Primary: Remove or ↓ disease risk factors.
  • Secondary: Promote early detection, initiate preventive measures for complications.
  • Tertiary: Limit impact of established disease.

Disease Prevention Examples

• Primary: Good nutrition, calcium & D3 intake, regular weight bearing exercises, not smoking to prevent osteoporosis
• Secondary: Skin tests for TB, mammography, colonoscopy, routine cervical Pap smear
• Tertiary: Rehabilitation to return to highest level of function

Impact of Physical Therapy

• Earlier PT intervention leads to decreased acute care length.
• Major roles in secondary & tertiary care.
  • Secondary: Wide range of settings from hospitals to preschools.
  • Tertiary: highly specialized, complex, & technologically based settings.
• Prevention/Wellness Role:
  • Prevention/wellness activities.
  • Screening programs.
  • Promotion of positive health behaviors.

Clinical Models of Health

• Biomedical:
  • Model for centuries were all illness is due to disease and physiologic processes.
  • Psychologic, social and spiritual influences independence of disease.
  • Focuses on internal factors only.
  • Illness is a deviation of the healthy state
• Biopsychosocial:
  • Biologic, psychologic, and social variables: key factors in health and illness.
  • Mind and body cannot be separated.
  • Psychologic, cognition, emotion, motivation, with biologic/environmental factors = various health states.
  • Family, community, society interactions influence health outcomes.
• Biopsychosocial Spiritual:
  • Developed with advent of holistic health
  • Recognizes the healing potential of faith, spirituality and religious beliefs.
  • Social and spiritual support important for promotion of health, decreasing susceptibility to disease, and facilitating recovery.
• Social-Ecologic:
  • Theoretic principles for understanding interrelations among diverse personal and environmental factors in health and illness.
  • Health is affected by interaction between the individual, group/community, and physical, social, political environments.

Epigenetics: Behavioral, Social, Environmental Factors and Health Implications

• Epigenetics: Study of how behaviors and environment can cause changes that affect the way genes function. Based on Social-Ecological Model of Health.
• Describes heritable mechanisms that are reversible occurs without alteration of underlying DNA sequence.
  • The expression of DNA and subsequent reading of the gene can be altered or manipulated.
  • The mind considered "master controller" of gene expression, hence change occurs by becoming aware of individual perceptions, beliefs, and attitudes, behaviors, and lifestyle choices.

Epigenetics: Lifestyle Factors Influencing Health

• Cultural influences
• Socioeconomic status
• Generational Differences
• Adverse childhood experiences
• Physical activity
• Nutrition
• Obesity
• Smoking/tobacco use
• Alcohol/drugs
• Domestic abuse

Epigenetic Factors Influencing Health

• Individual
• Family
• Community
• Society

Physical Therapist Practice Implications

• Co-morbidity with referral to PT
• Understanding & sensitivity of symptoms
• Understanding and removal of biases
• Plan of care and goals
• Include patient in goal setting
• Repetition of intervention implications
• Recognize for referral when not diagnosed