pathology

  • appendicitis

    • mcburney's point is 2/3 from umbilical cord to the hip

    • rebound tenderness→push on mcburney point=painful

    • rovsing's sign→push LLQ⇒pain in RLQ (bc of mesentery)

    • psoas test→hip flexor

    • heel tap→dorsally flex and tap heel

    • obturator test→

  • mesenteric adenitis→Inflammation of lymph nodes in the mesentery.

  • cholescystitis→Inflammation of the gallbladder.

  • triple A (abdominal aortic aneurysm)→An abdominal aortic aneurysm is an enlargement of the aorta in the abdomen.

  • crohn's disease→inflammation of ileum (third portion of small intesine)

  • symptoms→subjective, what patient tells you, like headaches

  • signs→objectives, what we can see; like edema

    • prognostic→future and outcomes, TNM scale

    • anamnestic→point to past like medical history

    • diagnostic→identify current, like blood test

    • pathognomic→linking condition to full certainty, like covid test

  • addressing pain - OPQRST

    • O→onset, when did pain start

    • P→provocation, what makes the pain worse

    • Q→quality, what kind and how painful

    • R→radiates, where does it hurt the most and spread

    • S→severity

    • T→time

  • X-rays

    • barium sulfate→intestinal tract

    • radiopaque oil→bronchogram

    • cardiac catheterization→blood flow through heart

    • intravenous pyelogram→urinary tracts

    • radiopaque tablets→visualize gallstone

    • arteogram→visualize blood flow

    • radiopaque→appears white on film

    • radiolucent→appears dark

  • x-ray→x-rays through body tissues, beam travels in only 1 direction

  • CT→2d x-ray that can be stacked to form 3d image, detect abnormality in organs, higher dose of radiation that x-ray

  • MRI→high power magnet that can rearrange water molecules in body, soft tissue resolution, no radiation

  • MRI→T1 v T2

    • T1→enhances fatty tissue as white, CSF is black

    • T2→fatty tissue as grey, enchases signal of water, CSF is white

  • Diagnostic Test of Electrical activity

    • ECG (electrocardiogram)→measures serial changes in electrical activity of heart in various phases in cardiac cycles; abnormal heart rate and muscle injury

    • EEG (electroencephalogram)→measures electrical activity of brain and brain waves

    • EMG (electromyogram)→measures electrical activity of skeletal muscles during contraction and at rest

    • NCV→nerve conduction velocity study

  • Other Tests

    • Endoscopy

      • tube with lens and light source

      • bronchoscope→trachea and major bronchi

      • colonoscopy→colon

      • cystoscope→bladder

      • laparoscope→abdomen

    • ultrasound→mapping echoes produced by high-frequency sound waves traveling through body; echos reflect change in tissue density to produce images

  • necrosis→premature death of cells and living tissue

    • dry gangrene→gray/black tissue, can develop into wet

    • wet gangrene→greenish white pus, foul smelling

    • caseous→cheese like consistency, tannish white color

    • fibrinoid→inflammation of nodules in joints

    • liquefactive→dissolves tissue that turns liquid

    • gaseous→releases exotoxins

  • four stages of somatic death

    • 1st→algor mortis, cooling of body to room temo

    • 2nd→livor mortis, ecchymosis (bruising) and hypostasis (blood and fluid pooling)

    • 3rd→rigor mortis, stiffening of joints after death

    • 4th→postmortis oltilistic, self-digestive decomposition

  • posmortem autolysis

    • 1st→decompostion, self digestion

    • 2nd→maceration, softening tissues due to enzymes

    • 3rd→putrefaction, decaying, abdomen turns greenish color

    • 4th→skeletonization, no soft tissue, skeleton exposed

  • noxious gases related to protein hydrolosis

    • putrescine→amino acid: ornithine

    • cadaverine→amino acid: lysine

  • Cardinal signs

    • rubor→redness/erythema

    • tumor→swelling/edema

    • calor→increased heat

    • dolor→nociception/pain

    • functio laesa→loss of function

  • white blood cells→never let my engine blow

    • never→neutrophils, 60%

    • let→lymphocytes, 30%

    • my→monocytes, 5%

    • engine, eosinophils, 4%

    • blow→basophils, 0%

  • exudate→fluid produced by wound that is normal part of healing

    • serous→primarily fluid, little protein (blisters)

    • serosanguineous→clear, thin, pink

    • sanguineous→thin, watery, red

      • sanguine→blood

    • purulent→opaque, milky, green (pus)

    • hemopurulent→purulent and red tinged (pus)

    • hemorrhagic→increased red blood cells, red and thik

      • hemo→blood

    • fibrinous→rich in fibronogen, coagulates and forms fibrin, sticky film on surface

    • catarrhal→cloudy mucous, rhinnorrhea (runny nose)

    • adhesions→bands of fibrous tissues that bind adjacent tissue together

  • exudate quantification

    • 1→nonpresent, wound is dry

    • 2→scant, wound is moist with no evidence of bandage

    • 3→small/minimal, exudate covers less than 25% of bandage

    • 4→moderate, wound is wet with 25-75% exudate covering bandage

    • large/copious→wound is seeping and covers over 75% bandage

  • Inflammation

    • pyrexia→due to varying normal body temp around 37C or 98.6 F

      • fever is→above 38C or 100.4F

    • macrophages→release endogenous pyrogen, Interleukin-I and TNF (tumor necrosis factor) that stimulate the release of cyclooxygenase (COX) in hypothalamus that causes fever

    • tylenol reduces fever how→Tylenol inhibits COX enzymes from making prostaglandins, reducing the fever response.

      • prostaglandins cause fever (pyretic)

      • most common→PGE2

  • Acute Inflammatory Process Sequences

    • congestion→capillaries dilate, vessels become permeable

    • exudation→leaking of plasma, immune reaction through diapedesis and chemotaxis

    • suppuration→pus formation, WBC and cell debris

    • resolution→response ends or becomes chronic

  • How does WBC leave capillary

    • margination→WBC normally flowing are attached to peripheral wall of vessel

    • rolling→roll, tumble, and heap on themselves

    • adhesions→adhere to vessel wall

    • trasmigration (diapedesis)→squeezing through interstitial space

  • Lesions

    • abscess→circumscribed collection of pus and inflamed tissue

    • ulcer→open sore/lesion, inflamed nectrotic tissue

    • furuncle→abscess or infection of sweat gland or hair follice

    • carbuncle→multiple boils with pus and dead tissue

    • cellulitis or plegmon→diffuse, non-circumscribed inflammatory infiltration of tissue

    • pustule→small, circumscribed elevation (pimple) has pus

    • vesicle→blister