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MARYVILLE PATHO NURS 611 EXAM 2 -
WITH 100% VERIFIED SOLUTIONS- 2023
Which body system is responsible for conserving energy and body resources Parasympathetic nervous system which system responds to stress by preparing the body to defend itself Sympathetic nervous system (SNS) how is blood flow redistributed by the sympathetic nervous system (SNS) blood flow to the muscles is increased while blood flow to GI and integumentary is decreased how are primary brain injuries classified focal or diffuse (aka multifocal) focal brain injuries specific, grossly observable brain lesions that occur in a precise location Epidural and subdural hemorrhages diffuse brain injuries include brain injury due to hypoxia, meningitis, encephalitis, and damage to blood vessels The brain is confined in a limited space so increased pressure can cause collateral dysfunction: Diabetes Insipidus (ADH not secreted thus polyuria) autonomic hyperreflexia affected at the t5-t6 level or above; characterized by paroxysmal HTN (up to 300 mmHg systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and bradycardia (30-40 beats/min)
location of lesions in cases of autonomic hyperreflexia individual most likely to be affected have lesions at the T5-T6 level or above sequence of events that lead to hyperreflexia induced bradycardia bradycardia (30-40bpm) is a sx of hyperreflexia Stimulation of the carotid sinus -->vagus nerve -->sinoatrial (SA) node. The intact ANS reflexively responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral vessels, the carotid sinus, and the aorta sense the HTN and stimulate the PNS. The heart rate decreases, but the visceral and peripheral vessels do not dilate because efferent impulses cannot pass through the cord Alzheimer's disease leading cause of dementia and one of the most common causes of severe cognitive dysfunction in older adults what are the greatest risk factors for Alzheimer's disease age, family history what are the proposed protective factors for Alzheimer's disease low calorie diets, estrogen replacement at time of menopause, NSAIDs, physical activity, antioxidants, the presence of apoE what genetic susceptibility tests are used to screen for early-onset AD PSEN 1 (presenilin) on chromosome 14, PSEN 2, and APP (amyloid precursor protein) on chromosome 21 When can a specific diagnosis of AD be given postmortem examination
myasthenia gravis clinical manifestations
- exertional fatigue and weakness that worsens with activity, improves with rest, and recurs with resumption of activity
- a recent history of recurring upper resp tract infections
- diplopia, ptosis, and ocular palsies
- facial droop and an expressionless face; difficulty chewing and swallowing associated with dietary changes and weight loss; drooling
- episodes of choking and aspiration Graves disease Graves disease is a result of autoantibodies binding to the TSH receptor sites. This leads to hyperthyroidism acute pain an event; cause often known; lasts less than 6 months; sudden onset; clinical signs include increased pulse rate, elevated bp, increased rr, diaphoresis, and dilated pupils; prognosis is usually complete relief low back pain most common chronic pain condition chronic pain constant situation; cause may be unknown; can be sudden or slow onset; duration is prolonged and persistent; complete relief rarely occurs myofascial pain syndromes
second most common chronic pain condition resulting from muscle spasms, tenderness and stiffness; ex: myalgia, muscle strain deafferentation pain painful condition resulting from damage to peripheral nerve; ex: burn pain caused by cold sleep deprivation serious disturbances of the sleep-wake cycle; circadian disruption; can occur in healthy individuals; reduced NK cell activity in healthy individuals conductive hearing loss sound is not properly conducted from the outer to inner ear. there is an interference in air conduction that can be caused by foreign body obstructions, tumors, or infection. can be treated and hearing will generally improve symptoms of conductive hearing loss diminished hearing, speaking in a SOFT voice, individual can hear better in a noisy environment (paracusia willisiana) causes of conductive hearing loss impacted cerumen, foreign bodies, benign tumor of middle ear sensorineural hearing loss caused by impairment of the organ of Corti or its central connections. Can possibly be congenital; conditions include noise exposure, aging, meniere disease, ototoxicity
chemotactic factor a biochemical substance that attracts leukocytes to the site of inflammation describe chemotactic activity this activity occurs distal to the inflammation in order to attract leukocytes from circulation. this activity is required for a much longer period than that of anaphylatoxic activity phagocytosis the destruction of microorganisms and cellular debris; the process by which a cell ingests and disposes of damaged cells and foreign material describe the action of phagocytes in inflammation
- opsonization (recognition of the target and adherence of the phagocyte to it
- engulfment (ingestion or endocytosis) and formation of phagosome
- fusion with lysosomal granules within the phagocyte (phagolysosome)
- destruction of the target what systemic changes are associated with acute inflammation fever, leukocytosis ( transient increase in the number of circulating leukocytes), and plasma proteins how can fever be beneficial the generation of a febrile response can be beneficial because the microorganisms that cause some conditions are highly sensitive to small increases in body temp
resolution of tissue is damage is minor, no complications occur, and destroyed tissues are capable of regeneration, it is possible to return injured tissues to an approximation of their original structure and physiologic function repair of tissue replacement of destroyed tissue with scar tissue; new tissue may not be able to function as the original tissue; occurs if resolution is not possible what happens if resolution is not possible repair takes place instead. This is when extensive damage is present, injury occurs in tissues not capable of regeneration, infection results in abscess or granuloma formation, or fibrin persists in the lesion; scar tissue forms what population is at risk for impaired inflammation and wound healing older adults; impaired healing may not be directly associated with again but can be linked to a chronic illness such as heart disease or DM. In addition, anti-inflammatory steroid medications can interfere with the healing process humoral immunity antibody circulates in the blood and binds to antigens on infectious agents cellular immunity T cells undergo differentiation during an immune response and develop into several subpopulations of cells that react directly with antigen on the surface of infectious agents. some develop into t-cells that can stimulate activities of other leukocytes; some develop into t-cytotoxic cells that attack and kill targets directly
IgM the largest of the immunoglobulins. The FIRST antibody produced during the initial/primary response to antigen. Synthsized early in neonatal life and the synthesis may be increased as a response to infection in utero; it is a pentemere-the initial most important responder to infection IgE the least concentrated of the Ig in circulation. Appears to have very specialized functions as a mediator of many common allergic responses and in the defense against parasitic infections Systemis Lupus Erythmatosus (SLE) chronic, multisystem, inflammatory disease that is one of the most common, complex, and serious autoimmune disorders increases intracranial pressure swelling, commonly seen after TBI can lead to dangerous which can cause collateral dysfunction (Reason to watch output during DI because ADH is not secreted-thus polyuria) hypoxia number 1 injury to the brain delerium acute, sudden onset, common during hospitalization, lasts hours to weeks, agitation, withdrawn/depression behavior, disoriented thoughts, hallucinations
dementia chronic, insidious or gradual onset, slow decline, can lasts months to years, attention and orientation are often intact early and impaired late alzheimers condition diagnosed by ruling out other possibilities signs and symptoms of stroke (middle cerebral artery) hemiplegia orhemiparesis greater in face and arm than leg, contralateral loss in same distribution as motor loss, expressive disorder with anomia, contralateral homonymous hemianoplopia (left vision is intact), cheyne-stokes respirations, occasional mydriasis, little to no sensory loss difference between guillain-barre syndrome and multiple sclerosis GBS is caused by a recent bacterial or viral infection; MS is not caused by a previous infection during pregnancy first MS event occasionally happens when? MS a chronic inflammatory disease involving degeneration of CNS myelin, scarring or formation of plaque, loss of axons. It is caused by an autoimmune response to self-antigen in genetically susceptible individuals
type III hypersensitivity caused by immune complexes ; primary difference between this hypersensitivity and type II hypersensitivity reactions are that the antibody binds to soluble antigen causing the complex to deposit in the tissues ex: raynaud phenomenon type IV hypersensitivity delayed reaction; ex: graft rejection, contact dermatitis from poison ivy SLE a chronic, multisystem, inflammatory disease; it is the most common, complex, and serious of the autoimmune disorders SLE tissue damage this is caused by deposition of immune complexes containing antibodies against DNA; deposited in renal tubules, heart, spleen, etc. SLE clinical manifestations facial rash confined to the cheeks, photosensitivity, renal disorder, neurologic disorders, hematologic disorders primary immune deficiency very rare; most common deficiencies are common variable deficiency, selective IgA deficiency, and IgG subclass deficiency
secondary, or acquired, immune and inflammatory deficiencies more common than primary deficiencies, complications of other physiologic or pathophysiologic conditions conditions known to be associated with acquired deficiencies metabolic disease or genetic syndromes (alcoholic cirrhois, sickle cell, SLE), environmental agents (UV light, ionizing radiation, chronic hypoxia), medical treatments (anesthesia, splenectomy) invasion results in direct confrontation with the individual's primary defense mechanism against bacteria evasion results in the microorganism transported in the blood to organs (septicemia) exotoxins proteins released during bacterial growth; usually enzymes that can damage cell membranes, activate second messengers, and inhibit protein synthesis antitoxins exotoxins are immunogenic and elicit the production of antibodies known as endotoxins
general adaptation syndrome
- alarm stage or reaction
- stage of resistance or adaptation
- stage of exhaustion low albumin levels this will reduce the ability of norepinephrine and epinephrine to circulate appropriately; associated with one's overall health and their ability to adapt alarm stage or reaction of general adaptation syndrome the CNS is aroused and the body's defenses are mobilized; one becomes alarmed by a stressor that activates the hypothalamus and sympathetic nervous system resistance or adaptation stage of general adaption syndrome individual perceives that they have a choice of either 'fighting' or flighting'; this phase begins with the actions of the hormones cortisol, norepinephrine, and epinephrine exhaustion stage of general adaptation syndrome continuous stress causes the progressive breakdown of compensatory mechanisms and homeostasis; this stage marks the onset of certain diseases cortisol secretion of this during stress exerts beneficial effects by inhibiting initial inflammatory effects; ex: vasodilation and increased capillary permeability
helper T cells cortisol acts to suppress the activity of these cells, which leads to a decrease in innate immunity and to the proinflammatory response resolution and repair cortisol promotes this
