Nursing 3366 Pathologic Processes: Implications for NursingBasic Concepts of PathophysiologyObjectives /outcomesDESCRIBE/DISCUSS/IDENTIFY:1. concepts underlying the nomenclature of physiology and pathophysiology. 2. appropriate, general application of those concepts to disease processes and situations. Outline for Lecture:I. OverviewA. PhysiologyB. PathophysiologyC. ExamplesII. Some basic physiologic concepts.A. HomeostasisB. Compensation and decompensationIII. Pathophysiologic concepts & terminology A. Disease vs disorder vs syndromeB. Terms relating to elements leading up to a diseaseC. Terms relating to causes of a diseaseD. Terms relating to course of a diseaseE. Sequela : aftermath of a disease________________________________I. OverviewA. Physiology-- study of functions & processes that occur in body, mostly the NORMAL processesB. Pathophysiology -- the study of the underlying changes in body physiologythat result from disease or injury C. Examples:1. physiologic amenorrhea versus pathophysiological amenorrhea2. physiologic albuminuria versus pathophysiological albuminuriaII. Some basic physiologic concepts.A. Homeostasis—maintenance of constant conditions in the body’s internal environment1. Cells must have constant supply of nutrients, H2O, O2, and exist in narrow pH & temperature range2. Maintaining homeostasis is essentially a balancing act-- the body is always trying to “right itself” when homeostasis is challenged by changes.3. These challenges to the body’s balance are sometimes called stressors.B. Compensation and decompensation1. The return to homeostasis after being challenged by a stressor is called ______________________; similar words are adaptation, healing, etc.Re: sidebar & other boxed info in all your lecture notes: a. Information in a sidebar box is generally not covered orally in lecture but is added knowledge for you, or a review of previous info or Prep info.b. If the info in the box is prefaced by “FYI,” you won’t be responsible for it on a test. c. If there is no “FYI” preface, the information IS eligible for test material. DO NOT FORGET TO STUDY THESE SIDEBAR NOTES!d. If a note says HOME STUDY, that means we will NOT go over FYI: pathology & pathophysiology come from Latin root word “pathos”—suffering.)Some standard language usage clarifications: o “AKA” means “also known as.” o “IE” or “ie” means “in otherwords.”o “eg” means “for example.” o this sign before a word means “approximately:” ~1a. Compensation is achieved by the body’s use of controlmechanisms, also called ________________________mechanisms.b. Control / compensatory mechanisms examples:1) Example of compensatory response to “normal” daily-life stressors: if you run out of available glucose between meals & can’t eat immediately, your body turns to the “back-up” system of glycogenolysis —breakdown of _____________________, which is a form of stored glucose. 2) Example of compensatory response to pathologic stressors: ifyou’ve lost a lot of blood (massive bleeding) or water (dehydration), the body uses certain compensatory techniques to keep remaining fluid volume circulating aseffectively as possible (temporary measures until the cause of the problem gets fixed) :a) heart rate would ___________________. b) also, arteries in your periphery (arms and legs) wouldconstrict, shunting whatever blood volume is left to the central areas, that is, to your most important organs—brain, heart, lungs, kidneys.2. If the body is unable to appropriately meet the challenge of stressors-- for example, if the control mechanisms are “exhausted”-- compensation can deteriorate either rapidly or slowly into ____________________________— the failure to compensate, adapt,heal, etc.III. Pathophysiologic concepts & terminology A. Disease vs disorder vs syndrome 1. a disease is a harmful condition of the body (and/or mind); a disorder is a disturbance in the healthiness of the body; a syndromeis a collection of symptoms2. for this class these terms will be basically interchangeable, as they all are a disturbance in body homeostasis; most of the time I will use the term disease (or abbreviate as “dz.”) B. Terms relating to elements leading up to a disease1. risk factorsa. factors that or contribute to and/or increase probability that a dz will occur …”setting the stage” Other examples of compensatory mechanisms:o If there is too much CO2 in your body for some reason, control mechanisms in the respiratory centers of the brain increase respiratory rate so that CO2 exhalation is increased. o If you have too much blood volume or the pressure in your arteries is too high over a long period of time: 1) the heart will need to pump with more force to eject blood into your arteries. 2) to do this, it will have to “shore up” its muscle-- this is called muscle hypertrophy: the heart muscle compensates for the extra stressors by undergoing hypertrophy.o Checks and balances example: 1) part of the inflammatory response to a cut on the toe is to begin the clotting process 2) if the clotting process continued indefinitely, the whole body would be one big clot 3) so, the fibrinolytic system that dismantles a clot is the “check and balance” to the clotting process 4) summary: control mechanism to bleeding = clotting; “check” to the clotting = fibrinolytic system.2b. ex-- heredity, age, ethnicity, lifestyle (smoking, eating habits,etc), environment 2. precipitating factora. a condition or event that triggers a pathologic event or disorder ….the “kick-off”b. ex—“an asthma attack can be precipitated by exertion”C. Terms relating to causes of a disease 1. ___________-- the cause of a disease; includes all factors that contribute to development of dz; examples: a. etiology of AIDS: HIV (human immunodeficiency virus)b. etiology of rheumatic heart disease: autoimmune reaction c. TB (tuberculosis): mycobacterium 3. idiopathic—dz with unidentifiable cause4. _______________________________ problem -- occurs as result ofmedical tx- ex—if kidney failure is due to improper use of antibiotics prescribed by a healthcare provider you could say “the etiology of the kidney failure was iatrogenic.”5. ____________________problems—result as consequence of being in hospital environment- ex— urinary tract infection is called a nosocomial