AH 120 Human Diseases

Studying DiseasesStudying Diseases

InflammationInflammation

Terminology

Disease : Altered function/physiology of a Disease : Altered function/physiology of a body organ or systembody organ or system

Etiology : The cause of the diseaseEtiology : The cause of the disease

Pathology : the abnormal physiology that Pathology : the abnormal physiology that produces the disease and its manifestationsproduces the disease and its manifestations

Terminology (cont.)

ManifestationsManifestations

SignsSigns Physical observations or measurementsPhysical observations or measurements

Pulse, Blood Pressure, Temperature, etcPulse, Blood Pressure, Temperature, etc

SymptomsSymptoms What the patient says or feelsWhat the patient says or feels

Pain, difficulty breathing, etcPain, difficulty breathing, etc

Test FindingsTest Findings

Terminology (cont.)

Diagnosis:Diagnosis: Determining the disease process by evaluating the Determining the disease process by evaluating the

manifestationsmanifestations Also includes:Also includes: HistoryHistory

Chief complaint, past medical history, social history, Chief complaint, past medical history, social history, occupational historyoccupational history

Physical exam and tests to obtain signs and symptomsPhysical exam and tests to obtain signs and symptomsPrognosis : prediction of the outcome, usually expressed Prognosis : prediction of the outcome, usually expressed

as likelihood of recovery or survivalas likelihood of recovery or survival

Tests

Besides signs and symptoms, test Besides signs and symptoms, test findings are the other category of findings are the other category of

disease manifestations used to make disease manifestations used to make the diagnosisthe diagnosis

Laboratory Tests

Blood and body fluids tests: CBC, Blood and body fluids tests: CBC, electrolytes, UA, etcelectrolytes, UA, etc

Cytology: biopsies, sputum samplesCytology: biopsies, sputum samples

Bacteriologic studies: C & S, Gram Bacteriologic studies: C & S, Gram staining, AFBstaining, AFB

Radiologic Tests

Simple chest x-ray showing Tuberculosis in the left lung

Radiologic Tests

Using a contrast mediumUsing a contrast medium

Angiogram of carotid artery

Radionuclide Tests (Scintiscans)

Administering a Administering a radioisoptope radioisoptope and then and then scanning the area with scanning the area with a Geiger counter-type a Geiger counter-type imaging deviceimaging device

Bone scan of head chest and pelvis showing tumors

Computerized Tomography-CT Scans-

Different planes or slices are x-rayed and then a Different planes or slices are x-rayed and then a computer generates a composite imagecomputer generates a composite image

CT Scans

Magnetic Resonance Imaging (MRI)

Similar to CT scan Similar to CT scan BUTBUT uses magnetism uses magnetism and radio frequenciesand radio frequencies INSTEADINSTEAD of ionizing of ionizing radiation to createradiation to create imageimage

Electrocardiogram (EKG or ECG)

Tracing of the Tracing of the electrical activity of electrical activity of the heart by placing the heart by placing electrodes on the arms, electrodes on the arms, legs, and chestlegs, and chest

Electroencephalogram (EEG)

Tracing of the Tracing of the electrical activity in electrical activity in the brain by placing the brain by placing electrodes on the headelectrodes on the head

normal

During grand mal seizure

Diagnostic Medical Sonography-DMS-

UltrasoundImage created by the echoes of high frequency sound Image created by the echoes of high frequency sound

waveswaves

Endoscopy

Using a scope to view the inside of the body through a Using a scope to view the inside of the body through a natural orifice or through a small surgical incisionnatural orifice or through a small surgical incision

Examples : Colonoscopy, Bronchoscopy, Examples : Colonoscopy, Bronchoscopy, Esophagogastroscopy, Laparoscopy, etcEsophagogastroscopy, Laparoscopy, etc

Pulmonary Function Tests (PFTs)

Measurement of lung volumes and flow ratesMeasurement of lung volumes and flow rates

Disease Treatment

Therapeutic treatment : affects the outcome of Therapeutic treatment : affects the outcome of the diseasethe disease

Includes drugs, radiation, surgery, nutrition, Includes drugs, radiation, surgery, nutrition, exercise, etcexercise, etc

Palliative treatment: Treating symptoms only Palliative treatment: Treating symptoms only without affecting the outcomewithout affecting the outcome

Surgery for pain relief with a terminal Surgery for pain relief with a terminal diseasedisease

Inflammation

The response of living tissue to injury. The response of living tissue to injury. The inflammatory process removes The inflammatory process removes

injured cells and debris and contains injured cells and debris and contains the area of injury.the area of injury.

Triggers of Inflammation

NOTE! Infection and Inflammation are not the same thing!

Septicemia (Sepsis)

Infection spreads via the blood Infection spreads via the blood stream and causes infectious stream and causes infectious inflammation in many body inflammation in many body

tissues/systems.tissues/systems.

White Blood Cells: PMNs

Polymorphonuclear LeukocytesPolymorphonuclear LeukocytesNeutrophilsNeutrophils

Largest quantity of the WBCsLargest quantity of the WBCs Perform phagocytosisPerform phagocytosis

EosinophilsEosinophils Number increases with allergyNumber increases with allergy

BasophilsBasophils Contain histamineContain histamine Migrate out of the blood and become mast cellsMigrate out of the blood and become mast cells

White Blood Cells: Mononuclear Leukocytes

MonocytesMonocytes Largest in size of WBCsLargest in size of WBCs Perform phagocytosisPerform phagocytosis Called Macrophages or Histiocytes when they Called Macrophages or Histiocytes when they

migrate out of bloodmigrate out of blood LymphocytesLymphocytes

Second largest in quantitySecond largest in quantity Release lymphotoxin and lymphokineRelease lymphotoxin and lymphokine More active in the immune processMore active in the immune process

The Inflammatory Process

Trigger: Trauma and Infection

4 Stages4 Stages Histamine released Histamine released

and blood flow and blood flow increases as does increases as does permeabilitypermeability

Neutrophil exudationNeutrophil exudation Monocyte exudationMonocyte exudation Repair/RestorationRepair/Restoration

Repair & Restoration

The Inflammatory process may end in The Inflammatory process may end in one of three ways:one of three ways:

Tissue Restoration with Varying Amounts of Scarring

Abscess Formation

Brain Abscess

Seen with infectious inflammationPus consists of dead tissue, WBCs, and microbes

Granuloma Formation(when foreign material or

microbes can’t be phagocytosed)

Non-phagocytosed material surrounded by WBCs and fibroustissue. Granuloma has a solid center while an abscess has aliquid (pus) center.

Acute Inflammation Manifestations

Local (due to increased Local (due to increased bloodflow and bloodflow and permeability)permeability)

RednessRedness HeatHeat Swelling/EdemaSwelling/Edema PainPain

GeneralGeneral FeverFever LeukocytosisLeukocytosis

Chronic Inflammation

Insidious and long lasting. Exudation and Insidious and long lasting. Exudation and repair occur togetherrepair occur together

There is less exudate and it has monocytes, There is less exudate and it has monocytes, lymphocytes, and plasma cells but no lymphocytes, and plasma cells but no neutrophilsneutrophils

Fibrosis (Scarring)Fibrosis (Scarring) Manifestations are less severe than acuteManifestations are less severe than acute

Treatment

DrugsDrugs Anti-inflammatory drugs: aspirin, acetaminophen (Tylenol), Anti-inflammatory drugs: aspirin, acetaminophen (Tylenol),

ibuprofen (Advil), naprosin (Alleve)ibuprofen (Advil), naprosin (Alleve) All reduce severity of process and its signs and All reduce severity of process and its signs and

symptomssymptoms Steroids – inhibit severity of exudation and edemaSteroids – inhibit severity of exudation and edema Antihistaminies – decrease severity of inflammation when Antihistaminies – decrease severity of inflammation when

caused by allergycaused by allergy Antimicrobials – for infectious inflammationAntimicrobials – for infectious inflammationRest and gradual exerciseRest and gradual exerciseDrainage of abscessDrainage of abscess