AH 120 Human Diseases Studying Diseases Inflammation

Terminology Disease : Altered function/physiology of a body organ or system Disease : Altered function/physiology of a body organ or system Etiology : The cause of the disease Etiology : The cause of the disease Pathology : the abnormal physiology that produces the disease and its manifestations Pathology : the abnormal physiology that produces the disease and its manifestations

Terminology (cont.) ManifestationsSigns Physical observations or measurements Physical observations or measurements  Pulse, Blood Pressure, Temperature, etc Symptoms What the patient says or feels What the patient says or feels  Pain, difficulty breathing, etc Test Findings

Terminology (cont.) Diagnosis: Determining the disease process by evaluating the manifestations Determining the disease process by evaluating the manifestations Also includes: Also includes: History History  Chief complaint, past medical history, social history, occupational history Physical exam and tests to obtain signs and symptoms Physical exam and tests to obtain signs and symptoms Prognosis : prediction of the outcome, usually expressed as likelihood of recovery or survival

Tests Besides signs and symptoms, test findings are the other category of disease manifestations used to make the diagnosis

Laboratory Tests Blood and body fluids tests: CBC, electrolytes, UA, etc Blood and body fluids tests: CBC, electrolytes, UA, etc Cytology: biopsies, sputum samples Cytology: biopsies, sputum samples Bacteriologic studies: C & S, Gram staining, AFB Bacteriologic studies: C & S, Gram staining, AFB

Radiologic Tests Simple chest x-ray showing Tuberculosis in the left lung

Radiologic Tests Using a contrast medium Angiogram of carotid artery

Radionuclide Tests (Scintiscans) Administering a radioisoptope and then scanning the area with a Geiger counter-type imaging device Administering a radioisoptope and then scanning the area with a Geiger counter-type imaging device Bone scan of head chest and pelvis showing tumors

Computerized Tomography -CT Scans- Different planes or slices are x-rayed and then a computer generates a composite image

CT Scans

Magnetic Resonance Imaging (MRI) Similar to CT scan BUT uses magnetism and radio frequencies INSTEAD of ionizing radiation to create image Similar to CT scan BUT uses magnetism and radio frequencies INSTEAD of ionizing radiation to create image

Electrocardiogram (EKG or ECG) Tracing of the electrical activity of the heart by placing electrodes on the arms, legs, and chest Tracing of the electrical activity of the heart by placing electrodes on the arms, legs, and chest

Electroencephalogram (EEG) Tracing of the electrical activity in the brain by placing electrodes on the head Tracing of the electrical activity in the brain by placing electrodes on the head normal During grand mal seizure

Diagnostic Medical Sonography -DMS- Ultrasound Image created by the echoes of high frequency sound waves

Endoscopy Using a scope to view the inside of the body through a natural orifice or through a small surgical incision Using a scope to view the inside of the body through a natural orifice or through a small surgical incision Examples : Colonoscopy, Bronchoscopy, Esophagogastroscopy, Laparoscopy, etc Examples : Colonoscopy, Bronchoscopy, Esophagogastroscopy, Laparoscopy, etc

Pulmonary Function Tests (PFTs) Measurement of lung volumes and flow rates Measurement of lung volumes and flow rates

Disease Treatment Therapeutic treatment : affects the outcome of the disease Includes drugs, radiation, surgery, nutrition, exercise, etc Includes drugs, radiation, surgery, nutrition, exercise, etc Palliative treatment: Treating symptoms only without affecting the outcome Surgery for pain relief with a terminal disease Surgery for pain relief with a terminal disease

Inflammation The response of living tissue to injury. The inflammatory process removes injured cells and debris and contains the area of injury.

Triggers of Inflammation NOTE! Infection and Inflammation are not the same thing!

Septicemia (Sepsis) Infection spreads via the blood stream and causes infectious inflammation in many body tissues/systems.

White Blood Cells: PMNs Polymorphonuclear Leukocytes Neutrophils  Largest quantity of the WBCs  Perform phagocytosis Eosinophils  Number increases with allergy Basophils  Contain histamine  Migrate out of the blood and become mast cells

White Blood Cells: Mononuclear Leukocytes Monocytes Monocytes  Largest in size of WBCs  Perform phagocytosis  Called Macrophages or Histiocytes when they migrate out of blood Lymphocytes Lymphocytes  Second largest in quantity  Release lymphotoxin and lymphokine  More active in the immune process

The Inflammatory Process Trigger: Trauma and Infection 4 Stages Histamine released and blood flow increases as does permeability Neutrophil exudation Monocyte exudation Repair/Restoration

Repair & Restoration The Inflammatory process may end in one of three ways:

Tissue Restoration with Varying Amounts of Scarring

Abscess Formation Brain Abscess Seen with infectious inflammation Pus 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 fibrous tissue. Granuloma has a solid center while an abscess has a liquid (pus) center.

Acute Inflammation Manifestations Local (due to increased bloodflow and permeability) Redness Heat Swelling/Edema Pain General Fever Leukocytosis

Chronic Inflammation Insidious and long lasting. Exudation and repair occur together There is less exudate and it has monocytes, lymphocytes, and plasma cells but no neutrophils There is less exudate and it has monocytes, lymphocytes, and plasma cells but no neutrophils Fibrosis (Scarring) Fibrosis (Scarring) Manifestations are less severe than acute Manifestations are less severe than acute

Treatment Drugs Anti-inflammatory drugs: aspirin, acetaminophen (Tylenol), ibuprofen (Advil), naprosin (Alleve) Anti-inflammatory drugs: aspirin, acetaminophen (Tylenol), ibuprofen (Advil), naprosin (Alleve)  All reduce severity of process and its signs and symptoms Steroids – inhibit severity of exudation and edema Steroids – inhibit severity of exudation and edema Antihistaminies – decrease severity of inflammation when caused by allergy Antihistaminies – decrease severity of inflammation when caused by allergy Antimicrobials – for infectious inflammation Antimicrobials – for infectious inflammation Rest and gradual exercise Drainage of abscess