1 Reason As a Special Operations Combat Medic, you will be - - PDF document

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Slide 1 JSOMTC, SWMG(A)

SOCM Introduction to Pathophysiology PFN: SOMCML1J

Hours: 2.0 Last updated: 13 November 2015

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JSOMTC, SWMG(A)

Terminal Learning Objective

 Action: Communicate knowledge of “PHP –

Introduction to Pathophysiology”

 Condition: Given a lecture in a classroom

environment

 Standard: Received a minimum score of

75% on the written exam IAW course standards

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JSOMTC, SWMG(A)

Reference

 Pathophysiology for the Health Professions

(4th edition; 2011; Gould; Dyer)

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Reason

As a Special Operations Combat Medic, you will be responsible for identifying and managing various pathological conditions and disorders. An understanding of pathophysiology will assist in the correlation of disease processes, affected anatomy and physiology, as well as appropriate treatments.

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Agenda

 Define the key terms related to

pathophysiology

 Communicate the role of pathophysiology

in health and disease

 Define the study of pathophysiology  Communicate the importance of a patient’s

medical history

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JSOMTC, SWMG(A)

Agenda

 Identify new developments in

pathophysiology

 Define terminology used throughout

pathophysiology

 Define terms used for common cellular

adaptations

 Communicate the common causes of cell

damage and necrosis

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Key Terms Related to Pathophysiology

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Vocabulary Development

 Anaerobic – metabolism and function without

• xygen

 Apoptosis – normal programmed cell death in

tissues

 Autopsy – an examination of part or all of a body,

including organs, after death (postmortem) to determine the cause of illness and death

 Biopsy – the removal of a small piece of living

tissue for microscopic examination to determine a diagnosis

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Vocabulary Development

 Endogenous – originating from within the body  Exogenous – originating from outside the body  Gangrene – necrotic tissue infected by bacteria  Infection – a disease caused by microorganism  Homeostasis – a relatively stable or constant

environment in the body, including blood pressure, temperature, and pH, maintained by the carious control mechanisms

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Vocabulary Development

 Hypoxia – a decreased or insufficient level of

• xygen in the tissues

 Iatrogenic – caused by a treatment, procedure, or

error

 Idiopathic – no known cause  Inflammation – the response to tissue damage,

indicated by redness, swelling, warmth, and pain

 Ischemia – decreased blood supply to an organ or

tissue

 Lysis – destruction of a cell

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Vocabulary Development

 Lysosomal – pertaining to a cell containing

digestive or lytic enzymes, including lysozyme

 Microorganisms – very small living organism, not

visible to the naked eye, usually single‐celled

 Microscopic – visible only when magnified by

lenses in a microscope

 Morphologic – the physical size, form, structure,

and shape of cells and organs

 Probability – the likelihood or chance of

• ccurrence

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The Role of Pathophysiology in Health and Disease

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Role of Pathophysiology

 Pathophysiology vs. Pathology

• Physiologic study vs. laboratory study
• Great deal of overlap

 Disease is deviation from homeostasis

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Applied Pathophysiology

 Seven Steps to Health

• 1. Don’t smoke
• 2. Eat healthy and limit alcohol
• 3. Be physically active daily
• 4. Protect yourself from the sun
• 5. Follow cancer screening guidelines
• 6. Visit your doctor/dentist if you notice any

changes in health

• 7. Follow health/safety instructions at

home/work with HazMat

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The Study of Pathophysiology

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Study of Pathophysiology

 Building Blocks of Pathophysiology

• Signs related to the specific site of damage
• Signs related to the pathologic process

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Study of Pathophysiology

 Prevention of disease is becoming the

primary focus in health care

• Center for Disease Control and Prevention

(CDC)

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Study of Pathophysiology

 Health Research (three‐stage process)

• First stage – “basic science”
• laboratory
• often uses animals and/or cell cultures
• Second stage – safe for humans?
• Third stage – clinical trials
• large number of patients
• single‐blind vs. double‐blind

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The Importance of a Patient’s Medical History

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Medical History

 Signs/Symptoms  Allergies  Medications  Past pertinent history  Last oral intake  Events leading up to the illness

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Medical History

 Patient’s medical/health history may

determine treatment

• What impact will treatment have on patient’s

condition

• How a patient’s illness might complicate care

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New Developments in Pathophysiology

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New Developments

 Extensive research/development continue

in efforts to prevent, control, and cure

• IDDM – insulin sensor/infuser implantation
• Cervical cancer – vaccine against HPV

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New Developments

 Human Papillomavirus (HPV) has nearly

200 types, most are asymptomatic

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New Developments

 Data collected by WHO, CDC, PHS, etc.

• Awareness reports
• Seems overwhelming but critical

 Organizations provide broad range of

information

• Weight management
• Pertussis vaccination
• Identifying rabies
• Latest resistant strands of microorganisms

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Terminology used Throughout Pathophysiology

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Language of Pathophysiology

 Gross Level vs. Microscopic

Level

• Gross – organ and system level
• Microscopic – cellular level

 Biopsy – excision of living

tissue

 Autopsy – examination after

death

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Language of Pathophysiology

 Determining Management

• Diagnosis – identification of a specific disease
• Etiology – cause of a specific disease
• Idiopathic – cause of disease is unknown
• Iatrogenic – disease caused by treatment,

procedure, or error

• Predisposing factors – tendencies towards a

particular disease in an individual

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Language of Pathophysiology

 Preventive measure based on accurate

research

• Vaccinations
• Proper diet/lifestyle
• Cessation of harmful behavior
• Removal of harmful materials

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Language of Pathophysiology

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Language of Pathophysiology

 Pathogenesis – development of a disease

• Onset – acute(sudden) or insidious(chronic)
• Different possible stages of disease
• subclinical state ‐ undetectable
• latent stage – dormant
• incubation period ‐ from exposure to

signs/symptoms

• prodromal period – nonspecific signs of an illness
• manifestation – clinical evidence or effects

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Language of Pathophysiology

Signs – objective evidence of disease Symptoms – subjective sensations

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Language of Pathophysiology

 Disease Progression

• Remission – manifestations subside
• Exacerbation – increase in severity
• Precipitating factors – triggers acute episode
• Sequelae – potential unwanted outcomes of a

condition

• Therapy – treatment measures to promote

recovery or slow progression

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Language of Pathophysiology

• Convalescence – rehabilitation/recovery
• Complications – an additional problem arising

after the original disease begins

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Language of Pathophysiology

 Outcomes

• Prognosis – probability for recovery/outcome
• Morbidity – disease rate of a group
• Mortality – death rate of a disease
• Epidemiology – science of tracking the pattern
• r occurrence of disease

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Language of Pathophysiology

 Occurrence of Disease

• Epidemic – higher than normal disease rate in

a given area

• Pandemic – higher than normal disease rate in

multiple areas

• Incidence – number of new cases
• Prevalence – number of existing cases

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Language of Pathophysiology

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Terms Used for Common Cellular Adaptations

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Cellular Adaptation

 Atrophy – decrease in the size of cells  Hypertrophy – increase in the size of cells  Hyperplasia – increase in the number of

cells

 Metaplasia – replacement of one mature

cell type by another

 Dysplasia – cells vary in size and shape

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Cellular Adaptation

 Neoplasm – new growth (abnormal cells)

• Benign – typically surrounded by fibrous

sheath preventing metastasis

• Malignant (cancer) – uninhibited abnormal cell

growth

 Anaplasia – undifferentiated cells (implies

advanced malignancy and metastasis)

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Cellular Adaptation

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The Common Causes of Cell Damage and Necrosis

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Cell Damage

 Cell injury can occur due to many factors

• Ischemia – deficit of blood supply
• Physical – hot, cold or radiation
• Mechanical damage – pressure or tearing
• Chemical toxins – exogenous or endogenous
• Microorganisms
• Abnormal metabolite accumulation

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Cell Damage

Nutritional deficits Fluid or electrolyte imbalances

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Cell Damage

 Stages of Cell Damage

• Initially causes altered metabolic reaction
• leads to loss of function
• reversible if the factor is removed quickly enough
• If damage increases, morphologic changes
• ccur
• Cells finally undergo lysis or dissolution leading

to necrosis

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Necrosis

Liquefaction Necrosis

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Necrosis

 Coagulative Necrosis – denaturing of

proteins following hypoxic injury

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Necrosis

Fat Necrosis

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Necrosis

Caseous Necrosis

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Necrosis

Gangrene

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Key Note

Specific types of cells die at different rates. Brain cells die quickly (4‐6 minutes) when deprived of oxygen, whereas cardiac cells can survive approximately 30 minutes.

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Questions?

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JSOMTC, SWMG(A)

Terminal Learning Objective

 Action: Communicate knowledge of “PHP –

Introduction to Pathophysiology”

 Condition: Given a lecture in a classroom

environment

 Standard: Received a minimum score of

75% on the written exam IAW course standards

Slide 54

JSOMTC, SWMG(A)

Agenda

 Define the key terms related to

pathophysiology

 Communicate the role of pathophysiology

in health and disease

 Define the study of pathophysiology  Communicate the importance of a patient’s

medical history

19

Slide 55

JSOMTC, SWMG(A)

Agenda

 Identify new developments in

pathophysiology

 Define terminology used throughout

pathophysiology

 Define terms used for common cellular

adaptations

 Communicate the common causes of cell

damage and necrosis

Slide 56

JSOMTC, SWMG(A)

Reason

 As a Special Operations Combat Medic, you

will be responsible for identifying and managing various pathological conditions and disorders.

 An understanding of pathophysiology will

assist in the correlation of disease processes, affected anatomy and physiology, as well as appropriate treatments.

Slide 57

JSOMTC, SWMG(A)

Break