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Pathology ch 1,2,3
| Question | Answer |
|---|---|
| what does pathology investigate? | the essential nature of disease, like changes in body tissues and organs that cause or result from disease |
| What is pathogenesis? | Cellular events and mechanisms that occur as a disease develops |
| What is clinical pathology? | Applied to clinical problems- especially laboratory methods in diagnosis |
| PTA focus of pathology? | Primary focus on how a relationship between impairment and functional abilities |
| What is whole-person care? | Modern practice considers activity level, environments, and social participation alongside the disease process |
| What is health? | A state of complete physical, mental, and social well-being (not necessarily the absence of a disease) |
| How is health best viewed? | As a dynamic continuum from wellness to illness that reflects biologic, psychologic, spiritual, and sociologic states |
| What is illness vs disease? | disease is a biomedical condition with objective data, whereas an illness is the person's perception and response to not being well |
| What is important for health care providers to understand when treating for illness and disability? | To understand where the individual is in the life stage, life span, and natural history of the condition |
| What encompasses wellness? | Social, physical, emotional, spiritual, intellectual, occupational |
| what is an acute illness? | rapid onset, short duration and often self-limiting |
| What is chronic illness? | Permanent impairment or disability requiring long-term management. Rehabilitation often means "getting different" not "getting better" |
| What are psychological aspects of illness | Premorbid personality shapes response to illness. Common reactions may include denial, fear, and anxiety. Symptoms may be functional (no brain dysfunction) or organic (physiologic brain damage) |
| What are the benefits of exercise? | Cardiovascular health, metabolic regulation, systemic function, musculoskeletal strength, and psychological well-being |
| What is acute inflammation? | Initial tissue response to injury or infection. Effects include fever, tachycardia, and hypermetabolic state with elevated serum proteins |
| What is chronic inflammation? | Persistent injury that leads to lymphocyte and macrophage accumulation with fibrosis. Effects include low-grade fever, malaise, weight loss, anemia, and elevated ESR |
| What are healing factors for inflammation? | Nutritional status, cardiovascular disease, cancer, and corticosteriod or immunosuppressive therapy |
| What are NSAIDS | Ex. tylenol and aspirin. Primarily for mild-moderate pain, inflammation, and fever. It inhibits prostaglandin synthesis. Risk of GI bleeding and ulceration, can mask pain leading to overexertion, and wtih aspirin there's a reye syndrome risk in children |
| What are glucocorticoids? | Ex. corticosterioids, dermacort, cordrol. Used w/ endocrine, rheumatic, respiratory. Cause atorphy, osteoporosis, weakened immune system and caution with joint laxity. Signs of toxicity- moon face buffalo hump. Tx of injected joint requires special care |
| What are opiod agents? | Ex. narcotics. Stimulates CNS opioid receptors. Cause sedation, confusion, orthostatic hypotension, schedule PT for peak analgesic effect approx 2 hours; monitor for respiratory depression, patient may not accurately report if technique is painful |
| What is a contusion? | Caused by a sudden, heavy, compressive force, often a direct blow |
| What is a strain? | Results from excessive tensile force, leading to myofiber overstraining. Most common at the myotendinous junction |
| Why would a repaired site of a contusion or strain experience a high right of re-injury? | Disorganized scar tissue with decreased tensile strength |
| PT intervention for muscle strain | 1- Short period of immobilization. 2- early controlled mobilization to aid muscle fiber regeneration and orientation to reduce scar formation 3-ROM, strength, endurance 4- RTA when 80% of strength is back |
| What are the three phases of fracture healing? | inflammatory (days 1-7), reparative (weeks 2-6), remodeling (months 6+) |
| describe the inflammatory phase and intervention of a fracture | hematoma formation at the fracture site followed by granulation tissue. PROM,AAROM, pain and edema management, patient education |
| describe the reparative phase and intervention for a fracture | fibrocartilaginous callus is gradually replaced by woven bone and forms a soft callus, eventually maturing to a hard callus. Progressive AROM, submax isometric exercises of surrounding muscles, focus on regaining pain free motion |
| describe the remodeling phase and intervention for a fracture | the hard callus is reshaped and refined by osteoclasts and blastss. woven bone replaced and the medullary canal is gradually restored. progressive strengthening exercises, focus on improving endurance, coordination, and functional overhead activities |
| What are tendons and ligaments composed of? | collagen (20%), water (78%) and glycosaminoglycans (2%) |
| how do tendons and ligaments help with specific tissue repair? | unidirectional tensile strength (sustain high loads), force transfer (transmit force between muscle/bone or bone/bone), support and stability, and viscoelasticity (capable of deformation under stress and returning to original state preventing damage) |
| what are the stages of progression for tendon and ligaments repair? why is it important to follow this? | proliferative phase (days 5-28), early remodeling phase (weeks 4-8), progressive loading (as strength improves), strengthening initiation (8-12 weeks), and full force activity (12+ weeks). important for collagen alignment and maturation |
| what is the proliferative phase for tendon and ligament repair | days 5-28. controlled passive movement is allowed and continues into the remodeling phase for 4-8 weeks post-injury/repair |
| what is the early remoding phase? for tendon and ligament repair | weeks 4-8. AROM is initiated with controlled, gravity-eliminated movement to prevent excessive resistance from limb weight |
| what is the progressive loading phase? for tendon and ligament repair | as the repair strengthens, increased force is gradually introduced, initially maintaining gravity-elimiated conditions |
| what is the strengthening initian phase for tendon and ligamnet repair | formal strengthening exercises begin no earlier than 8 weeks post-repair, with intensity progressing between 8-12 weeks |
| what is the full force activity phase for tendon and ligament repair? | full force muscle contractions may be permitted at 12 weeks, contingent on no complications and adequate healing |
| what is articular cartilage? | aneural, avascular, aplumphatic. composed of water (75%), type II collagen (20%), proteoglycans (5%). poor healing capacity in adults- avascular enviornment prevents repair cell migration. injury leads to fiburous scar and degenerative arthritis |
| what is the menisci? | the knee. outer 10-30% is vascular, inner zone is avascular by adulthood. peripheral tears heal via synovial cell migration. central tears have poor healing capactiy. water (70%) and type I collagen (90% of dry weight) comprise the bulk of meniscal comp |
| what is an intervertebral disk | outer annulus fibrosus, inner annulus and nucleus pulposus. blood supply limited to outer annulus. proteoglycan turnover takes 20 yrs. aging reduces water-binding capacity- dehydration- degeneration. herniation risk highest in the morning. |
| what are the effects of immobilizations? | result in significant impairment and functional limitations, limitations can occur in ROM and strength, immobilization can include bed rest, casting or splinting, and non wt. bearing status |
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