NUR 3129 Summer 2018
Unit 1 - Exam 1 Blue-Print
● 20 questions - Cell Metabolism, Inflammation, Integumentary, Wound Healing
● 20 questions - Pain, Sleep, Temp. & Vital Signs
● 20 questions - Fluid and Electrolytes
● 20 questions - Acids and Bases
● 20 questions – Neurotransmitters, Stress, Aging, Genes & Environment
Cell Metabolism, Inflammation, Integumentary, Wound Healing
Objectives:
1. Define Pathophysiology & Psychopathology.
● Physiology is the study of normal body function (specifically, the study of the origin,
nature and normal function of humans and the chemical and physical processes
involved)
● Pathophysiology is the study of disturbances of normal origin, nature, and functions of
human beings and the chemical and physical processes involved. In other words,
physiology (physiologic) is to health as pathophysiology (pathologic) is to disease.
● Psychology is the study of the mind, occurring via the study of behavior.
● Psychopathology is the study of mental illness, mental distress and abnormal
maladaptive behavior. Whiles psychopathology is more conceptual, pathophysiology is
more concrete
2. Relate principles of General Systems Theory to the study of Pathophysiology.
● The General Systems Theory (GST) is a theoretical framework that is the basis of our
approach to nursing and health care. It explains the breaking of whole things into parts
and the working together of those parts into systems. A system is any set of interacting
parts and organisms (humans are an example). Complex systems (human body) are
studied as subsystems, but always recall that the human body system acts as a whole.
● Dysfunction of a subsystem causes a human body system disturbance rather than only
the loss of a single function of the subsystem. Systems can be open (exchange with the
environment) or closed (no exchange with the environment). The human body system is
an open system where the system exchanges with the environment (food, air, water,
waste). This open system is a combination of positive and negative feedback loops.
● Input: anything that goes into the system (matter, energy, information), i.e food and
drink
● Throughput: transformation of input entering the system, i.e. digestion and absorption
of the food
● Output: consequence of the throughput process, matter, energy or information that is
released from the system, i.e. energy creates as well the excretion of waste (feces)
, ● Feedback: influences the way the system perpetuates itself, i.e. a variety of things. How
did the food make is feel? This will influence if we will eat it again (energized or
bloated?). What ended up in the toilet? (Constipated or diarrhea?)
3. Explain normal cellular metabolism.
● Cellular metabolism- chemical tasks of maintaining essential cellular functions. Phase 1
is digestion (larger molecules are broken down into smaller subunits via enzymes. Takes
place outside of the cell). Phase 2 is glycolysis (anerobic). Phase 3 is the citric acid cycle
(aerobic)
4. Identify several mechanisms and manifestations of cellular and tissue adaptation, injury, and
death.
● Cellular adaptation is the cells response to escape and protect itself from injury. Include
atrophy, hypertrophy, hypoplasia, hyperplasia, aplasia, metaplasia, and dysplasia.)
Cellular injury occurs if the cell is unable to maintain homeostasis. The cell may recover
or die.
● Cellular injury is the response of cells to failed adaptation and occurs if cells are unable
to maintain homeostasis when faced with injurious stimuli. Most diseases begin with cell
injury. It can be caused by any factor that disrupts cellular structures or deprives the cell
of oxygen and nutrients required for survival. There are two types of cellular injury:
reversible and irreversible.
, Pathophysiology and Causes of Cellular Injury
(1) Hypoxic Injury * This is the most common cause of cellular injury. Hypoxia is caused
by decreased O2 in the air, decreased red blood cells, loss of
This will be on every exam: hemoglobin or hemoglobin function, cardiovascular or respiratory
The most common cause of disease, or poisoning of oxidative enzymes within cells (i.e.
hypoxia is ischemia. cyanide). The most common cause of hypoxia is ischemia*.
Ischemia à hypoxia à Ischemia is reduced blood supply usually through vasoconstriction.
cellular injury. Examples include coronary artery disease and heart attack, cerebral
artery disease and strokes, peripheral vascular disease and
amputations. Hypoxic injury can be either sudden or gradual
(gradual is the better tolerated of the two because cells can adapt).
Cells are stuck in Phase 2, which results in decreased ATP and lactic
acidosis (need O2). Anoxia is a total lack of O2.
(2) Oxygen-derived free A free radical is an electrically uncharged atom or group of atoms
radicals and reactive having an unpaired electron, making it very unstable and capable of
oxygen species** injurious chemical bond formation with proteins, lipids and carbs.
This atom can leak out during the process of oxidative
phosphorylation. Free radicals are associated with over 200 disease
processes. It is also the leading theory of aging. **Detailed below**
(3) Chemical Injury Includes lead, carbon monoxide, ethanol, mercury, and social or
street drugs
(4) Infectious Injury Pathogenicity (or virulence) of a microorganism refers to its disease
producing potential. Viruses and parasites invade and destroy,
bacteria produce toxins, and fungi produce hypersensitive reactions.
(5) Immunologic and Helps protect and heal our bodies, but it can also have some injurious
Inflammatory Injury effects. Examples are phagocytic cells, immune and inflammatory
substances (histamine, antibodies, lymphokines, complement and
enzymes), and membrane alterations.
(6) Injurious Genetic Nuclear alterations and alterations in the plasma membrane structure,
Factors shape, receptors or transport mechanisms. Examples include sickle
cell anemia and muscular dystrophy.
(7) Injurious Nutritional Essential nutrients are required for cells to function normally.
Imbalances Deficient and excessive intake both negatively effect health.
, (8) Injurious Physical · Blunt force injuries are an application of mechanical injury to
Agents the body resulting in tearing, shearing or crushing of tissues. A
contusion is bleeding into the skin or underlying tissues as a
consequence of a blow that squeezes or crushes the soft tissues and
ruptures blood vessels. A hematoma is a collection of blood in soft
tissues. Abrasions are scrapes that result from removal of the
superficial layers of the skin. Lacerations are jagged and irregular
tears or rips. Fractures.
· Sharp force injuries include incised (longer than it is deep), stab
(deeper than long), puncture or chopping wounds.
· Gunshot wounds have two important components: entrance
wounds (contact range, intermediate range or indeterminate range)
and exit wounds (shored).
· Asphyxial injuries (hypoxic injury) are caused by a failure of
cells to receive or use oxygen. Examples include strangulation,
suffocation, chemical asphyxiants and drowning.
· Temperature extremes involve hypothermic injury (slows
cellular metabolic processes) and hyperthermic injury.
· Atmospheric pressure changes are sudden increases or
decreases in atmospheric pressure (blast injury, decompression
sickness or “the bends”).
· Ionizing radiation is any form of radiation capable of removing
orbital electrons from atoms (X-rays, gamma rays, alpha & beta
particles).
· Illumination injury is any eyestrain, obscured vision and
cataract formation caused by light modulation.
· Mechanical stresses are any physical impact or irritation.
· Noise is acoustic trauma and noise-induced hearing loss.
*Derrico stressed these two topics during his lecture (include ischemia)
*Free Radicals (narrated PowerPoint – continued from above)
Free radical damage can result in cellular injury to cell membranes and nucleic acids including lipid
peroxidation (destruction of fatty acids in cell walls), protein fragmentation, and DNA alterations. The
theory of aging is that the mitochondria become more damaged over time, causing decreased ATP
production and increased free radical damage. Antioxidants neutralize free radicals by pairing up with
the uncharged free electron. The process of inactivation or termination of free radicals is by quenching the
lone electron in the outer shell of the free radical. Antioxidants block the synthesis or inactivate the free
radical. Some examples include: endogenous or exogenous antioxidants, vitamin E and C, Beta Carotene,
Cysteine, Gluthathione, Albumin, Transferrin and more. Enzymes such as Superoxide dismutase (SOD),
Catalase (CAT), and Gluthathione peroxidase (GHX) can also inactivate free radicals. Research indicates
that chronic exercise results in elevated levels of these enzymes. Normally, cells have chemical
mechanisms to protect themselves from free radical damage (endogenous antioxidants). During hypoxia
Unit 1 - Exam 1 Blue-Print
● 20 questions - Cell Metabolism, Inflammation, Integumentary, Wound Healing
● 20 questions - Pain, Sleep, Temp. & Vital Signs
● 20 questions - Fluid and Electrolytes
● 20 questions - Acids and Bases
● 20 questions – Neurotransmitters, Stress, Aging, Genes & Environment
Cell Metabolism, Inflammation, Integumentary, Wound Healing
Objectives:
1. Define Pathophysiology & Psychopathology.
● Physiology is the study of normal body function (specifically, the study of the origin,
nature and normal function of humans and the chemical and physical processes
involved)
● Pathophysiology is the study of disturbances of normal origin, nature, and functions of
human beings and the chemical and physical processes involved. In other words,
physiology (physiologic) is to health as pathophysiology (pathologic) is to disease.
● Psychology is the study of the mind, occurring via the study of behavior.
● Psychopathology is the study of mental illness, mental distress and abnormal
maladaptive behavior. Whiles psychopathology is more conceptual, pathophysiology is
more concrete
2. Relate principles of General Systems Theory to the study of Pathophysiology.
● The General Systems Theory (GST) is a theoretical framework that is the basis of our
approach to nursing and health care. It explains the breaking of whole things into parts
and the working together of those parts into systems. A system is any set of interacting
parts and organisms (humans are an example). Complex systems (human body) are
studied as subsystems, but always recall that the human body system acts as a whole.
● Dysfunction of a subsystem causes a human body system disturbance rather than only
the loss of a single function of the subsystem. Systems can be open (exchange with the
environment) or closed (no exchange with the environment). The human body system is
an open system where the system exchanges with the environment (food, air, water,
waste). This open system is a combination of positive and negative feedback loops.
● Input: anything that goes into the system (matter, energy, information), i.e food and
drink
● Throughput: transformation of input entering the system, i.e. digestion and absorption
of the food
● Output: consequence of the throughput process, matter, energy or information that is
released from the system, i.e. energy creates as well the excretion of waste (feces)
, ● Feedback: influences the way the system perpetuates itself, i.e. a variety of things. How
did the food make is feel? This will influence if we will eat it again (energized or
bloated?). What ended up in the toilet? (Constipated or diarrhea?)
3. Explain normal cellular metabolism.
● Cellular metabolism- chemical tasks of maintaining essential cellular functions. Phase 1
is digestion (larger molecules are broken down into smaller subunits via enzymes. Takes
place outside of the cell). Phase 2 is glycolysis (anerobic). Phase 3 is the citric acid cycle
(aerobic)
4. Identify several mechanisms and manifestations of cellular and tissue adaptation, injury, and
death.
● Cellular adaptation is the cells response to escape and protect itself from injury. Include
atrophy, hypertrophy, hypoplasia, hyperplasia, aplasia, metaplasia, and dysplasia.)
Cellular injury occurs if the cell is unable to maintain homeostasis. The cell may recover
or die.
● Cellular injury is the response of cells to failed adaptation and occurs if cells are unable
to maintain homeostasis when faced with injurious stimuli. Most diseases begin with cell
injury. It can be caused by any factor that disrupts cellular structures or deprives the cell
of oxygen and nutrients required for survival. There are two types of cellular injury:
reversible and irreversible.
, Pathophysiology and Causes of Cellular Injury
(1) Hypoxic Injury * This is the most common cause of cellular injury. Hypoxia is caused
by decreased O2 in the air, decreased red blood cells, loss of
This will be on every exam: hemoglobin or hemoglobin function, cardiovascular or respiratory
The most common cause of disease, or poisoning of oxidative enzymes within cells (i.e.
hypoxia is ischemia. cyanide). The most common cause of hypoxia is ischemia*.
Ischemia à hypoxia à Ischemia is reduced blood supply usually through vasoconstriction.
cellular injury. Examples include coronary artery disease and heart attack, cerebral
artery disease and strokes, peripheral vascular disease and
amputations. Hypoxic injury can be either sudden or gradual
(gradual is the better tolerated of the two because cells can adapt).
Cells are stuck in Phase 2, which results in decreased ATP and lactic
acidosis (need O2). Anoxia is a total lack of O2.
(2) Oxygen-derived free A free radical is an electrically uncharged atom or group of atoms
radicals and reactive having an unpaired electron, making it very unstable and capable of
oxygen species** injurious chemical bond formation with proteins, lipids and carbs.
This atom can leak out during the process of oxidative
phosphorylation. Free radicals are associated with over 200 disease
processes. It is also the leading theory of aging. **Detailed below**
(3) Chemical Injury Includes lead, carbon monoxide, ethanol, mercury, and social or
street drugs
(4) Infectious Injury Pathogenicity (or virulence) of a microorganism refers to its disease
producing potential. Viruses and parasites invade and destroy,
bacteria produce toxins, and fungi produce hypersensitive reactions.
(5) Immunologic and Helps protect and heal our bodies, but it can also have some injurious
Inflammatory Injury effects. Examples are phagocytic cells, immune and inflammatory
substances (histamine, antibodies, lymphokines, complement and
enzymes), and membrane alterations.
(6) Injurious Genetic Nuclear alterations and alterations in the plasma membrane structure,
Factors shape, receptors or transport mechanisms. Examples include sickle
cell anemia and muscular dystrophy.
(7) Injurious Nutritional Essential nutrients are required for cells to function normally.
Imbalances Deficient and excessive intake both negatively effect health.
, (8) Injurious Physical · Blunt force injuries are an application of mechanical injury to
Agents the body resulting in tearing, shearing or crushing of tissues. A
contusion is bleeding into the skin or underlying tissues as a
consequence of a blow that squeezes or crushes the soft tissues and
ruptures blood vessels. A hematoma is a collection of blood in soft
tissues. Abrasions are scrapes that result from removal of the
superficial layers of the skin. Lacerations are jagged and irregular
tears or rips. Fractures.
· Sharp force injuries include incised (longer than it is deep), stab
(deeper than long), puncture or chopping wounds.
· Gunshot wounds have two important components: entrance
wounds (contact range, intermediate range or indeterminate range)
and exit wounds (shored).
· Asphyxial injuries (hypoxic injury) are caused by a failure of
cells to receive or use oxygen. Examples include strangulation,
suffocation, chemical asphyxiants and drowning.
· Temperature extremes involve hypothermic injury (slows
cellular metabolic processes) and hyperthermic injury.
· Atmospheric pressure changes are sudden increases or
decreases in atmospheric pressure (blast injury, decompression
sickness or “the bends”).
· Ionizing radiation is any form of radiation capable of removing
orbital electrons from atoms (X-rays, gamma rays, alpha & beta
particles).
· Illumination injury is any eyestrain, obscured vision and
cataract formation caused by light modulation.
· Mechanical stresses are any physical impact or irritation.
· Noise is acoustic trauma and noise-induced hearing loss.
*Derrico stressed these two topics during his lecture (include ischemia)
*Free Radicals (narrated PowerPoint – continued from above)
Free radical damage can result in cellular injury to cell membranes and nucleic acids including lipid
peroxidation (destruction of fatty acids in cell walls), protein fragmentation, and DNA alterations. The
theory of aging is that the mitochondria become more damaged over time, causing decreased ATP
production and increased free radical damage. Antioxidants neutralize free radicals by pairing up with
the uncharged free electron. The process of inactivation or termination of free radicals is by quenching the
lone electron in the outer shell of the free radical. Antioxidants block the synthesis or inactivate the free
radical. Some examples include: endogenous or exogenous antioxidants, vitamin E and C, Beta Carotene,
Cysteine, Gluthathione, Albumin, Transferrin and more. Enzymes such as Superoxide dismutase (SOD),
Catalase (CAT), and Gluthathione peroxidase (GHX) can also inactivate free radicals. Research indicates
that chronic exercise results in elevated levels of these enzymes. Normally, cells have chemical
mechanisms to protect themselves from free radical damage (endogenous antioxidants). During hypoxia
