Pathophysiology midterm 1 選擇題 (同一份) 總複習

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What defines the initial injury in the disease process?

The cause of the initial injury (correct)

The observable consequences of disease

The time of exposure to pathogens

The body's adaptive response to injury

Which period describes the absence of signs or symptoms following an initial injury?

Latent period (correct)

Acute period

Prodromal period

Chronic period

Which of the following best describes 'etiology' in the context of disease?

The observable effects of a disease

The cause of the disease (correct)

The location of the injury within the body

The physiological development of a disease

What characterizes signs in clinical manifestations?

They can be measured and objectively observed Signup and view all the answers

Which factor does NOT influence pathogenesis?

Patient's age Signup and view all the answers

What is a common cause of decreased plasma oncotic pressure leading to edema?

Decreased albumin production Signup and view all the answers

What role does the renin-angiotensin system primarily serve?

Maintains electrolyte balance Signup and view all the answers

What condition can result from lymphatic obstruction?

Lymphedema Signup and view all the answers

Which type of injury to cells is classified as intrinsic?

Congenital disorders Signup and view all the answers

What is the term for the balance of fluid within the extracellular and intracellular compartments?

Fluid homeostasis Signup and view all the answers

Which of the following is NOT a method for making a diagnosis?

Patient's subjective opinion Signup and view all the answers

What can lead to intracellular fluid changes when extracellular fluid (ECF) is altered?

Alteration in osmolarity Signup and view all the answers

What could excessive use of non-steroidal anti-inflammatory drugs (NSAIDs) lead to?

Altered renal function Signup and view all the answers

Which of the following drives passive fluid movement in capillaries according to Starling forces?

Capillary hydrostatic pressure Signup and view all the answers

What factor is a primary reason for the higher susceptibility to dehydration in females?

Higher body fat percentage Signup and view all the answers

What happens when there is a break in a capillary wall?

Leakage of fluid into interstitial space Signup and view all the answers

What component is critical for maintaining pH within normal ranges essential for enzyme function?

Bicarbonate ions Signup and view all the answers

Which of these can disrupt normal cellular function?

Cellular injury Signup and view all the answers

What is a function of Na+/K+ ATPase pumps?

Maintains resting membrane potential Signup and view all the answers

What is the primary function of oxidative phosphorylation in cellular metabolism?

Requires O2 and produces the most ATP Signup and view all the answers

What is the consequence of hypoxic injury due to ischemia?

Increased intracellular Na and Ca levels Signup and view all the answers

Which statement best describes atrophy in cellular adaptation?

Cell number remains the same, but cell size decreases Signup and view all the answers

What leads to the formation of free radicals?

Exposure to UV light and pollution Signup and view all the answers

Which process can result from chronic injury and lead to dysplasia?

Metaplasia of mature cells Signup and view all the answers

How does mitochondrial dysfunction contribute to cellular injury?

Alters ion balance in the cell Signup and view all the answers

What is the effect of lipid peroxidation on cell membranes?

Decreases enzyme activity and alters receptor activity Signup and view all the answers

What distinguishes hyperplasia from hypertrophy?

Generation of new cells versus increase in existing cell size Signup and view all the answers

What results from a complete loss of oxygen known as anoxia?

Impairment of mitochondrial function and cell injury Signup and view all the answers

Which of the following characterizes metaplasia?

Replacement of differentiated cells by stem cells Signup and view all the answers

What type of necrosis is characterized by tissue death without liquefaction?

Coagulative necrosis Signup and view all the answers

Which type of necrosis occurs when intracellular fat interacts with fatty deposits?

Fat necrosis Signup and view all the answers

Which part of the brain is primarily responsible for autonomic responses such as heartbeat and breathing?

Brain stem Signup and view all the answers

What is the primary function of astrocytes within the central nervous system?

Regulate blood-brain barrier Signup and view all the answers

Which area of the brain is responsible for producing intelligible speech?

Broca's area Signup and view all the answers

What occurs during programmed cell death known as apoptosis?

Removal of abnormal cells by immune cells Signup and view all the answers

What type of necrosis is specifically associated with tuberculous infection in lymph nodes?

Caseous necrosis Signup and view all the answers

Which of the following statements about cerebrospinal fluid (CSF) is correct?

It helps maintain optimal central nervous system ion concentrations. Signup and view all the answers

Which layer of the blood-brain barrier is primarily responsible for filtering substances?

Tight junctions Signup and view all the answers

How does increased magnesium affect hypertension according to the information provided?

It lowers blood pressure by relaxing smooth muscles in blood vessels. Signup and view all the answers

Which of the following correctly describes the relationship between Wernicke's area and Broca's area?

They communicate bidirectionally, affecting language processing. Signup and view all the answers

Which component of the brain is primarily involved in learned motor movements?

Cerebellum Signup and view all the answers

Which type of necrosis is characterized by the transformation of tissue into a liquefied state?

Liquefactive necrosis Signup and view all the answers

What condition is characterized by a loss of both plasma and electrolytes equally?

Isotonic volume depletion Signup and view all the answers

In which condition would you expect elevated osmolarity of extracellular fluid (ECF)?

Hypernatremia Signup and view all the answers

What factor causes potassium to shift out of the cell during acidosis?

Excessive H+ concentration in the cell Signup and view all the answers

Which buffer system is primarily involved in maintaining acid-base balance?

Bicarbonate buffer system Signup and view all the answers

What is a common cause of respiratory acidosis?

Hypoventilation Signup and view all the answers

How does metabolic acidosis affect bicarbonate levels?

Bicarbonate levels are decreased Signup and view all the answers

Which condition is characterized by excessive retention of CO2 in the lungs?

Respiratory acidosis Signup and view all the answers

Which of the following is a common cause of metabolic alkalosis?

Excessive bicarbonate intake Signup and view all the answers

What is the function of Na/K ATPase pumps in potassium regulation?

Facilitate sodium and potassium balance across membranes Signup and view all the answers

Which of the following describes a state of hyponatremia?

Dilution of sodium by excess water Signup and view all the answers

What is the primary role of renal regulation during acid-base imbalances?

Reabsorb bicarbonate and excrete H+ Signup and view all the answers

Which condition involves high HCO3- levels despite the presence of metabolic acidosis?

Partially compensated acidosis Signup and view all the answers

Which of the following is NOT a major buffer system in the body?

Hematopoietic buffer system Signup and view all the answers

What is the role of thyroid hormone in metabolism?

It triggers the production of Na/K ATP pumps. Signup and view all the answers

Which hormone is primarily responsible for stimulating the release of Growth Hormone (GH)?

GHRH Signup and view all the answers

How does the hypothalamus communicate with the anterior pituitary?

By releasing hormones into blood vessels. Signup and view all the answers

Which gland serves as the initial hormone-releasing gland in the hierarchical control system?

Hypothalamus Signup and view all the answers

What regulates calcium levels in the body?

Parafollicular cells and calcitonin Signup and view all the answers

What effect does cortisol have on blood glucose levels during stress?

Elevates blood glucose by inhibiting glucose uptake. Signup and view all the answers

Which structure is primarily responsible for processing sensory information in the spinal cord?

Dorsal horn Signup and view all the answers

Which part of the adrenal gland is primarily responsible for producing catecholamines?

Adrenal medulla Signup and view all the answers

What type of neurons are found in the lateral horn of the spinal cord?

Autonomic efferent neurons Signup and view all the answers

Which hormone is released by the posterior pituitary?

Vasopressin Signup and view all the answers

What defines the release pattern of Growth Hormone during sleep?

Occurs in larger and more frequent pulses. Signup and view all the answers

Which description accurately depicts the white matter of the spinal cord?

Composed of myelinated axon fibers that travel vertically Signup and view all the answers

What is the role of the interneuron located in the dorsal horn?

Processes sensory information Signup and view all the answers

What is the main function of T3 and T4 hormones?

To increase metabolic rate and sympathetic activity. Signup and view all the answers

During the knee jerk reflex, which response is created by the motor neuron serving the quadriceps?

Excitatory response causing contraction Signup and view all the answers

What characterizes the sympathetic pathway of the autonomic nervous system?

Preganglionic neurons originate from T1-L3 Signup and view all the answers

What type of synaptic arrangement is typical for the parasympathetic nervous system?

Two neurons and two synapses with varying locations Signup and view all the answers

Which of the following does not involve direct communication with the brain?

Knee deep tendon reflex Signup and view all the answers

In which area of the sympathetic nervous system do preganglionic neurons synapse onto postganglionic neurons?

Para vertebral ganglia Signup and view all the answers

Which function is primarily controlled by the autonomic nervous system?

Homeostatic functions like blood pressure Signup and view all the answers

Which sympathetic structures are associated with the adrenal medulla?

Preganglionic neurons synapsing directly onto adrenal cells Signup and view all the answers

Which pathway is primarily activated during the 'fight or flight' response?

Sympathetic nervous system Signup and view all the answers

Which of the following accurately describes an afferent neuron function in the ANS?

Relaying visceral function conditions to the brain Signup and view all the answers

Where is the primary location of preganglionic neurons for the parasympathetic nervous system?

Cranial nerves and sacral spinal cord Signup and view all the answers

What is the primary location where the norepinephrine system originates?

Locus Coeruleus Signup and view all the answers

Which of the following neurotransmitter systems is primarily involved in regulating mood and temperature control?

Serotonin System Signup and view all the answers

In which area do the leaky regions of the blood-brain barrier, known as circumventricular organs, NOT include?

Hippocampus Signup and view all the answers

Which circuit of the dopamine system is associated with modifying voluntary motor movements?

Substantia Nigra Signup and view all the answers

What type of functions do the ventral root of spinal nerves primarily control?

Motor functions Signup and view all the answers

Which system is known for making widespread projections throughout various regions of the brain but is less global than norepinephrine or serotonin systems?

Dopamine System Signup and view all the answers

What type of cranial nerves are the olfactory (I) and optic (II) nerves categorized as?

Sensory Signup and view all the answers

What type of receptors do preganglionic sympathetic cells target at peripheral neurons?

Nicotinic receptors Signup and view all the answers

Which of the following hormones is an example of a peptide and protein hormone?

Insulin Signup and view all the answers

Which neurotransmitter is most directly involved in cognitive processing and can lead to delirium if blocked?

Acetylcholine Signup and view all the answers

What phenomenon occurs if varicella remains in the spinal cord and reemerges due to reduced immune function?

Shingles Signup and view all the answers

What effect does norepinephrine binding to alpha 1 receptors have on blood vessels?

Vasoconstriction Signup and view all the answers

What is the primary role of the adrenal medulla in the sympathetic nervous system?

Releases neurotransmitters into the bloodstream Signup and view all the answers

Which structure is NOT a part of the serotonin system's origin in the brainstem?

Ventral Tegmental Area Signup and view all the answers

Which behavior is predominantly influenced by the norepinephrine system?

Attention Signup and view all the answers

Which statement correctly differentiates between the actions of lipid-soluble and water-soluble hormones?

Lipid-soluble hormones can cross the plasma membrane, while water-soluble hormones require a receptor. Signup and view all the answers

Which part of the brain is primarily responsible for controlling autonomic functions such as urinary and respiratory control?

Brainstem Signup and view all the answers

Which neurotransmitter system is characterized by its modulation of the sleep/wake cycle and levels of excitability across multiple brain regions?

Norepinephrine Signup and view all the answers

What is primarily conveyed through the vagus nerve?

Parasympathetic input to body organs Signup and view all the answers

What is the main function of the hormone aldosterone?

Promotes water retention Signup and view all the answers

Which neurotransmitter system is associated with hyperthermia and motor restlessness when overstimulated?

Dopamine Signup and view all the answers

What is the primary characteristic of central endocrine glands?

Part of the central nervous system Signup and view all the answers

What role does cortisol play in the body during stressful situations?

Increases mental agility Signup and view all the answers

What is the effect of sympathetic tone on the body's response during stress?

Increased sympathetic tone Signup and view all the answers

Which type of hormones are derived from cholesterol?

Steroid hormones Signup and view all the answers

What is required for the transport of lipid-soluble hormones in the bloodstream?

Carrier proteins Signup and view all the answers

Which type of receptors do beta 1 receptors primarily affect?

Cardiac muscle Signup and view all the answers

Which glands are classified as peripheral endocrine structures?

Thyroid and adrenal glands Signup and view all the answers

Which hormone directly activates specific genes to cause the formation of new proteins?

Cortisol Signup and view all the answers

Study Notes

Introduction to Pathophysiology and Cellular Basis of Disease

Disease is dynamic, involving an interplay between cause, injury, and the body's response to that injury.
Initial signs of disease manifest when physical parameters fall outside the normal range.
Etiology refers to the cause of disease, while pathogenesis describes the physiological development of the disease process.
Factors affecting pathogenesis include time, quantity of exposure, and the location of injury.
Morphological changes arise from chronic injuries, leading to observable clinical manifestations (e.g., damage to pancreas results in diabetes mellitus).

Clinical Manifestations

Observable consequences of disease are categorized into signs (measurable and objective, e.g., rash, fever) and symptoms (subjective experiences reported by the patient, e.g., nausea, pain).
Critical stages in the disease progression include:
- Latent period: Between injury and onset of symptoms.
- Prodromal period: First appearance of symptoms.
- Acute period: Peak of symptoms, followed by recovery or chronic phase.

Causes of Disease

Extrinsic injuries: Induced by inanimate (physical agents, chemical exposure) or animate (infectious organisms) factors.
Intrinsic injuries: Include inherited, congenital, metabolic, degenerative, and immunologic causes.
Idiopathic conditions lack a known cause.

Cellular Function and Homeostasis

Body functions depend on specialized cells organized into tissues and organs, requiring interdependent cellular responses to maintain functionality.
Maintaining cellular homeostasis involves regulating:
- Cell volume via water and osmolyte balance, particularly sodium and potassium.
- Electrolyte levels controlled by the Renin-angiotensin system.
- pH levels critical for enzyme function and metabolic processes.

Fluid Balance and Edema

Total body water (TBW) generally accounts for about 60% of body weight, varying with age and body fat percentage.
Edema can result from decreased plasma oncotic pressure (e.g., low albumin levels), increased capillary permeability, or lymphatic obstructions.
Starling forces determine fluid movement across capillaries: balances between capillary blood pressure and osmotic pressures.

Acid-Base Balance

Acids donate H+ ions; bases absorb them. pH is measured on a scale from 0 to 14, indicating acidity or alkalinity.
Major buffer systems, like bicarbonate and hemoglobin, help stabilize pH levels.
The lungs manage carbon dioxide levels; kidneys control bicarbonate and hydrogen ion concentration.
Conditions of acidosis or alkalosis can occur due to respiratory or metabolic imbalances, with compensatory mechanisms involving opposite organ systems.

Cellular Metabolism

Three steps of cellular metabolism produce ATP: glycolysis, citric acid cycle (Krebs), and oxidative phosphorylation.
Different transport mechanisms, including passive and active transport, regulate cellular materials.

Cellular Injury and Adaptation

Cellular responses to injury can include adaptive changes (e.g., atrophy, hypertrophy) or irreversible injury leading to necrosis.
Types of necrosis include coagulative, liquefactive, and caseous necrosis depending on tissue death characteristics.
Apoptosis or programmed cell death occurs in response to certain triggers, such as viral infections or DNA damage.

Nervous System Function

Major divisions of the central nervous system (CNS) include the spinal cord, brain stem, cerebellum, diencephalon, and cerebrum.
The somatosensory map aids in understanding how sensory inputs are processed, especially for those who are blind, highlighting brain plasticity.
Key areas for language processing exist in the brain, like Wernicke’s area (language comprehension) and Broca’s area (speech production). Damage to these areas results in aphasias, affecting communication capabilities.### Understanding Neurological Concepts
"Can Understand, Cannot Express": A condition often associated with strokes affecting specific brain areas.
Brodmann’s Areas: Specific regions in the brain linked to various body functions.

Central Nervous System (CNS) Anatomy

Glial Cells: Non-neuronal cells providing support in the nervous system. Types include:
- Astrocytes: Form the blood-brain barrier (BBB) by surrounding capillaries.
- Oligodendrocytes: Responsible for myelination of CNS axons.
- Ependymal Cells: Line cerebral ventricles and communicate with CSF.

Meninges and Cerebrospinal Fluid (CSF)

Meninges: Protective membranes (dura mater, arachnoid, pia mater) that encase the brain.
Cerebral Ventricles: Produce and secrete CSF, crucial for cushioning the brain.
- Choroid Plexus: Specialized tissue in ventricles responsible for CSF production.
CSF Composition: Lower sodium and potassium compared to plasma, influencing neuronal excitability and seizure potential.

Blood-Brain Barrier (BBB)

Structure: Comprised of tight junctions between endothelial cells, a basement membrane, and astrocyte end-feet.
Function: Filters substances entering the brain; allows selective permeability for water, O2, and lipids, while tightly regulating ions.

Neurotransmitter Systems

Norepinephrine System: Originates from the locus coeruleus; influences wakefulness, attention, and regulated by inhibition.
Serotonin System: Arises from the raphe nuclei; regulates mood, sleep, temperature control, and motor excitation.
Dopamine System: Key circuits include:
- Substantia Nigra: Modifies voluntary motor control.
- Ventral Tegmental Area: Involved in reward and motivation.
Acetylcholine (ACh): Plays a role in sleep/wake states and cognitive processing.

Peripheral Nervous System (PNS)

Cranial Nerves: 12 pairs involving both sensory and motor functions; specific nerves dedicated to particular sensory modalities.
Spinal Nerves: 31 pairs that control both sensory and motor functions; dorsal roots carry sensory input, while ventral roots transmit motor commands.

Spinal Reflexes and Cord Anatomy

Reflex Arcs: Involve afferent sensory neurons and efferent motor neurons for quick responses; can operate independently of brain input.
Ascending/Descending Tracts: Ascend via dorsal roots (sensory) and descend via ventral roots (motor); white matter comprises myelinated axons, gray matter contains neuron cell bodies.

Autonomic Nervous System (ANS)

Divisions: Parasympathetic (rest and digest) vs. sympathetic (fight or flight); both systems use two-neuron pathways to reach target organs.
Preganglionic Neurons: Sympathetic originates in the spinal cord (T1-L3), while parasympathetic arises from cranial nerves (III, VII, IX, X) and sacral spinal cord.

Neurotransmitters of the ANS

Acetylcholine and Norepinephrine play crucial roles in mediating responses for both sympathetic and parasympathetic systems through various receptor types.

Endocrine System Overview

Function: Hormonal signaling is wireless, impacting multiple body functions by binding to specific receptors.
Types of Hormones: Include peptide/protein, amino acid-derived, and steroid hormones, each with distinct production and transport mechanisms.
Central and Peripheral Endocrine Glands: Central glands (hypothalamus, pituitary) play vital roles in hormone release; peripheral glands serve dedicated endocrine functions.

Hormone Actions and Effects

Hormonal Action: Includes altering channel permeability, second-messenger systems, and gene activation to elicit physiological responses.
ADH (Vasopressin): Important for water reabsorption in kidneys and vasoconstriction effects.

These notes highlight crucial neurological, physiological, and hormonal functions essential for understanding the body's systems.### Hormonal Functions and Types

Hormones, like T3 and T4, can act both as hormones and neurotransmitters depending on their release method.
T3 is the only active form of thyroid hormone; T4 requires the removal of an iodine atom to become active.
Thyroid hormones are lipid-soluble and can cross cell membranes to influence gene expression, particularly those regulating energy consumption and metabolic rate.
Hyperthyroidism can induce anxiety in affected individuals.

Steroid Hormone Synthesis

Steroid hormones are synthesized from cholesterol, which can be dietary or produced by the liver.
Cholesterol, being a fat, is transported in the blood via lipoproteins (LDL) and binds to receptors on endocrine cells.
Inside endocrine cells, LDL is internalized and metabolized into pregnenolone, which can be converted into various hormones like aldosterone, cortisol, estradiol, and testosterone, with each step requiring specific enzymes.

Peptide Hormones and Signaling

Peptide hormones cannot cross cell membranes; they activate second messenger pathways such as cAMP or Ca²⁺, initiating cellular responses.
In contrast, steroids directly enter the nucleus to influence gene expression, as seen with thyroid hormones that increase metabolism via proteins like Na/K ATP pumps.

Hormonal Secretion Control

Hormonal secretion is regulated by negative feedback; the level of hormone in the bloodstream determines if additional production is necessary.
Hierarchical control involves a sequence where one hormone regulates the release of another from different glands.
For example, the hypothalamus signals the anterior pituitary, which then communicates with peripheral glands like the thyroid.

Hypothalamus and Pituitary Interaction

The posterior pituitary is an extension of the hypothalamus and releases vasopressin and oxytocin directly into capillaries.
The anterior pituitary functions as a true endocrine gland, releasing several hormones like TSH, ACTH, prolactin, growth hormone, LH, and FSH, controlled by hormones from the hypothalamus.

Growth Hormone (GH) Regulation

GH release is regulated by hormones from the hypothalamus, specifically GHRH, which stimulates GH release, and somatostatin, which inhibits it.
GH is primarily released during non-REM sleep and follows a circadian rhythm, with higher pulses occurring at night.
Quality and quantity of sleep significantly influence GH release, affecting overall health.

Thyroid Gland Anatomy and Function

The thyroid gland contains follicular cells that synthesize thyroid hormones, stored in colloid, and can regulate metabolic rate and sympathetic activity.
Parafollicular (C) cells in the thyroid release calcitonin, which regulates calcium levels in the body.
T3, derived from T4 through enzymatic conversion, binds to thyroid hormone receptors to influence energy-consuming processes like Na+/K+ pump activity and gluconeogenesis.

Adrenal Gland Structure and Hormones

The adrenal glands, located atop each kidney, consist of two main regions: the adrenal medulla and adrenal cortex.
The adrenal medulla produces catecholamines (mainly epinephrine and norepinephrine) as part of the sympathetic nervous system response.
The adrenal cortex produces steroid hormones, divided into three zones: zona glomerulosa (mineralocorticoids), zona fasciculata (glucocorticoids), and zona reticularis (sex hormones).

Effects of Cortisol

Cortisol, a glucocorticoid synthesized in the zona fasciculata, mediates the stress response by elevating blood glucose levels.
It promotes the breakdown of muscle and bone to release free amino acids and calcium, respectively, while also preventing insulin from lowering blood glucose.
Additionally, cortisol enhances sodium retention, potassium loss, and vasoconstriction, contributing to blood pressure regulation, while serving anti-inflammatory functions and increasing brain excitability for quick responses.

Cortisol Secretion Patterns

Cortisol levels are lowest in the evening and peak just before waking, aiding the body's natural wake-up process.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the cellular basis of disease and how various factors contribute to pathogenesis. This quiz covers the dynamic nature of disease, clinical manifestations, and the important distinctions between signs and symptoms. Prepare to explore the etiology and progression of diseases as discussed in your coursework.