NSY2122 Applied Life Science Lecture 1 - Altered Cells - PDF

NSY2122 Applied Life Science Topic 1 – Lecture Notes Welcome to Year 2 Applied Life Science NSY2122 Dr Katherine Rogers & Dr Gillian Carter...

NSY2122 Applied Life Science Topic 1 – Lecture Notes Welcome to Year 2 Applied Life Science NSY2122 Dr Katherine Rogers & Dr Gillian Carter Module Co-ordinators October 2020 1 Lecture 1 – Pathophysiology and Altered Cells Dr Katherine Rogers NSY2122 Applied Life Sciences 2 Dr. K. Rogers 1 NSY2122 Applied Life Science Topic 1 – Lecture Notes Prerequisite reading & review ▪ Revision of year 1 material ▪ Cells, tissues, organs ▪ Fluid and electrolyte balance ▪ Have a go at the Pre-reading quiz ▪ PRE-READING TOPIC 1 - A&P Revision: Cells and cellular biochemistry ▪ Completed reading of the following Nursing Standard papers (all available on Canvas): Nursing Standard A&P Papers for Prerequisite reading ▪ 02. Cells and Cell Biochemistry - Nursing Standard 2012 ▪ 03. Genes, Chromosomes and DNA - Nursing Standard 2012 ▪ 05. Cell, tissues, organs and systems - NS 2012 3 Learning outcomes for this topic ▪ Identify causes of disease ▪ Discuss the process of disease development ▪ Understand how the cell environment can change to cause disease ▪ Apply knowledge of cell changes and disease development to clinical situations ▪ Additional resources available on Canvas ▪ See prompts to guide you to further information 4 Dr. K. Rogers 2 NSY2122 Applied Life Science Topic 1 – Lecture Notes Introduction to pathophysiology and altered cell biology Changes to the normal anatomy and physiology due to illness or What is pathophysiology? disease; how disease affects the functioning of the body Gradual changes in the structure and function of cells (and hence What is altered cell biology? the relevant tissues, and organs) in response to harmful outside influences What is disease? Homeostasis has been lost; signs and symptoms are evident What is illness? The body is no longer in a state of normal health i.e. the body has “adapted” to disease (e.g. person may have asthma but is not showing S&S all the time because the body has adapted to the disease) 5 To fix a problem we need to know its source! 6 Dr. K. Rogers 3 NSY2122 Applied Life Science Topic 1 – Lecture Notes Key message: To treat a disease: Need to find the SOURCE of the problem Understand the problem at the source i.e. the pathophysiology Plan treatment Cure to stop symptoms (return back to normal A&P) Treat to alleviate/reduce symptoms and improve quality of life (qol) 7 8 Dr. K. Rogers 4 NSY2122 Applied Life Science Topic 1 – Lecture Notes See additional reading on Canvas Alterations to normal cell function Cells face many challenges to their normal function during their lifespan These can alter the cell’s normal function When cell integrity is threatened it will adapt to try and keep functioning despite the threat If enough reserve is available and the body doesn’t detect an abnormality the cell will adapt If insufficient reserve is available the cell dies All diseases cause damage or injury to cells This damage causes cells to stop working properly or cell death 9 See additional reading on Canvas Causes of disease - aetiology Most diseases begin due to cell injury when a cell is unable to maintain homeostasis Often diseases do not have a single cause but have many risk factors Understanding risk factors is important because many are modifiable meaning a person can reduce their chances of developing disease Important for patient education and health promotion Adaptation can occur due to: Cell injury Cell aging Cell death 10 Dr. K. Rogers 5 NSY2122 Applied Life Science Topic 1 – Lecture Notes See additional reading on Canvas What happens to make things go wrong? Cell injury – cells often adapt to injury by using their reserves 4 types of injury: Toxins, Infection, Physical injury, Deficit , [T.I.P.I.D.] Cell degeneration – usually affects metabolically active cells e.g. liver, heart, kidneys Non-lethal Occurs in the cytoplasm, nucleus is not affected – why is this significant? Caused by cell swelling, fatty infiltrates, atrophy etc. Cell aging – occur in all body systems, E.g. Loss of elasticity in blood vessels Loss of structure: Atrophy – decrease in size Loss of function: Hypertrophy – abnormal thickening (increased bulk); Hyperplasia – increase in cell number 11 See additional reading on Canvas Disease mechanism - pathogenesis Understanding how a disease develops and progresses can help you understand the clinical manifestations of a disease i.e. How a disease affects a patient How the patient presents – signs and symptoms! Symptoms = how a patient experiences the disease Signs = observations that can be made that indicate presence of disease E.g. asthma: symptom = difficulty breathing; sign = nurse’s observation of the difficulty breathing Also helps with understanding and making decisions about treatment and care management Recognise the clinical presentation of disease and relate it to the underlying pathophysiology 12 Dr. K. Rogers 6 NSY2122 Applied Life Science Topic 1 – Lecture Notes 1. [Recognise what is happening] Three Key Questions to ask wheezing and SOB yourself? is caused by 2. [Identify what causes it to happen at a cellular/tissue level] constriction of the airways (bronchoconstriction) – i.e.. Diameter of airways become narrow due to 3. [Explain what changes must have occurred to normal A&P] inflammation of the epithelial cells lining the tubes production of excess mucus constriction of the smooth muscle to physically reduce their diameter 13 Changes to the cell environment Fluid imbalance fluid deficit fluid excess Electrolyte imbalance Non-electrolytes How are these changes relevant to all diseases? 14 Dr. K. Rogers 7 NSY2122 Applied Life Science Topic 1 – Lecture Notes Fluid imbalance Fluid and electrolyte management is vital in patient care Maintain tissue perfusion Maintain balance of normal plasma components Dehydration – more fluid lost than taken in Hypovolemia – diminished circulatory fluid volume Fluid overload – overload in the circulation due to circulatory problems or fluid therapy Oedema – abnormal fluid accumulation in the interstitial compartment Not necessary a fluid excess but a distribution problem 15 Non-electrolytes Glucose Lipids Creatinine Urea Albumin 16 Dr. K. Rogers 8 NSY2122 Applied Life Science Topic 1 – Lecture Notes Electrolyte imbalance Electrolytes are normally maintained within a Sodium (Na+) very narrow rage Hyponatremia – blood sodium 145 Acid-base imbalance mmol/L Respiratory acidosis Potassium (K+) inc. CO2 = inc. H+ = pH 5.5 mmol/L) inc. H+ or dec. HCO3- Hypokalaemia – serum K < 3.5 mmol/L Respiratory alkalosis dec. CO2 = dec. H+ = pH >7.45 Calcium (Ca2+) Metabolic acidosis Phosphate (HPO3-) dec. H+ or inc. HCO3- Magnesium (Mg2+) 17 Sodium imbalance Hyponatremia Hypernatremia blood sodium 145 mmol/L Water intoxication Too much water overly dilutes Inappropriate administration of the blood saline Females are more at risk Severe V&D because their bodies retain more water Brain herniation (coning) 18 Dr. K. Rogers 9 NSY2122 Applied Life Science Topic 1 – Lecture Notes Maintaining a stable cell environment External and internal (extrinsic and intrinsic) factors will cause change E.g. body temperature – external temperature, internal temp (e.g. increased to infection) Cell environment must constantly be monitored to check conditions are homeostasis Make necessary remaining stable adjustment to maintain homeostasis If changes occur, they must be detected, reported and appropriate adaptations made to correct them – return the process to normal homeostasis 19 Review of today’s lecture Disease and illness Adaptive cell changes Cell injury – TIPID Cell degeneration Cell aging Development of disease Mechanism of disease – pathogenesis Changes to the cell environment Fluid imbalance Electrolyte imbalance Sodium imbalance Non-electrolyte imbalance 20 Dr. K. Rogers 10 NSY2122 Applied Life Science Topic 1 – Lecture Notes Key take home message! Cells are the building blocks of the body – a bit like the foundations of a house – if a problem arises at the cellular level and is not remedied, illness and disease can develop and affect many of the body's processes. Therefore… understanding pathophysiology requires an understanding of the cell since it is the 1. [recognise what is happening] body’s basic building block. 2. [identify what causes it to happen at a cellular/tissue level] 3. [explain what changes must have occurred to normal A&P] 21 Connect your learning - Online “bitesize” video Use the discussion boards - Additional notes Workshop 1 Online Tutorial Case Study on asthma (AD, LD, MH) OR MCQ quiz to test your knowledge Case Study on bronchiolitis (CYP) Asynchronous (not live) Next lecture – Altered Communication 22 Dr. K. Rogers 11 NSY2122 Applied Life Science Topic 1 – Lecture Notes For the workshop… Before you begin work on the group activities in the Workshop: ▪ Review the Example Workshop on Anaphylaxis ▪ Workshop Guidelines and Example ▪ Use this as a template for ALL the Workshops in this module ▪ Apply the same process to the workshop for this lecture ▪ asthma (AD, LD, MH) or bronchiolitis (CYP only) ▪ but remember you should consider the condition in the context of altered cells and tissues 23 Now complete the online tutorial - quiz: Online tutorial 1 - Altered cells 24 Dr. K. Rogers 12