help with disc (2) replies (2) due in 24 hours

due in 24 hours

attached

Diseases of the Nervous System

Disease

Definition

Characteristics

Notes

Trauma to the Brain

Concussion

Any injury of a soft structure, such as the brain, resulting from a blow or violent shaking with no physical damage apparent.

An immediate and temporary disturbance of brain function

It may result in only a temporary grogginess or there may be a wide spread loss of cerebral control with a sudden drawing of the knees and severe vomiting.

Contusion

A bruise to the brain causing swelling and pain

The skin is not broken at the site of the injury

May lead to hydrocephalus

Laceration

Tearing of brain tissue

May occur with or without fracture of the skull

Intracranial Hemorrhage

Hemorrhage in the cranium
Categorized according to the location in relation to the meninges

Layers from outside to inside: Bone, Dura Mater, arachnoid Mater, Pia Mater, Brain

Consequences depends on the location

Extradural or Epidural

Between the bone and dura mater

Subdural (Most Common)

Between the dura mater and arachnoid mater / Will cause sudden death in severe cases

Subarachnoid

Between the arachnoid mater and pia matter

Meningitis

Inflammation of the membranes around the spinal cord and brain

Caused by numerous bacteria and viruses
The form caused by the meningococcus (Neisseria meningitides) is called Epidemic meningitis – The most serious form

Transmitted via the respiratory tract by droplet spray or direct contact with discharges – It then reaches the meninges via the blood or lymph stream.

Encephalitis

Inflammation of the brain

Can be bacterial or viral
The most common form is viral encephalitis – Transmitted to humans via an infected mosquito

May also be a complication of other infectious diseases like malaria, influenza, measles.

General Paresis

A diffuse meningoencephalitis seen in the tertiary stage of syphilis

Inflammation and degeneration of brain tissue will lead to death

Cerebrovascular Accident / Stoke / Apoplexy

Damage to the brain as a result of circulatory interruption.

Usually due to thrombosis, embolism, or hemorrhage
These are usually secondary to atherosclerotic disease

If hemorrhage occurs where blood escapes into the tissue of the brain ti may be due to hypertension or possibly a congenital aneurysm.

Encephalomalacia

Softening of the brain due to death of tissue from lack of blood supply

Transient Ischemic Attack (TIA)

A temporary interference with blood supply to part of the brain – No permanent damage occurs

Characterized by dizziness, fuzzy vision in one eye, numbness or loss of sensation on one side of the body

May last a few minutes or several hours.

Diseases of the Nervous System

Disease

Definition

Characteristics

Notes

Hydrocephalus – “Water on the brain”

Hydrocephalus

The increased accumulation of cerebrospinal fluid within the ventricles of the brain

Caused by a blockage of the normal outflow of the fluid. Brain is pushed against the skull in adults

Dramatic enlargement of the cranium in infants. Bones have not ossified (fused) together yet. Severe cases lead to stillbirths or very short lifespans.

Myelitis

Inflammation of the spinal cord. Occurs due to infection or injury to the spinal cord

Poliomyelitis

Inflammation of the gray matter of the spinal cord. Often affects brain tissue also
Anytime the brain and spinal cord are both involved the term encephalomyelitis is used.

Acquired through a viral infection from respiratory system or contaminated food then reaches the spinal cord through the bloodstream

Affects the motor neurons of the central nervous system resulting in serious damage and paralysis of the muscles controlled by these nerves.

Neuritis

Inflammation of the nerves

May be a direct infection or a complication of other infections like tuberculosis, tetanus, or measles

May also be from damage by trauma or toxins

Epilepsy

A chronic disorder of the nervous system with recurring convulsions and losses of consciousness.

The result of some form of interference with normal electrical activity in the brain. Most causes are idiopathic. Some are associated with brain injury, trauma at birth, or tumors.

Grand Mal or Tonic Clonic Seizures

Violent convulsions – Includes the making of peculiar sounds, biting the tongue, excess salivation

Seizures vary in length and frequency. After a convulsion, the person is usually groggy and doesn’t know what has happened.

Petite Mal or Absence seizures

Loss of consciousness for short periods of time with dizziness

This form is more common in children. Often appears to be day dreaming.

Rabies (Hydrophobia)

Rabies
(Hydrophobia)

An acute, viral, infectious disease of warm-blooded animals

In humans, it causes spasms of the throat muscles when swallowing is attempted, therefore, they avoid fluids.

Transmitted to humans through the saliva of an infected animal via a bite. Characterized by involvement of the central nervous system.
Results in paralysis and death.

Multiple Sclerosis

A chronic degenerative disease of the nervous system characterized by remissions and relapses.

The myelin sheaths of the nerves are destroyed. Impairs motor and sensory nerve impulses. This causes muscle weakness and incoordination, tremors, paralysis, vision problems, and abnormal, rapid eyeball movements.

Scattered diffusely throughout the gray and white matter of the brain stem and spinal cord. Affects young adults between 20 and 40 years of age.

Diseases of the Nervous System

Disease

Definition

Characteristics

Notes

Parkinson’s Disease (Shaking Palsy or Paralysis Agitans)

Parkinson’s Disease
Shaking Palsy / Paralysis Agitans

A chronic, degenerative disease of the nervous system

Characterized by a slow spreading tremor, muscle weakness and rigidity with a peculiar gait.

Walking occurs in short, rapid steps. Loss of balance and falling often occurs.

Alzheimer’s Disease

A chronic, organic mental disorder which leads to presenile dementia.
Tends to occur after the age of 60

Characterized by loss of memory, mood changes, and other mental disturbances.

Destruction of neurons in the cortex of the brain occurs and plaques are deposited upon the nerve fibers. This is believed to be due to neurofibril degeneration. (Very small fibers found in the cytoplasm of the soma or nerve cell body).

Creutzfeld-Jakob Disease

A central nervous system disease that causes a slow degeneration. Leads to dementia

Caused by a small protein particle called a prion. Was once thought to be caused by a slow-moving virus

Can be transmitted by a parenteral injury with an object contaminated with the infectious agent.

Cerebral Palsy

A non-progressive paralysis resulting from some type of brain damage before or shortly after birth

May also include some mental retardation.

Diseases of the Heart

Disease

Definition

Characteristics

Dilation

Enlargement of the heart due to stretching of the heart walls

Result of the over-filling of a heart chamber

Hypertrophy

Enlargement of the heart due to an increase in the size of the muscle fivers

1) obstruction of the peripheral vessels
2) disease conditions involving the heart valve
3) inflammatory and degenerative changes in the heart muscle

Endocarditis

Inflammation of the inner layer of the heart

Includes inflammation of the heart valves
Valvular endocarditis caused by bacteria deposited on a valve (thrombi known as vegetations)

Valvular Defects

1) Valvular insufficiency or incompetence

Imperfect valve closure that permits leakage or regurgitation of blood

2) Valvular stenosis

The narrowing or construction of a valve

3) Prolapse

A valve or one of the cusps of a valve turns inside out

Paricarditis

Inflammation of the outer sac of the heart (pericardium)

Caused by T.B., pyogenic organisms, neoplasms, trauma, myocardial infarction.

Myocarditis

Inflammation of the muscle layer of the heart (myocardium)

After rheumatic fever and diphtheria or idiopathic

Rheumatic Heart Disease

A febrile inflammatory disease that is a sequelae of rheumatic fever

a. Cause – Group A. Beta Hemolytic Strepococci
b. Lesion – small nodules formed within the connective tissue of the heart (Aschoff’s Nodules / Bodies) Formation of scar tissue, usually in the mitral valve, causing stenosis.

Coronary Artery Disease

Pathologic changes in the walls of the coronary arteries and the consequences or results

Caused by a. Atherosclerosis; b. Thrombosis or Embolism, c. Spasms – usually caused by syphilitic involvement of the mouths of the coronaries, leads to uncontrolled contractions of the heart, contractions occlude the lumens of the coronary arteries.
Consequences:

Cardiac Failure

The condition resulting from the inability of the heart to pump sufficient blood to meet the body’s needs.

Types
a. Acute – Myocardial infarction
b. Chronic – Congestive heart failure as a result of high blood pressure, arteriosclerosis, prior myocardial infarctions, etc.

Hypertensive Heart Disease

Condition caused by a constant pumping against resistance – slowly “wears out the heart”

Caused by hypertension (high blood pressure)

Cardiomyopathy

Disease of the myocardium due to a primary disease of the heart muscle

Accompanies congestive heart failure, infectious diseases, hypertrophy of the heart chambers, and chronic alcoholism.

Carditis

A general term to encompass inflammation of any of the layers or valves of the heart

Congenital Heart Disease

A. Septal defects – the septa between the two sides of the heart. (Mixing of the blood between the left and right sides of the heart).
B. Patent ductus arteriosus – a defect in the closing of the opening between the pulmonary artery and the aorta; causes mixing of pulmonary and systemic blood. This defect predisposes to infection and thrombosis

Week 5- Diseases of the Blood (Anemia)

Week 5- Diseases of the Blood (Anemia)

Discussion Topic

Week 5- Diseases of the Blood (Anemia)

Discussion Topic

Top of Form

Anemia is a condition whereby you cannot bind enough oxygen to adequately perfuse your body tissues. Select one of the anemic pathologies, below, and generate a post whereby your classmates can comment. You will also need to comment on two other posts to receive full credit.

Regenerative anemia

Acute or chronic bleeding

Hemolytic anemia

Hereditary (hemoglobinopathy, enzymopathy, membrane-cytoskeletal defects)

Acquired (autoimmune, mechanical destruction, toxic-metabolic, drugs, infectious, PNH, hypersplenism)

Hypo-regenerative anemia

Bone marrow failure caused by stem cell pathology

Quantitative disorder

Selective: erythroblastopenia (pure red cell aplasia)

Global: aplastic anemia

Qualitative disorder (dysmyelopoiesis)

Inherited: hereditary dyserythropoiesis

Acquired: myelodysplasia

Bone marrow infiltration

Leukemia, lymphoma, multiple myeloma

Solid tumors

Myelofibrosis

Thesaurismosis (Gaucher disease)

Inflammatory chronic diseases, microorganisms (Histoplasma, HIV)

Drugs, hypothyroidism, uremia

Erythropoietic factors deficiency

Iron

IDA

ACD

Cobalamin and folate

Megaloblastic anemia

Hormones: erythropoietin, thyroid hormones, androgens, steroids

The discussions are a great way to learn and exchange information with others in the class.

Bottom of Form

NEIL’S POST:

Hemoglobinopathies are a type of anemia caused by problems with the gene that makes hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen. When the gene has a problem, the hemoglobin made is not normal and can’t carry oxygen, which causes anemia. Probably, the most well-known example of hemoglobinopathy is sickle cell anemia, which is very common in people with African ancestry.

Enzymopathies are a type of anemia caused by a lack of certain enzymes. Enzymes are needed to make red blood cells. When there’s a shortage of these enzymes, red blood cells can be abnormal, break easily, or be made too slowly, leading to anemia. One example is glucose-6-phosphate dehydrogenase (G6PD) deficiency. Some things like certain medicines, infections, and foods can trigger this type of anemia. One of the foods that can trigger this in people with G6PD deficiency is fava beans.

Membrane-cytoskeletal defects are a type of anemia caused by problems with genes that help keep red blood cells the right shape. This can cause the red blood cells to be warped, which means they can’t work right and causes anemia. An example is spherocytosis. Misshapen red blood cells can sometimes get stuck in small blood vessels, which can cause problems like pain, organ damage, or even death in severe cases. People with this type of anemia also have a higher chance of getting autoimmune diseases, where the body’s own immune system attacks itself.

I was always under the impressive that anemia was just a lack of iron in the blood. After doing this research I learned that there are many types anemia. Some are genetic and some are triggered by certain substances. This has been an interesting topic.

MICHAEL’S POST:

We should all know by now that anemia is a condition associated with a decrease in red blood cells which can be problematic on its own. There is a condition known as
ACD, or Anemia of Chronic Disease, which I would like to explore a bit today.

ACD is a common cause of anemia in people who are experiencing chronic inflammatory diseases, which can include autoimmune disorders like Ulcerative Colitis, Chron’s, Rheumatoid Arthritis, Lupus, various cancers, HIV/AIDS, Hepatitis B & Hepatitis C, and others.

When it is caused by chronic diseases or disorders, ACD is rather mild and the symptoms can be overlooked. Some of the more common symptoms associated with ACD include tiredness, shortness of breath, paleness, and headache. I would assume that the reason it is determined to be rather mild and why symptoms can be easily missed is because many of the autoimmune disorders listed already cause those symptoms.

ACD is diagnosed utilizing a test to confirm anemia in addition to the diagnosis of a chronic condition. The treatment is the same as it would be for anemia, blood transfusion, or hormone therapy, particularly Erythropoietin which is administered as a shot. Erythropoietin is already produced by the kidneys. Additionally, if the disorder that is causing the anemia is resolved, then the anemia caused by it will be improved, as well.

I was not familiar with ACD before reading this. I knew, of course, that those chronic conditions could have complications that arise and that they could affect the individual’s health in other ways. I just wasn’t aware that anemia was such a common complication of them all. So common that it is labeled as its own type of anemia.

Source:

Anemia of chronic disease. (n.d.). Mount Sinai Health System. https://www.mountsinai.org/health-library/diseases-conditions/anemia-of-chronic-disease

FSS 223 Chemistry II –

Week Five: Discussion Forum

Week Five: Discussion Forum
Top of Form

This forum is going to be a little bit different than the others we have done. It’s kind of like the muddiest point but with a twist. I call this discussion “Ask the Professor”.

I would like for YOU to pose a forum discussion question. What is unique to this discussion is that it is NOT a requirement that it come from the topic of chemistry – this is your chance to ask me a question about anything related to the funeral service education or industry. You can even ask a question regarding your other classes that maybe I can clarify for you.

I would like for it to be a well put together, thought provoking question pertaining to funeral service, education, or even this class. I will let you know my thoughts on the questions you ask. Please provide at least paragraph describing your own thoughts on the topic, you will not receive all of your point.

PLEASE, be creative!

When you are responding to 2 other students, please try and respond first to someone who has posted a question that does not have a response yet. If every question has a response then feel free to respond to anyone.

Bottom of Form

Top of Form

VIII

DISEASES OF THE BLOOD

A. Reactive Changes

1. Leukocytosis

–

– part of the protective mechanism in inflammation

2. Leukopenia

–

– seen in typhoid fever, measles, mumps, flu, and T.B.

3. Acapnia

–

seen in instances of asthma, pulmonary embolism, and anxiety

Acidosis

–

often seen in diabetes, renal disease and severe dehydration

5. Alkalosis

–

– can be seen in many metabolic disorders

B. Anemia

–

– a sign of disease

Primary Anemia

–

– occurs in two ways

a. Nutritional deficiencies

1) Iron

–

– iron is essential for R.B.C. development

2) Pernicious Anemia

–

– erythrocytes (R.B.C.) require two factors to mature: an intrinsic factor found in normal gastric juice and an extrinsic factor – vitamin B12. The intrinsic factor is the carrier for B12 and it is not secreted in pernicious anemia. Therefore, B12 is not being absorbed from the small intestine

– because of this, R.B.C. cannot develop properly

– commonly occurs in the white race after 40 years of age

– rarely before 35

–

– Treatment: intramuscular injection of vitamin B12

Aplastic Anemia

–

– the result of drug and chemical damage, radiation, infection, and metabolic disorders

Secondary Anemia

–

– due to disease or trauma such as:

a. Hemolytic Anemia

–

– seen in Malaria, Sickle cell anemia, erythroblastosis fetalis

b. Hemorrhage

– acute from trauma

– chronic from lesions of the gastro-intestinal tract

C. Hematopoietic(Hemopoietic) Disorders

– the disruption of any substance that assists in or stimulates the production of blood cells

1. Leukemia

–

– bone marrow, lymph nodes, and W.B.C.

– commonly called

–

– common signs and symptoms include:

– swollen spleen and lymph nodes, fever, weight loss, fatigue, joint pain and a tendency to hemorrhage

2. Polycythemia Vera(Erythrocytosis)

–

– referred to as a chronic, life-shortening myelo-proliferative disorder involving all bone marrow elements

– leads to an increase in R.B.C. mass and hemoglobin concentration that increases blood viscosity, causes high blood pressure, and leads to extra work on the heart.

– secondary to many disorders

D. Bleeding Disorders

1. Hemophilia

–

– characterized by a tendency toward excessive and sometimes spontaneous bleeding

– affects males but transmitted by females

2. Thrombocytopenia

–

– platelets are responsible for initiating the blood clotting process

– this leads to a tendency toward widespread, spontaneous bleeding into the skin or mucus membranes resulting in

IX. DISEASES OF THE HEART AND BLOOD VESSELS

A. Predisposing Conditions

5. Social Factors

B. Heart Disease

– the most common cause of disability and death in U.S.

1. Dilatation

–

– usually occurs as a result of the over-filling of a heart chamber

2. Hypertrophy

–

– the result of an increased amount of work put upon the heart

– this increased work may be caused by:

1) obstructions of the peripheral vessels

2) disease conditions involving the heart valves

3) inflammatory and degenerative changes in the heart muscle

BOTH DILATATION AND HYPERTROPHY CAUSE ENLARGEMENT OF THE HEART

– which is an important sign of heart disease

3. Endocarditis

– inflammation of the inner layer of the heart(endocardium)

–

– without qualification this always means…

–

– usually caused by bacteria that is deposited on a valve

– this collection creates thrombi known as…

–

4. Valvular Defects

a. Valvular Insufficiency or Incompetence

–

b. Valvular Stenosis

–

c. Prolapse

–

5. Pericarditis

–

– can be caused by

T.B., pyogenic organisms, neoplasms, trauma, myocardial infarction

6. Myocarditis

–

– occurs commonly after rheumatic fever and diphtheria or may be idiopathic

Rheumatic Heart Disease

– a febrile inflammatory disease that is a sequelae of rheumatic fever

a. Cause

–

b. Lesion

– small nodules formed within the connective tissue of the heart

–

– these nodules lead to the formation of scar tissue in the tissues of the heart

– commonly seen in the mitral valve

– causing stenosis

– all of this leads to serious, chronic heart disease

8. Coronary Artery Disease

– pathologic changes in the walls of the coronary arteries and the consequences or results

– Caused by:

– usually caused by syphilitic involvement of the mouths of the coronaries

– this leads to uncontrolled contractions of the heart muscle

– the contractions occlude the lumens of the coronary arteries

– Consequences:

9. Cardiac Failure

– the condition resulting from the inability of the heart to pump sufficient blood to meet the body’s needs

2 types:

a. Acute –

b. Chronic –

– as a result of high blood pressure, arteriosclerosis, prior myocardial infarctions, etc.

10. Hypertensive Heart Disease

–

– slowly “wears out” the heart

–

– which is also known as

11. Cardiomyopathy

– disease of the myocardium due to a primary disease of the heart muscle

– accompanies congestive heart failure, infectious diseases, hypertrophy of the heart chambers, and chronic alcoholism

12. Carditis

– a general term to encompass inflammation of any of the layers or valves of the heart

13. Congenital Heart Disease

– septal defects

– patent ductus arteriosus

– a defect in the closing of the opening between the pulmonary artery and the aorta

– causes mixing of pulmonary and systemic blood

– more importantly, this defect predisposes to infection and thrombosis

C. Disease of the blood vessels

– like any other tissue, blood vessels are subject to various disease processes

– they react to injury and repair, infection, inflammation and tumors like any other tissue

1. Arteritis

–

2. Arteriosclerosis

–

– results in altered function of the tissues and organs because of decreased blood flow

Mitral Sclerosis –

3. Atherosclerosis

–

– specifically occurs in the large elastic arteries such as the aorta, coronary arteries, and cerebral arteries

4. Aneurysm

–

3 types:

– an equal dilation around the circumference of the vessel creating a tubular swelling

– yielding of a weak area on one side of the vessel not involving the entire circumference

– appears as a bulging, sac-like dilation

– a separation of the tissues in the wall of an artery

– allows blood to enter and further separate the tissues

– any one of these types of aneurysms may increase in size and rupture causing a severe hemorrhage

5. Phlebitis

–

6. Varicose Veins

–

– can occur in almost any part of the body, but are most commonly observed in the lower extremity, the esophagus, and the perianal veins

– some causes may be:

–

– other names are

–

X. DISEASES OF THE NERVOUS SYSTEM

— Any infectious disease of the nervous system is called

A. Trauma to the brain

1. Concussion

–

– an immediate and temporary disturbance of brain function

– it may result in only a temporary grogginess or there may be a wide spread loss of cerebral control with a sudden drawing of the knees and severe vomiting

2. Contusion

–

– the skin is not broken at the site of the injury

– may lead to hydrocephalus

3. Laceration

–

– may occur with or without fracture of the skull

4. Intracranial Hemorrhage

–

– categorized according to the location in relation to the meninges

– Layers from outside to inside:

– Bone, Dura Mater, Arachnoid Mater, Pia Mater, Brain

– types:

a. – between the bone and dura mater

b. – between the dura mater and arachnoid mater

c. – between the arachnoid mater and pia mater

– consequences depend on the location

–

– will cause sudden death in severe cases

B. Meningitis

–

– caused by numerous bacteria and viruses

– the form caused by the meningococcus(
Neisseria meningitidis) is called

–

– transmitted via the respiratory tract by droplet spray or direct contact with discharges

– it then reaches the meninges via the blood or lymph stream

C. Encephalitis

–

– can be bacterial or viral

–

– it may also only be a complication of other infectious disease like malaria, influenza, measles

D. General Paresis

–

– inflammation and degeneration of brain tissue that will lead to death

E. Cerebrovascular Accident/Stroke/Apoplexy

–

– usually due to thrombosis, embolism, or hemorrhage

– these are usually secondary to atherosclerotic disease

– if hemorrhage occurs where blood escapes into the tissue of the brain it may be due to hypertension or possibly a congenital aneurysm

F. Encephalomalacia

–

G. Transient Ischemic Attack(TIA)

–

– no permanent damage occurs

– characterized by:

–
–
–

– may last a few minutes or several hours

H. Hydrocephalus -“Water on the brain”

–

– caused by a blockage of the normal outflow of the fluid

– brain is pushed against the skull in adults

– dramatic enlargement of the cranium in infants

– severe cases lead to stillbirths or very short lifespans

I. Myelitis

–

– occurs due to infection or injury to the spinal cord

J. Poliomyelitis

–

– often affects brain tissue also

– acquired through a viral infection from respiratory system or contaminated food then reaches the spinal cord through the bloodstream

– affects the motor neurons of the central nervous system resulting in serious damage and paralysis of the muscles controlled by these nerves

— Anytime the brain and spinal cord are both involved the term is used

K. Neuritis

–

– may be a direct infection or a complication of other infections like tuberculosis, tetanus, or measles

– may also be from damage by trauma or toxins

L. Epilepsy

–

– the result of some form of interference with normal electrical activity in the brain

–

– some are associated with brain injury, trauma at birth, or tumors

– characterized by convulsions of which there are two types:

1) Grand Mal or Tonic Clonic seizures

–

– includes the making of peculiar sounds, biting the tongue, excess salivation

2) Petite Mal or Absence seizures

–

– this form is more common in children

–

M. Rabies

– an acute, viral, infectious disease of warm-blooded animals

–

– transmitted to humans through the saliva of an infected animal via a bite

– characterized by involvement of the central nervous system

–

N. Multiple Sclerosis

– a chronic degenerative disease of the nervous system characterized by remissions and relapses

– the myelin sheaths of the nerves are destroyed

– the areas of damaged or “demyelinated” nerves are replaced with sclerotic plaques

–

– scattered diffusely throughout the gray and white matter of the brain stem and spinal cord

–

O. Parkinson’s Disease

–

– characterized by a slow spreading tremor, muscle weakness and rigidity with a peculiar gait

–

– walking occurs in short, rapid steps

– loss of balance and falling often occurs

P. Alzheimer’s Disease

– a chronic, organic mental disorder which leads to presenile dementia

–

– characterized by loss of memory, mood changes, and other mental disturbances

– destruction of neurons in the cortex of the brain occurs and plaques are deposited upon the nerve fibers

–

Q. Creutzfeld – Jakob Disease

– a central nervous system disease that causes a slow degeneration

–

– caused by a small protein particle called a

– can be transmitted by a parenteral injury with an object contaminated with the infectious agent

R. Cerebral Palsy

–

– may also include some mental retardation

EXAM # 1

XI. DISEASES OF THE DIGESTIVE SYSTEM

A. Mouth and Associated Parts

1. Stomatitis

–

– causes may be pathogenic organisms, mechanical trauma, irritants ie. alcohol, tobacco, hot foods

2. Glossitis

–

– often associated with stomatitis

3. Gingivitis

–

– usually caused by the long term effects of plaque buildup on the surface of the teeth

– also may be associated with generalized stomatitis

– can occur with deficiency diseases such as scurvy or metallic poisoning

4. Cheilitis

–

Common organisms that cause inflammation of the oral cavity include:

–
Candida albicans –

– Herpes simplex I –

–
Treponema pallidum –

B. Pharynx

– Pharyngitis

–

– may be a primary infection such as strep throat or diphtheria

– may be a complication of other infections such as rhinitis, sinusitis or influenza

C. Esophagus

– Esophagitis

–

– often caused by regurgitation of stomach acid through the cardiac sphincter

– stenosis or stricture of the esophagus is also a common condition

D. Stomach

1. Gastritis

–

– may result from pernicious anemia, bacterial or viral infection, excessive indulgence in alcoholic beverages, dietary indiscretions or too much aspirin

2. Peptic Ulcer

–

– this hyperacidity is caused by the presence of the bacterium
Helicobacter pylori

– a complication of peptic ulcers is

–

– this refers to an ulcer that eats through the stomach wall and allows the contents to reach the abdominal cavity causing a severe infection known as

–

– another complication of peptic ulcers that occur in the area of the pyloric valve is

–

– this refers to stenosis of the valve between the stomach and small intestine

–

E. Small Intestine

1. Enteritis

–

– caused by a number of organisms some of which are normal flora

– these organisms are often obtained from

–

– symptoms may include:

– abdominal pain, cramping, diarrhea, fever and dehydration

– an idiopathic inflammatory bowel disease that may lead to blockage of the intestine by swelling and scar tissue formation

3. Hernia

–

– the major concern with hernias is that the intestine may become obstructed blocking the passage of its contents

– or the blood supply could be pinched off resulting in necrosis

Types of hernias:

– a hernia in which a segment of small intestine protrudes through the inguinal ring

– this loop may protrude down into the scrotum of the male or the labia majora of the female

– a hernia in which a segment of small intestine protrudes through the femoral ring

– this loop may protrude into the soft tissues adjacent to the femoral vessels in the area of the groin

– most commonly seen in women

– a hernia at the navel in which a segment of small intestine of an infant protrudes through an imperfect closure of the umbilicus following birth

– a hernia in which a segment of an organ protrudes through one of the orifices of the diaphragm

– a special type of this is the

– a hernia in which a portion of the stomach protrudes through the diaphragm

F. Colon and Rectum

1. Colitis

–

– the most frequently seen gastrointestinal disease

– the most common causes seem to be stress and certain foods and beverages

– another idiopathic inflammatory bowel disease that causes ulcers in the lining of the lower colon and rectum

– causes diarrhea, the ulcers bleed and produce pus

– 25 to 40% of patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon or risk of cancer

3. Diverticulosis

– the condition of having a sac or pouch-like structure in the wall of the large intestine

– these structures are called

– Diverticulitis

–

– occurs when the diverticula become impacted with fecal material and bacteria

– symptoms include chronic constipation, mucus in the stool and severe abdominal pain

4. Obstructions:

– a decrease in peristalsis in a section of the large intestine caused by a lack of nerve or blood supply

– a twisting of a loop of intestine

– a slipping or telescoping of one segment of intestine into another

– scar tissue formed on loops of the bowel adhere the loops together preventing the

normal process of peristalsis

– inflammation of the rectum and anus

– varicose veins of the rectum or anus

– also known as

-Two kinds:

– internal and external

– determined by how close they are to the anorectal line

– inflammation of the appendix

– if untreated, an inflamed appendix may burst and cause peritonitis

– very common benign tumor-like growths

G. Liver

1. Infiltration and degeneration

– review your Pathology I notes on fatty infiltration, fatty degeneration, and fatty change

– inflammation of the liver

a. Two types:

1) Toxic

–

2) Viral

– Caused by several viral agents – Three known as:

a) Hepatitis A

–

– usually due to poor sanitation methods

– not as serious as other forms

b) Hepatitis B

–

– represents an occupational hazard to people who work with blood and blood products

– more serious than hepatitis A

– may result in chronic hepatitis and permanent liver damage

c) Hepatitis C

–

– even more serious because there is not yet a vaccine available

– a yellowish staining of the integuments, deeper tissues and the excretions with bile pigments

–

– causes a yellowness of the skin, whites of the eyes, mucous membranes, and body fluids due to the presence in the blood of the bile pigment bilirubin

– degenerative changes in liver parenchyma cells with the formation of dense connective tissue, fatty infiltration, and scarring

– results in the loss of functioning liver cells and an increased resistance to the flow of blood through the liver

– seen in the end stage of chronic liver disease

–

– Postmortem Conditions:

a. Jaundice

b. Ascites

c. Edema

d. Hemorrhage

–

– occurs because of the blockage of the portal vein

–

H. Gallbladder and Bile Ducts

– inflammation of the gallbladder

– may be acute or chronic

– acute form is usually a result of the irritation caused by gallstones

– chronic form is important in the production of gallstones

– the formation or presence of calculi or bilestones in the gallbladder or common duct

– most commonly composed of cholesterol, but mixed stones are common as well

– stones may block the passageway for bile and cause a backup leading to cholecystitis

– inflammation of the bile ducts

– caused by the obstruction of a duct by gallstones infected with bacteria

I. Pancreas

–

– inflammation of the pancreas

– acute form is characterized by necrosis, suppuration, gangrene, and hemorrhage

– chronic form leads to the formation of scar tissue associated with malfunction

–

J. Peritoneum

–

– inflammation of the membrane that lines the wall of the abdomen and covers the abdominal organs

– usually due to a bacterial infection caused by perforation of an ulcer or intestine

K. Postmortem Conditions of Digestive System Disorders

2. 8.

3. 9.

4. 10.

5. 11.

XII. DISEASES OF THE RESPIRATORY SYSTEM

A. Upper Respiratory Tract

1. Acute Inflammation

– inflammation of the nasal mucosa

– part of having a cold

– inflammation of the sinuses

– due to a variety of allergic, viral and bacterial causes

– inflammation of the pharynx

–

– inflammation of the larynx

–

– an acute viral infection of the upper respiratory tract

–

– characterized by:

– nasal congestion – mild sore throat

– runny nose – headache

– runny eyes

– a common upper respiratory viral infection

–

– characterized by:

– fever – headache

– chills – cough

– sore throat – muscle pain

– possible vomiting

– a form of allergy as a result of hypersensitivity to various grass and tree pollens

– a common upper respiratory problem characterized by watery and itchy eyes, a runny nose, and sneezing and coughing

– inflammatory growths with a stem or a pedicle

– the most common tumor-like growth to the nose

B. Trachea and Bronchi

– inflammation of the trachea

–
2.

– inflammation of the bronchi

– characterized by fever, chest pain, difficulty breathing and a chronic cough

– caused by the person trying to clear excess mucous from the linings of the respiratory passageways

– inflammation of the smaller bronchi and bronchioles

– an allergic response characterized by a hypersecretion of mucous and spasms of the bronchial muscles

C. Lungs

– inflammation of the lungs due to infection with bacteria, viruses or other pathogenic organisms

–

– if the lungs are inflamed due to other agents that are not infectious, the term pneumonitis is used

a. Varieties

– inflammation localized in one or two lobes of the lung

– the affected lobe(s) is usually full of a thick, fibrinous exudate making the exchange of respiratory gases impossible

–

– responds well to antibiotic treatment and therefore is usually an acute disease

– inflammation of the bronchi and terminal bronchioles that can spread into the lungs

– more scattered throughout the bronchi and lungs as spotty patches than lobar pneumonia

– it is most commonly a secondary disease

– seen as a complication of:

– –

–

– it is also a common nosocomial infection

Viral Pneumonia

– caused by a variety of viruses

b. Associated Conditions

– inflammation of the membranes surrounding the lungs

–

– often accompanies lobar pneumonia

– fluid in the pleural cavity

–

– accompanies circulatory disorders

– pus in the pleural cavity

–

– accompanies many infectious diseases

– blood in the pleural cavity

– may accompany wounds, infections, or tumors

– air in the pleural cavity

– the result of a penetrating wound from outside the body or from the rupture of an alveoli in diseases like tuberculosis and emphysema

– deficient blood oxygen supply to tissues

c. Postmortem conditions of pneumonia

1) rapid coagulation of blood

2) cyanosis (bluish color of mucous membranes resulting from lack of oxygen)

3) dehydration

4) edema

2. Tuberculosis

a. Cause

–

b. Lesion

–

– has a granulomatous characteristic with gross visible necrosis forming a cheesy, crumbly, caseous mass

–

– tubercle contents may become liquified and resemble pus but without all the cardinal signs of inflammation

–

– tubercles may also erode the wall of a bronchus leaving an empty cavity

–

c. Sputum is grayish yellow or white

d. Forms of Tuberculosis

– involving the lungs

– the most common form

– generalized tuberculosis with minute tubercles in the affected part

– most often affected organs are:

–

– –

–

e. Postmortem conditions of tuberculosis

1) cavitation 4) emaciation

2) hemorrhage 5) cold abscess

3) dehydration 6) caseation necrosis

– a fibrous inflammation of the lungs resulting from the inhalation of dust

Specific types:

– inhalation of carbon particles

– hazard to coal miners

– inhalation of silica(stone dust)

– hazard to miners and rock workers

– inhalation of asbestos dust

– state of collapse of the lungs in which the air sacs are completely airless

– collapse may be caused by:

– a complete obstruction of a bronchus

– an accumulation of fluid or air in the pleural cavity that presses against the lung

– a chronic deterioration and destruction of lung tissue

– causes an incomplete or partial bronchial obstruction with the presence of excess mucous and tissue irritation

–

– the difficulty is in moving the air
out because of the increased resistance to the flow of air in the lung.

– the alveolar walls eventually break down and join the air sacs together into much larger, functionless sacs called

– these will also rupture eventually leaving the person with no way to exchange respiratory gases

–

– a combination of two or more conditions in which the exchange of respiratory gases is ineffective

– these include, but are not limited to, emphysema, bronchial asthma, and chronic bronchitis

– a disease of the pancreas that is characterized by chronic respiratory infections

– the infections are caused by the presence of a thick, sticky mucous that is secreted from the respiratory epithelium

–

– most of the deaths from this disease are attributed to the obstruction of air flow to the lungs by the mucous

8. Carcinoma of the lung

–

EXAM # 2

XIII. DISEASE OF THE URINARY SYSTEM

A. Terms dealing with urinary disturbances

– a decrease in the amount of urine excreted

– may indicate kidney failure

– complete suppression of urine excretion

– indicates total kidney failure

– an increase in amount of urine excreted

– usually an indication of problems somewhere in the body other than the kidneys

– such as diabetes insipidus

– the presence of albumin or protein in urine

– often associated with glomerulonephritis

– hemoglobin in the urine

– associated with hemolytic anemias

– that occur due to certain poisons, snake bites, and malaria

– blood in the urine

– an important sign in tumors of the urinary system

– also associated with glomerulonephritis

– pus in the urine

– indicates a urinary tract infection

– sugar in the urine

– associated with diabetes mellitus(sugar diabetes)

– the toxic condition of excess urea and other nitrogenous wastes in the blood

– associated with renal insufficiency or failure

C. Disease of the kidney

– a general term for inflammation of the kidney

– a form of nephritis in which the lesions affect primarily the glomeruli

–

– often follows a previous streptococcal infection

– especially those of the upper respiratory tract

– inflammation of the renal pelvis

– the expanded upper part of the ureter

– inflammation of the kidney substance and pelvis

– most common kidney disease

The two previous conditions are caused by pyogenic bacteria that enter the kidney by way of the bloodstream or due to bacteria that have ascended from the bladder after entering through the urethra.

– a collection of urine in the renal pelvis due to an obstructed outflow

–

– the ureters above an obstruction dilated with urine

– the formation of renal calculi

–

– inflammation of the ureters

– the tubes that carry urine from the kidneys to the urinary bladder

– causes constriction and narrowing

– inflammation of the urinary bladder

– usually occurs secondary to ascending urinary tract infections

– inflammation of the urethra

– the tube that carries urine from the urinary bladder to the outside of the body

— Ureteritis, Cystitis, and Urethritis are all generally caused by infections with pyogenic bacteria that work their way up the urinary tract

– a condition in which there is the formation of many cysts in or on the kidney

– can lead to a variety of renal problems:

–

XIV. DISEASES OF THE FEMALE REPRODUCTIVE SYSTEM

Most of the inflammations of the parts of the female reproductive tract are due to numerous bacterial infections that often are associated with STD’s to be discussed later

A. Uterus

– inflammation of the uterus

– inflammation of the inner lining of the uterus(endometrium)

– inflammation of the mucous membrane of the cervix

– ectopic endometrium located in various sites throughout the pelvis or in the abdominal wall

5. Preeclampsia

– occurs in pregnant women usually during the third trimester

– characterized by edema of the extremities and face, high blood pressure and high albuminuria

–

– there are not really any toxins in the body

– can lead to convulsions, coma, and death (Eclampsia)

B. Fallopian (Uterine) Tubes

– inflammation of the fallopian tubes

– when a fertilized ovum attaches to the wall of the fallopian tube or abdominal surface

– embryo will die from lack of blood supply

–

C. Ovaries

– inflammation of the ovaries

– numerous cysts on or in the ovaries

– a cyst containing elements of hair, teeth or skin

– commonly seen in the ovaries and testes

D. Vagina

– inflammation of the vagina

– can be caused by

– a gonococcal infection

– mechanical irritations such as tight panty hose

– chemical irritations and highly irritating uterine discharges

– yeast infections

–

– the normal flora bacteria of the vagina are destroyed, allowing the fungus to grow

– a condition of septicemia following childbirth

-caused by a hemolytic streptococcus

– infection is usually spread by contaminated obstetrical instruments

E. Breasts

–

– inflammation of the mammary glands

F. Neoplasms

– a common tumor of the ovaries

2. Uterine cancer

– most commonly affect the cervix

–

– usually squamous cell carcinomas

3. Leiomyoma of the uterus

– also a very common tumor

–

4. Carcinoma of the breast

–

– spreads rapidly through the surrounding tissues

– including the blood and lymph vessels in the area

– often requires surgical removal of the breast and surrounding tissues

–

XV. DISEASES OF THE MALE REPRODUCTIVE SYSTEM

A. Testes and Epididymis

– inflammation of the testes

– may be caused by

–

– if this infection is serious enough, it may cause scarring, atrophy of the testes and sterility

– failure of the testes or a testis to descend into the scrotum

– sperm cannot develop properly because of the higher temperature in the pelvic cavity

–

– inflammation of the epididymis

– usually the result of a gonococcal infection

– severe cases could cause scarring and stop the passage of sperm

– varicose veins of the spermatic cord

– a fairly common occurrence

B. Prostate Gland

– Muscle organ which surrounds the first part of the urethra

– inflammation of the prostate gland

– usually secondary to urethritis

– often caused by
Neisseria gonorrheae and
Escherichia coli

– an enlargement of the prostate gland in men 50 and over

– NOT an inflammatory condition

– associated with a hormone imbalance

– the consequence of this is interference with the passage of urine

C. Scrotum

– the collection of serous fluid in the scrotum

– may be a complication of orchitis, epididymitis, or improper closure of the opening between the peritoneal cavity and the scrotum

– the term can actually be used to mean the collection of serous fluid in any sacculated cavity of the body

D. Neoplasms

1. Carcinoma of the prostate

– common in older men

–

2. Carcinoma of the testes

–

E. STD’s

– this section applies to both the male and female reproductive systems

– one of the most common and widespread of the STD’s

– most often caused by a chlamydial organism

– characterized by painful, itchy ulcerations or blisters on the genitals and surrounding areas

– caused by the Herpes simplex II virus

– there is no cure

–

– caused by the bacterium
Neisseria gonorrheae

–

– will lead to sterility if not properly treated

– caused by the spirochete
Treponema pallidum

– characterized by three stages of development

a. Primary stage

–

– heals after about 4-6 weeks

b. Secondary stage

–

– these symptoms indicate the organism has spread throughout the body

– will last for 2 to six weeks

c. Tertiary syphilis

–

– most commonly affected by this are the nervous and cardiovascular systems

1) Neurosyphilis

– can cause several conditions

a) damage to the brain causing mental deterioration and paralysis called

b) degeneration of the posterior part of the spinal cord called

2) Cardiovascular syphilis

– tends to affect the arteries

–

– causes inflammation, aneurysms and aortic insufficiency

F. Postmortem Conditions for both male and female reproductive system conditions

1. Rapid blood coagulation

2. Ascites

3. Edema

4. Infection

XVI. DISEASES OF THE BONES AND JOINTS

A. Bones

– inflammation of bone tissue

– the formation of cysts and fibrous nodules within bones

– due to a hormone imbalance

– a chronic inflammation resulting in thickening and deformation

– also known as osteitis deformans

– looks like an overproduction of bone

– inflammation of the bone marrow

– bacteria enter by way of broken bones or through the blood or lymph streams

– an increase in porosity or loss of bone density

–

– bone becomes brittle and tends to break more easily

– the softening of bone in children

– due to a deficiency of vitamin D

– Vitamin D is essential for absorption of calcium from the digestive tract

–

– long, weight-bearing bones of the leg tend to be bent or “bowed”

– softening of bones due to faulty calcification in adulthood

– may also be due to a lack of vitamin D

– inflammation of the outer covering of bone (the periosteum)

– usually due to bacterial infection

– tuberculosis of the vertebral column

-vertebrae are destroyed and collapse

–

– a defect in the formation of cartilage in the growth centers of long bones

–

– a hereditary condition of connective tissue and skeletal structures

–

10. Abnormal curvatures of the spine

– an abnormal posterior curvature of the spine

– a humpback

– an abnormal anterior curvature of the spine

– a lateral curvature of the spine in opposite directions

– causes an S-shaped curvature

11. Fractures

– a break that does not pierce the skin

– a break in which at least a piece of the bone pierces the skin resulting in an open wound

– could also be a wound that leads to a bone that is broken

– a break in which the bone is splintered or crushed

– there must be at least three pieces of bone to constitute this

– a break in which the bone is cracked or broken on one side and bent on the other

B. Joints

– inflammation of a bursa

– small, sac-like structures that contain synovial fluid

– help to reduce friction in areas where a lot of movement occurs

– inflammation of a joint

– may be either acute or chronic

– could result from:

– trauma – tumors

– allergic reactions – degenerative conditions of old age – infectious agents (bacteria, fungi, and viruses)

– Most common forms:

– a form of chronic arthritis

–

– there is usually bilateral involvement of the hands and wrists

– in the later stages the joint may be destroyed and the bones fused together causing a permanent crippling

–

– inability of joint movement

– another chronic arthritis

–

– affects the larger, weight-bearing joints

– not usually bi-lateral

– thought to be associated with “wear and tear” on the joints

– an hereditary form of arthritis

– the result of a metabolic problem with uric acid in the body

– deposits urates of sodium crystals around certain joints

–

EXAM # 3

XVII. DISEASES OF THE ENDOCRINE GLANDS

– ductless glands that secrete hormones directly into the bloodstream

A. Pituitary Gland

–

– found under the circle of willis

– it is composed of two parts:

– Anterior pituitary controls skeletal growth, the thyroid and adrenal glands, and sexual development

– Posterior pituitary controls smooth muscle contraction, as in birth and peristalsis

1. Anterior Pituitary

–

– one of the secretions is somatotropin or the human growth hormone(HGH)

–

– problems with the secretion of this hormone will possibly lead to one of the following conditions:

– the result of a condition of hyperpituitarism during childhood

– a hypersecretion of somatotropin occurs while a child is still actively growing

– leads to the growth of a child into a giant or abnormally tall person

–

– the result of hyperpituitarism during adulthood

– a hypersecretion of somatotropin after bones have solidified and can no longer grow

– characterized by enlargement of the bones and soft tissues of the hands, feet, and head

– especially the frontal bone, jaws, nose lips, and ears

–

– will eventually lead to sexual impotence, drowsiness, and possibly obesity

– Both of the above conditions are typically caused by the growth of an adenoma

– the result of hypopituitarism during early life

– a hyposecretion of somatotropin from the adenohypophysis

– person remains quite small and never develops any secondary sex characteristics

– a hyposecretion of somatotropin in adulthood

–

2. Posterior Pituitary

–

– the result of hypofunction of the posterior lobe of the pituitary

– a hyposecretion of the antidiuretic hormone occurs

– leads to the passing of large quantities of urine ( )

– accompanied by excessive thirst ( )

– found to be idiopathic in half of the cases

– trauma to the head or a tumor in that area causes the remainder of cases

3. Entire Pituitary

–

– a condition in which there is complete atrophy of the pituitary gland

– leads to a loss of function of the thyroid, adrenal and gonad glands

– there is necrosis of the gland

– characterized by the following:

– –

–

B. Thyroid Gland

– consists of two lateral lobes

– found in the neck on either side of the windpipe

–

– it influences body growth and development

– exerts an influence over the nervous system

– enlargement of the thyroid gland

– can be due to lack of iodine in diet, inflammation from infection, tumors, hyper or hyposecretion of thyroxin

2. Hypothyroidism

–

– the gland enlarges in an effort to compensate and secrete more thyroxin

–

– the condition resulting from
congenital hypofunction of the thyroid gland

– characterized by a lack of physical and mental development

– –

– the condition resulting from hypofunction of the thyroid gland in
adulthood

– characterized by:

– weight gain – general sluggishness

– mental dullness – thickening of the tongue and lips

– swelling of eyelids and other soft tissues

– due to the presence of a mucous-like edema

– body temperature and metabolism fall

– an over-active thyroid

– a goiter could develop due to hyperplasia

– will likely lead to the following condition:

a. Grave’s Disease

– the condition resulting from prolonged hyperthyroidism

–

– the gland enlarges and produces excessive amounts of thyroxin

–

– characterized by:

– low body weight because of a very high BMR

– weakness

– tachycardia

– nervous excitability

– profuse sweating

– eyeball protrusion

–

– frequent in young adults and can lead to heart damage because of fibrillation

C. Parathyroid Glands

–

– a condition due to hypofunction of the parathyroid glands

– lowered amounts of parathormone are secreted

–

– causing nerve cells to become irritable and overactive

– leading to spasmatic muscular twitching, abnormal reflexes and convulsive seizures

– usually fatal due to constant contractions of the heart muscle

– also slows blood coagulation

– increased amount of parathormone is secreted

– calcium is drawn out of the bones and into the bloodstream

–

– these will cause:

– softening and deformation of bones

– formation of kidney stones

– hardening of the arteries

– heartbeat irregularities

– fibrous cysts may form in the bones causing a condition known as

–

D. Adrenal Glands

– located on top of the kidneys

– composed of two layers

– the inner layer called the medulla

– the outer portion called the cortex

– the cortex is the part of the gland that is essential to life

– it secretes several hormones that regulate:

–

– a condition due to the hypofunction of the adrenal cortex

– affects the hormones that regulate metabolism and blood pressure

– characterized by:

– bronze pigmentation – weakness and loss of weight

– low blood pressure – gastro-intestinal disturbances

– usually caused by a chronic adrenal cortical insufficiency as a part of an autoimmune disorder

2. Waterhouse-Friderichsen Syndrome

–

– causes acute adrenal insufficiency due to hemorrhage into the adrenal gland

– a condition due to hyperfunction of the adrenal cortex

– due to excess exposure to hormones called glucocorticoids (steroids)

–

– characterized by:

– adiposity – fatigue

– impotence – excess hair growth

– purplish skin discolorations

– the build-up of a fatty pad over the shoulders and upper back

– creates a “moon-shaped” facial appearance

E. Pancreas

– a heterocrine gland

– the endocrine function takes place in the Islets or Islands of Langerhans

– produces two hormones

–

– a condition caused by a deficiency in insulin secretion

– causes a disorder in carbohydrate metabolism

– sugars cannot be carried into the cells and a buildup in the bloodstream ensues

–

– when the cells have no glucose to use, they begin metabolizing fats and proteins

– with excess fat in the bloodstream, several of the following complications occur:

Atherosclerosis

– predisposes to myocardial infarctions, gangrene, blindness

– last one due to affect on capillaries of the retina

Poor wound healing

3. Vascular Obstructions

4. Hemorrhage

5. Gangrene

–

– usually requires hypodermic injections of insulin and special diet

–

– can be controlled with diet and oral medications

F. Gonad Glands

– actually a part of the adrenal cortex

– has to do with the secretion of androgen and estrogen

– a condition caused by a hyperfunction of the gonads

– appears to be premature puberty

–

– a condition caused by a hyperfunction of the gonads

–

– in females it leads to:

– –

– in males it leads to:

– –
–

– excessive breast development

– atrophy of the testes or ovaries due to old age

EXAM # 4

XVIII. DISEASES OF THE INTEGUMENTARY SYSTEM

– an inflammatory disease of the sebaceous glands and hair follicles

– the result of an abnormal or profuse production of oil in the sebaceous glands

– this leads to the pores of the skin becoming clogged with sebum

B. Abscess

– many different types seen here

– in the secondary stage a skin rash and lesions on the mucous membranes form to be the primary symptom

D. Superficial fungal infections

– known as dermatomycoses

–

– these infections are characterized by red, scaly, and itchy lesions

– tend to localize in certain body areas

– a fungal infection of the groin area

–

– a fungal infection of the feet

–

– inflammation of the skin

– caused by a variety of agents like poison ivy, soaps, fabrics, dyes, formalin

–

– results when the skin is exposed to agents to which it has become sensitized

– inflammatory skin disease beginning on the scalp

– characterized by rounded, irregular lesions covered with yellow or brown-gray greasy scales

– these are caused by an excessive secretion of sebum(oil) from the sebaceous glands

– will spread to the face, neck and eyebrows if not cared for properly

– tuberculosis of the skin

– characterized by ulcerations that leave scars when healed

H. Other skin diseases or changes

1. Senile changes – old age changes in skin

2. Melanocytic nevus – any nevus containing melanin

3. Malignant melanoma

4. Squamous cell carcinoma’s

I. Postmortem Conditions of Skin Diseases

1. Discolorations 4. Lesions

2. Dehydration/dryness/scales 5. Pigmented or depigmented spots

3. Burns 6. Edema

XIX. DISEASES OF THE LYMPHATIC SYSTEM

– inflammation of a

– a mass of lymphatic tissue found in the very back of the oral cavity

– usually due to infection by a pyogenic streptococci

– the enlargement of a lymph node

– caused by a variety of conditions

– may be a sign of serious disease

– inflammation of a lymph node

– inflammation of the lymphatic channels or vessels

– usually occurs secondary to lymphadenitis

– enlargement of the spleen

– caused by many, many diseases

– the biggest danger is in that an enlarged spleen is much easier to rupture

– edema due to an obstruction of the lymphatic vessels

G. Lymphoma – see Tumors & Cysts

H. Postmortem Conditions

1. Edema 2. Emaciation

3. Dehydration 4. Metastasis

FORENSIC/MEDICO-LEGAL PATHOLOGY

I. CORONER AND/OR MEDICAL EXAMINER

– A Public Official

A. Jurisdiction

–

B. Qualifications

– physicians, dentists, nurses, funeral directors

– an official examination & investigation into the cause, circumstances, and manner of sudden, violent, or unexplained death

II. MEDICO-LEGAL INVESTIGATION

A. Types of death with medico-legal potential

1. Injury and death by violence

a. Missile wounds: gunshot and other projectiles

b. Sharp force injury: stabbing and cutting

c. Blunt force injury: blows and falls

d. Land, water, aircraft accidents

2. Sudden and/ or unexpected death

a. At home

b. Hospital

c. Not in care of physician (variable state laws as to specific care and time limits)

3. Environmental death (state laws)

a. Industrial pollutants

b. Pesticides

c. Additives

4. Health, welfare, and safety

a. Drug abuse

b. Contagious disease (local state laws)

c. Cremation permits (special state laws and regulations)

5. Medical litigation

a. Malpractice/negligence

b. Insurance claims

– performed to demonstrate significant disease processes within the body and their relation to clinical findings versus diagnosis

C. Forensic autopsy

– aimed at:

3. Being an unrestricted autopsy with accessory investigations

– to prevent future legal actions or allegations

a. Biochemical tests(toxicological)

b. Microbiological tests

c. Radiological tests

4. Determining cause of death

– the pathologic entity responsible for death at the time of the terminal event

– the pathologic entity involved in, but not causing, the terminal event

– how the death occurred

– includes the circumstances of death, the investigational information and the cause of death

1. Natural

2. Homicide

3. Suicide

4. Accident

5. Unexplained

6. Undetermined

– final pronouncement is awaiting test results

– an explanation of the sequence of events leading to the death

e. Recovery of evidentiary information

– includes the recovery and preservation of evidence

III. INJURIES: GENERAL FEATURES

– any deviation of the natural continuity of a tissue

– a superficial injury

– such as a scratch or a scrape

– a circumscribed removal of the epidermis of the skin or mucous membrane

– an excoriation

– the escape of blood into the tissue of a living person following a rupture of vessels

– a splitting or tearing apart of tissues

– the loss of tissues by tearing away or tissue that has been torn away

B. Incised wounds

– looked at according to appearance and site

– multiple, shallow wounds

– usually indicate suicide attempts

– seen on the back of the forearms and/or shoulders

– may indicate homicide

3. Stab or puncture wounds

a. Through clothing

–

b. Not through clothing

–

C. Wounds and injury by gunshot

– classified according to the following:

1. Accidental

– may occur in any location

– wound may be found anywhere on the body

– more likely to be witnesses

2. Suicidal

– gunshot wound to the head

–

– gunshot wound to the chest

– slit wrists

–

– wounds to the head, heart, and/or back

4. Types of firearms

5. Entrance wound

–

– especially if close range

– range can be determined by examining this wound

a. Contact

b. Close range (up to one yard)

c. Distant

6. Exit wounds

–

D. Electrical injuries

–

– due to the rupturing of vessels close to the surface of the skin

– may be burn marks on body

E. Thermal injuries

– due to exposure to excessive heat

– the local effect of heat

– tissue destruction from contact with hot liquids

– ie. metal, oil, water, steam

b. Injury or burns by corrosive poisons

Corrosive acids

Corrosive alkalis

– most dangerous of the two

– due to exposure to excessive cold

– may cause death from chilling

a. Accidental

–

b. Due to exposure (accidents/disasters)

– the local effect of cold

–

– blood stops flowing there to retain the heat for vital organs

– any loss of consciousness due to a deficiency of oxygen

– mechanical interference around the neck that impedes the access of air to the lungs, interferes with the cerebral circulation, or disturbs vagus nerve action

– blocks off oxygen to the brain

– constriction of the neck as a result of suspension in such a manner that all or part of the weight of the body pulls on a ligature

– classified according to the following:

a. External signs of hanging

– rope burns on neck

– stretching of the neck

b. Posture and clothing of the victim

– helps to determine whether homicidal or not

c. Accidental (sexual deviation) vs. suicide

d. Types of ligatures

– application of pressure to the neck in such a manner that the force acting on the neck is exerted by a ligature only

a. By ligature

– usually occurs in cases of homicide

b. Manual

– usually accomplished by the strangle-hold

– compression by weight against a resisting surface

– is accidental only

– causes intense cyanosis in the upper parts of the body

– causes a reproduction of the clothing patterns on the skin

5. Suffocation

– synonymous to asphyxia

– but this term is used for other circumstances than constriction of the neck

– covering the mouth and nose to impede the intake of oxygen

– asphyxia caused by an obstruction within the air passage

– the result of submersion or partial submersion in a fluid

IV. SUDDEN INFANT DEATH SYNDROME

–

– usually occurs between the ages of three weeks to seven months

V. MALTREATMENT OF CHILDREN

– anytime there is evidence of improper child rearing practices

B. Physical abuse

– a repetitive injury of a severe nature, involving wounds, internal injuries, fractures or intracranial hemorrhages

a. Parental assault

b. Story does not appear to explain injuries

c. Suspicion should be reported to authorities (state laws vary)

– killing of an infant with consent of the parent(s), family or community

VI. POISONING

–

– any substance which when taken into the body whether by ingestion, inhalation, injection, or absorption, interferes with normal physiology

– the poisonous matter which certain animals secrete in a state of health

– communicated by a bite or sting

– any poisonous substances from animals or plants

– the study of poisons and the effects of poisons upon the body

– includes a study of antidotes and remedies used to counteract the adverse effects of poisons

EXAM # 5

SPECIAL

PATHOLOGY

VIII. DISEASES OF THE BLOOD

A. Reactive Changes
1. Leukocytosis
– a temporary increase in the number of circulating white blood cells.
– part of the protective mechanism in inflammation
2. Leukopenia
– a temporary decrease in the number of circulating leukocytes.
-seen in typhoid fever, measles, mumps, flu, and T.B.

Leukocytosis
Leukopenia

3. Acapnia
– a marked decrease in carbon dioxide content
– seen in instances of asthma, pulmonary emoblism and anxiety
4. Acidosis
– the condition in which there is an excessive proportion of acid in the blood
– often seen in diabetes, renal disease, and sever dehydration

5. Alkalosis
– the condition in which there is an excessive proportion of alkali in the blood
– can be seen in many metabolic disorders

B. Anemia
– a deficiency of circulating erythrocytes and/or hemoglobin
– a sign of disease

B. Anemia
– a deficiency of circulating erythrocytes and/or hemoglobin
– a sign of disease
1. Primary Anemia
– anemia due to a decrease in production of erythrocytes
– occurs in two ways

a. Nutritional deficiencies
1. Iron
– most common deficiency
– iron is essential for R.B.C. development

2. Pernicious Anemia
– occurs when Vitamin B12 cannot be absorbed from food
– erythrocytes (R.B.C.) require two factors to mature: an intrinsic factor found in normal gastric juice and an extrinsic factor – vitamin B12. The intrinsic factor is the carrier for B12 and it is not secreted in pernicious anemia. Therefore, B12 is not being absorbed from the small intestine
– because of this, R.B.C. cannot develop properly

Pernicious Anemia – commonly occurs in the white race after 40 years of age
– rarely before 35
– it is associated with the absence of hydrochloric acid
– treated with intramuscular injections of vitamin B12
b. Aplastic Anemia
– anemia due to marrow suppression
– the result of drug and chemical damage, radiation, infection, and metabolic disorders

Normal Bone Marrow
Bone Marrow in Aplastic Anemia

2. Secondary Anemia
– anemia due to increased destruction or loss of erythrocytes
– due to disease or trauma such as:
a. Hemolytic Anemia
– the rupturing of R.B.C.
– seen in malaria, sickle cell anemia, erythroblastosis fetalis

C. Hematopoietic Disorders(Hemopoietic)
– the disruption of any substance that assists in or stimulates the production of blood cells
1. Leukemia
– a malignancy of the hemopoetic tissues (blood-forming organs) – bone marrow, lymph nodes, and W.B.C.
– commonly called “cancer of the blood”
– an uncontrolled overproduction of white blood cells that are malformed

Normal Bone Marrow

Bone Marrow in Leukemia

Normal blood smear on left and one with leukemia shown on right

– Common signs and symptoms include:
– swollen spleen and lymph nodes
– a tendency to hemorrhage
– fever
– weight loss
– fatigue
– joint pain

2. Polycythemia Vera (Erythrocytosis)
– an uncontrolled production of red blood cells
– referred to as a chronic, life-shortening myelo-proliferative disorder involving all bone marrow elements

– leads to an increase in R.B.C. mass and hemoglobin concentration that increases blood viscosity, causes high blood pressure, and leads to extra work on the heart

– secondary to many disorders

D. Bleeding Disorders
1. Hemophilia
– an hereditary abnormality resulting in a defect in the clotting mechanism
– characterized by a tendency toward excessive and sometimes spontaneous bleeding
– affects males but transmitted by females

2. Thrombocytopenia
– an abnormal decrease in the number of platelets
– platelets are responsible for initiating the blood clotting process
– a deep purplish pigmentation known as
– this leads to a tendency toward widespread, spontaneous bleeding into the skin or mucus membranes resulting in…
Purpura

IX. DISEASES OF THE HEART AND BLOOD VESSELS

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Social Factors

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Social Factors

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Social Factors

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Social Factors

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Elevated cholesterol levels
Social Factors

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Elevated cholesterol levels
Social Factors
Smoking

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Elevated cholesterol levels
Social Factors
Smoking
Substance abuse

OH MY GOODNESS,
ANOTHER TEST???

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Elevated cholesterol levels
Social Factors
Smoking
Substance abuse
Stress

Predisposing Conditions

1. 2.

5.
a)
b)
c)
d)
Heredity
Obesity
Diabetes
Elevated cholesterol levels
Social Factors
Smoking
Substance abuse
Stress
Diet

B. Heart Disease

– the most common cause of disability and death in the United States

1. Dilatation
– enlargement of the heart due to stretching of the heart walls
– usually occurs as a result of the over-filling of a heart chamber

2. Hypertrophy
– enlargement of the heart due to an increase in size of the muscle fibers
– the result of an increased amount of work put upon the heart

obstructions of the peripheral vessels
– this increased work may be caused by:
1)

3)
disease conditions involving the heart valves
inflammatory and degenerative changes in the heart muscle

BOTH DILATATION AND HYPERTROPHY CAUSE ENLARGEMENT OF THE HEART

– which is an important sign of heart disease

3. Endocarditis
– includes inflammation of the heart valves
– valvular endocarditis
– vegetations
– inflammation of the inner layer of the heart (endocardium)
– without qualification, this always means…
– usually caused by bacteria that are deposited on a valve
– this collection creates thrombi known as…

4. Valvular Defects
– Imperfect valve closure that permits leakage or regurgitation of blood
– the narrowing or constriction of a valve
b. Valvular Stenosis
a. Valvular Insufficiency or Incompetence

4. Valvular Defects
– valve closure that permits leakage or regurgitation of blood
– the narrowing or constriction of a valve
– a valve or one of the cusps of the valve turns inside out
c. Prolapse
b. Valvular Stenosis
a. Valvular Insufficiency or Incompetence

5. Pericarditis
– inflammation of the outer sac of the heart – the pericardium
– can be caused by:
T.B., pyogenic organisms, neoplasms, trauma, myocardial infarction
– inflammation of the muscle layer of the heart – the myocardium
6. Myocarditis
– occurs commonly after rheumatic fever and diphtheria or may be idiopathic

7. Rheumatic Heart Disease
– Group A Beta Hemolytic Streptococci
– a febrile inflammatory disease that is a sequelae of rheumatic fever
a. Cause
– called Aschoff’s Nodules or Aschoff’s Bodies
– small nodules formed within the connective tissue of the heart
b. Lesion
– these nodules lead to the formation of scar tissue in the tissues of the heart

– commonly seen in the mitral valve
– causing stenosis
– all of this leads to serious, chronic heart disease

8. Coronary Artery Disease
Atherosclerosis
Thrombosis or Embolism
– pathologic changes in the walls of the coronary arteries and the consequences or results
Caused by:
a.
b.

At high magnification, the dark red thrombus is apparent in the lumen of the coronary. The yellow tan plaques of atheroma narrow this coronary significantly, and the thrombus occludes it completely.

c.
Spasms
– usually caused by syphilitic involvement of the mouths of the coronaries
– this causes uncontrolled contractions of the heart muscle
– the contractions occlude the lumens of the coronary arteries
– Consequences:
1)
2)
Coronary Occlusion
Myocardial infarction(heart attack)

Scar Tissue

Cardiac Failure
Myocardial infarction
Congestive Heart Failure
– the condition resulting from the inability of the heart to pump sufficient blood to meet the body’s needs
2 types:
a. Acute –

b. Chronic –
– as a result of high blood pressure, arteriosclerosis, prior myocardial infarctions, etc.

10. Hypertensive Heart Disease
– condition caused by constant pumping against resistance
– caused by hypertension
– which is also known as high blood pressure
– slowly “wears out” the heart

11. Cardiomyopathy
– disease of the myocardium due to a primary disease of the heart muscle
– accompanies congestive heart failure, infectious diseases, hypertrophy of the heart chambers, and chronic alcoholism
12. Carditis
– a general term to encompass inflammation of any of the layers or valves of the heart

13. Congenital Heart Disease

– septal defects

– patent ductus arteriosus
– a defect in the closing of the opening between the pulmonary artery and the aorta
– causes mixing of pulmonary and systemic blood
– more importantly, this defect predisposes to infection and thrombosis

C. Disease of the blood vessels
– like any other tissue, blood vessels are subject to various disease processes

– they react to injury and repair, infection, inflammation and tumors like any other tissue
1. Arteritis
– inflammation of an artery

2. Arteriosclerosis
– the thickening, hardening, and loss of elasticity of the walls of arteries
– hardening of the mitral valve of the heart
– results in altered function of tissues and organs because of decreased blood flow
Mitral Sclerosis

3. Atherosclerosis
– a form of arteriosclerosis characterized by the deposition of fatty deposits called plaques
– specifically occurs in the large elastic arteries such as the aorta, coronary arteries, and cerebral arteries

These three aortas demonstrate mild, moderate, and severe atherosclerosis from bottom to top. At the bottom, the mild atherosclerosis shows only scattered lipid plaques. The aorta in the middle shows many more larger plaques. The severe atherosclerosis in the aorta at the top shows extensive ulceration in the plaques.

4. Aneurysm

3 types:
– a localized weakening and dilation of an artery
– an equally dilated circum-ference creating a tubular swelling of the vessel
a. Fusiform Aneurysm

– the yielding of a weak area on one side of the vessel not involving the entire circumference
b. Sacculated Aneurysm
– appears as a bulging, sac-like dilation

c. Dissecting Aneurysm
– a separation of the tissues in the wall of an artery
– allows blood to enter and further separate the tissues

– any one of these types of aneurysms may increase in size and rupture causing a severe hemorrhage
5. Phlebitis
– inflammation of the veins

6. Varicose Veins
– dilated, tortuous superficial veins
pregnancy
obesity
occupations requiring prolonged standing or sitting
– varix or varices
– can occur in almost any part of the body, but are most commonly observed in the lower extremity, the esophagus, and the perianal veins
– some causes may be:
– other names are
–
–
–

DISEASES OF THE
NERVOUS SYSTEM

THE BRAIN

Any infectious disease of the nervous system is called
a neurotropic disease

A. Trauma
1. Concussion
– an injury of a soft structure, such as the brain, resulting from a blow or violent shaking with no physical damage apparent
– an immediate and temporary disturbance of brain function
– it may result in only a temporary grogginess or there may be a wide spread loss of cerebral control with a sudden drawing of the knees and severe vomiting

A. Trauma
2. Contusion
– a bruise to the brain causing swelling and pain
– the skin is not broken at the site of the injury
– may lead to hydrocephalus

A. Trauma
3. Laceration
– tearing of brain tissue
– may occur with or without fracture of the skull

A. Trauma
3. Laceration

4. Intracranial Hemorrhage
– tearing of brain tissue
– may occur with or without fracture of the skull
– hemorrhage in the cranium
– categorized according to the location in relation to the meninges
– Layers: – Bone, Dura Mater, Arachnoid Mater, Pia Mater, Brain

4. Intracranial Hemorrhage
Types:
a.

c.
Extradural or Epidural
– between the bone and dura mater
Subdural
– between the dura mater and arachnoid mater
Subarachnoid
– between the arachnoid mater and pia mater

4. Intracranial Hemorrhage
– Consequences depend on the location
– Subdural is the most common
– will cause sudden death in severe cases

B. Meningitis
– inflammation of the membranes around the spinal cord and brain

B. Meningitis
– inflammation of the membranes around the spinal cord and brain
– caused by numerous bacteria and viruses
– the form caused by the meningococcus (Neisseria meningitidis) is called
epidemic meningitis
– this is the most serious form

B. Meningitis
– transmitted via the respiratory tract by droplet spray or direct contact with discharges
– it then reaches the meninges via the blood or lymph stream

C. Encephalitis
– inflammation of the brain
– can be bacterial or viral
– the most common form is viral encephalitis
– transmitted to humans via an infected mosquito
– it may also only be a complication of other infectious disease like malaria, influenza, measles

D. General Paresis
– a diffuse meningoencephalitis seen in the tertiary stage of syphilis
– inflammation and degeneration of brain tissue that will lead to death

E. Cerebrovascular Accident/
Stroke/Apoplexy
– damage to the brain as a result of circulatory interruption
– usually due to thrombosis, embolism, or hemorrhage
– these are usually secondary to atherosclerotic disease
– if hemorrhage occurs where blood escapes into the tissue of the brain it may be due to hypertension or possibly a congenital aneurysm

F. Encephalomalacia
– softening of the brain due to death of tissue from lack of blood supply

G. Transient Ischemic Attack (TIA)
– a temporary interference with blood supply to part of the brain
– no permanent damage occurs
– characterized by:
–
–
–
dizziness
fuzzy vision in one eye
numbness or loss of sensation on one side of the body
– may last a few minutes or several hours

H. Hydrocephalus
-“Water on the brain”
– the increased accumulation of cerebro-spinal fluid within the ventricles of the brain
– caused by a blockage of the normal outflow of the fluid
– brain is pushed against the skull in adults
– dramatic enlargement of the cranium in infants
– severe cases lead to stillbirths or very short lifespans

I. Myelitis
– inflammation of the spinal cord
– occurs due to infection or injury to the spinal cord
J. Poliomyelitis
– inflammation of the gray matter of the spinal cord
– often affects brain tissue also

Poliomyelitis
– acquired through a viral infection from respiratory system or contaminated food then reaches the spinal cord through the bloodstream
– affects the motor neurons of the central nervous system resulting in serious damage and paralysis of the muscles controlled by these nerves

Anytime the brain and spinal cord are both involved —– the term
is used
encephalomyelitis

K. Neuritis
– inflammation of the nerves
– may be a direct infection or a complication of other infections like tuberculosis, tetanus, or measles
– may also be from damage by trauma or toxins

L. Epilepsy
– a chronic disorder of the nervous system with recurring convulsions and losses of consciousness
– the result of some form of interference with normal electrical activity in the brain
– most cases are idiopathic
– some are associated with brain injury, trauma at birth, or tumors

– characterized by convulsions of which there are two types:
1) Grand Mal or Tonic Clonic seizures
– Violent convulsions
– includes the making of peculiar sounds, biting the tongue, excess salivation

2) Petite Mal or Absence seizures
– loss of consciousness for short periods of time with dizziness
– this form is more common in children
– often appears to be day-dreaming

M. Rabies
– an acute, viral, infectious disease of warm-blooded animals
– commonly known as hydrophobia
– transmitted to humans through the saliva of an infected animal via a bite
– characterized by involvement of the central nervous system
– results in paralysis and death

N. Multiple Sclerosis
– a chronic degenerative disease of the nervous system characterized by remissions and relapses
– the myelin sheaths of the nerves are destroyed
– impairs motor and sensory nerve impulses
– the areas of damaged or “demyelinated” nerves are replaced with sclerotic plaques

– scattered diffusely throughout the gray and white matter of the brain stem and spinal cord
– affects young adults between 20 and 40 years of age

O. Parkinson’s Disease
– a chronic, degenerative nervous disease
– characterized by a slow spreading tremor, muscle weakness and rigidity with a peculiar gait
– sometimes referred to as “shaking palsy” or paralysis agitans
– walking occurs in short, rapid steps
– loss of balance and falling often occurs

P. Alzheimer’s Disease
– a chronic, organic mental disorder which leads to presenile dementia
– characterized by loss of memory, mood changes, and other mental disturbances
– tends to occur after the age of 60

– destruction of neurons in the cortex of the brain occurs and plaques are deposited upon the nerve fibers
– this is believed to be due to neuro-fibril degeneration

Q. Creutzfeld – Jakob Disease
– a central nervous system disease that causes a slow degeneration
– leads to dementia
– caused by a small protein particle called a
– can be transmitted by a parenteral injury with an object contaminated with the infectious agent
prion

R. Cerebral Palsy
– a non-progressive paralysis resulting from some type of brain damage before or shortly after birth
– may also include some mental retardation

EXAM TIME
!!!!!

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