Complete Study Guide
Chapter 9 & 10
1. Define pyloric stenosis. Know the manifestation, diagnosis and treatment.
2. Define gastroesophageal reflux disease. Know the manifestation, diagnosis and treatment.
3. Define hepatitis. What are the different types, phases, clinical manifestations, diagnosis, and treatment? How to determine past or current infections?
4. What are the clinical manifestations and treatment of cirrhosis? How is it diagnosed?
5. What are the manifestations and treatment of Esophageal Atresia? How is it diagnosed?
6. How are esophageal varices developed and what are the treatments?
7. What are some causes of a fatty liver?
8. What is cholecystitis? What are the contributing factors, clinical manifestations, diagnosis, and treatment?
9. What are some changes that happens in the GI system with aging?
10. What is clostridium difficile and how is it manifested?
11. Define Gastritis. Chronic vs acute. What are the clinical manifestations, and treatment? How is it diagnosis?
12. How do fat soluble vitamins get absorbed?
13. Define Peptic Ulcers? What are the risk factors, contributing factors, clinical manifestations, common cause and treatment? How is it diagnosis?
14. Define Cholelithiasis? What are the risk factors, contributing factors clinical manifestations, and treatment? How is it diagnosis? Gallstones in bile duct vs cystic duct.
15. What does a elevated alkaline phosphatase and elevated -glutamyl transpeptidase (GGT) signify?
16. What is bacterium Helicobacter pylori? How does it affect the mucosal lining?
17. Which diagnosis best supportsmucus and blood (currant jelly)?
18. What is Barrett esophagus? What is it a precursor of?
19. What is the difference in how food is absorbed in the small vs large intestine?
20. Intestinal motility is controlled by which cranial nerve?
21. What are the functions of Escherichia coli in the intestine?
22. What are some manifestations would support a diagnosis of diabetes insipidus?
23. What is prolactinemia? What causes it and what are the clinical manifestations?
24. What are some diagnostic test findings supports that a pituitary problem and how are they expressed?
25. What are some characteristic of acromegaly and what other manifestations could occur with it?
26. Define hypothyroidism. What are the potential complications? What are the different causes and how is it diagnosed? What are the lab values involved? Most common type?
27. What are some benefits of cortisol? When is it released?
28. Hyperparathyroidism? What are some lab values associated with it normal vs abnormal? Treatment? Diagnosis?
29.
30. Define Diabetes Mellitus. What are the potential complications? What are the different types, causes, treatments, contributing factors, lab values and how is it diagnosed? Patient teachings? Know the medication class and how they work. What are the physiologic responses to increase blood sugar?
31. Define hyperthyroidism. What are the potential complications? What are the different causes and how is it diagnosed? What are the lab values involved?
32. Addisons Disease? Treatment and manifestations? How is it diagnosed? Lab values.
33. Where does fat distribution confers the highest risk for more complications?
34. What is the protein that is bound to the thyroid hormone?
35. What are the Anterior and posterior pituitary gland and how do they work?
36. What are differences between an endocrine and an exocrine gland?
37. What is pheochromocytoma? Treatment? How is it diagnosed?
38. Cushings Syndrome? Treatment and manifestations? How is it diagnosed? Lab values.
39. What are the characteristics of hormonal regulation? World Headquarters
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Library of Congress Cataloging-in-Publication Data
Names: Dlugasch, Lucie, author | Story, Lachel, author. | Based on (Work):
Story, Lachel. Pathophysiology.
Title: Applied pathophysiology for the advanced practice nurse / Lucie
Dlugasch & Lachel Story.
Description: Burlington, Massachusetts : Jones & Bartlett Learning, [2020] |
Includes bibliographical references.
Identifiers: LCCN 2019014108 | ISBN 9781284150452
Subjects: | MESH: Pathology | Physiology | Advanced Practice Nursing | Nurses Instruction
Classification: LCC RB113 | NLM QZ 140 | DDC 616.07–dc23
LC record available at https://lccn.loc.gov/2019014108
6048
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Contents
Preface
Acknowledgments
Contributors
Chapter 1 Cellular Function
Basic Cell Function and Structure
Cellular Components
Exchanging Material
Energy Production
Chromosomes, DNA, and Genes
Replication and Differentiation
Cellular Organization
Types of Tissue
Cellular Adaptation and Damage
Cellular Adaptation
Cellular Injury and Death
Neoplasms
Benign and Malignant Neoplasms
Genetic and Congenital Disorders
Patterns of Inheritance
Single-Gene Disorders
Chromosomal DisordersNumber or Structural
Autosomal Aneuploidy
X-Linked Aneuploidy
Chromosomal Structural Disorders
Multifactorial Disorders
Chapter Summary
References and Resources
Chapter 2 Immunity
Innate Immunity
Barriers
Inflammatory Response
Adaptive Immunity
Cellular Immunity
Humoral Immunity
Vaccines
Altered Immune Response
Hypersensitivity
Hypersensitivity by Mechanism
Hypersensitivity by Antigen
Immunodeficiency
Developing a Strong Immune System
Chapter Summary
References and Resources
Chapter 3 Hematopoietic Function
Hematopoietic System
Hematopoiesis
Hemostasis
Lymphoid System
Diseases of the White Blood Cells
Neutrophils
Eosinophils and Basophils
Lymphocytes and Monocytes
Lymphomas
Myelodysplastic Syndrome
Leukemias
Diseases of the Red Blood Cells
Anemia
Polycythemia
Iron Overload
Diseases of the Platelets
Thrombocytopenia
Thrombocythemia
Diseases of Coagulation or Hemostasis
Hemophilia
Von Willebrand Disease
Disseminated Intravascular Coagulation
Thrombophilia
Chapter Summary
References and Resources
Chapter 4 Cardiovascular Function
Anatomy and Physiology
Heart
Cardiac Cycle
Conduction System
Blood Vessels
Blood Pressure and Cardiac Output
Lymphatic System
Understanding Conditions That Affect the Cardiovascular System
Impaired Cardiac Output: Heart Disease
Pericarditis
Infective Endocarditis
Myocarditis
Valvular Disorders
Cardiomyopathy
Electrical Alterations
Heart Failure
Congenital Heart Defects
Impaired Tissue Perfusion: Vascular Disorders
Arterial Disorders
Arterial and Venous Disorders
Venous Disorders
Lymphedema
Conditions Resulting in Decreased Cardiac Output and Altered Perfusion
Hypertension
Shock
Chapter Summary
References and Resources
Chapter 5 Pulmonary Function
Anatomy and Physiology
Understanding Conditions That Affect the Pulmonary System
Infectious Disorders
Upper Respiratory Tract Infections
Lower Respiratory Tract Infections
Alterations in Ventilation
AsthmaObstructive
Chronic Obstructive Pulmonary Disease
Sleep ApneaObstructive
Cystic FibrosisObstructive
Lung Cancer
Pleural Effusion
Pneumothorax
Acute Respiratory Distress SyndromeRestrictive
Alterations in Ventilation and Perfusion
AtelectasisRestrictive
Acute Respiratory Failure
Chapter Summary
References and Resources
Chapter 6 Fluid, Electrolyte, and AcidBase Homeostasis
Fluid and Electrolyte Balance
Distribution
Fluid Movement
Fluid Regulation
Electrolytes
Fluid and Electrolyte Imbalances
Water, Sodium, and Chloride Relationship
Fluid Excess
Fluid Deficit
Sodium
Chloride
Potassium
Calcium
Phosphorus
Magnesium
AcidBase Balance
pH Regulation
Buffers
Respiratory Regulation
Renal Regulation
Compensation
Metabolic Acidosis
Metabolic Alkalosis
Respiratory Acidosis
Respiratory Alkalosis
Mixed Disorders
Arterial Blood Gas Interpretation
Chapter Summary
References and Resources
Chapter 7 Urinary Function
Anatomy and Physiology
Structure and Function
Urine Formation and Elimination
Understanding Conditions That Affect the Urinary System
Conditions Resulting in Altered Urinary Elimination
Incontinence
Neurogenic Bladder
Painful Bladder Syndrome/Interstitial Cystitis
Congenital Disorders
Urinary Tract InfectionsCystitis and Pyelonephritis
Urinary Tract Obstructions
Tumors and Cysts
Benign Prostatic Hyperplasia
Conditions Resulting in Impaired Renal Function
Polycystic Kidney Disease
Glomerular Disorders
Kidney Injury and Disease
Chapter Summary
References and Resources
Chapter 8 Reproductive Function
Anatomy and Physiology
Normal Male Reproductive System
Normal Female Reproductive System
Congenital Disorders
Epispadias
Hypospadias
Cryptorchidism
Infertility Issues
Disorders of the Penis
Erectile Dysfunction
Phimosis and Paraphimosis
Priapism
Disorders of the Testes and Scrotum
Hydrocele
Varicocele
Testicular Torsion
Disorders of Pelvic Support
Clinical Manifestations
Diagnosis and Treatment
Menstrual Disorders
Abnormal Uterine Bleeding
Amenorrhea
Heavy and Intermenstrual Bleeding
Dysmenorrhea
Premenstrual Syndrome
Disorders of the Uterus
Endometriosis
Leiomyomas
Disorders of the Ovaries
Ovarian Cysts
Polycystic Ovary Syndrome
Disorders of the Breasts
Benign Breast Masses
Mastitis
Reproductive Tract Infections
Prostatitis
Epididymitis
Candidiasis
Sexually Transmitted Infections
Bacterial STIs
Viral STIs
Protozoan STIs
Trichomoniasis
Cancers
Penile Cancer
Prostate Cancer
Testicular Cancer
Breast Cancer
Cervical Cancer
Endometrial Cancer and Uterine Sarcoma
Ovarian Cancer
Chapter Summary
References and Resources
Chapter 9 Gastrointestinal Function
Anatomy and Physiology
Upper Gastrointestinal Tract
Lower Gastrointestinal Tract
Liver
Pancreas
Gastrointestinal Changes Associated With Aging
Understanding Conditions That Affect the Gastrointestinal System
Disorders of the Upper Gastrointestinal Tract and Accessory Organs
Congenital Defects
Cleft Lip and Cleft Palate
Esophageal Atresia
Pyloric Stenosis
Dysphagia
Vomiting
Hiatal Hernia
Gastroesophageal Reflux Disease
Gastritis
Peptic Ulcers
Cholelithiasis
Disorders of the Liver
Hepatitis
Cirrhosis
Disorders of the Pancreas
Pancreatitis
Disorders of the Lower Gastrointestinal Tract
Diarrhea
Constipation
Intestinal Obstruction
Appendicitis
Peritonitis
Celiac Disease
Inflammatory Bowel Disease
Crohn Disease
Ulcerative Colitis
Irritable Bowel Syndrome
Diverticular Disease
Cancers
Oral Cancer
Esophageal Cancer
Gastric Cancer
Liver Cancer
Pancreatic Cancer
Colorectal Cancer
Chapter Summary
References and Resources
Chapter 10 Endocrine Function
Anatomy and Physiology
Hormonal Regulation
Pituitary Gland and Hypothalamus
Pancreas
Thyroid Gland
Parathyroid Glands
Adrenal Glands
Understanding Conditions That Affect the Endocrine System
Disorders of the Pituitary Gland
Hyperpituitarism
Hypopituitarism
Prolactin Disorders: Prolactinemia
Growth Hormone Disorders
Antidiuretic Hormone (Vasopressin) Disorders
Diabetes Mellitus
Type 1 Diabetes
Type 2 Diabetes
Gestational Diabetes
Metabolic Syndrome
Clinical Manifestations and Complications
Diagnosis and Treatment
Obesity
Clinical Manifestations
Diagnosis and Treatment
Disorders of the Thyroid
Goiter and Thyroid Nodules
Hypothyroidism
Hyperthyroidism
Disorders of the Parathyroid Glands
Hypoparathyroidism
Hyperparathyroidism
Disorders of the Adrenal Gland
Pheochromocytoma
Cushing Syndrome
Addison Disease
Chapter Summary
References and Resources
Chapter 11 Neural Function
Anatomy and Physiology
Central Nervous System
Peripheral Nervous System
Autonomic Nervous System
Blood Supply to the CNS
Understanding Conditions That Affect the Nervous System
Congenital Neurologic Disorders
Hydrocephalus
Spina Bifida
Cerebral Palsy
Infectious Neurologic Disorders
Meningitis
Encephalitis
Zika Virus Disease
Traumatic Neurologic Disorders
Brain Injuries
Increased Intracranial Pressure
Hematomas
Diagnosis and Treatment
Spinal Cord Injuries
Vascular Neurologic Disorders
Cerebrovascular Accident
Cerebral Aneurysm
Arteriovenous Malformations
Headache Disorders
Migraine Headaches
Tension-Type Headaches
Cluster Headaches
Seizure Disorders
Clinical Manifestations
Diagnosis and Treatment
Chronic Degenerative Disorders
Multiple Sclerosis
Parkinson Disease
Amyotrophic Lateral Sclerosis
Clinical Manifestations
Diagnosis and Treatment
Myasthenia Gravis
Huntington Disease
Dementia
Alzheimer Disease
Vascular Dementia
Dementia With Lewy Bodies
Frontotemporal Dementia
Creutzfeldt-Jakob Disease
AIDS Dementia Complex
Cancers of the Nervous System
Brain Tumors
Mental Health Disorders
Depressive Disorders
Bipolar Disorders
Schizophrenia
Anxiety Disorders
Obsessive-Compulsive Disorders
Chapter Summary
References and Resources
Chapter 12 Musculoskeletal Function
Anatomy and Physiology
Bones
Bone Remodelling
Joints
Muscles
Understanding Conditions That Affect the Musculoskeletal System
Congenital and Developmental Musculoskeletal Disorders
Developmental Hip Dysplasia
Osteogenesis Imperfecta
Spinal Deviations
Traumatic Musculoskeletal Disorders
Fractures
Dislocations
Sprains
Strains
Child Abuse
Bursitis
Anatomic-Specific Injuries
Low Back Pain
Metabolic Bone Disorders
Osteoporosis
Rickets and Osteomalacia
Paget Disease
Inflammatory Joint Disorders
Osteoarthritis
Rheumatoid Arthritis
Juvenile Idiopathic Arthritis
Gout
Ankylosing Spondylitis
Chronic Muscle Disorders
Muscular Dystrophy
Fibromyalgia
Bone and Muscle Neoplasms
Chapter Summary
References and Resources
Chapter 13 Integumentary Function
Anatomy and Physiology
Epidermis
Dermis and Appendages
Subcutaneous Tissue
Nails
Understanding Conditions That Affect the Integumentary System
Congenital Integumentary Disorders
Birthmarks
Disorders of Melanin
Integumentary Changes Associated With Aging
Inflammatory Integumentary Disorders
Contact Dermatitis
Atopic Dermatitis
Urticaria
Psoriasis
Infectious Integumentary Disorders
Bacterial Infections
Viral Infections
Parasitic Infections
Traumatic Integumentary Disorders
Burns
Pressure Injuries
Clinical Manifestations
Diagnosis and Treatment
Chronic Integumentary Disorders
Acne Vulgaris
Rosacea
Integumentary Cancers
Manifestations
Hair Disorders
Nail Disorders
Chapter Summary
References and Resources
Chapter 14 Sensory Function
Anatomy and Physiology
Pain Mechanisms
Pain Transmission
Types of Pain
Eyes
Ears
Understanding Conditions That Affect the Senses
Congenital Sensory Disorders
Sensory Conditions Associated With Aging
Infectious and Inflammatory Sensory Disorders
Traumatic Sensory Disorders
Chronic Sensory Disorders
Sensory Organ Cancers
Miscellaneous Sensory Organ Conditions
Chapter Summary
References and Resources
Glossary
Index
Preface
Pathophysiology is a critical foundational course for all nurses. Advanced
pathophysiology is a core course that must be included in all graduate nursing
curriculums preparing nurses in direct care roles. These roles are varied and include
nurse practitioners, nurse anesthetists, nurse midwives, clinical nurse specialists,
and nurse educators. This text includes content across the life span and content to
meet the needs of advanced practice population areas including pediatrics,
psychiatric mental health, and gerontology and incorporates information from an
acute and primary care focus.
Many pathophysiology books are geared toward undergraduate nursing students
and often lack the requisite content and focus to prepare advanced practice nurses.
Educators teaching this course often have to create supplementary materials to
ensure their students are better prepared for their advanced practice roles. Some of
these books are also unwieldly and contain too much information, and educators
must often edit texts content to make it manageable and understandable. Without a
dedicated pathophysiology text available for advanced practice nursing, students are
often overwhelmed, and educators are frustrated when teaching this course. This
text was developed with these issues in mind and takes a comprehensive yet
concise approach to presenting the content.
The text was also developed with the awareness that graduate students have a
foundation in pathophysiology yet have different experiences. Students enter
advanced pathophysiology with varying numbers of years since they took basic
sciences and nursing courses. Therefore, this text serves as a bridge between their
basic education and clinical experience and the advanced knowledge necessary for
their new advanced roles. Concepts in pathophysiology can be difficult to understand
and remember. In this text, concept descriptions are repeated several times within a
chapter and between different chapters. As an example, there is an extensive
discussion pertaining to osmosis in the cellular function chapter. The concept of
osmosis is then briefly described again when discussing the process in the vascular
and renal systems. This repetition serves as a prompt for students to remember and
see concepts in different contexts, disorders, and practice situations.
Advanced pathophysiology is usually one of the courses students must take in
the beginning of their academic programs. This text was written in a format so that
students can start to transition into their new roles and think like an advanced
practice nurse. Advanced practice nurses must have the ability to understand and
compare and contrast presenting signs and symptoms and then discern between
one diagnosis and another. Choices must then be made pertaining to necessary
diagnostic tests, and treatment plans need to be developed. The text contains
information and examples in a way that helps students to begin mastering these
competencies. In each chapter, there are several Application to Practice activities.
Within these application activities are case studies that I have developed from real-
life scenarios accumulated from 35 years as a practicing nurse (24 of those as an
advanced practice registered nurse) and educator. These cases represent common
encounters an advanced practice nurse may face in practice. Some of the cases
were developed by other faculty who are also expert practicing clinicians and
educators. The content in the cases is concise, mimicking typical clinical encounters.
These shorter cases allow students to practice what they just read and help them
gain understanding and confidence. Several of the application activities have
multiple cases that have common features, yet the diagnosis or clinical
manifestations may be different. These activities allow the students to develop
knowledge necessary to differentiate between clinical presentations, pathogenesis,
diagnosis, and treatment.
The chapters are written in a format providing students with information
pertaining to the most common scenario and likely underlying disorder. Chapters are
organized with overarching concepts and disorders organized by underlying
pathophysiologic processes. Disorders that have a common presentation are
discussed in a common section as patients come in with concerns and clinical
manifestations, not diagnoses. The grouping of common presentations with varying
diagnoses is another technique to help students think like an advanced practice
nurse and develop critical thinking skills. As an example, when a patient is
complaining of a sore throat the various possible diagnoses can include viral
pharyngitis, streptococcal pharyngitis, and infectious mononucleosis. Infectious
mononucleosis in other texts is often discussed in hematology chapters, and in this
text, it is discussed with other common pharyngitis causes. Providing information in
this format sets the stage for future courses and clinical encounters where students
need to establish a diagnosis based on a patients presentation. Tables are also
provided to help students understand differentiation between disorders.
Diagnostic links are another tool found throughout each chapter. These
diagnostic links provide the student with a background for commonly used diagnostic
tests in practice. The links are strategically placed in the chapter where content
pertaining to the diagnostic test was just discussed to maximize understanding. As
examples, a reticulocyte count is discussed with a description of hematopoiesis or
clotting studies are discussed with hemostasis.
The strength of this text is that the content is written in a format linking together
multiple concepts from an applied pathophysiologic perspective; a style that is often
lacking in other pathophysiology texts. This text is written to answer the how, when,
and why to how things can go wrong, along with guidelines for diagnosis and
treatment. With this practical approach to discussing the complex topic of
pathophysiology, the student will gain confidence and be prepared to make sound
decisions.
Sources
APRN Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee.
(2008). The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, Education.
Retrieved Dec. 9, 2019 from https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf
AACN. (2011). The essentials of masters education in nursing. Retrieved from
http://www.aacn.nche.edu/education-(2011). The essentials of master education in nursing. American
Association of Colleges of Nursing.
American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculties. (2016).
Criteria for evaluation of nurse practitioner programs: A report of the National Task Force on quality nurse
practitioner education.
https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf
http://www.aacn.nche.edu/education-(2011
Acknowledgments
I would like to thank my husband, Philip, for supporting me during all my career
endeavors such as writing this book. You are not only my husband but are also my
best friend and are one of the most passionate fellow nurse practitioners I know.
Thank you for reviewing many sections in my book. The personal sacrifices you
have made for me are immeasurable and have been noticed, and for this I am so
grateful. To my daughters, Nicole and Lauren, I thank you for your words and
gestures of encouragement and pushing me along the way when I was tired and
doubted myself. To Analise, my daughter in heaven who now lives as an eternal part
of my soul, I was able to find inspiration in my memories of how passionately you
lived your life. I was also fueled by the drive and dedication you displayed in all your
pursuits. To my friends and colleagues, thank you for listening and instilling
confidence in my abilities. To my mom and stepdad, thanks for picking up the pieces,
bringing me food, helping me with the house and just always being there for me; I
am lucky to be the recipient of your tireless generosity. I love you both so much. To
all my students, I am happiest when I am with you in the classroom. Our
discussions, even the contentious ones, energize me and remind me how in health
care, information is always evolving and learning is lifelong. Although we may
become weary, we must never rest, as we are charged and entrusted with caring for
the most important thing in life and that is the health of others.
A big thank you to Lachel Story, my coauthor, who enabled me to embark on this
journey, provided much encouragement, and guided me along the way. I am also
thankful to the team at Jones & Bartlett Learning: Anna Maria Forger, Tina Chen,
and Alex Schab, and many behind-the-scenes people who were supportive and
flexible with me throughout this process.
Lucie Dlugasch
First, I would like to thank my husband, Tom, and children, Clayton and Mason, for
their never-ending love and encouragement. I would also like to express my deepest
gratitude to my mom, Carolyn, and dad, Tommy, because I would not be who I am
today without them. I would also like to acknowledge all my students past, present,
and future for constantly teaching me more than I could ever teach them and for all
their feedbackI heard it and I hope this is more what you had in mind. Finally, I
would like to convey my appreciation to my colleagues for their gracious mentoring
and support.
Lachel Story
Contributors
Philip Dlugasch, MSN, APRN, ACNP-BC
Intensive Care Unit APRN
Jackson Memorial Hospital
Adjunct Nursing Instructor
University of Miami School of Nursing
Lt. Colonel, Retired
Chief Nurse
United States Air Force
Derrick C. Glymph, CNAP, CRNA, APRN, COL., USAR
Nicole Wertheim College of Nursing and Health Sciences
Florida International University
Miami, Florida
Deana Goldin, PhD, DNP, MSN, APRN, FNP-BC
Assistant Clinical Professor and Family Nurse Practitioner Program Leader
Nicole Wertheim College of Nursing and Health Sciences
Florida International University
Miami, Florida
Dana Sherman, DNP, MSN, APRN, ANP-BC, FNP-BC
Assistant Clinical Professor
Nicole Wertheim College of Nursing and Health Sciences
Florida International University
Miami, Florida
Reviewers
Nicole R. Clark, DNP, FNP-BC
Oakland University
Rochester, Michigan
Angie M. Fetsko, BSN, RN-BC
Greater Waco Advanced Health Care Academy
Waco, Texas
Julian L. Gallegos, PhD, RN, FNP-BC, CNL
Touro University
Vallejo, California
Mary Knowlton, DNP, RN, CNE
Western Carolina University
Cullowhee, North Carolina
Leanna R. Miller, DNP, CCRN-CMC, PCCN-CSC, CEN, CNRN, CMSRN, NP
Western Kentucky University
Bowling Green, Kentucky
Katie Morales, PhD, RN, CNE
Berry College
Mount Berry, Georgia
Tonya Sawyer-McGee, DNP, MBA, MSN, RN, ACNP
Abilene Christian University
Abilene, Texas
Crystal Slaughter, DNP, APRN, CNS
Saint Francis Medical Center College of Nursing
Peoria, Illinois
P
C H A P T E R 1
Cellular Function
L E A R N I N G O B J E C T I V E S
Analyze the purpose and function of cellular structures.
Analyze how various substances cross the cell membrane.
Explain cellular energy sources and production.
Discuss the process of protein synthesis.
Summarize how cells are organized.
Analyze mechanisms of cellular proliferation, differentiation, and adaptation
as they relate to disease development.
Describe the correlation between genetics, epigenetics, and environment in
disease development.
Evaluate patterns of inheritance and compare how various disorders are
inherited.
Differentiate genetic and congenital disorders.
athophysiology inquiry begins with exploring the basic building blocks of living
organisms. Cells give organisms their immense diversity. Organisms can be
made up of a single cell, such as with bacteria or viruses, or billions of cells,
such as with humans. In humans, these building blocks work together to form
tissues, organs, and organ systems. Alterations and maladaptation in these basic
units of life are also the foundation for the development of disease.
The impact of disease is evident from the cellular level up to the system level.
Knowledge of cellular-level mechanisms, genetics, genomics, and epigenetics have
led to scientific breakthrough in the understanding of disease and treatment
strategies. Therefore, understanding basic cellular function and dysfunction are core
and essential to understanding pathophysiology.
Basic Cell Function and Structure
Cells are complex miniorganisms resulting from millions of years of evolution.
Individual cells are part of a network of other cells that are grouped together to serve
a function and purpose. These groupings of cells are organized into tissues. Groups
of tissues then form organs, and groups of organs are organized into systems.
Survival of an organism is dependent on these groupings and not just on individual
cells. Cells, therefore, must coexist and communicate with each other to proliferate
and survive. When this communal environment does not exist, then adaptation or
disease occurs. Cells can arise only from a preexisting cell, and through the process
of differentiation, cells become specialized to perform certain functions. Cells will
vary greatly in size and shape in order to perform certain functions. Despite having
varying functions and features, cells have several commonalities such as a nucleus,
cytoplasm, and organelles. Cells also have the remarkable ability to exchange
materials with their immediate surroundings, obtain energy from organic nutrients,
synthesize complex molecules, and replicate themselves.
Cellular Components
The basic components of cells include the cytoplasm, organelles (including the
nucleus), and cell membrane. The cytoplasm, or protoplasm, is a colorless, viscous
liquid containing water, nutrients, ions, dissolved gases, and waste products; this
liquid is where the cellular work takes place. The cytoplasm suppo
