2-15-12 Wednesday

PHYS/PATH

Alpha 1 and barrel chest=emphysema

Formation of urine
glomerular filtration
glomerular filtrate
tubular reabsorption
diffusion
osmosis (same as diffusion but with water)
active transport - requires ATP
Tubular secretion
**countercurrent mechanism
concentration of urine
antidiuretic hormone ADH, reabsorb more water
drink more, more dilute urine; less fluid= less dilute
65% reabsorb in proximal convoluted tube

Control bp
-juxtaglomerular apparatus: specialised cells that regulate kidney function

Triggered by low bp
-secretes renin enzyme
(Dr. Lou drew a picture)

ureters: long slender, mm tubes
epithelial, involuntary
gravity
urinary bladder: transitional epithelium
multi-layer, mucous membrane, 3 layer involuntary mm
urethra

urination (peeing aka micturition)
involuntary, internal urethral sphincter
voluntary, external urethral sphincter

urine
95% water, 5% dissolved solids and gases
pH ave 6.0
specific gravity measures amount of dissolved substance
-normal range 1.002 to 1.040

Normal constituents
-nitrogenous waste: urea, uric acid, creatine
-Electrolytes: sodium chloride, sulfates, phosphates
-pigments

Abnormal const.
-glucose, albumin, blood, ketones, wbc, casts

Body fluids: maintenance; thirst, kidneys, H. , buffers

Sense thirst: hypothalmus
electrolytes: positive and negative ions
aldosterone adrenal cortex

Pathology

Kidney Stones: crystals develop in renal pelvis
people who are dehydrated; M>W, whites
types: calcium oxalate (most commmon)
S&S: silent until stuck; pain, may have referal pain, fever
can cause renal failure

Pyelonephritis: infection of nephrons
acute or chronic, can die from this
S&S: infection, fever, pain/ tender to touch, cloudy pee
preg, diabetes, contaminated medical instruments
chronic silent with damage
comp. sepsis, scarring, renal failure
Tx: antibiotics
M: contra

Renal Failure: not function with demands
acute: pre/intra/post renal problems
chronic: stages
people with hypertension, diabetes, blacks
loss EPO= decrease rbc leads to anemia
Tx: control symptoms
M: ? be careful, energy work ok



ORTHO ASSESSMENT

Orthopedic: involves assessing disorders of: locomotion, joints, ligaments, tendons, mm, nerve, fascia
Assessment: gathering information and ruling out

Acute vs Chronic

FORCES that destroy soft tissue:
compression: 2 struct. come together with force
tension: pulling apart
shear: opposite force b/w 2 surfaces
torsion: rotary component (ACL, MCL, - knee)
bending: bone; just short of breaking

MM
concentric: bringing 2 end together (shorten and strenghten/ TrPs)
eccentric: contraction with elongation (lengthens, weakens/ TrPs)
isometric: contraction w/o movement

Atrophy: wasting away of mm tissue
due to disuse (48hrs)
denervation: interruption of nerve impulse

Strain: first to third degree
contusion: blunt force trauma

Tendon: transmits contraction from mm to bone
afflictions (4)
1) tendinosis: no inflammation, chronic, degenerative
2) tendonitis: inflammation, and tearing sheath
3) tenosynovitis: inflammation in and around sheath; no tearing
4) avulsion: separation from bone (achilles most common)

Ligaments- sprains (first to third degree)
inert tissue: unable to move or resist motion; because lack of recoil
acute lead to chronic due to lack of recoil/ ligament laxity
dense collagen
Joint capsule-example, tearing labrum of shoulder (whatever that is)