exam clinical pathology

• Inflammation


  Body's first response to tissue damage or injury
• Acute inflammatory response


  • Redness (rubor)
  • Heat (calor)
  • Swelling (tumor)
  • Pain (dolor)
  • Loss of function (functional laesa)
• Stages of tissue healing

  1. Inflammatory phase

  2. Proliferation phase

  3. Remodeling or maturation phase
• Specific inflammatory conditions


  • Osteoarthritis
  • Bursitis
  • Ligament sprain
  • Muscle strain
  • Tendinitis
  • Capsulitis
  • Plantar fasciitis
• Diagnosis of Disease


  1. Medical history

  2. Physical exam

  3. Laboratory tests (blood count, chemistry, etc.)

  4. Imaging tests (MRI, CT, X-ray, ultrasound, etc.)

  5. Biopsy

  6. Miscellaneous tests (pulmonary function, cultures, etc.)
• Goals of treatment


  Cure, control symptoms, support, or a combination of all three
• Therapeutic elements of a medical care plan

  • Preventative measures
  • Therapeutic procedures
  • Administration of medications
  • Surgery
  • Physical therapy
  • Diet modifications
  • Psychotherapy
  • Patient education and follow up care
• Holistic medical care


  Focuses on the needs of the whole person - physical, spiritual, psychological, social, emotional, intellectual
• Cultural diversity


  Individuality based on numerous differences - race, ethnicity, language, culture, religious beliefs, values/life experiences
• Pain


  Subjective and individualized; Physiological or psychological
• Terms used to describe pain

  • "Burning" along a nerve root
  • "Cramping" describes abdominal-visceral
  • "Throbbing" head pain
  • Shooting, stabbing, or stinging
• Factors influencing pain

  Cultural values; past experiences; religious beliefs; emotion support; anxiety; level of education; and specific situation
• Pain physiology


  1. Stimulation of nociceptors found on free nerve endings

  2. Impulses travel through spinal cord to brain

  3. Usually signals injury or tissue damage

  4. May travel a parallel pathway along spinal cord to brain, resulting in referred pain in another part of the body
• Pain receptors


  Respond to temperature extremes, mechanical damage, and dissolved chemicals
• Pain


  Is a signal that helps locate and eliminate or reduce the source of tissue damage; Part of the normal healing process
• Psychological pain

  Feelings of sadness, despair, anger, depression, helplessness, or hopelessness; Thought processes may be impaired; Sleep patterns may be disrupted; May exhibit changes in personality; May cry or show signs of withdrawal
• Pain medications


  • Analgesics
  • Opioids (narcotics) - patient controlled anesthesia
  • Non-steroidal anti-inflammatory drugs (NSAIDS)
  • Antidepressants
  • Anticonvulsants
  • Antispasmodics
• Transcutaneous Electrical Nerve Stimulation (TENS)

  Sends nerve impulses to the nerve endings to block nerve transmission to the brain
• Complementary and alternative methods

  Physical therapy and massage of the area of pain to increase the blood flow to and from the area and to increase the flow of lymph from the area
• Stress


  Can alter both perception and response to pain
• Referred pain


  Neurons from certain organs may travel a parallel pathway along the spinal cord to the brain; Follows a dermatome, i.e., angina - pain in chest radiating to the left arm
• Nervous system of the brain

  Has no pain receptors; Still, headaches are reported
• Pain classification


  • Acute - sudden; severe in intensity; short duration
  • Chronic - less severe; duration is longer than six (6) months
  • Intractable - generated by nerve damage or cancer
  • Transient - comes and goes; brief duration
  • Superficial - located on the body surface
  • Deep - related to muscles, joints, or tendons
  • Visceral - internal organs
• Goals of client/patient teaching

  Facilitate client/patient compliance with the medical treatment plan; Clarify information and instructions; Foster patient independence and responsibility; Establish trusting, therapeutic relationship
• Additional reasons for client/patient teaching

  • Ease anxiety
  • Facilitate greater sense of client/patient control
  • Improve patient/family coping
  • Highlight goals for recovery or acceptance
  • Reduce unnecessary clinic visits and hospitalizations
• Predisposing factors of disease

  • age
  • gender
  • lifestyle
  • environment
  • heredity
• Non-changeable predisposing factors


  • age
  • gender
  • heredity
• Changeable predisposing factors


  • Lifestyle
  • physical abuse and violence
  • poor nutrition
  • tobacco, drugs, and alcohol
  • Environment
  • air and water pollution
  • chronic stress
• Preventive health care


  • Modification of identified risk factors
  • Prophylactic medical services
  • Environmental and workplace safety
• Immune disorders


  • Hypersensitivity reaction (allergy)
  • Autoimmune disease
  • Immunodeficiency disorder
• Hypersensitivity reaction


  1. Exposure to allergen, which acts as antigen

  2. Triggers release of histamine, etc.

  3. Symptoms produced (mild to life-threatening)
• Aging Process


  • Metabolic changes (e.g., decreased liver and kidney function)
  • Decreased total body water
  • Changes in body composition (e.g., increased adipose tissue, decreased muscle mass)
  • Decreased bone density
  • Onset of immunosenescence
• Screening tests recommended after age 50

  • Electrocardiogram for heart disease
  • Rectal exams for bowel cancer and prostate enlargement
  • Blood pressure check for hypertension
  • Mammogram for breast cancer
  • Pap smear for cervical cancer
  • Urinalysis for suspected diabetes and renal disease
  • Blood cholesterol levels for hyperlipidemia
• Common laboratory tests

  • Complete blood count (CBC) – hemogram; evaluates the cellular components of blood
  • Hemoglobin (Hb) – measurement of the oxygen carrying pigment of the red blood cells
  • Hematocrit (HCT) – measurement of the percentage of red blood cells in a volume of whole blood
  • Toxicology studies: drug screens
  • Arterial blood gas (ABG) analysis – measurement of dissolved oxygen and carbon dioxide in arterial blood
  • Urinalysis (UA) – screening test using a urine specimen that provides an indication of the client's overall state of health and the state of the urinary tract
• Diagnostic tests


  • Electrocardiogram (ECG, EKG) – records the electrical activity of the myocardium; diagnoses ischemia and arrhythmias
  • Echocardiogram – ultrasound examination of the cardiac structure (size, shape, thickness, position, movements of the structures)
  • Holter monitor – small electrocardiograph which records the heart's electrical activity for the heart for a certain amount of time; client also records all activities during the time period to correlate with atypical cardiac patterns
  • Stress testing, treadmill, exercise tolerance – assessment of cardiac functioning using moderate exercise after a 12 lead electrocardiogram
  • Pulse oximeter – instrument which measures oxygen saturation of the arterial blood
  • Cardiac catheterization – visualization of the either side of the heart by passing a catheter into the right or left chamber and injecting dye
  • Radiographs – electromagnetic radiation is used to visualize internal organs and structures; contrast medium is used to distinguish soft tissue and some organs (i.e., gallbladder, stomach, and esophagus)
  • Magnetic resonance imaging (MRI) – a magnetic field is used to visualize internal organs; three (3) dimensional
  • Computed tomography (CT) scan – radiograph technique using a scanner which provides images of the internal structure of tissue and organs
  • Fluoroscopy – real time imaging process that provides continuous visualization of the area; studies the functioning of tissues and organs
  • Sonograms, ultrasound, echogram – beam of sound waves which are projected into target tissues or organs; outline of the structure is produced and recorded on a file or videotape for examination
  • Stool analysis
  • Sputum analysis
  • Endoscopy tests – visual inspection of internal organs and/or cavities of the body using the appropriate scope
  • Spirometry – measurement of lung capacity, volume, and flow rates by a spirometer
  • Immune or immunoglobulin studies
  • Biopsies – removal of tissue from the living body, followed by examination by a microscope
  • Lumbar puncture (LP) – surgical procedure to withdraw spinal fluid for analysis
  • Electroencephalogram (EEG) – recording of the electrical activity of the cerebral cortex of the brain
  • Electromyelogram (EMG) – electrodiagnostics assessment and recording of the activity of the skeletal muscles
  • Pregnancy tests – human chorionic gonadotropin (HCG-UCG); diagnosis pregnancy, uterine pathology
• Screening tests

  • Hepatic
  • Tuberculosis (TB) – intradermal injection
  • Prostatic-specific antigen (PSA) – blood test
  • Pap (Papanicolaou) smear
  • Mammograms
• Developmental characteristics

  • Developmental process
  • Fertilization and conception
  • Prenatal stages (embryonic, fetal)
  • Perinatal (during birth process)
  • Postnatal (neonatal, up to 1 month after birth)
• Congenital anomalies


  • Abnormal developmental process
  • Etiology (genetic, non-genetic, or both)
  • Results in physical or mental defects
  • May be present at birth or diagnosed later
  • Often occur in multiple
• Methods of prenatal diagnosis

  1. Amniocentesis (take amniotic fluid sample 15-18 weeks, test for chromosomal abnormalities or abnormal substances)

  2. Ultrasound (identify spine and skull abnormalities in early pregnancy)
• Prematurity


  • Birth before 37 weeks gestation
  • Low weight (less than 5 lbs 8 oz)
  • Incomplete development of organ systems
  • Leading cause of death in neonatal period
  • High-risk infants