hello and my name is Miss White welcome to pathophysiology and today we will be discussing chapter one this chapter focuses on the introduction to pathophysiology okay so to start we'll discuss what is pathophysiology so it's basically the study of functional changes and again let's focus on the word changes and it's the changes that are in the body that is caused by injury disorder or different diseases you'll notice that pathophysiology has multifaceted areas that we addressed there's pathology anatomy and physiology biology microbiology and chemistry all of these areas in science help describe the pathophysiology or changes that are occurring in the body overall when we discuss pathophysiology we're trying to understand what's occurring with the injury disease or disorder that's causing the body to malfunction but what that helps us learn is what is required to help the body stay homeostatic or remain stable and again homeo stasis is required in all of these fields in pathology Anatomy physiology microbiology chemistry homeostasis is so important because it helps the body maintain balance and balance is what's required to help the body function so we'll move into disease disease is the functional impairment of cells tissues organs or organ systems so we're looking at all areas that can be diseased um and it normally includes injuries disorders illnesses and syndromes and all the slide of same that you'll see parallels and even these words used interchangeably to describe things that are going wrong with the body but just understand that when we discuss disease injuries disorders illnesses syndromes it is some type of functional impairment related to the tissues organs cells or organ systems within the body another concept that we learn in pathophysiology is pathogenesis and if you look at the word patho means what's wrong with the body or the disease of the body in the Genesis meaning the origin so when we look at pathogenesis that is the origination and development of a disease or illness and it can involve three areas um it's the point at which the disease process begins it's the point where the disease actually presents itself and then there are risk factors that would cause the origination of um that disease or illness and we have modifiable risk factors and non-modifiable risk factors when we study pathogenesis it's really to help prevent the disease once we understand how it starts that's the point where we can decide hey this is how we can have early intervention early diagnosis and help stop that disease from progressing so again when we look at pathogenesis is a very important concept because we don't necessarily arrive at the answer to how to treat the said illness or treat the disease unless we look at how it starts going further into the pathogenesis we're moving into a separate concept called etiology so these um areas can be related because pathogenesis is the start of the disease when we talk about eyology it is the precise cause of disease so we can pinpoint what exactly started the uh disease process so we have several areas that we can have an eyology we have the pathogen which is a microorganism and it causes diseases so that could be your viruses that could be your bacteria that could be Fung it could be anything that is a microorganism or considered a microorganism that would cause a disease process and then we have multifactorial etiologies and all this is saying is that hey we know that there is one cause but sometimes there are multiple causes sometimes it could be genetic and a pathogen sometimes it can be um environment versus a pathogen it's just multiple areas it could even be genetics actually so multiple areas that would predispose an individual to getting a disease so when we talk about multifactorial etiologies is more than one cause then we're moving into idiopathic so earlier in this lecture I mentioned that sometimes we don't know what causes a disease well that by definition is called idiopathic so when we talk about an idiopathic iology there is no known cause it just happens we can't explain it by science we can't explain it by genetics we can't explain it via pathogens it's just something that develops within the human process and up until this point there has been no study showing what could specifically cause that disease then we're moving into nosocomial and that is a infection or an illness caused by a health care environment so normally these are your hais or Healthcare Associated infections you see these terms use one and the same so we'll move into a different Concept in just a little while but understand that this is just related to um being inside of the healthcare environment so let's say a individual is uh boarded in the same room as an individual with tuberculosis unknowingly well because both of those individuals were in a healthc care environment and that person that was not infected with tuberculosis thus gets tuberculosis that would be called a nosocomial infection now tuberculosis is an extreme case normally we know about tuberculosis prior to its spreading because of the signs and symptoms but if that person did get an infection the same infection by their rooming partner then that's how we look at a nosocomial infection another example of that would be an individual getting pneumonia just normal pneumonia within the health care environment if that is the case um the person didn't come in with pneumonia but all of a sudden comes up with pneumonia that would also be uh considered a nosocomial infection or hhi Healthcare Associated infection now we're going to move into iatrogenic and this is caused inadvertently by medical treatment so do not get nocom androgenic confused this is C this is a disease caused by being treated so let's say that an individual goes to surgery and they get um stitches or some type of incision from the surgery well that surgery was not closed off correctly they didn't close the incision correctly which caused an individual to get sepsis or that area of the incision gets infected that would be iatrogenic and it's an inadvertently caused by medical treatment so the person's being treated so again no soomal the person does not come in with an infection the person gets an infection from the health care environment or a disease from the healthcare environment iatrogenic it's directly caused by something that we have done to the patient to help treat them so moving on to clinical manifestations this is another important concept within pathophysiology because now we need to be able to label and name our disease processes we've just talked about etiologies what causes them but now we're looking at what happens to the body when we are presented with this disease so we look at clinical manifestations and that is what we see as in signs symptoms of a disease and just know that signs and symptoms can be local um which is only in one area of the body it could be systemic and it shows up all over the body you have acute versus Subacute versus chronic acute is just it happens in that moment where chronic is it happens over a period of time and you see those same signs and symptoms rep reappear over and over and over again you have remissions which um shows that the signs and symptoms have gone away and then we have exacerbations where those signs and symptoms are represented and then strangely enough you have something that's called asymptomatic which means you don't see any signs and symptoms but sometimes that can be a clinical manifestation that's the oxymoron but again just understand that clinical manifestations help us to determine what type of disease process it is and it helps us label it across the board for um people affected with that type of disease so now that we talked about our signs and symptoms we're going to move on into diagnosis and treatment again these are two important concepts of pathophysiology because we're looking at what is wrong with the patient now that we've developed our signs and symptoms and we know what's presenting with the patient we normally assign something called a diagnosis and a diagnosis is a label for a disease so that could be influenza that could be tuberculosis that can be viral hepatitis it's just a name or a label for a disease process with specific signs and sent symptoms and it is based on diagnostic criteria so you have different Diagnostics such as laboratory data that is your blood work you have Imaging data that is your um pictures basically of parts of the body that are affected so that could be a MRI scan that could be a CT scan that can even be some sort of X-ray but um you have different Diagnostics that help you determine um what type of disease and the processes thereof now you have the prognosis and a lot of times nurses don't assign the prognosis the doctor or a health care provider assigns the prognosis but all that means is that it is the prediction of how one will proceed through the disease process so now that we have diagnose the patient how do we expect for them to progress to either heal or unfortunately maybe not heal as much or how can we get them into a place of stability and when we look at prognosis we have to look at Concepts such as morbility morbidity and mortality mortality is if people die um morbidity is more how long and how affected the person um becomes with the disease process so again when we discuss diagnosis that is the label when we look at prognosis that's how long the person will progress through that said diagnosis and then we have treatment treatment is basically how do we handle the diagnosis um or the disease process and when it comes to treatment depending on how well we treat and how early the disease process is caught um it will actually either increase the prognosis or decrease that prognosis um more oftentimes than not you want to decrease in your prognosis you don't want to stay within that disease process long because again that is affecting your body so treatment will help directly affect the prognosis and how well a person tolerates that disease so here we have a really good concept map on pathophysiology and just to recap pathopysiology is the overall um picture here that we're discussing in this class ultimately we're trying to move towards treatment which will help improve the prognosis of a individual that is affected by said disease so when we look at pathophysiology we want to look at the pathogenesis or how it starts we want to look at the clinical manifestation and see what the signs and symptoms are those are our Clues to help determine a diagnosis and once we look at that diagnosis we can determine treatment and once we determine treatment we can either Aid with the prognosis or at least help manage it um for the person that is affected with said disease so why are we discussing all of these Concepts in pathophysiology well the main part of this is to discuss individual health and we do focus on the whole person and their perception of health and illness pathophysiology discusses a lot about what's wrong with the body physiologically and how the body is affected by said diseases and injuries and everything thereof but the reason why we study pathophysiology is to help educate these individuals um with their perception of health and illness and we focus on the person as a whole so when we discuss health and we are educating our patients it is to um discuss why things are happening but also be equipped enough to discuss the treatment and help um assist with their understanding of their prognosis so all of that would lead to individual health and their perception when we talk about health that is the perceived wholeness of the Body Mind and Spirit so this is a multifaceted area but the main thing that we help with uh when we're in the medical field is that perceived wholeness when we explain when we're doing education when we're caring for our patients this is something that we're discussing all the time and that affects the patient Mind and Spirit and body as a whole and then when we discuss illness with the patient it is the state that results in suffering or distress from a disease process again this would affect our patients and their perception of health so again when we are discussing pathophysiology the main goal is to try and understand what's going on with the body that way you could be more equipped to discuss these matters with your patients when you're in the field so we just talked about the individual as it relates to health but now we're going to move into the population and the health status of that population thereof when we look at the health of a population that is generally termed epidemiology and that is the study of disease within these populations and when we look at the disease in populations we're looking at the incidence and the prevalence of those diseases so the difference between incidence and prevalence is that incidents is the number of new cases within a given time so for example we just went through covid so the number of new cases that would be reported daily weekly monthly would be the incidences within that given time frame that week or day or month um and normally is given as a statistic so you can see um covid rates is oh generally it's 100 cases per 100,000 people that would be the in incidence amongst the population whereas the prevalence is the number or percentage of a population living with the disease at that time so again if we look at the case of covid um you can state that 12,000 people um within this month we're living with covid now granted that's a very low um um statistic given that Co was more widespread than that but just as an example it is a number or percentage whereas incidence tells you the direct number of new cases so again new cases is an incidence prevalence is how many people already present with that disease and are living with it at a given time frame so why do we look at incidence and prevalence well it helps to describe the epidemiology and population Health as a whole and there are benefits to that we can see where benef where the disease is more widespread in some areas than others you can see who's most affected by the disease so that'll give you some risk factors or if it's affected in certain populations male versus female um different ethnic groups things like that you can see who is most affected by the disease you can also look at why the disease is presenting in that population so again why is it happening in this area and then once we look at all of that we can see how to reduce the spread how to reduce the mortality and morbidity and ultimately hopeful and hopefully eradicate that disease in that population so when we look at epidemiology when we look at the incidences or the number of new cases and we look at the prevalence how many people are living with it um it helps us determine how we can help solve that problem and help provide treatment for those um individuals now when we look at epidemiology there are different classifications as we discuss it within different populations when we have endemics that means that the incidence is equal to the prevalence so all that is saying is that endemic we're stable with the disease processes and the number of people that are living with it so new cases are approximately balanced with the number of people that are living with a disease then we move into epidemic and all epidemic is saying is that there's a sudden increase in the disease incidences or the number of new cases so we have a sudden increase in the number of new cases within a population and then when we look at pandemic again this is covid um all over again but we have a pandemic and that is global spread of an epidemic so we have Global spread of the number of new cases within a given time now again we look at all of these factors because of the benefits that they provide and ultimately eradicating the disease process now there is an organization that helps to do this and it's one of the centralized uh organizations that helps report these values and that organization is called the World Health Organization again it serves as an epidemiology resource they report health statistics regard regarding life expectancy and mortality rates inciden SE prevalence not only for those populations but globally across Ross the world so the World Health Organization is a very good tool they have a website um that they provide these statistics on and it helps us monitor how um bad a disease is progressing when we talk about disease processes and treatments the ultimate goal is to not only discover um what is wrong with the body and how we can treat it but it also speaks to how can we prevent this from occurring again that way the person is not affected by it we don't have pandemics and epidemics again so we look at the levels of prevention to help us decide or at least to help us classify how we can help prevent a disease process from spreading so when we do primary prevention that is the prevention ultimately from occurring so we stop it before it happens and a good example of that is immunizations for example if you get an immunization for the flu flu the flu vaccine it is likely that you won't get um the flu or if you do catch it you won't get as severe of symptoms of the flu another example of that would be wearing a bike helmet there's a high risk of head injury if you are riding a bike especially on main roads and highways and things of that nature so wearing a bike helmet would help prevent a head injury say the person gets hit by a car or they fall off the bike or something drastic happens the head is protected so these are both these are both examples of primary prevention then we're moving into secondary prevention and that is um early detection of diseases by screening so we're doing tests to make sure that people are not predisposed or individuals are not predisposed to a particular disease process and a really good example of that is your testicular examinations your prostate examinations and your breast examinations um your mammographies so this is to say hey if you do have um a risk for developing these diseases or if you just simply want to get checked secondary prevention is those screening tools that helps us determine if a person has breast cancer or testicular cancer prostate cancer um then we look at tertiary prevention so this is for a patient or individual that has already had um a disease process that occurred but tertiary prevention focuses on preventing complications and the progression of the disease so for example if a individual has a stroke and they have been impaired physically generally you'll see those patients with physical therapy and or occupational therapy to help prevent further uh progression of the stroke symptoms um you want to use physical therapy and occupational therapy to help strengthen those areas that are affected by the stroke so tertiary prevention only focuses on a person or individual that has already been um diagnosed or have already had some sort of disease or Illness but we're helping to decrease the progression of that disease and again that could be physical or occupational therapy that can be um with medications even um for those with HIV or Aids are taking different medications to help stop that viral load from progressing so that would be a level of tertiary prevention so again tertiary prevention focuses on individuals that have already been um plagued by the disease or Illness but it just helps stop the progression of it now the main and the most effective way to um prevent the disease is to not have the disease so primary prevention would be the most effective way to help with um disease processes a lot of our nursing practice has been tried and true and is continue to be developed due to the concept of evidence-based practice so all evidence-based practice is is that it's a way of caring for others that is cognizant of the most current research and knowledge in the Health Professions so I mentioned that this is always progressing when we look at evidence-based practice there are cases that individuals look at to see if care is um most effective for patients or if it's not effective if we determine that it's not effective evidence-based practice helps us to develop more ways and new ways and a cognizant way to help care for those individuals um it does go beyond the one piece of research it takes several cases in multiple um areas to see what works and what does not work it encompasses that there is research and knowledge of the practice with EXP experts so you have people that are doing this daily that this is their um this is their specialty that are developing these practices because they have been in the field so long and again it requires the respect for human human variations when we look at evidence-based practice we're trying to capture what is best practice what is working and what doesn't work but you have to understand that not one size fits all and when you look at evidence-based practice it's not the cook it's not the fix all but it's something that we can go by as a guideline to help care for certain disease processes when we look at pathogenesis we're also looking at different risk factors that would start a disease process and you'll notice that some of these factors are modifiable versus non-modifiable and when we talk about modifiable it is something that you can change versus non-modifiable is something that you cannot change ultimately this speaks to the diversity of humans and how different disease processes occur with different areas of human diversity so we do have gender here we have age race ethnicity socioeconomic status local all of these areas can affect pathogenesis and the predisposition of a individual developing a disease when we discuss functional concepts of altered Health what this is is that these are your conceptual approaches or your disease models that would help you understand altered health so we're going to go through several examples within each chapter to help you describe why something is going wrong with the human body and those clinical models help us to determine what we can do to not only treat that specific one but what we can do to help treat others that are similar in the disease process so again when we're looking at these Concepts it's meaning meaningful clusters of current knowledge about human health and disease and we're trying to apply them to different concepts so that we will be able to um effectively um develop our knowledge regarding human health and disease and again when we do this conceptual approach in this class it'll be applying the general processes to specific diseases so we are going to look at an array of diseases to help us develop our concept of pathophysiology so with that being said I hope you enjoyed this course and I look forward to helping you guide you through this um Journey so consider this your road map to be successful in this course um some things I want you to consider and do is to one complete your guided learning questions and complete your system disorder cards I'll also call them disease cards these are the same thing make sure you engage in your case studies and your activities make sure you review those disease cards review your guided learning questions make sure you're understanding those risk factors clinical manifestation Diagnostics treatment and application and make sure you check your understanding of that so it's not enough to review you also got to check and make sure you understand you can do that by quizzing yourself quizzing each other you can also answer questions in the textbook and also make sure you ask questions I am here and I'm available as a resource to you I am available for tutoring and if you need to schedule anything with me I am more than happy to do that with you so just make sure that um you're focusing on all of these things and you should be successful in this course I look forward to leading you through this journey thank you and I'll see you in class