Anatomy / Pathology

General
1. Please Specify the digestive enzymes, their place of education and
describe their effects

Enzyme training venue effect

Amylase salivary glands Carbohydrate division
Among tongues Lipase
Big Mouth division, milk fats
Mage lipase stomach fat cleavage, milk fats
Pepsinogen stomach protein cleavage (by hydrochloric acid conversion to pepsin)
Galle liver emulsification of fats (Ellen spleen Education)
Big pancreatic lipase division
Pancreatic alpha-amylase Carbohydrate division
(multiple sugar Simple sugar)
Trypsinogen pancreatic protein cleavage (only by the alkaline environment in the small conversion to trypsin)
Chymotrypsinogen pancreatic protein cleavage (only by the alkaline environment conversion to Chymotrysin)
Carboxypeptidase pancreatic protein cleavage (only by the alkaline environment in the small conversion to
Carboxypeptid)

2. Where is the liver, and what they met in the human body
Makroskopischer building

Largest metabolic organ of theϖ body

• Right upper abdomen below the diaphragm under / behind the arch ribs
• Ca. 1 ½ kg
• 2 large and 2 small liver lobe
• between small liver,
• the liver lobes gate
• that is the entry point of Hepatic artery, and the portal vein and the exit point
of the Ganges Gall
• production Gall juice:
• bile acid, cholesterol, bilirubin
formation of growth hormones, Soma Tome
• Dine formation of the hormones and their precursors eg Somatomedine.Activation
of vitamin D and thyroid hormones
detoxification: body toxins – ammonia
• supplied poisons - alcohol, drugs
reduction of red blood dye – haemoglobin
 • to bilirubin - elimination of the bile
metabolic functions
• protein
• metabolism - albumin, globulins, coagulation factors, transport proteins
• fat metabolism - Neutral fats are stored as triglycerides
carbohydrate
• metabolism - insulin creates glucose into the cells, excess glucose in the liver as
glycogen stored
glucagon creating glucose from the liver –
• Modernization of the glucose in Glycogens

3. From what sections of the colon is built, and what functions it

Macroskopischer building

 Ca. 1.5 m long

 If Frame shape
 to the small intestine Sections caecum (appendectomy)
 with worm progress rate (vermiform appendix) ascending colon –
ascending
 colon transverse colon - Across the course
 colon
 colon descendens –
 descending colon
Sigma Colon Sigmoid - S-shaped colon
 Rectum - Rectum 7-15 cm long
 goes from the colon, and ends on the aftermarket
 Anus closure of the anus consisting of the
 internal and externalϖ
 sphincter Hämorrhoidale braid
 Physiology: withdrawal of water
 and electrolytes
 thickening of the chair
 fermentation and decay byϖ
 Coli mucus incorporation by mucus production in the cells cup

4. Please describe the situation and the functions of the various lymphoid
organs

Thymus:
 Location: in the mediastinum (in the middle of the thorax (chest))
 "basic school" T-Lymphocyten later fatter and he has no function – Thymus fats

Almonds: tonsils
  belong to the lymphatic revenge ring
they control as "bouncer" the
 entrance to the throat, then catch debris and infectious pathogens from
 we differ:
• Palatine tonsil - tonsils
• Tonsil pharyngea - throat almonds
• Lingual tonsil - tongue almonds you are with one of the main centres for the
Production of Lymphocyten

Spleen - Splen or Lien

 position: left upper abdomen, below the diaphragm, dorsal (back), protected by
the ribs arch

Function:
 Blood Renewal - outdated disposition and reduce blood cells, iron recycling
immunological control of the blood,
 enartete cells and debris are identified and defense operations launched,
Lymphocyten education.
 Blood memory function - at risk by shock volume deficiency leads to the
contraction in the volume attempt by the lack of small blood reserve rebuild, and
thus the cycle to maintain.

5. Please describe the emergence of an jaundice

Prähepatischen jaundice: (from the liver)

Fault lies in front of the liver.

 The liver in its function as excretory organs overwhelmed and the
 Concentration of bilirubin in the blood rises. For example. Reinforced sinking of the
red cells in the spleen leads to increased bilirubin in the blood.

Intrahepatic jaundice: (in the liver)

 Fault lies in the liver
 Severe liver injury, the liver is only to a limited extent in a position to perform
their work.
 Z. Ex. As part of a hepatitis or cirrhosis of the
 Liver Ikerus newborns the liver of newborn for the first days of
 Life still unable (due to a lack of maturation), the resulting bilirubin in the bile
acid to the pair.

Posthepatischen jaundice or Verschlussikterus (behind the liver)

 Fault lies behind the liver
 the bile ducts are laid,
 Meaning they are protected by gall stones or tumours closed. It comes at a jam
bilirubin.

6. What's lymph and how does it

The lymph is a light yellow liquid, which consist mainly of water, Lymph plasma and white
blood cells, and most of the cells of the body lapped. It is produced by leakage of blood
plasma from the blood capillaries in the tissues. About lying between the cells Lymph
capillary cell debris, slag materials, fat, bacteria and viruses disposed.
7. Why is the lymphatic system is so important to (tasks)

As a network spans the lymphatic system by the body. At various points in this network are
large and small lymph nodes.

And so the system works:

The blood pressure are small and liquid ingredients through the thin walls of the fine hair
vessels (capillaries) in the body tissues pressed. Thus, nutrients and oxygen in the tissues. In
return, the lymphatic system waste materials and carbon dioxide. The larger and solid
ingredients remain in the blood. The liquid squeezed out returns mostly in the bloodstream.
The task consists of the lymph nodes in the control and cleaning of them about the lymph
Lymph capillaries added.
In the lymph nodes are bacteria, viruses, dead cell components, and others completely alien to
their basic building blocks apart and in the venous system returned. The lymph nodes
continue to contain immune cells, called macrophages large (Phagocyten). They not only
destroy bacteria, but also stimulate the production of antibodies against the pathogen.

Other tasks:
Spleen: reduction of blood impurities production of white blood cells production of protective
substances
Thymus: Development of the white blood cells in childhood development of immune
functions until puberty (after no function more)
Almonds: defense against infections
 Anatomy / Pathologie

General

The heart and circulatory system

1. What criteria for the measurement of pulse information on the condition

of the heart and circulatory system

Frequency
 Tachycard > 100 / min
 bradycard <60/min

Rhythm
 Rhythmically
 Arrhythmisch

• Irregular
• With breaks
• With extra shots (extrasystoles)

Restorative condition weak

 Volume forming
 Strong

The pulse provides information on the heart rate and rhythm in part on the

2. Which pulse changes may arise?

In the frequency:
Tachycardia and Brady card

In rhythm
Arrhythmic
 With tactile breaks or extra systoles

In filling state

3. What is TIA. Please describe the appearance of symptoms

TIA is "transient ischemic attack" (temporary lack of blood / oxygen deficiency

accompanying attack), a harbinger of a short stroke occurring circulatory disorders by oxygen
deficiency caused, is the term TIA. Neurological failures Appoplex = stroke
What is it? "What is this? Causes?
As a TIA are all neurological failures, which, a few minutes, seldom more than 1 to 2 hours.
By definition, a TIA to 24 hours. Within this time, the symptoms completely. During a TIA
remains awareness. TIA's need as a sign Brain infarct’s seen. The causes have to be clarified
and dealt with.
Common symptoms of TIA
 balance disorders withϖ and without dizziness,
 eyesight and hearing disorders, usually in one eye (Amaurasis fugax)
 Disruption of the language or the language understanding,
 The inability to read, write or calculate,
 Feeling numbness in the arm or leg and knocked the legs.

Causes and symptoms

TIA is a Micro Emboli
A TIA occurs at the moment when a small blood clot (Micro emboli) a blood vessel is
blocked. It ends when the clot suddenly shatters and again dissolves in the blood.
Main sources of these clots are vascular sealed platelet accumulation in the arteries and heart
valves, as well as clot in the context of irregular heart activity. Other sources are occasionally
low blood pressure, mechanical Crack cable
of blood vessels during a head rotation, and heart rhythm disturbances.

Symptoms of affected skull base.

If one of the arteries trees at the base of the skull is affected, the symptoms often include
visual disturbances such as double vision (Diploplie) and dizziness, nausea and vomiting,
slow language, inability to speak and understand language, numbness around the mouth and
itching or weakness in the arms or legs.

Symptoms of head affected artery.

Is the head artery affected, it can be a complete vision loss ("Blackout") cause. A blood
emptiness, or a lack of blood flow (ischemia) of a cerebral hemisphere has symptoms such as
unilateral paralysis, numbness, unilateral vision loss or speech loss.

Treatment
Medication or surgical intervention. TIA can be medically or surgically treated. With a
narrowing (stenosis) of the head artery of more than 70% is a Endarterieektomie that means a
cut the vascular wall deposits, appropriate. With a narrowing of less than 70%, this treatment
is not as plausible.
Clot Formation against drugs. A therapy against platelets / Clot formation
should be instituted. Aspirin has been shown in several studies of its effectiveness against TIA
and stroke.
Ticlopidine, a platelet aggregation inhibitor, has been shown in two large studies a higher
efficacy than aspirin show

4. What phrophylaktischen measures can be taken to prevent a Apoplex

Thrombosis Embolism Bleeding

40-50 percent of 30 to 35 percent of all 20 to 25 percent of all

all strokes are strokes are caused by
caused by a an embolus, in a
thrombus different region of the
body (such as heart
arose)
strokes are supported by
a rift caused a brain
artrie
In order to prevent a Apoplex, you must, in any case, reduce the risk factors
Risk factors for stroke in general:

 Stress
 Obesity: promotes atherosclerosis
 Lack of movement: sport preventsϖ arteriosclerosis and may even partially und o.
smoking
 Alcohol
 fat metabolism disorders
 diabetes mellitus
 hypertension

It may also be medically with a Thrombocytenaggregationshemmer, eg ASA 100, to prevent

this event

Digestive System

5. Please describe the emergence of an jaundice

Prähepatischen jaundice: (from the liver)

 Fault lies in front of the liver.

The liver in its function as excretory organsϖ overwhelmed and the concentration of
bilirubin in the blood rises. For example. Reinforced sinking of the red cells in the
spleen leads to increased bilirubin in the blood.

Intrahepatic jaundice: (in the liver)

 Fault lies in the liver severe liver injury, the liver is only to a limited extent in aϖ
position to perform their work.
 Z. Ex. As part of a hepatitis or cirrhosisϖ of the liver

Newborn ikterus
the liver of newborn for the firstϖ days of life still unable (due to a lack of maturation),
the resulting bilirubin in the bile acid to the pair.

Posthepatischen jaundice or Verschlussikterus (behind the liver)

Fault lies behind the liver

 the bile ducts are laid, meaning they are protected by gall stones or tumors closed. It
comes at a jam bilirubin.
6. When it comes to a hepatic encephalopathy and what the symptoms of
The hepatic encephalopathy is a brain leberbedingte dysfunction:

The diseased liver is in the metabolism of ammonia incurred

 no longer effectively remove from the blood.

 The toxic ammonia reaches
 High concentrations in the brain.
 disruption of the metabolism and the
 functions of the brain are the result

First evidence of hepatic encephalopathy are:

 discount end concentration ability

 restriction
 of logical thinking Compact attention
 decrease in the response
 capability deterioration in the short-term memory and psychomotor skills (fine motor)

7. What is a liver cirrhosis and what specific symptoms to

When cirrhosis is referred to a chronic disease of the liver, from the entire body is affected.
Liver cells are increasingly destroyed. The liver tries to compensate for this loss, and new
forms as a substitute Cicatricial liver cells and connective tissue. This nodules formation of
connective tissue and liver cells, the duties of the healthy liver but not in its entirety. The liver
functions are sustained disrupted.
If this process of rules proliferation of new connective tissue and liver cells progresses,
hardens the liver, is knotty and finally shrinks. As a result of the destruction of liver structure
is also the circulation of the liver severely hampered, so that the portal vein and blood from
Hepatic artery
No longer flow through the liver and can be dam. Consequently there is a Pfort artery
pressure.

The most common Causes cirrhosis:

 Over consumption of alcohol over a

 long period (alcoholic cirrhosis)
chronic viral hepatitis (B, C, D with B)
 Autoimmune chronic hepatitis
 Congenital disorder of iron, copper and
 fat metabolism Autoimmune chronic diseases of the biliary tract (such as primary
biliary cirrhosis) severity longtime cardiac weakness

Symptoms
 fatigue is a guiding
 weight loss
 impotence

 liverskin characters
 • Palmarerythem, it is a clear red Kleinfingerballens
• reduction of body hair with the development of a female Behaarungstyps in
men
• Spider naevi, or vascular spiders in the neck and upper body area
• White nails

 Dupuytrensche contracture, or connective tissue hardening andϖ shrinking of the

palms of tendon
 jaundice, a yellowing of the eyes and skin
itching
 bleeding and bruising
 water abdomen (ascites)
 varicose veins bleeding from the oesophagus
 Hepatic encephalopathy.

Respiratory system

8. Explain the clinical picture of Mucoviscidose

The cystic fibrosis is a hereditary disease with a risk of 1:2500, the predominantly white
population.
A typical feature is the formation of very tough Mucus in the lung, pancreas, liver and small
intestine, the function of these organs affected. The first symptom is often the bowel
obstruction of the infant. Later, the problems from the lungs to the fore. Frequent infections
must always be treated with antibiotics and lead to increasing deterioration of respiratory
function. The damage to the liver and pancreas can be very well controlled with medication.
The diagnosis is done through analysis, which already investigation by amniotic fluid during
pregnancy is possible. Because the genetic is not curable, is the therapy in the treatment of the
symptoms. In rare cases, a lung transplant is possible and promising. Today, the average life
expectancy of over 40 years.
Cystic fibrosis occurs, as mentioned, almost only white people. Germany is homing to 6000 -
8000 to cystic fibrosis patients, of which about 30% are older than 18 years.

Symptoms
The disease usually results in any adverse changes secretion in the lungs, pancreas, liver,
small bowel, skin and sexual organs. Today, about 90% are dying of cystic fibrosis sufferers
to complications in the lungs.

Lungs
Due to the disturbed chloride exchange in the lung is a zäh liquid mucus, the bronchi and
their ramifications, and the alveoli Bronchiolen clogged. Glimmer hairs
With your wall is normally equipped with a thin layer of mucus, on the inhalation particles
remain liable, and how on a conveyor to the throat and then managed cough or swallowed.
The tough, thick mucus of sick person, but the assets Glimmer hairs poorly or not at all away.
This can lead to a narrowing of the airways and obstruct breathing. At the same time,
however, develop infections, because bacteria are not removed and in the airways remain.
Such recurrent infections damage lung tissue, because their immune cells of the immune
system to be activated, the aggressive chemicals and enzymes release, and so inflammatory
reactions. The destruction and narrowing of the bronchi progressing with the times as far
away, until finally the lungs failed.
Very rarely occurs in these cases, a lung transplant in question.
Forecast
In the 50s and early 60s, most patients died already in the infant or child's age.
Due to a significant improvement of symptomatic, not causal therapy, the average life
expectancy today-born patients in more than 40 years.

9. Describe it in or emphysema, and the consequences for the patients that can

Definition
The Emphysema is a pathological Billow
the lungs. There are the reversible acute pulmonary emphysema at acute asthma attack and the
chronic emphysema, mostly as a result of chronic bronchitis in smokers from the 50th Year of
life occurs. There are also occupational causes. You can dust loads, a number of chemical
substances, as well as pressure loads at a emphysema. At least with dust and chemical
substances, the emergence of emphysema, chronic bronchitis. The chronic bronchitis, in the
case of dust by a foreign body reaction caused, in the case of chemicals with the chemical
irritant itself burdens pressure of the lungs can be a strain of the alveoli also lead to
emphysema.

Symptoms
Power reduction, shortness of breath, chest Barrel shaped and chronic cough.

Diagnosis
Medical examination, lung X-ray, lung function testing and blood gas analysis

Therapy
Smoking, bronchodilator medications, breathing exercises, oxygen transfer, administration of
alpha-1-proteinase inhibitor and surgery.
Complications and history

Acute complications:
Spontaneous pneumo thorax
This leads to a collapse of the lung, if marginal Emphysen blow
burst in the air in Pleura gab dismissed.
Infections of the airways can also complicate pulmonary emphysema, as the power reserve of
the respiratory system quickly overwhelm.

Chronic complications
Pulmonary hypertension, A high pressure in the pulmonary circulation
Overloading of the right heart, this particular form of heart failure is called cor pulmonale.

Forecast
The prognosis of this disease is bad, because the changes in the lung structure even when
treatment is not Education capable Patients with congenital α1-proteinase inhibitor deficiency
develop the symptoms of a Lungenemphysems mostly between 30 And 40 Year of life.

Secondary diseases such as Cor pulmonale complicate the disease and therefore worsen the
prognosis. Under a Cor pulmonale is a right heart enlargement on the basis of increased
vascular resistance in the pulmonary circulation.