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Pulmonary embolism

= partial or complete transfer of the pulmonary arteries is flooded blood clots in the peripheral venous circulation.

symptoms

• massive dyspnea
• Thraxschmerz
• dizziness, RR , pulse, shock
• agony
• if hemoptysis
  

diagnosis

• clinical examination / vital signs
• chest x-ray
• (ECG signs of right heart failure can be detected)
• Laboratory: BGA (blood gas analysis)
  
• echocardiography
  
• possibly Angio-CT, MRI
• pulmonary angiography
• perfusion / Ventilationsszintigraphie

therapy

Conservative:

• bed rest (except for 1)
• Waist High Store
• anticoagulation in 1 & 2
• intensive monitoring, O ₂ gift
• if catecholamines

Systemic thrombolysis and anticoagulation in 3 and 4
Pulmonalisthrombektomie possibly at 3 and 4
4 risk groups:
[1] Hämodyn. stable without right ventricular dysfunction
[2] Hämodyn. stable with right ventricular dysfunction
[3] shock (RR syst \u0026lt;100 mmHg, pulse> 100 / min)
[4] Resuscitation duty

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heart failure heart attack

= heart failure; inability of the heart, to promote the supply of necessary blood volume; clinical syndrome of varying origin, not a disease, eg myocardial infarction, angina pectoris, myocarditis, valvular heart disease, permanent hypertension, cardiac arrhythmias
Symptoms

left heart failure (congestion in pulmonary circulation)	right heart failure (congestion in the systemic circulation)
dyspnea	renal failure / Dysfunction
pulmonary edema	Stauungsgastritis; ascites
cough (Stauungsbronchitis)	ankle edema
"rales	distended neck veins
orthopnea	exertional
tachypnea	liver / spleen enlargement

true for both:

cyanosis

tachycardia

Decreased performance

nocturia

oxygen - reduced supply of the organism

may oliguria

severity

1. NYHA 1: Complete freedom from symptoms are asymptomatic with normal physical activity, affected people (determination by measurement).
2. NYHA 2: Slight limitation of exercise capacity in physical activity.
3. NYHA 3: Strong restriction of capacity even at light physical activity. Dyspnea and fatigue occur.
4. NYHA 4: possible No strain. Every physical activity increased the most in peace insufficiency existing characters such as dyspnea or cyanosis.

[NYHA = New York Heart Association]

Drug therapy

• ACE inhibitor -
• Beta - receptors - Blocker
• diuretics
• digitalis
  

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Definition:
irreversible destruction of heart muscle (myocardial necrosis) caused by insufficient oxygen supply, usually by thrombotic occlusion of the supply section of the coronary vessels.
Cause:
# 95% CHD
# breaking an ulcerated atherosclerotic plaque and thrombus formation of a vessel closure
process of atherosclerosis

	What happened?	What occurs?
1.	fats are deposited on arterial inner wall plaques arise from
second	fat deposits are covered by a connective tissue layer harden	fat deposits are
third thicken form	new muscle cells within the sediments, the vessel walls
4th	caused cracks in hardened deposits	particles dissolve and form a blood clot
5th	Blood clots seal the already narrowed artery, or plaques on break and bleeding occurs	blood supply in the following modified tissue is closed

Drug treatment

• acute phase: analgesics / opioids
• continuous therapy:
  
• CSE inhibitor / lipid lowering agents [CSE = cholesterol synthesis inhibitors]
• antiplatelet anticoagulants

HEART ATTACK DRUG

drug	effect	acute phase	term therapy
morphine analgesia		5-20 mg diluted with NaCl	-
diazepam	sedation	5-10 mg, sc / iv	-
nitrates	dilation of the vessels	Spray Perfusor	tablets
beta-receptor blockers	preventing tachycardia	oral; iv	tablets
heparin (high dose)	preventing thrombus formation, anticoagulation	5000 IU iv bolus; Perfusor 1000 IU / h	-
heparin (low dose)	- "-	1-2 times daily sc	- iv
ASS	platelet aggregation inhibitors	Aspisol;	oral tablet 1 time daily
OR (based on long-term treatment)
warfarin / Falithrom	Vitamin K - antagonist	-	tablet
ADP receptor antagonist	platelet aggregation inhibitors	oral	tablet, about 1 year
thrombolytics	resolution of the thrombus	iv; syringe pump for 1 h	-
ACE inhibitors	-	-	tablets
lipid lowering	lowering cholesterol	-	tablets

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coronary heart disease

ì Synonyms: CHD = coronary artery disease ischemic coronary artery disease

ì Definition: manifestation of atherosclerosis in the coronary arteries.

ì process:

1. 
   
   Atherosclerosis in the coronary arteries


2. 
   
   development of stenosis


3. 
   
   reduced blood flow to the heart muscle


4. 
   
   mismatch between 0 ₂ -demand and O ₂ offer

ì Etiology: [ á increased =]

risk factors of first order 2 risk factors = heart attack risk increased 4-fold 3 risk factors = risk of heart attack 10-fold increase	risk factors of second order
hypertension smoking diabetes mellitus dyslipidemia genetic predisposition age male gender metabolic syndrome	sedentary stress lipoprotein A á fibrinogen á homocysteine á

ì pathophysiology (4 degrees of severity of coronary stenosis)

Grade 1 25 - 49%

; Grade 2 50 - 74% Grade 3 75

- 99% (critical stenosis)

, Grade 4 100% (total occlusion)

Ü only 75% the first symptoms

two forms of CHD

latent coronary heart disease ~ KHK manifest

(asymptomatic (Symptomatische DL)

DL; Stumme ;

Ischämie)

                                                 

diseases manifest CHD

diseases	share of onset (in%)	Description
angina pectoris	55	chest pain due to reversible Myocardischmie
heart attack	25	Ischemic Myocardnekrose
heart failure	-	Ischemic heart muscle damage
arrhythmias	-	ventricular arrhythmias and ventricular fibrillation
Sudden cardiac death	20

ì coronary vessels (coronary arteries)

(Click HERE) Click

Extras:

# are end arteries

#, there are no anastomoses with the einzellne arteries

# dies at closing tissue from

effect of the risk factor nicotine

adrenal medulla:

• 
  
  release of adrenaline and noradrenaline


• 
  
  ð peripheral increase in heart rate


• 
  
  ð increase in O 2 -consumption of the heart

coronary vessels & Vessels:

• 
  
  narrowing of these vessels


• 
  
  ð increased vascular resistance


• 
  
  ð reduced O ₂ offer

vessel walls:

• 
  
  promote platelet aggregation


• 
  
  increase in fibrinogen levels


• 
  
  damage the intima of the arteries


• 
  
  ð increase the clotting ability Blood


• 
  
  ð encouraging early deposits


• 
  
  ð promote atherosclerosis

effect of the risk factor of alcohol

positive	negative reduced
increase in HDL-cholesterol platelet aggregation reduction of fibrinogen in serum blood pressure reduction with low regular alcohol consumption	increase in triglycerides in serum blood pressure with increased regular alcohol consumption (from 30 g / d = 0.3 liters of wine or 0.8 liters of beer)

main complaints / symptoms in diseases of the heart

symptom	statement	differential diagnosis
chest pain	linksthorakal or retrosternal	angina pectoris, pulmonary embolism, heart attack, tuberculosis
dyspnea	breathlessness	pneumonia, lung CA, heart attack, Tbc
palpitations	unpleasant perception of one's own heartbeat	heart attack, hyperthyroidism
cyanosis	bluish discoloration of lips, mucous membranes, skin	hypothermia, pulmonary embolism
distended neck veins	by damming the blood before the right heart	bronchial CA, pericarditis, valve stenosis
nocturia	increased urination at night	right heart failure, urinary incontinence
cough	-	flu, colds, pneumonia
syncope	sudden, brief loss of consciousness, by reducing supply to the brain with O 2	cardiac arrhythmias, arteriosclerosis
reduced exercise capacity	-	-

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wound management

W. is not limited to: *
medically prescribed treatment
; infection prophylaxis
* * Perform emergency measures
but also
# from the wound resulting consequences for those affected
# Instructions and advice of the patient's relatives
+ # collaboration of various institutions during observation

# # #
wound pain observation & documentation treatment
# plot the latest scientific evidence
# Research and Evaluation
objectives of W.

• pain
• Preservation and promotion of the movement
• balanced diet
• maintenance of daily activities / social embeddedness
• acceptance of the altered body image
• boosting self-esteem
• acceptance of new wound dressing materials
• observance of precautions

WOUND = any tissue defect with more or less gaping Gewebsdurchtrennung the outer skin or mucous membrane.
WOUND HEALING = defect closure by Cicatricial supporting tissue related to epithelialization.
wound history

• cause of skin damage
• mobility
• pain
• medication allergies
• nutrition
• acceptance of the wound
  

factors on wound healing

;

local factors	general / systemic factors
location of the wound pressure and mechanical load in the wound area condition of the wound bed temperature fluid secretion from the wound [»exudate ] size of the defect age of wound complications wound healing as an accompanying disease	nutrition age health status immune status Hormone status blood circulation drugs life pain

wound observation
{a} location of the wound

• often regard development
• evidence of appropriate care

{b} wound size

• determined on the basis of wound area and depth
• calculation: Wundlinieal means of the two longest at right angles to each other to determine diameter lines and multiply

{c} wound depth
= Distance between the level of intact skin and wound bed

• measuring point = introduce deepest
• sterile button cannula vertically without sterile cotton swab to the skin surface to the deepest part of the wound, pull dannach and measure

{ d} wound environment

• is evidence of integrity of the skin, healing phase; health
• are observational criteria:
• color
• maceration (Swollen)
• Hautstrucktur
• callus (callus barriers)

{e} wound edge

• direct wound environment is in wound edge over
• important info's {f} on healing tendency of the wound
• vital [healthy] OR nonvital [lifeless]

wound bed / bed

• color & texture = indicator for various phases of wound healing
• Color:
• black / brown = occupied necrotic, dry necrosis
• yellow = fibrinous evidence, pus
• pale pink = unhealthy granulation
• deep pink / pink = healthy granulation Epithelisierungsgewebe
• consistency:
• Œ Nekrosen_trocken, leathery, hard, wet, greasy, scaly
• Granulationsgewebe_leicht-bleeding, glassy, watery, fibrinous occupied, dry, well supplied with blood, shiny wet

{g} =
exudate secretion of fluid wound

• observation criteria are: size, color / appearance, smell

wound healing phases

catabolic phase anabolic phase
~ Inflammation ~ proliferation / / ~ repair

inflammation

• activation of biochemical and cellular processes responsible for the defense against infections & Healing are significant
• leakage of blood and plasma as a result of vascular lesions and local circulation disorders
• bleeding and clotting
• resistance to infection and inflammation
• debridement / wound secretion
• beginning of the epithelialization

, proliferation

• neovascularization as condition for formation of granulation tissue
• granulation (formation of new tissue to the defect filling)
• epithelialization
• infection defense

ƒ repair

• epithelialization
• transformation to scar tissue and scar contraction
• maturation (= maturation of collagen fibers, resulting wound contraction)
  

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Drainagen.doc

TB
8 - Wundmanagement_Selbststudium drainage

drainage

first Indications of drains

A
drainage is in the soft tissue, bone and vascular surgery
induced when blood and wound secretions should be removed from surgical wounds
.

2.

interior drainage	exterior drainage
connection between 2 organs (example: for hydrocephalus, the CSF drainage the ventricles) or seemed a narrowed duct system (eg stents in coronary vessels)	discharge of pus, blood, secretions or body fluid collections outward Open systems Semi-open systems Closed systems

third

Open derivation	suitable for the infected and potentially infected wounds & Stripes ; wicks: manage the wound exudate into the dressing directly from [no receptacle] Corrugated rubber drains: keep open the drainage channel by inserting a plate of rubber or plastic material
	Positive lead secretion relatively painless easier change good wound observation		negative more change, because no collector high (secondary) Infection secretion at the wound infection + remains irritation of the surrounding skin areas
Half open derivation	end on the principle of gravity secretion can proceed in both directions Silikonkapillardrainagen: drains with thin, fluted silicone wall; secretion in a body bag glued derived T-Drain: guided bile post-operatively in a Bag from Robinson Drainage: intraabdominal silicone drainage without suction, but with replaceable bag system
	Positive low infection no manipulation of the wound secretion runs	negative secretion can go back to the wound
Closed systems	wound fluid can flow only in one direction Prerequisite: airtight conclusion of the wound to contraindicated for wounds in the abdominal cavity [ risk of bowel wall damage ] Redon suction drain: suction drainage with controlled suction, negative pressure in the tank secretions actively collects blood + secretion flushing or irrigation-suction drainage: one or two drains with integrated irrigation catheter for continuous flow the peritoneal cavity or an infected joint
	Positive low Infection no manipulation of the wound secretion can occur continuous suction drainage promotes the secretion	negative relatively expensive drainage exchange

4th Change and removal of a
Redon bottle

preparation of the material

• vacuum bottle;
  sterile

  
  

• 
  Péan 2 terminals (if not included in package)

  
  

• disinfectant

  
  

• one document
  [as bed protection]

  
  

• refuse collector

  
  

• gloves

  
  

implementation

• disinfect hands
  

  
  

• required
  objects on disinfected Arbeitsflä che address, check for completeness
  functioning [intact
  vacuum, the flask: the vacuum is intact when the rubber bellow
  is not developed.]

  
  

• patient
  on proposed measure include information

  
  

• 
  window and doors; ask visitors from patient rooms

  
  

• blanket
  retaliate in such a way that will create enough space for changing

  
  

• 
  privacy of the patient note

  
  

• bed protection
  insert

  
  

• 
  wear gloves

  
  

• hose
  for patients with terminal disconnect Péan or tube into the
  narrow place the terminal on the system slide

  
  

• vacuum bottle
  disconnect

  
  

• hose
  from the rubber flange on the bottle turn

  
  

• drainage tube
  with disinfectant spray Connect

  
  

• new
  vacuum bottle, sprayed by passing the
  drainage tube on the approach of the new bottle is screwed
  

  
  

• bottles near
  open terminal; near-patient terminal is still closed

  
  

• near patient
  clamp on the drainage tube slowly open [the action of the new
  suction to the wound can be painful.] Read

  
  

• amount of secretion
  in the old and new bottle ; observe additives and appearance
  
  document

  
  

• drainage
  on integration and suction control

  
  

• 
  patients may support the return bearings and tightening

  
  

follow

• 
  used materials properly disposed of

  
  

• hands
  

  
  

• measure
  disinfect in the maintenance report with hand signals and time to document [+
  secretion quantity, appearance, additions]

  
  

• control
  if both terminals are open, the vacuum bottle under
  patient level depends, vacuum bottle touches the ground
  [infection]

  !
  

5th Hazards / complications of drainage

• 
  Hemorrhage by
  tissue damage (most emanating from the secretion is
  tissue reaction to the foreign material!) »
  additional pain
  

  
  

• Ascending
  infections (through the lumen of the drain, or outside along the tube
  )
  

  
  

• Disabilities
  
  Dislokationsgefahr; risk of falling

  
  

• Allergic reactions
  
  

  
  

6th Association of different techniques
drainage

Silikonkapillar-
("Easy Flow") or latex tube drainage:

• 
  using Stomahesivplatten
  with the smallest possible diameter
  

  
  

• change
  the plates at least 2 times a week
  

  
  

• passage point
  with 0.9% NaCl and sterile swab (if H ₂ O ₂ )
  
  

  
  

Robinson
and T tube:

• 
  exit point is with NaCl
  greinigt 0.9%, a neutral, _{H 2 O 2}
  
  

  
  

• With
  Betaisadonna disinfected
  

  
  

• Sterile
  Schlitzkompresse to exit point
  

  
  

• fixation
  with adhesive bandage
  

  
  

7th Nursing tasks:

a) control of the secretion

• 
  control on size, appearance,
  color, additive, possibly smell
  

  
  

• 
  liquid level of the drainage needs in post-operative Ü , Assumption of the patient
  be marked with date & time
  

  
  

• Several
  drainage enumerate
  

  
  

• if necessary.
  storage for microbiological Investigations
  

  
  

b) control of the drainage system

• 
  secretion drainage, and Sogstärke
  Soggeräusche
  

  
  

• wake
  and consistency check regularly Check
  

  
  

• tubing
  not opened in the system "udders / knead"
  

  
  

• In
  mobilization to reflux of the secretion and eighth
  disconnecting the drainage tube!
  

  
  

c) removing the drainage

• 
  blood drains: Distance
  if only small amounts of blood are encouraged
  

  
  

• abscess drainage:
  distance abscess disappeared soon is Drains are
  previously cut piece by piece so that the drainage channel includes
  
  

  
  

sources
[accessed 15.04.2009]

http://bilder.buecher.de/zusatz/20/20779/20779911_lese_1.pdf

http://www.altenpflegeschueler.de/ care / wunddraiangen.php

© 2009 Matthias Bohr; K1/07

Page 1 of 5

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language disorders

TB 2

people with stroke care

language disorders

cause

retro country tables lesions (infarction in the supply area of the temporal artery posterior)

Prärolandische lesions, anterior part of the language area (infarction in the supply area of the precentral artery)

temporo-parietal lesions (abscesses in brain tumors, temporal lobe and cerebral processes degradation)

Large linkshemi-spherical lesions (infarction in the entire supply territory of the middle cerebral artery)

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illness experience






"serious diseases are among the most profound and most dramatic experience of man, with immalle dimensions of human existence are concerned. "

• altered body image and diminished well-being [Foreign bodies in the body]
• changed self-concept [Biography, changing roles]
• disorders of emotional balance by perception of potential threat
• uncertainty related to the observance of social roles and relationships
• need for situational adjustment
• fear of vital threat / death
  

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The self-concept according to Carl Rogers






"Man is a tendency to self- to develop the inherent possibilities, and although this is done under the right circumstances in a constructive, socially unifying Art .. "
-> actualizing tendency

"People know and feel inside of it, what does it well."

"Man can and will solve their problems themselves."

The basic variables of the helper - Role:

• acceptance
• empathy
• congruence

The process of personality development
7 stages: low -> high or
standstill -> motion
first Relationship to feelings and personal opinions
2. Experiential way (restrained; straight on sinking)
third Incongruence
4th The communication of the self (anxiety, resistors)
5th Construction experience
6th Relationship problems (fight or flight)
7th Personal relationships

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Coping






= describes an effective coping strategy in stressful situations.
"This strategy is not the destruction of a protective function, but the reality-based management of a crisis." This would include
...:

• cognitive control
• emotional control [can drain rage] [get her disease under control, even learn to care?; What can I do with my body still]
  
• pragmatic control
• social control [Waiting, family, friends, living will]

Which coping strategies used by the patient, which can strengthen that, I positive?

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instance model of Freud's model of crisis

superego (Moralitätsprinzip)

Reviewed the wishes of the ES, if they should be allowed or not.

• shaped by society, education
• values, norms and rules are stored

I (reality principle)

reality _ nature and demands of the outside world How do I do in the real world ?

mediated between the superego and ES; verified the reality: realized or wards off claims by the ES.

ES (pleasure principle)

Bring to specific needs and requirements.

• dreams, motivations

The layer model of Sigmund Freud

• any threat, crisis, traumatic situation runs the risk of displaced instead managed to
• from the subconscious out to be messages sent to "knock" and you to; message = mostly

distorted defenses
> Projection [Transfer of desires and disapproval to others]
> Identification [increase self-esteem by identifying with a person or institution of higher "rank"]
> denial [A. strongest, "it never happened", do not have true / can]
'repression' Societal [. & Morally illicit / prohibited is pushed away -> develops may an "internal dynamics"; briefly displacing the viability]
ensures> regression [revert to an earlier stage of development, let go, to retreat inward, is age] irrelevant
> reaction formation [displacement to be secured by the reversal into its opposite (eg unrequited love to hate)]
> shift [outer emotions are transformed into physical symptoms, psychosomatic medicine]
> rationalization [feelings not to be left only arguments offered]
> shift [substitute satisfaction, comfort eating, shopping, addictions;. Etc.]

importance of defense mechanisms

positive (rather short duration)	negative (if over)
protection act remains signaling allows a "relative" comfort	unresolved costs in the long term power, changed the perception can pathological behavior / Experience promote may may not be workable, accessible then only on a psychoanalysis

dealing with defense mechanisms perceive

~ ~ sensitive learn
not name offensive! (Strengthens the defense, destroys the protective function) do not personally take
~! (See separate defenses; perceive their own feelings) give
~ Area (without respect evaluation; name your own feelings)

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processing ...

... as a learning process into eight phases of spiral Erika Schuchardt

The phases are not necessarily run in chronological order. Phases can be skipped and you can fall back.

first Uncertainty

• 
  preoccupation with symptoms, but no assignment
• What's going on ...?

second Certainty

• diagnosis is made
• Yes, but this can not be ...?

3. Aggression

• anger, disappointment, etc.
• why me ...?

4th Negotiating

• in the phase are often chosen strategies
• If ..., but must ...?

5th Depression

• depressed mood -> sadness, withdrawal, hopelessness
• ... Why, everything is meaningless ...?

6th Adoption

• acceptance of change by the disease -> exhaustion
• I realize now .. erst.!

7th Activity

• debate with the disease -> learn
• I am doing this ..!

8th Solidarity

• my experiences I share with others ... We
• act!

What can help in a period of ...
... Uncertainty: reconnaissance / / active listening
... certainty: advice / / active listening
... aggression can live out active listening / / in a given frame / / scream therapy
. .. trial: evaluation of therapy / / self-concept support, make conscious risk assessment / / no false promises / / Nurse must maintain objectivity
... Depression: support group / / coping strategies / / include family & friends -> Living with the disease mourn / / make & promote
... adoption: Motivate / / accompany and support ...
Activity: instruction, advice, training as needed / / Note does not overburden
... Solidarity: imagine support groups

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Active listening






means ... to try

• in the party empathize
• to think about when talking to
• the interviewer attention and interest towards bringing (nonverbal communication)
  

goals:

• my conversation partner feels accepted and understood
• problems
• discuss feelings let out [entlastet_Hilfe to help themselves through new perspectives ]
• provide security

techniques:
paraphrasing (rewriting)
verbalization (feelings of the interlocutor mirror)
demands (what, how ?;... never: Why)
summarize (what arrived for me)
Clarify (comprehension questions Next run for me)
(keep conversation going)
weighing
Error Active listening
come ... most often when the listener the momentary feelings of the other party can not follow or is unable to understand or to keep out his own feelings tries.

• trivializing (play down -> "Wars not so bad")
• diagnose (drawers thinking, generalize)
• conducting (the "only" pretend right solution -> inhibits independent thinking)
• examine ( targeted questions, manipulate determine the direction of conversation /)
• interpret (particular interpretation of the problem)
• moralizing (through moral approach to put pressure, role behavior demand)
• and more ...

more information, click HERE

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The four - ears - model of Schulz von Thun






Guide
factual content:
says what the speaker objectively, as established fact, assertion or expression. (. Does not matter whether he is right Every takes its environmental differently.)
appeal:
would achieve what the speaker to the listener? Why did he invite him?
self-revelation ear
says what the speaker about himself? What we learn about his person, his mood, his worries, his mental state?
relationship:
As the speaker sees his relationship to the listener? As
whom he treated him?

more information, click HERE

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life & Dietetics in ancient






This is my Einsprechthema for the oral exam!

• dietetics, "diaita" = life

• includes the regulation of the order of life, basic human needs

• today's diet, comprising only a small area of dietetics

• following basic conditions:

first Light and air

second Food and drink

third Work and rest

4th Sleep and waking

5th Excretions and secretions

6th Stimulation of the mind, mental balance

• not only to cure diseases, including those for prevention

• was tailored to the patient tailored application

• the concept dietetics also included provisions:

~ about the clothes and the bearing

~ on Diet, Physical Activity & ; baths

~ via body and speech exercises

&

• measures to drain juices adulterated with:

~ emetics and laxatives
~ bloodletting
~ Cupping

• nursing
  was as part of treatment is always in your treatment plan anchored
  - therefore belonged to the then medicine to

• dietetics was the most important part of the general treatment

• only in recent centuries was strictly between Medicine and nursing distinction

• the field of dietetics in the care has remained and was even strengthened (ATL)

dietetics from Hippocrates	ATL's by L. Juchli
light and air, food and drink work and rest sleep and waking excretions / secretions stimulation of the mind	find meaning Eating and Drinking deal be waking and sleeping retirement deal

Humoral and cellular pathology
four humours theory

1. black bile (earth)
2. phlegm (water)
3. blood (air)
4. yellow bile (fire)

All diseases are derived from the incorrect composition of the blood
and body fluids and the accumulation of pollutants; dyscrasia.

• disease course was divided into several stages:

1. disturbance of the juice mixture
2. reaction of the body with fever and / or inflammation
3. leaving the slag

• internal and external influences on recovery course

life in ancient

• Greek philosophers developed the first medical & health science
• disease is no longer supernatural, by gods
• release sent by a natural reaction of the body
• strongest principle: Dietetics and juices teaching
  

Total
health education based on the principle of Dietetics
juices and teaching. The highest bid for it is a life under absolute
discipline. Only then complete health (primary objective) is achieved.
But life unworkable

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infection routes






= section between the exit and entrance Forte Forte, on the way of pathogen in the new host organism enters.

infection routes

direct transfer	indirect transfer
airborne (by exhaling, coughing, sneezing)	dirt & lube infection inanimate (on linen, Books, dishes, etc.) alive (about beetles, flies, fleas, lice, etc.)
contact infection	food poisoning
placental infection (over placenta to the newborn)

Cyclic general, infection

• with local infections begin
• pathogens in the tissue
• kill the pathogen into the host lymphatic system
  
• phagocytosis in lymph nodes ( the pathogen)
• breaking the Lymphschranke (pathogen into the blood)

By breaking the Lymphschranke, transition from a local infection to a general infection.
stages
first Incubation

• symptoms
• time of penetration of the pathogen to the outbreak of the disease
  

second Generalization

• hämotogene spread of the pathogen
• head & body aches, mild fever

third Organ manifestation

• localization of excitation in certain organs and tissues
• expression of the clinical Photo
  

symptoms	general symptoms
hepatitis [yellowing, liver swelling] meningitis [neck stiffness, increased muscle tone, vomiting, headaches] vomit bowel disease [diarrhea, nausea] respiratory [cough, labored breathing, sputum]	fever

4.Rekonvaleszenz

• recovery agents will be the body's own defense or therapy or killed

4th

• death due to insufficient body defense, high virulence or lack of therapy

permanent shedders: Risk of infection from others, by the elimination of pathogens due to illness made.

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virus - genetics

The viral genetic information is subject to permanent genetic changes. Constant adjustments to the defense reactions of the infected organism are possible.

infection forms

infest a body cell by viruses is from "non-injury" to the "total destruction".

• 
  
  cytolytic infection




• 
  
  Efficient replication of the virus in the host cell


• 
  
  massive changes in cell metabolism -> necrosis!


• 
  
  non-lytic infection




• 
  
  be virus replication without destroying the host cell


• 
  
  host cells are often destroyed by the body's own defense


• 
  
  latent infection




• 
  
  infection of the Will cell


• 
  
  virus enters Latenszustand on


• 
  
  viruses to escape the clutches of the immune system and remain for life in the body


• 
  
  possible activation of the virus by stress, hormonal influences , psychological stress, ...


• 
  
  transforming infection / tumor formation




• 
  
  a deregulation of the generation cycle of the cell


• 
  
  there is an excessive growth and reproduction

virus infections are treated symptomatically in particular. Viruses are ressistent antibiotics. Vaccinations work well. The go through a viral infection has also immunogenic. Special form of immunization: Feiung silent, ie one has the virus without falling ill and is taken become immune.

reproduction cycle of viruses

Einzellschritte	Description	Figure
adsorption	binding of the virus to its host cell by specific interaction between viral proteins on the surface of the virus and host cell receptors
penetration	naked viruses by endocytosis (invagination of the cell membrane and Education a vesicle -> lysis and release of viral nucleic acid enveloped viruses: fusion of the viral envelope with the host cell membrane, release of capsid into the cell
uncoating	release of the nucleic acid of the capsid and penetration of nucleic acid through the pores of the nuclear membrane into the nucleus, empty protein shell disintegrates
replication	synthesis of viral envelope protein, often replicating the virus nucleic acid -> Composition of a new generation of infectious virus particles
composition "self assembly"	spontaneous joint storage matching Parts, composed of protein folding
release "Release"	helpers by lysis of the host cell with programmed cell death by exocytosis budding virus is like a vesicle pinched off

further information; HERE

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edema

= accumulation of extravascular extracellular click and / or liquid in body cavities or tissues. Edema can occur localized and generalized.

nature

doughy, swollen, pale tissue

pathogenesis

intravascular (room in the blood vessels)	interstitium (space between cells)	intracellular (space inside the cells)
infirmity of the capillary membrane result: increased Wasserausstrom into the interstitium protein deficiency in the blood	transfer of lymph vessels

Clinical form of edema

1. inflammatory edema [through increased Kapillarwanddurchlässigkeit _{for H 2 O} and increase the colloid osmotic pressure caused by proteins in the tissue and increase the Capillary pressure caused by histamine]


2. 
   
   toxic edema [Kapillarwandschädigung by toxins, such as end-stage renal failure, etc.]


3. 
   
   mechanical edema [to transfer large lymphatic vessels (hence " lymphedema ) ; occurs locally after surgery with, for example Lymphgefäßentfernung]


4. 
   
   congestive edema [in obstruction of venous outflow, generally in heart failure]


5. 
   
   renal edema [Nierenkapillarschädigung by protein deficiency or increased salt retention]


6. 
   
   hunger edema / cachectic edema [by protein deficiency in the blood due to food shortage]


7. 
   
   edema due to liver damage [reduced albumin production, impaired lymphatic circulation in the liver, ie Lymph passes through the liver surface into the abdominal cavity, it comes to ascites ]


8. 
   
   Schwangerschaftsödem [Altosteron by increased release with a result of the increased salt retention in the kidney, the pressure of the uterus Pelvic & iliac vein, there is a congestive edema in the legs]
   

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ischemia (ischemia)

= reduced blood flow through a Organ District, as a result of reduced blood supply.

causes

local causes	General causes
narrowing or complete blockage of an artery	hypovolemia

consequences: depend on:

(a) duration [3 - 5 min. ischemia has no harmful effect min> 5. are to follow recorded according to fabric]

(b) primary sensitivity of the tissue [specialized cells or organ tissues holds 1 - from 1.5 hours ischemia, skin tissue for several hours]

(c) vascular architecture [is possible, a collateral circulation ?; dual blood supply is available;? are functional end arteries exist]

infarction localized necrosis of a body part ...? verurscht ligated by blood flow.

1. 
   
   ischemic infarction




• 
  
  blaser infarction


• 
  
  by arterial occlusion (coagulation necrosis)


2. 
   
   hemorrhagic infarction




• 
  
  red infarct


• 
  
  by venous occlusion (blood pressure into the body)

further information? Click HERE

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inflammation

= sum of all reactions of the connective tissue prior to tissue damage. Inflammation is a vital reaction, ie bound to life.

causes

1. busy organisms [fungi, worms, bacteria, viruses ,...]


2. 
   
   allergens [foreign allergens, Car allergens]


3. 
   
   physical and chemical stimuli [poisons, Radiation ,...]


4. 
   
   foreign bodies [objects tumors ,...]

expiry of an inflammatory response

impairment (Functional laesa)

injurious action of a substance

tissue damage (Alteration)

Local reaction of the organism

Transient vasoconstriction the arterioles ("initial ischemia")

vasodilation of arterioles and formation of an active hyperemia (increased blood circulation by 10-fold)

REDNESS (rubor) / / WARMING (Calor)

enlargement of the lumen of the capillaries and venules

exudation (plasma leakage into the interstitium

)

SWELLING (tumor)

increasing the viscosity of the blood

(irritation of the nerve terminal)

PAIN (Dolor)

emigration of leukocytes from the vessels into the damaged Tissue ("chemotaxis" = attraction of leukocytes

phagocytosis of bacteria (or the like.) And tissue debris

regression with resorption of

exudate without tissue destruction

"restitution ad integrum" =

complete cure

progression in the continuance of

harmful effect / inflammatory response

proliferation

= formation of granulation tissue with capillary buds

scarring

(regression of the capillaries)

Common symptoms

• 
  
  leukocytosis with left shift


• 
  
  increase in immunoglobulins


• 
  
  fever as a sign of metabolic increase


• 
  
  subjective fatigue and malaise

influences on the course of the inflammatory Reaction

• 
  
  type of inflammation caused


• 
  
  duration of the injurious effect


• 
  
  responsiveness and disease resistance of the affected organism

forms of inflammation

first serous inflammation

• 
  
  abundant protein-rich exudate


• 
  
  "serous catarrh "


• 
  
  much mucus

second fibrinous inflammation

• 
  
  accumulation of exudate with Fibrinmaterial


• 
  
  at (mucus) skin


• 
  
  formation of grayish-yellow pseudomembrane on the inflammatory area (eg diphtheria)

third purulent inflammation

• 
  
  little exudate


• 
  
  enriched [thereby placing a proteolytic enzyme which leads to liquefaction of tissue] with leukocytes are going to be essentially fatty


• 
  
  yellowish cream-like texture

further information, click HERE