Cellular Aberration Module 1 PDF

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Summary

1. INTRODUCTION TO ONCOLOGY2. LABORATORY TESTS, DIAGNOSTIC TESTS,AND SURGERY3. ANTINEOPLASTIC THERAPY4. RADIATION THERAPY5. NURSING INTERVENTIONS6. ONCOLOGIC DISORDERSLEARNING OBJECTIVESOn completion of this chapter, the learner will be able to: 1. Compare the structure and function of the normal ce...

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CELLULAR ABERRATION

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INTRODUCTION TO ONCOLOGY LABORATORY TESTS, DIAGNOSTIC TESTS, AND SURGERY ANTINEOPLASTIC THERAPY RADIATION THERAPY NURSING INTERVENTIONS ONCOLOGIC DISORDERS

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● LEARNING OBJECTIVES On completion of this chapter, the learner will be able to: 1. Compare the structure and function of the normal cell and the cancer cell. 2. Explain the origin of cancer. 3. Identify agents and risk factors that contribute to carcinogenesis. 4. Discuss the importance of antioxidants from the devastating effects of free radicals. 5. Differentiate between the benign and malignant tumors. 6. Explain the roles of the immune system. 7. Describe the role of nurses in health education and prevention of oncologic disorders. 8. Discuss the levels of prevention.

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ALARA (As Low As Reasonably Achievable)(you as a nurse, even if you have small dose of exposure to radiation or even if it does not affect you, but as much as possible you have to avoid it) ALOPECIA- (ideally, we cannot say it’s permanent or temporary, but rather usually temporary, it means to say that we have different responses to chemotherapy it can be either permanent or temporary) ANAPLASIA ANGIOGENESIS- (is one of the defense mechanism of cancer cells in which it triggers the vascular endothelial growth factor (VEGF) for the formation of new blood vessels, in order for the cancer cells to maintain its nourishment because cancer cells are parasitic in nature, very dependent of the glucose, protein, and growth hormone coming from the host, that’s why it has to be nourished with the expense of new blood vessels, this explains why cancer cells and tumors are growing everyday) APOPTOSIS BIOLOGIC RESPONSE MODIFIER (BRM) THERAPY BIOPSY BRACHYTHERAPY CANCER CARCINOGENESIS CHEMOTHERAPY CONTROL CURE

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as the functioning of the components of the immune system, it prevent the cells form further cellular damage or DNA mutation) DYSPLASIA EXTRAVASATION GRADING GRAFT-VERSUS-HOST DISEASE (GVHD)(undesirable, very bad effect, because the donor the graft or the donor is not giving good effect to the host, but rather it affects the recipient) GRAFT-VERSUS-TUMOR-EFFECT (GVTE)(desirable, good effect, because the graft or the donor is giving good effect to the recipient) MALIGNANT METAPLASIA MUCOSITIS- (inflammation of the mucosal lining, slightly similar to stomatitis but different in terms of location (lips, gums, buccal area, throat, stomach, intestine,anus) MYELOSUPPRESSION NADIR- (aka NADIR COUNT, in which the blood forming elements are unforgivably low, WBC in particular that makes clients so immune suppressed, it jeopardize the existence of the client because they might die of septicemia, not just WBC but also platelet, RBC, and so on and so forth) NEOPLASIA NEUTROPENIA ONCOLOGY PLEOMORPHISM PRECISION MEDICINE RADIATION THERAPY STOMATITIS- (inflammation of the mucosal lining, oral cavity (lips, gums, buccal area) STAGING TARGETED THERAPIES TUMOR-SPECIFIC ANTIGEN VESICANT WARBURG EFFECT-(other defense mechanism of cancer cells in which it converts glucose into lactic acid through glycolysis even with the presence of oxygen) XEROSTOMIA

Cancer is not a single disease with a single cause; rather, it is a group of distinct diseases with different causes (multifactorial, unknown cause, genetics, familial, physical, chemical, or even if you don’t have any history of cancer in the family but still you can be a victim of random mutation), manifestations, treatments (manifestations and treatments will vary depending on which organ it will affect), and prognoses (matters on how early or how late the recognition). -Brunner and Suddarth’s TMSN, 14th edition TOP 10 CAUSES OF MORTALITY (2017) 1. ISCHEMIC HEART DISEASES 2. NEOPLASMS 3. CEREBROVASCULAR

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CYTOKINES- (substance produced by the immune system, it enhances production as well

4. PNEUMONIA 5. DIABETES MELLITUS

CELLULAR ABERRATION 6. 7. 8. 9. 10.

TOP 10 CANCERS (2018) 1. BREAST 2. LUNG 3. COLON 4. LIVER 5. PROSTATE 6. CERVIX 7. THYROID 8. LEUKEMIA 9. RECTUM 10. OVARY

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HYPERTENSION CHRONIC RESPIRATORY DISEASES RESPIRATORY TUBERCULOSIS OTHER HEART DISEASES GENITOURINARY

CELL MEMBRANE NUCLEUS CYTOPLASM ENDOPLASMIC RETICULUM ○ ROUGH ○ SMOOTH RIBOSOMES GOLGI COMPLEX LYSOSOMES PEROXISOMES MITOCHONDRIA

CELL MEMBRANE- separates internal and external environment of the cell ○ protects cell from fast cellular damage and dehydration ○ we also notice the presence of pores in which the nutrients or the chemical substances will get into the cell through that channel ○ substances can be passive or active

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it is selectively permeable, WHY? because it only allows molecules or small substances, larger molecules cannot penetrate into the cell generally, the functions of the cell membrane acts as barrier controls the flow of substances helps identify the cell to other cells participates in cell signalling , in which cells are communicating at each other from the scalp down to toes

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WHAT IS GLYCOCALYX? The sugar coat on the extracellular surface of the plasma membrane. It is composed of carbohydrates of membranes that includes the glycolipids and phospholipids.

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NUCLEUS- command center of the cell because of the presence of the DNA ○ controls cellular functions ○ directs cellular activities ○ produces ribosomes in nucleoli ○ as you can observe, there are many ribosomes surrounding the nucleus, it is synthesize by the nucleus and assembled in the cytoplasm ○ also you can observe the presence of the endoplasmic reticulum, it makes a trap, because the potent form of the ribosomes are confined there ○ you can also observe the presence of chromatin, these are complex of DNA, proteins and some of the RNA

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PROTEIN SYNTHESIS ○ TRANSCRIPTION- occurs within the nucleus, in which the genetic information represented the sequence of

form

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base triplets in DNA, will serve as template for copying the information TRANSLATION- occurs outside the nucleus, it is in the cytoplasm to be exact, WHY? because the mRNA are large molecules, the highlight of this one is for the synthesis of proteins with ribosome and RNA WHY ARE PROTEINS IMPORTANT IN THE LIFE OF A CELL? Because it determines the physical and chemical characteristics of the cells.

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HOW DOES THE FOLLOWING REACHES PLASMA MEMBRANE? because they have the mechanism to transport glycoproteins and phospholipids in the manner of EXOCYTOSIS, through the vesicle transporting it towards the cell membrane, that explains why the cell membrane contains the following SMOOTH ER

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CYTOPLASM- semi-fluid gelatinous material or nutrient matrix also know to be CYTOSOL ○ the rest of the organelles were bathe within the entity of the cytoplasm EXCEPT for the plasma membrane ○ where majority of chemical of metabolic reactions occur ENDOPLASMIC RETICULUM- divided into two types: ROUGH and SMOOTH ○ ROUGH ER

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WHY IS IT ROUGH? presence of ribosomes Ribosomes- produces proteins’ role of ROUGH ER: synthesizes GLYCOPROTEINS AND PHOSPHOLIPIDS through this we’ll now have the idea how does cell membrane possesses the glycoproteins and phospholipids

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absence of ribosomes, but despite that you cannot discard the vitality of the smooth ER it is responsible in the synthesis of the fatty acids and steroids it inactivates or detoxify drugs and other potentially harmful substances (just  like alcohol), because of that it gives you the idea that it must be the liver because it is a known organ for detoxification process, other than the liver we also have kidneys and intestines, or any parts of the body that involves detoxification process, your SMOOTH ER is always behind that it removes phosphate groups from glucose-6-phosphate, this is in the process of DEPHOSPHORYLATION, it increases your free glucose, WHY? because the body is in need of energy, the mitochondria cannot extract energy without having glucose stores and releases calcium ions, that gives you the idea that the moment there is cell destruction aka cell lysis, once the cell is damage the calcium thrown away from the cell, it will leak out and incorporate with

your blood circulation, may

CELLULAR ABERRATION result to increase blood calcium level---HYPERCALCEMIA (there is bad effect of high calcium, it will be filtered in the kidneys and causes renal failure

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RIBOSOMES- known for the site of protein synthesis ○ ribosomes cannot function by itself without merging with other subunits ○ once combined in can now be potent for protein synthesis

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these are the transfer RNA (tRNA)

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the tRNA carries the three bases, aka ANTICODON, the bases in the mRNA are called CODON

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the tRNA carries amino acids which are which are essential or non-essential amino acids, that is heading towards the ribosomes to have PROTEIN CHAIN

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during the start of protein synthesis, it will always start with the “AUG” anticodon

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these are the growing protein chain, it is important to remember that most of the proteins synthesized by the ribosomes are not  mature, therefore it has to processed by another organelle GOLGI APPARATUS which is known as the packaging plant (transform into something important) WHY IS IT IMPORTANT TO HAVE PROTEINS? WHAT ARE THE TYPES OF PROTEINS? the role of proteins is not only one but there are other functionalities of your proteins: ○ STRUCTURAL- (collagen, bone, connective tissues, keratin, hairs, fingernails) ○ REGULATORY- (hormones, neurotransmitter) ○ CONTRACTILE- (movement of muscles

WHY ARE SUBUNITS OF RIBOSOMES SYNTHESIZED AND ASSEMBLED? the ribosome is being synthesized in the nucleus (nucleolus), and then assembled in the cytoplasm

the picture above shows the ribosome, the site for protein synthesis, large and small subunits are emerged together in order to become a potent material in the synthesis of protein

this is the messenger RNA, when comparing mRNA and transfer RNA, they are both in opposite direction

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or contractility)

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IMMUNOLOGICAL TRANSPORT CATALYTIC- (speeds up reaction)

GOLGI COMPLEX- known to be as a packaging plant, anything that is not mature will become a mature form for various uses ○ FUNCTIONS: ■ modifies, sort, packages, and transport proteins received from the rough ER (any substances produced in ER specifically rough ER are not mature yet, it has to be repackaged by the golgi apparatus to become a potent material for better use) ■ forms secretory vesicles that discharge processed proteins via exocytosis into extracellular fluid ■ forms membrane vesicles that ferry new molecules to the plasma membrane ■ forms transport vesicles that carry molecules to other organelles, such as LYSOSOMES

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it will then be processed in the MEDIAL CISTERN, until it will become mature and ready for distribution

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it will now then be confined to in the TRANSFER VESICLE

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then, it will EXIT or TRANS FACE

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then, it will be delivered throughout the body through SECRETORY VESICLES in the manner of EXOCYTOSIS, only the specific receptors or cell will recognize that HOW DO ENTRY AND EXIT FACES DIFFER IN FUNCTION? the ENTRY FACE receives and modifies proteins from wrapped from the endoplasmic reticulum, while the EXIT FACE modifies, sort, and packages the molecules and is now ready for transport to other destination

for your proteins or any kind of hormones in which that are not yet mature, it has to be transported in the GOLGI APPARATUS, proteins and hormones will be transported through the TRANSPORT VESICLES

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the first part of golgi apparatus is named as the ENTRY or CIS FACE

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WHAT ARE THE THREE GENERAL DESTINATIONS FOR PROTEINS THAT LEAVE GOLGI COMPLEX? some proteins are: secreted  from the cell by exocytosis, incorporated  into the plasma membrane (fats, glycolipids, phospholipids), occupy  storage vesicles that become lysosomes

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LYSOSOME- the prefix lyso- means dissolving and -somes means body, it means to say that it is a dissolving body, it aids in dissolving or digesting something ○ FUNCTIONS: ■ digest substances that enter a cell via ENDOCYTOSIS and transport final products of digestion into CYTOSOL (ENDOCYTOSIS: engulfing; EXOCYTOSIS: transport going outside the cell) ■ carry out AUTOPHAGY, the digestion of worn-out organelles ■ it implements AUTOLYSIS, the digestion of an entire cell ■ accomplishes extracellular digestion WHAT IS THE NAME OF THE PROCESS IN WHICH THE WORN-OUT ORGANELLES ARE DIGESTED BY LYSOSOMES? AUTOPHAGY 

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PEROXISOMES there are two types of hydrogen peroxide, the ENDOGENOUS in which the body is able to synthesize it, and EXOGENOUS coming from the external sources such as the Agua Oxygenada (2 H2O2- hydrogen peroxide)

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CATALASE- present in the blood, once the catase is in contact with the hydrogen peroxide--it will oxidize, that’s why it will be broken down into two molecules----water (2 H2O) + oxygen (O2) WHY IS IT THAT THERE ARE A LOT OF BUBBLES WHEN WE APPLY HYDROGEN PEROXIDE ON THE WOUNDS? the very reason why there are bubbles is that the blood contains the catalase, because of that there are bubbles on it, it does not represent the abundance of microorganisms present on the wound, whether there are a lot of bubbles in it or not, still it does not mean the presence of microorganisms the very reason why we apply hydrogen peroxide for the purpose of hoping to kill the microbes, but the disadvantage is it also oxidizes the tissues OXIDATION- is the removal of charges, the cell contains both cations and anions, the very reason why it should posses the ions because it provides electricity to the cell, without electrical current or electricity the cell cannot function, it cannot perform its tasks, as expected, that’s why when the cell is oxidized there will be removal of charges and it weakens the cell, and if there are a lot of cells in your body that has been oxidized, as expected they weaken tissues and they are prone to damage and CELLULAR MUTATION that’s why oxidation most especially from external surface is very bad to our health, also that explains why we need to take ANTIOXIDANT to buffer the oxidizing agent that destroys the functionality of the cell example: the mouthwash, they are oxidizing

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these are the membranes enclosed vesicles that form from the GOLGI COMPLEX, they contain as many as 60 kinds of powerful DIGESTIVE ENZYMES and HYDROLYTIC ENZYMES that can break down wide variety of molecules once lysosome is fused with vesicles during ENDOCYTOSIS cause lysosome enzymes works best in the acidic pH, mostly they are found in the gastric

lysosome membranes also includes transporters that move final products of digestion such as glucose, fatty acids and amino acids into the CYTOSOL, it is more powerful compared to cytosol it can perform engulfing of another organelle once the organelle is dead or not anymore useful, it will engulf or digest it, called as AUTOPHAGY

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agents, we gargle that because we are hoping to

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kill the microbes and then we have to spit it out that’s because it is not good once it is absorbed longer in our body that explains why it is not good to administer large amounts of hydrogen peroxide to our wound because other than it oxidizes the microbes and soon die, but the problem with that is it also oxidizes the tissues, instead of helping the tissue to recuperate to heal faster but hen it destroys the cell, instead of promoting healing process, it delays the healing process. example: what will happen to your hair once you apply hydrogen peroxide? Your hair will oxidize that’s why the color separates from the hair, black hair will turn to blond just apply small amount of hydrogen peroxide instead of soaking it because it impairs or delays the healing process

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MITOCHONDRIA- powerhouse of the cell because it is where ATP is being extracted

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the mitochondria contains ribosomes (RIBOSOMES: mitochondria, endoplasmic reticulum, surfaces of the nucleus) WHERE DOES RIBOSOME PRODUCED? nucleolus in the nucleus, assembled in the cytoplasm

contains the lipids, fats and cholesterol (fat-soluble) which is exactly opposite in terms of property of glucose that explains why GLUCOSE cannot immediately penetrate into the cell, that’s why it requires INSULIN as a key for entry. when it reaches into the cytoplasm, GLUCOSE will then be converted into PYRUVIC ACID, once became PYRUVIC ACID that’s the best time when the mitochondria will convert that to ATP or ADENOSINE TRIPHOSPHATE ATP is a form of energy and it is calorigenic, it gives HEAT DNA regulates body temperature, it dictates the desirable temperature, that is why it has to maintain 36.5-37.5 degree celsius. WHY IT HAS TO BE IN THAT BRACKET? because the metabolic activity of our body cannot prosper without having this physiologic bracket; if it fall below we become HYPOMETABOLIC, if it goes above we become HYPERMETABOLIC

MITOSIS- a cellular division in which the main cell splits into two identical cells PHASES OF MITOTIC ACTIVITY: PMAT ○ PROPHASE ■ EARLY PROPHASEmembranes are intact, chromosomes are not well-defined ■ LATE PROPHASE-chromosomes are well-defined, centrioles are migrating towards the opposite pole ■ at the last part of the prophase the membranes disappeared; with the expense of SPINDLE FIBER, chromosomes will be held and directed towards the middle

enzymes confines in the mitochondria, participates in ATP SYNTHESIS HOW DO MITOCHONDRIA CRISTAE CONTRIBUTE IN ATP PRODUCTION? ○ MITOCHONDRIA CRISTAE increases  the surface are available for chemical reactions, and contains some of the enzymes needed for ATP production ○

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GLUCOSE is a water soluble nutrient;

METAPHASE- alignment of chromosomes called METAPHASE PLATE ■ IF YOU OBSERVED THAT A CELL DID NOT HAVE CENTROSOME, WHAT COULD YOU PREDICT ABOUT ITS CAPACITY FOR CELL DIVISION? cell division won’t

meanwhile, the composition of cell membrane

prosper because the spindle

CELLULAR ABERRATION fiber and centrosome participates in the cell division, it cannot complete its process or sequence

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ANAPHASE ■ EARLY ANAPHASEchromosome is splitted in half/ V-SHAPE, pulled towards the opposite end ■ LATE ANAPHASE- CLEAVAGE FURROW

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TELOPHASE- splitted equally, the cell make sure that before it is completely splitted it assures identical distribution of properties and components

INTERPHASE- in the mitotic sequence interphase is not anymore part of it because it is also considered as PROPHASE CYTOKINESIS- occurs during ANAPHASE and completed next to TELOPHA...