Department of Pathophysiology
Pathological physiology
Part I
Tutorial for practical classes for students in specialty 060103 “pediatrics”, 060101 “general medicine”
Khabarovsk 2014
G.N. Dubinina
I.G. Yakovenko
Pathological physiology. Part I .
Publishing house
State Budgetary Educational Institution of Higher Professional Education of the Far Eastern State Medical University of the Ministry of Health
UDC 616-092(076.5)
BBK 52.5ya73
Compiled by: Associate Professor, Ph.D. G.N.Dubinina, Associate Professor Ph.D. I.G.Yakovenko
Reviewers: head normal physiology.m.s. E.N.Sazonova, head Department of Microbiology, Immunology, Virology Associate Professor, Ph.D. I.P. Koltsov, methodologist of the testing department M.D. Verbovskaya
Educational and methodological manual for practical classes in pathological physiology: / Educational and methodological manual for conducting practical classes in the discipline “Pathological physiology, clinical pathophysiology”. – Khabarovsk: Far Eastern State Medical University, 2014. - p. 111.
The educational and methodological manual for students in the specialty “pediatrics”, “general medicine” is intended for conducting practical classes in the academic discipline “Pathological physiology, clinical pathophysiology”, compiled on the basis of the Federal State Educational Standard, approved by the Ministry of Education and Science Russian Federation November 8, 2010 No. 1122.
IN methodological manual issues of general nosology, typical pathological processes and metabolic disorders are outlined. Intended for students of pediatric and medical faculties.
CMS approved
DVSMU as an educational and methodological aid for students specializing in pediatrics and general medicine.
SECTION I
GENERAL NOSOLOGY
Topic No. 1. “Introductory lesson. Subject, tasks and methods of pathological physiology.
Motivational characteristics of the topic
Pathological physiology is a science that studies the vital activity of the body in conditions of the development of disease.
Pathological physiology is one of the main fundamental disciplines of medicine. In the receiving system medical education pathophysiology is the connecting link of the disciplines of the natural scientific and clinical block of disciplines of the Federal State Educational Standard, contributing to the formation of medical thinking among students.
2. Goals:
2.1.Know the definition of the concept of “pathological physiology”, the subject and methods of its study, its significance for medicine.
2.2. Be able to define the concepts of “disease”, “pathological process”, know the main types of modeling pathological processes.
2.3. Know the features of the course of typical pathological processes in elderly people (medical faculty), in children (pediatric faculty).
Academic discipline“Pathological physiology, clinical pathophysiology” refers to a cycle of disciplines where the main method of studying diseases and pathological processes is experiment. In this regard, student groups are given initial on-the-job instruction during the introductory lesson.
I. General requirements
1. Students in classrooms must wear gowns.
2. The workplace should be kept clean, not cluttered with foreign objects: clothes, bags, etc. At the end of work, tables should be clean.
3. While working in the classroom, you should maintain silence, orderliness and cleanliness, and avoid haste, disorder and sloppiness.
4. Students work in the classroom with a teacher, and are also prohibited from being in the classroom at unspecified times without the permission of the teacher.
6. Students can begin performing each work only after receiving safety instructions and permission from the teacher.
7. Upon completion of work you must:
· tidy up your workplace;
· turn off the water and electricity.
8. During practical classes, students are required to strictly follow the general rules for working with electrical appliances. If exposed wires, faulty electrical sockets, etc. are identified, immediately notify the teacher and laboratory assistant about this. Take action necessary measures precautions to prevent accidental contact of students with faulty equipment and electrical wiring.
9. Before connecting an electrical device to the network (electrocardiograph, electrical stimulator), together with the teacher, check their grounding.
II. Safety rules when working with electrical appliances.
When working with electrical devices (laptop, computer, media projector, power supply and lighting for a microscope, etc.), there is a danger of electrical injury or fire. When working with electrical equipment and electrical appliances, it is strictly prohibited.
Every person should have basic knowledge of safety precautions (HS) when working in electrical installations. When in contact with electric current, our body reacts as if it were a normal, but thousands of times stronger, nerve impulse. Muscle tissues begin to contract chaotically at high speed, but they cannot be relaxed due to the fact that external stimulus acts on the brain more powerfully than signals internal organs about damage.
Most common reasons electric shock
Causes and Effects
The most common example is electricians touching wires. outside hands so that in the event of an electric shock, the hand does not clasp the conductor, but clenches into a fist and pushes the limb away from the contact. Prolonged contact with current can result in muscle ruptures, dislocations and even bone fractures.
The dangerous parameter is the current, not the voltage. In household networks its value is 10-16 A, which is a deadly level for a living organism. Such electric current may cause malfunction nervous system, paralysis respiratory system, fibrillation and cardiac arrest.
The mechanical effects of electricity are divided into chemical and physical:
- Chemical – change current properties chemical composition body fluids (blood, lymph, gastric juice and other glands). Causes a serious condition for the victim.
- Physical – the release of heat when passing through body tissues. Body resistance healthy person V normal conditions is 1 kOhm. In the event of an impact under such conditions, a person receives burns of varying severity. If the skin is wet, then the overall resistance of the body decreases, and electronic flows begin to affect the internal organs.
The degree of injury depends on the magnitude of the current and voltage class, body parameters, external conditions under which the incident occurred, and the duration of action physical quantity. Fatal outcome is approximately 0.5% of total number, but getting injured in almost any situation is inevitable. Therefore, you should not neglect the rules safe use electrical installations.
A source of increased danger is a cable with a damaged or removed top layer of insulation, because internal parts become more susceptible to mechanical stress. In such cases, it is necessary to measure the current on the wires.
The source of electrical discharges at home is household appliances and electrical appliances that contain capacitors in their circuits.
In de-energized circuits, a leakage current remains and when touched, a person can receive a fairly serious discharge. To prevent this from happening, it is necessary to use grounded sockets for the corresponding devices.
Fire safety
The cause of such incidents is considered to be faulty wiring and long-term operation old aluminum wires. Their insulation cannot provide the required level of safety for new devices (air conditioners, heaters, electric furnaces, etc.). Increasing the power has a negative effect on old wiring - it causes excessive heating and increases the possibility of a fire.
In the event of a short circuit (hereinafter referred to as short circuit) with a line break, an explosion may occur, characterized by a strong magnetic field. In such cases, all electrical equipment within the affected area fails. Fires can be caused by a short circuit. Short circuits are caused by: faulty wiring, insulation, electrical appliances, weak contact at connections.
Basic rules of TB
It is forbidden:
- check the presence of current in the network with your hands;
- come close to power transformers, distribution devices, other electrical facilities;
- You cannot continue to use electrical devices if sparking appears when turned on;
- plug in large number devices, general meaning whose power exceeds what is permissible for a given consumer;
- approach sagging cables, broken wires (if the power line voltage is more than 380 V, then the minimum safe distance is 10 m);
- use faulty sockets and circuit breakers (if the device begins to overheat, it is necessary to find out and eliminate the cause of the malfunction as soon as possible);
- touch switched on electrical appliances with wet hands;
Failure to comply with safety rules when handling electricity at home
- touch taps and metal (wet plastic) pipes if you are holding a switched-on electrical appliance (hair dryer, etc.);
- leave electrical devices turned on for a long time (irons, heaters, electric stoves);
- install electric stoves closer than 0.5 m to curtains and curtains;
- leave heating devices (straighteners, hair straighteners, hair dryers, heaters) on plastic surfaces;
- bend and twist household cables (insulation failures appear after several years of operation);
- nail wires to walls;
- touch the exposed parts of electrical cables and lighting accessories during installation (household switches, sockets, sockets, lamps);
- replace lamps while standing on a damp floor with wet hands;
- repair live electrical networks;
- do not allow liquid to come into contact with switched on electrical appliances;
Failure to follow electrical safety rules in the bathroom means a high probability of an accident
- cover incandescent lamps with fabrics and plastic materials;
- use homemade electrical devices (circuit breakers, fuses);
- leave electrical appliances plugged in when leaving home;
- pinching cables and wires in doors and window frames to avoid breakdown of insulation and fracture of current-carrying conductors;
- leave unused electrical appliances plugged into sockets - when network parameters change (thunderstorms or line failures), current may be present in them;
- use devices that feel tingling when touched - this indicates the presence of breakdown and leakage current;
- allow children to play wet areas, near sockets, insert pins into them, pull wires, etc.;
- turn devices on and off with both hands;
- turn appliances on and off, while holding onto wet or metal pipes, grounding objects;
- caused by electrical fault with water. In this case, you can get an electric shock through the jet.
Failure to comply with electrical safety rules in the kitchen
Household electrical network
- It is necessary to install fuse links in accordance with the installed load (exceeding the indicator can lead to a fire).
- Junction boxes, switches, and sockets must not be left open.
- Connect the devices according to the diagram (cord to the device, and then to the network).
- Do not wash or clean live equipment from dust.
- Fill kitchen appliances (kettles, coffee makers) with water while switched on.
- It is necessary to monitor the load on the apartment's electrical network and the readings of the electric meter. If the indicator deviates from the norm, the cause should be found out and eliminated.
TB during repairs
- All work should be done in a group of at least 2 people. This is necessary in the event of an incident in order to be able to provide assistance to the victim.
- During construction, it is always necessary to monitor the condition of the power tool. The slightest crack can lead to electric shock.
- Children should not be in the room. The effect of current on a child’s body is many times more dangerous than on an adult’s body.
- Before carrying out work, it is necessary to de-energize the room in the correct order (household switches, then automatic switches for each load, RCDs and input circuit breakers).
- During the period of work, a sign warning about repair work should be hung on the floor panel to prevent accidental switching on by neighbors.
- Before work, check that there is no voltage in the network.
- It is prohibited to replace old plugs with similar homemade ones. This can cause a fire, especially if the load increases.
- It is prohibited to carry out construction and installation work in damp areas, standing on a wet floor.
- After all the work has been carried out, it is necessary to verify the quality of the network: there should be no exposed wires and open sockets. To check the operation of the lines, their continuity is necessary.
- You cannot drill into walls in places where electrical wiring may be laid without the need to replace a section of wire or install a junction box.
- Wires must not be laid openly above gas pipes and radiators.
- If after the repair the machine is triggered, it means there is a short circuit in the area. In this case, diagnostics are necessary - completely disconnecting the load and connecting electrical appliances in series to the sockets of the area.
- Do not cut wires and cable sheaths lengthwise with knives.
- It is prohibited to conduct renovation work under voltage.
- Wires should not be cut with wire cutters.
- All sockets and household switches must be promptly replaced with new ones. Even a part of the network that is completely normal in appearance may have loose or broken pieces of wire inside. Replacement will help avoid a number of accidents and damage to household appliances.
- It is prohibited to lay wires in a bundle or openly in residential areas.
Improving electrical safety
- When working with electrical appliances, you should follow the instructions. Devices should be connected to the electrical network if this is required by the operating rules.
- It is necessary to provide differential protection - an introductory RCD (to increase fire safety), differential circuit breakers for bathrooms and children's rooms, for washing, dishwashers, boilers and electric boilers.
- Check regularly for proper operation circuit breakers and differential circuit breakers, monitor the insulation condition of household appliances.
- Never use extension cords with defective plugs. There should be no dust on the carriers so that sparking does not start a fire.
- Do not pull plugs out of sockets by cords.
- Portable lights should not be used in the bathroom.
- Lamps with a higher wattage than the permissible wattage should not be screwed into the lamps (if they are overheated, the plastic elements may begin to melt).
- Do not leave lamp sockets hanging only on the wire. Over time, the contacts will loosen and sparking will occur when turned on.
Occupational safety. Video
About ensuring the safety of electricians when servicing transformer substations and distribution points narrates the video below.
Compliance will help avoid dangerous situations and also extend the life of electrical equipment.
Rules for safe behavior at home
How dangerous are electrical appliances?
Under certain conditions, when using well-known equipment and devices, dangerous situations can arise for you, for your loved ones and for your home.
Such situations can arise for two reasons. In the first case, you yourself can create a dangerous situation by violating the rules for using equipment and household appliances. In another case, a dangerous situation may arise regardless of you: the electrical voltage in the network has sharply increased, the faucet is leaking, turning off the water in the bathroom, etc.
So that you know how to avoid occurrence dangerous situation in everyday life, and if it occurs, to reduce its harmful consequences, we will consider the main everyday situations in which it is necessary to follow certain rules.
Rules for using electrical appliances.
Electric current passing through human body causes it to heat up and can cause burns. Electrical burns can cause serious damage to the internal tissues of the human body. In addition, electrical shock can cause cardiac arrest or respiratory arrest.
To prevent this from happening, a number of things must be observed in everyday life: general rules safe handling of electricity:
do not use faulty electrical appliances, never leave a switched-on electrical appliance unattended;
do not plug several electrical appliances into one outlet;
follow the order of connecting an electrical appliance to the network: first connect the cord to the device, and then connect the cord to the network.
The device is turned off in reverse order;
do not touch the switched on electrical appliance with wet hands;
remember: you cannot use electrical devices while in water;
Immediately inform your parents or elders about detected malfunctions in electrical appliances, exposed or poorly insulated wires.
Remember!
Do not extinguish burning electrical devices connected to the electrical network with water.
A computer is a very useful and sometimes necessary thing. However, improper handling can be harmful to health.
Rules for working at the computer:
make sure that the position of the monitor corresponds to the direction of view, the middle of the monitor screen is located on a horizontal line drawn at eye level or 10-20° below;
Do not work in a dark or semi-dark room.
in accordance with established standards, the continuous duration of a student’s work at a computer should not exceed 25 minutes;
After each long session on the computer, it is recommended to perform certain physical exercises.
Household gas and its properties
Perhaps, with your parents' permission, you use a gas stove for cooking. To use domestic gas, a gas pipeline has been installed in the apartment and gas stove or geyser. You constantly use various electrical appliances: iron, lamp, TV, radio equipment. For this purpose, there is electrical wiring, and in certain places there are electrical sockets and room lighting switches.
Currently, household gas is widely used in everyday life. It can be used in gas stoves for cooking and in geysers for heating water.
Gas used for domestic purposes can be of two types: liquefied gas in cylinders and city main gas.
Household gas has neither color nor odor, but in order to detect its leak, special substances that have a specific odor are added to it.
Rules for safe handling of gas appliances
A gas leak can lead to human poisoning and explosion of the premises. To prevent this, you must follow safety rules when using domestic gas. We list the main ones:
To light a gas burner, first hold a lit match and then open the gas tap smoothly and carefully.
Do not leave switched on gas burners unattended.
Make sure that the liquid heated on the gas stove does not flood the burner flame.
If you notice an extinguished burner, do not try to light it again - this may lead to an explosion. Turn off the gas tap, open the windows and ventilate the kitchen properly. Report the incident to an adult.
The most ordinary gas stove in the kitchen can become a source of many troubles if you do not take certain precautions: after all, when burning, the gas releases various toxic substances into the air.
Therefore, while the gas is burning, keep the window or transom open, and kitchen door be sure to close it.
Make sure that the flame above the burner is blue, without any admixture of yellow or red.
Try to place teapots or pots with a wide bottom on a high stand, otherwise the access of air to the burner is reduced and the gas does not burn completely.
Gas is convenient and safe only if you handle gas appliances skillfully and correctly.
You must always remember and follow the rules for using it:
do not leave switched on gas appliances unattended;
Do not allow children to use gas appliances preschool age, as well as persons who do not know the rules for handling these devices.
Keep gas appliances clean and in good working order.
During the period of soil freezing, the possibility of rupture of underground gas pipelines cannot be ruled out. Gas coming out of damaged areas can spread over long distances and penetrate into basements and first floors of even non-gas-free buildings. When going down into the basements, do not use open flames or electrical switches without making sure there is no smell of gas.
If you smell gas, immediately report it by calling 04. Before the emergency vehicle arrives, take safety measures: do not allow open fire and, if possible, ventilate the room.
Be careful and careful!
Don't neglect safety measures. Save gas.
Avoid prolonged work gas burners no dishes.
Adjust the flame of gas burners. Reduce gas to minimum size torch after the water boils in the container.
If you have gas burners of different capacities, use the larger burner only when necessary.
Prevent scale formation in kettles. Boiling water for a long time increases scale deposits.
Cover dishes with lids while cooking; this technique allows you to save 15% of gas.
What to do if there is a gas leak?
Turn off the gas burners. Turn off the gas valve.
Avoid any actions that cause sparks and increase the room temperature. Do not touch electrical switches, this may also cause a spark. Ensure intensive ventilation of the room by opening all windows. Remove everyone present. Stop the gas supply if possible. Call the technician on 04.
Devices containing mercury
Household appliances containing mercury:
fluorescent lamps (these are gas-discharge tubes containing inert gases and mercury vapor). All such lamps contain mercury - from 40 to 70 mg.
mercury thermometers;
instruments for measuring pressure (pressure gauges).
Thermometers are found in every home; they are made of glass and easily break if dropped. In this case, mercury balls easily roll into floor cracks or are sucked into the carpet.
Fluorescent lamps are often thrown away with household waste. trash cans, where they break easily, and mercury vapor enters the surrounding atmosphere.
Children and teenagers who break such lamps out of hooliganism usually do not even suspect what gets into their lungs.
Poisonous properties of mercury
Mercury is a heavy liquid metal, silvery in color. It has a highly convex surface. In small quantities it collects into very mobile balls. It easily penetrates into the cracks of floors, furniture, walls, is absorbed by porous bodies, including wood, paper, fabric, plaster, remaining there for a long time, and is a source of indoor air pollution. Mercury freezes at -38.9°C. Mercury evaporates at room and even zero temperatures, mercury vapor is colorless and odorless.
Mercury and its compounds can enter the body through the lungs, gastrointestinal tract, and skin.
Mercury vapor and its compounds are very poisonous. Chronic poisoning with mercury and its compounds results in a metallic taste in the mouth, loose gums, severe salivation, excitability, and weakened memory. The danger of such poisoning exists in all rooms where mercury is in contact with air. The smallest drops of spilled mercury that have clogged up under baseboards, linoleum, furniture, and in floor crevices are especially dangerous. Total surface The number of small mercury balls is large, and evaporation is more intense.
Children, a few hours after they start inhaling mercury vapor, may develop severe pneumonia (pneumonia) - cough, shortness of breath, and fever. In case of severe poisoning, pulmonary edema is possible (this is a deadly condition). Possible diarrhea (diarrhea), drowsiness, followed by nervous excitement.
Actions in case of mercury spill
The smallest drops of spilled mercury that have clogged up under baseboards, linoleum, furniture, and in floor crevices are especially dangerous. The total surface of small mercury balls is large, and evaporation is more intense.
If the device breaks and mercury gets on the floor, you should carefully collect all visible balls in a hermetically sealed bottle, wipe the area of the mercury spill with a rag moistened with a solution of potassium permanganate, and then contact a specialized organization, which will check whether there are any mercury vapors left in the apartment, and if there are any left, it will help remove them.
It is better not to use mercury fluorescent lamps (fluorescent lamps) in residential premises at all. Remember that one mercury fluorescent lamp, broken in a medium-sized room, can create a concentration of mercury vapor in the air above the permissible limit.
1. All sockets, electrical appliances and lamps must be removed from grounded heating and water pipes and other metal communications in such a way as to prevent simultaneous contact with communications and an electrical appliance, cord or socket.2 It is dangerous to wipe dust off lighting fixtures and electric lamps with a wet rag. when they are energized. This should be done with the switch off, using a dry rag, standing on a non-conductive base. The presence of electrical wiring and electrical receivers with proper insulation is a guarantee of safety. Therefore, you should carefully protect the electrical wiring from damage: do not hang the electrical wire on nails, metal and wooden objects, twist or tie the wires in a knot, do not lay the wire and cords behind gas and water pipes, behind heating radiators; do not hang anything on the wires; do not pull the plug out of the socket by the cord; Do not pinch electrical wiring from doors and window vents. Painting or whitewashing external electrical wiring during renovation of premises can lead to destruction of the insulating material, electrical injury, and fire.3. A fire in an electrical wire must not be extinguished with water. It is necessary to first de-energize the network and then begin to extinguish the fire.4. Currently, the vast majority of apartments have electrical wiring completed in a hidden way(under plaster) during interior decoration premises construction organization carrying out repairs or installation of electrical equipment Naturally, the tenant does not have a diagram of the passage of wires along the walls of the apartment. Therefore, randomly driving nails and crutches into the walls for hanging pictures, curtains and other household items, as well as punching holes and grooves before familiarizing yourself with the internal (hidden) diagram electrical wiring can lead to damage and electric shock to a person.5. It is very dangerous to use portable electrical appliances: lamps, power tools near a heating radiator, water pipes and other grounded metal structures, since if the insulation is damaged electrical appliance or a lamp and touching metal structures a person may find himself in a chain of passage electric current 6. It happens that when you touch the body of an electrical appliance, water pipe, radiators, etc. electrocutes. This is a dangerous phenomenon! Means, this equipment is live due to some kind of damage electrical network. It is necessary to immediately disconnect the damaged device from the network, and if voltage appears on pipes, radiators, etc., immediately turn off automatic ones or unscrew ordinary plugs, then call an electrician on duty to repair the damage7. The procedure for connecting any electrical equipment to the network should be as follows. First, the cord is connected to the device, and then to the network. Switching off the device is done in the reverse order. Violation of this rule may result in electrical injury.8 In bathrooms and shower rooms, utility rooms and garages, in garden houses and basements, in damp rooms, as well as in rooms with earthen, brick and concrete floors When using electricity, special care must be taken. Firstly, in such rooms the insulation wears out faster. Secondly, the aggressive environment itself has a negative effect on isolation. Therefore, it is necessary to use electrical appliances and lamps of special design here. In rooms with a high concentration of water vapor (bathroom) or where there is no good ventilation, conditions are created for greater conductivity of electric current. Current rules for electrical installations prohibit the installation of sockets and switches in such rooms. They should be taken out into the corridor or into a room without high humidity. It is extremely dangerous to use portable electrical appliances and lamps connected to the network in such conditions, as well as to use stationary lamps without safety fittings.9. Do not touch live electrical appliances with wet hands. It is especially important to observe safety precautions when working and repairing washing machine. While the machine is operating, do not touch its body with wet hands. The main safety rule: no work related to the repair of electrical networks and household electrical appliances should be carried out under voltage. When using the electrical network and household electrical appliances caution, diligence, and attention are required.