A) Postural abnormalities and associated muscular and skeletal conditions. B) advantages/disadvantages in therapeutic exercise. C) types of postural stresses

Burn Victim Case Study – BIO 168 Chief Complaint: 7-year-old girl admitted for severe second- and third-degree burns following her rescue from a burning house. History: Helen Hogan, a 7-year-old white female, was transported by ambulance to the emergency room after being rescued from her burning house. She was asleep at night when a spark from the family fireplace started a fire, leaving her trapped in her bedroom. By the time the fire rescue squad arrived, she had suffered severe burns and excessive smoke inhalation. In the emergency room, Helen was unconscious. She had second-degree burns over 5% of her body and third-degree burns over 15% of her body -- both covering her thoracic and abdominal regions and her right elbow. Her vital signs were quite unstable: blood pressure = 55 / 35; heart rate = 210 beats / min.; and respiratory rate = 40 breaths / min. She was quickly deteriorating from circulatory failure. Two IVs were inserted and fluids were administered through each. Her vital signs stabilized and she was transported to the pediatric intensive care unit (ICU). Helen regained consciousness the following morning, surprisingly complaining of only minor pain over her trunk. Following debridement of her burns and application of a broad-spectrum, topical antibiotic, a plastic epidermal graft was applied over the burned areas. Despite treatment with a broad-spectrum antibiotic, she developed a systemic staphylococcal infection, necessitating a switch to a different antibiotic. Helen began a long, slow recovery. Her position in bed had to be changed every 2 hours to prevent the formation of decubitus ulcers (i.e. bedsores). She lost 9 pounds over the next 3 weeks, despite nasogastric tube feeding of 5000 calories ("Kcals") per day. After 9 weeks, sheets of cultured epidermal cells were grafted to her regenerating dermal layer. By the 15th week of her hospitalization, her epidermal graft was complete, and she was back on solid foods, her antibiotics were discontinued, and she was discharged from the hospital with a rehabilitation plan for both physical and occupational therapy at home, as well as twice-weekly visits by a nurse.

Questions: Research the following questions about Helen’s case fully using lecture notes, your textbook, and any other sources to help you. Answer in full, complete sentences using proper terminology.

1.Briefly describe the three major layers that make up healthy skin and the connective tissue that holds it on. What is found in each layer and what purpose does each layer serve?

2.Briefly describe the extent of damage seen in first-degree, second-degree, and third-degree burns. How are they different?

3.Why was Helen (the patient) relatively pain-free when she woke up? Would she have been pain-free if she had suffered first-degree burns rather than third-degree burns?

4.Explain why Helen’s blood pressure was so low and her heart rate so high upon arrival at the emergency room.

5.Why was it important to immediately administer intravenous fluids to Helen?

6.What is a “broad-spectrum” antibiotic, and why did Helen need one so quickly?

1. Elders with PEM will likely present with?
   1. Obesity, anemia, and elevated serum cholesterol
   2. Recent weight gain, reduced serum albumin (a biomarker of protein status), and fatigue
   3. Recent weight loss, anemia, and reduced serum albumin (a biomarker of protein status)
   4. Weight loss, osteoporosis, and recent broken bone
2. Treatment for coronary heart disease includes which of the following?
   1. Dietary management – The DASH diet
   2. Physical activity
   3. Medications
   4. a and c only
   5. All of these
3. Which of the following statements is true?
   1. Elders with a BMI over 30 kg/m² are obese and need to reduce their BMI to less than 25 kg/m²
   2. Serum cholesterol levels < 200 mg/dL is an increased risk for protein-energy-malnutrition
   3. Low serum albumin levels and weight loss are predictive of hospital readmission and LOS (length of hospital stay)
   4. Serum albumin is the best indicator of malnutrition due to its short half-life
4. Which physiological change that occurs with aging does not influence nutrient metabolism?
   1. Decreased lean body mass
   2. Increased proportion of body fat
   3. Decreased body water
   4. Decreased height
5. The majority of older adults do not use dietary supplements.
   1. True
   2. False

Explain why it is beneficial for regulation of fasting blood glucose concentrations that the liver express

Glucokinase (Type IV hexokinase) rather than hexokinase type I or II?

How is partial pressure of a gas determined?

What factors cause the oxyhemoglobin dissociation curve to shift downward and to the right to reflect enhanced unloading?

Describe how anatomy and physiology are closely related. why is it difficult to separate anatomy from physiology

Hyperparathyroidism questions:

1. Based on what you know about the targets of parathyroid hormone, predict the symptoms and complications of hypersecretion of this hormone.

2. Where would the dysfunction be occurring in this condition?

3. Identify the actual complications by searching online: Why would these complications occur?

4. How could this condition be diagnosed?

What is the difference from general somatic afferent fibers and special somatic afferent fibers? Is it possible for a nerve to have more than 1 fiber classification? Which nerve classification is responsible for conducting sensory impulses to the brain from the receptors of hearing and sight?

Why is acidosis more common than alkalosis?

• What is the difference between nutrition "recommendation" and "prescription?"
• What are the risks and possible alternatives of dietary supplementation?
• What are the risks of crash, fad, and myth diets; how do they affect exercise?

An otherwise healthy 30 year old male is being observed in the Emergency Department for chest discomfort. Blood pressure is 140/95 mmHg, respiration rate of 24/minute. Temp 98.9 F. By cardiac monitor, heart rhythm is normal, with normal intervals. A normal QRS complex follows each P wave. A 6 second rhythm strip shows 8 QRS complexes. An ECG is normal. On echocardiogram, all cardiac chambers and heart valves are normal in appearance. Left ventricular end diastolic volume is 100 ml. Left ventricular end systolic volume is 40 ml. All calculations and units must be included in calculations for full credit.  Calculate heart rate. __________________________  Calculate stroke volume. __________________________  Calculate left ventricular ejection fraction. __________________________  Calculate cardiac output. __________________________  Calculate mean arterial pressure. _______________________

A patient appears to have “white coat” hypertension- very high blood pressure when they come to the doctor’s office. When they are relaxed at home, blood pressure is fairly normal. Blood tests show that the patient has high sodium levels and low potassium levels during these periods of hypertension. Additionally, the patient’s medical records also showed that blood pressure rises unusually during fasting and illness as well, and that they had to stop taking an anti-inflammatory drug due to hypertension as a side effect. The physician talks to a colleague who is an endocrinologist specializing in genetics (to the rescue!).

The endocrinologist concluded that the patient might have inherited a mutation that affects the activity of a steroid hormone receptor (Receptor A) that binds to a steroid hormone (Hormone A) that plays an important role in blood pressure regulation. She found that the patient has a mutation that allows Receptor A to be activated even better by a second, related steroid Hormone B. Hormone B can now, by accident, strongly activate Receptor A even within the normal range of blood levels regulated by its negative feedback loop.

• Hormone A: What is Hormone A? What regulates its secretion? What cells secrete it? What is its normal physiological role?
• Hormone B: What is Hormone B? What regulates its secretion? What cells secrete it? What is its normal physiological role?

Which environment separated by the respiratory membrane would display the highest oxygen partial pressure?

A)Pulmonary capillary blood

B) Alveolar air

PLEASE EXPLAIN

The Renin-Angiotensin-Aldosterone Pathway and the roles that the kidney plays in the human body and how it works to keep the body in balance. Include what happens if there is a homeostatic imbalance as it plays this role.

1. How does the heart rate from the subject at rest, immediately after exercise, and at 1 min, and 2 min after exercise compare? Explain the physiology reasons for any differences.

2.What is occurring during the P-Q interval? How do the average P-Q intervals from rest and each time interval compare? How does the average at rest value compare to the "normal" value?

3. How does the average pulse-wave amplitude from rest and each time interval compare? Explain any variations.