On one particular day, two patients were brought in to a local emergency room, each with different signs and different prognoses, but each with the same underlying disease, stroke.

The first patient, a 70-year-old male, arrived by ambulance and was accompanied by his elderly wife. The patient was awake and alert, but was unable to move independently due to paralysis on his right side. He looked responsive and seemed to understand what was said to him, but he could not speak. His condition was first discovered by his wife when she woke him that morning. She called 911 when she realized that her husband could not get out of bed, he was unable to move his right arm and leg, and he could not talk to her.

The second patient arrived a few hours later, also by ambulance. Unlike the first patient, this woman was unconscious. She was breathing on her own and she showed no signs of paralysis. Her daughter had discovered her sitting in her chair, slumped over the table. She had been unable to arouse her and called 911.

CAT-scans were done on both patients and confirmed the tentative diagnosis of stroke. They were immediately treated with clot-dissolving drugs, in hopes of stopping more progressive damage. In Patient #1's case, the CAT-scan revealed a blockage in the left middle cerebral artery which supplies the posterior portion of the frontal lobe called the pre-central gyrus. In the case of Patient #2, the blockage was seen in the basilar artery which supplies the brainstem

1. What is the function of the two different areas of the brain affected in these two different cases of stroke? How does that account for the differences seen in Patient #1 and Patient #2?
2. What would account for Patient #1 seeming to understand what he heard, but not be able to speak? If the stroke had affected the first patient's right cerebral artery instead, would the outcome have been different?
3. Why was patient #2 unconscious? What are the underlying causes that lead to unconsciousness.
4. Are there any differences in prognoses for these two patients?

Tom is diagnosed with obesity and hypercholesterolemia and failed to see improvements with diet and exercise.

1. What other therapies are available to Jack and how do these therapies work against obesity?

2. Name two cardiovascular diseases that Jack is likely to develop.

What is the difference between resting potential and repolarization?

- Resting potential is maintained by leaky potassium channels. Repolarization occurs when potassium leaves the cell (and sodium channels are closed preventing sodium entry into the cell) causing the membrane potential to become more negative.

- Resting potential is maintained by leaky potassium channels. Repolarization occurs when potassium enters the cell causing the membrane potential to become more negative.

- Resting potential is maintained by potassium entry into the cell. Repolarization occurs when sodium levels increase inside the cell.

- Resting potential resets the neuron to by adjusting the sodium and potassium levels. Repolarization is when potassium is leaking out of the cell to make the cell more negative.

1-1. Ecstasy or MDMA uses a unique mechanism; it binds to the serotonin reuptake transporter and does two things. Ecstasy stops serotonin reuptake and causes the transporter to reverse direction, moving serotonin from the synaptic terminal into the synapse. Due to this mechanism, what effect will ecstasy have on postsynaptic neurons? (Include in your answer whether EPSP or IPSP is affected.)

1-2. The pharmaceutical company is looking to introduce a new drug that enhances neurotransmission. Knowing what you know about the physiology of neurotransmission, the company is asking you what part of the pathway you would recommend targeting and how that would enhance neurotransmission. Explain how your drug would work and what part of neurotransmission your drug would target.

1). How does the number of muscle fibers found in various motor units differ? For example, the number found in a motor unit of a muscle that moves the eye and the number found in a motor unit in the calf muscle.

2). Briefly describe the difference between fast-twitch and slow-twitch muscle fibers. Are fibers of the same type found in a single motor unit?

3). Explain the nervous system’s role in increasing the force of contraction and potential ways to avoid fatigue.

4). Explain the physiological factors associated with various types of fatigue (either central or peripheral).

11. Define Chondromalacia Patella.

12. List 3 guidelines for working with clients with Chondromalacia Patella.

13. For clients with knee ligament instability/injury, what should you try to limit when designing their exercise program?

14. Define "Anterior Impingement Syndrome", and what types of repetitive movements lead to this chronic injury?

15. List 3 key to the management of Low Back Pain.

ONLY FILL OUT THE TABLE AND ANSWER THE QUESTION BELOW THE TABLE

Fourth workout design – Knee Ligament Instability (5 points)

Your client is a 29 year-old man that tore his ACL, MCL, and medial meniscus 12 months prior while skiing. He had surgery to repair all three structures 10 months ago, and has completed 3 months of physical therapy. His goals are to continue to strengthen his hamstring muscles (physical therapy), reduce the occasional swelling and pain he has in the knee, and he would eventually like to resume skiing (with a brace).

Give a 3 to 4 sentence explanation of why you chose this workout for this client.

Chief Complaint: 68-year-old man with a cough and dyspnea ("shortness of breath") for the past week.

History: Daniel McDonald, a 68-year-old white male with a 40-pack-year smoking history suffered from chronic bronchitis for which he had been on antibiotics for several months. Two weeks ago, he began coughing up a bloody sputum ("hemoptysis"). In the past week he's become increasingly short of breath. A routine chest X-ray revealed two silver dollar-sized opacities on the right side of the carina. Bronchoscopic examination revealed a tumor that was nearly occluding the right mainstem bronchus. A bronchial biopsy revealed the diagnosis: bronchogenic carcinoma.

Explain why this man has bloody sputum ("hemoptysis").

Explain why this man has shortness of breath ("dyspnea").

If you examined the cancerous tissue under the microscope, how might the cells differ in appearance from normal bronchial epithelium?

How might this type of cancer metastasize (i.e. spread to other parts of the body)? In other words, by which routes might the cancer cells reach other organs?

Why is the surgical removal of a lung cancer so ineffective in halting the disease?

Identify and compare two primary and two secondary lymphoid organs

Calculate the # of ATP produced from the complete oxidation of 1 glucose molecule during rest?

Ryan is finishing his trail half marathon and starts to sprint the last half mile of the race. During this time Ryan’s legs really start to burn. Describe, in detail, what is happening metabolically in his muscles during this last half mile. Elaborate on how this affects the rest of the metabolic pathways.

Q1. Kwasi Manu (a 54-year-old man) examined by an ophthalmologist was found to have a
bitemporal hemianopia. Radiologic and biochemical examinations showed the pituitary gland to
be of normal size and function.
a) What visual pathway structure is responsible for the visual field defect - bitemporal
hemianopia?
b) What other anatomic structure, if enlarged, might press on the visual pathway structure
named in (i) above?

Q2. Dr Serwaa examined the fundi of a 30-year-old man by means of an ophthalmoscope. Dr
Serwaa was experiencing difficulty distinguishing between retinal arteries and veins. What are
the normal visible differences between retinal arteries and veins?

Q3. An inflammation of the ciliary body and iris may give rise to a so-called ciliary injection.
Describe the arteries that give rise to the ciliary injection.

Q4. What is the innervation of the sphincter and dilator pupillae muscles?

Q5. Corneal deturgescence is dependent upon:
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in 1-2 sentences describe why this statement is false:

The humoral immune response involves Natural Killer T Cells that function to degrade ‘non-self’ foreign cells or cells that are infected with pathogens.