Case Scenario

Mrs Lee is a 60 years old woman. She is the housewife and lives with his husband and son in the public estate. Last week, she went to the wet market for buying food and groceries. She slipped fall on the street. Her right upper arm and armpit region were hit on the kerb. She went home and massage the armpit and upperarm immediately with massage oil. However pain over upper arm and armpit were still. At evening severe bruising was noted over upper arm and also the axilla. Mrs Lee was admitted to A&E department. She complaint numb over upper arm and could not move her wrist. Her X-ray indicated fractures over proximal part of humerus and she was sent to the ward for further treatment. The examination showed that her shoulder movement was limited due to pain elicited and muscle weakness. Numbness was also noted over upper arm, forearm and dorsum of the right hand. Sensory test showed that diminished sensation, only pain sensation was intact. She had weakness in wrist movement. Right hand grip was normal. Please answer according to the following guidance:

1. According to Mrs Lee condition, please indicate the structures that were involved in this accident? a) List out the fracture sites along the humerus with Mrs Lee presentation and the bony landmarks. b) List out the artery (arteries) and vien (veins) involved in this accident c) List out the nerve (nerves) that would be invloved in this accident

2. What is/are movement limitation that Mrs Lee would come across and please explain the reason underneath.

3. Please describe the sensation issue of Mrs Lee and explain the type/mode of injury resulting in present condition.

Case scenario

Mr. C, 50 years old, is an amateur soccer player who regularly plays with his friends over weekend. He has chronic anterior right hip pain and weakness over his groin region for 5 years. One day, when he was playing soccer, he was injured by another player who crushed on him from lateral side of his left leg. Then, he fell down on the grassland after twisting his left knee and ankle due to the crush. He started to feel pain and weakness over his left leg from knee to ankle. He could not move his left leg to stand up. When he fell down, he fell on the leg of that player which caused pain, swelling, numbness and weakness over the posterior side of his own left leg. Then, he was send to the emergency room of a nearby hospital. The doctor of the emergency room of the hospital assessed his legs and arranged X-ray check for him. Your supervisor asked you to identify all key anatomical structures in the initial assessment that are related to his hip, knee and ankle discomfort according to the above information. You need to provide clear rationale to support your answers when you report to your supervisor. Please answer according to the following guidance:

1. What bone(s), bony landmark(s) and joint(s) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons.

2. What muscle(s) and soft tissue(s) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons. The relevant origin and insertion should be included.

Case Scenario

Mr. Chan (40 years old) is a computer programmer and needs to spend long periods on computer work during daily work. He went to the clinic and complaint that he has neck pain over the past two months. He also had the feeling of pain and numbness radiate from the neck into the right shoulder and right arm, and numbness over his thumb.

Physical examination revealed pain and numbness was mainly over right deltoid and biceps brachii muscles, and over the lateral side of the thumb. Report from the magnetic resonance imaging showed that the spinal canal in his cervical vertebral column was narrowed. After initial management, the doctor sent Mr. Chan to your team for further follow up. Your supervisor told you to give Mr. Chan an introduction of the spinal structure at neck region.

Please answer according to the following guidance:

1. List the name and numbers of vertebral column in 5 regions. Compare and contrast three main characteristics of typical cervical vertebra, thoracic vertebra, and lumbar vertebra.

2. How does the intervertebral foramen formed and what contents can be found in the vertebral canal?

3. How many cervical spine nerves do we have? When a cervical spinal nerve exits the spinal cord through the intervertebral foramen, what’s the relationship of this nerve with its corresponding vertebra? How about the relationship of the spinal nerves in thoracic and lumbar regions with their corresponding vertebrae?

4. In Mr. Chan’s case, name the nerve roots which were compressed that resulted in the pain and numbness. State the reasons that support your answer.

I need an answer to this question. If you can describe it in 250 words that would be great. Thank you in advance.

Select one stress-hormone and one water-hormone and describe how they change during an acute bout of aerobic exercise. Next, describe how their actions help to provide energy and conserve water, respectively, during exercise. Please be sure to cite all sources of information used in your post

How are systolic and diastolic blood pressures measured with a sphygmomanometer?

what happens to STDP(spike timing dependent plasticity) if all biological neuron in brain just generate inhibitory postsynaptic potential(IPSP) not generate EPSP?why?

1. The branching structure at the end of each neuron is the _____.

Group of answer choices

dendrite

synergy

axon

myelin sheath

Question 2. The function of the myelin sheath is to:

Group of answer choices

provide a barrier between the brain and the body.

get rid of the neurons a person does not need.

help neural impulses flow quickly.

allow the skull bones to close.

Question 3. Newborn reflexes typically:

Group of answer choices

disappear as the cortex matures.

develop months after birth.

are under conscious control.

have no useful function.

Question 4 .A mother of a newborn tells her doctor, "When something touches my baby's cheek, she turns towards it and begins to suck." Her doctor should respond by saying:

Group of answer choices

"This is normal. It's called the sucking reflex."

"This is abnormal. Go get medical help."

"This is great! Your baby will be intellectually advanced."

"This is normal. It's called the rooting reflex."

Question 5 Which is a possible advantage of breast-feeding?

Group of answer choices

This activity makes new mothers slim.

Breast-feeding helps promote mother–baby bonding time.

This activity decreases babies' immunities to disease.

Breast-feeding can lead to reduced myelin formation.

Question 6. Visual capacities:

Group of answer choices

worsen throughout childhood.

improve in many ways during the first year of life, but babies also lose sensitivity to visual differences they don't need.

improve throughout childhood.

have no relationship to later social preferences.

Question 7. When does depth perception or fear of heights fully develop?

Group of answer choices

at different ages, depending on a baby's scores on intelligence tests

at around the time babies become mobile

at birth

at 1 month of age

Question 8. Which is the correct sequence of motor milestones?

Group of answer choices

lift head; pivot upper body; sit

lift head; sit; pivot upper body

sit; pivot upper body; lift head

pivot upper body; life head; sit

Question 9. Which is the correct order for language acquisition?

Group of answer choices

cooing; babbling; holophrases; telegraphic speech

telegraphic speech; cooing; holophrases; babbling

holophrases; cooing; babbling; telegraphic speech

babbling; cooing; telegraphic speech; holophrases

Question 10. Harlow's findings with motherless monkeys showed that physical contact (or love) is:

Group of answer choices

less important than food.

an overrated human need.

not really that important.

a basic need.

Question 11. A baby's temperament is:

Group of answer choices

due to poor mothering.

based on the environment.

biological or inborn.

due to poor feeding.

Can you paraphrase the following rationale for me, thank you!

Urinary System

1. Blood in the renal arcuate arteries flows next into which vessels?

a. Afferent arterioles

b. Efferent arterioles

c. Glomerular capillaries

d. Interlobar arteries

e. Interlobular arteries

Rationale:

The blood that goes to kidneys passes thru the INTERLOBAR ARTERIES first before flowing in the renal arcuate arteries. Then it goes to INTERLOBULAR ARTERIES passing thru AFFERENT ARTERIOLES then GLOMERULAR CAPPILLARIES before reaching EFFERENT ARTERIOLES.

2. Which cell type comprises the visceral layer of Bowman capsule?

a. Endothelial cells

b. Juxtaglomerular cells

c. Mesangial cells

d. Podocytes

e. Extraglomerular mesangial (or Lacis) cells

Rationale:

The inner wall of Bowman's capsule is a visceral layer, and it is composed of podocytes that closely surround the glomerular capillary tuft. Thus making Podocytes highly specialized cells of the kidney glomerulus that wrap around capillaries and that neighbor cells of the Bowman’s capsule. This cell plays an active role in glomerular filtration by preventing plasma proteins from entering the urinary filtrate by providing a barrier comprising filtration slits between foot processes, which act as dynamic network of cellular extensions.

3. Which type of epithelium lines the thick ascending limb of the loop of Henle?

a. Pseudostratified columnar

b. Simple columnar

c. Simple cuboidal

d. Simple squamous

e. Transitional (urothelium)

Rationale:

The loop of Henle consist of two long loop lengths: one is the short loop that descends to the cortical-medullary border, and a long loop, which ascend to the renal papilla. Furthermore, there are 3 parts of Loop of Henle. (a) The short Henle loops have a descending thin limb and a thick ascending limb. The long Henle consists of thin descending and ascending thin limb followed by pars recta of the distal tubule. (b) The thin parts of the loop of Henle are lined with a single-layer flat epithelium with a high permeability for water (and ions via solvent drag) through a weak tight junction (zonula occludens). (c) The thick ascending limb of the Henle loop is lined by simple cuboidal cells without a brush border. These cells are specialized to perform a secretion and reabsorption of the substance resulting to the production of urine.

4. Which cell is a modified smooth muscle cell that secretes renin?

a. Macula densa cells

b. Mesangial cells

c. Podocytes

d. Juxtaglomerular cells

e. Endothelial cells

Rationale:

Juxtaglomerular cells are located near glumerulus that highly that synthesize, store, and secrete the enzyme renin. They are made up of specialized smooth muscle cells mainly resides on the walls of the afferent arterioles (and some in the efferent arterioles) that transport the blood to the glomerulus. In synthesizing renin, they play a crucial role in the renin–angiotensin system and thus play the role in self- regulation of the kidney.

5. Epithelial cell membrane domains containing many stiffened plaques of protein are an important feature in which part of the urinary system?

a. Juxtaglomerular apparatus

b. Bladder mucosa

c. Collecting ducts

d. Renal pyramids

e. Membranous urethra

Rationale:

The urinary bladder functions as storage reservoir for urine. Anatomically, urinary bladder is located in the pelvic cavity, posterior to the symphysis pubis, and below the parietal peritoneum. It composed of smooth muscle lining wall that is covered by a bladder mucosa thus separating muscle from the urine.

6. An immunohistochemical technique using antibodies against aquaporins to stain a section of kidney would be expected to stain cells in which structures most intensely?

  a. Collecting ducts

  b. Lining of the major and minor calyces

c. Proximal convoluted tubules

  d. Distal convoluted tubules

  e. Glomeruli

Rationale:

Immunohistochemical technique is used to detect antibody that was present in the specimen. Therefore, antibodies will aggregate where the antigens are. Since aquaporin antibodies is the basis of immunohistochemical technique stain, the target of the antibodies are the aquaporin that was found in the kidney which located at segment of collecting ducts.

7. What type of epithelium lines the prostatic urethra?

a. Simple columnar

b. Pseudostratified columnar

c. Stratified squamous

d. Simple squamous

e. Transitional (urothelium)

Rationale:

The transitional epithelium are the unique cell type structure that possess a high plasticity and defense mechanism for urethra. The urothelium stretch when filling phase of micturition reflex takes in place resulting umbrella cells to increase in size thus activation of the sensory fibers.

8. A 14-year-old patient presents in the nephrology clinic with fatigue, malaise, anorexia, abdominal pain, and fever. She reports a loss of 6 lb in the past 2 months. Serum gamma globulin and the immunoglobulins IgG, IgA, and IgM are all elevated. Her serum creatine is 1.4 mg/dL (normal 0.6-1.2 mg/dL) and urinalysis of glucose and protein are 2+ on a dipstick test, confirmed by laboratory at 8.0 g/ dL and 0.95 g/dL, respectively. A renal biopsy is prepared for light microscopy, and an infiltrate containing lymphocytes, plasma cells, and eosinophils is found among tubules having cells with prominent brush borders. Which one of the following statements correctly pertains to these epithelial cells?

a. Impermeable to water despite presence of ADH

b. The primary site for the reduction of the tubular fluid volume

c. The site of the countercurrent multiplier

d. The site of action of aldosterone e. Indirectly involved in the release of renin

Rationale:

The primary site for the reduction of the tubular fluid volume takes place mainly in proximal convoluted tubule of the nephron. Since prominent brush borders are present to the biopsy that can be only seen in PCT, PCT are the affected cell.

9. A 45-year-old man presents with nephrolithiasis or kidney stones. The process of calcium oxalate stone formation as seen in this patient begins with Randall plaques found in the basement membranes of which one of the following structures found only in the renal medulla?

a. Proximal convoluted tubules

b. Distal convoluted tubules

c. Thin loops of Henle

d. Afferent arterioles

e. Collecting ducts

Rationale:

Randall’s plaque is plaque of calcium deposited in the tissue of the renal papilla. Large amounts of Randall’s plaque plays a vital role as pre requisite to form a kidney stone. Calcification happens at the basement of loop of henle and from there, Randell plaques spread throughout kidney toward urothelium. Due to the failure on urothelium, plaques can be exposed to urine resulting to formation of renal stones. Renal stones are formed within the collecting ducts of kidney resulting to growth of crystals into stones that later will calcified. This calcified stones located in the basement membrane of the loops of Henle, from which it extended into the medullary cavity.

10. A 15-year-old male presents with hematuria, hearing loss, lens dislocation, and the onset of cataracts. Genetic analysis reveals a mutation in the COL4A5 gene. Transmission EM examination of a renal biopsy confirms that the disorder has affected a component of the renal corpuscles in which damage disrupts normal glomerular filtration. Which one of the following structures would most likely be abnormal in the TEM of this patient’s biopsy?

a. Pedicels

b. Filtration slits

c. Slit diaphragms

d. Glomerular basement membranes

e. Fenestrated endothelium of glomerular capillaries

Rationale:

COL4A5 is a gene mutation that causes a changes to a protein called collagen. Collagen was known important to the structure and function of the kidney. This changes to protein can lead on hearing loss and eye problem. This gene is known to be present to those patients who is suffering Alport syndrome. Alport syndrome is a disease that damages the blood vessels inside the kidney that result to loss of kidney function. It is known to cause hematuria by the attacking the glomerular basement membrane. Glomerular basement membrane is a unique thick basement membrane that keeps kidney’s filtration barrier. The glomerular basement membrane is made up of podocyte and endothelial cell basement membranes throughout glomerulogenesis.

Can you paraphrase the following rationale, thank you!

1. Which function is carried out by all lymphoid tissues and organs?

a. Filtration of lymph

b. Filtration of blood
c. Extramedullary hemopoiesis
d. Production of lymphocytes
e. Destruction of old erythrocytes

Rationalization: Filtration of blood, extramedullary hemopoiesis, destruction of old erythrocytes occurs in spleen, but filtration of lymph occurs in lymph nodes. All of the lymphoid tissues and organs function in the production of lymphocytes

2. Which structure is partly encapsulated and covered by nonkeratinized stratified squamous epithelium?

a. Appendix

b. Lymph node

c. Palatine tonsil

d. Peyer’s patch

e. Thymic (Hassal’s) corpuscle

Rationalization: Palatine tonsil is located in the posterior lateral walls of the oral cavity, it means that it is prone to abrasion and stratified squamous forms thick layer of cells to protect against abrasion and acts as a mechanical barrier.

3. Which cell type gives rise to both memory and effector cells and is primarily associated with humoral immunity?

a. B lymphocyte

b. Nk cell

c. Macrophage

d. T lymphocyte

e. Reticular cell

Rationalization: Given with the clue “humoral immunity” B lymphocyte is known to be responsible for secreting antibodies (specifically Plasma B-cell)

4. Recycling of iron and heme, the major complex containing iron, occurs most actively in which lymphoid organ(s)/ tissue?

a. Lymph nodes

b. Peyer’s patch

c. Tonsils

d. Spleen

e. Lymphatic vessels

Rationalization: Spleen is responsible for filtration of blood

5. Which description is true of all secondary (peripheral) lymphoid organs?

a. Capable of antigen-independent lymphopoiesis

b. Contain crypts

c. Contain epithelial-reticular cells

d. Lack connective tissue capsules

e. Contain lymphoid nodules

Rationalization: Antigen-independent lymphopoiesis occurs in primarily in lymphoid organs, secondary lymphoid organs are surrounded by connective tissue

6. Which structure would be most heavily labeled by an immunohistochemical method targeting the CD8 surface antigen

a. Germinal centers

b. Paracortex

c. Peyer’s patch

d. Sheathed arterioles

e. Splenic cords

Rationalization: The paracortex of contains lymphoid tissue rich in T-cells distinguishable by immunohistochemistry.

7. A baby is born with a cleft palate and a condition called DiGeorge syndrome, which involves failure of third and fourth pharyngeal pouch derivatives to develop properly. The palate defect is corrected surgically, but regarding the pharyngeal pouch defect the parents are advised that the growing child may expect which of the following health problems?

a. Insufficient B-cell production by lymph nodes in the head and neck

b. Inability to secrete IgA

c. Excessive numbers of circulating but defective erythrocytes

d. Increased oral infections due lack of palatine and pharyngeal tonsils

e. Conditions related to autoimmunity

Rationalization: There are common problems that occur in DiGeorge syndrome such as heart defects, hypothyroidism, thymus gland dysfunction, cleft palate and developmental problem. Due to small or absence of thymus, may have increased risk of autoimmune diseases.

8. Many immune-related cellular activities are often impaired in aged patients. Which lymphoid organ(s) normally develop less functionality and increasing amounts of adipose tissue with age?

a. Axillary lymph nodes

b. Lingual tonsils

c. Thymus

d. Splenic white pulp

e. Splenic red pulp

Rationalization: Because as we grow old, thymus gland begins to deteriorate and less functional. Thymus is the site of T-lymphocyte differentiation and selection, it is most active during neonatal and pre-adolescent period.

9. A 12-year-old girl of African descent presents with anemia and a large percentage of her peripheral erythrocytes appear sickle-shaped. Genetic testing reveals homozygosity for sickle cell disease. In which of the following sites will the abnormal RBCs be removed from the circulation?

a. Thymic cortex

b. Periarteriolar lymphoid sheathes of splenic white pulp

c. Medullary sinuses of lymph nodes

d. Thymic medulla

e. Splenic cords (of Billroth)

Rationalization: Because the red pulp is composed almost entirely of splenic cord (of Billroth) and splenic sinusoids and it the site where the effete RBC in blood are removed.

10. A 6-year-old boy is brought to the clinic where his mother reports that he was bitten by a neighbor’s dog two days earlier. The child’s right hand is lacerated between the thumb and index finger and this area is inflamed but healing. The doctor’s examination reveals small but painless swellings beneath the skin inside the right elbow and armpit and he explains to the mother that these are active lymph nodes enlarged in response to infection in the hand. What has produced swelling?

a. Increased flow of lymph through the nodes’ afferent lymphatics

b. Formation of germinal centers for B-cell proliferation in each node’s cortex

c. Arrival of antigen-presenting cells in each node’s medulla

d. Enlargement and increased activity of the nodes’ high endothelial venules

e. Increased thickness of each node’s paracortex

Rationalization: It was the immune response of B-cell to invading pathogens. Antibodies are secreted by plasma cells that arise by terminal differentiation.

1. Which is/are formed during the embryonic stage?

Group of answer choices

circulatory system alone

brain alone

major body organs

digestive system alone

2. The brain forms during

Group of answer choices

the germinal phase

the fetal stage

birth and delivery

the embryonic stage

3. Professor Misra is an evolutionary psychologist. To explain morning sickness, what statement would he make

Group of answer choices

"Morning sickness evolved to protect the embryo from poisonous foods."

"Women who have morning sickness are at high risk for miscarrying."

"A woman who has morning sickness is unconsciously rejecting her fetus."

"Morning sickness is all in the mind. Women who expect to get sick, do."

4. A teratogen:

Group of answer choices

develops during the third trimester of pregnancy.

is a poisonous substance that crosses the placenta, harming the fetus

is a gene that causes a birth defect.

enters the ovum with the sperm

5. Which prenatal test samples the fluid that surrounds the fetus

Group of answer choices

measurement of gestational age

amniocentesis

3-D ultrasound

ultrasound

6. Which is the correct order of events during labor?

Group of answer choices

expulsion of placenta; birth; dilation and effacement

dilation and effacement; birth; expulsion of placenta

dilation and effacement; expulsion of placenta; birth

birth; dilation and effacement; expulsion of placenta

Two infants are in NICU. One has meconium aspiration syndrome (MAS) while the other has an alpha 1- antitrypsin (AAT) deficiency, which has led to development of sever emphysema. Briefly discuss the basis behind these tow pathophysiological states. For both these patients, what is the change in lung compliance and why does this change occur? Which of these patients would benefit from artificial surfactant treatment?

Hindlimb muscles on you:

5 types were the biceps femoris , the tensor fascia latae , the hamstring muscles (semimembranosusand semitendinosus) , the quadriceps femoris , the gastrocnemius(or “calf” muscle)

Try and copy the movements listed with each of the five hindlimb muscles above. As you do this, which one is easiest for you to understand? Which is the hardest to understand? Why?

Fill out the following chart with each of the five leg muscle (groups). Answer each question with which muscle is primarily used-in other words,you have many muscles and each movement uses many of those muscles, but think about which one is doing most of the work. Use the specimens, descriptions, and your own life experience.

What muscle is used when you go up on your tippy toes?

What muscle is used when you stretch out your legs while seated?

What muscle is used to march?

What muscle is used to swing your leg backwards while standing?

What muscle is used to kick yourself in the bum?

Cardiac Physiology Prelab

Match the following placing the letter in the appropriate space. Place your name of this sheet before submitting