18. Explain the process of reabsorption using the following structures.

a. Tubular Lumen, Tubular cells, Tubular fluid, Peritubular fluid, Peritubular capillary

****PLEASE USE THESE TERMS

If calcium binding sites on troponin proteins were blocked by 25%, how would this impact the maximum contractile force of a muscle fibre in the context of the cross bridge cycle?

1. Regarding countercurrent mechanisms:
   1. List which structure(s) is/are responsible for establishing the concentration gradient in the renal medulla? Describe how this is accomplished. (5 points)
      1. Note: You do not need to describe the entire positive feedback loop, I am looking more simply for structures or structural modifications and functions of those structures. Do mention how the tubular fluid concentration changes and the interstitial fluid of the medulla is affected as a result.
   2. List which structure(s) is/are responsible for maintaining the concentration gradient in the renal medulla? Describe how this is accomplished. (2 points)
   3. ACE inhibitors (angiotensin converting enzyme inhibitors) are a popular class of drug that treats hypertension. Use your knowledge of the renin-angiotensin-aldosterone system to describe the physiological mechanism of how this medication works at the nephron and kidney level to reduce blood pressure. (3 points)
   4. Predict how ADH hypersecretion would affect the sodium concentration of the urine, and explain why. (2 points)

Case Study 5 - Swallowing

Sarah Miller is a 48 yo female who admitted to the ED with right hemiparesis, dysarthria and a reflexive cough while taking small sips of water. MRI of the brain confirmed an MCA distribution stroke. A bedside swallow evaluation was ordered which revealed the following: R facial droop with moderately dysarthric speech. Tongue deviates to the right on protrusion. Lips strength is moderately impaired. Palpation of larynx/hyoid during a dry swallow revealed mildly reduced laryngeal elevation/excursion. Vocal quality is soft and breathy. Unable to complete diakochokinetic rate due to poor approximation and coordination of movements.

1. Name 3 cranial nerves you think could be damaged and explain why? (6)

2. What indications (ie symptoms) do you subjectively consider based on the patient’s presentation (prior to initiating the exam) just based off of what you see, hear and have read about the medical history? (2)

3. What does the inability to complete the diadochokinetic rate tell you about the patient’s speech/swallow deficits? (2)

A 50-year-old man, who is a chronic alcoholic, presents to the emergency room with a sudden onset of abdominal pain that radiates to the back. A blood test reveals elevated serum pancreatic lipase levels and a CT abdomen suggests inflamed pancreas. Both of these findings together confirm the diagnosis of acute pancreatitis. The patient was admitted and appropriately managed. The pain reduces over the next two days. On day 3, the patient reports worsening of pain, nausea, and vomiting. An emergency CT abdomen was ordered, and the images reveal a pseudocyst around the pancreas. A pancreatic pseudocyst is a cavity surrounding the pancreatic head filled with pancreatic enzymes and is a common complication following acute pancreatitis. In a few hours following the diagnosis, the patient’s symptoms worsen, develops a fever, hematemesis (blood vomiting), cold and clammy skin, multi-organ failure, and dies. As a physician, you think that the patient developed these complications and died because the pancreatic pseudocyst ruptured. Based on the knowledge learned in this course, provide an explanation as to why this rupture led to complications and death of the patient.

Clue: Think about what the functions of pancreatic enzymes are, and why these enzymes are secreted first in an inactive form and not directly in an active form.

David, a 55 year old high school teacher is a heavy smoker with really poor eating habits. He was admitted to the ER a week ago because he was experiencing symptoms including shortness of breath, chest pain, weakness in his left arm and left leg. He was rushed to the Coronary Care Unit, where clinicians performed Electrocardiogram (ECG) and arteriogram tests. Results showed 80% occlusion of the left main coronary artery.

1. What condition does he have? a) dilated cardiomyopathy, b) atherosclerosis, c) myocardial infarction, d) cardiac arrhythmia, e) endocarditis

2. Which treatment is David most likely to receive for this condition?

3. What are the risk factors for this condition?

4. What are the underlying mechanisms (causes) that result in this condition?

Acquired (adaptive) immunity allows the immune system to respond to a large number of antigens with a strong targeted response. Please briefly explain this statement

give me REFERENCE to these question with APA 7....in text format, please....

1: Minute arteries bring blood to areas deep inside the brain. Hypertension can cause minute arteries to rupture, releasing blood into the brain tissue. An intracerebral hemorrhage is usually caused by rupture of tiny arteries within the brain tissue. Ans 2: At the base of the brain, the carotid and vertebrobasilar arteries form a circle of communicating arteries known as the Circle of Willis. From this circle, other arteries—the anterior cerebral artery, the middle cerebral artery , the posterior cerebral artery arise and travel to all parts of the brain. Because the carotid and vertebrobasilar arteries form a circle, if one of the main arteries is occluded, the distal smaller arteries that it supplies can receive blood from the other arteries. The anterior cerebral artery extends upward and forward from the internal carotid artery. It supplies the frontal lobes, the parts of the brain that control logical thought, personality, and voluntary movement, especially of the legs. The middle cerebral artery is the largest branch of the internal carotid. The artery supplies a portion of the frontal lobe and the lateral surface of the temporal and parietal lobes, including the primary motor and sensory areas of the face, throat, hand and arm, and in the dominant hemisphere, the areas for speech. The posterior cerebral arteries stem in most individuals from the basilar artery but sometimes originate from the ipsilateral internal carotid artery. Small, deep penetrating arteries known as the lenticulostriate arteries branch from the middle cerebral artery Occlusions of these vessels or penetrating branches of the Circle of Willis or vertebral or basilar arteries are referred to as lacunar strokes. Ans 3: The affected pupil does not immediately respond to direct or consensual light reflex; however, if light stimulus is prolonged, this pupil will slowly constrict to light and slowly dilate in the dark. Accommodation in the affected pupil is sluggish. The other pupil is of normal size and reacts to light. Ans 4: Smoking. Smoking is linked to both the development and rupture of cerebral aneurysms. Smoking may even cause multiple aneurysms to form in the brain. High blood pressure. High blood pressure damages and weakens arteries, making them more likely to form and to rupture. Size. The largest aneurysms are the ones most likely to rupture in a person who previously did not show symptoms. Family history. A family history of aneurysm rupture suggests a higher risk of rupture for aneurysms detected in family members. Ans 5: An end artery/ terminal artery is an artery that is the only supply of oxygenated blood to a portion of tissue. Because vital tissues such as the brain or heart muscle are vulnerable to ischaemia, arteries often form anastomoses to provide alternative supplies of fresh blood. Comment

Stopping bleeding in the human body requires different biological steps that are interdependent. Write an essay where you identify and explain each one of these steps. (Don’t exceed 800 words.

What are the physiologic implications of the congenital adrenal hyperplasia? (what is abnormal about the physiology of people with this disease?)

What is the molecular basis of Congenital Adrenal Hyperplasia? (what is abnormal at the cellular, biochemical, or molecular level?) (250 words or less)

1. Which of these hormones is regulated by a very similar feedback mechanism to that of the regulation of cortisol?

   		glycogen
   		Insulin.
   		T3 and T4.
   		Glucagon

List the effect on cardiac output, SV, HR, EDV, and/or ESV and describe why this change occurred for each of the following cases:

1. an increase in sympathetic autonomic stimulation
2. an increase in afterload
3. a decrease in end diastolic volume