How Does the Urinary and respiratory systems work together? Make sure to list organs Ions and Hormones used.

Characteristics of the EKG waveforms:

1. A normal PR interval has a normal duration __________________
   1. ST segment is measured from: __________________________________

Describe the histology of the urinary tract and how that changes between the ureter and the renal tubules.

1. Which wave of the QRS-complex has the largest amplitude in Lead II and why is this so?

Ms. Bewcyk is a 31 year old office worker with recurrent back pain since the age of 18. She initially was injured, as a result of a fall, while playing softball with friends. Diagnosis was “muscle strain” and was treated with pain killers and muscle relaxants. Her back improved quickly, but the pain never subsided. Ms. Bewcyk feels better when active, but has had a hard time keeping active due to the varying nature of her back pain. Just recently she had some test done. The results are as follows:

X- Ray – Normal
MRI – bulging disk between L4-5
Radiating pain from right buttock to right knee

1. What contraindication must you be aware of with Ms. Bewcyk?

2. What, if any, issues should you inquire of, or modify of her current employment?

3. Develop a core program for Ms. Bewcyk.

4. Develop a cardiovascular conditioning exercise program for Ms. Bewcyk to compliment the

   core strength program developed in question 3.

You have been contracted by a triathlete to determine their maximal aerobic capacity. As the athlete arrived at your laboratory, you realized that your metabolic chart had stopped functioning, and you need to measure blood gasses to perform the test. The data you obtain are as follow:

-Age: 35 years old

-Height: 1.75m

-Weight: 73kg

-Speed at VO_2max: 16.2 km/h

-Heart Rate at VO_2max: 192 bpm

-End Diastolic Volume: 242mL

-End Systolic Volume: 90mL

-Hemoglobin concentration: 163g/L (16.3 g/100mL)

-Arterial PO₂: 95mmHg (O2 sat: 97%)

-Venous PO₂: 20mmHg (O2 sat: 35%)

-Arterial PCO₂: 35mmHg

-Venous PCO₂: 40mmHg

Can you provide your triathlete with their maximal aerobic capacity? Include all your calculations (20 points) (Fick's equation)

How is it that we urinate different amounts everyday but our body is able to keep the glomerular filtration stabled?

Children Case Study

Subjective

Medical History

Mr. ST, a 16 yr old Caucasian boy, who was previously diagnosed with juvenile idiopathic arthritis (JIA) at the age of 12, has recently been determined to be in remission. Previously this patient did not respond well to a number of nonsteroidal anti-inflammatories. After a period of trial and error, the patient responded well to azathioprine and seems to have better control of his disease now. Is has been a concern of the parents and primary care physician that, although this patient seems to be in remission, he has failed to increase his activity and has poor dietary habits, and as such he is beginning to develop other potential chronic health issues. Mr. ST’s latest physical exam and lab work has noted that body weight status is in the 95th percentile, with elevated resting blood glucose and triglycerides. The parents are concerned that if these poor health indicators continue, their son will have to deal with more than his JIA. The family physician wants the boy to begin a structured exercise program as well as to begin following the DASH diet plan.

Objective and Laboratory Data

Exercise testing was not requested.

Assessment and Plan

Diagnosis

JIA with overweight/obese weight status and prediabetes

Exercise Prescription

Mr. ST was referred to Exercise Medical Clinic to meet with an exercise physiologist. In consultation with the child’s parents it was determined that the child would begin with a programmed exercise routine developed by the exercise physiologist and would be administered here at the clinic. The patient will come to the clinic 3 d per week for the first 4 wk. At week 5 the child will move to completing his exercise program from home. At week 8 the child will come to the clinic to be assessed on his ability to maintain his at-home exercise program. If the child is compliant then adjustments will be made to the program for intensity, duration, frequency, and mode. If the child is struggling then it may be appropriate to have him exercise in the structured environment for 2 wk to help him get back on track.

Finally, it would be beneficial to have the child’s parents begin an exercise program as well. This will help them but would also provide positive role models for their child. Additionally, the parents and child should be referred to a dietitian to help them with their meal planning and diet plans.

Discussion

A patient such as this, with JIA, is often in poor physical condition due to the adoption of a sedentary lifestyle, possibly due to the discomfort accompanying the disease. Although drug therapy has improved the quality of life for children with JIA, increasing physical activity may help to enhance it further.

Case Study Discussion Questions

1. What would your initial exercise prescription look like for this patient? Include the mode, intensity, and duration (or volume) you would prescribe. Include your rationale for your choices.
2. What modifications to your program would you make at week 5 when the patient starts a home based exercise program? Explain.
3. Assuming the patient is making progress at week 8, how would you progress your program. Explain.

A (Co-Cr-Mo) hip implant was inserted into a patient’s femur. The acetabular cup was made of surgical stainless steel. After one year of operation, the patient was complaining about severe pain. He was put on painkillers because the situation was getting worse with time. X-ray radiography revealed wear debris as well as a large gap at the interface between the implant and bone. The orthopaedic surgeon decided to re-operate to retrieve the old implant and replacing it with a new one. He found massive corrosion in the retrieved implant.

i) What would be the causes of that corrosion, wear and the occurrence of the interfacial gap between the implant and bone?

ii) Describe the factors that should be taken into consideration in the design to minimize these failures.

Please type or submit a PDF document so that I am able to legibly understand the answer. ( This is ome question

2. In the case study below you will explore the causes of B12 deficiency in three patients.

A. Patient A is a college student who has become increasingly tired over the last six months. She thought it was because of her tough schedule but since she noticed tingling in her feet, she thought she should see a doctor. Patient A also has hyperparathyroidism, an autoimmune disorder that affects 100,000 people in the U.S. every year. She is not a vegetarian and eats milk, eggs and meat - all great sources of B12. The doctor ran some blood work and found very low levels of B12. The patient also had parietal cell antibodies present in her blood.

• What do you think is the cause of her B12 deficiency? Why is her body not able to absorb the necessary B12?

• What is the treatment and prognosis for this patient?

• B. **** Patient B had gastric bypass surgery three years ago. He is a vegetarian and sees a nutritionist who ensures his diet is adequate to meet his nutritional needs. Despite this, on a recent trip to his doctor, his blood work showed declining levels of vitamin B12.

• Why does this patient have low B12 even though his diet should be providing enough?

• Why didn’t Patient B have low B12 until three years after surgery?

• C. **** Patient C suffers from Crohn’s disease and had a 60 cm terminal ileal resection 4 months ago.

• What is a terminal ileal resection?

• What is Crohn’s disease and what complication led to the need for an ileal resection?

• What is absorbed by the ileum?

• Will amino acid and glucose uptake be affected by the ileal resection? Explain.

• What is the treatment and prognosis for this patient to ensure she receives necessary nutrition?

The biomolecules make it possible for the cell to make changes, defend and repair itself continue to grow and continue survival. What are those molecules? what is the major difference among them? Add a reference.

Discuss how the movement of substance throughout the cell happened and contribute to its maintenance/ survival. Add a reference

Discuss the elements of cellular structures that make the cell viable and able to withstand changes. Add reference

2. The primary action of the hamstrings muscle group is ______________________ of the lower leg at the knee. The group in composed of the following muscles: ___________________________________, ________________________________________, and _________________________________________. 3. The Gastrocnemius muscle acts to mainly ______________________ flex the foot at the ankle. Its main (opposing action) _________________________________ muscle is the ____________________ ______________________, which mainly ______________________ flexes the foot at the ankle. 4. The Biceps brachii muscle ________________ the forearm at the elbow. The insertion of this muscle is on the ___________________. The main forearm extensor muscle is the ___________________ _____________________, and it inserts on the ______________________________. 5. The pectoral muscles have their origin in the _______________ and _______________, and insertion on the ______________________. Their main action is to ________________ and medially _________________ the arm. 6. The abdominal muscles protect the abdominopelvic cavity and also ______________ and __________________ the trunk. 7. What is the function of lumbodorsal fascia