Biomechanics, Body segments as Levers

1A: The “Sit-up” Draw or explain

• Differences in muscle involvements and spinal demands with each phase and variation?

1B: Push-ups, Squats, and Vertical Leg Press

• Differences in Internal vs. External Torques?
• Varying demands on the key joints depending on hip and foot positioning?

1. What is mean arterial pressure (MAP) and why is it important? 2. Identify three factors that maintain MAP. 3. What role does the heart play in regulating MAP? 4. What role does peripheral resistance play in maintaining MAP? 5. What effect would acute heart failure have on MAP?

A 24-year old Latin American woman was in good health until she experienced a seizure at home. She was brought to the emergency room and a CT scan was ordered. Multiple cranial lesions were revealed.

A. Identify by scientific name the parasite causing these lesions and name the condition.

B. Based on the epidemiology of the life cycle, how did she become infected with this parasite?

C. How is this infection differ from intestinal infection?

D. What in the patient's history predisposes her to this infection?

Discuss the phosphate regulation mechanism

High-resolution peripheral quantitative computed tomography

1. How does this technique work and what does it measure?
2. What equipment is required for this technique?
3. How is the experiment/measurement performed?
4. What do the typical results look like? (you may want to include images here)  

1. The Endocrine System

a. Give an example of the negative feedback relationship between the hypothalamus, anterior pituitary, and other endocrine glands

b. What are leptin, ghrelin, and growth factors? Where and how do these substances act?

What location in the central nervous system coordinates the response to low blood pressure? Explain how.

QUESTION 41

Sperm is delivered through the body by a system of ducts:

1. Epididymis

2. __________

3. Ejaculatory Duct

4. Urethra

QUESTION 42

The site where fertilization usually occurs?

QUESTION 43

Water, Na+, amino acid, and glucose are reabsorbed back into the peritubular capillaries.

True

False

QUESTION 44

What is the bulky middle layer consisting of interlacing layers of smooth muscle?

QUESTION 45

What is the name of the mucosal lining (in the uterus) where the egg burrows and resides to develop?

QUESTION 46

The stratum functionalis is shed during menstruation.

True

False

QUESTION 47

The uterus functions has the birth canal, passageway for menstrual flow and organ of copulation.

True

False

QUESTION 48

What is the range of pH for urine?

QUESTION 49

The _______ region of the small intestine propels waste to the large intestine.

QUESTION 50

__________ ligament anchors ovary laterally to pelvic wall.

Dexamethasone is a drug used to suppress the secretion of adrenocorticotrophic hormone (ACTH) from the anterior pituitary. Two patients with hypersecretion of cortisol are given dexamethasone. Patient A’s cortisol secretion falls to normal as a result, but patient B’s cortisol secretion remains elevated. Draw maps of the reflex pathways for these two patients and use the maps to determine which patient has primary hypercortisolism. Explain your reasoning.

Directions: Write a SOAP note for the patient scenario described below. A complete S, O and A section addressing all problems should be written. Only those problems that are primary or secondary priority need to be addressed in the plan (P section). Be sure to include references for recommendations.

Date of encounter: 5/25/20

CC: Post-discharge follow-up

Patient “Paul” is a 54 year-old Caucasian male being seen in the clinic following a recent hospital discharge 1 week ago for acute myocardial infarction. During his admission, he underwent a heart catheterization and subsequent drug-eluting stent placement to the left anterior descending coronary artery. He was initiated on atorvastatin, aspirin, and clopidogrel therapy in the hospital and discharged on these medications in addition to his previous home regimen.

Upon presentation to the clinic, the patient was noticeably limping and when asked, he stated that his hip pain has gotten much worse over the past few months. He was previously able to control the pain with OTC naproxen and acetaminophen, however he says that these medications have not been working as well lately. Additionally, he states that his legs have been swollen since he was discharged from the hospital. The swelling seems to be better in the morning, but gets worse the longer he is on his feet, so he has been spending a lot of time in his recliner. He is worried that it may interfere with him going back to work as an elementary school teacher.

PMH:

T2DM diagnosed 5 years ago

HTN diagnosed 10 years ago

OA diagnosed 5 years ago

Family History:

                Father – alive, age 80, HTN, MI x 2, T2DM

                Mother – alive, age 78, COPD, hypothyroidism

                Sister – alive, age 46, HTN

Surgical History:

                Heart catherization with LAD stent placement approximately a week and half ago

Social History:

                Lives at home with wife, 5 year old son, and 6 months old daughter

                Works as an elementary school teacher

                Tobacco: 15 pack-year smoking history; quit 2 months ago

                Alcohol: 1-2 drinks/day with dinner

                Negative illicit drug use

                Compliant with prescribed medication regimens

Allergies: NKDA

Medication List:

                Metformin 500 mg PO BID with meals

                Lisinopril 10 mg PO daily

                Metoprolol tartrate 50 mg PO BID

                Acetaminophen ER 650 mg PO every 8 hours as needed for hip pain (OTC)

                Naproxen sodium 220 mg PO BID (OTC)

                Atorvastatin 20 mg PO daily – new medication started in hospital

                Aspirin EC 81 mg PO daily – new medication started in hospital

                Clopidogrel 75 mg PO daily – new medication started in hospital

Vaccinations:

                PPSV23 in 2015

                Yearly flu vaccine

                Td in 2016, never received Tdap

Height: 72 inches

Weight: 224 pounds

Vitals:

BP 162/98 mmHg

HR 76; RR 18

Temp 98.9°F

O₂ sat 97% on RA

Physical Assessment: WNL aside from 3+ bilateral lower extremity edema

Diagnostic studies: TTE completed during hospitalization showed LVEF of 30%

Labs:

Develop a thorough SOAP note for this patient, addressing all primary and secondary problems fully within the plan.

1. (Triglyceridase/Lipoprotein lipase/Lipoprotein hydrase/Pyruvate) is an enzyme that removed excess triglycerides from the bloodstream and put them into fat storage. This enzyme is found to have a higher rate of activity in obese individuals.

2. When more calories are taken in than expended energy balance is said to be (consistent/positive/negative/reversed)

3. Adipose tissue is made up of both fat and the (myofibrils/osteocytes/adipocytes/neurons) that store the fat.

4. The enzyme responsible for pulling circulating, excess triglycerides out of the bloodstream and placing them into fat storage is called (triglycerades/Lipoprotein lipase/protease/hydrolase)

5. While genetics have been found to play a role in a person’s susceptibility to develop obesity, lifestyle factors such as diet, stress management, and physical activity have been shown to play a role in the development of obesity. These factors are known as (epigenetic/ susceptibility/ genetic/ intrinsic) factors

6.When body fat increases, the hormone (cortisol/leptin/testosterone/ ghrelin) increases suppresses appetite.

7. (Gherlin/ Estrogen/ Norleptin/ Norepinephrine) is produced in the stomach and promotes appetite and weight gain. Levels generally increase before a meal and decrease after a meal.

Bolded part are the options to choose from for each question.