Questions
Bobby Sue was brought to the ER where she was assessed for trauma. Physicians were worried...

Bobby Sue was brought to the ER where she was assessed for trauma. Physicians were worried about a myocardial contusion or other myocardial damage, and ran an EKG. Below is an image of a 6 second strip. They checked her systemic blood pH (7.11; low), blood oxygenation (86%, low), and body temperature (95.8 oF). The broken knees were wrapped, but surgery was put off until her metabolic condition was stabilized. After all, bones can be fixed later—cells are more difficult to replace. This is termed “Damage Control” in trauma: stabilize the patient, schedule major surgeries to repair massive injuries once the patient is stable. In exsanguinating hemorrhage, patients die from coagulopathy, hypothermia, and metabolic acidosis. The metabolic failure is often the terminal condition, and therefore must be dealt with immediately.

The ER physician diagnosed myocardial contusion. A first year Medical student knew that this could cause A-fib, and could lead to blood clotting and stroke. He suggested that they give her heparin. In unison, the ER trauma team yelled “NO!”.

 Given her pH and body temperature what is her blood clotting status?

 How does heparin work to prevent blood clots?

 Why would you not give heparin to Bobby Sue?

In: Anatomy and Physiology

1) Physician orders part of a hepatic function panel: serum albumin, total bilirubin, and direct bilirubin....

1) Physician orders part of a hepatic function panel: serum albumin, total bilirubin, and direct bilirubin. CPT Code(s)

2)Vancomycin assay for peak and trough levels. CPT Code(s)

3) Basic metabolic panel and renal function. CPT Code(s)

4) Hospital blood bank irradiates two units of leukoreduced red cells. CPT Code(s)

In: Anatomy and Physiology

A 70 kg 68 y/o male sees his cardiologist for a follow-up following his myocardial infarction...

A 70 kg 68 y/o male sees his cardiologist for a follow-up following his myocardial infarction 3 months earlier. He has been taking digoxin and LisinoprilTM since his MI. At the follow-up, he complains of shortness of breath and has to sleep sitting up in his recliner. He also complains of fatigability and swelling of his ankles and hands. A physical examination finds that he has distended jugulars and pitting edema in the lower legs. His breathing was rapid 22 breaths/min) and rales were heard in the both sides at the base of the lungs. He does not have a fever, but his pulse is 116 bpm and his blood pressure is 110/80. The physician immediately admits him and orders a blood and urine analyses with the results as follows:

Blood

Urine

[Na+]

128 mEq/L

[Na+]

150 mEq/L

[K+]

3.0 mEq/L

[K+]

65 mEq/L

[Cl-]

98 mEq/L

[Cl-]

120 mEq/L

[HCO3-]

21 mEq/L

[HCO3-]

15 mEq/L

Creatinine

1.2 mg/dl

Creatinine

128 mg/dl

PCO2

24 mmHg

24 hr volume

750 ml

pH

7.51

Osmolality

600 mOsm

a) Calculate the volumes of ECF and ECV in this Px assuming the total body osmoles of the Px is 12 Osm. Do these volumes have any impact on the symptoms the Px is exhibiting and what is the cause of these changes (ie, what is the pathology)?

b)   How does this pathology alter the renal sodium handling in this Px and what are the mechanism(s) for developing hyponatremia?

c)   The physician orders an infusion of 2L of 3% saline with 40 mg of Lasix® given twice a day for three days. Calculate how this treatment would impact the Px’s symptoms assuming the osmolarity of the urine dropped to 400 mOsm?

d) What are the renal mechanisms affected by this treatment. Does this treatment impact the Px’s hypokalemia? If so, why?

In: Anatomy and Physiology

Describe the process of involution of the uterus

Describe the process of involution of the uterus

In: Anatomy and Physiology

Which of the following would not be recommended to minimize the risk of stress fracture and...

Which of the following would not be recommended to minimize the risk of stress fracture and promote recovery?    

a.   Ensure old injuries have been fully rehabilitated.   

b.   Enhance muscle strength around chronically loaded bones.   

c.   Increase training intensity or alterations gradually over a period of two to four weeks.    

d.   Maintain a minimum of 1000 mg/day dietary calcium and 800 IU/day vitamin D.

In: Anatomy and Physiology

Humuculi in the cerebellum overlap sensory and motor maps. Explain why.

Humuculi in the cerebellum overlap sensory and motor maps. Explain why.

In: Anatomy and Physiology

When the spinal cord is injured some bodily functions such as breathing and toilet control may...

When the spinal cord is injured some bodily functions such as breathing and toilet control may be impaired. Many of these injuries occur as a result of high risk behaviors.how do you think these individuals cope with such injuries? How can decrease the number of these types of injuries.considering structure and function, has modern activity outdistanced the structural protection for our nervous system that was provided by nature?

In: Anatomy and Physiology

What are the four types of bones? There are three types of muscle tissue. a) Muscle...

What are the four types of bones?

There are three types of muscle tissue.

a) Muscle tissue that is voluntary and striated, primarily attached to bones and moves parts of the skeleton is called…..
   b) Muscle tissue that is involuntary and striated, forming the bulk of the heart wall is called…
   c) Muscle tissue that is involuntary and nonstriated, located in the walls of hollow internal structures such as the intestines is called …

6. (3 pts) The median plane is a special case of what type of plane in the body? Name the two planes that are perpendicular to this plane. i think this is it? Transvere plane; front and horizontal plane

In: Anatomy and Physiology

What are the types of membrane channels ?

What are the types of membrane channels ?

In: Anatomy and Physiology

What are the differnt types of plaque?

What are the differnt types of plaque?

In: Anatomy and Physiology

1. What is an adaptation of a sensory receptor? At what stages does it occur? What...

1. What is an adaptation of a sensory receptor? At what stages does it occur? What are its functions?

In: Anatomy and Physiology

summarize the different types of thyroid cancers. What are the treatments for thyroid cancer? What types...

summarize the different types of thyroid cancers. What are the treatments for thyroid cancer? What types of problems do you think a person with thyroid cancer might encounter? Why do you think there is a resource link on the website for a low iodine cookbook? What are the risk factors for thyroid cancer?

In: Anatomy and Physiology

What is the chloride shift and why does it occur?

What is the chloride shift and why does it occur?

In: Anatomy and Physiology

By what mechanism does neuromusuclar fatigue occur?

By what mechanism does neuromusuclar fatigue occur?

In: Anatomy and Physiology

For each selected joint you should discuss: The anatomical features of the joint (What type of...

For each selected joint you should discuss:

  • The anatomical features of the joint (What type of joint is it? What bones/bony structures are present? If relevant, what soft tissue structures are associated with the joint?)
  • Movements that are possible at the joint (What types of movement are possible? What anatomical plane do those movements occur in?)
  • An example of a complex motion that would require an action at that joint to happen (for example, if you chose “ankle joint” you might select “dorsiflexion of the foot” and you might use “releasing pressure from a gas pedal while driving” as a specific example)

KNEE

SHOULDER

WRIST

In: Anatomy and Physiology