Question

1) Describe the effect of hypovolemic shock on the blood vessels and the heart.

2) Atherosclerosis is a progressive disease of blood vessels that is responsible for millions of deaths each year. Describe the disease process, noting the involvement of specific cell/tissue types and molecules.

3) A woman in her early 50s appeared at a walk-in clinic, complaining of aching pain in her right leg following a fall. Visual examination revealed that the medial aspect of that leg was red and swollen. A diagnosis of phlebitis was made. What is phlebitis, and what more serious condition may result if proper healing does not occur?

4) For each of the following situations, describe the anticipated effect on blood pressure and the physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages (disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor resulting in excess ADH production.

5) Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pains in her legs. She reports that they have been getting progressively worse since the birth of her last child. During her physical examination, numerous varicosities are seen in both legs. How are varicosities recognized? What veins are most likely involved? What pathologic changes have occurred in these veins, and what is the most likely cause in this patient's case?

6) Mr. Wilson is a 45-year-old stockbroker with essential hypertension. He is African American, obese, and he smokes 2-3 packs of cigarettes daily. What risk factors for hypertension are typified by Mr. Wilson? What steps should be taken to treat Mr. Wilson, and what lifestyle changes should he make? What complications are likely if corrective steps are not taken?

7) A pregnant patient comes into a clinic and asks about a small painless dark compressible bulge that is becoming more apparent on her leg. What is it and what caused it?

8) At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he realized that he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually ineffective in stopping the bleeding from this wound?

9) A patient lost a lot of blood during surgery and his blood pressure dropped from 120/80 to 90/50. Describe how the kidneys respond to this change in blood pressure.

10) A patient has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.

Answer 1

1. The hypovolemic shock occurs when the body loses the one fifth of the of body fluid or blood. The heart can not get enough supply of blood to pump,thus causes decreased cardiac output and pulse pressure. It also affects the blood vessels, causes the peripheral vascular resistance and decrease in blood pressure.

2.Artherosclerosis develops initially when inner lining of the arteries (tunica intima) get attacked by the pathogens or chemicals in the blood results into the damage of the endothelial cells. The damged endothelial cells allows passage of the low density lipoproteins,fat,cholesterol from blood. As a result, the macrophages changes the oxidized fat into foam cells . Eventually, the foam cells mixes up with the collagen and elastic fibers released by the smooth muscles ,it starts depositing in the artery wall also known as plaque which blocks the artery and thus the blood flow .Sometimes, it may rupture the artery and forms the blood clot.

3. The inflammation the vein due to blood clots or without them also (in some cases), known as phlebitis.Phlebitis mostly occurs in the surface or deep veins. If proper healing doesn't occur,it can be result into the local infections,abscess formation, deep vein thrombosis and pulmonary embolism.

4. 1. High salt diet cause the increase in the level of sodium in the blood which reaches to the kidney reduces the release of water ,thus accumulation of fluid in the kidney. It increases the blood pressure due to the strain on the vessels.

2.A blow on the head that damages (disables) the vasomotor center causes the loss of the sympathetic activation due to the loss of the vasomotor tone. Due to that it decreases the blood pressure.

3.The mugger attack initiates the fight or flight response under the sympathetic nervous system stimulation, It triggers the release of the catecholamines hormones from the adrenal gland causes the vasoconstriction.and the increases in the blood pressure.

4.The excessive ADH release by the hypothalamic tumor results into the vasocontriction which causes the accumulation of water and increased blood volume,increases the blood pressure.