Unit 1 Extra Credit Case Study
Giovanni Shah comes home from work one day to find his wife (Mina Shah) laying on the couch. This is very uncommon for her as she tends to spend her days keeping busy in the garden or kitchen, so he goes to check on her. Mrs. Shah states she felt a tightening of her chest earlier in the day and has since felt nauseous and short of breath. Mr. Shah decides to take her to the ER.
Upon entry to the ER Mrs. Shah’s vital signs were record:
Blood pressure = 90/52
Resting Heart Rate = 104 beats/min
Respiratory Rate = 33 breathes/min (normal 12-20)
Oxygen Saturation = 89% (normal 95-100%)
An ECG is performed and indicates Mrs. Shah had a minor heart attack.
1) Describe the purpose of blood flow. (1 point)
2) Describe the blood flow through the heart starting with blood entering the right side of the heart and include all chambers, valves, and major blood vessels. (3 points)
3) What is the function of heart valves? (1 point)
4) What is the function of papillary muscles? (1 point)
After running a cardiac MRI, the doctor noticed damage to the papillary muscle in Mrs. Shah’s left ventricle.
5) Which valve is affected when there is damage to the papillary muscle in the left ventricle? (1 point)
6) How would the direction of blood flow be disrupted if this valve is not closing properly? (1 point)
7) Over time, would this cause an increase, decrease, or not change stroke volume? How would this affect cardiac output? (2 points)
8) How does damage to the papillary muscle in the left ventricle affect systemic blood pressure? (1 point)
9) Explain the reflex that caused Mrs. Shah’s heart rate to increase Be sure to include the receptor stimulated, brain center involved and division of ANS in control. (3 points)
As the day progressed Mrs. Shah’s breathing became increasingly difficult, and she could barely speak without losing her breath. The nurse that came to check on Mrs. Shah noted her breaths were rapid and wet sounding.
10) The left side of the heart receives blood from which part of the body? (1 point)
11) If the papillary muscles in the left ventricle are damaged, how is pulmonary circulation affected? (increased, decreased, or not changed) (1 point)
12) How is pulmonary blood pressure affected (increased/decreased)? How does this affect capillary filtration within the lungs? How is this related to the wet breath sounds heard by the nurse? (3 points)
13) Explain the reflex that caused Mrs. Shah’s breathing rate to increase. Be sure to include the receptor stimulated, brain center involved and division of ANS in control. (3 points)
The following morning the nurse checked in on Mrs. Shah and noticed her cardiovascular and respiratory conditions were worsening. She also noted that Mrs. Shah’s urine output was less than optimal.
14) What is the main function of the kidneys? (1 point)
15) What is the force needed to cause filtration from the blood capillaries within the kidneys? (1 point)
16) Would damage to the papillary muscles in the left ventricle cause an increase, decrease, or not affect kidney filtration? Explain. (1 points)
17) Urine output is also regulated by hormonal control. What 3 hormones (they all start with the letter A) decrease urine production? (1 point)
18) In Mrs. Shah’s condition, what is causing the release of these three hormones and why are they causing a decrease in urine production? (2 point)
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