1. A gang member was stabbed in the chest during a street fight. He was cyanotic and unconscious from lack of blood delivery to the brain. The diagnosis was cardiac tamponade. What is cardiac tamponade and how does it cause the observed symptoms? (4 points). Answer:
2. You have been called upon to demonstrate the technique for listening to valve sounds. (a) Explain where you would position your stethoscope to auscultate (1) aortic valve of a patient with severe aortic valve insufficiency (2) Stenotic mitral valve. (b) During which periods would you hear these abnormal heart sounds most clearly? (During atrial diastole, ventricular systole, ventricular diastole, or atrial systole? (c) What cues would you use to differentiate between an insufficient and a stenosed valve? (4 points). Answer:
3. Florita Santos, a middle-aged woman, is admitted to the coronary care unit with a diagnosis of Left ventricular failure resulting from myocardial infarction. Her history indicated that she was aroused in the middle of the night by severe chest pain. Her skin is pale and cold, and moist sounds are heard over the lower regions of both lungs. Explain how failure of the left ventricle can cause these signs and symptoms. (4 points). Answer:
4. Heather, a newborn baby, needs surgery because she was born with an aorta that arises from the right ventricle and a pulmonary trunk that issues from the left ventricle, a condition called transposition of the great vessels. What are the physiological consequences of this defect? (4 points) Answer:
5. Gabriel, a heroin addict, feels tired, is weak and feverish, and has vague aches and pains. Terrified that he has AIDS, he goes to a doctor and is informed that he is suffering not from AIDS, but from a heart murmur accompanied by endocarditis. What is the most likely way that Gabriel contracted endocarditis? ( 4 points). Answer:
Ch. 19, page 751, Questions (1-5)
1. Mrs. Johnson is brought to the emergency room after being involved in auto accident. She is hemorrhaging and has a rapid, thready pulse, but her blood pressure is within normal limits. Describe the compensatory mechanisms that are acting to maintain her blood pressure in the face of blood loss. (4 points). Answer:
2. A 60-year-old man is unable to walk more than 100 yards without experiencing severe chest pain in his left leg; the pain is relieved by resting for 5-10. He is told that the arteries of his leg are becoming occluded with fatty material and is advised to have the sympathetic nerves serving that body region severed. Explain how such surgery might help to relieve this man’s problem. (4 points). Answer:
3. Your friend Joanie, who knows little about science, is reading a magazine article about a patient who had an aneurysm at the base of the brain that suddenly grew much larger. The surgeons’ first goal was to “keep it from rupturing,” and the second goal was to “relieve pressure on the brain stem and cranial nerves.” The surgeons were able to “replace the aneurysm with a section of plastic tubing,” so the patient recovered. Joanie asks you what all this means. (Hint: Check chapter 19 Related clinical terms, p. 748) (4 points). Answer:
4. The Agawam High School band is playing some lively marches while the coaches are giving pep talks to their respective football squads. Although it is September, it is unseasonably hot (88 degrees Farenheight/31 degrees Celsius) and the band uniforms are wool. Suddenly, Harry the tuba player becomes light-headed and faints. Explain his fainting in terms of vascular events. (4 points). Answer:
5. When one is cold or the external temperature is low, most venous blood returning from the distal part of the arm travels in the deep veins where it is picks up heat (by countercurrent exchange) from the nearby brachial artery en route. However, when one is hot, and especially during exercise, venous return from the distal arm travels in the superficial veins and those veins tend to bulge superficially in a person who is working out. Explain why venous return takes a different route in the second situation. (4 points). Answer:
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