Ian Philbrick

4/14/2015
Physiology
per. 2

Paragraph 1:
An artery carries blood away from the heart and veins carry blood to the heart. Arteries
are thicker than veins because they are under more pressure. Veins have thinner walls and also
have one-way valves to help the blood go against gravity.
Paragraph 2:
Cardiac output (CO) is the amount of blood ejected into the aorta per minute.
CO = stroke volume x pulse rate
CO = 80(ml) x 60(bpm)
CO = 4800(ml/min)
CO = 4.8(liters/min)
Paragraph 4:
A positive blood type can receive a transfusion from a matching negative blood type
because while it does not have Rh antigen, it doesn't have anything that is foreign to the
immune system. The reverse of this would not work because the positive blood would be
introducing an unfamiliar antigen into the bloodstream that will be attacked by antibodies and
rejected. O- is the universal donor because it has no antigens that can be rejected. AB+ is the
universal receiver because it cannot be given any antigens that it doesn't already have.
Paragraph 5:
The Rh factor is an additional antigen that cause blood to have a positive blood type if it
is present. When an Rh- mother has an Rh+ baby, the baby may develop hemolytic disease
may occur. Hemolytic disease will cause the Rh- mothers Rh antibodies to destroy the fetuses
red blood cells. It is very rare for a fetus to develop hemolytic disease, however if it does then
doctors will monitor it to look for anemia, ischemia, and blueing of the skin then they flush the
babys system if severe symptoms occur. Babies born to Rh+ mothers are not in danger
because the mother already has the Rh antigen and will not create antibodies that attack the
fetus.

Clinical 1:
Atherosclerosis is a condition where the artery walls thicken and cause a buildup of fatty
substances that form plaque on the inside of the artery causing it to narrow. Hypertension, or
high blood pressure, can cause the stretching and tearing of artery walls. When the artery walls
tear they lay down plaque causing atherosclerosis. This patient has a blood pressure of 140/90,
is overweight, and a heavy smoker. All of these things can contribute to atherosclerosis and the
clogging of arteries because being overweight makes the heart work harder to push blood

through fatty tissue and smoking puts nicotine into the bloodstream which deteriorates the artery
walls. The patient is experiencing angina pectoris which is chest pain caused by ischemia.
Ischemia is the starvation and suffocation of cells due to a lack of localized blood flow. The
localized ischemia in the myocardium has caused a myocardial infarction, which is commonly
known as a heart attack. An MRI revealed that the patient has a clogged coronary artery. The
coronary artery is responsible for supplying the myocardium, and the rest of the heart, with
blood. Because it is clogged there is ischemia in the myocardium which has lead to a
myocardial infarction. I would suggest that this patient undergo coronary artery bypass grafting
(CABG). CABG is getting an artery from somewhere else in the body and patching it onto the
heart so that blood can go around the clot.
Clinical 2:
The patients complaining of severe fatigue and inability to be active. An EKG is a test
that measures the flow of electrical current across the heart. The EKG shows that the patient
has a heat rate of less than 60 beats per minute and a heartbeat that is highly irregular. The
patients heart beat is so slow because the depolarization in their sinoatrial node is delayed,
causing the signal to be less frequent than normal. This slow heartbeat is known as
bradycardia. Bradycardia can cause a lack of blood flow to parts of the body, leading to
ischemia. Ischemia in the myocardium due to bradycardia can lead to a myocardial infarction. I
would recommend that the patient get a permanent pacemaker surgery. The pacemaker will do
the job of a healthy sinoatrial node and keep the heart pumping blood at a normal rate (60-100
Beats per minute).

Clinical 3:
This patient is suffering from severe fatigue to the point that they are bedridden and
cannot maintain normal activities. They suffered from rheumatic fever as a child. Rheumatic
fever is caused by streptococcus A which has entered the bloodstream and lined the walls of the
inner heart. The bacteria in the heart increases the pressure which strains both atria and both
ventricles, but mostly severely the left ventricle because it has the heaviest work load. The left
ventricle stretches out and so does the mitral valve which can lead to blood pooling in the
ventricle and congestive heart failure. The damage to the mitral valve causes the blood to
backflush which causes the abnormal sounds. This abnormal sound is a heart murmur. The
reason the blood back flushes is because of mitral stenosis which is the narrowing of the mitral
valve. The narrowing makes it so that the valve cannot completely close. If the mitral stenosis is
severe then two possible things can happen. Firstly the blood could not be fully oxygenated, or
secondly insufficiently oxygenated blood could be pumped to the rest of the body. These two
factors can cause extreme fatigue. To treat this condition I would suggest replacing the valve
with either an artificial valve or the valve from an animal.