Crawfish Body Systems Essay

Crawfish Body Systems Essay
Body Systems The four main body systems are, circulatory, respiratory, nervous/sensory, and
digestive. The circulatory system consists of the heart, lungs, arteries, veins, coronary and portal
vessels. It transports blood, nutrients, and gases to and from cells. The respiratory system is made up
of the nose, pharynx, larynx, trachea, bronchi, and lungs. It serves to intake oxygen and get rid of
carbon dioxide. The sensory system is composed of the brain, spinal cord, spinal nerves, and
peripheral nerves. This allows you to feel things that you touch and that are touching you. The
mouth, throat, esophagus, stomach, small and large intestines, rectum, and anus join together and
make up the digestive system. The circulatory system of an earthworm ... Show more content on
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Unlike the earthworm, crawfish have open circulatory systems. There are no veins, but tissue spaces
called sinuses instead. Two arteries leave the heart, the abdominal and anterior dorsal aortas. The
blood circulates from the dorsal arteries, to capillaries, and continues on into the sinuses. Crawfish
breathe through gills that are located on the outside of the body in between the body wall and
carapace. The gills are attached to the walking legs so that crawfish can breathe as it walks. They
store water in a pocket so that they can breathe even while they are on land. The crawfish's brain is a
mass of nerve ganglion that is directly in front of the esophagus. Small nerves connect the eyes,
antennae, antennules, and brain together. From the brain, two nerves go around the esophagus,
combining into the ventral nerve cord that then runs all the way into the abdomen. Each segment has
a small group of ganglion, with pairs of nerves shooting off of them to appendages and internal
organs. They have a two part stomach with a cardiac and pyloric stomachs. The cardiac stomach is
large, sac–like, and holds food. Meanwhile, the pyloric stomach has digestive glands on each side
that produce digestive enzymes. They then have an intestine and anus. Their kidney–like structures
are called green glands and are located at the base of the
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Exam 38176000 Med Billing & Coding Essay
Page 1/11 Ashley Kailian 1800 N.Hills Rd Apt 406 York, Pa, 17406 Student Number: 21648849
Examination: 38176000 1.List the three goals of Physician Payment Reform. 1. Decrease Medicare
expenditures, Re–Distribute physicians payments more equitibly, Ensure quality health care at a
reasonable rate. 2. Mr. Jones is admitted to the hospital by the orthopedic surgeon for severe hip
pain. The ortho surgeon provides an initial hospital visit during which it's determined that Mr. Jones
has a fractured hip that will require surgical intervention. Mr. Jones is taken later that day to the OR,
where the doctor performs the surgical procedure to repair Mr. Jones' hip. Which modifier would
you use for the hospital ... Show more content on Helpwriting.net ...
SUBJECTIVE: This is a 38–year–old female who presents to the emergency room with a history of
currently being under treatment for a right corneal abrasion that occurred on Sunday. She states she
was seen by the "eye doctor earlier today" and now has a bandage over her eye. Apparently her eye
is opened underneath the bandage, and she is unable to close her eyelid. She feels her eyelid is stuck
to the bandage. OBJECTIVE: She is afebrile with stable vital signs. The patch was removed and
there was a folded piece of Telfa that had slipped down and her upper eyelid was unable to close
over the top of this. The Telfa was removed and a wet patch was placed. This did provide significant
comfort. Her eye patch was reinforced. ASSESSMENT: 1. Right corneal abrasion under treatment.
2. Eye patch replaced as described above. PLAN: She has a follow up visit tomorrow morning with
ophthalmology. I told her she needs to keep that appointment. She is to return here sooner if she is
having increasing problems. CPT Code: ____________________ ICD–9–CM Code:
____________________ 14. CPT Code: 99281/ICD–9–CM Code: 918.1 15. Provide the CPT
code(s) for the following hospital scenario. PROGRESS NOTE: The patient is seen today. She has
been transferred from the ICU to the floor. She has essentially stabilized. Again, she is having some
type of seizure activity. PHYSICAL EXAMINATION: Her vitals overall are fairly well stabilized.
Her

Schizophrenia Case Study Essay
On the 19th December the patient was transferred from Daisy Hill Hospital to a specialist
Neurosurgical unit in the Royal Victoria Hospital. On admission to the neurosurgical unit the
Glasgow Coma Scale (GCS) was 14/15 and she had no neurological deficits with the nerve, spinal
cord, or brain function, although she was still complaining of neck stiffness and pain in head.
Although the CT scans showed no evidence of subarachnoid haemorrhage, due to her very strong
history the patient was referred for further imaging through angiogram techniques. This included use
of catheters inserted under the skin to provide a contrast material which was detected through the
use of magnetic resonance imaging scans (M.R.I). The results for these again showed no evidence of
a recent bleed. ... Show more content on Helpwriting.net ...
The ophthalmic artery connects to the circulatory anastomosis in the brain known as the Circle of
Willis. One of its branches known as the retinal artery runs behind the optic nerve of the eyeball.
The resultant compression of this artery as a result of the build–up of pressure caused by the onset of
the headache and the dysplastic cells could have contributed to the patient's initial symptoms of
blurred vision and photophobia. This is a common symptom experienced by patients who develop
aneurysms in this region of the artery [15]. After careful discussion of these findings, the location of
the aneurysm, the current results and strong history, it was decided that the saccular aneurysm would
require

Diffusion Weighted Imaging
Trigger
Diffusion Weighted Imaging (DWI) is an established tool to demonstrate the structural changes to
the neuronal fibers (microstructures) in brain. Diffusion Tractography Imaging (DTI) metrics based
on DWI are vital non–invasive measures in multiple sclerosis and spinal cord injury. Diffusion of
water molecules is on the scale of 13 microns/sec in the spinal cord, which is 15mm in diameter and
exhibits a periodic physiological movement. Therefore, DWI should exhibit high spatial and time
resolution, importantly to acquire data during least motion phase (quiescence) of SC. The desired
quiescence can be detected from physiological signals (ECG, Pules) to trigger the acquisition
(gating). However, this increases the scan time (time to wait ... Show more content on
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Earlier studies have used agar phantom diffusion metrics, however the motion model we used is one
directional, unlike multi directional spinal cord.
2. The spinal cord movement is complex and affected by physiological changes. The assumption,
that patient heart rate and blook pressue does not change between VE (to detect motion) and DTI
scan., or it imposes insignificant effect on spinal cord motion
3. The spinal cord motion is affected by cervical spine length and curvature of the subject. There is
no single position technique to standardize the neck curvature as it affects the cord movement.
4. Every manufacturer uses different internal clock to synchronize pulse oximeter measurement and
image acquisition. Therefore our technique cannot be directly applied to other manufacturer and
need to account for their internal clock time delay.
Required resources (the main ones)
1. Agar phantom
a. Its most common, validated, phantom material and it can be prepared in laboratory.
2. Moving table for phantom that is MRI compatible
a. Requires a MRI compatible actuator to move the phantom.
3. MRI Scanner
a. 02 hrs (02 x 1 hr) for phantom study (test and re–test)
b. 10 hrs (10 x 1 hr) for human study
Proposed

The Peripheral Nervous System
The nervous system of the human body can be separated into two parts: the Central Nervous System
(CNS) and the Peripheral Nervous System (PNS). The brain and the spinal cord make up the Central
Nervous System, which is the nervous system's processing center. The Peripheral Nervous System
"consists of nerves that branch from the Central Nervous System and connect it to other body parts"
(Shier, Butler, Lewis 2015). The somatic nervous system and autonomic nervous system are the
subdivisions of the Peripheral Nervous System. In this essay, I will distinguish between the Central
Nervous System and the Peripheral Nervous System. The Central Nervous System serves as the
communication center for the entire nervous system. Therefore, it is the mediator ... Show more
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It contains both cranial and spinal nerves which connect the skeletal muscles and skin to the Central
Nervous System. There are twelve pairs of cranial nerves. Olfactory nerves are the first pair of
cranial nerves, and they contain sensory neuron axons. Sense of smell is linked with this pair of
nerves. The second pair of cranial nerves is the optic nerves, which are responsible for vision.
Oculomotor nerves are the third pair of cranial nerves, and they consist of both voluntary and
involuntary muscles. The voluntary muscles function to move the eye and raise the eyelid. The
involuntary muscles focus the lenses of the eye and regulate how much light enters the eye. The
fourth pair of cranial nerves is the trochlear nerves, which carry out motor impulses that move the
eye independently from the oculomotor nerves. Trigeminal nerves are the fifth pair of cranial nerves,
and they can be divided into three separate parts. The maxillary division manages sensory impulses
of the skin of the face, upper teeth, and upper lip. The mandibular division oversees sensory
impulses of the lower lip, lower teeth, and skin of the jaw, as well as motor impulses that control
chewing. The ophthalmic division is in charge of sensory impulses from tear glands, the forehead,
etc. to the brain. The abducens nerves are the sixth pair of cranial nerves, and they stimulate motor
impulses that move

Spinal Cord Protection Strategies For Thoracic...
Spinal Cord Protection Strategies for Thoracic Endovascular Aneurysm Repair With an incidence
once as high as 40%, spinal cord paralysis in thoracoabominal procedures has declined, however,
still remains a devastating threat post–surgery (Roman, Grewal, Taylor, & Grigore, 2014). Modern
techniques for repair of thoracic aneurysms and dissections include an open incision with
extracorporeal bypass and aortic clamping. This surgical procedure puts patients at great risk for
spinal cord paralysis. Open procedures required meticulous reimplantation of intercostal blood
vessels, deep hypothermic cardiac arrest, epidural cooling, and various pharmacologic interventions.
As surgical technique has advanced to percutaneous endograft repair, most of these techniques are
no longer needed. However, the incidence of paralysis is still prevalent in patients having a TEVAR
procedure. Naloxone, an opioid antagonist, has been studied as an additional pharmacologic adjunct
in the prevention of spinal cord paralysis (Roman, Grewal, Taylor, & Grigore, 2014). Spinal cord
injury can be multifactorial and a review of the literature indicates for patients undergoing
endovascular repair of thoracic aneurysms, the use of multiple spinal cord protection strategies
collectively reduce spinal cord injury compared to the use of naloxone as a primary measure.
Literature Review
Pathophysiology
To understand the techniques utilized for spinal cord protection, providers must first understand the
anatomy of

Medulla Oblongata Essay
1) The medulla oblongata is arguably the most important part of the brain since it controls critical
involuntary functions such as breathing, heart rate, and blood pressure via critical nuclei within the
medulla's reticular formation known as the medullary respiratory center, the cardiac center, the
vasomotor center, in addition to reflexes for vomiting(in the area postrema), sneezing, and coughing.
At the location of the foramen magnum, the medulla sits directly adjacent to and is continuous with
the spinal cord and is the most caudal and inferior segment of the brainstem. The pons lies
superiorly to the medulla. The medulla is approximately an inch in length and the superior portion is
formed where the dorsal surface of the medulla meets ... Show more content on Helpwriting.net ...
It descends posteriorly to the brachial artery and continues following distally to the insertion of the
latissimus dorsi on the anterior and proximal aspect of the humerus (the medial lip of the inter–
tubercular groove). It then sharply turns posterior to the humerus to enter what is known as the
'radial groove' which courses inferiorly and laterally along the posterior surface of the bone. While
in the groove, the nerve is covered superficially by the lateral head of the triceps brachii towards
which it is sending branches for innervation. The nerve continues along the groove on route to the
epicondyle of the lateral elbow where it divides into a superficial branch which follows the lateral
edge of the radius terminating in the dorsolateral skin of the hand, and a deep branch running
posteriorly to innervate the forearm's extensor muscles at its termination. Injury to the radial nerve
may result in trouble extending the arm, trouble extending the wrist, also called "wrist drop", and
weakness in hand

The Tell-Tale Heart
The short occipitovertebral artery separates into two arteries: the occipital artery and the vertebral
artery, which connects to the skull and vertebral column respectively. The top of the right and left
vena cava are connected to the jugular vein and flow into the lingual vein from the mouth and
maxillary vein. The internal jugular vein however; as well as the subscapular vein from the shoulder,
receive blood from the innominate vein. The blood flows directly into the subclavian vein, formed
by the musculocutaneous veins from the muscles of the skin of the side and back, and into the
brachial vein from the forelimb.
The posterior vena cava carries deoxygenated blood to the lower half of the body – the hepatic veins
of the liver, the renal veins of the kidney, and the genital veins of the gonads. Also connected to the
posterior vena cava is the hepatic portal system, an abdominal vein formed by the two pelvic veins.
The hepatic portal vein of this system provides blood flow to the stomach, intestine, and spleen. The
renal portal system contains veins, as mentioned previously, to the kidneys and the veins obtain the
blood ... Show more content on Helpwriting.net ...
A female frog has its ovary attached dorsally on one side and is suspended into the coelom by a
mesentry, which is a coiled oviduct with a funnel–shaped opening called the ostium at its anterior
end, and its uterus being an enlargement near the cloaca. Meanwhile, the male frog has two tests
which each suspend from the dorsal abdominal wall by a mesentery, and the several vasa efferentia
are small ducts that carry sperm from the testes into the kidneys followed by cloaca by the ureters,
also known as the genital ducts. The mating position of frogs is called the amplexus, a position
where the male grasps onto the female and fertilizes the eggs as they are being laid by the

Cranial Nerves
Cranial Nerves The human body is a unique and fascinating entity. There is not much notice taken of
the features the human body is capable of. The brain is necessary to perform day–to–day actions,
such as the ability to speak, and see amongst us. This brain is made up of simple mater (Pia mater,
Arachnoid mater, Dura mater) and the cranial surface to protect the brain. We live our daily lives
without acknowledging the importance of this organ, the brain, unless you're a medical student of
course! Despite that people go on with their daily activities using the human natural senses. Looking
at the world through the eyes, watching for any danger around us; ears for hearing the sounds
detecting something that may call for danger, the ... Show more content on Helpwriting.net ...
The second cranial nerve is optic nerve. Optic nerves main function is vision, one of the important
senses of the human body. Allowing oneself to see around them. The cell bodies of the optic nerve
are located in the Retina (ganglion cells). Optic nerve begins with unmyelinated axons of the
rentinal ganglion cells, which later become myelinated in the optic disc. CN II enters the cranium
via the optic canal. The retina has bipolar cells that are connected to the special sensory fibers (rods
and cone cells). When light hits the rod and cone cells, electrical impulse are relayed and transmitted
to the bipolar cells. That is when the bipolar cells transmit electrical activity to the CNS through the
optic nerve. Loosing the sense of vision can be very detrimental. Some of the dysfunctions that
occur with CN II are immediate monocular blindness (partial or complete), visual field deficits,
blurring, scotomata, and monocular diplopia. There can be many possible causes for these
dysfunctions to name a few, immediate loss of vision is due to injury to optic nerve due to ischemia
or death, delayed vision loss is due to infarction of the optic nerve or less frequently by hematoma
surrounding the nerve. Complete monocular blindness is usually due to non–organic disorders.
Blurring and scotomata are due to trauma to the cornea, vitreous tears, traumatically induced

The Most Common Form Of Dementia
The second most common form of dementia is vascular dementia, which happens when there is a
blockage in the blood vessels that is in the vast system of the arteries that feeds the brain. Vascular
dementia is known to affect the thinking process and older people are generally more prone to
developing this disorder. Vascular Dementia, also known as multi–infarct dementia, occurs when
cells in the brain are deprived of oxygen. Mini–strokes, also known as silent strokes, are the cause of
partial blockage of the blood vessels. The people that suffer from strokes have a 30% chance of
getting dementia within three months of their stroke (Kumral and Özgören, 2017).
The vascular system oversees the blood vessels and provides the brain with oxygen. ... Show more
Which older people are more prone to blockage of these arteries
Correspondingly, there are two pathways that transports blood to the brain called internal carotid
artery and vertebral artery. The internal carotid artery has three layers call the tunica adventitia,
tunica media, and tunica intima. Tunica intima is made up of smooth muscle cells and elastin. The
basilar artery forms and it branches out to the posterior cerebral arteries. The posterior cerebral
arteries form the internal carotid arteries and when they connect they make cerebral arterial circle (
circle of willis). The middle cerebral arteries branch out two separate arteries called the anterior
cerebral arteries. Each of these arteries are the force that direct the blood flow to the brain. There are
three tiny vascular systems that work together to profuse the deep brain. Which are the pial,
subependymal, and lenticulostriate arteries. The small area of white matter that depends on blood
flow is called the subcortical "shed water" area. The subcortical is more prone than other areas of
the brain to have ischemia. The leading cause of ischemia is the fibrin builds up and this cause a
narrowing of the lumen. Which does not allow the flow of red blood cells and deprives the white
matter of tissue of oxygen. The tissue then losses density and produces white matter lesions. The
neurons become demyelinated which leads to loss of cognitive ability.
Furthermore, the symptoms displayed by vascular dementia will

Causes Of Visceral Pleura
The parietal pleura drains its lymphatic fluid into the internal thoracic chain anteriorly and
intercostal chains posteriorly, while the diaphragmatic pleura drains into the mediastinal, retrosternal
and coeliac axis nodes.
Should we move this under parietal pleura?
Importance of difference in drainage to that of lung in the behaviour of malignant mesothelioma.
Recognized in latest 8th TNM revision with no demarcation between N1 and N2 as per lung cancer,
just N1 for all ipsilateral nodal metastasis.
I am unsure how to make thir read better?
The visceral pleura is devoid of somatic innervation. Nerves of the visceral pleura originate from the
thoracolumbar sympathetic system and are supplied via the pulmonary plexus. The visceral ... Show
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With a combination of sharp and blunt dissection, the parietal pleura is mobilized off important
structures, namely aorta, left subclavian artery, left common carotid artery, phrenic and vagus nerves
on the left and on the right, subclavian vessels, azygous vein, superior vena cava and phrenic nerve.
Resection of malignant solitary fibrous tumours, arising from the parietal pleura may require
resection of underlying chest wall if tumour invasion beyond the endothoracic fascia is suspected or
apparent.
Even in primary malignant disease of the pleura partial thickness resection over the diaphragm
???????????????? as there is a potential plane between the parietal pleura and the diaphragmatic
muscle fibres.
Do we actually perform partial thickness resections in malignant disease or should we get rid of this
sentence all together?
Again when removing a malignant pleural tumour it may be possible to dissect a plane between the
pericardium and mediastinal pleura if there is direct invasion then a part of pericardium must be
resected en bloc
The parietal pleura receives its blood supply from systemic arteries. These include intercostal
arteries, bronchial arteries, branches of the internal mammary and subclavian artery. Drainage is

mostly through the bronchial veins or directly into the vena cavae. The visceral pleural is supplied
by the bronchial arteries and the pulmonary circulation. Its venous drainage

The Longitudinal Layer
The longitudinal layer is 2.5 mm thick and the thickness decreases with age. Cranially the layer is
predominantly muscular while fibro–elastic caudally. The fibro–elastic tissue of the longitudinal
layer is continuous with the fibro–elastic network outside the sphincter to the perianal skin to form
the corrugator cutis ani, thereby forming an intra–sphincteric fibro–elastic network passing through
the external sphincter(Stoker, 2009).
External anal sphincter The external sphincter is a cylindrical striated muscle under voluntary
control and comprises predominantly slow–twitch muscle fibres, capable of prolonged contraction.
With age there is a shift towards more type II (rapid) fibres (Cni, 1993). The external sphincter has a
nerve supply by the inferior rectal branch of the pudendal nerve (S2, S3) and the perineal branch of
the fourth sacral nerve (S4). Primary function is closure of the anal canal to postpone evacuation,
regulation is partly reflex (e.g., sudden increase in abdominal pressure) and partly voluntary through
the visceral and somatic afferent and somatic efferent nerves. The external sphincter also contributes
to some extent to the anal resting tone. The external sphincter constitutes the inferior outer aspect of
the anal sphincter and envelops the inter–sphincteric space . The external sphincter is approximately
2.7 cm high, but is anteriorly shorter in women (approximately 1.5 cm) (Rociu et al., 2000). The
lateral part of the external sphincter is

Cerebral Circulation Of The Body
Cerebral circulation
Cerebral circulation is the movement of blood through the blood vessels to supply the brain.As brain
is the most complicated structure of our body,it needs lots of energy,and then it needs lots of blood
supply.Almost 20 percent blood of the body is used by the brain.And the rate of the cerebral blood
flow is 750ml per minute for an adult,representing 15 percent of the cardiac output.The arteries
deliver oxygenated blood,glucose,and some other nutrients to the brain to make it function properly.
Blood supply to the brain
The cerebral circulation includes two systems:the anterior cerebral circulation system and the
posterior cerebral circulation system.The anterior circulation system supplies blood primarily to the
middle and front portion of the brain and consists of the left and right carotid arteries.The anterior
blood supply system originated from the carotid arteries.The carotid artery is from the heart and
goes up to the head through the neck.The carotid artery bifurcates into internal carotid artery and
external carotid artery,and the internal carotid artery will go inside the skull to supply blood to the
brain hemisphere,the external carotid artery goes outside of the skull to supply blood to the face.In
the anterior system,there are another two important arteries––––the anterior cerebral artery and the
middle cerebral artery.The anterior cerebral artery originate from the internal carotid artery,stays in
the midline of the brain and supplies blood

Cerebrovascular Accident : The And Haemorrhagic Stroke
Cerebrovascular Accident: Ischaemic & Haemorrhagic Stroke
A CVA occurs when a part of the brain is damaged or destroyed due to an interruption of blood flow
to the area resulting in brain cell death (Martini, Nath & Bartholomew 2015 pp. 496–470).There are
two main types of a CVA, Ischaemic stroke and Haemorrhagic stroke (AIHW 2013). The most
common cause of stroke is ischaemic, which can be caused by embolism/thrombosis (AIHW 2013).
An embolism/thrombosis occurs when there is a clot in an artery or vein, which stops blood flow to
the brain (AIHW 2013). A haemorrhagic stroke is when an artery ruptures and bleeds into the
surrounding brain tissue (AIHW 2013). This form of stroke occurs when blood pools and forms a
clot therefore putting pressure on the area of the brain depriving it of oxygen and nutrients it needs
to remain healthy (AIHW 2013).
Lastly, Ischaemic stroke is fatal in one third of cases, making it the third most common cause of
death in developed counties (Nedeltchev & Mattle 2014, pp. 124–129). Among the survivors of
stroke, at least half are permanently disabled, making stroke a major cause of long–term physical,
cognitive, emotional, and social disability (Redfern, Mckevitt & Wolfe 2006, pp. 123–141).
However, there has been a reduction in stroke deaths over the last ten years due to an increase in
public awareness through programs and education around reducing risk factors for stroke (AIHW
2013). These programs targeted specific causes, such as; smoking,

Anthropology Case Study Judy
Judy is a 53 year old mother of two and grandmother of 3 grandchildren. On a simple trip to the
store on afternoon, Judy's life changed in just a split second. While waiting at a red light, Judy was
rear ended and violently hit her head on the steering wheel. Judy states she tried to remove her
seatbelt but was unable due to her arms being paralyzed. During this ordeal, Judy also stated that her
pain felt as if "a knife had been stuck in her neck." During her hospital stay the emergency room
doctor told Judy that she was suffering from whiplash. While at the hospital, Judy kept telling the
doctor that she was in a lot of pain, but no further testing could be performed, such as an MRI,
because her insurance wouldn't cover it. Judy was sent home with a cervical collar and the diagnosis
of whiplash. Unable to have very much mobility and having a hard time lying down, one night while
... Show more content on Helpwriting.net ...
The back of the skull is called the occipital bone, hence the term atlanto–occipital dislocation. The
spinal cord is the column of nerve fibers responsible for sending and receiving messages from the
brain, these nerves are what are responsible for controlling movement and organ function.
(Foundation, 2015) (Nicholas Theodore, 2013)The spinal cord runs through a hollow space in the
spine referred to as the vertebral foramen. Without the protection of the spine for the spinal cord,
many nerve issues can arise and if there is a drastic separation from the cervical spine especially,
even death can occur. Internal decapitation is a rare dislocation that has a higher rate of fatality then
it does of

Treatment Of Malignant Middle Cerebral Artery Infarction
DECOMPRESSIVE CRANIECTOMY FOR MALIGNANT MIDDLE CEREBRAL ARTERY
INFARCTION
INTRODUCTION
Stroke represents a public health issue that is affecting both developed and developing countries. A
lot money and time have been invested in attempts to improve outcome in these patients. The
majority of patients are treated with medical management. There are however few patients in which
an occlusion of the middle cerebral artery (MCA) can lead to progressive edema, mass effect and
herniation of the brain. As a consequence of this progressive rise in intracranial pressure surgical
decompression of the cranium is often considered creating a role for the neurosurgeon in the
management of stroke patients. I will present a case of a young boy with an underlying predisposing
factor who presented with malignant progression of an MCA infarct, that required surgical
intervention.
CASE
A 14 year old boy presented to the Accident and Emergency department of the Kingston Public
Hospital with a history of acute left sided weakness. He was known to have sickle cell disease with
the HbSS genotype. He had previously presented with a stroke and had residual right sided
weakness. There was no history of headaches fever, vomiting, chest or joint pain. He was admitted
to the medical ward where treatment was instituted. On admission he had a Glasgow Coma Score
(GCS) of 15 with grade 2 power (MRC) in the upper limbs and grade 3 (MRC) in the lower limbs.
Radiological investigations were

Human Anatomy lab answers Essay
Instructor's Manual for the Laboratory Manual to Accompany Hole's Essentials of Human Anatomy
and Physiology Eighth Edition Terry R. Martin Kishwaukee College Instructor's Manual for the
Laboratory Manual to Accompany Hole's essentials of human anatomy and physiology, eighth
edition David shier, jackie butler, and ricki lewis Published by McGraw–Hill Higher Education, an
imprint of The McGraw–Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020.
Copyright © The McGraw–Hill Companies, Inc, 2003, 2000, 1998. All rights reserved. The
contents, or parts thereof, may be reproduced in print form solely ... Show more content on
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The instructor's manual also parallels the laboratory manual, exercise by exercise, providing labels
for unlabeled diagrams and answers to questions that appear in the laboratory reports. For some
exercises, special instructional suggestions that propose alternative procedures, laboratory
equipment, or laboratory techniques are provided. Most of the illustrations and labels parallel the
textbook very closely, as requested by many of the users of the laboratory manual. Many of the
leader lines are arranged differently than the textbook, and several illustrations are different than the
textbook. This has been requested also by many of the users of the laboratory manual. I have
attempted to reach a balance that will be beneficial for all students and instructors. An Overview The
Laboratory Manual to Accompany Hole's Human Anatomy and Physiology, eighth edition, was
written to accompany the textbook Hole's Essentials of Human Anatomy and Physiology, eighth
edition, by Shier, Butler, and Lewis. As in the case of the textbook, the laboratory manual is planned
for students pursuing careers in allied health fields who have minimal backgrounds in the physical
and biological sciences. The manual contains forty–eight laboratory exercises that are integrated
closely with the content of the textbook. The exercises are designed to review and illustrate various
anatomical and physiological facts and principles presented in the textbook and

Anterior Corpectomy Essay
Complications: Anterior cervical discectomy and fusion (ACDF) or anterior corpectomy carries the
risk of recurrent laryngeal nerve injury or superior laryngeal nerve injury which leads to hoarness of
voice and the incidence is about 1–3%. The left side approach and placing the retractor under longus
collis can help prevent the injury. One of the most common complication of anterior approach is
postoperative dysphagia which is due to hematoma formation, prolonged retraction and denervation
of the upper esophagus by injury to the pharyngeal plexus. Temporary hoarseness incidence is 3%,
while permanent hoarseness is 0.33%. other complications are vertebral artery injury, hardware
breakage or migration, pseudoarthrosis, graft dislodgement, Horner's

TJR Case Study
Due to the large number of TJR cases and the high cost associated with the procedure, TJR
continues to be bundled into episodes of care with success. As a result, in 2015 CMMI initiated the
Comprehensive Care for Joint Replacement Program (CJR), a sort of next generation of Model 2,
but specifically for TJR. CJR is not voluntary but rather a mandatory program in which hospitals
across 67 Metropolitan Statistical Areas (MSAs) must participate.6 CJR represents continued
refinement in the shift from Fee–For–Service to value–based medicine. The program increases the
risk carried by the hospital by putting each hospital at risk for the total cost of TJR. This includes
DRGs 469 and 470. In order to minimize losses and maximize savings, ... Show more content on
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The Cardiac Rehabilitation (CR) model has been developed to encourage greater utilization of post–
acute treatment for AMI or CABG patients in the 90–day post–discharge period. The goal of the
models is to improve the quality of care for several heart conditions and surgery on hips other than
total hip replacement.11 After the success of CJR, CMS expects the EPM and CR programs to
significantly increase quality and reduce cost by the same principles. Moreover, while the
mandatory programs show promise, voluntary–based bundle–based programs are also improving
value–based care. For example, a study evaluating AMI, heart failure, and pneumonia demonstrated
that hospitals that participated in these Medicare value–based programs led to a reduction in thirty–
day standardized readmission rates.9 This study suggests that even in the absence of a mandatory
episode of care based payment model, it may be to a hospital's advantage to consider these programs
as they may lower cost while increasing quality of care.
Defining Episode of Care in Spine Operations CMS has defined 48 episodes of care, and while TJR
and CABG were the most subscribed, several of the episodes have been defined for operations on
the spine. These episodes include: cervical spine fusion, combined anterior posterior spinal fusion,
complex non–Cervical spinal fusion, non–Cervical spinal fusion, and various back and neck
procedures.10 In general, spine bundle payments are currently not as well defined under CMS

A case of cerebrovascular accident
1. Define the terms ischemia and infarction. Ischemia– local decrease in blood supply Infarction–
death & deterioration of tissue resulting from lack of blood supply. 2. What is a stroke? Name the
two main types of strokes and describe the mechanism(s) by which each type occurs.
Cerebrovascular Accident– condition in which brain tissue is deprived of blood supply. The most
common stroke symptoms are: Numbness or weakness (paresis) of the face, arm, or leg, sometimes
only on one side; Confusion, trouble speaking or understanding speech (aphasia) Trouble seeing
Trouble walking or dizziness; loss of balance or coordination (ataxia) Severe headache with no
known cause 1. Ischemic stroke (~83%) – blood vessel supplying brain ... Show more content on
Helpwriting.net ...
Motor Tracts– Lateral and Anterior corticospinal tracts all decussate (cross over) between the
cerebral cortex and the spinal cord. Samuel's motor and sensory deficits are on his right side,
therefore his CVA must involve his left cerebral hemisphere. His type of aphasia also indicates
involvement of Broca's area (also on the L cerebral cortex). The fact that he has both right side
sensory and motor deficits and speech deficits, indicate damage to the motor and sensory cortex
located on the frontal and parietal lobes, both of which would mainly be supplied with blood by the
left middle cerebral artery. Samuel's CVA is most likely due to a clot there. 10. Describe the means
by which individuals who survive a stroke regain at least part of their lost abilities. In my personal
opinion, I think that brain cells can made a by–pass with another working or living brain cell. With
the fast action of a MD, and a proper rehabilitation this could happen. There are numerous
approaches to stroke rehabilitation, some of which are still in the early stages of development.
Behavioral performance in any area, such as sensory–motor and cognitive function, is most likely to
improve when motor activity is willful, repetitive and task specific. Stroke rehabilitation may
include some or all of the following activities, depending on the part of the body or type of ability

Earthworm Research Paper
The Earthworm is a crucial component of the environment due to their interactions with soil which
then, in turn, provides benefits to other living organisms such as their burrowing behavior, which
allows nutrients, air, and water to delve deeper into the soil. After soil is swallowed by the pharynx,
the food matter is sent through the esophagus and into the crop, where the soil is stored until it
interacts with the gizzard. The main function of the gizzard to grind the soils so that it can enter the
intestine, where gland cells within release fluid to aid in the process. When organic matter is finally
excreted from the intestine to the anus through the worm through the process of casting, more
nutrients are introduce into the soil that benefit plant life. The earthworm also has a brain located
behind its pharynx, called the cerebral ganglia, that is crucial for movement. The ... Show more
An aquatic vertebrate, the perch has a semi–complex digestive system. It consists of the kidneys,
intestines, stomach, pyloric cecum, liver, and esophagus. When food is swallowed by the tongue,
food passes through the esophagus to the stomach, which digests the food then brings it to the
intestines. The liver secretes a bile to aid in the digestion process and the pyloric cecum allows
fermentation to occur. Their nervous system includes a vertebral column, connected by the neural
spine, the spinal cord, and finally the brain. The perch's brain is surrounded by a skull and is located
in the anterior of the body. Also, the perch has both an olfactory bulb and nerve, which relays
sensory information to the brain. Finally, the perch's circulatory system includes the two–chamber
heart, a spleen, a ventral aorta (which has four branches), and its gills. Blood leaves the sinus
venosus to the heart, then to the ventricle. The ventral aorta carries the blood to the gills to exchange
carbon dioxide for oxygen ("Anatomy of a

Biology Questions
BIO 169 Ch. 20 S.G.
Name: __________________________ Date: _____________
1. The anatomical region found between the lungs that extends from the sternum to the vertebral
column and from the first rib to the diaphragm.
A) Epicardium
B) Abdominal cavity
C) Pericardium
D) Mediastinum
E) Thoracic cavity
2. The membrane that surrounds and protects the heart is called the
A) pericardium.
B) pleura.
C) myocardium.
D) mediastinum.
E) endocardium.
3. The apex of the heart is normally pointed
A) at the midline.
B) to the left of the midline.
C) to the right of the midline.
D) is different for males and females
E) posteriorly.
4. The outermost layer of the pericardium, which consists of inelastic dense irregular
connective ... Show more content on Helpwriting.net ...
Cardiac muscle fibers are electrically connected to neighboring fibers by
A) desmosomes.
B) tight junctions.
C) gap junctions.
D) interneurons.
E) chordae tendinae.
22. Which of the following types of muscle contains the largest number of mitochondria per cell? A)
Smooth muscle
B) Skeletal muscle
C) Cardiac muscle
D) All the muscle types contain approximately the same number.

E) Mitochondria are not found in muscle cells.
23. This is a network of specialized cardiac muscle fibers that provide a path for each cycle of
cardiac excitation to progress through the heart.
A) Systemic circuit
B) Intercalated discs
C) Cardiovascular center
D) Cardiac conduction system
E) Pulmonary circuit
24. Which of the following correctly lists the sequence of structures that a cardiac action potential
follows in order to excite normal contraction of the heart?
A) Bundle of His, Purkinje fibers, Atrioventricular (AV) node
B) Sinoatrial (SA) node, Purkinje fibers, AV node, Bundle of His
C) Purkinje fibers, AV node, SA node, Bundle of His
D) SA node, AV node, Bundle of His, Purkinje fibers
E) Bundle of His, SA node, AV node, Purkinje fibers
Page 4
BIO 169 Ch. 20 S.G.
25. In comparison to skeletal muscle fibers, the contractile fibers of the heart are depolarized for
____ period of time.
A) a shorter
B) a longer
C) the same
26. The volume of blood ejected from the left

Magnetic Resonance Imaging And Its Effects On The Brain
MRI it is stands for Magnetic resonance imaging which is the best modality to choice when we want
to see the of the spine, it is not invasive procedure, not associated with ionizing radiation to the
patient, and provides an excellent soft tissue contrast compared to the other imaging modality. MRI
it is use for clarification substantially all spine problem such as degenerative disc diseases and
infectious or inflammatory diseases of the spinal cord, identify any spinal tumors, vascular
malformations, bone diseases and trauma of the spine. However cervical spine imaging had some
challenges to MR imaging due to the small structures such as neural foramina and the lack of fat
within it, also the neural foramina are positioned in an ... Show more content on Helpwriting.net ...
Cervical degenerative disc disease is less common than the lumbar area and it often called cervical
spondylosis, the stresses of the changes in ligaments and facet joints to enlarge become hypertrophy
as they need to spread the load over a larger area leading to compression of the spinal cord and
nerves causing some symptoms that can be range from mild to severe this is starting with pain and
over the years the symptom gets worse like spread out of the pain from the region that is affected to
shoulders and base of the skull, also down from arms to the hands ending in fingers and this is
because of compression to the nerves that courses down to supply the hands, the pain may get worse

Gross Morphology
Gross Morphology:
The vastus medialis (VM) muscle is often described as having two parts to it. Proximally (and
running down most the length of the femur) is the longus component (VML). Distally where the
VM angle of muscle fibres begins to change from parallel/ vertical to an oblique angle is the oblique
component (VMO) (Adds and Skinner 2012).
Proximally, (VM) attaches to the proximal femur. Starting at the intertrochanteric line and moving
posteroinferiorly to the medial supracondylar line (having passed over the pectineal line and the
medial lip of the linear aspera (Drake et al 2013)). Distally the VM attaches to the medial boarder of
the patella bone over the knee joint.
VM is innervated by the femoral nerve, as with the rest of the quadriceps group. The femoral nerve
is derived from the lumbosacral plexus, in particular spinal nerves L2,L3 and L4 (Drake et al). This
however ... Show more content on Helpwriting.net ...
It runs from medially to the vastus intermedius and contracts with it (both being innervated
primarily by the femoral nerve). The distal portion, VMO, has a stabilising role of the patella during
knee extension (Benjafield 2013). The angle of pennation of VMO acts as evidence and the
contraction will occur in the direction of pennation, thus demonstrating the VMO will provide a
medial pull when activated (during knee extension)
Normally, the patella tracks down from the intercondylar groove of the femur with extension
(Standring 2008). Senavongse ##@%)% found that VMO is predominantly active and functioning
as a stabilizer in the last 15 of active extension.The influence of VMO on the patella's normal
movements is to supply a stabilizing medial pull to counter that of vastus lateralis. It is the main
provider of the medial force during contraction due its dominant contribution to cross sectional area
(largely increase by having an increased angle of pennation (Raimondo et al

Cardiovascular System Essays
The cardiovascular system, which consists of the heart and blood vessels, is the circulatory systems
in our body. The major function of the system is transportation; the heart is the system pump and the
blood vessels are the delivery routes. The heart transport respiratory gases, nutrients, wastes, and
other substances vital to the body's homeostasis to and from the cells by using the blood as a
medium.
The heart is a cone–shaped organ approximately the size of a fist with an apex and a base. It is
located within the mediastinum or medial cavity of the thorax. The heart is enclosed within a double
walled pericardium, a fibroserous sac. The pericardium has a superficial fibrous pericardium and
deep two–layer serous pericardium. The ... Show more content on Helpwriting.net ...
Left ventricle pumps the blood into the aorta, where the blood is supplied to the body tissues by the
systemic arteries.
Heart valves ensure one way blood flow through heart. The atrioventricular (AV) valves lie between
the atria and the ventricles prevents the back flow of blood in to the atria while the ventricles
contract. Chordae tendinae anchor AV values to papillary muscles. The left AV valve, the mitral or
bicuspid valve consists of two cusps of endocardium. The right atrioventricular valve, the tricuspid
valve, has three cusps. The second sets of valve are the semilunar valves. The pulmonary semilunar
valves lie between the right ventricle and pulmonary trunk. Aortic semilunar valves lie between
ventricle and the aorta. Semilunar valves prevent the backflow of blood into the ventricle.
The hearts function as a double pump that serves two circulations. The pulmonary pump in the right
side of heart is provided for the gas exchange in the body, and the systemic circulation in the left
side provides the functional blood supply to all body tissues. The functional blood to the heart is
provided by the coronary arteries. Right coronary artery supplies the heart through the posterior
interventricular and marginal artery branches; and the left coronary artery supplies the heart via
anterior interventricular artery and the circumflex artery. The myocardium is drained by great, small,
and middle cardiac veins which

Cerebrovascular Injury
Main Question Post Cerebrovascular accidents, or strokes, will lead to brain damage that affects the
functioning of executive function, memory, language, visuospatial performance and emotional
states. Corresponding vertebral arteries and carotid arteries provide blood to the brain from the heart
that the carotid arteries are internal and external sections of the thyroid cartilage. Where the optic
nerve rests the internal artery distributes into the anterior and middle cerebral arteries. The vertebral
arteries arise through the spinal vertebrae and meet the lower pons to form the basilar artery. The
brain receives 15% to 20% of the oxygenated blood from the heart and can only endure fleeting
interruptions of blood flow before neural operations ... Show more content on Helpwriting.net ...
It is important to agree with them, contradiction leads to frustration for both individual and
caregiver. If they have trouble with language, understanding, speak slowly with simple words, using
gentle tones and repeating them. Utilize visual cues often, show the brush brushing your hair. Do not
get into verbal conflict, walk away to calm yourself, then come back and listen to them. Always stay
with a routine, this allows the body memory to work; same time waking, bedtime, meals, dressing
and bathing. Participate in simple activities, things they enjoy doing (Paturel, 2015). The caregiver
also needs to take care of themselves by eating healthy, and regularly as well as getting enough
sleep. A caregiver can achieve this by cultivating a network of support or join a support group of
caregivers. Understanding the behaviors of the stroke patient is not personal is critical, it is
symptoms of the disease. Living in the moment with the individual who suffered a stroke is key, the
moments of marvel and amazement that are delightful, compared with the unbearable moments
(Paturel,

Pathological Observation
Today, I have a chance to observe a pathologist who had done an autopsy. The autopsy is begun at 7:
30 A.M. The first victim is a white woman, 50 years old. The body is enclosed in a black plastic bag.
The victim is lying on her supine position with her palms faced forward. The pathologist palpates
the head to examine any skull damages or trauma. He starts removing the brain by incision in the
back of the skull, and then the scalp is removed. The brain is coved by meninges which are
composed of three thin layers. There is no abnormality of meninges found. However, there is
deficiency of blood supply of the brain arteries; therefore, he predicts that the victim had ischemic
stroke before death. There is no evident of dementia such as Alzheimer ... Show more content on
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The Y–shaped incision is performed from the shoulders joining over the sternum and continuous cut
through umbilical region down to the pubic bone. He examines the oral cavity, and the air tube from
back of the nose pharynx that connects to the voice box larynx; all of these are normal. However,
the inflammation of esophagus is found right behind the upper esophageal sphincter. He predicted
the victim used to suffer postprandial burning chest pain. Chyme is found in the duodenum part of
the small intestine. The pathologist can take them to the laboratory for further examination. He also
isolates the pancreas which is connected to the duodenum to examine any pancreatic diseases. The
result is the victim had type 2 diabetes; it means the pancreas is unable to produce insulin to control
the blood sugar level. In victim's urinary system, he dissects the kidney and found she had pyelitis
which is the inflammation of renal pelvic region of the kidney. The victim may experience the
unconscious urination such as micturition syncope as well. About the reproductive system, the
victim had no

Essay On Pulmonary Embolism
Various studies has been presented many methods to prevent pulmonary embolism in high–risk
patents which mostly focus on using of inferior vena cava filters, and anticoagulation. However,
contradictory results are suggested within this research because only a certain type of inferior vena
cava filters are examined, for example, prophylactic inferior vena cava filters. Dazley et al. (2012)
shows the efficacy of propyl lactic IVC filters in preventing the development of venous
thromboembolic event in patients undergoing surgery, while the other study proposes the different
result. To understand how IVC filters and anticoagulation effect on high–risk patients. This paper
study Dazley et al.'s (2012) research to express better understand how ... Show more content on
Helpwriting.net ...
Small embolism that stuck in the peripheral branches of the pulmonary artery are clinically silent
and may go unrecognized. People with moderate–sized emboli often present with breathlessness
accompanied by pleuritic pain, apprehension, slight fever, and cough productive of blood–streaked
sputum. Patients with massive emboli frequently specific with sudden collapse, crushing substernal
chest pain, shock, sometimes loss of consciousness; so massive emboli often are mortal (Porth,
2011).
Spinal cord injury is the serous risk that cause VTEs and lead to PE, so Dazley et al. (2012) research
concentrations on the efficiency of prophylactic IVC filters PE in patients undergoing major spinal
injury to prevent PE. Pulmonary embolism has been present in up to 12% of patients undergoing
spine surgery and 2% fatal rate (Dazley et al., 2012); therefore, patients diagnosed with PE require
prompt and aggressive treatment with anticoagulation such as low–dose heparin and low molecular–
weight heparin. However, the anticoagulation pharmacologic agent can cause bleeding problems, up
to 67% (Dazley et al., 2012), and the most bleeding complication in spinal cord surgery is
compressive epidural hematomas; therefore, the bleeding complications become worst in patients
who cannot be treated with anticoagulation. Their effects require immediate surgical intervention
and still may leave patients with permanent neurological deficits in as many as 37.5% of patients
((Dazley et

Importance Of Cerebral Circulation
Cerebral Circulation
A constant flow of blood to the brain is vital to its proper functioning. Blood supplies the brain with
oxygen and to perform maximally the brain requires about 25% of the body's oxygen (Webb, 2016).
Lack of oxygen for a prolonged period results in cell death causing irreversible damage to the brain.
Two paired arteries, four total, supply the vital source of blood to the brain and spinal cord.
Arterial Structures
Blood supply to the brain is divided between the internal carotid arteries (ICA) and the vertebral
arteries. As stated in Cippola's text, the right and left ICA from the bifurcations of the common
carotid arteries and the ICA itself also split in the anterior and middle cerebral arteries. Its primary
function is to supply blood to the cerebrum. The vertebral arteries originate from the subclavian
artery and then "join distally to form the basilar artery", (Cipolla, 2009). The basilar artery later
bifurcates into two posterior cerebral arteries , these arteries "supply the inferolateral surface of the
temporal lobe and the lateral and medial surfaces of the occipital lobe," (Webb, 2016). While the
ICA mainly provides blood to the cerebrum, the vertebral arteries are the primary supply to brain
stem and cerebellum. The ICA and the vertebral arteries join together to form what is known as the
Circle of Willis.
Circle of Willis
The Circle of Willis is also known as the circulus arteriosus. It is a structure that is formed by the
joining of the two

The Fusion Of Spinal Fusion
Spinal fusion is categorized into three different categories: cervical, thoracic, and lumbar, in
conjunction with the different segments of the spine. Each type of spinal fusion has a different goal
depending on the purpose of the surgery. Most surgeries involve fusing vertebrae together to limit its
range of motion, thereby hopefully reducing the pain or correcting any physical deformities.
Depending on the levels of fusion, spinal fusion surgeries tend to last a few hours. Complications
may arise during surgery, and they greatly increase depending the location of the fusion, levels of
fusion, and if the surgery crosses any important nerve sites. Levels of spinal fusion are known as the
fusion between two different vertebrae. If there is a fusion between L1 and L2, that is known as one
level of fusion. If there is another site of fusion at L3 and L4, than there will be two levels of spinal
fusion. Lumbar fusion are further complicated when more then one level of performed. By limiting
one segment's range of motion, other segments of the spine will have to compensate and create
greater range of motion. With lumbar fusion, most doctors will need to be able to identify why a
patient needs lumbar fusion, and being able to identify if lumbar fusion will help alleviate the pain.
Most cases of lumbar fusion involve spondylolisthesis, fractures, spinal stenosis, scoliosis, and
possibly herniated disk if no other further treatment has proven successful. Most physicians will
order an

Circle Of Willis Research Paper
The circle of Willis is a circular collection of blood vessels, which is formed when the blood flows
from the internal carotid artery and enters into the cranial cavity bilaterally. Once blood circulates
into the brain, it divides into the anterior cerebral artery and middle cerebral artery. The anterior
cerebral artery supplies blood to the medial surface of the frontal and parietal blobs, while the
middle cerebral supplies the lateral portions of the hemispheres and through branches that supply
internal structures such as basal ganglia and internal capsule. As the blood branches out into these
structures, the anterior cerebral arteries are connected to the anterior communicating artery. These
connections form the anterior half of the circle

Clipping Of Aneurysms Essay
"It's not stress that kills us, it is our reaction to it." That is a famed quote from Hans Selye, a famous
Hungarian endocrinologist, that relates to moments when a life is in a physician's hands. One wrong
move of a doctor and a patient could die. Learning to overcome fears and concentrate on the task at
hand is the most needed skill for a surgeon, a brain surgeon to be exact. Focusing on the central
nervous system I can fix the abnormalities and diseases of the brain. One of the highest pressure
surgeries neurosurgeons perform are the clipping of aneurysms.
Aneurysms are a ballooning and weak area in the wall of an artery that supplies blood to the brain.
They can burst at any moment and cause a subarachnoid hemorrhage, which is bleeding under the
layer of brain coverings called the arachnoid. This can cause increased intracranial pressure which
can lead to a stroke or even death if they aren't discovered in time. They most commonly occur in
the Circle of Willis in the anterior cerebral artery. ... Show more content on Helpwriting.net ...
I always send my patients to get an MRI or magnetic resonance image if they are complaining of
acute cephalalgia, which is a sudden and painful headache. This can mean many things but one of
the most serious reasons is the bursting of an aneurysm. In addition, I saw on her chart she had a
family history of deaths caused by ruptured aneurysms. Once her scans came back I saw indeed that
she had an immense ruptured aneurysm in her anterior cerebral artery which supplies blood to the
midline portions of the frontal lobes and superior medial parietal lobes. This meant that she would
need to be rushed into emergency surgery to clip her aneurysm. This is a life or death situation that
needs to be solved within

Essay On Coronary Intervention
Abstract:
Aim: Combined PCI and TAVR placement through a non conventional access in an elderly male
with multiple co–morbidities along with difficult access.
Methods and Results: 68 year old male with Society for Thoracic Surgeons score 4.55% and Euro
score II 2.92% due to the presence of myriad of diseases such as severe aortic stenosis, NYHA class
II, CCS class III angina, HIV, stage III COPD, severe peripheral vascular disease with prior right
axillary–femoral and femoral– femoral artery bypass with occluded abdominal aorta and
cerebrovascular disease with carotid stenosis underwent transaortic valve replacement through a
nonconforming transaxillary route simultaneously with a percutaneous coronary intervention with
immensely enhanced quality of life objectively one month post procedure.
Conclusion: Percutaneous coronary intervention and TAVR execution as a single procedure can
occur in discerning patient population as it does not increase the risk of mortality even in the setting
of severe multi–organ involvement.
Introduction:
In a ... Show more content on Helpwriting.net ...
His past medical history was remarkable for hypertension, stage III COPD by GOLD criteria, HIV,
severe peripheral vascular disease with prior right axillary to femoral and femoral to femoral artery
bypass with occluded "lead–pipe" abdominal aorta, cerebrovascular disease with moderate–to–
severe carotid stenosis, pulmonary hypertension, spinal stenosis and several previous orthopedic
procedures. Moreover he had an elevated Charlson Comorbidity Score and a prolonged 5–meter
walk test. The predicted operative mortality for surgical aortic valve replacement based on the
Society for Thoracic Surgeons score and Euro score II was 4.55% and 2.92% respectively. He was
deemed inoperable in light of his history and predicted surgical

Curricular Epidemiology: Basilar Cellular
I) Describe what would happen if there was a thrombosis (clot) in the middle cerebral artery?
Anterior cerebral artery? Basilar artery? MCA: hemiparesis or hemiplegia of lower half of the
contralateral face, Hemiparesis/hemiplegia of the contralateral upper and lower extremities, sensory
loss of contralateral face arm and leg, ataxia and contralateral extremities, speech impairments or
aphasia usually from a left brain lesion; perceptual deficits, visual disorders –ACA: hemiparesis or
hemiplegia of contralateral lower limbs and pelvic floor, sensory deficits contralateral and especially
leg and perineum, apraxia, disconnection syndrome, urinary incontinence, grasp reflex or sucking
reflex contra laterally –Basilar artery: neurosurgical emergency ... Show more content on
Helpwriting.net ...
All of these connections help to mediate the formation of memories. Interruption of such pathways
has shown disruption of memory. These connections are necessary to integrate the multiple areas of
the brain that are involved in the formation of emotion and memory. – The fornix primarily
functions to connect 1) Hippocampus to mammillary bodies 2) Mamillary bodies to anterior nuclei
of thalamus 3) Hippocampus to the septal nuclei and nucleus accumbens. VII) Describe how the
shape of the thalamus and brainstem reflect the presence of impinging cortical structures along the
antero–posterior axis. Describe the difference between sheep and human brains. – The thalamus is
divided along the anterior posterior axis – from front to back by a strip of myelinated fibers called
the Internal Medullary Laminal (IML). – The brainstem in humans runs vertically and in sheep it
runs horizontally because that is the direction of the spine. – I imagine that when there is a brain
injury in a human that causes swelling and herniation the brain stem is more at risk for damage
because it is vertical and in sheep it is not as much at risk for damage and impingement because it is

A&P Lab
Evaluate how the name of a muscle can distinguish its location, action, shape, and function. Select
five different muscles to make this distinction. Descriptive terms are used to name skeletal muscles.
Some names give the location in the body. The temporalis muscle is attached to the temporal bone in
the skull. The brachialis muscle is attached to the humerus bone, but brachial refers to the main
artery in the arm. Some muscles are named for their origins and insertions, like the genioglossus
muscle, for example, originates at the chin (geneion) and inserts in the tongue (glossus). Some
muscles are named for the arrangement of the fascicle groups. For example the rectus abdominus is
the straight muscle that is in the adbominus. ... Show more content on Helpwriting.net ...
scapula Mandible and skin of the cheek Depresses mandible; tenses skin of neck Facial nerve
Sternocleido–mastoid clavicular head attaches to sternal end of clavicle; sternal head attaches to
manubrium clavicular head attaches to sternal end of clavicle; sternal head attaches to manubrium
Together, they flex the neck; alone, one side bends head toward shoulder and turns face to opposite
side Accessory nerve (N XI) and cervical spinal nerves (C2–C3) of cervical plexus Splenius Spinous
processes and ligaments connecting inferior cervical and superior thoracic vertebrae Mastoid
process, occipital bone of skull, and superior cervical vertebrae Together, the two sides extend neck;
alone, each rotates and laterally flexes neck to that side Cervical spinal nerves Scalenes Transverse
and costal processes of cervical vertebrae Superior surfaces of first two ribs Elevate ribs or flex neck
Cervical spinal nerves External Coastals Inferior border of each rib Superior border of more inferior
rib Elevate ribs Intercostal nerves (branches of thoracic spinal nerves) External Oblique External
and inferior borders of ribs 5–12 Linea alba and iliac crest Compresses abdomen, depresses ribs,
flexes or bends spine Intercostal, iliohypogastric, and ilioinguinal nerves Diaphragm Xiphoid
process, cartilages of ribs 4–10, and anterior surfaces of lumbar vertebrae Central tendinous sheet
Contraction expands thoracic cavity, compresses abdominopelvic cavity Phrenic

The Trapezius Muscle Essay
The trapezius muscle:
– Origin: it has an extensive origin from the base of the skull to the upper lumbar vertebrae.
– Insertion: it inserts on the lateral aspect of the clavicle, acromion, and scapular spine.
– Nerve supply: It is innervated by the spinal accessory nerve.
– Action: It functions mainly as a scapular retractor and elevator of the lateral angle of the
scapula[19].
The rhomboids muscles:
The rhomboids, consisting of the major and minor muscles.
– Origin: the major and minor muscles originate from the spinous processes of C7 and T1 and T2 to
T5, respectively.
– Insertion: They insert on the medial aspect of the scapula.
– Nerve supply: The dorsal scapular nerve innervates the rhomboids.
– Action: and retract and elevate the scapula. [19]
The levator scapulae muscle:
– Origin: originates on the transverse processes of the cervical spine.
– Insertion: inserts on the superior angle of the scapula.
– Nerve supply: Innervation is from the third and fourth cervical spinal nerves.
– Action: The levator scapule elevates the superior angle, resulting in upward and medial rotation of
the scapular body[19].
The serratus anterior muscle:
– Origin: it takes origin from the bodies of the first nine ribs and the anterolateral aspect of the
thorax
– Insertion: it inserts through three portions from the superior to the inferior angle of the scapula.
– Nerve supply: Innervation is by the long thoracic nerve, and nerve injuries here often manifest as a
winged scapula.
–

Medical Experience Research Paper
Gavin McDowell Amy Professor Swathi Seeke Human Anatomy & Physiology I April 11, 2016
Medical Experience Sharing Paper – Ulnar Nerve Trailer The medical experience topic I would like
to explore and discuss is the ulnar nerve, a large and important nerve, and the anatomical and
physiological sequelae of damage to it. The topic is based on my own experience. In 2010, I
suffered a severe laceration of my left arm near the wrist, which, fortunately, was able to be treated
and partially relatively quickly. This is part of the reason that I was medically retired from the Army
in 2012, for combat–related injuries. The ulnar artery of that arm and several interossial tendons
were also severed. The artery was ligated (tied), and the nerve was repaired ... Show more content
on Helpwriting.net ...
I suffered a laceration of my arm, which proceeded laterally from the medial aspect of my left wrist.
The laceration only reached about halfway across this site, but that was enough to cause major
physiopathology in my left hand (primarily). The laceration severed my left ulnar nerve, ulnar
artery, and palmar interossei. I immediately lost sensation in the region described above (pinky and
medial aspect of ring finger, as well as proximally down my entire hand). Table 14.4 in the textbook
illustrates exactly the region affected (McKinley, O'Loughlin, & Bidle 556). I completely lost motor
control of the affected region, as well. I received first aid, and eventually surgeons were able to
repair the nerve, ligate the artery ("to tie," as in "ligament" or "ligature"; the artery could not be
repaired), and repair the palmar interossei. The reason that I still have a functioning left hand is that
both the ulnar and radial arteries supply blood to the hand. As the textbook describes (as if the
authors are describing my own situation), "If the left ulnar artery were cut, the left hand and fingers
could still receive blood via the left radial artery, since both vessels contribute to the superficial and
deep palmar arches" (McKinley, O'Loughlin, & Bidle

The Body System : The Endocrine System
The action of typing this assignment involves almost all the body systems: the endocrine system, the
cardiovascular system, the nervous system (brain, nerves, and spinal cord), the integumentary
system, the respiratory system, lymphatic system, digestive system, urinary system, immune system,
and the muscular system. The nervous system and the muscular system work together to perform the
action, while all the other systems provide the necessary support such as the energy required, the
oxygen required, and the skeletal support required.
The nervous system is the master communications and controlling system of the body. It is
organized into two main divisions: the Peripheral Nervous System (PNS) and the Central Nervous
System (CNS). CNS ... Show more content on Helpwriting.net ...
The sodium–potassium pump plays an important role in depolarization and repolarization of the
action potentials of the membrane. When the membrane is at resting potential, the sodium and
potassium channels are closed. The stimulus starts the depolarization of the membrane to a
threshold, after which sodium channels are opened. A large influx of sodium ions into the cell
generates a positive membrane potential and causes rapid depolarization as a result of which an
action potential is generated. As the membrane potential reaches +30 V, the sodium channels get
inactivated, and the potassium channels are opened. The potassium ions move out of the cells
beginning the repolarization of the membrane and restore it to its resting potential (Martini et al. pp.
408–409). These action potentials developed by the stimulus are carried by the axons of the sensory
neurons to the CNS. The information carried by the action potentials is processed at every relay
synapse, and is sent to the multiple nuclei and centers in spinal cord and brain (Martini et al. p. 510).
In the brain, the general somatic sensory information is relayed to the Primary Somatosensory
Cortex neurons. The Premotor Cortex (Somatic Sensory Association Area) interprets the received
sensory information, and the instructions to type are relayed to the Primary Motor Cortex. The
Primary

Transjustic And Cultural Reflection Of A Personal Experience
There are a few memorable experiences that assisted me in learning to work with diverse clients and
caregivers with linguistic and cultural differences from my own. The first one being a client age 82
with a diagnosis of moderate–severe global aphasia and severe verbal and oral apraxia. After a
transient ischemic attack (TIA) evolved into a left middle cerebral artery occlusion (MCA), her
speech output largely involved stereotypical "ma" utterances. This client has always arrived to her
speech and language sessions with a smile and in a timely manner. More often than not, we would
start by some small talk that involved some yes or no questions for her to answer and it was amazing
what she can convey with just her varying intonations of "ma"s and animated facial expressions. I
found it challenging to understand what she wanted to share in the beginning since I did not phrase
my questions or comments in a way that warranted clear answers nor did I use her low–tech AAC
book to supplement the conversations but after learning to shape my own words and getting
acquainted to her AAC book, her responses became clearer to me. I had the pleasure with working
with an amazing individual with Locked–in Syndrome who was 42 years old. Although limited
physically, she floored me with her motivation and humor during each session. This client and my
supervisor taught me the importance of using materials that related to their culture to spark interest
but also to balance those materials

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