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6529 Systemic Anatomy And Physiology
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6529 Systemic Anatomy And Physiology
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Course Code: 6529
University: University Of Canberra
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Country: Australia
Question:
Case Study
Sarah is a recently married 30-year-old English teacher who enjoys playing rugby 7s. Earlier today Sarah was hit hard during a tackle in her weekly rugby game. She immediately felt pain on the left side of her chest which got worse with every breath. She was having trouble breathing in that she felt she couldn’t “breath in” very well and her chest felt tight.The sports trainer on the ground called an ambulance as they suspected a pneumothorax. On the way to the hospital Sarah’s symptoms began to worsen, her blood pressure started to drop and her heart rate increased. At the hospital she was taken for an X-ray where the diagnosis of a tension pneumothorax was made.1.Compare and contrast a tension pneumothorax and a pneumothorax? 2.Using your knowledge of the processes and pressures involved in inspiration explain why Sarah is having trouble breathing 3.How would Sarah be treated and explain the physiological purpose of this treatment?4.Explain one factor that can impact the affinity of haemglobin for oxygen?5.What are the consequences of the tension pneumothorax on the cardiovascular system and how does this explain the symptoms of increased heart rate and decreased blood pressure? 6 months post recovery Sarah confirms she is pregnant. The growing fetus can impact a number of other physiological systems.6.Choosing two (2) systems covered in systemic anatomy and physiology (endocrine, cardiovascular, respiratory, urinary and gastrointestinal) explain how pregnancy can impact them.
Answer:
Pneumothorax is a condition in which the air becomes trapped into the pleural cavity that is in the space between the chest wall and lungs. This air then starts affecting the wall of the lungs by pushing it towards the wall resulting from collapsing. In the case of pneumothorax, the air is not appropriately pulled into the lungs and escapes into chest cavity, which leads to accumulation of air inside the thoracic cavity. According to [1], in particular, condition the accumulation of air to possess adverse impact on adjacent organs. When the air inside the thoracic cavity starts affecting other nearby organs, the condition is called tension pneumothorax. Rendering to the research channeled by [2], it is possible to have collapsed or punctured lung without having a buildup of pressure inside the lungs unlike tension pneumothorax, which is called pneumothorax.
By critically reviewing the case study of Sarah, it can be stated that she got hurt while playing rugby and felt an immediate pain on the left side of her chest. By observing the symptoms experienced by Sarah, it is evident that the patient is suffering from tension pneumothorax. It is recorded that Sarah is suffering from breathing complications which are due to the rise of pressure inside the chest. In tension pneumothorax, the injured tissue of the lung starts working as a one-way valve, which allows inflow of the air inside the lungs with the aid of inhalation process, whereas the outflow of the air is prohibited. With each inspiration, the volume of non-absorbable intra-pleural air inside the lung increases which increases the pressure [3]. Due to which, difficulty in the breathing process is observed in individuals suffering from tension pneumothorax, and it gets worse with each inspiration as found in Sarah.
Tension pneumothorax is a chronic illness which if not treated appropriately, might lead to adverse health outcome such as cardiovascular complications or can even lead to death.
One of the most common treatment method used in the case of a patient suffering from tension pneumothorax is needle decompression. In the needle compression, a large needle is inserted into pleural space to remove the air. After that a chest tube also known as Thoracostomy is inserted in to the thoracic cavity to drain out the excess amount of air and allow the lung to re-inflate again. It is done to release pressure from the lungs as the primary complication observed in tension pneumothorax is due to the pressure inside the lungs, which causes shortness of breathing, chest pain and other complications. It is done to remove air which has been trapped inside the thoracic cavity [4].
Rendering to the research conducted by [5], haemoglobin has a higher affinity towards oxygen as it can effectively bind with oxygen. There are several psychological factors which according to [6], influence the affinity of haemoglobin for oxygen. One of the factors which are commonly observed to alter oxygen’s affinity for haemoglobin is pH. When the pH in the body decreases, the deoxygenated form of haemoglobin tends to stabilise thereby reducing affinity of oxygen for haemoglobin. During optimal condition, haemoglobin plays a significant role in the body as it transfers oxygen from the lungs to different tissue. The process of transportation of blood is due to the pH difference of the lungs. As the pH in the blood near the lungs is high as compared to other parts, affinity of haemoglobin for oxygen is also increased, and as result haemoglobin is taken away to other parts of the body. However, in case of pneumothorax, blood is unable to reach the lungs disrupting the whole process.
Rendering to the study conducted by [7], tension pneumothorax possesses a negative impact on the cardiovascular system and also on the blood pressure of the individual. In the case of pneumothorax, the air remains trapped inside the lungs and builds up tension. This rise of pressure inside the wall of lungs tends to reduce the amount of blood going in to heart from the body resulting in low blood pressure in the patient and thereby increasing the risk of hypotension.
It possesses a negative impact on the cardiovascular system as due to the low blood pressure, heart also does not get adequate amount of blood which needs to be pumped therefore leading to shock. Apart from that, reduced cardiac output is also observed in the case of tension pneumothorax. Heart cavities in tension pneumothorax are not able to open up due to the pressure which leads to decreased cardiac feeling and hence as a result cardiac output of the individual also decreases.
By critically reviewing the case study of Sarah, it can be stated that pregnancy might possess a negative impact on respiratory system and gastrointestinal system. Pregnancy of Sarah possesses a negative impact on both of the organ system and gives rise to other physiological symptoms such as, shortness of breathing and bowel disorder. According to the research piloted by [8], the growing fetus possesses physical constraint on the lung, thereby decreasing the lung capacity as the lungs of the individual get compressed. Apart from that, during pregnancy progesterone hormone stimulated the respiratory centre in the brain, thus causing shortness of breathing.
Pregnancy also possesses a negative impact on the gastrointestinal system as increased level of progesterone hormone impacts gastrointestinal motility. The progesterone hormone also causes slowing down the digestion process in small and large intestine. Apart from that as the uterus grows, it can sometimes block or press some part of the digestive system thereby causing bowel disorder.
References:
Roberts DJ, Leigh-Smith S, Faris PD, Blackmore C, Ball CG, Robertson HL, Dixon E, James MT, Kirkpatrick AW, Kortbeek JB, Stelfox HT. Clinical presentation of patients with tension pneumothorax: a systematic review. Annals of surgery. 2015 Jun 1;261(6):1068-78.
Bergman M, Thomas S, Lee YI. A Rare Cause Of Abdominal Compartment Syndrome; Tension Pneumothorax-Related Tension Pneumoperitoneum In A Patient With Bullous Emphysema. InB45. OBSTRUCTIVE LUNG DISEASE: INTERESTING CASES 2016 May (pp. A3599-A3599). American Thoracic Society.
Jones GP, Shaw A. Pneumothorax. InThe Beginner’s Guide to Intensive Care 2018 Jun 14 (pp. 225-230). CRC Press.
Li DS, Luo G, Yao QQ, Jiang N, Jiang L. High temperature compression properties and failure mechanism of 3D needle-punched carbon/carbon composites. Materials Science and Engineering: A. 2015 Jan 5;621:105-10.
Toffaletti JG, Rackley CR. Monitoring oxygen status. InAdvances in clinical chemistry 2016 Jan 1 (Vol. 77, pp. 103-124). Elsevier.
Chu MP, Ghosh S, Chambers CR, Basappa N, Butts CA, Chu Q, Fenton D, Joy AA, Sangha R, Smylie M, Sawyer MB. Gastric acid suppression is associated with decreased erlotinib efficacy in non–small-cell lung cancer. Clinical lung cancer. 2015 Jan 1;16(1):33-9.
Udupa AN, Shetty RM. Advanced cardiovascular support in refractory shock. Indian Journal of Respiratory Care. 2018 Jul 1;7(2):67.
Hunter M, Barreiro T. Sudden Onset Shortness of Breath and Chest Pain in a Pregnant Woman: A Rare Case of Pneumothorax. InA48. DYSPNEA: CASE REPORTS I 2018 May (pp. A1778-A1778). American Thoracic Society.
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