Case Study3 REF

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Georgia Institute Of Technology *

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3753

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Mechanical Engineering

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Dec 6, 2023

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docx

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Case Study #3 (BIOS 3753) 1) Describe, in detail, the mechanics of human ventilation. Your answer must include the following terms: diaphragm, 760mm/hg, Boyle’s law, external intercostal, internal intercostal, 762mm/hg, 756mm/hg, pulmonary ventilation, volume, pressure, contraction, relaxation, alveoli, inspiration, expiration, parietal pleura, visceral pleura, pleural cavity and serous fluid. Using all terms will get you full credit. a. Boyle’s Law states that pressure and volume are inversely related. This means that as volume decreases, then the pressure must increase or vice versa. When a human breathes, pulmonary ventilation , the muscular movements create pressure changes in three specific pressures: atmospheric pressure, intrapulmonary pressure, and intrapleural pressure. The partial and visceral pleura and the serous fluid cause the lungs to stay attached to chest cavity allwing easy expansion & contraction . At rest the atmospheric pressure is 760mm/hg . During inspiration , the external intercostal muscles and diagram are in a state of contraction causing an increase of volume and slightly negative pressure of 756mm/hg which expands the alveoli & helps gas exchange. During expiration , the diaphragm relaxes and internal intercostal muscles recoil which causes the volume to decrease & pressure increase to 762mm/hg pushing the air out of the lungs. 2) A 9 month old infant girl is brought into the emergency department by her mother because of a history of irritability and restlessness. The mother reports that two months earlier the infant had a middle ear infection (otitis media) that required a procedure to lance the eardrum and drain the fluid (myringotomy). She also reports since then the infants breathing has been labored and there is an audible wheezing and noise produced especially at night. After diagnostic tests were run, the diagnosis was confirmed as left-sided mediastinal pleurisy with fluid (exudate). The pleural cavity was tapped and drained of 200cc of serous fluid. The infant recovered and breathing returned to normal. a) What are the normal contents of the pleural cavity? o Serous fluid b) What are the two layers of the pleura called? o Parietal pleura (outer) o Visceral pleural (inner) c) Do the pleural cavities of the two sides, right and left ever communicate?

o There is no physical connection between right & left cavities d) Name the subdivisions of the parietal pleura. o Mediastinal part - mediastinum and its structures o Costal part - inner surface of the thoracic cage (i.e. ribs) o Diaphragmatic- diaphragm . o Cervical(aka pleural or “cupula”) e) What are friction rubs in relation to the condition pleurisy? How do clinicians detect it? o Friction rub is an audible raspy breath sound due to the pleural layers being inflamed & rubbing against each other. A clinician typically detects it by using a stethoscope to hear internal body sounds. 3. Trace a drop of blood from the azygous vein, through the heart and lungs to the aorta (include all vessels, valves and chamber) Be complete! a. Azygous vein  superior vena cava  right atrium  right AV valve (tricuspid)  right ventricle  pulmonary semilunar valve open  pulmonary trunk  right & left pulmonary arteries  lungs(capillaries/alveoli)  pulmonary vein  left atrium  left AV value(bicuspid/mitral)  left ventricle  aortic semilunar valve opens  aorta 3) A 50 year car salesman complained of excruciating chest pain in his sternum accompanied by nausea, vomiting and sob (shortness of breath.) He has had a history of radiating chest pain into his left arm, for several years, after he exercises. Unfortunately, he has succumbed to his condition before he could get to the hospital. During his postmortem examination, the pathologist noted marked narrowing and occlusion, with atherosclerotic plaque of both coronary arteries. The pathologist also noted a fresh intimal (inner line of an artery) hemorrhage in the left anterior descending coronary artery, near its origin to the left coronary artery. A blood clot was also found in the LAD. Define the following terms: a) Infarct: An area of tissue that experiences necrosis (tissue death) because of lack of blood supply caused by obstruction (i.e. thrombus or embolus). b) Thrombus: A fibrinous clot in a blood vessel that is impedes the blood flow at the site it was formed. c) Embolus: An unattached mass, large enough to block flow, that travels through bloodstream (i.e air bubble, blood clot). d) Ischemia: A decrease in blood supply to part of body caused by obstruction of blood vessels.

e) End-artery: An artery which provides the only supply of blood to portion of tissue. (the artery does not anastomose with neighboring arteries) f) Intracoronary anastomosis: A surgical procedure that forms connections between coronary arteries & heart., to increase blood flow. g) Thebesian veins: A small, valveless vein that drains deoxygenated blood directly into the right atrium of the heart

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