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In the article "Playing the Odds", Ellen, a woman in her fifties, had symptoms of a stroke. When further investigated, they found that Ellen had a small tumor growing in the dorsal horn of the brain a numb right arm, but it was merely the result of sleeping on it incorrectly. an enlarged heart resulting from years of competitive swimming a "leaky" foramen ovale that allowed mixing of blood betweent the two atria

In the article "Playing the Odds", Ellen, a woman in her fifties, had symptoms of a stroke. When further investigated, they found that Ellen had a small tumor growing in the dorsal horn of the brain a numb right arm, but it was merely the result of sleeping on it incorrectly. an enlarged heart resulting from years of competitive swimming a "leaky" foramen ovale that allowed mixing of blood betweent the two atria

Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Hi Can you please help me answer this question , since I could not attach more then 2 image . Below I have attached the article first page . I hope that will help to find the article. Thank you !
In the article "Playing the Odds", Ellen, a woman in her fifties, had symptoms of a stroke. When further investigated, they found that Ellen had a small tumor growing in the dorsal horn of the brain a numb right arm, but it was merely the result of sleeping on it incorrectly. an enlarged heart resulting from years of competitive swimming O a "leaky" foramen ovale that allowed mixing of blood betweent the two atria
Transcribed Image Text:In the article "Playing the Odds", Ellen, a woman in her fifties, had symptoms of a stroke. When further investigated, they found that Ellen had a small tumor growing in the dorsal horn of the brain a numb right arm, but it was merely the result of sleeping on it incorrectly. an enlarged heart resulting from years of competitive swimming O a "leaky" foramen ovale that allowed mixing of blood betweent the two atria
normal, like someone crying, "Look! A shooting star!" But you look up and behold only night sky TIAS can be thrombotic or embolic, arising from clots formed in a brain artery diseased with atherosclerotic plaque, or from clots traveling to the brain from the heart or arteries "But can I still go to the Virgin Islands?" Ellen, 51, vivacious and trim, looked the perfect candidate for some fun in the sun. "I feel fine. It was only a minute or two," she said. "I'm sure you're OK," I said. "But better to do all the tests quickly in the hospital and start treatment." "I do everything right." She ticked off her fingers, "I work out. I quit smoking. I even skip birthday cake!" "The CT scan and your lab work look good so far." "Do I really need to stay overnight?" I held her shoulder. "We'll get the MRI in a few minutes, then we need some heart tests. It would make me much happier if you stayed." attack, or ministroke. "But to where?" I rang Dr. Redder, our chief neurologist. "My office is all booked up," she said. "But ER's better anyway. I can monitor her while we get everything done." I relayed that to Bill. "Tell her to ask for me." DEALING IN DILEMMAS TIAS are the devil's work-red flags that pop up then vanish. Mechanically, they are simple: just block any blood vessel in the brain for a few minutes. Clinically, they make doctors crazy, unleashing a cascade of what-are-the- odds dilemmas: Was that momentary hand weakness a TIA or a carpal tunnel flare? That spell of vertigo upstream. If the body's clot-dissolving system chews up the wayward clots before neurons die, then it's a TIA. If not, it's a stroke. Why the urgency to test Ellen? Because up to 1 in 10 TIAS will progress to a full-blown stroke within 48 hours. The good news is that these odds can be slashed through prompt treatment with aspirin or blood thinners, surgery for blocked carotids, statins for high cholesterol, regimens for smoking cessation and meds for blood pressure control. The tempting counterbet? Up to two-fifths of TIA patients may never have another. But no one knows which two-fifths Dr. Redder came by. Compact and wicked smart, she pulled me aside: "The MRI is not normal. Scattered white-matter microinfarcts. She's been an inner-ear misfire or a clot to the cerebellum? That blurred vision a blocked retinal artery or a migraine? By definition, TIA usually means by the time you see the patient, all appears It started with a phone call. "Couldn't move her arm." It was my good friend Bill. Ex-ER doc, now in-house company physician, he is a master at plucking rare needles of disease from a haystack of healthy young people. "How long?" I asked. "That's the funny thing. Yesterday she was getting ready for the gym, then couldn't move her arm. Thought maybe she'd slept on it funny, but realized it had been fine when she Up to 1 in 10 TIAS will progress to a full-blown stroke within 48 hours. showering small clots for a while. Probably from the heart." White matter is the layer just beneath the brain's surface neurons Region of decreased blood flow (imaginatively called "gray matter"). The specks of damage were so small, Ellen probably hadn't sensed them. But they drew an ominous pattern. wo ke up. After a minute or so, the strength came back. Today she decided to see me. Right now she could do 30 push-ups." Artery temporarily blocked My alarm bells went off. "Send her in." Ischemia is a medical term describing insufficient supply of blood to an organ. In a transient ischemic attack (TIA). a clot temporarily interrupts blood flow in the brain. "I know," he answered. We both suspected TIA, a transient ischemic If the clot does not dissolve in time, neurons die. and the TIA progresses to a full-blown stroke. Blood flow to brain 24 DISCOVERMAGAZINE.COM Vital Signs TREATMENT IS NOT CLEAR-CUT Dr. Redder went back to Ellen. "The MRI shows you've probably had similar events in the past. It's very important we investigate where they're coming from." Ellen took the news quietly. After Dr. Redder left, I added, "In healthy people under 55 with a TIA, we don't always find a clear explanation. But now I'm sure you need to stay." "What will I tell my family?" "That we're not sure yet." The next morning, I spied Dr. Redder and a cardiologist talking animatedly in the hallway. "What?" I asked. "TEE showed a big PFO," she said. Translation: An echocardiogram showed a hole in Ellen's heart. Or more accurately, a flap. The specks of damage So what were the odds a PFO caused Ellen's TIA? were so small, Ellen Cryptogenic strokes- those lacking known causes like a blocked carotid probably hadn't sensed them. But they drew an ominous pattern. or heart arrhythmias like atrial fibrillation that spawn clots- comprise almost half of strokes in patients under 55. In such patients, PFOS are more common (39 percent compared with 26 percent) and bigger than in the general population. The usual treatment for any cryptogenic TIA or stroke is cholesterol and blood pressure reduction, if indicated, plus an anti-platelet agent, like aspirin. Studies have tested whether closing PFOS with umbrella-like devices introduced into the right atrium via the femoral vein would help. The procedure showed no additional benefit, but some experts Opening between left and right atrium Left atrium Right atrium Left ventricde A FAILURE OF FUSION From a developmental perspective; our four-chambered heart (the right atrium and ventricle pump venous blood to the lungs; their more powerful counterparts on the left side pump oxygenated blood to the body) is a surprisingly jury-rigged machine. In utero, it must shunt oxygenated Right ventride believe it could if medications don't hold the line. "I have a hole in my heart?" Ellen exclaimed when we told her. "It's been In a patent foramen ovale (PFO), a flap between the two upper chambers of the heart allows venous blood to mix with oxygenated blood. If the blood crossing over contains clots, these can travel up the carotid artery to the brain. there my whole life?" "One in four people do to some extent," I reassured her. "We can't be sure the PFO caused your TIA, but the MDI enanaete tim elate hae eneaked
Transcribed Image Text:normal, like someone crying, "Look! A shooting star!" But you look up and behold only night sky TIAS can be thrombotic or embolic, arising from clots formed in a brain artery diseased with atherosclerotic plaque, or from clots traveling to the brain from the heart or arteries "But can I still go to the Virgin Islands?" Ellen, 51, vivacious and trim, looked the perfect candidate for some fun in the sun. "I feel fine. It was only a minute or two," she said. "I'm sure you're OK," I said. "But better to do all the tests quickly in the hospital and start treatment." "I do everything right." She ticked off her fingers, "I work out. I quit smoking. I even skip birthday cake!" "The CT scan and your lab work look good so far." "Do I really need to stay overnight?" I held her shoulder. "We'll get the MRI in a few minutes, then we need some heart tests. It would make me much happier if you stayed." attack, or ministroke. "But to where?" I rang Dr. Redder, our chief neurologist. "My office is all booked up," she said. "But ER's better anyway. I can monitor her while we get everything done." I relayed that to Bill. "Tell her to ask for me." DEALING IN DILEMMAS TIAS are the devil's work-red flags that pop up then vanish. Mechanically, they are simple: just block any blood vessel in the brain for a few minutes. Clinically, they make doctors crazy, unleashing a cascade of what-are-the- odds dilemmas: Was that momentary hand weakness a TIA or a carpal tunnel flare? That spell of vertigo upstream. If the body's clot-dissolving system chews up the wayward clots before neurons die, then it's a TIA. If not, it's a stroke. Why the urgency to test Ellen? Because up to 1 in 10 TIAS will progress to a full-blown stroke within 48 hours. The good news is that these odds can be slashed through prompt treatment with aspirin or blood thinners, surgery for blocked carotids, statins for high cholesterol, regimens for smoking cessation and meds for blood pressure control. The tempting counterbet? Up to two-fifths of TIA patients may never have another. But no one knows which two-fifths Dr. Redder came by. Compact and wicked smart, she pulled me aside: "The MRI is not normal. Scattered white-matter microinfarcts. She's been an inner-ear misfire or a clot to the cerebellum? That blurred vision a blocked retinal artery or a migraine? By definition, TIA usually means by the time you see the patient, all appears It started with a phone call. "Couldn't move her arm." It was my good friend Bill. Ex-ER doc, now in-house company physician, he is a master at plucking rare needles of disease from a haystack of healthy young people. "How long?" I asked. "That's the funny thing. Yesterday she was getting ready for the gym, then couldn't move her arm. Thought maybe she'd slept on it funny, but realized it had been fine when she Up to 1 in 10 TIAS will progress to a full-blown stroke within 48 hours. showering small clots for a while. Probably from the heart." White matter is the layer just beneath the brain's surface neurons Region of decreased blood flow (imaginatively called "gray matter"). The specks of damage were so small, Ellen probably hadn't sensed them. But they drew an ominous pattern. wo ke up. After a minute or so, the strength came back. Today she decided to see me. Right now she could do 30 push-ups." Artery temporarily blocked My alarm bells went off. "Send her in." Ischemia is a medical term describing insufficient supply of blood to an organ. In a transient ischemic attack (TIA). a clot temporarily interrupts blood flow in the brain. "I know," he answered. We both suspected TIA, a transient ischemic If the clot does not dissolve in time, neurons die. and the TIA progresses to a full-blown stroke. Blood flow to brain 24 DISCOVERMAGAZINE.COM Vital Signs TREATMENT IS NOT CLEAR-CUT Dr. Redder went back to Ellen. "The MRI shows you've probably had similar events in the past. It's very important we investigate where they're coming from." Ellen took the news quietly. After Dr. Redder left, I added, "In healthy people under 55 with a TIA, we don't always find a clear explanation. But now I'm sure you need to stay." "What will I tell my family?" "That we're not sure yet." The next morning, I spied Dr. Redder and a cardiologist talking animatedly in the hallway. "What?" I asked. "TEE showed a big PFO," she said. Translation: An echocardiogram showed a hole in Ellen's heart. Or more accurately, a flap. The specks of damage So what were the odds a PFO caused Ellen's TIA? were so small, Ellen Cryptogenic strokes- those lacking known causes like a blocked carotid probably hadn't sensed them. But they drew an ominous pattern. or heart arrhythmias like atrial fibrillation that spawn clots- comprise almost half of strokes in patients under 55. In such patients, PFOS are more common (39 percent compared with 26 percent) and bigger than in the general population. The usual treatment for any cryptogenic TIA or stroke is cholesterol and blood pressure reduction, if indicated, plus an anti-platelet agent, like aspirin. Studies have tested whether closing PFOS with umbrella-like devices introduced into the right atrium via the femoral vein would help. The procedure showed no additional benefit, but some experts Opening between left and right atrium Left atrium Right atrium Left ventricde A FAILURE OF FUSION From a developmental perspective; our four-chambered heart (the right atrium and ventricle pump venous blood to the lungs; their more powerful counterparts on the left side pump oxygenated blood to the body) is a surprisingly jury-rigged machine. In utero, it must shunt oxygenated Right ventride believe it could if medications don't hold the line. "I have a hole in my heart?" Ellen exclaimed when we told her. "It's been In a patent foramen ovale (PFO), a flap between the two upper chambers of the heart allows venous blood to mix with oxygenated blood. If the blood crossing over contains clots, these can travel up the carotid artery to the brain. there my whole life?" "One in four people do to some extent," I reassured her. "We can't be sure the PFO caused your TIA, but the MDI enanaete tim elate hae eneaked
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