Thank you for reviewing Ronald Cocks, an 89 year old gentleman with an array of medical comorbidities. Ronald has a history of prior asbestos exposure and is an ex-smoker of approximately 20 pack years. He is quite frail, although still ambulates independently with a 4-wheel frame and is currently living at a retirement village. Ronald was referred to me just prior to Christmas with a two month history of sudden onset voice hoarseness. He was noted to have a 4.5cm left upper lobe cavitatory mass in close proximity to the left upper lobe pulmonary arteries and abutting the left upper lobe pleura.
The potential space between the instinctive and parietal pleurae is known as the intrapleural space. The intrapleural and intrapulmonary pressures fluctuate amid ventilation. The intrapulmonary pressure is subatmospheric amid inspiration and more prominent than the atmospheric pressure amid expiration. Pressure changes in the lungs are delivered by varieties in lung volume, as per the opposite relationship between the volume and pressure of a gas portrayed by Boyle's law. The mechanics of ventilation are affected by the physical properties of the lungs.
The exudative phase unfolds over the first 1 to 7 days after attack of lung injury. Accumulation in the alveoli of excessive fluid, protein and inflammatory cells that have move into the air spaces from the alveolar capillaries. Intrapulmonary shunt develop and blood passing cannot be oxygenated. Alveolar type I and type II cells are spoiled causing surfactant dysfunction. Alveoli become unstable and collapse and fibrotic changes take place.
Normally, low-oxygen blood entering the right side of the heart stays on the right side, and subsequently oxygen-rich blood stays on the left side of the heart, where it is then pumped to the body and tissues. When a defect or "hole" is present between the atria (or upper chambers of heart), some oxygen-rich blood leaks back to the right side of the heart. It then goes back to the lungs even though it is already rich enough in oxygen. Because of this, there is a significant increase in the blood that goes to the lungs overall. Atrial septal defects can
While auscultating sounds of lung fields no wheezing was found, and VS were within normal range for patient as determined through comparison of chartings on 10/23/2015 thru the morning and lunch VS of 10/26/ 2015 before impaired gas exchange was detected. 10/26/2015 2. Administer O2 @ 2L N/C
Upper Lateral Thoracic Pain Dx: Pneumothorax (Pulmonary System) Clinical Presentation: Signs and symptoms vary depending on the size and the location of the pneumothorax.1 Patients may present with severe upper lateral thoracic back pain, ipsilateral shoulder pain, and sudden sharp chest pain or pain over the abdomen.1 Movement and coughing may provoke or aggravate the patients pain.1 The most comfortable position for the patient may be sitting upright and they might also present with dyspnea, a dry hacking cough, change in respiratory movements on affected side, increased neck vein distension, weak and rapid pulse, and/or fall in blood pressure.1 Other common signs and symptoms of a pneumothorax include a decrease or absence in breath sounds,
As a result, these patients can’t bring the carbon dioxide out, they become retain the carbon dioxide which makes it so hard for them to breathe
If Timmy was punched hard enough, he can have fractures on the cartilage structure of the throat, since the cartilage is flexible and not as strong as the bones. If damage is inflicted, by strong hit for example, on the larynx, it begins to swell. If it swells too much, the flow of air can blocked and you start to suffocate. How would this affect his respiratory system?
Detailed physical exam reveals no head injury, no neck, back pain or midline spinal tenderness. Right clavicle guarding and malformation, ecchymosis and tenderness right posterior thoracic region, no evidence of flail chest (Caroline, 2014). No abdominal tenderness or distention, no pelvic pain or neurological deficit in any limbs. Pain score 6/10, 8/10 on deep inhalation (Breivik et al., 2008) (Appendix 4). Auscultation reveals reduced breath sounds mid-axillary right side.
RIce, T. W., & Bernard, G. R. (1998-2023). Institutional Review Board. American Thoracic Society.
You develop difficulty breathing, chest pain, a racing heart beat, or heart palpitations. These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).
Hypoxia: is the lack of adequate oxygen but hypoxic injury is due to low blood supply, which impacts the heart muscle (Huether & McCance, 2012, p. 63-65 ). After the cessation of blood supply to the heart muscle, the contraction stops due to decline in mitochondrial phosphorylation. This leads to low ATP production, which causes an increase in anaerobic metabolism, producing ATP from glycogen. Even when that is used up, the sodium and potassium pump on the plasma membrane and the sodium-calcium exchange fail to function. All of this causes cellular swelling and also lead to vacuolation, formation of vacuoles.
The explosion of internet information has prompted a lot of 'cyberchondria ', which often means patients are worrying about symptoms that are frequently harmless," says Dr Steve Hambleton, president of the Australian Medical Association. "On the other hand, the internet can also cause the other problem, where people self-diagnose instead of going to talk to their doctor." We asked Australia 's leading medics to explain what the good (harmless), bad (may need medical attention) and ugly (serious) symptoms of common health problems may mean. Calf pain The good: Calf pain may be due to muscular strain or even referred pain from the back, hip or knee.
Pulmonary edema or congestion happens when the left ventricle of the heart fails. This is simply because the inefficiency of its ventricle to pump effectively causes the blood to back up to the pulmonary capillaries as the pulmonary venous blood rises its pressure into the tissues and alveoli impairing the gas exchange. Pulmonary congestion will be manifested in crackles, difficulty of breathing, frothy pink-tinged sputum and shortness of breath. In addition, the decreased amount of blood ejected from the left side causes ineffective tissue perfusion. This is detrimental to other vital organs such as the kidneys.
Thomas Hobbes has been famous for his philosophies on political and social order. In many of his scholastic works, he maintains the position that in the presence of a higher authority the duty of the rest of mankind is to simply obey. The discourse on this essay will focus on his views expressed in his book The Leviathan. In this book Hobbes’ views are fundamentally entrenched in his description that in a society with no higher authority life would be nasty, short and brutish (?) .This essay will engage in discussion by first laying out the conceptual arguments of anarchy and the human state of nature.
