Heart Lab Case Study
Heart Lab Case Study 272-01LL
Popular in Anatomy and Physiology II Lab
One Day of Notes
verified elite notetaker
Popular in Kinesiology
This 2 page One Day of Notes was uploaded by Juliana Bernard on Tuesday February 3, 2015. The One Day of Notes belongs to 272-01LL at University of Massachusetts taught by Dr. Gordon in Spring2015. Since its upload, it has received 6042 views. For similar materials see Anatomy and Physiology II Lab in Kinesiology at University of Massachusetts.
Reviews for Heart Lab Case Study
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 02/03/15
KIN 272 Clinical Case Study Crimes of the Heart A Case on Cardiac Anatomy Tiffaney is worried about her newborn son Ever since she brought Caleb home from the hospital it has been so hard to get him to eat and he seems to be breathing too hard all the time She stopped breastfeeding and tried every bottle and formula on the market but nothing has worked So at his one month checkup her stomach is in knots as they place Caleb on the scale The nurse says quot9 pounds 7 ouncesquot Tiffaney realizes Caleb has only gained one pound since he was born and she breaks into tears Dr Baker checks over Caleb in the exam room taking extra time feeling and listening to his chest During the exam Tiffaney explains her struggle with trying to get her son to eat and how he cries almost the entire day After the exam Dr Baker says quotWhen I listen to Caleb39s heart I hear an extra sound called a murmur I want to use an echocardiogram and an ECG to get a good picture of all the parts of his heartquot After a full day of tests Tiffaney meets with Dr Baker in his office He explains quotAfter a careful review of all the information l have discovered that Caleb has a hole in the heart muscle wall between his right and left ventricles We call it a ventricular septal defect That is probably why he has been so irritable and hard to feed The hole is not very big but he will still need to have surgery to repair itquot Although the thought of her tiny son having surgery is terrifying Tiffaney is relieved to know why things have been so tough at home 1 Dr Baker spends a long time listening to auscultating Caleb39s heart Question part a Where on the thoracic surface do you auscultate to the tricuspid mitral bicuspid pulmonary and aortic valves Question part b Where do you think would be the best place to auscultate Caleb39s abnormal heart sound Explain your answer For part a Remember that tricupsid is the 5th intercostal space on the right upper sternal border mitral bicuspid is the fifth intercostal space medial to left midclavicular line pulmonary is the second intercostal space on the left upper sternal border and aortic is the second intercostal space on the right upper sternal border For part b Caleb39s defect lies in the interventricular septum between the atrioventricular valves So the best place to hear it would be from the lower left sternal border to the right lower sternal border because this is the area that overlies the defect 2 Caleb has abnormal heart sounds that tipped the doctor off to a problem Question part a Name the normal sounds of the heart and indicate what causes these sounds Question part b In relation to the normal heart sounds when would you expect to hear the abnormal sound Dr Baker heard Explain your answer For part a S1 is the first heart sound or quotlubquot and occurs due to closure of the atrioventricular tricuspid and bicuspid valves SZ is the second heart sound or quotdupquot and occurs due to closure of the pulmonary and aortic semilunar valves For part b VSDs generate a pansystolic spanning the length of systole murmur between S1 and SZ This timing occurs because the atrioventricular valves close first S1 then the ventricles contract and blood shunts rapidly from left ventricle to right ventricle pansystolic murmur and finally the semilunar valves close SZ 3 The defect in Caleb39s heart allows blood to mix between the two ventricular chambers Question part a Due to this defect would you expect the blood to move from lefttoright ventricle or righttoleft ventricle during systole Question part b Based on your understanding of blood pressure and resistance in the heart and great vessels explain your answer to question 3a For part a Caleb39s defect causes blood to move from the left ventricle to the right ventricle during systole For part b Blood moves into an open space where there is the least amount of resistance pressure or down its resistance pressure gradient The blood pressure in the right ventricle is lower than the pressure in the left ventricle This phenomenon occurs because the afterload in the right ventricle is lower than the afterload of the right ventricle The difference between these afterloads is due to the pulmonary blood vessels generating less resistance when compared to the systemic blood vessels 4 When an echocardiogram is performed the technician colorcodes oxygenated blood red and deoxygenated blood blue Question part a In a healthy baby what color would the blood be within the right and left ventricles respectively Question part b In Caleb39s heart what color would the blood be within the right and left ventricles respectively For part a The right ventricle has deoxygenated blood blue The left ventricle has oxygenated blood red For part b The right ventricle has both deoxygenated and oxygenated blood both blue and red Note In a real echocardiogram this shows up as yellowwhite The left ventricle has oxygenated blood red 5 Caleb39s heart allows oxygenated and deoxygenated blood to mix Based on your knowledge of the heart and the great vessels describe other anatomical abnormalities that cause the mixing of oxygenated and deoxygenated blood Patent ductus arteriosus Normally the ductus arteriosus which connects the fetal pulmonary trunk to the aorta closes very soon after birth However if it fails to close then it remains open or patent A patent ductus arteriosus allows a portion of the oxygenated blood from the aorta to flow back to the pulmonary trunk where it mixes with deoxygenated blood that is sent to the lungs Because of this there is a significant increase in the volume of blood that goes to the lungs Atrial Septal Defect ASD A hole in the wall between the two upper chambers is called an atrial septal defect or ASD Normally systemic deoxygenated blood is carried by the superior and inferior vena cavae to the right atrium and the left atrium receives oxygenrich blood from the pulmonary veins When a defect is present between the atria some oxygenrich blood leaks back to the right side of the heart It then goes back to the lungs even though it is already rich in oxygen Because of this there is a significant increase in the volume of blood that goes to the lungs 6 What happens to Caleb39s systemic cardiac output as a result of his ventricular septal defect VSD Explain your answer Due to a lefttoright blood shunt the left ventricular volume falls during systole prior to the opening of the aortic valve This shunt decreases stroke volume and cardiac output from the left ventricle into the aorta 7 One of the problems that worried Tiffaney was that Caleb seemed to be breathing too hard all the time Let39s consider how this symptom is related to his heart defect Question part a Describe what would happen to the blood volume and pressure entering the pulmonary circuit as a result of his VSD Question part b Describe what would happen to the myocardium of Caleb39s right ventricle as a result of his VSD For part a There is an increase in the total amount of blood pumped to the pulmonary trunk during each systole Thus the total pressure in these vessels also increases Note This excessive volumepressure or pulmonary hypertension causes pulmonary edema indicated by Caleb39s increased work of breathing For part b Due to the lefttoright shunt the blood volume within the right ventricle increases Due the volume overload the right ventricle cannot effectively pump out blood causing an increase in end systolic volume and stretching of the myocardium The end result is an overall enlargement of the wall of the right ventricle called hypertrophy 8 Based on the location of Caleb39s defect what part of the conduction system might be at risk for abnormalities The bundle of His atrioventricular bundle and the bundle branches are along the interventricular septum So if the defect included a large portion of the septum all of these areas could be at risk for abnormalities This would show up as a bundle branch block on an ECG rhythm strip Note One way VSDs are classified is if they include the contractile myocardium the conduction system or both
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'