Vital Capacity and Expiratory

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Ms. MC is a 59 yo woman with long history of smoking 1 – 1.5 packs/day (20+ years) but is no longer smoking. She notices that she fatigues quickly, is often short of breath, coughs frequently and has ankle swelling. She has trouble sleeping but noted some improvement with extra pillows. You note an increase in anteroposterior chest diameter, prolonged expiratory phase with wheezing. She also has cyanosis of nailbeds with moderate pitting edema bilaterally. Lab tests reveal Hgb is high normal, PaO2 is low at 48 mmHg, O2 saturation is at 80%, PCO2 is significantly elevated (70 mmHg) and HCO3- is also elevated above normal (35 mEq/L). Your diagnosis is a combination of chronic bronchitis and emphysema (COPD). Pulmonary function tests revealed a decrease in Vital Capacity and Expiratory Flow Rate combined with an increase in both Residual Capacity and Functional Residual Capacity. These types of tests could also reveal other conditions, such as asthma, as well as guide treatment to prevent significant attacks.

1 What changes occurred in her airways that led to obstruction and increased airway resistance? (Hint: View it in two parts: 1) the airway changes and 2) the alveolar tissue changes relating to elasticity and compliance). (Pulmonary System MO2,3,5,7,8,23,26)

2 How does acidosis, such as caused by ketones or CO2 retention, alter the delivery of oxygen to the tissues? (Pulmonary System MO2,5,9,11,12,16)

3 What is a V/Q ratio and how does it affect oxygenation of blood in health and disease? In late stages of COPD, such as seen above, how is V/Q altered (Hint, see fig. 27-17) (Pulmonary System MO5,6,9,10)

4 Why does she have ankle edema? What role does the lung play in hydrostatic pressure changes seen here? What is the effect pulmonary artery pressure and resultant changes to the right side of the heart? (Pulmonary System MO9,13,14,18,25,30)

 

 

 

 

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Dark Holes

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representation of a dark holeThe measure of astounding logical disclosures being made these days is unfathomably high. Consistently, humankind finds something that either affirms or prevents the current comprehension from securing the Universe. Nonetheless, there still are various secrets that space experts are on the cusp of settling. Among such puzzles are dark openings—being maybe the most mainstream and notable (because of mass culture) space wonder—which are one of the least inquired about.

As a rule, a dark gap is a space object having extraordinary thickness; its mass is so colossal, and the individual gravitational fascination is ground-breaking to the point, that even light can’t get away from its snare. This is the reason they are called ‘dark openings’— you can’t see them without exceptional gadgets, since there is no light in where a dark gap is. The principal individual to have anticipated this wonders was Albert Einstein, and the term ‘dark gap’ showed up in 1967, presented by the American stargazer John Wheeler. Be that as it may, just in 1971 was the primary dark gap found (Space.com).

Be that as it may, how dark gaps show up? Science offers us the accompanying clarification: when a huge star consumes the remainder of its ‘fuel,’ it might begin crumbling under its own mass, falling in on itself until it therapists to an article a lot littler than the first star, yet with a similar mass—the excellent dark gap (Space.com).

Nobody knows precisely what is happening inside dark openings. A mainstream sci-fi subject (brought up in the ongoing film ‘Interstellar,’ for instance) alludes to what occurs in the event that someone falls into a dark gap. Some accept dark gaps to be the anticipated wormholes to different pieces of the Universe. Others make less awesome proposals. In any case, what is really astounding about dark openings is the manner by which they mutilate existence. On the off chance that an individual ‘falls’ into a dark gap, for an outcast, the development of this individual will back off, except if it at long last freezes (universetoday.com). In addition, as indicated by Stephen Hawking, the mind blowing gravity of a dark opening will be interminably extending this individual long. Be that as it may, for the individual ‘falling’ into a dark gap, time will appear to go obviously—and, separately, this individual won’t notice any spacial mutilations either.

Another mainstream question is, “The thing that occurs if a dark gap gets excessively near Earth?” Black gaps don’t move around space. Nothing terrible will happen to Earth, in light of the fact that no dark opening is sufficiently close to the nearby planetary group to devour our planet. Be that as it may, if hypothetically a dark opening, having a similar mass as the sun, had its spot, nothing would happen at any rate. A similar mass methods a similar gravity, so the planets of the Solar System would keep circling the dark gap as though nothing had occurred (nasa.gov).

Dark gaps are an incredible space marvel, with its properties being strange. Despite the fact that anticipated and portrayed a century back, they despite everything have perhaps the greatest problem for researchers. Beginning from crumbled stars, dark gaps have such a tremendous gravity, that they can twist reality. Be that as it may, as researchers guarantee, Earth isn’t at serious risk—yet.

References

Redd, Nola Taylor. “What is a Black Hole?” Space.com. N.p., n.d. Web. 10 Aug. 2015.

“10 Amazing Facts about Black Holes.” Universe Today. N.p., 22 Jan. 2015. Web. 10 Aug. 2015.

Dunbar, Brian. “What is a Black Hole?” NASA. NASA, n.d. Web. 10 Aug. 2015.

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