An a Pa Tho Lab

8/9/2019 An a Pa Tho Lab

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The heart is a hallow, cone-shaped

organ about the size of the fist. It is

located in the mediastinum,

between the lungs and underlying

the sternum. It is enclosed by a

double layer of fibroserous

membrane known as pericardium.

The parietal, or outermost,

pericardium serves to protect the

heart and anchor it to surrounding

structures. The visceral pericardium

adheres to the surface of the heart

forming the hearts outermost layer,

the epicardium. The heart wall

contains two additional layers: the

myocardium which is the middle

and thickest muscular layer of the

heart and is responsible for the

contraction of the heart and the

endocardium which is the

innermost layer of the heart that

lines the chambers and valve.



y The heart also has four chambers, two atria (left atrium and the right atrium)and two ventricles (left ventricle and the right ventricle). The two atria andtwo ventricles are separated longitudinally by the interventricular septum,

forming two parallel pumps. The atria and ventricles are separated from oneanother by the atrioventricular(AV) valves, the tricuspid valve on the rightand the bicuspid or mitral valve on the left. The ventricles in return, areseparated by the great vessels (the pulmonary arteries and aorta) by thesemilunar valves: the pulmonic valve on the right and aortic valve on the left.

The valves serves to direct the flow of blood, allowing it to move from theatria to the ventricles, and then ventricles to the great vessels, but preventingbackflow. The heart has four one-way valves, the aortic, mitral valve,pulmonary valve and tricuspid valve. The blood supply of the heart comesfrom the left and right coronary arteries.

y Deoxygenated blood from the veins enters the right side of the heart throughthe superior and inferior vena cavae. From here, it flows into the right ventricle, which pumps it through the pulmonary artery into the lungs for gasexchange at the alveolar/capillary membrane. Freshly oxygenated bloodreturns to the left atrium via the pulmonary veins. From here, the blood

enters the left ventricle to be pumped out to the systemic circulation through



y W ith each heart beat, the myocardium goes through a cycleof contraction (systole) and relaxation (diastole). Systole is when the heart ejects ( propels) the blood into the

pulmonary and systolic circulations. Diastole is when the ventricles fill with blood. The diastolic phase of the cardiaccycle is twice as long as the systolic phase. This isimportant because diastole is largely a passive process. Thelonger the diastolic phase allows this filling to occur. S1 isthe first sound, beginning of ventricular systole and caused

by closure of the atrioventricular valves-the tricuspid andthe mitral. S2 is the second sound and the beginning of the ventricular systole, the sound is caused by closure of thesemilunar vales, the aortic and the pulmonic.

y The main functions of cardiovascular system are totransport oxygen, hormones and nutrients to the tissues,also, the transport of waste products to the lungs andkidneys for excretion. The conducting system of the heartconsist if the SA node, the AV nod, Bundle of His and thePurkinje fibers



y The amount of blood the heart pumps out in each beatis called the stroke volume. W hen this volume is

multiplied by the number of the heart beat in oneminute, it becomes the cardiac output. W hen thecardiac output is multiplied by the total peripheralresistance, it becomes the blood pressure. The preloadis the degree of stretching of the heart muscle when itis filled up with blood. The after load is the resistanceto which the heart must pump to eject the blood.

y The vascular system is consists of the arteries, veinsand capillaries. The arteries are the vessels that carry

blood away from the heart to the periphery. The veinsare the vessels that carry blood to the heart. Thecapillaries are lined with squamous cells and connectthe veins and arteries.



The pancreas is a

glandular organ that

secretes digestive enzymes

(internal secretions) and

hormones (external

secretions). In humans,

the pancreas is a yellowish

organ about 7 inches (17.8

cm) long and 1.5 inches

(3.8 cm) wide.

The pancreas lies beneath

the stomach and is

connected to the small

intestine at the duodenum

(first section of small

intestine).

THE PACREAS



y The pancreas contains enzyme producing cells that secretetwo hormones. The two hormones are insulin and glucagon.Insulin and glucagon are secreted directly into thebloodstream, and together, they regulate the level of glucosein the blood. Insulin lowers the blood sugar level andincreases the amount of glucagon that is stored carbohydratein the liver. Glucagon slowly increases the blood sugar level if it falls too low. If the insulin secreting cells do not work

properly, diabetes occurs.y The pancreas produces the body's most important enzymes.

The enzymes are designed to digest foods and break downstarches.

y The pancreas also helps neutralize chyme and helps break

down proteins, fats and starch. Chyme is a thick semifluidmass of partly digested food that is passed from the stomachto the duodenum. If the pancreas is not working properly toneutralize chyme and break down proteins, fats and starch,starvation may occur.



Modifiable FactorsObesity BMI: 34Sedentary Lifestyle


Non-Modifiable Factors Age 72yoFamily History Hx HypertensionHx DM


Normoglycemic StateNormoglycemic State

Increased level of plasmatriglyceridesLow levels of high-density lipoproteins

Increased level of plasmatriglyceridesLow levels of high-density lipoproteins

Abnormal fibrinolysisCoronary Artery DiseaseHypertension

Abnormal fibrinolysisCoronary Artery DiseaseHypertension

Pumping ability of the heart becomes

impaired

Pumping ability of the heart becomes

impaired

HASCVDHASCVD

Congestion of body tissues fromsystemic venous congestionCongestion of body tissues fromsystemic venous congestion

V entricular Gallop S3 V entricular Gallop S3

CHFCHF

Right Side of the heart is affectedRight Side of the heart is affected

Peripheral EdemaPeripheral Edema Pulmonary CongestionPulmonary Congestion

PneumoniaPneumonia

CoughCough DOBDOB CracklesCrackles





Impaired Insulin ProductionImpaired Insulin Production

Fasting HyperglycemiaFasting Hyperglycemia

Normoglycemic StateNormoglycemic State

Increased resistance to the action of insulinIncreased resistance to the action of insulin

Increased visceral (intra-abdominal) fatIncreased visceral (intra-abdominal) fat

Peripheral Tissues inhibit glucose uptakePeripheral Tissues inhibit glucose uptake

Increased in Blood Glucose LevelsIncreased in Blood Glucose Levels

Amount of glucose filtered by the glomeruli of the kidney exceedsthe amount that can be reabsorbed by the renal tubules Amount of glucose filtered by the glomeruli of the kidney exceedsthe amount that can be reabsorbed by the renal tubules

GLYCOSURIA GLYCOSURIA

+ Large doses of water in the urine+ Large doses of water in the urineCKDCKD + HYPERGLYCEMIA + HYPERGLYCEMIA

Tea-colored urineOutput: 250cc/voidTea-colored urineOutput: 250cc/void POLYURIA POLYURIA

Intracellular dehydrationIntracellular dehydration

Water is pulled out of the body cellsincluding in the thirst center Water is pulled out of the body cellsincluding in the thirst center

POLYDIPSIA POLYDIPSIA

Favor the growth of microorganismsFavor the growth of microorganisms

Impaired wound healingImpaired wound healing

Skin InfectionsSkin Infections

CELLULITISCELLULITIS

Necrotic tissuesNecrotic tissues

LICHENIFICATIONon right leg

LICHENIFICATIONon right leg



DIAGNOSTIC/LABORATORY STUDIES

NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST

NORMAL VALUES ACTUAL

RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

HEMATOLOGY` 2/8/10 Complete Blood

Count (CBC) is to

check the specimen of

venous blood;

includes hemoglobin,

hematocrit

measurements, RBC

count and indices,

WBC count and a

differential white cell

count.

WBC 5-10x109/L 12.6 (increased) Increase in WBC indicates an

infection.

(Fundamentals of Nursing, p

800)

Used of Antiinfective drugs

such as Metronidazole

interferes in WBC count.

(Diagnostic Tests, p 497)

SEG 0.6-0.7% 0.85 (increased) Increase in segmenter indicates

Viral or Bacterial Infection


800)



NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST


RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

HEMATOLOGY` 2/8/10 Complete BloodCount (CBC) is to

check the specimen of

venous blood;

includes hemoglobin,

hematocrit

measurements, RBC

count and indices,

WBC count and a

differential white cell

count.

LYM 0.2-0.4% 0.12 (increased) An increase in lymphocyteindicates Viral or Bacterial

Infection (Fundamentals of

Nursing, p 800)

EOSI 0.01-0.05% 0.03 (increased) Low in eosinophils indicates

Tissue injury (Fundamentals of

Nursing, p 800)

HGB F:120-160

G/L

93 (decreased) Low in hemoglobin implies

Anemia (Fundamentals of

Nursing, p 800)

HCT 0.42-0.52% 0.29 (decreased) Decrease in hematocrit

signifies anemia


800)



NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST


RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

URINALYSIS 1/30/10 Urinalysis is to

determine urine

composition and possible abnormal

components (e.g.

protein or glucose) or

infection.

Physical

Color

Transparency

Specific

Gravity

Amber

SlightlyTurbid

1.010-1.025

Amber

Slightly Turbid1.015

NORMAL

Chemical

Albumin

Sugar

Negative

Negative

Positive (3)

Negative

Presence of Albumin indicates

diabetes

mellitus.(http://en.wikipedia.or

g/wiki/Protenuria)

Indicates renal failure.

(Diagnostic Test, p 353)

NORMAL

Chemical

Albumin

Sugar

Negative

Negative

Positive (3)

Negative

Presence of Albumin indicates

diabetes

mellitus.(http://en.wikipedia.or

g/wiki/Protenuria)

Indicates renal failure.


NORMAL



NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST


RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

URINALYSIS 1/30/10 Urinalysis is to

determine urine

composition and possible abnormal

components (e.g.

protein or glucose) or

infection.

Cells

RBC

Pus cells

Bacteria

Amorphous

urates

0-3/HPF

absent

absent

absent

2-5/HPF

1-4/HPF

Moderate

Some

Decrease in RBC indicates

anemia (Diagnostic Tests. p378)

Presence of pus cells indicates

infection (http://www.biology-

online.org/dictionary/Pus_cell)

An indication that there may be a presence of (infection

http://www.biology-

online.org/dictionary/Bacteria)

Result of the refrigeration

process of urine

(http://www.irvingcrowley.co

m/cls/urin.htm)



NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST


RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

BIOCHEMISTRY 2/15/10 Biochemistry is

used to keep the body¶s fluid

levels in balance,

and are necessary

to help the

muscles, heart

work properly.

BUN

Creatinin

e

K

1.9-

9.2mmol/L

53-133

mmol/L

3.6-5.5

mEq/L

9.7 (increased)

171

(increased)

3.3 (decrease)

Increase in BUN

indicates congestiveheart failure and renal

failure. (Diagnostic Test,

p 56)

Increase in Creatinine

signifies heart failureand renal failure.


Decrease in Potassium

can be the side effect of

his diuretics. (Diagnostic

Test, p 340)



NAME OF TEST

OR

PROCEDURE

DATE

DONE

INDICATION FOR

THE TEST


RESULTS/

FINDINGS

SIGNIFICANCE OF THE

RESULTS/FINDINGS

ARTERIAL

BLOOD

GAS

1/30/10 Arterial blood gas is

used to measure the

partial pressure of

arterial oxygen,

PaCO2,pH, oxygen

Saturation and

bicarbonate.

pH 7.35-7.45 7.467 An increase in pH indicates

alkalosis

(http://en.wikipedia.org/wiki/Ar

terial_blood_gas)

pCO2 35-

45mmHg

40.5 NORMAL

pO2 80-100

mmHg

76.8 (decreased) A decrease in O2 indicates that

the patient is not respiring

properly, and is hypoxemic.


terial_blood_gas)

HCO3a 22-25

mEq/L

29.5 (increased) An increase in HCO3í indicates

kidneys are working to

compensate for a respiratory

issue so as to normalize the

blood pH


terial_blood_gas)



Microbiology 1/30/10 Deals with the study of

microorganisms

including bacteria, v iruses, fungi and

parasiteswhich are of

medical importance

and are capable of

causing diseases in

human beings.

Presence of Enterobacter

aerogenes(hea v y gro wth)

Ultrasound 1/30/10Used to v isualize

muscles, tendons, and

many internal organs, to

capture their size,

structure and any

pathological lesions

with real time

tomographic images.

Ultrasound has been

used by sonographers to

image the human body

for at least 50 years and

has become one of the

most widely used

diagnostic tools in

modern medicine.

Bilateral mild diffuse

renal parenchymal

disease moderately

distended urinary

bladder.

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An a Pa Tho Lab