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Applied Anatomy and Physiology Open inguinal Hernia
Assessment task (s) Written assignments of 3000 (learning Outcomes 1, 2, 3) 100% weighting
Pass required 40%
Title Case Study where students will follow a patient through an
Investigation/clinical procedure from admission to discharge to the department/unit
Date of submission 05/01/2014
Place of submission Via Turnitin GradeMark deadline 14.00hrs (2pm)
Release of Marks 01/02/2014
Date of DAP 05/02/2014
Resubmission W/C 21/01/2014
All coursework assignments and other forms of assessment must be submitted by the published
deadline which is detailed above. It is your responsibility to know when work is due to be submitted –
ignorance of the deadline date will not be accepted as a reason for late or non-submission.
Any late work (submitted via Turnitin GradeMark, person or by post) will NOT be accepted and a mark of
zero will be awarded for the assessment task in question.
You are requested to keep a copy of your work.
In writing this assignment you should consider the following:
This study is an analysis of physiological data collection derived from patient observation/clinical
procedures, explaining the treatment’s impact on the patient’s physiological parameters relating
this to the underlying theory and its relation to practice.
Choose a patient, procedure etc. that interests you. Do not try to undertake the study of highly
complex areas or procedures. The aim of the case study is to demonstrate your understanding,
knowledge and analytical abilities in relation to the area of anatomy and physiology within your
clinical practice. Keep this statement paramount within your memory whilst undertaking your
study and preparation of the assessments.
The case study would involve you initially identifying a patient who you will be involved with whilst
on duty; this may be for the whole or part of your shift. You will need to collect and collate data
which is relevant to your patient but which does not identify your patient in anyway or form. Such
identification would be a serious breach of confidentiality as would the identification of your
working environment or employer.
Collection of relevant bio-psychosocial data should be directly related to the discussions you
present with regards to the anatomical and physiological aspects of your case study. Data
collection will also involve areas of relevant treatment and care/investigation delivery which leads
to physiological changes or aiding a patient adapting, in a physiological sense, to the procedures
they are undergoing. For instance if a patient has a colloid infusion commenced one would
expect that you would provide an analysis as to why such a fluid is given, the reasons for a
change in the patient’s blood pressure and what physiological effect this administration of such a
fluid would have on the patient. This is not a pharmacological study but some demonstration of 7
knowledge and analysis of drugs and how they were utilised would be required along with their
All your discussions within your study must be referenced appropriately using a wide variety of
literature and sources to demonstrate you have read sufficiently around your subject matter. You
will need to demonstrate analysis of your chosen subject areas as required at level 2. Overuses
of quotes are best avoided since this does not necessarily demonstrate understanding but only
your ability to copy another author’s work. Read, understand and then incorporate into your work
appropriately. Sometimes it is necessary to quote since paraphrasing may lose the essence of
what the author was trying to convey.
Remember this is an Anatomy and Physiology module and as such should be the focus of you
In presenting your work for assessment you must be sure that you have addressed all of the learning
outcomes of the module. Your submission will be marked against these learning outcomes and the
assessment criteria. The assessment criteria are a measure of how well you have met the learning
outcomes at this level of academic study.
Guidance on maintaining confidentiality in submitted work is available in your Student Handbook, and
you should read this guidance.
You are required to submit your final assignment via Turnitin GradeMark
For this module you are required to submit your summative assessment (for your written assignment) via
To check your draft (formative) assignment there will be a class section called ‘Check Originality Report’
(COR) set up in your Turnitin account. You will be able to submit to the Check Originality Report
section as many times as you wish and it will be available throughout your studies. This resource
is also a useful tool to share with your module leader or tutor. You can download your originality report
as a PDF file and email it to your tutor, print the originality report and bring it to the tutorial, or log into
Turnitin whilst in the tutorial to show and discuss your work.
Clancy, J. and McVicar, A. (2009) Physiology &
Anatomy: A Homeostatic Approach. 3
rd ed. London:
This book relates many of the concepts in
anatomy and physiology to homeostasis and is
Martini F. H., Nath, J. L. and Bartholomew,E. F.
(2012) Fundamentals of Anatomy and Physiology 9
ed. London: Pearson Education
Marieb, E. N. (2009) Essentials of Human Anatomy
and Physiology International edition 9th ed. London:
Pearson Benjamin Cummings
McCance, K. L. and Heuther, S. E. (2009)
Pathophysiology The biological basis for Disease in
Adults and Children 6
th ed. St Loius: Mosby Elsevier
This provides in-depth exploration of anatomy
and physiology and complements the lectures
well and is available in the library
This is highly recommended as a text and
informs the lectures with many of the slides
from lectures being gained from this book
This text provides excellent background
information with regards to many pathologies
and complements the normal anatomy and
physiology texts effectively
THIS IS AN EXAMPLE ESSAY GIVEN BY THE LECTURER AS TO HOW WE SHOULD TRY AND FOMURLATE OUR OWN ESSAY it will be fine if you can follow along the same principle xxxxxxxxx
In an ever changing environment, the body is constantly adapting to maintain a relatively steady internal balance. This state of constancy is called homeostasis, a process that begins at a cellular level and relies on the regularity of a water-based medium known as the internal environment (Waugh & Grant, 2006). This environment continually alters and changes within very narrow limits to preserve a state of equilibrium in order to meet the functional needs of the body (Marieb, 2008).
In this assignment, the writer will examine the physiological processes in the maintenance of homoeostasis by following a chosen individual through their anaesthetic induction and operative procedure. The writer aims to demonstrate their understanding of patho- physiology, by analysing the patient’s physiological changes, to include, patient observations through the interpretation of clinical data, the role and function of the endocrine system, the physiological stress response, and the contributions made by other body systems to maintain homeostasis within the body. To respect and maintain confidentiality as specified by the Health Professions Council (2008), Standards of Proficiency 1a .3, the identity of the patient selected for this case study will remain anonymous, and for this reason will be referred to as Mr X.
The patient chosen for this assignment is an otherwise healthy sixty eight year old male, undergoing a carotid endarterectomy under general anaesthesia. This procedure is carried out to reduce the risk of strokes, and involves the surgical removal of fatty deposits called plaque (such as cholesterol and calcium), which build up in the carotid artery. The condition is caused by a disease process called atherosclerosis which narrows and constricts the
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artery causing a reduction in blood flow to the brain (Oxford Concise Colour Medical Dictionary, 2007).
The process of this physiological study began at pre-assessment, during which time Mr X’s routine observations were checked. These were recorded at a time when Mr X was thought to be calm and relaxed (Darlene Reid & Chung, 2004), and are shown against the normal adult values set out in the table below.
?????Mr X’s observations
???Normal Adult Parameters (Darlene Reid & Chung 2004)
????80 beats per minute
????60-100 beats per minute
??14 breaths per minute
?12-16 breaths per minute
???Oxygen Saturation (Sp02)%
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The readings indicated that Mr X’s blood pressure was well within normal adult parameters. Blood pressure, according to Clancy and McVicar (2009), is the force of circulating blood exerted against the inner walls of the blood vessels as it is pumped around the body. Two readings determine this pressure, measured in millimetres of mercury (mmHg). These are the systolic and diastolic pressures. The highest refers to the systolic pressure which is produced when blood is pushed into the aorta following the contraction of the left ventricle. The lower pertains to the diastolic pressure which is obtained when the heart is at rest (Better Health Channel, 2009). Blood pressure is influenced by three primary elements; cardiac output, the peripheral resistance and blood volume. These elements are conveyed in the following formula as suggested by Clancy & McVicar (2009).
Total peripheral resistance, as described by Sells, et al. (2006), is concerned with the forces that oppose blood due to the amount of friction it encounters as it travels through the blood vessels. This is largely determined by the length and width of the vessels, and the thickness or viscosity of the blood itself (Clancy & McVicar, 2009). Peripheral resistance is controlled by the sympathetic nervous system which prompts the blood vessels to dilate and constrict accordingly. Any factors which alter total peripheral resistance will cause a reflex variation in blood pressure (Marieb, 2008).
Godfrey (2004) defines cardiac output as the total amount of blood expelled from the left ventricle every minute. It also works in direct relationship with blood pressure, in that a fluctuation in either one will have the same, direct effect on the other. Cardiac output is the product of heart rate (HR), the number of heart beats per minute based on the rate of ventricular contractions, multiplied by stroke volume (SV), the volume of blood ejected by each ventricle per contraction (Silverthorn, 2010). Stroke volume, as explained by Kindlen (2003), can be controlled either extrinsically (via nerves and hormones), or intrinsically, e.g.
?????Blood pressure (BP) = Cardiac output (CO) x Total peripheral resistance (TPR)
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Starling’s law (Sherwood, 2007). The extrinsic control of cardiac function originates within the sympathetic branch of the autonomic nervous system. This mechanism increases myocardial contractility by stimulating the heart to beat stronger, allowing more blood to be expelled per beat (Clancy & McVicar, 2009). The intrinsic mechanism, as described by McGeown (2007), is concerned with the heart’s innate ability to alter stroke volume. It is directly linked to the force produced by the cardiac muscle during each contraction and is related to the length of the myocardial cells and the end diastolic volume. Klabunde (2004) differentiates stroke volume as a correlation between end-diastolic volume (EDV) and end- systolic volume (ESV). EDV, often referred to as preload, is determined by the amount of blood in each ventricle during diastole (relaxation), and is influenced by the amount of blood returning to the right atrium through the ascending and descending vena cava and pulmonary vein (venous return). According to Marieb (2008) stroke volume is governed by a mechanism known as Starling’s law and is considered to be the most important intrinsic control mechanism in cardiac function. As discussed by Hale (2004) Starling’s law is a phenomenon which deals with variations in venous return and is concerned, more importantly, with the pressure at which the blood is returned to the heart via the central veins. It works on the principle that, the more the heart muscles are stretched, the more powerfully it contracts (Silverthorn, 2010). Therefore, anything that influences an increase in venous return prompts a relevant rise in blood flow to the heart. As the ventricles expand (within certain physiological tolerances), the muscle fibres stretch, stimulating the cardiac muscle to contract more forcibly (Solomon, 2009). As a result, the heart pumps a greater volume of blood into the arteries (Silverthorn, 2010).
When Mr X arrived in the anaesthetic room he appeared to be very nervous and looked extremely pale. An oxygen saturation probe, a non-invasive blood pressure (NIBP) cuff, and a set of electrocardiograph leads were applied to Mr X to monitor his vital signs. These were recorded by the monitoring equipment to reveal the following clinical data:
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