1808NRS - Human Anatomy and Physiology 2 A2 Written Assignment

A2 Written Assignment

Aim

In this assessment item you will have the opportunity to apply the knowledge you have gained in the first five weeks of your course. You will respond to questions arising from four scenarios, which will assess your knowledge of important anatomical and physiological concepts relating to the cardiovascular and respiratory system.

Learning Outcome 1: Using appropriate terminology, identify the key anatomical structures and explain the key physiological functions of the cardiovascular, respiratory, gastrointestinal, renal, and reproductive systems.

Task Description

For this task you need to provide a 1500-word written response to (5) questions related to (4) scenarios Each question includes multiple sub-tasks. Write your responses on the answer sheet provided.

Scenario 1

Jane was recently rushed to Gold Coast University Hospital Emergency Department following a myocardial infarction (heart attack). Following a series of tests, it was determined that this episode resulted in severe damage to a papillary muscle in Jane’s left ventricle, causing the heart valves to prolapse.

Questions

1. Explain what effect this cardiac event would have on the function of the left side of Jane’s heart by answering the following questions.

1a) Explain the oxygenation status of the blood entering the left side of the heart.

1b) Starting from the structure(s) responsible for delivering blood directly to the left side of the heart,describe the path the blood takes through the various structures on the left side of the heart.

1c) Identify the specific structure where the blood is delivered after being ejected from the left ventricle.

1d) Myocardial infarction (heart attack) usually occurs due to a blockage in the coronary arteries that supply the heart muscle. Name what branch (of either the left or right coronary artery) is most likely to have been affected in the case scenario above. Briefly state what other structure(s) of the heart, in addition to the papillary muscles, this coronary branch supplies.

1e) Based on the scenario above (Scenario 1), refer to the cardiac output equation to explain how cardiac output would immediately be affected.

1f) Explain how preload and afterload may be affected in this case scenario and how it may affect cardiac output.

Scenario 2

Before discharge from hospital, Jane’s nurse discusses some of the risk factors for myocardial infarction. In
their case, this includes hypertension. The nurse also discusses the medications they have been prescribed to treat the hypertension:

• Calcium channel blockers
• Beta blockers

2.  How do these drugs work to lower blood pressure?

2a) Explain how calcium channel blockers work (i.e., the mechanism of action) to lower blood pressure. Make sure you refer to the blood pressure equation (BP = CO x SVR) when writing your answer.

2b) Explain how beta blockers work (i.e., the mechanism of action) to lower blood pressure. Make sure you refer to the blood pressure equation (BP = CO x SVR) when writing your answer

3.  The electrical signals sent through Jane’s cardiac conduction system appear to be “blocked”. Answer the following questions.

3a) In the ECG trace below, circle where the abnormality is and label the effected wave/component.

3b) Where in Jane’s cardiac conduction system is the “blockage” likely to be? 

3c) Referring to the cardiac cycle, what mechanical event is likely to be adversely affected due to this blocked conduction issue?

Scenario 3

John has been diagnosed with emphysema (an obstructive disease of his airways). He finds it relatively easy to inhale, but when he exhales, his airways close and it is difficult to forcefully exhale the air from his lungs. In addition, emphysema leads to the destruction of alveoli walls leading to larger sized, but fewer alveoli overall.

4. Answer the following questions regarding how emphysema may affect the normal function of the respiratory system.

4a) Explain what lung volumes and/or capacities may be affected by John’s condition.

4b) Explain how gas exchange at the alveoli is affected in these conditions, and why?.

4c) Using the bicarbonate buffer system equation, explain what happens to blood carbon dioxide levels and how this may correlate with blood pH in obstructive respiratory conditions.

Scenario 4

Julie has previously been diagnosed with chronic bronchitis – a long-term inflammatory disease of the airways that results in thick viscous mucous obstructing multiple airways. In Julie’s recent visit to the hospital, she was also diagnosed with right-sided heart failure due to her poorly managed pulmonary hypertension. Consequently, she has also developed peripheral oedema (fluid shifting from the intravascular space to the interstitial area).

5. Answer the following questions regarding how chronic bronchitis and right-side heart failure affect the normal function of the respiratory and cardiovascular systems.

5a) Describe two protective mechanisms of the respiratory tract to help prevent the passage of bacteria into the lungs.

5b) Use your understanding of ventilation-perfusion coupling (V/Q), to explain how the respiratory (ventilation) and cardiovascular (perfusion) systems would respond to airway obstruction (as seen in chronic bronchitis) and how this obstruction might result in pulmonary hypertension.

5c) Use your understanding of capillary exchange to explain how ineffective contractions on the rightside of the heart (i.e. Right-sided heart failure) can alter capillary exchange dynamics resulting in peripheral oedema.

Brief Summary of Assessment Requirements

The A2 Written Assignment required students to apply their understanding of anatomical and physiological concepts related to the cardiovascular and respiratory systems . The assessment was designed around four patient-based scenarios, each with multiple sub-questions.

Key requirements included:

• Scenario 1 (Cardiovascular Dysfunction): Explain the impact of myocardial infarction on heart function, oxygenation, cardiac output, preload/afterload, and coronary artery supply.

• Scenario 2 (Hypertension and Medications): Analyse the mechanism of action of calcium channel blockers and beta blockers using the blood pressure equation.

• Scenario 3 (Emphysema): Discuss the effect of obstructive lung disease on lung volumes, gas exchange, and blood pH using the bicarbonate buffer system.

• Scenario 4 (Chronic Bronchitis & Right-Sided Heart Failure): Explore protective mechanisms of the respiratory tract, ventilation-perfusion mismatch, pulmonary hypertension, and development of peripheral oedema due to impaired capillary exchange.

The expected word count was 1500 words , with structured, evidence-based responses that use correct medical terminology.

Mentor’s Step-by-Step Guidance Approach

1. Understanding the Assessment Brief

   The mentor began by carefully breaking down the task into four scenarios with sub-parts , helping the student see how each scenario connected back to the learning outcomes . Emphasis was placed on using clinical reasoning and terminology while linking physiological concepts to patient cases.

2. Scenario 1 Myocardial Infarction

   • The mentor guided the student to start with the oxygenation status of blood entering the left atrium , then map the pathway through the left heart chambers and valves.

   • To explain cardiac output, the CO = HR x SV equation was applied, showing how papillary muscle dysfunction could reduce stroke volume.

   • Preload and afterload were explained in terms of volume overload and vascular resistance, with real-life examples from Jane’s case.

3. Scenario 2 Hypertension Medications

   • The mentor encouraged the student to link the BP = CO x SVR formula with drug actions.
   • Calcium channel blockers were explained as reducing vascular resistance by relaxing smooth muscles, while beta blockers reduce heart rate and stroke volume.

   • The student was shown how to relate these mechanisms to Jane’s condition.

4. Scenario 3 Emphysema

   • The mentor helped the student identify lung volumes (e.g., increased residual volume, reduced vital capacity) and their implications.
   • Gas exchange impairment was discussed in relation to reduced surface area of alveoli.

   • The bicarbonate buffer equation was applied to show how CO₂ retention leads to respiratory acidosis.

5. Scenario 4 Chronic Bronchitis and Right-Sided Heart Failure

   • The student was guided to describe mucociliary clearance and cough reflex as protective mechanisms.
   • V/Q mismatch was explained with reference to hypoxic vasoconstriction leading to pulmonary hypertension.

   • Capillary exchange principles (hydrostatic vs oncotic pressures) were used to explain peripheral oedema.

6. Structuring the Responses

   The mentor reinforced the importance of clear headings, subheadings, and concise explanations , ensuring each sub-question was fully answered with appropriate clinical detail.

7. Final Review

   • References were checked for accuracy (Harvard style).
   • Terminology was revised to ensure alignment with anatomical and physiological standards.
   • Word count was balanced across scenarios to avoid overemphasis on a single section.

Final Outcome and Learning Objectives Achieved

By the end of the assignment, the student:

• Demonstrated the ability to apply theoretical knowledge to real-life clinical cases.
• Accurately identified key structures and physiological processes in the cardiovascular and respiratory systems.
• Explained drug actions using the blood pressure equation and cardiac output concepts.
• Integrated knowledge of ventilation, perfusion, and gas exchange with pathological conditions.
• Applied principles of capillary exchange to explain clinical signs such as oedema.
• Enhanced critical thinking and clinical reasoning skills, showing readiness for further nursing practice.

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