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Gasping for AirIntroduction Why can the human body last for only a few minutes without oxygen, yet can survive for days without food or water? Rule of Three. The body can last three minutes without air; yet it can last three days without water and three weeks without food! From these time limits it is easy to see that oxygen must be very important and that the body needs a near constant supply. What does oxygen provide to the body that is so important for survival? Cells need energy to function. They obtain this energy from the energy storing molecule ATP. Think back to what you have already learned about ATP. It is formed by combining the nucleoside adenosine with three high energy phosphate groups. In order for ATP to be produced, oxygen must be available. Without oxygen, the addition of the third phosphate group does not occur, and ATP is consequently not produced. Without ATP, the body’s cells do not have a source of energy and will die once a cell’s ATP reserves are used up. The body’s source of oxygen is the air in the atmosphere. Getting oxygen from the air to each cell in the body requires a complex and coordinated effort from the respiratory and cardiovascular systems. Every minute these systems work together to take in oxygen the body needs and get rid of the waste gases produced. In this activity, you will meet a young girl who is struggling to breathe. As you work to diagnose her, you will investigate the structure of the respiratory system and consider what happens in the body when low levels of oxygen cause a person to gasp for even a simple breath. Equipment Computer with Internet accessMedical History – Visit #1 Resource SheetMedical History – Visit #2 Resource SheetColored pencils or markersLaboratory journalHuman Body System OrganizerProcedurePart I: Meet MelissaMelissa Martin, age 11, is finding it harder and harder to catch her breath during her normal activities. As you work your way through the lesson, you will analyze Melissa’s symptoms, research a diagnosis, and provide recommendations for treatment and control. Obtain Medical History – Visit #1 Resource Sheet. See attached.Read the case notes provided for your patient. Highlight or underline any symptoms or relevant history you feel will be helpful in making a diagnosis. Research information from the medical history and physical exam as needed. Take notes in your laboratory journal. Brainstorm what might be going wrong and come up with an explanation of Melissa’s symptoms. Add your explanation to the appropriate section on the Medical History Resource Sheet. Discuss your theory with your teacher.Research next steps for Melissa Martin. How can you confirm the diagnosis and begin to treat your patient?Record any ideas in the Recommendations section of the Medical History document. Discuss Melissa’s case as a class.Part II: Inside the Respiratory SystemBegin to investigate the structure and function of the respiratory system. Go to the National Geographic Health and the Human Body webpage on Lungs and Lung Information, accessible at (HBS is uppercase; lungs is lowercase; all one term)Read the introduction titled The Breath of Life in the mini window. Select Lung Anatomy in the mini window. Click on either the lung diagram or the names of structures to see more information about the lobes, trachea, diaphragm, bronchi, and bronchioles.Sketch a diagram of the respiratory system on a blank Human Body System Organizer (see attached). Label each of the components and write a brief description of each component’s function.Select the Alveoli tab in the lower left corner. The diagram and names of structures should change to represent the smallest structures associated with the lungs. Again click on either the diagram or the names of the structures to see more information about the alveoli, bronchioles, and blood vessels. On the side or bottom of your Body System Organizer, describe the relationship between the bronchioles, alveoli, and blood vessels. Add a drawing or sketch if desired.Select Lung Functions. Complete the interactive demonstration of lung function. Watch carefully what is happening in the alveoli. Make sure to continue through the entire animation. View the Anatomy of Breathing animation available at Watch gas exchange on inhale and exhale, also paying attention to the role of muscles in respiration. Take notes about the process on your note sheet 4.01 Gasping for Air.Click on Take a Closer Look to examine gas exchange at the level of the alveoli. Complete Conclusion Questions 1 and 2 on loose leaf titled “4.01 Gasping for Air Conclusion Questions”Visit the American Lung Association site on asthma available at Define asthma in your notes titled 4.01 Gasping for Air. Watch the What is Asthma? video to explore how asthma impacts normal functioning of the lungs. Take notes on 4.01 Gasping for Air in your binder/notebook. View the Kids Health video What Happens During an Asthma Flare-up available at Answer Conclusion Question 3. Part III: Follow-up VisitObtain a Medical History – Visit #2 Resource Sheet. Read the updates to the Case History.Review Melissa’s Peak Flow Chart. Note that average (or normal) peak flow for a patient of Melissa’s size is 267. The chart below describes the classification of peak flow values. Normal Peak Flow Values% of Normal Peak Flow:Meaning:Classification:80% - 100% All is fineGreen Zone50% - 80%CautionYellow ZoneLess than 50%Medical AlertRed ZoneCalculate the value ranges that relate to the Green, Yellow, and Red zones for Melissa. List the values on the Medical History form under the graph and use colored pencils or markers to shade in the associated ranges of the peak flow chart. Analyze Melissa’s peak flow graph as well as her descriptions of her symptoms and activities on each day of her diary. Describe conclusions about her condition on the Explanation of Results section of the Medical History Resource Sheet. Read the Recommendations section of the report. Answer the remaining Conclusion questions.Conclusion QuestionsThe walls of the alveoli in the lungs are incredibly thin. Explain how this structure is related to function in the body. Remember what you learned about diffusion in Principles of Biomed or another science class. Use the principles of diffusion to explain why oxygen molecules in the tissues of the lung go into the blood, and then in other tissues the oxygen molecules leave the blood.What changes inside the airways in the lungs lead to an asthma attack? Explain how monitoring Melissa’s response to medication during wheezing events can help in making a clinical diagnosis of asthma. Note that Melissa’s exam indicates a pulse ox value of 91%. What is this value and how can it be used to monitor overall health?What environmental conditions might cause damage to the alveolar sacs, and what would be the consequences of that damage?Describe how the muscular system is interconnected to the respiratory system. What role do muscles play in an asthma attack?Describe the interaction between the cardiovascular system and the respiratory system. Make sure to include the words hemoglobin and carbon dioxide as well as relevant anatomy you have learned in this lesson. Gasping for Air: Medical History – Visit #1Patient’s Name:Age:Date:Melissa Martin11February 5 Height:Weight:Temperature:52 inches70 lbs.98.3°FBlood Pressure:Pulse:Respiration Rate:110/7275 bpm22 bpmCase HistoryMelissa is an 11 year-old girl who has been having coughing fits for the past 6 days. Her mom is concerned as her school reports that she has been reluctant to participate in gym class. Melissa states that she is embarrassed that she can’t keep up with her friends. She has also been having trouble lasting her entire ballet class without feeling tired or starting to cough. Melissa’s records report five upper respiratory infections and associated coughing in the past 18 months. Mild wheezing is reported at each of these appointments. Melissa describes the cough as “dry” and says during these times of infection, she wakes up coughing more than once a night. Physical ExamPatient’s pulse is normal. Pulse ox = 91%No wheezing is appreciated on this appointment. Patient said she has no ear pain or a sore throat. Upon inspection, her ears, nose, and throat all look normal.Patient’s glands are not swollen.Patient’s speech, hearing, and vision appear normal.. Explanation of SymptomsRecommendationsBody System Graphic OrganizerBody System: _________________________________center3810000Gasping for Air Medical History – Visit #2Patient’s Name:Age:Date:Melissa Martin11February 12Height:Weight:Temperature:52 inches70 lbs.98.6°FBlood Pressure:Pulse:Respiration Rate:100/7573 bpm22 bpmCase HistoryOn the last visit, it was determined that Melissa had a high probability of asthma. The patient was asked to measure her peak expiratory flow rate (PEFR) using a peak flow meter for one week. A peak flow meter is a simple device used to monitor how open your airways are. A patient blows into the device as hard as he or she can and records the value shown on the indicator. Melissa was tasked to keep a peak flow diary, recording peak flow at the same time each morning and evening. She was instructed to take three readings at each time period and record the best of the three readings. She was also asked to add any notes about particular activities each day, as well as other factors that may have influenced her breathing. Physical ExamPatient’s pulse is normal. Pulse ox = 93%No wheezing is appreciated on this appointment. Patient’s glands are not swollen.Patient’s speech, hearing, and vision appear normalPatient Peak Flow MonitoringSYMPTOMS – Use an X to show when you have symptomsDay1Day2Day3Day4Day5Day6Day7AMPMAMPMAMPMAMPMAMPMAMPMAMPMCoughXXXXXXWheezeXXBreathing ProblemsXDay 3 – Dance class at night after school/Mild coughing and chest tightness during classDay 6 – Stayed up late studying for a test/woke 2-3 times during the nightDay 7 – Colder than normal outside when waiting for the bus/brief coughing spell with wheezing at schoolPEAK FLOW READINGSDay 1Day 2Day 3Day 4Day 5Day 6Day 7AMPMAMPMAMPMAMPMAMPMAMPMAMPM250210240255240150185245275255230200230200Peak Flow RangesGreen Zone Ranges: Yellow Zone Ranges: Red Zone Ranges: Explanation of ResultsRecommendationsMelissa will complete spirometry testing to test overall lung function. Patient was also given an inhaler of a “rescue medication” to take if wheezing or coughing keeps her from taking normal breaths. Patient will report back on response to this medication at the next visit. ................
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