Large Hematoma on Occipital Lobe of Cranium

Case Study 2 Hemostasis

Patient is brought into emergency room following a fall while walking in the yard during an icy storm.

Noted during an examination: Large hematoma on occipital lobe of cranium. HR: 114 BPM BP: 70/50 mmHg Pupils dilated Respiration: 21 MAP = __57__mmHg_ Blood type O+

1.What can be assumed about the condition of the patient? (3 points) hint: look at Stroke Volume and Cardiac Output and MAP

My patient is experiencing low blood pressure, very fast heart rate, and very low mean arterial pressure (about 57 mmHg). These factors allow me to assume that the patient is suffering from major blood loss from the hematoma forming on the occipital lobe of the cranium. The low blood pressure along with a high heart rate is a tell tale sign that the body is trying to cope very high levels of blood loss.

2. Which of the blood types can she receive Type A- blood, Type B+, Type O- (3 points) explain why.

The patient could receive type O blood. When is comes to a person with type O blood, the blood contains no antigens but both anti-a and anti-b antibodies. This means that all other blood types can receive type O blood due to its lack of antigens, but type O blood can not receive type A, B, or AB due to the presence of A and B antigens. For this reason, type O blood is often referred to as the universal donor.

3. Considering the area of impact, if cranial pressure keeps increasing, a. What effect will it have on the Autonomic Nervous System? (2 points)

As the patient is hemorrhaging the autonomic nervous system is responding in order to keep the body working normally through sympathetic responses. Firstly, vasoconstriction will take place in order to reduce the amount of blood loss. Secondly, the sympathetic response will cause heart rate to increase in order to compensate for the low blood pressure and blood volume.

b. What effect will the ANS have on systemic blood vessels? Why? (2points) The autonomic nervous would cause systemic blood constrict in order to decrease possible blood loss.

4. In order for the cranial bleeding to stop, homeostasis occurs in a series of reactions called Hemostasis.

a. Name and give a brief description of each step. (6 points) Step 1-Vascular Spasm: damaged blood vessel constricts in order to limit the amount of blood that escapes

Step 2-Platelet Plug Formation: platelets come along and sticked to exposed collagen fibers within the cut

Step 3-Coagulation Phase: Inactive proteins are activated and a blood clot is created

b. What is the primary difference between the intrinsic and extrinsic pathways? ( 2 points )

Intrinsic pathways are initiated when the damage is on the inside of the vessel whereas extrinsic pathways are initiated when the damage is to the tissue outside of the blood vessel.

c. Both of the above pathways lead to a common pathway, list the steps in a common pathway. (2 points)

Factor XPromthrombinThrombinFibrinogenFibrin

6. The process of a clot dissolving is called __clot retraction__what digestive enzyme is involved? __plasmin__. (2 points)

7. What are the effects of aspirin in the above process? (2 points) Aspirin would keep a clot form forming because it blocks thromboxane; the chemical that leads to the congregation of platelets.

References ( 1 point) http://www.umc.edu/uploadedFiles/UMCedu/Content/Education/Schools/Medicine/Basic _Science/Physiology_and_Biophysics/Facilities/Modeling_Workshop/Integrative_Physio logy_Model/Simulations/Hemorrhage_DOC.pdf

McGraw Hill: Anatomy & Physiology- An Integratvie Approach Michael P McKinely