Question

*Questions 9-11 refer to the following patient: A 74 year old man in the ER has had a severe MI, which led to Vfib. He then had a several minute period of pulselessness & apnea before his breathing was finally restored. His BP is 78/56. He is unconscious and unresponsive to any kind of stimulus 9. Which mini-concept map is best to describe causal events and likely patient presentation in this scenario? (you may need to review a bit of cardiac info for this question; also, read each answer CAREFULLY) a. MI & ventricular fibrillation- diminished cardiac output to brain- decreased cerebral perfusion pressure (CPP)diffuse ischemic brain tissue-diffuse cerebral edema-increased intracranial pressure (ICP)comatose state. b. Pulselessness-low BP- increased CPP-diffuse arterial bleeding onto brain tissue- irritation of brain cells->diffuse cerebral edema->increased ICP- comatose state. c. MI & ventricular fibrillation-embolus thrown from right ventricle directly to brain stem brain stem ischemia-> respiratory and other reflex functions affected-pulselessness, low BP, and apnea-comatose state. d. MI & ventricular fibrillation diminished cardiac output to brain decreased cerebral perfusion pressure (CPP)-focal cerebral edema increased ICP of left side of brain-left pupil fixed and dilated and right arm and leg flaccid. Choose from this list for questions 10 & 11: decorticate posturing of the right arm and leg; left side normal. symmetric decerebrate posturing of arms and legs. complaint of severe nausea and dizziness. asymmetric grip strength. garbled speech. bilateral positive plantar reflexes. positive Babinski on the right, negative on the left. Cheyne-Stokes respirations. "upgoing big toe" bilaterally. A. B. C D E. F. G. H. I. Additional S&S most consistent with the correct answer in #9 include (choose one) 10. A a. b. E C. d. G Additional S&S most consistent with the correct answer in #9 include (choose one) 11 C a.

Answer 1

MI & ventricular fibrillation--->Diminished cardiac output to brain--->Decreased cerebral perfusion pressure--->Diffuse ischemic brain tissue--->diffuse cerebral edema--->Increased intracranial pressure--->comatose state.

Explanation:

Ventricular fibrillation is the abnormal rhythm of the heart which cause ventricles to restrict from its function.

Myocardial infarction which makes the cardiac muscles deprive for oxygen supply. Hypoxia and abnormal rhythm is the effect present in the body which cause reduction in cardiac output.So it cut off blood supply to the vital organs.The primary organ to get damage is brain.Reduced cardiac output cause decrease in BP.Cerebral perfusion pressure indicates the perfusion state to the brain.Reduced blood supply to the brain so the CPP gets reduced.No perfusion makes the tissues deprive for oxygen supply it leads to the tissue damage and results in edema in the brain tissues.ICP gets increased due to ischemia and cerebral edema which leads to comatose state.

reduced cardiac output cause bradycardia,apnea. Then due to cerebral ischemia unconsciousness and unresponsiveness happens.