The Discussion Section question is:  

Add a comment pertaining to the effect of workload on coronary blood flow. Please detail our potential to image the ratio of decrease blood flow for  diagnostic value. Add to to the DICUSSION PANNEL for this unit.

Here some example for you :

1- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

According to The Journal of the American Association, coronary blood flow is determined by the rate at which blood flows out of the coronary arteries to other parts of the body. For example, during rest, the amount of blood flows through the coronary arteries is 225 ml per minute which is 4-5% of total cardiac output. During stress, the blood flow is faster and the heart muscle contracts during systole. As a result, during diastole, the cardiac muscle relaxes to allow the flow of blood through the body without any resistance. One significant effect on coronary blood flow is the workload the heart is subjected to during stress. With an increase in stress rate, the heart reacts to pump blood in a faster rate to ensure oxygen is supplied to the rest of the body. When imaging, the vasodilator stress agents are helpful in decreasing the blood flow and relaxing the heart muscle. These pharmacological agents help when measuring the supply to the heart and viewing the heart’s workload.

2- The following is regarding the effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

The heart is a very smart organ with very smart systems. An auto-regulatory mechanism known as coronary autoregulation is constantly maintaining the interaction of pressure and resistance of coronary blood flow. Decreases in pressure are compensated for by decreases in resistance and conversely, increases in pressure by increases in resistance so that flow remains constant for a give cardiac workload. This regulatory mechanism operates within the range of physiologic arterial pressures but fails during hypotension when flows become strongly dependent on the driving pressure.

For imaging purposes, pharmacological vasodilator stress agents seek to maximally lower the vascular resistance through relaxation of the vascular smooth muscle cell at the level of the microcirculation, thereby uncoupling coronary flow (supply) and myocardial work (demand). With the help of such pharmacological agents, imaging can take place in order for diagnostic purposes.

References

Schelbert H. R. (2010). Anatomy and physiology of coronary blood flow. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 17(4), 545–554. doi:10.1007/s12350-010-9255-x

3- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

Blood flow to the heart mainly occurs during diastole, the great majority of blood flow to the left ventricle occurs during diastole. The diastolic pressure from the aorta propels blood through the coronary circulation. The more coronary blood flow to the left ventricle means the longer time that diastole will last. The right ventricle receives blood equally during both systole and diastole. Diastole lasts for about two thirds of the cardiac cycle. The coronary arties through the myocardium are compressed during ventricular contraction when fibers are thickening and are unable to fill.  The pressure within the left ventricle offers resistance to this flow. Blockage of coronary arteries can reduce coronary blood flow at rest, resulting in a buildup of a clot, and also anything that causes arteries to constrict and not allow the vasodilatation to even improve coronary blood flow.

For imaging potential of decreased blood flow, pharmacological vasodilator stress agents can be utilized to cause a lower vascular resistance through relaxation of the smooth muscles of the heart during a nuclear stress test. This can lead to measuring the supply and demand of the heart, it is which these pharmacological stress agents that when can possibly use to help increase the potential to image the ratio of decreased blood flow for diagnostic reasons and value.

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As you near the end of the course, you will get to apply all that you have learned to a practical application scenario! You will select from two case studies, one of a child experiencing symptoms of autism and the other experiencing symptoms of attention-deficit/hyperactivity disorder (ADHD). Putting on the hat of a clinician, you will provide a written report of what you would say to the parents of this child, including symptoms, treatment options, and prognosis.

To prepare for this Assignment:

• Review information on disorders that begin in childhood.
• Read through and choose one of the two case studies to explore in your Assignment (autism or ADHD).
• Utilize at least one of the websites provided for support, depending on your chosen case.
• Utilize at least one peer-reviewed journal article to support your treatment recommendation.

• Consider the following scenario, in which you presume the role of a clinician: You have recently met with Johnny and his family. Johnny is 7 years old and in the first grade. He has trouble sitting still, often loses things, will climb under and over the classroom desks, and will leap out of line in the hallways. He has an affinity for math, but he makes careless mistakes on previously mastered concepts. Other children in the classroom have complained about Johnny being too bossy or loud and tend to avoid sitting next to him or inviting him to play.
• Your evaluation has determined that Johnny meets the criteria for attention-deficit/hyperactivity disorder. Johnny’s parents are coming to your office tomorrow to discuss the results of your evaluation.
• Prepare a written report of what you will tell Johnny’s parents about attention-deficit/hyperactivity disorder. Be sure to cover the symptoms that Johnny meets from the DSM-5 Checklist.
• Discuss symptoms of attention-deficit/hyperactivity disorder in light of normal development in the following domains: language, cognition, emotion, and social. In other words, what is noticeably different in children with attention-deficit/hyperactivity disorder versus what you might see in their same-age peers? Speak briefly to the controversy regarding these differences.
• Summarize the research evidence on the effectiveness of different approaches to treatment, based on your textbook reading andat least onepeer-reviewed journal article. Include your final treatment recommendation to Johnny’s parents.
• Consider how you might answer if the parents ask, “How did our child end up with this disorder? What did we do wrong? Is there any hope for him?”
• To close your paper, based on what you have reviewed in your textbook as a whole regarding disorders in childhood, make a comment about how you could be an advocate for social change for children struggling with these disorders.
• Comer, R. J. (2016).Fundamentals of abnormal psychology(8th ed.). New York, NY: Worth
• Chapter 14, “Disorders Common Among Children and Adolescents”
• Chapter 15, “Disorders of Aging and Cognition”
• Alzheimer’s Association. (2016). Retrieved from http://www.alz.org/index.asp
• Autism Speaks. (2016). Retrieved from http://www.autismspeaks.org/
• Center for Autism and Related Disorders. (n.d.). Retrieved May 11, 2016, from http://www.centerforautism.com/
• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). (2016). Retrieved fromhttp://www.chadd.org
• National Institute of Mental Health. (2016). Attention deficit hyperactivity disorder. Retrieved from http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

• Aquarius Health Care Media. (Producer). (2002).Straight talk about autism[Video file]. Retrieved from http://search.alexanderstreet.com.ezp.waldenulibrary.org/ctiv/view/work/1779170
• Barkley, R. A. (Producer). (1994).ADHD in adults[Video file]. Retrieved from http://search.alexanderstreet.com.ezp.waldenulibrary.org/ctiv/view/work/1779081

• King, W. (Producer). (2005).ADHD: What it is, what it isn’t[Video file]. Retrieved from  http://search.alexanderstreet.com.ezp.waldenulibrary.org/ctiv/view/work/1779118

The Assignment (2- to 3-page paper):

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