Ethical Dilemma In Nursing - 1599 Words

Introduction The choice of right versus wrong is instilled throughout childhood. However, there are some situations where you have to choose between the two because both choices have their advantages and disadvantages. This is an ethical dilemma. An ethical dilemma involves morals that clash between each other, and some involve the legal aspect of the choices (Grohar- Murray). Everyone faces some sort of ethical dilemma. There are some professions that have to battle ethical dilemmas every day. Amongst those professions the nursing occupation and other healthcare related titles have to keep in mind several different laws, rules, and regulations that effects these decisions. The nurse also must remember their primary duty is to the†¦show more content†¦What happens when the patient is legally incompetent and the patient’s family agrees to the treatment while the patient is refusing? The next section, 2.1: Primacy of the Patient’s Interests, explains what to do â€Å"when t he patient’s wishes are in conflict with those of other.† In these situations â€Å"the nurse’s commitment remains to the identified patient† (2015). Simply put the nurse must listen to the desires of the patient that is admitted to the hospital or care facility over the patient’s family. Background On this particular floor, there was a patient who was legally incompetent. This patient has a history of being noncompliant with his medicines and hypertension. He has a drug issue and a list of medical problems. Those health problems include a left middle cerebral artery infarct with a hemorrhagic conversion, ejection fraction of 30%, and a heart rhythm of atrial fibrillation. Occasionally this patient’s heart rhythm would switch to sinus tachycardia during the shift. Along with the pervious complications listed this patient had other symptoms associated with strokes. The healthcare team was not sure as to what was the cause of the sudden spikes in heart rate. The increase happened while the patient was in the bathroom, however, the cardiologist advised his heart rate should not drastically increase as it did from a bowel movement. The cardiologist decided to perform a heart catheterization (Heart Cath) on thisShow MoreRelatedImportance Of Ethical Dilemmas In Nursing723 Words   |  3 Pages In nursing, one must rely on principles of ethics to guide his or her decisions and actions. As I have journeyed through nursing school, I have been faced with multiple scenarios in practice that I believe that now, with the new information I have learned through these past few weeks’ readings, I would be more prepared to recognize as ethical dilemmas, to challenge, or to act on, ethically. After taking the Ethical Leadership Self-Assessment, I have been able to highlight two opportunities forRead MoreThe Ethical Dilemma Of Pediatric Nursing1204 Words   |  5 PagesIn pediatric care, nurses are regularly faced with situations where they must make ethical decisions that impact them and their patients. An ethical dilemma occurs when the options for a solution present both favorable and unfavorable outcomes (Burkhar dt Nathanial, 2008). In pediatric nursing, ethical dilemmas arise when there are conflicting views on how course of treatment should be perused. If a patient’s wishes conflict with others, nurses help resolve the conflict (American Nurses AssociationRead MoreEthical Dilemmas in the Nursing Field537 Words   |  2 PagesThere are several dilemmas in the nursing field though nurses reactions to ethical dilemmas are based on their individual values and beliefs as well as ethical principles, professional codes and the climate of the healthcare setting. Nurses encounter ethical dilemmas when conflicting values and judgments are present regarding what is the best course of patient care. Ethical dilemmas are faced by nurses on a daily bases. I am choosing two of these dilemmas to address. 1. Empirical Knowledge vs. PersonalRead MoreEthical Dilemmas Of The Nursing Field2773 Words   |  12 PagesEXPLAINING ETHICAL DILEMMAS IN THE NURSING FIELD Nurses face ethical dilemmas on a daily basis regardless of where they practice. No matter where nurses function in their varied roles, they are faced with ethical decisions that can impact them and their patients. There is no â€Å"right† solution to an ethical dilemma (Fant 2013). So what is an ethical dilemma? It is a problem without a satisfactory resolution. The significance of ethical decision-making lies in the fact that very different ethical choicesRead MoreEthical Dilemmas Of Nursing Practice1763 Words   |  8 PagesI will explore an ethical dilemma that may arise within my nursing practice. I have presented a narrative, from the article â€Å"A Dilemma in the Emergency Room†, that portrays an ethical situation involving patient confidentiality. I will focus on Standard IV: Ethical Practice of the College of Registered Nurses of British (CRNBC) as well as the other (CRNBC) Standards of Practice to further evolve my understanding of the ethics involved wit hin the professional practice of nursing. FROM 110? Read MoreThe Ethical Dilemma Of The Nursing Profession3196 Words   |  13 PagesIntroduction Although the nursing profession is based on caring for patients, there are scenarios that arise that test the nurse’s ability to make decisions that are beneficial for the patients. There can be situations that are simple and the decision is clear. However, there are scenarios that many nurses encounter that challenge their personal, professional, ethical values and principles along with addressing laws. It becomes a mental battle to decide which value and principle is the best optionRead MoreNursing Ethical Dilemma Essay1541 Words   |  7 Pagesthe one who has an understanding and forgiving heart one who looks for the best in people. Leave people better than you found them.† Nursing is more than just doing assessments and giving medications; it is going beyond that to know what is right or wrong, what can and cannot be done, and what is considered harming the patients rather than doing them good. In nursing, there is a fine line between what is considered to be negl igence and beneficence. According to Marquis (2017), â€Å"Ethics is the systemicRead MoreThe Ethical Dilemma Of Grand Nursing Theories1577 Words   |  7 PagesGrand nursing theories are global in their application to nursing and have been instrumental in developing the science of nursing (McEwen Wills, 2014). Grand nursing theories are abstract and can be applied to many different situations. Because grand nursing theories are broad they can be applied to ethical dilemmas that occur in nursing practice. Ethical dilemmas are a part of the healthcare field and it is important to know how to navigate through the murky waters that dilemmas can present. NursingRead MoreThe Ethical Dilemmas Of The Pediatric Field Of Nursing1316 Words   |  6 PagesNurses working in the pediatric field of nursing are faced with a wide variety of ethical dilemmas. There are many ethical dilemmas that can arise in the work field. Many individuals are having a tough time deciding to vaccinate their c hildren; this in turn can leave society with a huge dilemma ethically. I am choosing to write about not vaccinating your child and why I feel this can be an ethical dilemma. Society today is faced with so many preventable illnesses that can simply be resolved byRead MoreNursing Leaders Are Struggling Ethical Dilemmas1263 Words   |  6 PagesNursing leaders are struggling in ethical dilemmas daily. Ethical dilemma is one of the issue/challenge to the nursing leader. Ethical dilemmas occur when nursing personal values and beliefs conflict with some aspect of nursing care. The struggle is to provide the best nursing care despite of the nurses’ feelings. For example: RN/ nursing leader in residential home has always dilemmas while restraining the patient. sometime patient become so aggressive that they can harm other people and worker.

Nobility in Sir Gawain and the Green Knight Essay - 468 Words

King Arthur and his knights represent the pinnacle of bravery, chivalry, and honor. However, when a strange knight, the Green Knight, enters Camelot with a challenge, none of the knights accept it (?). No knights wanted to go blow for blow with the Green Knight for fear of losing their lives. It is not until Arthur rises to face the challenge, to defend the honor of his court, that Gawain steps forward and accepts it. Therefore, the purpose of the Green Knight is to teach Sir Gawain to value his honor and the honor of the king more than his life. One may consider Gawain’s acceptance of the challenge a noble gesture. Gawain says, â€Å"Though you be tempted thereto, to take it on yourself†¦I am the weakest, well I know, and of wit feeblest;†Ã¢â‚¬ ¦show more content†¦Gawain is not making a grand gesture, but he is doing his duty defending the life of his king. Furthermore, during Gawain’s speech why he should take Arthur’s place, Gawain states â€Å"While so bold men about upon benches sit† (351). This appears as a complement to his fellow knights, but Gawain is implying that he is better (that the other knights should be stepping forward?) than the other knights. Gawain, alone, accepts the challenge to protect the life of his king. King Arthur and his knights represent the pinnacle of bravery, chivalry, and honor. However, when a strange knight, the Green Knight, enters Camelot with a challenge, none of the knights accept it (?). No knights wanted to go blow for blow with the Green Knight for fear of losing their lives. It is not until Arthur rises to face the challenge, to defend the honor of his court, that Gawain steps forward and accepts it. Therefore, the purpose of the Green Knight is to teach Sir Gawain to value his honor and the honor of the king more than his life. One may consider Gawain’s acceptance of the challenge a noble gesture. Gawain says, â€Å"Though you be tempted thereto, to take it on yourself†¦I am the weakest, well I know, and of wit feeblest;† (350,354). While Gawain appears to be acting humble and willing to sacrifice himself, this tells the reader that he values the life of his king more than his own. Gawain is not making a grand gesture, but he is doing his duty defending the life of his king.Show MoreRelated Sir Gawain: A Man of Virtue Essay861 Words   |  4 PagesSir Gawain: A Man of Virtue Nobility, honesty, valiance and chivalry are the values instilled in Sir Gawain. He is a respected knight due to these characteristics. Both Sir Gawain and The Green Knight and in The Wedding of Sir Gawain and Dame Ragnell present these qualities of Sir Gawain. In both tales, he proves these traits through many events. Sir Gawain and The Green Knight proves Sir Gawain’s nobility and honesty while The Wedding of Sir Gawain and Dame Ragnell provides proof of his chivalryRead MoreThe Code Of Chivalry And The Fundamental Thoughts And Actions Of Human Nature1499 Words   |  6 PagesEnglish 2223 Jennifer Smith 26 November 2015 Sir Gawain†¦ Chivalric? By analyzing Sir Gawain’s attempts of following the Code of Chivalry and the fundamental thoughts and actions of human nature helps to further analyze Gawain’s character. The definition of Chivalry is the â€Å"set of values and code of conduct for the medieval knightly class† (Shatz) examining Gawain’s attempts to achieve his goal of being the perfect chivalric knight, the nature of his obstacles has to be determined, andRead MoreAnalysis Of Sir Gawain And The Green Knight940 Words   |  4 Pages In Sir Gawain and the Green Knight, the men and women appear to have different roles in the society. The men attempt to live a more noble life while emasculating the power of the women. Throughout the poem, women display hints of their potential through manipulation and trickery, traits that are uneasily recognized by men as growing power. Morgan la Fay manipulates the Lord Bercilak to assume the role of the Green Knight, and she uses him for revenge against Queen Guenevere. She engineered a planRead MoreMain Ideas and Themes of Beowulf Essay1138 Words   |  5 Pages Beowulf and Sir Gawain have many things in common. We will be discussing them later on, but their main similarity is that theyre both heroes. A hero is a person who must pass through a test and a battle (mental, spiritual or physical) to help someone else. He must be selfless, and act for others rather than himself. All societies have supported heroes, like the ancient Greeks Hercules and the modern day Spiderman. These are hero stereotypes, with supernatural Read MoreArchetypes In Sir Gawain And The Green Knight829 Words   |  4 Pagesespecially in Sir Gawain and the Green Knight. In Sir Gawain and the Green Knight most characters or objects served to aid in the development of the hero by being either a situational, character, color, or a symbol archetype. The poem begins with a challenge being presented to the knights of the Round Table by the Green Knight. While seeing that no one else will accept the challenge, putting Camelot’s honor at stake, Gawain accepts and then realizes that in a year they must meet again and the Green KnightRead MoreSir Gawain And Don Quixote1373 Words   |  6 PagesChivalrous, Sir Gawain or Don Quixote? Sir Gawain and Don Quixote†¦these brave men bolster the honor, courage, and bravery which can be only demonstrated by that of the chivalrous knight. They face strong adversity, yet are able to use their wit and cunning in order to gain the upper hand. They uphold the laws of chivalry every knight must obey. First a knight must obey God. Then a knight must obey his King and his Lords. And then a knight must obey his Lady Love. Yes with their majestic nobilities, theseRead More Sir Gawain and the Green Knight Essays847 Words   |  4 PagesSir Gawain and the Green Knight As with so many stories written in the Middle Ages Sir Gawain and the Green Knight is filled with wonders, magic and knightly pursuit of fame and nobility. It combines folklore and romance as does, according to The Norton Anthology, no other known work. The character of the Green Knight fascinates and amuses. Most people would not think of it as an Arthurian-time creature. The Green Man in fact, is a part of an ancient folklore where the beheading of a green manRead MoreEssay on The Big Sleep1073 Words   |  5 PagesIn the books The Big Sleep and Sir Gawain and the Green Knight, both authors, Raymond Chandler (The Big Sleep) and Simon Armitage (Sir Gawain and the Green Knight), create the protagonist of each story into archetypal knights. The protagonist of The Big Sleep is named Phillip Marlowe and in Sir Gawain and the Green Knight the protagonist is named Sir Gawain. The 3 knightly qualities that we will be focusing on in this essay are self-sacrifice, loyalty and courage. These qualities are displayed throughoutRead MoreWilliam Shakespeare s Sir Gawain And The Green Knight804 Words   |  4 Pageseach of these traits, because of the importance they put on acts of nobility and chivalry. The themes of medieval stories were based on beliefs or ideas, expressed by the people of the time. Themes often involved the code of chivalry, which emphasized the importance of honor to the medieval people. The tale of â€Å"Sir Gawain and the Green Knight† focuses primarily on beliefs of honor, bravery, and chivalry. The main character, Sir Gawain, embodies these qualities. His character is meant to be a model ofRead MoreArchetypal Characters In Sir Gawain And The Green Knight : Character Analysis1143 Words   |  5 Pagesmiddle ages of literature, a story such as Sir Gawain and the Green Knight had many aspects of Joseph Campbell’s view of the hero’s journey. In the story of our character Sir Gawain accepts a â€Å"Call to adventure† (Campbell 45) and goes on a quest that will go through many of the archetypes. Likewise, there lies one character, The Green Knight, that can be many of the archetypal characters in the cycle of the hero’s journey. Sir Gawain and the Green Knight dramatically demonstrates how a single character

Physio free essay sample

Describe the gross structure of the lungs and pleurae. Mechanics of Breathing 7. Explain the functional importance of the partial vacuum that exists in the intrapleural space. 8. Relate Boyle’s law to the events of inspiration and expiration. 9. Explain the relative roles of the respiratory muscles and lung elasticity in producing the volume changes that cause air to flow into and out of the lungs. 10. List several physical factors that influence pulmonary ventilation. 11. Explain and compare the various lung volumes and capacities. 12. Define dead space. 13. Indicate types of information that can be gained from pulmonary function tests. Gas Exchanges Between the Blood, Lungs, and Tissues 14. State Dalton’s law of partial pressures and Henry’s law. 15. Describe how atmospheric and alveolar air differ in composition, and explain these differences. 16. Relate Dalton’s and Henry’s laws to events of external and internal respiration. Transport of Respiratory Gases by Blood 17. Describe how oxygen is transported in the blood, and explain how oxygen loading and unloading is affected by temperature, pH, BPG, and Pco2. 18. Describe carbon dioxide transport in the blood. Control of Respiration 19. Describe the neural controls of respiration. 20. Compare and contrast the influences of arterial pH, arterial partial pressures of oxygen and carbon dioxide, lung reflexes, volition, and emotions on respiratory rate and depth. Respiratory Adjustments 21. Compare and contrast the hyperpnea of exercise with hyperventilation. 22. Describe the process and effects of acclimatization to high altitude. Homeostatic Imbalances of the Respiratory System 23. Compare the causes and consequences of chronic bronchitis, emphysema, asthma, tuberculosis, and lung cancer. Developmental Aspects of the Respiratory System 24. Trace the embryonic development of the respiratory system. 25. Describe normal changes that occur in the respiratory system from infancy to old age. Lecture Outline I. Functional Anatomy of the Respiratory System (pp. 805–819; Figs. 22. 1–22. 11; Table 22. 1) A. The Nose and Paranasal Sinuses (pp. 806–809; Figs. 22. 1–22. 3) 1. The nose provides an airway for respiration; moistens, warms, filters, and cleans incoming air; provides a resonance chamber for speech; and houses olfactory receptors. 2. The nose is divided into the external nose, which is formed by hyaline cartilage and bones of the skull, and the nasal cavity, which is entirely within the skull. 3. The nasal cavity consists of two types of epithelium: olfactory mucosa and respiratory mucosa. 4. The nasal cavity is surrounded by paranasal sinuses within the frontal, maxillary, sphenoid, and ethmoid bones that serve to lighten the skull, warm and moisten air, and produce mucus. B. The Pharynx (p. 809; Fig. 22. 3) 1. The pharynx connects the nasal cavity and mouth superiorly to the larynx and esophagus inferiorly. a. The nasopharynx serves as only an air passageway, and contains the pharyngeal tonsil, which traps and destroys airborne pathogens. b. The oropharynx is an air and food passageway that extends inferiorly from the level of the soft palate to the epiglottis. c. The laryngopharynx is an air and food passageway that lies directly posterior to the epiglottis, extends to the larynx, and is continuous inferiorly with the esophagus. C. The Larynx (pp. 810–812; Figs. 22. 3–22. 5) 1. The larynx attaches superiorly to the hyoid bone, opening into the laryngopharynx, and attaches inferiorly to the trachea. 2. The larynx provides an open airway, routes food and air into the proper passageways, and produces sound through the vocal cords. 3. The larynx consists of hyaline cartilages: thyroid, cricoid, paired arytenoid, corniculate, and cuneiform; and the epiglottis, which is elastic cartilage. 4. Vocal ligaments form the core of mucosal folds, the true vocal cords, which vibrate as air passes over them to produce sound. 5. The vocal folds and the medial space between them are called the glottis. 6. Voice production involves the intermittent release of expired air and the opening and closing of the glottis. . Valsalva’s maneuver is a behavior in which the glottis closes to prevent exhalation and the abdominal muscles contract, causing intra-abdominal pressure to rise. D. The trachea, or windpipe, descends from the larynx through the neck into the mediastinum, where it terminates at the primary bronchi (pp. 812–813; Fig. 22. 6). E. The Bronchi and Subdivisions (pp. 813–815 ; Figs. 22. 7–22. 9) 1. The conducting zone consists of right and left primary bronchi that enter each lung and diverge into secondary bronchi that serve each lobe of the lungs. 2. Secondary bronchi branch into several orders of tertiary bronchi, which ultimately branch into bronchioles. 3. As the conducting airways become smaller, the supportive cartilage changes in character until it is no longer present in the bronchioles. 4. The respiratory zone begins as the terminal bronchioles feed into respiratory bronchioles that terminate in alveolar ducts within clusters of alveolar sacs, which consist of alveoli. a. The respiratory membrane consists of a single layer of squamous epithelium, type I cells, surrounded by a basal lamina. b. Interspersed among the type I cells are cuboidal type II cells that secrete surfactant. c. Alveoli are surrounded by elastic fibers, contain open alveolar pores, and have alveolar macrophages. F. The Lungs and Pleurae (pp. 815–819; Figs. 22. 10–22. 11) 1. The lungs occupy all of the thoracic cavity except for the mediastinum; each lung is suspended within its own pleural cavity and connected to the mediastinum by vascular and bronchial attachments called the lung root. 2. Each lobe contains a number of bronchopulmonary segments, each served by its own artery, vein, and tertiary bronchus. . Lung tissue consists largely of air spaces, with the balance of lung tissue, its stroma, comprised mostly of elastic connective tissue. 4. There are two circulations that serve the lungs: the pulmonary network carries systemic blood to the lungs for oxygenation, and the bronchial arteries provide systemic blood to the lung tissue. 5. The lungs are innervated by parasympathetic and sym pathetic motor fibers that constrict or dilate the airways, as well as visceral sensory fibers. 6. The pleurae form a thin, double-layered serosa. a. The parietal pleura covers the thoracic wall, superior face of the diaphragm, and continues around the heart between the lungs. b. The visceral pleura covers the external lung surface, following its contours and fissures. II. Mechanics of Breathing (pp. 819–826; Figs. 22. 12–22. 16; Tables 22. 2–22. 3) A. Pressure Relationships in the Thoracic Cavity (pp. 819–820; Fig. 22. 12) 1. Intrapulmonary pressure is the pressure in the alveoli, which rises and falls during respiration, but always eventually equalizes with atmospheric pressure. 2. Intrapleural pressure is the pressure in the pleural cavity. It also rises and falls during respiration, but is always about 4 mm Hg less than intrapulmonary pressure. B. Pulmonary Ventilation (pp. 820–822; Figs. 22. 13–22. 14) 1. Pulmonary ventilation is a mechanical process causing gas flow into and out of the lungs according to volume changes in the thoracic cavity. a. Boyle’s law states that at a constant temperature, the pressure of a gas varies inversely with its volume. 2. During quiet inspiration, the diaphragm and intercostals contract, resulting in an increase in thoracic volume, which causes intrapulmonary pressure to drop below atmospheric pressure, and air flows into the lungs. . During forced inspiration, accessory muscles of the neck and thorax contract, increasing thoracic volume beyond the increase in volume during quiet inspiration. 4. Quiet expiration is a passive process that relies mostly on elastic recoil of the lungs as the thoracic muscles relax. 5. Forced expiration is an active process relying on contraction of abdominal muscles to increase intra-abdominal pressure and depress the rib cage. C. Physical Factors Influencing Pulmonary Ventilation (pp. 822–824; Fig. 22. 15) 1. Airway resistance is the friction encountered by air in the airways; gas flow is reduced as airway resistance increases. . Alveolar surface tension due to water in the alveoli acts to draw the walls of the alveoli together, presenting a force that must be overcome in order to expand the lungs. 3. Lung compliance is determined by distensibility of lung tissue and the surrounding thoracic cage, and alveolar surface tension. D. Respiratory Volumes and Pulmonary Function Tests (pp. 824–826; Fig. 22. 16; Table 22. 2) 1. Respiratory volumes and specific combinations of volumes, called respiratory capacities, are used to gain information about a person’s respiratory status. a. Tidal volume is the amount of air that moves in and out of the lungs with each breath during quiet breathing. b. The inspiratory reserve volume is the amount of air that can be forcibly inspired beyond the tidal volume. c. The expiratory reserve volume is the amount of air that can be evacuated from the lungs after tidal expiration. d. Residual volume is the amount of air that remains in the lungs after maximal forced expiration. e. Inspiratory capacity is the sum of tidal volume and inspiratory reserve volume, and represents the total amount of air that can be inspired after a tidal expiration. . Functional residual capacity is the combined residual volume and expiratory reserve volume, and represents the amount of air that remains in the lungs after a tidal expiration. g. Vital capacity is the sum of tidal volume, inspiratory reserve, and expiratory reserve volumes, and is the total amount of exchangeable air. h. Total lung capacity is the sum of all lung volumes. 2. The anatomical dead space is the volume of the conducting zone conduits, which is a volume that never contributes to gas exchange in the lungs. 3. Pulmonary function tests evaluate losses in respiratory unction using a spirometer to distinguish between obstructive and restrictive pulmonary disorders. E. Nonrespiratory Air Movements (p. 826; Table 22. 3) 1. Nonrespiratory air movements cause movement of air into or out of the lungs, but are not related to breathing (coughing, sneezing, crying, laughing, hiccups, and yawning). III. Gas Exchanges Between the Blood, Lungs, and Tissues (pp. 827–830; Figs. 22. 17–22. 19; Table 22. 4) A. Gases have basic properties, as defined by Dalton’s law of partial pressures and Henry’s law (pp. 827–828; Table 22. 4). 1. Dalton’s law of partial pressures states that the total pressure exerted by a mixture of gases is the sum of the pressures exerted by each gas in the mixture. 2. Henry’s law states that when a mixture of gases is in contact with a liquid, each gas will dissolve in the liquid in proportion to its partial pressure. B. The composition of alveolar gas differs significantly from atmospheric gas, due to gas exchange occurring in the lungs, humidification of air by conducting passages, and mixing of alveolar gas that occurs with each breath (p. 828). C. External Respiration: Pulmonary Gas Exchange (pp. 28–830; Figs. 22. 17–22. 19) 1. External respiration involves O2 uptake and CO2 unloading from hemoglobin in red blood cells. a. A steep partial pressure gradient exists between blood in the pulmonary arteries and alveoli, and O2 diffuses rapidly from the alveoli into the blood, but carbon dioxide moves in the opposite direction along a partial pressure gradient th at is much less steep. b. The difference in the degree of the partial pressure gradients of oxygen and carbon dioxide reflects the fact that carbon dioxide is much more soluble than oxygen in the blood. . Ventilation-perfusion coupling ensures a close match between the amount of gas reaching the alveoli and the blood flow in the pulmonary capillaries. d. The respiratory membrane is normally very thin, and presents a huge surface area for efficient gas exchange. D. Internal Respiration (p. 830; Fig. 22. 17) 1. The diffusion gradients for oxygen and carbon dioxide are reversed from those for external respiration and pulmonary gas exchange. 2. The artial pressure of oxygen in the tissues is always lower than the blood, so oxygen diffuses readily into the tissues, while a similar but less dramatic gradient exists in the reverse direction for carbon dioxide. IV. Transport of Respiratory Gases by Blood (pp. 830–834; Figs. 22. 20–22. 22) A. Oxygen Transport (pp. 830–83 2; Figs. 22. 20–22. 21) 1. Because molecular oxygen is poorly soluble in the blood, only 1. 5% is dissolved in plasma, while the remaining 98. 5% must be carried on hemoglobin. a. Up to four oxygen molecules can be reversibly bound to a molecule of hemoglobin—one oxygen on each iron. . The affinity of hemoglobin for oxygen changes with each successive oxygen that is bound or released, making oxygen loading and unloading very efficient. 2. At higher plasma partial pressures of oxygen, hemoglobin unloads little oxygen, but if plasma partial pressure falls dramatically, such as during vigorous exercise, much more oxygen can be unloaded to the tissues. 3. Temperature, blood pH, Pco2, and the amount of BPG in the blood all influence hemoglobin saturation at a given partial pressure. B. Carbon Dioxide Transport (pp. 832–834; Fig. 22. 22) 1. Carbon dioxide is transported in the blood in three ways: 7–10% is dissolved in plasma, 20% is carried on hemoglobin bound to globins, and 70% exists as bicarbonate, an important buffer of blood pH. 2. The Haldane Effect encourages CO2 exchange in the lungs and tissues: When plasma partial pressure of oxygen and oxygen saturation of hemoglobin decrease, more CO2 can be carried in the blood. 3. The carbonic acid–bicarbonate buffer system of the blood is formed when CO2 combines with water and dissociates, producing carbonic acid and bicarbonate ions that can release or absorb hydrogen ions. V. Control of Respiration (pp. 834–839; Figs. 22. 23–22. 26) A. Neural Mechanisms (pp. 834–836; Fig. 22. 23) 1. Two areas of the medulla oblongata are critically important to respiration: the dorsal respiratory group near the root of cranial nerve IX, and the ventral respiratory group extending from the spinal cord to the pons/medulla junction. 2. The ventral respiratory group is a rhythm-generating and integration center containing separate groups of neurons, some that fire during inhalation and others that fire during exhalation. a. The inspiratory neurons, via phrenic and intercostal nerves, stimulate contraction of the diaphragm and intercostal muscles. b. When the expiratory neurons fire, output to the respiratory muscles stops, muscles relax, and lungs recoil. 3. The cyclic behavior of inspiratory and expiratory neurons produces a breathing rate of 12–15 breaths per minute, which is called eupnea. 4. The pontine respiratory group within the pons modifies the breathing rhythm and prevents overinflation of the lungs through an inhibitory action on the medullary respiration centers. . It is likely that reciprocal inhibition on the part of the different respiratory centers is responsible for the rhythm of breathing. B. Factors Influencing Breathing Rate and Depth (pp. 836–839; Figs. 22. 24–22. 26) 1. The most important factors influencing breathing rate and depth are changing levels of CO2, O2, and H+ in arterial blood. a. The receptors monitoring fluctuations in these parameters are the cen tral chemoreceptors in the medulla oblongata, and the peripheral chemoreceptors in the aortic arch and carotid arteries. b. Increases in arterial Pco2 cause CO2 levels to rise in the cerebrospinal fluid, resulting in stimulation of the central chemoreceptors, and ultimately leading to an increase in rate and depth of breathing. c. Substantial drops in arterial Po2 are required to cause changes in respiration rate and depth, due to the large reserves of O2 carried on the hemoglobin. d. As H+ accumulates in the plasma, rate and depth of breathing increase in an attempt to eliminate carbonic acid from the blood through the loss of CO2 in the lungs. 2. Higher brain centers alter rate and depth of respiration. a. The limbic system, strong emotions, and pain activate the hypothalamus, which modifies respiratory rate and depth. b. The cerebral cortex can exert voluntary control over respiration by bypassing medullary centers and directly stimulating the respiratory muscles. 3. Pulmonary irritant reflexes respond to inhaled irritants in the nasal passages or trachea by causing reflexive bronchoconstriction in the respiratory airways. 4. The inflation, or Hering-Breuer, reflex is activated by stretch receptors in the visceral pleurae and conducting airways, protecting the lungs from overexpansion by nhibiting inspiration. VI. Respiratory Adjustments (pp. 839–840) A. Exercise (p. 839) 1. During vigorous exercise, deeper and more vigorous respirations, called hyperpnea, ensure that tissue demands for oxygen are met. 2. Three neural factors contribute to the change in respiration: psychic stimuli, cortical stimulation of skeletal muscles and respiratory centers, and excitatory impulses to the respiratory areas from active muscles, tendons, and joints. B. High Altitude (pp. 839–840) 1. Acute mountain sickness (AMS) may result from a rapid transition from sea level to altitudes above 8000 feet. . A long-term change from sea level to high altitudes results in acclimatization of the body, including an increase in ventilation rate, lower than normal hemoglobin saturation, and increased production of erythropoietin. VII. Homeostatic Imbalances of the Respiratory System (pp. 840–842; Fig. 22. 27) A. Chronic obstructive pulmonary diseases (COPD) are seen in patients that have a history of smoking, and result in progressive dyspnea, coughing and frequent pulmonary infections, and respiratory failure (pp. 840–841; Fig. 22. 27). 1. Obstructive emphysema is characterized by permanently enlarged alveoli and deterioration of alveolar walls. 2. Chronic bronchitis results in excessive mucus production, as well as inflammation and fibrosis of the lower respiratory mucosa. B. Asthma is characterized by coughing, dyspnea, wheezing, and chest tightness, brought on by active inflammation of the airways (p. 841). C. Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and spread by coughing and inhalation (pp. 841–842). D. Lung Cancer (p. 842) 1. In both sexes, lung cancer is the most common type of malignancy, and is strongly correlated with smoking. 2. Squamous cell carcinoma arises in the epithelium of the bronchi, and tends to form masses that hollow out and bleed. 3. Adenocarcinoma originates in peripheral lung areas as nodules that develop from bronchial glands and alveolar cells. 4. Small cell carcinoma contains lymphocyte-like cells that form clusters within the mediastinum and rapidly metastasize. VIII. Developmental Aspects of the Respiratory System (pp. 842–843, 846; Fig. 22. 28) A. By the fourth week of development, the olfactory placodes are present and give rise to olfactory pits that form the nasal cavities (p. 842; Fig. 22. 28). B. The nasal cavity extends posteriorly to join the foregut, which gives rise to an outpocketing that becomes the pharyngeal mucosa. Mesoderm forms the walls of the respiratory passageways and stroma of the lungs (p. 842; Fig. 22. 28). C. As a fetus, the lungs are filled with fluid, and vascular shunts are present that divert blood away from the lungs; at birth, the fluid drains away, and rising plasma Pco2 stimulates respiratory centers (p. 43). D. Respiratory rate is highest in newborns, and gradually declines to adulthood; in old age, respiratory rate increases again (p. 843). E. As we age, the thoracic wall becomes more rigid, the lungs lose elasticity, and the amount of oxygen we can use during aerobic respiration decreases (p. 846). F. The number of mucus glands and blood flow in the nasal mucosa decline with age, as does cili ary action of the mucosa, and macrophage activity (p. 846).

The Hours Film Review Essay Example

The Hours Film Review Essay Everywhere we go, we constantly find ourselves furious and dissatisfied with film adaptations that never seem to serve us justice The book is just sooooooo much better!. But is it really fair to imprint this impression on all film adaptations of much-loved novels? The answer is NO. From the director of Billy Elliot, Stephen Daldry and his talented team on-and-off camera will prove you wrong.It is insanely difficult for most of us, to even begin to imagine the intolerable pain derived from those who endure immense depression or those who suffer from some form of mental illness. They are locked up in a jail that resembles their mind and are unable to break free. The Hours encapsulates this emotional stress endured by women across different eras to utter perfection.Based on the Pulitzer Prize-winning novel written by Michael Cunningham, The Hours depicts the lives of three women in three generations along with the twisted struggles they experience imprisoned in their hopeless souls. Au stralian actress Nicole Kidman (Moulin Rouge, Rabbit Hole), captures the role of Virginia Woolf in 1925, working on Mrs. Dalloway (a stream-of-consciousness novel) about the hostess of society, whose artificial nature of perfection masks her inner turmoil. Julianne Moore (The End of An Affair) portrays stereotypical American housewife, Laura Brown residing in 1951 American suburbia a woman who feels compelled to maintain her loyalty towards her son and husband (John C. Reilly). What may seem like a contentful heart and cheerful face may possibly be something else underneath the surface. Critically acclaimed actress, Meryl Streep (Adaptation, Sophies Choice) as Clarissa Vaughan in 2001, neglects her partner for the chapter in her life that she is reluctant to close, whom is shared with AIDS sufferer, Richard Brown played by Ed Harris.Kidman stands taller than the rest, delivering an extraordinary Oscar-worthy performance of astonishing courage, revealing the destructive war between her intellectual mind and the chaos revolving around her personal world. Every gesture and every facial expression convinces the audience that this character was tailor-made especially for her. Streep reflects this level of performance and as always, handles her role carefully producing a believable performance as a result. Her switch between absolute lunacy to a cheerful hostess is measured to perfection. But there is always one that lets the team down. Moores approach to the complex character of Laura Brown shows that she is just another pretty lady in a pretty dress. The recurring empty face is a snooze-fest that blocks the audience from entering her state-of-mind. Last but certainly not least, it is not a surprise that the youngest member of the cast, young and adorable Ritchie Brown played by Jack Rovello, angelically lights up the screen, making us aww time after time, whilst stealing our vulnerable hearts with his truthfully honest words, and innocent stare. Cuuute.Perhaps o ne of the most memorable scenes from the film is the opening sequence, which immediately draws attention to Virginia Woolfs irreversible decision, intertwined with a beautifully written voiceover of a note devoted her husband that exercises our minds in preparation for the incoming wave of emotions. The three distraught women and their lives are carefully woven together into a fluid piece of artistic interpretation. But in the end every life must continue, no matter how dull it may be. Tensions crescendo. Fears arise. The once-somber mood is finally uplifted and brightened when a series of fresh, blooming flowers are shot to complete the sequence with an excellent finish.The emotionally driven power of the themes featured in The Hours automatically select the targeted age group to mature audiences, as the multi-layered plot is possibly too chunky to digest for younger audiences. A certain fascination with mortality is explored by the female trio, who are explicitly sensitive, posses sing a clear perception of the revolving world. Constant evaluations are made by each of the main characters, questioning their monotonic lifestyles. The common through-line can be identified between the victims.David Hares masterfully constructed screenplay for the film stays faithful to Cunninghams novel and the devoted fans that are attached to his work. Hare took confident risks, to approach his duty with maturity. The script produced is not afraid to treat its audience as if they were knowledgeable geniuses. The screenplay successfully communicates the moral of the narrative, that there is a never-ending variation of experiences throughout the course of ones life, where no two days are exactly same.The impeccable costuming, cinematographic and musical aspects of The Hours cover up the puzzling holes in the films plot. Costume designer Ann Roth, did a remarkable job in interpreting the personalities of the characters via fashion [which is essential in many ways], as well as pain ting of eras in which each scene is set in. Kidman sports a simple yet effective prosthetic nose, which allows the audience to see an unrecognisable actress, making her role that much more realistic. Seamus McGarveys artistically gorgeous cinematography, consisting of lingering shots on the deeply, afflicted faces of the three leading women, is probably recognised as the films prominent instrument.An immaculate motion picture is presented as a result of his skillful work. Philip Glass exquisitely composed score is one secret and powerful weapon, which successfully accompanies the story, setting a range of moods and expressing atmospheres in a way that dialogue is occasionally unable to do so. The melodic harmonies produced by an enchanting combination of piano and strings are a vital aspect of the film, establishing and developing the characters by pouring their emotions out. This is somewhat rare in a typical Hollywood film. It is truly the flawlessly calibrated finishing touch to the magnificent creation.Every single inch of detail and aspect of the film from the heart-wrenchingly convincing acting performed by the majority of the cast, to the astounding screenplay and the haunting score is attacked with intelligence, seriousness and meaningfully precise measures which ultimately produced an original and dazzling masterpiece that is The Hours. It goes without any doubt at all, that the film thoroughly deserves its showering praise and awards. The Hours is a definite must-see film of the year.