1 Flashcards
(235 cards)
1
Q
What is Diffusion?
A
Process in which molecules move from an area of higher concentration to an area of a lower concentration.
2
Q
Inhalation
A
The active muscular part of breathing
*Diaphragm and intercostal muscles contract during inhalation
*Diaphragm act as a voluntary (actions that are under our control) - taking deep breathes - holding your breath - coughing
and involuntary muscle (Automatic functions) - constant breathing
3
Q
Accessory Muscles
A
What is not ordinary used during normal breathing
4
Q
Ventilation
A
The act of moving air into and out of lungs
5
Q
What is the Diaphragm and intercostal muscles responsible for?
A
Regular rise and fall of the chest that accompanys normal breathing
6
Q
What does the Upper Airway consist of ?
What are they responsible for?
A
Consists of: Nasopharynx, Nasal Air passage, Pharynx, mouth, Epiglottis, and Larynx.
( Jaw,Larynx, Mouth, Nose, Oral Cavity, Pharynx )
Responsible for: Warm, filter and humidify air as it enters the body through the nose and mouth.
7
Q
Pharynx and what does it consist with (3).
A
Muscular tube that tends from nose and mouth to the level of the esophagus and trachea
1.Nasopharynx
2.Oropharynx
3. Laryngopharynx
8
Q
Nasopharynx
A
Lined with the ciliated mucous membrane and filers out dust and small particles.
Warms and humidifies air as it enters the body
9
Q
Oropharynx
A
Entrance for the Respiratory and Digestive system
(Superior to the larynx is the epiglottis)
Helps prevents food and liquid from entering the larynx during swallowing
10
Q
Larynx
A
A. Complex structure formed by many independent cartilaginous structures
B. Upper Airway ends and the Lower airway begins
11
Q
Epiglottis (superior to the Larynx)
A
Helps prevent the digestion system to form the respiratory system.
12
Q
Thyroid Cartilage (Adam’s apple)
A
Shield shaped structure formed by two pallets that join in a V shaped anteriorly to form a laryngeal prominence
13
Q
Cricoid Cartilage ( cricoid Ring )
A
Inferior to the Thyroid
- Lowest part of the Larynx
-First ring in the trachea and the only lower airway structure that forms a complete ring.
14
Q
Cricotthyroid Membrane
A
Elastic Tissue that connects the thyroid cartilage super way to cricoid ring Inferiorly
15
Q
Glottis ( glottis opening )
A
Space between the vocal cords and the narrowest portion of the adult airway
16
Q
Vocal Cords
A
White bands of thin muscles tissues are partially separated at the rest and serve as he primary center for speech production
17
Q
What is the function of the Lower Airway?
A
Deliver oxygen to the Alveoli
18
Q
Trachea ( windpipe )
A
-Passage for air entry into the lungs
(Structure approx. 4-5 inches / 10-12 cm of C shaped cartilaginous rings)
-Directly below the cricoid cartilage and descends anteriorly down the midline of the neck to the thoracic cavity
- Divides at heel level of the carina
19
Q
Carina
A
Two main stem bronchi (right and left)
Hollow bronchi are supported by thee cartilage and distribute air into the lungs
20
Q
What do the lungs consist of ?
A
The entire mass of the tissue that includes the SMALLER BRONCHI, BRONCHIOLES, AND THE ALVEOLI.
21
Q
Visceral Pleura
A
Covers the outer surface of the lung tissues
22
Q
Parietal Pleura
A
Lines the inside of the thoracic cavity
23
Q
Bronchioles
A
Thin hallow tubes made of smooth muscles
Tons of these muscles allows the bronchioles to dilate and constrict in response to various stimuli’s
- small bronchioles branch out into alveolar ducts that end at the alveolar sacs.
24
Q
The Alveoli
A
Is located at the end of the airway, are millions of thin-walled, balloon like sacs, that serve as the functional site for the exchange of oxygen and carbon dioxide.
25
What is the Pulmonary capillaries job within the alveoli?
Hint*: Oxygen vs. Carbon Dioxide
Oxygen diffuses through the lining of the alveoli into the pulmonary capillaries where, depending on adequate blood volume and the pressure is carried back to the heart to then be distributed to the rest of the body.
At the same time …
Carbon Dioxide (waste) diffuses from the pulmonary capillaries into the alveoli, where it is exhaled and removed from the body.
26
What is Mediastinum? AND What does it contain?
The space between the lungs
It contains: The heart, The Great Vessels. Esophagus, Trachea, Major Bronchi, and many nerves.
27
Ventilation
The physical act of moving air into and out of the lungs
28
Oxygenation
the process of loading oxygen molecules onto the hemoglobin molecules in the bloodstream
29
Respiration
The actual exchange of oxygen and carbon dioxide in the alveoli as well as the tissues of the body
30
Phrenetic Nerve
*found in the thorax. *Important structure of the nervous system
-It allow the diaphragm to contract, which is necessary for breathing to occur.
31
Why do the respiratory and cardiovascular systems work together?
-Ensure the constant supply of oxygen and nutrients are delivered to all of the cells of the body
-Remove carbon dioxide and waste products from the cells
32
Partial pressure
the amount of gas in air or dissolved in fluid, such as blood
*measured in millimeters of mercury (mm Hg)
33
Tidal volume
The amount of air (ml)that is moved into or out of lungs during one breath
*average tidal vol. 500ml)
34
Dead Space
Portion of the tidal volume that does not reach the alveoli and dos not participate in gas exchange
35
Minute Ventilation (minute volume)
Amount of air moved through the lungs in 1 minute minus the dead space
36
Vital Capacity
Amount of air that can forcefully expelled from the lungs after breathing deeply
37
Residual Volume
The air that remains after maximal expiration
38
Regulation of Ventilation is primarily by ?
pH of cerebrospinal fluid, which is directly related to the amount of carbon dioxide dissolved in the plasma portion of the blood.
39
What do patients with COPD have difficulty with and what does it cause them to use?
Have difficulty eliminating carbon dioxide though exhalation
-Causes them t use “backup system “ aka Hypoxic Drive to control breathing.
*always have higher levels of carbon dioxide
*potentially alters their drive for breathing
40
EARLY Signs of Hypoxia (signs and systems)
* Restlessness * Irritability * Apprehension * Tachycardia * Anxiety
41
LATE signs of Hypoxia
* mental status changes * Weak (thready) pulse * cyanosis
* conscious patients : complain of dyspnea or shortness of breath
42
Internal Respiration
Exchange of oxygen and carbon dioxide between the systematic circulatory system and the cells of the body.
*oxygen passes from blood in capillaries to tissue cells.
*carbon dioxide and cell waste travel in the other direction, from cells through capillaries and into the veins.
43
In trauma emergencies, what conditions typically obstruct flow to individual cells and tissues?
*Pulmonary Embolism
*Tension Pneumothorax
*Open Pneumothorax (sucking chest wound)
*Hemothorax
*Hemopnuemothorax
44
Hypovolemic Shock
Abnormal decrease in blood volume
45
Vasodilatory Shock
Abnormal increase in blood vessel diameter, decreasing blood pressure
46
Agonal Repirations
Patient may appear to be breathing after heart has stopped
47
Non rebreather Mask
Preferred way to give oxygen in prehospital setting to patients who are breathing adequately but are suspected of having or showing signs of hypoxia
48
CPAP (continuous positive airway pressure) - Mechanism
Increases pressure in the lungs,opens collapsed alveoli, pushes more oxygen across the alveolar membrane, and forces interstitial fluid back into the pulmonary circulation.
*use with caution: patients with potentially low blood pressure = Drop is cardiac output
49
Dyspnea
Felling short of breath or having trouble breathing
50
What are conditions cause Dyspnea?
*Asthma*Heart Failure *Pulmonary Embolism * common Cold
51
What does the respiratory system consists of?
*diaphragm
*chest wall muscles
*Accessory muscles of breathing
*Nerves from the brain and spinal cord to those muscles
52
What is the principal function of the lungs?
RESPIRATION- the exchange of oxygen and carbon dioxide.
53
Inspiration
the act of breathing in, or inhaling
54
Exhalation
The act of breathing out, or exhaling
55
What happens as the alveoli lie against the pulmonary capillary vessels?
(Oxygen vs. Carbon Dioxide)
Oxygen passes freely though tiny passages in the alveolar wall int these capillaries
Carbon dioxide returns to lungs
56
What happens when carbon dioxide drops too low?
a. Person automatically breathes at a slower rate and less deeply
b. Less carbon dioxide is expired (levels in the blood return to normal)
57
What happens if the level of carbon dioxide rises above normal?
A. Person breathes more rapidly and more deeply
B.More carbon dioxide diffuses out of the bloodstream
58
When does Esophageal Varices occur?
*Common signs and symptoms
The pressure within the blood vessels surrounding the esophagus increase, frequently as a result of liver damage.
*Liver Damage *Fatigue
*weight loss *jaundice *anorexia
*edema in the stomach *abdominal pain * nausea *vomiting
59
When does Esophageal Varices occur?
*Common signs and symptoms
The pressure within the blood vessels surrounding the esophagus increase, frequently as a result of liver damage.
*Liver Damage *Fatigue
*weight loss *jaundice *anorexia
*edema in the stomach *abdominal pain * nausea *vomiting
60
When does Esophageal Varices occur?
*Common signs and symptoms
The pressure within the blood vessels surrounding the esophagus increase, frequently as a result of liver damage.
*Liver Damage *Fatigue
*weight loss *jaundice *anorexia
*edema in the stomach *abdominal pain * nausea *vomiting
61
What does it mean to have blood in urine?
Injury to the urinary tract
*kidney
*Ureter
*Bladder
*Urethra
62
What are some signs and symptoms of internal bleeding?
bloody vomit (hematemesis)
Bright red coffee ground
Bright red in stools (Hematochezia)
Dark / tarry Stools (Melena)
63
What organs are part of the Endocrine System?
(Endocrine Glands)
*Producing hormonal secretion that pass directly into the bloodstream.
(Endocrine Glands): *thyroid, Parathyroids, testes, Pituitary, Pancreas, Ovaries, Adrenal.
64
Gallbladder
(UPPER RIGHT QUADRANT- Underneath liver)
Small pouch extending from the bile ducts that serves as a resocior for the temporary storage and concentration of bile. (Bile is formed in liver)
**Gallbladder and liver make up the Biliary system*
65
Vital Signs: Infant (birth-12months)
RR: 30-60
HR:100-180
SYSTOLIC BP: 72-104
66
Vital Signs: Toddler (1 - 2 yrs )
RR: 22-37
HR:98-140
Systolic BP: 86-106
67
Vital Signs: Preschooler (3 - 5 yrs)
RR: 20-28
HR: 80-120
Systolic BP: 89-112
68
Vital signs: School Age Child (6-12 yrs)
RR: 18-25
HR: 75-118
Systolic BP: 97-115
69
Vital Signs: Adolescent (12-18 yrs)
RR: 12 -20
HR: 60-100
Systolic BP: 110-131
70
Side effects for Meter dose Inhaler
Increases Heart rate
71
Symptoms of Asthma include:
Shortness of breath
Wheezing breath sounds
Cough
72
Suctioning airway by age
Young children : 5-10 seconds
Adults: 10-15 seconds
Infants: 5 seconds
73
Where do DVT (deep vein thrombosis) form?
Veins
*a patient who has had a DVT within he last year is TWICE as likely to experience an ischemic stroke
74
Where do cerebral embolisms and thrombosis form?
Arteries
75
What is a coup-contrecoup injury caused by?
Severe car accident, in which there is a lot of head movement with great force.
76
Priapism is associated with what portion of the spine?
Cervical Spine
77
Acute Coronary Syndrome (ACS)
*signs and symptoms
*most common indicator = Chest Pain*
Dyspnea
Nausea
Diaphoresis
78
Subcutaneous Emphysema
Crackling sensation felt on palpation of the skin, cause by the air in the soft tissues.
79
When do you commonly hear crackling (rales) breath sounds?
COPD
Pneumonia
Bronchitis
Pericarditis
CHF
80
Hypovolemic Shock
Severe blood and fluid loss make the heart unable to pump enough blood to the rest of the body
81
Spontaneous Pneumothorax
A rupturing of a weakened area of the lungs
82
Hemothorax
An accumulation of blood in the pleural space in which the source can be the chest wall , heart,or blood vessels in the area
83
Tension Pnuemothorax
Cause by air entering the pleura (cause by a hole in the thoracic cavity wall or a hole in the lungs due to the trauma).
84
Congestive heart failure signs and symptoms
*pink frothy sputum (fluid in the lungs caused by acute, severe left ventricle failure)
*chest pain
*poor skin sign
*diaphoresis
*anxiety
85
Beta-agonists
Bronchodilator medicine that opens the airways by relaxing the muscles around them
86
Beta-antagonist
A type of drug that blocks the action of certain substance and is used to treat angina, high blood pressure,CHF, and arrhythmias
87
alpha-agonists
Binds to receptors on vascular smooth muscle and induce vasoconstriction and contraction, and are prescribed to treat congestion and hypotension
88
Alpha-antagonist
Sub-class f beta-blockers generally used to treat high blood pressure
89
Reticular activating system
Made up of several bunches of nerves located in the upper brain stem that controls consciousness
*Without RAS, wakefulness and awareness would not be possible
90
Hypertensive Disorders
Occur in patients who are pregnant for the first.
-Pre-eclampsia (20 week of gestation) pregnancy induced hypertension
-eclampsia is characterized by seizure due to hypertension
91
Coronary blood flow
Blood vessels that carry oxygenated blood to the heart in order to provide oxygen and metabolic support for the heart itself
92
What is Barrel Chest?
Who is most likely to have “barrel chest”?
*A barrel chest is associated with a long history of respiratory disease, such as bronchitis, emphysema, or COPD.
—Because the alveoli are not functioning properly, air trapping occurs in the lungs. The increased effort it takes to move air in and out of the lungs results in an overdevelopment of the chest muscles and in time, leads to the barrel-shaped appearance.
93
Primary Blast Injuries
Due entirely to the blast itself
94
Secondary Blast injuries
Damage to the body results from bing struck by flying debris
95
Tertiary Blast Injuries
Hurled by force of the exposition, sometimes against a stationary object.
96
Miscellaneous blast Injuries
*burns from hot gases or fires started by the explosion
*Respiratory Injury from inhaling toxic gases
*Crush injury from the collapse of buildings
97
Shock
State of collapse and failure of the cardiovascular system that leads to inadequate circulation
98
Hemostasis
A balanced of all systems in the body
99
What is the Circulatory System made of ?
Complex arrangement of connected tubes, including; arteries, arterioles, capillaries, venues, and veins
100
What does Systemic Circulatory do?
Carries oxygen- rich blood from the left ventricle through the body and back to the right atrium
101
What does Systemic Circulatory do?
Carries oxygen- rich blood from the left ventricle through the body and back to the right atrium
102
What are the two circuits in the body?
*The systemic Circulation in the body
*The pulmonary Circulation in the lungs
103
The cardiovascular system consists of what 3 parts?
1. The heart (pump)
2. Set of pipes (blood vessels and arteries that at as the container)
3. The blood (The content of the container)
**PERFUSION TRIANGLE**
*If patient is in Shock= one or more parts are not working properly*
104
Systolic Pressure
Peak arterial pressure
105
Diastolic Pressure
Pressure maintained within the arteries while the heart rest between heartbeat
106
Automatic Nervous System
Regulates involuntary function
*sweating and digestion*
107
Pump Failure
*causes & types of shock*
Causes: Heart Attack, Trauma to heart, Obstructive causes
Types of shock: Cariogenic Shock and Obstructive Shock
108
Pump Failure
*causes & types of shock*
Causes: Heart Attack, Trauma to heart, Obstructive causes
Types of shock: Cariogenic Shock and Obstructive Shock
109
Low Fluid Volume
*causes & Types of shock*
Causes: Trauma to vessels or tissue, fluid loss from the gastrointestinal tract (vomiting / diarrhea can also lower the fluid component of the blood)
Types of Shock : Hemorrhagic Shock and Nonhemorragic Shock
110
Poor Veessel Function
*Causes and Types of Shock*
Causes : Infection, drug Overdose (narcotic), Spinal Cord Injury, anaphylaxis
Types of Shock : Distributive Shock
A. Septic Shock
B.Neurogenic Shock
C. Anaphylaxis Shock
D. Psychogenic Shock
111
Cardiogenic Shock
Signs and symptoms
*Caused by: inadequate function of the heart, or pump failure
*Develops: when the heart cannot maintain sufficient output to meet the demands of the body
Signs and symptoms
chest pain
Usually Low Pressure
Weak, Irregular pulse
Cyanosis - lips & underfingernails
Anxiety
Nausea
112
Pulmonary Edema
The presence of abnormally large amount of fluid between cell in the body tissues, causing swelling of the affected area.
* Lead to impaired ventilation
113
Obstructive Shock
Occurs when conditions that cause mechanical obstruction of the cardiac muscle also effects the pump function
114
Cardiac Tamponade
(Related to obstructive shock)
collection of fluid between the pericardial sac and the myocardium
*caused by blunt or penetrating trauma - can progress quickly
*this accumulation leads to compression of the heart
**sign and symptoms— Becks triad (JVD,muffled heart sounds, hypotension)**
115
Tension Pnuemothorax
(Related to Obstructive shock)
Caused by damage to lung tissues
*the damage allows air normally held within the lung to escape into the chest cavity — air pressure to the organs, including the heart
116
Distributive Shock
**4 types of Shocks**
Results when there is a widespread dilation of small arterioles, venues or both.
*Septic Shock
*Neurogenic Shock
*Anaphylactic Shock
*Psychologic Shock
117
Septic Shock
Severe infection— usually bacterial, in which toxins are generated by the bacteria or by infected body tissues
*The vasodilation of vessels , in combination with plasma loss through the injured vessel walls = shock
*might interfere with ventilation due to fluid leak into respiratory system
118
Neurogenic Shock
*causes*
Usually a result of injury to the part if the nervous synth that control the size and muscle tone of the blood vessels
Causes: Damage to the spinal cord , brain conditions, tumors, pressure on the spinal cord, spinal bifida
*all vessels below the level of the spinal injury dilate widely, increasing the size and capacity of the vascular system and causing blood to pool
119
Anaphylactic Shock
*causes*
Occurs when person reacts violently to a substance to which they have been sensitized
*sensitized=sensitive to a substance that did not initially cause a reaction
Causes: injections (Penicillin), stings (bees), Ingestion (medication), Inhalation (dust)
**Cyanosis = late sign of anaphylactic shock**
120
Psychogenic Shock
Sudden reaction of the nervous system that produces a temporary, generalized vascular dialation, resulting in fainting (syncope)
*blood pool in dialated vessels, reducing the blood supply to the brain
**life threading causes include — irregular heartbeat and brain aneurysm**
121
Hypovolemic Shock
Result of an inadequate amount of fluid or volume in the system — also result of thermo burns
*intravascular plasma is lost
*Plasma leaks from the circulatory system into the burned tissues that lie adjacent to the injury
122
Respiratory Insufficiency
*A patient with a severe chest injury, such as Flail Chest or obstructive airway, may be unable to breathe in an adequate amount of oxygen
*Carbon Monoxide poisoning
*Cyanide poisoning
123
What are the 3 stages in the Progression of Shock?
Compensated Shock
Decompensated shock
Irreversible Shock
124
Compensated Shock
Signs & Symptoms
Agitation
Anxiety
Restlessness
Feeling of Impending doom
ALOC
Weak/rapid(thready) or absent pulse
125
Decompensated Shock
Signs & Symptoms
*Falling blood pressure (systolic BP of 90mmHg)
*Labored or irregular breathing
*Dull eyes/ dialated pupils
*Thready or absent peripheral pulses
126
Irreversible Shock
*terminal stage of shock
*A transfusion of any type will not be enough to saves a patent life
127
How do you treat Cardiogenic Shock?
*Place patient in sitting position or semi sitting position
*Nitroglycerin “more” — consult with medical control for instructions
*Give high flow oxygen
*assists ventilations if necessary — possible suction
*rapid Transport
128
How do you Treat Obstructive Shock?
*in Cardiac Tamponade — increasing cardiac output should be the priority in cardiac Tamponade
- Apply high flow oxygen
-surgery is the only definitive treatment
-Early Recognition along with rapid transport - ALS management
*Tension Pnuemothorax -
- High flow oxygen via Non rebreather mask
-Decompression of the injured side of the chest , releasing pressure in the chest and allowing the heart to expand fully again
-Early recognition with Rapid transport ALS management
129
Septic Shock
*antibiotics at hospital
*Standard Precaution - Transport promptly
*High flow oxygen during transport
*Ventilatory Support may be necessary to maintain adequate tidal volume
*Blankets to conserve body heat
130
How do you Treat neurogenic Shock?
-Obtain and maintaining airway
-Spinal immobilization
-Assist inadequate breathing as necessary
-conserving body heat
-transport
131
How to treat Anaphylactic Shock?
-administer epinephrine
-supplemental oxygen
-consider ALS if available
132
How do you treat Psychogenic Shock?
-if patient has fallen; look for injuries especially in older patients
-Asses the patient thoroughly for any other abnormality
-transport the patient promptly
-record all initial observation of vital signs and level of consciousness
*if after regaining consciousness; the patient is unable to walk normally, suspect head injury*
133
How do you treat Hypovolemic Shock?
-control all obvious external bleeding
-Splint any bone and joint injuries
-secure and maintain an airway
-provide respiratory support (supplemental oxygen and ventilation if needed)
-make sure the patient does not aspirate or vomit
-rapid transport
134
How do you treat Respiratory Insufficiency?
-immediately secure and maintain the airway
-clear the mouth and throat or anything obstructing the air passages (vomit,mucus, and foreign material)
-if necessary, provide ventilations with BVM
-give supplementary oxygen, and transport
135
What does Perfusion require ?
Intact cardiovascular system and functioning respiratory system
136
what are most shocks caused by?
Dysfunction in the heart, blood vessels, or volume of blood.
137
what does blood act as?
The vehicle for carrying oxygen and nutrients through the vessels to the capillary beds to the tissue cells, where these supplies are exchange for waste products.
138
Seizures may occur as a result of what?
-recent or old head trauma
-brain tumor
-metabolic problem
-genetic disturbances
139
What does the Cerebrum control?
—located above the cerebellum—
*front of the cerebrum = controls emotion and thought
*middle of the cerebrum = controls touch and movement
*back of cerebrum = processes sight
*Speech = controlled on the left side of the brain near the middle of the cerebrum
140
What does the Brainstem control?
Controls basic functions;
*breathing
*blood pressure
*swallowing
*pupil constriction
141
What does the Cerebellum control?
Controls muscle and body coordination
*walking
*writing
142
What a the General rules of the brain?
- if problem is caused mainly by disorder in the heart and lungs, the entire brain will be affected
-if problem is caused in brain, only part of the brain is affected
143
Migraine
They are thought to be caused by changes in the blood vessel size in the base of the brain
144
Cerebrovascular Accident (CVA)
**stroke**
-an interruption of blood flow to the brain that results in the loss of brain function
145
What are the two main types of Strokes?
Ischemic stroke
Hemorrhagic Stroke
146
Ischemic stroke
*due to direct blockage of blood flow through the cerebral arteries*
-blockage due to thrombosis — where a clot forms at the site of the blockage
-blockage due to embolism —where the clot forms in a remote area and then travels to site of blockage
*80% of strokes
-disorder in which calcium and cholesterol build up, forming a plaque inside the walls of the blood vessels— plaque obstructs blood flow
147
Hemorrhagic Stroke
*results from bleeding inside the brain*
-Blood forms a clot, which squeezes the brain tissue next to it
-when the tissue is squeezed hard enough, oxygenated blood cannot get in and cells begin to die
-people at high risk= high blood pressure or long term elevated blood pressure
-blood vessels in the brain weakens—if vessels rupture, bleeding in the brain will increase the pressure inside the cranium
148
Aneurysm
Swelling or enlargement of an artery due to weakening of the arterial wall
149
Transient Ischemic Stroke
Stroke symptoms go away on their on in 24 hours
About one third of patients who have TIA will experience a stroke soon after
150
Signs and symptoms of Stoke
Facial droop, sudden weakness or numbness in face, arm, leg or one side of the body
Loss of movement
Lack of muscle coordination (ataxia)
Speech disorder (dysphasia)
Slurred Speech (dysarthria)
Sudden loss of balance
151
What is the left side of the hemisphere responsible for?
May cause aphasia— inability to produce or understand speech
- Stroke that affect the left side of the brain can also cause paralysis of the right side of the body
152
What is the right hemisphere responsible for?
Strokes that affect the right side of the brain can cause paralysis o the left side of the brain body
-usually the patient will understand the language and be able to speak, BUT their speech will be slurred and hard to understand
-“neglect” — patient with a problem affecting he back of the cerebrum may neglect certain parts of their vision
153
Bleeding in the brain
-patient will have very high blood pressure
*may be the cause of the bleeding OR may be caused by bleeding, as a compensatory response
**monitor BP and watch for a trend of increasing BP
**significant drop = patient’s condition has worsened
154
What are conditions that mimic a stroke?
Hypoglycemia — not enough glucose
Prostical State —period following seizure that last between 5 - 30 minutes (labored respiration and AMS)
Subdural or epidural bleeding — collection of blood near the skull that presses on the brain
155
Generalized Seizure
*Grand mal seizure
-Characterized by unconsciousness and a generalized severe twitching of all muscles
- this type of of seizure results from abnormal discharges from large areas of the brain, usually involving both hemispheres
156
Partial Seizure
Begins in one part of the brain
SIMPLE — no change of lvl of consciousness
-possible numbness, weakness, dizziness, visual change or unusual smells and tastes
-some twitching or brief paralysis
COMPLEX — AMS and does not interact normally with environment, results from abnormal discharges from the temporal lobe of brain
Lip smacking, eye blinking, isolated jerking
157
Tonic-clonic seizure
Sudden loss of consciousness, chaotic muscle movement and tone, and apnea
158
Tonic phase
Patient may exhibit bilateral muscle rigidity
*first phase*
159
Clonic phase
Muscle contraction and relaxation
**last about 1-3 minutes for clonic-tonic**
160
Clonic phase
Muscle contraction and relaxation
**last about 1-3 minutes for clonic-tonic**
161
Status Epilepticus
Seizures that continue every few minutes without the person regaining consciousness or last longer that 30 minutes
*seizures that last more than 5 minutes are likely to progress to status epilepticus
162
What is the Patient assessment in order?
Scene size up — safety and MOI
Primary Assessment — General Impression , AVPU and ABC or CAB
History Taking — investigate Chief complaint *SAMPLE
Secondary Assessment — Physical Examination (stroke assessment / vital signs
Reassessment — ABC, vital signs and interventions provided
COMMUNICATION AND DOCUMENTATION
163
How to treat a migraine ?
*Apply high flow oxygen, if tolerated
*Provide dark and quiet environment (in ambulance)
*Do not use lights and sirens during transport
164
How to treat a stroke?
*support ABC’s
*rapid transport to stroke center
*may require manual airway opening
*suction if needed — high flow oxygen and monitor patient’s oxygen saturation (pulse oximeter)
*continuously talk to patient to inform what is going on
*spend little time at scene (brain is time)
165
Gynecology
Branch of medicine that deals with the disease and care of the reproduction system of women
166
Gynecology
Branch of medicine that deals with the disease and care of the reproduction system of women
167
Obstetrics
The branch of the medicine that deals with birth
168
External female genitalia
Vaginal opening
Labia majora / minors
Clitoris
Perineum
169
What is the narrowest part of the uterus?
Cervix
170
PID (Pelvic Inflammatory Disease)
Infection of the upper organs of the reproductive system —
signs & symptom: generalized lower abdominal pain, abdominal or foul smelling discharge, increased pain with intercourse or fever, nausea and vomiting.
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What is the outermost cavity of a woman’s reproduction system?
Vagina
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The muscular system include what 3 part of muscle?
Skeletal
Smooth
Cardiac
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Skeletal muscle
Voluntary muscles — under direct voluntary control of the brain, responding to commands to move specific body parts (movement and posture)
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Smooth muscle
Involuntary muscles — it is not under voluntary control of the brain, preforms much of the automatic work of the body
*found i the wall of most tubular structure of the body, such as gastrointestinal tract and blood vessels
*contracts and relaxes t control the movement of the contents within these structures
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Cardiac Muscle
Adapted involuntary muscle with its own regulatory system
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Fracture bone
Broken bone
- an occur anywhere on the surface of thee bone and in many different types of patterns
*there is no difference in broken bone and a fracture bone
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Dislocation
Disruption of a joint in which the bone ends are no longer contact
-supporting ligaments are often torn, usually completely, allowing he bone ends to separate completely from each other
-fracture-discoloration is a combination injury at the joint in which the joint is dislocated and there’s a fracture of end of one or more nones
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Sprain
Injury to ligaments — after the injury the joint generally goes back to place and isn’t displaced.
Most vulnerable joins are ; Kees, shoulders, ad ankles
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Strain
A muscle pull, is stretching or tearing of the muscle, causing swelling, and bruising of the soft tissues in the area
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Amputation
Injury in which the entire extremity is severed off the body
*injury can potentially damage every aspect of the musculoskeletal system - from bone to ligament to muscle.
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Closed fracture vs. Open fracture
Open fracture: external wound, caused either by the same blow that fractured the bone or by the broken bone ends lacerating the skin
Closed Fracture: no overlying skin is damaged
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Non displaced fracture
*hairline fracture
- a simple crack of the bone that may be difficult to distinguish from the sprain or simple contusion
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Greenstick Fracture
An incomplete fracture that passes only partly through the shaft of the bone
*occurs in children
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Comminuted Fracture
Fracture in which the bone is broken in more than two fragments
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Pathologic Fracture
Fracture of weakened or diseased bone generally produced by minimal force
*seen in patients with osteoporosis and cancer
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Oblique Fracture
Fracture in which the bone is broken at an angle cross the bone
*usually a result of a sharp-angled blow to the bone
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Transverse Fracture
Fracture that occurs straight across the bone
*a result of a direct blow or stress fracture caused by prolonged running
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Spiral Fracture
Fracture case by twisting force, causing oblique fracture around the bone and through the bone
*often the result of abuse in very young children
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Incomplete Frcture
Fracture does not run completely through the bone
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Signs and Symptoms in suspected Fracture
Deformity — limb may appear to be shortened, rotated, an age later at a point where there is no joint
Tenderness
Guarding— inability to use the extremity is the patients way of immobilizing it to minimize pain
Bruising
Crepitus — grating it grindiing sensation can be felt or heard when fractured bone ends rub together
False motion — motion at a point in the limb where is no joint
Exposed Fragments — never attempt to push protruding bone back in
Locked Joint — joint that is locked into position is difficult to move
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What makes up solid and hollow organs ?
Gastrointestinal System
Genital System
Urinary System
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What are the solid organs?
-Spleen
-Pancreas
-Liver
-Ovaries in woman
-Kidneys
**Injury to solid organ can result in shock and bleeding **
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What are the Hollow Organs?
Small Intestine
Large Intestine
Urinary Bladder
Gallbladder
Stomach
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What is the Gastrointestinal System Responsible for?
Responsible for the digestion system
-digestion = food is put into the mouth and chewed —> food passes down esophagus —> the stomach (main organ of the digestive system) gastric juices break down food —> liver —> assists in digestion (secretes bile) filters toxic substances produced by digestion - creates glucose stores AND produces substances necessary for blood clotting and immune function —> gallbladder is a reservoir for bile —- food then travels to small intestine
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In the small intestine; what are the 3 sections it consist of?
Duodenum
Jejunum
Ileum
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What happens in the Duodenum ?
-digestive juices from the pancreas and the liver mix together
*pancreas releases amylase - responsible for breaking down starches into sugar
Bicarbonate produced in pancreas —> neutralizes stomach acid
Insulin produced in pancreas—> regulates amount of glucose in the blood stream
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What happens in the Jejunm?
-plays a major role in absorption of digestive products
*does much of the work in the small intestine
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What happens in the ileum ?
Soluble mo;Eccles are absorbed into the blood
*proteins,fats and starches are reduced to amino acids, fatty acid, and simple sugar
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Large Intestine
-colon — food not broken down and used moves into the colon as waste product
**movement called peristalsis moves the waste matter through the intestines**
-water is absorbed and stool is formed
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Spleen
*location
-part of the lymphatic system
*significant role in relation to red blood cells and immune system
-assists in filtration of blood
-aids in development of red blood cells
-serves as blood reservoir
-produces antibodies
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What does the Genital System consist of ?
Male and female Reproductive System
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Male Reproduction system
Seminal Veesicles
Testicles
Epididymis
Prostate gland
Penis
Vasa Deferentia
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Female Reproduction system
Fallopian Tubes
Uterus
Cervix
Overies
Vagina
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What does the unitary system do?
Kidneys + ureters —>bladder—>urethra
Controls discharge of waste materials filtered from blood by the kidneys
*kidneys —> lie posterior muscle wall of abdomen behind the peritoneum in the retroperitoneal space
- play important part in the regulation o acidity and blood pressure
-rid of body toxic waste AND control balance of fluid and electrolytes
*Ureters join kidneys to the bladder ——> bladder found immediately behind pubic symthysis
*bladder empties to the outside of the body via the urethra
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What does the abdominal cavity line with & what does it cover?
Lines with a membrane called Peritoneum — covers the organs of the abdominal
-Parietal peritoneum lines with the abdominal cavity
-Visceral peritoneum covers the organs
*presence of the foreign material (blood,pus,bile, pancreatic juice, amniotic fluid) can irritate the peritoneum causing Peritonitis*
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What does Acute abdomen refer to?
Onset of abdominal pain
*often associated with severe, progressive problems requiring medical attention
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Peritonitis
Inflammation of the peritoneum =causing i.lee.uhs
**lleus= paralysis of the muscular contractions that normally propel materials through the intestine
Signs and Symptoms: retained gas = abdominal distention
Stomach can only empty itself by vomiting (emesis) , nausea and vomiting , loss of bodily fluid into abdominal cavity
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Diverticulitis
Inflammation of abnormal pockets at weak areas in the lining of the large intestine (colon)
*lower left quadrant pain
*substantial elevation in temperature
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Cholecystitis
Gallbladder inflammation
*right upper quadrant pain
*substantial elevation in temperature
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Cholecystitis
Gallbladder inflammation
*right upper quadrant pain — may refer to the right upper back, flank, or shoulder
S/s: nausea, vomiting, indigestion,bloating gas, and bleching
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Parietal Peritoneum
Supplied by the dame nerves that supply the skin of the abdomen
*can perceive pain, tough, pressure, and heat, cold
*can easily identify and localize a point of irritation
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Visceral peritoneum
Supplied by the autonomic nervous system
*patient will tell exactly where the pain is — referred pain
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Ulcers
*common cause of acute abdomen*
Protective layer of mucus lining erodes, allowing acid to eat into organ
S/s: nausea, vomiting, bleching, heat burn — some ulcers can heal without ntevention
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Gallstones
*common cause of acute abdomen*
Gallbladder is a storage pouch for the digestive system and waste from the liver
*gallstones may form, and i the blockage does not pass, it can lead to severe inflammation of the gallbladder = cholecystitis
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Pancreatitis
Inflammation of the pancreas
*caused by obstructing gallstones,alcohol abuse , or other diseases
S/s: upper left and right quadrants — radiating to the back
Nausea, vomiting, abdominal distention , tenderness , sepsis or hemorrhage , tachycardia, and fever
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Appendicitis
Inflammation or infection in the appendix
*can cause tissue to die, causing an abscess, peritonitis or shock
Right lower quadrant
S/s: Nausea , vomiting , fever, chills, tenderness
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Gastrointestinal Hemorrhage
Bleeding within the gastrointestinal tract
*Can be chronic— may be longer duration and less severe
*Can be acute — shorter term and more severe
-Bleeding in the upper GI Tract occurs from the esophagus to the upper small intestine
-Bleeding from the lower GI Tract occurs between the upper part of the small intestine and the anus
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Esophagitis
Occurs when the lining of the esophagus becomes inflamed by infection or acids from the stomach
**in worse cases, bleeding can occur from the capillary vessels within the esophageal lining or the main blood vessels**
Signs and symptoms: heartburn, nausea,vomiting, sores in mouth and pain in swallowing
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Esophageal Varices
Occurs when the mount of pressure within the blood vessels surrounding the esophagus increases
**when he blood is blocked up in the portal vessels , vessels dilate, causing th capillary network of the esophagus to begin leaking**
Signs and symptoms show in liver disease: fatigue, weight loss, jaundice , anorexia, edema in the abdomen, nausea and vomiting
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Mallory Weiss syndrome
Junction between esophagus and stomach tears. *severe bleeding and possible death*
Risk factors: alcoholism and eating disorder
Signs and symptoms: vomiting (principle symptom), possible shock, upper abdominal pain,hematemesis,and Melena
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Gastroenteritis
Infection combination with diarrhea, vomiting, and nausea
*caused by bacterial or viral organisms AND enter body through food or water*
Signs and symptoms: large dumping-type diarrhea or frequent small liquid stools, diarrhea containing blood or pus,abdominal cramping, nausea,vomiting,fever and anorexia
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Diverticulitis
The consistency of stools became more solid, requiring more intestinal contractions, increasing pressure in the colon
*fecal matter is caught in bulges and bacteria forms, causing inflammation and infection*
Signs and symptoms: abdominal pain in the lower left abdomen, fever,malaise , body aches, chills, nausea and vomiting
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Cystitis
Bladder infection — also known as as UTI
Caused by bacterial infection
Lower quadrant abdominal pain
My report frequent urination
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What do kidneys play a part in ?
Maintains homeostasis — eliminating waste from from the blood
When the kidney fail, uremia results—> kidney stones can occur over time and cause blockage —> acute kidney failure—> chronic kidney failure — irreversible — s/s: ALOC, seizure,coma,lethargy,nausea,cramps, and edema in the extremities and face
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What is the reason for dialysis?
Dialysis filters th blood, cleanses the toxins, send returns to to the body
*dialysis eliminates waste, normalizes blood chemistry and reduces excess fluid*
Signs and symptoms: hypotension, muscle cramps, nausea and vomiting, hemorrhagic from the site, and infection at the site
****some dialysis patient have urinary catheters ****
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What are some early signs of hypothermia?
Rapid pulse
Rapid respiratory rate
Red skin
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What is the normal electrical pathway?
SA node (upper atrium) > pauses @ AV node (lower atrium) to allow blood to fill the ventricles > continues through the bundle of His (branches)> surrounds the ventricles through the Purkinje Fibers
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Respiratory Distress
Patient is compensating for potential hypoxia
*Patient breathes: faster,deeper and/or harder
*Patients mental status: remains good
*Oxygen saturation : remains good
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Respiratory Failure
Mental status : changes from alert to confused to unconscious — as the brain runs out of oxygen or fills with carbon dioxide
Oxygen Saturation: levels drop below normal
Patient breathes: slow and shallow
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What is the chain of survival?
Early access —early CPR — early defibrillation — early advanced care — integrated post arrest care
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What is the chain of survival?
Early access —early CPR — early defibrillation — early advanced care — integrated post arrest care
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The heart is divided down the middle into two sides (right and left) by what
Septum
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What does The left coronary artery do?
Divides into two major branches, which supply blood to the left ventricle
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The umbilical consists of how many blood vessels ?
3
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How many layers of cells does the placental barrier consist of for the exchange of nutrients and waste between fetus and the Mother?
2
