Final Exam (chapter 1-14) Flashcards
(331 cards)
1
Q
Highway safety act of 1966:
A
required each state to establish a highway safety program that met prescribed federals standards and included EMS
2
Q
Emergency Medical Services System act of 1973:
A
provided millions of $ for funding for EMS system planning/implementation, personnel availability/training
3
Q
Who is responsible for the care delivered by EMS System?
A
Department of Transportation
4
Q
Scope of Practice
A
legal range of services an EMT can provide
5
Q
Where do 911 calls go?
A
Public service answering point (PSAP)
6
Q
911-
Phase 1 911-
Phase II 911-
A
provider transmits call whether the caller is subscribes to providers service or not
Provider must provide PSAP with phone #/location of call
provider must give long/lat of caller and must be accurate within 50-300 meters
7
Q
What are the types of EMS?
A
Fire Dept. EMS Municipal EMS- “3rd service” fire→ Law→ EMS Private EMS Hospital based EMS- Law enforcement EMS Public safety officer
8
Q
What are the 4 National levels of EMS providers?
A
Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Advanced EMT (AEMT)
Paramedic
9
Q
Indirect medical oversight:
Direct medical oversight:
On-line medical direction:
On scene medical direction
A
processed and activities that influence/control the practice of prehospital care in EMS system
real time oversight/medical direction provided by a physician to RMS provider seeking feedback
Over radio/phone
physician is on scene to direct
10
Q
Quality improvement (QI):
A
internal/external review of EMS system to ensure adequate care- identify areas that need improvement and determine how effective a system is
11
Q
Evidence based medicine(EBM):
A
Research to provide clear evidence that certain procedures/meds/equipment improve patient outcome
12
Q
Evidence based guidelines(EBG): Use strong research to develop medical guidelines
A
Use strong research to develop medical guidelines
13
Q
Burnout:
A
state of exhaustion and irritation
14
Q
What are 2 approaches to Critical incident stress management?
A
Critical incident stress-within 72 hours EMT meets with peer counselors to receive help work through stress
debriefing/Defusing: within 8 hours including only the person involved in incident
15
Q
What causes diseases?
A
pathogens
16
Q
Pathogens:
A
bacteria, viruses, fungi, protozoa, helminths
17
Q
Hepatitis B- What does it affect how is it transmitted what are S/S PPE
A
It affects the liver
Transmitted through blood/body fluids
Fatigue/nausea/loss of appetite/abdominal pain/headache/fever/yellow skin/dark urine
Gloves
18
Q
Hepatitis C
how is it transmitted
what are S/S:
PPE
A
Blood born
jaundice/fatigue/abdominal pain/nausea/dark urine/loss of appetite
Wear gloves and be careful of any needles
19
Q
TB: What does it affect: how is it transmitted what are S/S: PPE
A
lungs/surrounding tissue
Droplets from cough/septum
fever/cough/night sweats/weight loss
HEPA respirator or N-95– gloves– wash hands
20
Q
HIV/AIDS What does it affect: how is it transmitted what are S/S: PPE
A
Destroys bodies ability to fight off infections
sex/infected needles/infected blood/mother to child in utero/infected blood or secretion
fever/night sweats/swollen lymph glands/loss of appetite/nausea/diarrhea
Follow standard precautions at all times- gloves
21
Q
Severe acute respiratory syndrome(SARS): What does it affect:
how is it transmitted
what are S/S:
PPE
A
Respiratory system
Close person to person contact, through respiratory droplets
Headache/high fever/diarrhea/respiratory symptoms/dry cough
Surgical mask and eye protection
22
Q
West Nile Virus:
how is it transmitted
what are S/S:
PPE
A
Infected mosquitoes
headache/fever/confusion/seizures/numbness/paralysis/vision loss
Standard PPE precaution
23
Q
MRSA:
A
Transmitted through respiratory droplets→ follow standard PPE and wash hands
24
Q
What type of high visibility vest is required when responding to a scene on or near a roadway?
A
An ANSI/ISEA 207-2006 American National Standard for High-Visibility Public Safety Vest (PSV) was approved to increase visibility on the roadway.
25
Scope of practice:
state laws that identigy the care that EMTS can legally provide
26
Standard of care:
care that is expected to be provided by an EMT with similar training when managing a patient in a similar situations
27
Duty to act:
legal obligation to provide services
28
Medical direction:
ollowing standard protocols- On-line direction -- in person direction
29
Expressed consent:
must obtain from every conscious mentally competent adult before treatment is started. They must be of legal age, able to make rational decisions, and be informed of assessments and procedures and the related risks. Can also be nonverbal cues
30
Implied consent:
Patient is unresponsive or unable to make rational decisions (ie. a head injury/under the influence)
31
Minor consent:
Must obtain parent/legal guardian permission to begin assessment→ UNLESS emancipated(married/pregnant/a parent/member of Military/financially independent/living alone/ legally emancipated minor
32
Advanced directive:
instructions written in advance against resuscitation signed by patient and legally recognized
33
DNR:
Legal document regarding resuscitation attempts
34
Living will:
most often used to cover long term life support equipment( ventilators/feeding tube)
35
Durable power of attorney:
person legally empowered to make health care decisions for signer of document- usually pertain only to in hospital/long term care facility
36
Physicians order for life sustaining treatment:
patients with terminal illness- designed to specify level of treatment in case of deterioration prior to need for resuscitation(ie. Medication is ok but not advanced airway or defibrillation)
37
Negligence:
EMT had duty to act→ did not→ patient suffered injury that is recognized by law→ injury was a result of breach of duty to act
38
Proximate cause:
injuries suffered were a direct result of EMTs negligence
39
Intentional tort: a
ction knowingly committed that is considered civilly wrong according to law(abandonment/assault/battery/false imprisonment/defamation
40
Health insurance portability and accountability act of 1996:
protects privacy of patient health care info and gives patient control over how info is distributed and used
41
Consolidated Omnibus Budget Reconciliation Act (Cobra)/ Emergency Medical treatment and active labor act(EMTALA):
federal regulation that ensures the public's access to emergency health care regardless of ability to pay
42
Special reporting situations:
Abuse: suspected child/elderly/spousal abuse
Crime: report injury that was a result of a crime (ie. GSW, knife wounds, susp. burns/poisonings
Drug related injuries
43
Prehospital care report (PCR):
record of patient assessment,treatment and transportation to facility
44
Important functions of PCR:
1- Essential to continuum of care once handing off patient to facility staff
2- May be used later in legal proceedings
3-reimbursement is often linked to PCR(ie. equipment/medication/supplies used)
45
Minimum data set and what should go in it:
Chief complaint * time incident was reported
Level of responsiveness *time unit was notified
BP in patients 3+ y/o *time of arrival at patient
Skin perfusion in patients less than 6 y/0
*time unit left scene
Skin color/temp/condition *time the unit arrived @ hospital
Pulse rate *time of transfer of care
Respiratory rate and effort
Patient demographics (age/sex/race/weight)
46
Steps when patient refuses care:
perform as much of assessment as possible--make one more effort of persuasion--inform why patient should go to hospital--discuss with medical direction--still refuses, thoroughly document in PCR findings/attempts made/give patient consequences of refusing care--have patient sign refusal care
47
Requirements for a patient to refuse care:
Fully informed of risks
Must be alert and oriented
Must be legally able to consent
Sign refusal sheet
48
SOAP
S:ubjective- info patient tells you (ie. symptoms) that you can see/feel during assessment
O:bjective- info identified in examination- also known as signs(ie. a cut is a sign of injury)
A:ssessment: general idea formed about patients condition based on info collected from objective/subjective components and scene assessment.
P:lan- plan of action
49
CHART
```
C:hief complaint
H:istory
A:ssessment
R- Rx or treatment provided
T:ransport- change in patient condition en route
```
50
CHEATED
C:hief complaint
H:istory
E:xam- info found in physical examination
A:ssessment- field impression from processing history/physical exam findings to determine possible condition
T:reatment
E:valuation
D:isposition- transfer of patient to another healt-care provider
51
Base station:
serves as dispatch and coordination-- sends out EMS
52
Land Mobile radio systems:
```
Base-to-vehicle, Vehicle-to Vehicle, and med facility-to med facility
Mobile radios (transmitter/receivers):
Vehicle mounted devices used to communicate within EMS system(con: rough terrain can interrupt transmission)
```
53
Portable radios:
handheld radios that are useful when outside of vehicle
54
Repeaters:
Devices that receive transmission for low powered source and rebroadcast them at another frequency and higher power
55
Encoder:
Decoder:
breaks down sound waves into unique digital codes
recognizes and responds only to those codes
56
```
SBAR:
S:ituation--
B:ackground--brief past medical history and patient response to treatment to that point
A:
R:
```
method of organizing communication into standardized format
S:“hey you, its me” patient age/gender and chief complaint
B: brief past medical history and patient response to treatment to that point
A: ssessment-- pertinent subjective/objective findings (ie. mental status, vitals, neuro findings)
R:ecommendation
57
What are body mechanics defined as?
Safest and most efficient methods of using your body to gain a mechanical advantage
58
What are the rules to lifting and moving using body mechanics?
Keep weight of object as close to body as possible
Use leg, hit and gluteal(butt) muscles + contracted abdomen muscles
Stack: shoulders/hips→ hips/feet→ move as one unit
Reduce height/distance object must be moved
59
Lordosis:
posture where stomach is too anterior and butt is too posterior
60
What part of back does Lordosis cause stress to?
Lumbar region of back
61
Kyphosis:
posture where shoulders roll forward
62
What damage does having a kyphosis posture cause?
Causes fatigue on lower back and increases pressure in every region of the spine
63
What technique offers best defense against injury/stable move for patient when lifting?
Power lift.
64
Power lift steps:
feet shoulder length apart and turned slightly outward→
bend knees to lower closer to object without bending at the waist→
tighten back/abdominal muscles →
straddle object→
place hands apart from each other to provide balance→
lift
65
What gives you maximum force from the hands when lifting an object?
Power grip
66
Power grip:
palm, fingers come in complete contact with object w/ all fingers bent at the same angle
67
Squat lift steps:
place weaker leg forward→
squat down until you can power grip object→
push with stronger leg and stand
68
What is the easiest and safest way to move patients- Push or pull?
Push rather than pull
69
When should an emergency move be performed?
When there is immediate danger to patient/rescuer
70
When should an urgent be performed?
When there is a threat to life
71
When should be a non-emergent move be performed?
When there is no immediate threat to life
72
Armpit-forearm drag:
patient lying on floor→
grab under their armpits from behind→
your left hand grasps patients right right arm and your right hand grasps their left arm
73
Shirt drag: patient on floor and ground→
link patients hands together, crasp neck/shoulders of the shirt, then pull the patient towards you
74
When should rapid extraction be used?
Abnormalities of the airway(breathing, oxygenation, circulation/spinal injuries/mental state/fractures to both femurs/major bleeding
75
Draw sheet method:
loosen bed sheet→
| move stretcher next to bed→ reach across patient, grab sheet, and pull onto stretcher
76
Portable stretcher:
convenient carrying device when patient must be removed from confined space
77
Stair chair-
stretcher in form of a chair where each emt picks up simultaneously - 3 rescuer spots at the feet of chair
78
Stacked Stair chair-
has tracks that allow it to contact the stairs
79
Backboard-
back board helpful for rough terrain and to strap patient down/stabilize head
80
Scoop stretcher:
is made for obese patients
81
Basket stretcher:
backboard used to move patient and can be attached to wheeled stretcher
82
Flexible stretcher:
is assembled in park
83
Flexible stretcher:
is assembled in parts
84
anatomy:
structure of the body and relationships of its park
85
physiology
functions of the living body and its parts
86
anatomical position:
patient is standing erect, having forwards w/ arms down @ sides with palms facing forward
87
supine
laying face up on back
88
prone:
patient lying face down
89
later recumbent position:
patient lying on right or left side
90
fowlers position:
patient lying on back at a 45-60 degree angle
91
semi-fowlers position:
patient lying on back w upper body elevated at an angle less than 45 degree
92
trendelenburg position:
laying on back w legs elevated above head
93
shock position:
laying on back with legs elevated about 12 in. above head
94
landmarks that divide the body and help describe upon assessment
anatomical planes
95
sagittal/medial plane:
line that runs vertically down the body dividing it into a R/L segment
96
frontal/coronal plane:
divides body lengthwise into from/back halves
97
transverse/horizontal plane:
parallel w/ ground and divides body into upper and lower potions
98
midline:
a line from head to navel, to ground and between legs
99
midaxillary
line down middle of armpit to Ankle
100
transverse line:
line drawn horizontally across patients waist, dividing body into 2 planes 1. upper 2. lower body
101
musculoskeletal system:
bony/skeletal framework help together by ligaments/tendone
102
ligaments
connects bone to bone
103
tendon
connects muscle to bone
104
what are the 4 functions of the musculoskeletal system
1. give body shape
2. protect vital organs
3. allow for movement
4. store minerals/produce red blood cells
105
functions of the skull
top of spinal column
| houses/protects brain
106
parts of the skull:
1. cranium
| 2. face
107
cranium
forms top/back/sides/forehead
108
what are the interlocking books of the cranium?
occipital/parietal/temporal/frontal
109
what is the face made up of
brow/chin which is made up fo 13 immovable bones
110
immobile bones:
```
orbits: eye socket
nasal bones= bed of the nose
maxillae= fused bones of upper jaw
zygote bones=cheek bones
mandible= lower jaw
```
111
spinal/vertebre column:
support system of the body
112
vertebrae
make up the spinal column- connected by intervertebral disks- act as shock absorbers and allow mobility
113
cervical spine
C1-C7 (neck) first of vertebra and most prone to injury
114
thoracic
T1-T12(upper back) help support vertebra
115
lumbar
L1-15(lower back) least mobile
116
sacral
S1-25(back wall of pelvis/sacrum
117
coccyx:
tailbone: last 4 vertebra are fused together and do not presume
118
Order of spine
```
C:cervical C1-C7
T: thoracic T1-T12
L: Lumbar L1-L5
S: Sacral S1-S5
C: coccyx last 4 vertebra
```
119
Thorax/chest:
composed of sternum/ribs/thoratic spine (T1-T12)
120
manubrium:
superior portion fo sternum--> xiphoid process is inferior portion of sternum
121
iliac crest
forms wings of pelvis
122
pubis
anterior/inferior portion of the pelvis
123
ischium: posterior
inferior portion of pelvis
124
what does the pelvis form and what does it support?
forms floor of abdominal cavity- supports intestines/houses bladder/reproductive organs
125
lower extremities:
legs from hit to toe
126
acetabulum:
socket where hip joint is located
127
femur:
if injured look for excessive bleeding
128
tibia
weight bearing bone of the calf
129
fiber
located posterior to the tibia
130
medial malleolus:
where tibia meets/forms to Ankle
131
tarsal:
group of bones that make up the proximal portion of the foot
132
calcaneus
heel bone
133
metatarsals
form substance of foot
134
phalanges
form the toes (2 in big toe, 3 in every other)
135
upper extremities:
upper limbs (shoulders arms forearms wrists and hands
136
Clavicle/ scapula
Form a shoulder girdle, the tip of which is called the acrpmion--> helps attach arm to trunk
137
olecranon
Part of Alma that forms bony prominence of the elbow
138
carpals
The eight bones the risk consists of
139
metacarpals:
Structural strength of the hand
140
flexion
Bending towards the body
141
extension
Bending away from the body
142
abduction
Movement away from the midline
143
adduction
Movement towards the midline
144
circumduction
360 Movement
145
supination:
Turning forearm so palm is turning toward the front
146
ball socket
Widest range of motion.
| Example is shoulder/hip
147
hinged joint
Elbow knee and finger or an example
| Permit flexion and extension
148
pivot joint
Allows for turning motion and example would be the head/neck
149
gliding joint:
One bone slips a crossed another to point where surrounding structure stops at
150
condyloid jointL
Modified ball/socket joint which permits limited motion and two directions
example: the wrist
151
condyloid joint
Modified ball/socket joint which permits limited motion and two directions
example: the wrist
152
Cardiac muscle
Controls heart has automaticity and can function on impulse without nervous system
153
Basic functions of the respiratory
Respiration
ventilation oxygen
removal of CO2
helps maintain normal acid base balance
154
Respiration
Moving O2/CO2 across membranes in/out of capillaries Alviola/cells
155
Ventilation
Changes of pressure inside chest that causes air to flow in and out of the lungs
156
Airway
Passage of air from entry in the body to the lungs
157
Larynx
Anterior portion of throat to trachea
158
Thyroid cartilage
Adams apple
159
Cricoid cartilage
Most inferior cartilage
160
Vocal chords
Contained and larynx
161
False vocal cords
Superior Ligman covered by mucous membranes
162
True vocal cords
Inferior ligaments
163
Epiglottis
Flexible cartilage extends superior lead to tongue opens/closes when swallowing to prevent aspiration
164
Aspiration
Liquid and nasal or oral cavity of unresponsive patient
165
Trachea
Attached to the distal end of the larynx -- 5th thoracic vertebrae
166
chealis muscle
Smooth muscle on back of trachea
167
Bronchi
Distal portion of trachea that branches into two main tube in Toombs
168
Bronchioles
Subdivision of bronchi tissues
169
Alveoli
Network of capillaries at end of bronchiolus which is the area of CO2/02 gas exchange
170
Respiratory membrane's
Site or alveoli and capillaries meet also the site where gas exchange in the lungs
171
Lungs
Principal organs of respiration to sax holding alveolar sacs responsible for exchange of CO2/02
172
Visceral pleura
Thin layer of tissue covering inside of the lung
173
Parietal pleura
Thicker/more lasting tissue lining the outside of the lung
174
Plural cavity
In between visceral/parietal pleura which helps lungs stay inflated during pressure
175
Plural cavity
In between visceral/parietal pleura which helps lungs stay inflated during pressure
176
Diaphragm
Domed shaped muscle essential to breathing and separates the rustic/a domino cavity
177
Anatomy and infants/children
Features are smaller which are easy to obstruct
Infants and children are primary nose breathers/her to switch to mouth breathing
Tongue is proportionately larger in mouth and more likely to block pharynx
Smaller/more soft trachea can easily be obstructed
178
cricoid cartilage:
Less developed and less rigid
179
Chest wall
Smaller in children so they rely on diaphragm more for breathing leading to excessive movement of diaphragm and respiratory distress
180
And
Causes intercostal muscles/muscles in between rooms to contract increasing size of throughout a cavity
181
Diaphragm
contributes 6070% of efforts to breathe while intercostal muscles contribute to 30 to 40%
182
Adequate breathing
Eight through 24 breast well average is between 12/20 breaths elderly is an average of 20 to 22 per minute
Infants have an average respiratory rate of 30 through 60 per minute
183
Circulatory system
Composed of heart/blood/vessels-- transports blood/02 to all parts of the body
184
Myocardium
Middle layer of muscle to contract/ eject blood to body
185
Arteries
Carry blood away from Hart except for pulmonary arteries
186
Aorta
Major artery of the heart which is located in front of spine and supplies other arteries with blood
187
Coronary
Supplies the heart with blood
188
Cartoid
F supplies brain/head with blood
189
femoral
Major artery of the thigh and supplies groin/legs with blood
190
Dorsalis
Artery that can be felt during pulse Asian on the surface of the foot on big toe side
191
Posterior
Travels from calf the foot and can be felt behind ankle
192
Radial
Major artery of distal arm to elbow joint and can be felt blow the thumb
193
Brachial artery's
Major artery of upper arm and can be felt front of
194
Pulmonary artery
Originates in right ventricle of heart and carries and carries blood low of O2 to lungs to oxygenate
195
Arteriole
Smallest kind of artery which carries blood from arteries to capillaries
196
Capillaries
Tiny blood vessels connect to arterials to a venue all that has walls that exchange gases/nutrients/waste
02 goes out of Alviola and into alveolar capillary's
CO2 goes out of alveolar and into our your life
197
Venules
Smallest branch of veins connected to distal part of capillaries
02 depleted blood flows from capillary venules to larger vein
198
Veins
Carries blood back to heart
All but the pulmonary vein which carries 02 depleted oxygen
199
The major veins of the
Vena cava
| Pulmonary veins
200
Superior vena cava
Carries 02 depleted blood from upper body to the right atrium
201
Inferior Venna cava
Carries 02 depleted blood from lower body
202
Pulmonary veins
Carrie 02 rich blood from the lungs to left atrium
203
Red blood cells
Carrie 02 to bodies cells and CO2 out of cells
204
White blood cells
Help defend against infections
205
Platelets
Essential to formation of blood clots and stop bleeding
206
Plasma
Liquid part of blood that carries blood cells/nutrients
207
Pulse
Can be felt when left ventricle contracts standing wave of blood through arteries
208
Hydrostatic pressure
Force exerted on inside of vessel
209
Edema
Swelling in tissues one capillaries leak fluid
210
Profusion
Delivery of O2/glucose/nutrients to all organs and removal of co2
211
Hypo fusion
Not enough 02/nutrients to sell and lack of eliminating see you too
212
How was 02 carried throughout the body
Hemoglobin
213
What are cells primary source of energy
Glucose
214
Anaerobic respiration
Metabolizing glucose without much energy--- the end result his ass
215
Aerobic respiration
CO2 carried away from cells and out by lungs
216
Nervous system
controls voluntary/involuntary activity of the body
217
what parts of the body are in the nervous system
spinal cord
| brain
218
what are the 3 main parts of the brain
cerebellum
cerebrum
brainstem
219
outermost potion of the brain:
body functions, sensations, thought, speech, and memory
220
posterior/inferior brain
coordinates muscles, balance
221
medulla oblongata
made up of respiratory
cardiac
and vasomotor
222
spinal cord:
main function is to conduct nerve impulses
223
peripheral nerve system
nerves located side of spinal cord that carry out sensory/motor into from brain--> spinal cord--> body
224
voluntary system
influences activity of skeletal muscles/movements
225
automatic system
influences activities of the smooth muscles/glands
226
endocrine system and its purpose
regulator of hormones `
227
pineal gland
superior/posterior to thalamus and produces melatonin
228
thyroid gland:
anterior neck--> metabolism, growth and development
229
parathyroid
behind thyroid and produces necessary hormone for metabolism for calcium in bones
230
adrenal
sits atop of kidney -- secretes epinephrine and norepinephrine, postpone muscle fatigue increases storage of sugar, and controls kidney function
231
gonads:
produce hormones that govern no reproduction and sex characteristics
232
Islet of landgerbans
Located in pancreas makes insulin
233
Pituitary gland
Base of the brain and is the master gland regulates growth your thyroid/parathyroid gland the pancreas the gonads metabolism of fatty acids and some basic proteins blood sugar reactions and urinary excretion
234
Thymus gland
Located in neck superior to the heart secretes the hormone by thymosin which influences the development and maturation of immune system
235
Alpha-1
Causes the vessels to constrict- relates to the heart can increase heart rate increase the force of cardiac contraction and speed up the electrical impulse traveling down the heart conduction system
236
Alpha-2
Regulate the release of alpha one-- causes smooth muscles to dilate especially in the bronchioles and some vessels
237
What are the two main hormones secreted by the sympathetic nervous system
epinephrine and norepinephrine
238
integumentary system
The skin
239
what does the integumentary system do
Separates inside organs tissues and systems from outside environment
Regulating the temperature of the body
Heat receptor for heat cold touch pain and pressure what me who are you texting nothing
240
Layers of the skin
Epidermis: outer most layer of the skin composed of four layers of cells
dermis: Second layer of skin contains blood vessels that supply skin as well as hair follicles sweat glands oil glands and sensory nerves
subcutaneous layer
241
Digestive system
alimentary track(passage way for food) --> accessory organs(helps prepare food for absorption)--> waste is eliminated
242
the stomach
A large hollow organ is the main organ of the digestive system secretes gastric juices that begin converting ingested food to a form that can be absorbed and used by the body
243
Pancreas
Secretes pancreatic juices that aid in digestion of fats starches and proteins
244
The liver
Produces bile which aids in digestion of fat it also store sugars until needed by the body produces components necessary for immune function blood clotting and production of plasma
245
The spleen
Hopsin filtration of blood conserve as a reservoir of blood the body can use an emergency such as hemorrhaging
246
Gallbladder
Acts as a reservoir for bile and aids in digestion of fats
247
Small intestine
Receives food from the stomach and secretions from the pancreas and liver
248
Urinary or renal system
Filters and excretes waste from the blood
249
What does the urinary system contain
Kidneys
ureters
urinary bladder
urethra
250
Sodium/potassium pump
Sodium is primarily outside of the cell while potassium is primarily in the cell. These molecules naturally move from a high to low concentration sodium molecules do not just flow out of cell they have to be actively pumped out against concentration
251
Perfusion
Delivery of oxygen and glucose and other substances to the cell and illumination of waste products from the cell
252
Patent airway
No obstruction located in the nasopharynx or oropharynx
253
Larynx
Structure that contains the vocal cords
254
Trachea
extends downwards and bifurcates into left and right bronchi
255
Broncus
Branches and even smaller bronchi and even smaller bronchioles
256
What supplies alveoli with oxygenated air
Bronchioles
257
Boyles law
and increase in pressure will decrease volume of gas
decrease in pressure will increase the volume of gas
258
accessory muscles
should not be used during regular respiration--> if they are it means the patient is requiring more energy to do a passive process
259
minute ventilation/ volume
amount of air moved in and out of lungs in one minute
260
tidal volume
volume of air breathed in with each breath
261
frequency of ventilation
number of ventilations in one minute
262
minute ventilation equation
tidal volume x frequency of ventilation
263
a decrease in tidal volume
will decrease minute volume
264
a decrease in frequency of ventilation will
decrease the minute ventilation
265
what does a decrease in min ventilation cause?
reduces air available for gas exchange in alveoli
266
what can a decrease in minute ventilation lead to?
cellular hypoxia
267
alveolar ventilation
amount of air moved in/out of alveoli in one minute
268
dead air space
No areas in respiratory tract where air collects during an allusion and does not participate in gas exchange
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alveolar ventilation equation
(tidal volume-dead air space) x frequency of ventilation
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low tidal volume
decreases alveolar ventilation by not putting enough air into alveoli
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inadequate ventilatory rate
not enough air will get to alveoli for gas exchange
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too fast of a ventilatory rate
doesn't allow lungs adequate time to fill
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chemoreceptors:
monitor pH CO2 and oxygen in arterial blood
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central chemoreceptors
most sensitive to CO2 and pH-- greater amount of CO2 in blood, greater amount of acid
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central chemoreceptors- fast, deeper breathing
blows off more CO2 during exhalation
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central chemoreceptors- slow, shallow breathing
blows off less CO2
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peripheral chemoreceptors
sensitive to levels of oxygen in arterial blood
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peripheral chemoreceptors: -a decrease of 02 in blood
peripheral chemoreceptors sinal respiratory center to increase rate/depth of respiration
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hypoxic drive
body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.
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lung receptors
irritant receptors
stretch receptors
j receptors
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irritant receptors:
found in airway and are sensitive to irritating gases
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stretch receptors
found in smooth muscles and measure size and volume of lungs
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j receptors
found in alveoli and are sensitive to pressure in capillaries- can stimulate rapid, shallow ventilation
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respiratory control center
dorsal
ventral
pontine
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Ventral respiratory groups
located in anterior portion of the medulla- responsible for initiating neural impulses to stimulate external intercostal muscles/diaphram causing them to contract
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dorsal respiratory group
posterior to VRG and provide further input on depth and rate of respiration
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pontine respiratory center
sends inhibitory impulses to VRG to turn off inhalation
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ventilation/perfusion V/Q ration
describes relationship between amount of ventilation alveoli receive and amount of perfusion through surrounding capillaries
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what does the ventilation/perfusion ratio determine
quality of gas exchange across alveolar/capillary membrane
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cardiac output
amount of blood ejected out of the L ventricle in one minute
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stroke volume
amount of blood ejected by L ventricle with each contraction
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cardiac output equation
heart rate x stroke volume
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an increase in stimulation in sympathetic nervous system
leads to increase in heart rate
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a decrease in stimulation by sympathetic nervous system
decreases heart rate
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increase in stimulation by parasympathetic nervous system
decreases heart rate
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a decrease in stimulation from parasympathetic nervous system
increases heart rate
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preload
pressure generated in left ventricle at end of diastole
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afterload
resistance in the aorta that must be overcome by contraction of L ventricle to eject blood
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systemic vascular resistance
resistance offered to blood flow through a vessel
300
sympathetic stimulation causes-
vasoconstriction
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parasympathetic stimulation causes
vasodilation
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microcirculation
blood flow through the smallest blood vessels
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what are the smallest blood vessels
arterioles, capillaries venues
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baroreceptors
stretch sensitive receptors in aortic arch/carotid sinuses- detect change in blood pressure
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Shock:
inadequate perfusion of cell tissues, and organs with oxygen and other nutrients resulting in cell, tissue, and organ dysfunction → also known as hypoperfusion
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Hypovolemic shock-
shock that is caused from a low blood volume- most common form of shock
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Hemorrhagic hypovolemic shock:
results from the loss of whole blood from the intravascular space→ leads to decrease in profusion from a reduction in pressure/decrease in 02 carrying capabilities of the blood
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Non Hemorrhagic hypovolemic shock:
caused by the shift of fluid out of the intravascular space but when red blood cells and hemoglobin remain within the vessel. Mainly water, plasma proteins, and electrolytes that are lost→ reduces blood volume/pressure/perfusion of cells
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Distributive shock:
caused by a decrease in intravascular volume caused by massive systemic vasodilation/increase in capillary permeability
Massive systemic vasodilation: relative reduction in volume -is inadequate to fill increased vessels
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Cardiogenic shock:
caused by ineffective pump function of the heart
In heart attack/CHF/abnormal heart rhythm, patients heart is unable to make generate enough force to eject sufficient blood from chamber into systemic circulation
Stroke volume and cardiac output are reduced
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Obstructive shock:
result from a conduction that obstructs forward blood flow→
Large clots in lungs can prevent blood from getting to the left atrium/left ventricle → as well as pulmonary embolism. Tension pneumothorax and tamponade
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Metabolic/Respiratory Shock:
dysfunction in the availability of O2 to diffuse into the blood- carried by hemoglobin- and off load at the cell, or be used by cell for metabolism
Certain poisons like cyanide interfere with the cells ability to use oxygen
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Burn shock:
specific form of nonhemorrhagic shock resulting from a burn. Burns interrupt the integrity of capillaries and vessels→ when a vessel is damages, it become permeable and allows the plasma proteins to leak out and collect in the interstitial space→ once out the plasma can not return inside the cell
Loss of fluid and plasma oncotic pressure leads to edema
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Anaphylactic shock:
distributive shock reaction→ causes massive and systemic vasodilation/capillaries to become permeable and to leak→ decrease of BP and perfusion→ EPINEPHRINE is the medicine used for anaphylactic shock
315
Septic shock:
distributive shock reaction→ results from sepsis which is an inflammatory response to infection that causes the vessels throughout the body to dilate and become permeable→ fluid leaks out into vessels into interstitial space→ shock is caused by massive vasodilation, which reduces systemic vascular resistance/blood pressure/profusion
316
Neurogenic shock:
distributive shock: can be a response to a spinal cord injury→ may damage the sympathetic nerve fibers that control vessel tone below level of injury→ causes vessels to dilate, drop in systemic vascular resistance, blood pressure and perfusion
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Cardiogenic shock:
due to an acute myocardial infraction/heart attack, CHF, overdose
318
stages of shock:
compensatory shock
| decompensated shock
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compensatory shock:
ressure in aorta/carotid decreases→ arterial wall tension reduces→ triggers baroreceptors to send decreased signals to hypothalamus→ hypothalamus activates organ/gland stimulation which increase blood pressure restore arterial wall tension
Body is able to maintain near-normal blood pressure/perfusion to vital organs
Blood is shunted away from non-vital areas
Pulse pressure may be narrowed
320
Decompensated shock:
in advanced stage of shock where body can no longer maintain blood pressure and perfusion of major organs→ if not managed these compensatory methods become exhausted and lead to failure
Anaerobic metabolism occurs
Vital organs are not being perfused
321
AHA 2015 chain of survival: Adult
```
Immediate recognition and activation
Immediate high quality CPR
Rapid defibrillation
Bls/ALS medical services
ALS and post-arrest care
```
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AHA 2015 chain of survival:
```
pediatric
Prevention of arrest
Early high quality CPR
Rapid activation of EMS
Effective ALS support/rapid transport
Integrated post-cardiac-arrest care
```
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Wheezing:
high pitched whistling sounds→ indication of swelling/constriction of inner lining of the lower airways- specifically the bronchioles
324
Rhonchi:
coarse crackles, snoring or rattling noise→ indication of the larger conducting airways of the respiratory tract- typically fluid/mucous
325
Crackles/rales:
bubbly or crackling sound→ indication of fluid in alveoli or bronchioles
326
Circulatory system has 3 major components:
Heart
Blood vessels
Blood
327
Pacemaker sites:
Sinoatrial node: primary
Atrioventricular node
Purkinje fibers
328
Atherosclerosis --
#1 killer worldwide
Atherosclerosis- Inflammatory disease that affects the arteries- starts in the innermost lining of the blood vessel where endothelial cell become damaged
May eventually lead to a development of a thrombus or plaque build up and occlusion of the vessel
Atherosclerosis of the coronary vessel is called coronary artery disease (CAD)
329
Arteriosclerosis
Condition that causes the smallest of the arterial structures to become stiff and less elastic→ commonly referred to as “hardening of the arteries”
330
Anaphylactic
reaction is a severe- life threatening allergic reaction
Severe systemic response to an allergen
Chemicals released by the body in anaph. Cause airway swelling/bronchoconstriction and vasodilation
331
S/S related to anaphylaxis
itching, hives, swelling to eyes/mouth/extremities, cramping/abdominal pain, nausea, vomiting, diarrhea, anxiety, headache, stridor, dyspnea, wheezing, rhonchi, tachypnea, tachycardia,
