health science midterm Flashcards

(250 cards)

1
Q

Dorothea Dix

A

Superintendent of Female nurses of the Army in 1861

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2
Q

Superintendent of Female nurses of the Army in 1861

A

Dorothea Dix

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3
Q

Florence Nightingale

A

founder of modern nursing

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4
Q

founder of modern nursing

A

Florence Nightingale

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5
Q

Christian Barnard

A

preformed the first successful heart transplant

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6
Q

preformed the first successful heart transplant

A

Christian Barnard

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7
Q

Elizabeth Blackwell

A

first female physician in the U.S in 1849

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8
Q

first female physician in the U.S in 1849

A

Elizabeth Blackwell

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9
Q

Marie Curie

A

isolated radium in 1910

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10
Q

isolated radium in 1910

A

Marie Curie

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11
Q

Gabriel Fahrenheit

A

created the first mercury thermometer

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12
Q

created the first mercury thermometer

A

Gabriel Fahrenheit

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13
Q

William Harvey

A

described the circulation of blood to and from the heart

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14
Q

described the circulation of blood to and from the heart

A

William Harvey

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15
Q

Robert Koch

A

developed the culture plate method to identify pathogens

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16
Q

developed the culture plate method to identify pathogens

A

Robert Koch

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17
Q

Renee Laennec

A

invented the stethoscope

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18
Q

invented the stethoscope

A

Renee Laennec

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19
Q

Joseph Lister

A

began using disinfectants and antiseptics during surgery

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20
Q

began using disinfectants and antiseptics during surgery

A

Joseph Lister

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21
Q

Louis Pasteur

A

began pasteurizing milk to kill bacteria and proved microorganisms cause disease and created a vaccine for rabies

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22
Q

began pasteurizing milk to kill bacteria and proved microorganisms cause disease and created a vaccine for rabies

A

Louis Pasteur

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23
Q

Joseph Priestley

A

discovered the element oxygen in 1774

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24
Q

discovered the element oxygen in 1774

A

Joseph Priestley

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25
Wilhelm Roentgen
discovered x-rays in 1895
26
discovered x-rays in 1895
Wilhelm Roentgen
27
Anton van Leeuwenhoek
invented the microscope in 1666
28
invented the microscope in 1666
Anton van Leeuwenhoek
29
standard precautions (extended version)
the minimum infection prevention practices that apply to all patient care regardless of suspected or confirmed infection status of the patient in any setting where health care is delivered
30
what is RACE
R - rescue/remove your patients A - alert/alarm (fire alarm) C - confine/contain the fire (by closing doors) E - extinguish or evacuate
31
what is PASS
P - pull the pin A - aim (at the base of the fire) S - squeeze S - sweep (back and forth)
32
what are the correct techniques for lifting heavy items?
- maintain a broad base - bend from hips and knees - use the weight of your body to help push/pull an object - carry heavy objects close to your body - avoid twisting your body as you work - avoid bending for long periods of time
33
what is the MOST important thing to do if there is a fire?
remain calm, get out and alert!
34
long term care facility
to provide assistance and care mainly for elderly patients
35
to provide assistance and care mainly for elderly patients
long term care facility
36
home health care
provide care in a patient's home
37
provide care in a patient's home
home health care
38
hospice
provides care for terminally ill persons who usually have life expediencies of 6 months or less
39
provides care for terminally ill persons who usually have life expediencies of 6 months or less
hospice
40
hospitals
one of the major types of health care facilities that vary in size and services provided
41
one of the major types of health care facilities that vary in size and services provided
hospitals
42
medicare
a federal government program that provides health care for almost all individuals over the age of 65
43
a federal government program that provides health care for almost all individuals over the age of 65
medicare
44
medicaid
pays for the healthcare of individuals with low incomes, children who qualify for public assistance, and individuals who are physically disabled or blind
45
pays for the healthcare of individuals with low incomes, children who qualify for public assistance, and individuals who are physically disabled or blind
medicaid
46
medigap
health insurance plans that help pay expenses not covered by Medicare
47
health insurance plans that help pay expenses not covered by Medicare
medigap
48
worker's comp.
health insurance plan providing treatment for workers injured on the job
49
health insurance plan providing treatment for workers injured on the job
worker's comp.
50
HMO
type of health insurance plan that provides a managed care plan for the delivery of health care services - prevention - set list of Dr.'s but GP (general practitioner) has to give referrals to see specialists - cheaper premiums - less choice of Dr.'s
51
PPO
type of managed care health insurance plan usually provided by large industries or companies to their employees - prevention - set list of Dr.'s and specialists - NO GATEKEEPER
52
what are the steps in the chain on infection?
- Infectious Agent - Source of Reservoir - Portal of Entry - Mode of Transmission - Portal of Exit - Susceptible Host
53
infectious agent
a pathogen such as a bacterium or virus that can cause disease
54
a pathogen such as a bacterium or virus that can cause disease
infectious agent
55
source of reservoir
an area where the infectious agent can live
56
an area where the infectious agent can live
source of reservoir
57
portal of entry
a way for the infectious agent to escape from the reservoir in which it has been growing
58
a way for the infectious agent to escape from the reservoir in which it has been growing
portal of entry
59
mode of transmission
a way that the infectious agent can be transmitted to another reservoir or host where it can live
60
a way that the infectious agent can be transmitted to another reservoir or host where it can live
mode of transmission
61
portal of exit
a way for the infectious agent to enter a new reservoir or host
62
a way for the infectious agent to enter a new reservoir or host
portal of exit
63
susceptible host
a person likely to get an infection or disease, usually because body defenses are weak
64
a person likely to get an infection or disease, usually because body defenses are weak
susceptible host
65
standard precautions (short version)
precautions used for everyone based on if you're going to be in contact with bodily fluids
66
what are the standard precautions? (list)
- wash hands (after touching blood, bodily fluids, secretions, and contaminated items) - wash hands immediately after gloves are removed and between patients - always wash hands as you enter and leave a patients room - remove gloves after use, before touching non-contaminated items - change gloves before caring for a new patient - always wash hands if visibly soiled
67
airborne precautions
- use standard precaution - patient must be placed in private room (door kept closed) - each person who enters room must wear a N95 mask - air must be discharged to outdoor air or filtered before circulating other areas
68
droplet precautions
- use standard precaution - patient must be placed in private room - masks must be worn when working within 3 feet of patient
69
contact precautions
- use standard precaution - patient must be places in private room - hand hygiene before and after all patient contact (with gloves and hand washing) - use of personal protective equipment (gloves, gowns, masks, eye protection, etc.) - the room and items in it must receive daily cleaning and disinfection as needed - all equipment must be cleaned and disinfected before using on another patient
70
nosocomial
an infection aquired by an individual in a health care facility; transmitted by health care workers to the patient (ex: staphylococcus, pseudomonas and enterococci)
71
an infection aquired by an individual in a health care facility; transmitted by health care workers to the patient (ex: staphylococcus, pseudomonas and enterococci)
nosocomial
72
opportunistic
infections that occur when the body's defenses are weak (es: kaposi's sarcoma (rare type of cancer) or pneumoncystis carinii (pneumonia in individuals with AIDS))
73
infections that occur when the body's defenses are weak (es: kaposi's sarcoma (rare type of cancer) or pneumoncystis carinii (pneumonia in individuals with AIDS))
opportunistic
74
antisepsis
prevent or inhibit growth of pathogenic organisms but are not effective against spores and viruses (can usually be used on the skin) (ex: alcohol and betadine)
75
prevents or inhibit growth of pathogenic organisms but are not effective against spores and viruses (can usually be used on the skin) (ex: alcohol and betadine)
antisepsis
76
asepsis
the absence of disease-producing microorganisms, or pathogens
77
the absence of disease-producing microorganisms, or pathogens
asepsis
78
clean
objects or parts of objects that do not contain disease-producing organisms
79
objects or parts of objects that do not contain disease-producing organisms
clean
80
pathogen
microorganisms that cause infection and disease
81
microorganisms that cause infection and disease
pathogen
82
contaminated
organisms and pathogens are present/objects contain disease producing organisms
83
organisms and pathogens are present/objects contain disease producing organisms
contaminated
84
disinfection
a process that destroys all microorganisms, both pathogenic and non-pathogenic (including spores and viruses)
85
a process that destroys all microorganisms, both pathogenic and non-pathogenic (including spores and viruses)
disinfection
86
types of bodily fluids that can carry pathogens
- semen - vaginal secretions - cerebrospinal fluid (found in brain and spinal cord) - synovial fluid (found between your joints) - pleural fluid (located between layers of pleura (lungs)) - peritoneal fluid (by the peritoneum (abdominal cavity)) - amniotic fluid - saliva
87
steps for donning
- gown - mask - goggles - gloves
88
steps for doffing
- gloves - goggles - gown - mask
89
relationship between tissues, organs, cells and organ systems
cells combine to form tissues, tissues combine to form organs, and organs combine to for systems cells > tissues > organs > organ systems
90
4 main types of tissue
- connective - nerve/nervous - muscle - epithelial (skin)
91
connective tissue
the supporting fabric of organs and other body parts; soft; (ligaments, tendons)
92
the supporting fabric of organs and other body parts; soft; (ligaments, tendons)
connective tissue
93
nerve/nervous tissue
made up of special cells called neurons; control and coordinated body activities by transmitting messages throughout the body; nerves, brain, and spinal cord are composed of this tissue
94
made up of special cells called neurons; control and coordinated body activities by transmitting messages throughout the body; nerves, brain, and spinal cord are composed of this tissue
nerve/nervous tissue
95
muscle tissue
produces power and movement by contraction of muscle fibers; skeletal cardiac, and visceral (smooth) are the main kinds
96
produces power and movement by contraction of muscle fibers; skeletal cardiac, and visceral (smooth) are the main kinds
muscle tissue
97
epithelial (skin) tissue
covers the surface of the body and is the main tissue in the skin; forms the lining of the intestinal, respiratory, circulatory, and urinary tracks; also forms body glands (produces specific secretions such as mucus and digestive juices)
98
covers the surface of the body and is the main tissue in the skin; forms the lining of the intestinal, respiratory, circulatory, and urinary tracks; also forms body glands (produces specific secretions such as mucus and digestive juices)
epithelial (skin) tissue
99
tort
wrongful act that does not involve a contract; occurs when a person is harmed or injured because a health care provider does not meet standards of care
100
wrongful act that does not involve a contract; occurs when a person is harmed or injured because a health care provider does not meet standards of care
tort
101
what is the range for temperature?
97.6-99.6
102
what is the range for temperature?
oral: 97.6-99.6
103
what is the range for BP?
normal: 100-120/60-80
104
what is the range for BP?
normal: 100-120/60-80
105
what is the range for pulse?
60-100
106
what is the range for pulse?
60-100
107
what is the range for respiration?
12-20
108
what is the range for respiration?
12-20
109
what are patient's rights?
factors of care that patients can expect to receive
110
what are types of legal directives?
living will and POA
111
legal directives
legal documents that allow individuals to state what medical treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care
112
living will
documents that allow individuals to state what measures should/should not be taken to prolong life when their conditions are terminal
113
living will rules
must be signed when individual is competent and witnessed by 2 adults who cannot benefit from the death
114
Designation of Health Care Surrogate or Durable Power of Attorney (POA)
a document that permits an individual (known as principal) to appoint another person (known as agent) to make any decisions regarding health care if the principal should be unable to make decisions
115
POA rules
must be signed by the principal, agent, and 1 or 2 adult witnesses
116
permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand; all procedures must be explained to the patient and no procedure should be preformed if the patient does not give consent
informed consent
117
what are the types of legal directives that can be given?
- DNR (do not resuscitate) - DNI (do not intubate) - living will (for when you are terminal; how far/how much you want them to do to keep you comfortable) - POA (choosing someone to make decisions for you in case something happens)
118
functions of the bones
- framework: support the body's muscles, fat and skin - protection: bone surround vital organs to protect them - levers: muscles attach to bones to help provide movement - production of blood cells: help produce red and white blood cells and platelets - storage: store most of the calcium supply of the body in addition to phosphorus and fat
119
what are the parts of the long bone?
- diaphysis: long shaft (meduallary canal is found inside here and yellow marrow is found in the medullary canal) - epiphysis: ends of the bone - endosteum: membrane that lines medullary cavity and holds yellow marrow intact - periosteum: tough membrane that covers the outside of the bone - osteoblasts: special cells that form new bone tissue - articular cartilage: covers epiphysis and acts as a shock absorber where 2 bones meet
120
where are long bones found?
in vertebrae, ribs, sternum, cranium, proximal humorous, pelvis and femur
121
what and where is red and yellow marrow?
- yellow marrow: mainly a storage area for fat cells: fills the medullary canal (in the diaphysis/extremitie (arms/legs)) - red marrow: produces red blood cells, cells, platelets, and some white blood cells; is sometimes transplanted into people with defective immune systems; found in certain bones (ribs, vertebrae, sternum, cranium and proximal ends of the humerus and femur)
122
endosteum
a membrane that line the medullary canal and keeps yellow marrow intact; also produces bone growth
123
periosteum
tough membrane which contains blood vessels, lymph vessels, and osteoblasts
124
fontanels
"soft spots"; allow for the enlargement of the skull as brain growth occurs; made of membrane and cartilage, and turn into solid bone by approximately 18 months of age
125
formina
openings in bones that allow nerves and blood vessels to enter or leave the bone
126
sutures
areas where the cranial bones have joined together
127
joints
areas where 2 or more bones join together
128
ligaments
connect bone to bone (help hold long bones together at joints)
129
tendons
the attachment from muscle to bone (strong, tough, fibrous, connective tissue cords)
130
fascia
a tough, sheetlike membrane that covers and protects the tissue
131
diathrosis/synovial
freely movable (ball and socket joints of the shoulder and hip, or the hinge joints of the elbow and knee)
132
amphiarthrosis
slightly movable (attachment of the ribs to the thoracic vertebrae and the symphysis pubis/joint between pelvic bone)
133
synarthrosis
immovable (suture joints of the cranium)
134
types of fractures
- greenstick - simple (closed) - compound (open) - impacted - comminuted - spiral - depressed - colles - closed fx - open fx
135
names of fixing fractures
- closed reduction: positioning bone in correct alignment (applying a cast or splint to maintain position until fracture heals) - open reduction: surgical repair of the bone
136
greenstick fx
bone is bent and splits, causing a crack or incomplete break
137
simple (closed) fx
complete break of the bone with no damage to the skin
138
compound (open) fx
bone breaks and ruptures through the skin
139
impacted fx
broken bone ends jam into each other
140
comminuted
bone fragments or splinters into more than 2 pieces (like a "community" of broken bones)
141
spiral fx
bone twists resulting in one or more breaks
142
depressed
a broken piece of skull bone moves inward
143
colles
breaking and dislocating of the distal radius that causes a characteristic bulge at the wrist
144
closed fx
when broken bone occurs within the skin
145
open fx
when the bone comes though the skin at time of fracture
146
what are the functions of muscles?
- excitability: the ability to respond to a stimulus such as a nerve impulse - contractibility: muscle fibers that are stimulated by nerves, contract, or become short and thick which causes movement - extensibility: the ability to be stretched - elasticity: allows the muscle to return to its original shape after it has contracted or stretched
147
what is the skeletal muscle?
- attach to bones and provide voluntary movement - produce heat and energy for the body - help maintain posture by holding the body erect - protect internal organs
148
what are the 3 types of muscle?
- cardiac muscle: forms walls for the heart and contracts to circulate blood; involuntary - visceral (smooth) muscle: contracts to cause movement in these organs (in digestive and respiratory systems, blood vessels, and eyes); involuntary - skeletal muscle: attached to bones and causes body movement; voluntary
149
difference between ligament and tendon
ligament is attachment from bone to bone and tendon is attachment from muscle to bone
150
what are the 3 parts of communication
- sender: individual who creates message - message: info, ideas, or thoughts - receiver: individual who receives message
151
what are the 5 vital signs
pulse, BP, temp, respiration and pain
152
list the body planes
- transverse plane: divides the body into a top and bottom half - midsagittal/medial plane: divides the body into right and left sides - frontal/coronal plane: divides the body into a front and a back section
153
body parts that are above & below the transverse plane
- superior: above | - inferior: below
154
body parts located near the head?
cranial
155
body parts located near the "tail" region?
caudal
156
body parts that are close to the midline/plane?
medial
157
body parts that are away from the midline/plane?
lateral
158
body parts in the front plane
ventral/anterior
159
body parts in the back plane
dorsal/posterior
160
body parts close to the point of reference
proximal
161
body parts distant from the point of reference
distal
162
list the body cavities
- dorsal cavity: one long, continuous cavity located on the back of the body and is divided into 2 sections (cranial and spinal) - ventral cavities: larger than the dorsal cavities and is separated into 2 distinct cavities by the diaphragm - thoracic cavity: located in the chest and contains - abdominal cavity: is divided into an upper and lower part - orbital cavities - nasal cavities - buccal cavities
163
dorsal cavities
- cranial cavity: contains the brain | - spinal cavities: contains the spinal cord
164
thoracic cavity
contains the esophagus, trachea, bronchi, lungs, heart, and large blood vessels
165
abdominal cavities
- upper part: contains stomach, small intestine, most of large intestine, appendix, liver, gallbladder, pancreas, and spleen - lower part (pelvic cavity): contain the urinary bladder, reproductive organs, and the last part of the large intestine
166
orbital cavity
contains the eyes
167
nasal cavity
contains the nose structures
168
buccal cavity
(mouth) contains the teeth, tongue
169
what are the regions of the abdomen (quadrants)?
*insert picture*
170
what are the regions of the abdomen (regions)?
*insert picture*
171
what is correct anatomical position
standing erect (upright), feet slightly apart, arms at side, palms facing forward
172
malpractice
"bad practice"; failure to use the degree of skill expected in an individual's profession, resulting in injury, loss, or damage to the person receiving care
173
"bad practice"; failure to use the degree of skill expected in an individual's profession, resulting in injury, loss, or damage to the person receiving care
malpractice
174
negligence
failure to give care that is normally expected of a person in a particular position, resulting in injuries to another person
175
failure to give care that is normally expected of a person in a particular position, resulting in injuries to another person
negligence
176
defamation
occurs when false statements either cause a person to be ridiculed or damage the person's reputation
177
occurs when false statements either cause a person to be ridiculed or damage the person's reputation
defamation
178
libel
written statements (that are not true)
179
slander
spoken statements
180
invasion of privacy
unnecessarily exposing an individual or revealing personal info about an individual without that person's consent
181
written statements that are not true (defamation)
libel
182
spoken statements
slander
183
unnecessarily exposing an individual or revealing personal info about an individual without that person's consent
invasion of privacy
184
assault
a threat or attempt to injure
185
a threat or attempt to injure
assault
186
battery
the unlawful touching of another person without consent
187
the unlawful touching of another person without consent
battery
188
informed consent
permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand; all procedures must be explained to the patient and no procedure should be preformed if the patient does not give consent
189
abuse
any care that results in physical harm, pain, or mental anguish
190
what are the types of abuse?
- physical: hitting, restraining, etc. - verbal: swearing, shouting, using inappropriate words, writing threats, etc. - psychological abuse: threatening harm, denying rights, intimidating, threaten to reveal info about a person, etc. - sexual: any unwanted sexual touching, gestures, suggesting sexual behavior, etc.
191
what are the signs and symptoms for abuse?
- unexplained bruises, fractures, burns, or injuries - neglect such as personal hygiene - irrational fears or change in personality - aggressive or withdrawn behavior - pt. statements indicate abuse/neglect
192
what is the Patient Self-Determination act?
the job of health care workers if to ask the patient what they want to happen to them (ask pt. if they have legal directives and if they do get a copy and put in chart, if not, offer if they want legal directives) (educate healthcare workers to ask pt. for legal directives)
193
HIPAA
- established for maintaining confidentiality of health care records - patients have total control on how info in their medical records is used - states that you cannot give info without patient permission - you are granting permission to share medical info to health insurance, etc. - states who can call and ask for your medical info
194
what is OBRA
guarantees certain rights to residents in long-term care facilities
195
examples of individuals with legal disabilites
- minors (individuals under legal age) - under the influence of drugs that alter mental state - semiconscious/unconscious people
196
what are privileged communicatios and what are exempt?
info that is given by the patient (is to be kept confidential and shared only with other members of the patient's health care team); exempt: injuries caused by violence that may require police involvement, (drug) abuse, (anything illegal really), etc.
197
what are the abnormalities found in curvatures of the spine?
- kyphosis: "hunchback"; a rounded bowing of the back at the thoracic area - scoliosis: side-to-side (lateral) curvature of the spine - lordosis: "swayback"; an abnormal inward curvature of the lumbar region
198
abduction
moving a body part away from the midline
199
moving a body part away from the midline
abduction
200
adduction
moving a body part toward the midline
201
moving a body part toward the midline
adduction
202
flexion
decreasing the angle between 2 bones, or bending a body part (bending a body part)
203
decreasing the angle between 2 bones, or bending a body part (bending a body part)
flexion
204
extension
increasing the angle between 2 bones, or straightening a body part (straightening a body part)
205
increasing the angle between 2 bones, or straightening a body part (straightening a body part)
extension
206
circumduction
moving in a circle at a joint or moving one end of a body part in a circle while the other end remains stationary (swinging an arm in a circle)
207
moving in a circle at a joint or moving one end of a body part in a circle while the other end remains stationary (swinging an arm in a circle)
circumduction
208
rotation
moving a body part around its own axis (turning head side to side)
209
moving a body part around its own axis (turning head side to side)
rotation
210
contracture
tightening or shortening of a muscle
211
tightening or shortening of a muscle
contracture
212
elasticity
allows the muscle to return to its original shape after it has contracted or stretched
213
allows the muscle to return to its original shape after it has contracted or stretched
elasticity
214
excitability
the ability to be stretched
215
the ability to be stretched
excitability
216
muscle tone
a state of partial contraction
217
a state of partial contraction
muscle tone
218
deltoid
shoulder
219
shoulder
deltoid
220
biceps
upper arm (palm side)
221
upper arm (palm side)
biceps
222
triceps
lower arm (elbow side)
223
upperr arm (elbow side)
triceps
224
trapezius
upper back & neck
225
upper back & neck
trapezius
226
pectoralis major
upper chest
227
upper chest
pectoralis major
228
gluteus maximus
butt, booty
229
butt, booty
gluteus maximus
230
rectus abdominus
ribs to pubis (pelvis)
231
ribs to pubis (pelvis)
rectus abdominus
232
quadriceps femoris
front of thigh
233
front of thigh
quadriceps femoris
234
communication
the exchange of an idea or info that results in understanding
235
difference between verbal and nonverbal communications
- verbal: primarily the spoken word | - nonverbal: messages conveyed by facial expression, eye contact, body language, touch, personal space, and appearance
236
what would involve listening?
- show interest and concern for what speaker is saying - be alert and maintain eye contact with speaker - avoid interrupting speaker - pay attention to what the speaker is saying - avoid thinking about how you are going to respond - try to eliminate your own prejudices and see the other persons pov - eliminate distractions - watch the speaker closely to observe actions that may contradict what the person is saying - reflect statements back to the speaker to let the speaker know that statements are being heard - ask for clarification if not understanding - keep temper under control and maintain a positive attitude
237
how are senses used in communication?
- sight: the presence of a rash/sore, color of urine/stool, amount of food eaten, etc. - smell: alerts a health care worker to body oder/unusual odors of breath, wounds, urine/stool - touch: to feel pulse, dryness of temp of skin, etc. - hearing: listening to respirations, abnormal body sounds, coughs, and speech
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difference between subjective and objective data
- subjective: cannot be seen or felt, statements made by patients (what can be interpreted) - objective: can be seen or measured; bruise, cut, rash, etc. (what is visually seen)
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locations for taking pulse
- temporal (temple/head) - carotid (neck) - brachial (arm; 2 spots) - radial (thumb side of your arm) - femoral (groin/femur) - popliteal (behind your knees) - dorsalis pedis (foot) - posterior tibial (back of leg, near ankle) - apical (base of heart)
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where can you take temporal pulse
temple/head
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where can you take carotid pulse
neck
242
where can you take brachial pulse
arm (in elbow bend and inside of arm)
243
where can you take radial pulse
thumb side of your arm (wrist)
244
where can you take femoral pulse
groin/femur
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where can you take popliteal pulse
behind the knees
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where can you take dorsalis pedis pulse
foot
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where can you take posterior tibial pulse
back of leg (near ankle)
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where can you take apical pulse
base of heart
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what are the correct steps in taking BP
- find pulse/rate - find the rhythm (regularity of pulse) - calculate volume (strength, force, quality, or intensity of pulse)
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what can cause abnormal vital signs?
^ exercise, stimulant drugs, excitement, fever, dehydration, shock, nervous tension v sleep, depressant drugs (like alcohol), heart disease, coma, physical training