EMT exam 2

Plane that cuts through torso horizontally

transverse

Plane that cuts through midline vertically, dividing front and back

frontal (coronal)

Plane that cuts through sides vertically, dividing R & L

sagittal

Ligaments

stabilize joints (connect bone to bone)

Cartilage (skeletal)

cushions joints

tendons

attach bone to muscle

Synovial membrane and synovial fluid:

membrane generates fluid to lubricate joints

Foramen magnum

• opening at base of cranium

  • Cranium: frontal bones, temporal bones, parietal bones, occipital bone

  • Facial bones: maxillae: upper jawbone

    • Lower jawbone: mandible

    • Cheek bones: zygomas

    • Eye socket: orbit

Sections of the spine

• cervical, thoracic, lumbar, sacrum, coccyx

  • Thoracic spine contains sternum:

    • Manubrium

    • Body

    • Xiphoid process

Hand bones wrist to fingertip

Carpals, metacarpals, phalanges

Pelvic coxae

• Ilium

• Ischium

• Pubis

• Joined by pubic symphysis

leg bones

 femur, knee, patella, tibia>fibula

Foot bones

tarsals, metatarsals, phalanges

airway anatomy

• Upper: nasopharynx, pharynx, oropharynx, epiglottis

• Lower airway structures:

  • Larynx

  • Trachea

  • Bronchi

  • Bronchioles

  • Alveoli

respiration

gas exchange. Controlled by diffusion, CSF acidification, hypoxic drive

Ventilation

• air movement in/out of lungs

  • Tidal volume: air moved in single breath

    • Minute volume: air moved in a minute (RR x TV)

  • Residual volume: air remaining in lungs after exhale

  • Dead space: portion of respiratory system with no alveoli (no exchange of gas). i.e mouth, trachea, bronchi.

stroke volume and cardiac output (CO)

• blood moved in one beat

  • Cardiac output (CO): blood moved in 1 min

Pulmonary artery:

deoxygenated blood

Integumentary system (skin)

• Epidermis

• Dermis: sweat and oil glands, nerve endings, hair follicles 

• Subcutaneous tissue: fat. Mucous membranes

Digestive system quadrants

• Upper right: liver, gallbladder

• Upper left: stomach, spleen 

• Lower right: appendix, small and large intestine

• Lower left: large and small intestine

Lymph system

• Supports immune and circulatory system. Lymph transports materials from lymph tissue into circulation, and lymph nodes filter the lymph

endocrine system

hormones

urinary system components

kidneys, ureter (works by peristalsis, contraction of smooth muscle), urethra

types of metabolisms

• Aerobic: with oxygen. Efficient. Byproducts: CO2, H2O, and heat

• Anaerobic: without oxygen. Not efficient. Byproduct: lactic acid

pathophysiology

 the study of how normal human body processes are affected by disease

ages of different life stages

• Neonate: birth-1mo

• Infant: 1mo-1y

• Toddler: 1y-3y

• Preschooler: 3y-6y

• School-age: 6y-12y

• Adolescent 13-18y

• Early adult: 19-40y

• Middle adult: 41-60y

• Older adult: 61+y

infant reflexes

moro, palmar grasp, rooting, sucking

Types of reasoning in school-age children

• Preconventional reasoning: moral compass is directed by outside forces, like reward and punishment. 

• Conventional reasoning: moral compass guided by approval and disapproval from peers

• Postconventional reasoning: moral compass guided by abstract concepts. This develops more during adolescence

Body mechanics

relationship between the body's anatomical structures and the physical forces associated with lifting, moving, and carrying. Essentially, the way in which the body moves to achieve a specific action.

Emergency vs urgent vs nonurgent moves:

• Emergency: scene and pt are unstable, or you can't treat patient where they currently are

• Urgent: inadequate ventilation, shock, or altered consciousness.

• Nonurgent: scene and pt are stable. Involves transfers: direct carry, sheet method, backboard, scoop stretcher.

How to position patients: unresponsive patients without suspected spine injury, chest pain, discomfort, difficulty breathing, suspected spine injury, pregnant with hypotension, nauseated or vomiting

• Spinal injuries: use backboards

• Chest pain: position of comfort: fowler’s/high fowler’s 

• Pregnant: transport on left side

• Hypotension: supine

• Nauseated or vomiting: transport in fowlers or high fowlers OR if they have suspected spinal injury, just suction the blood while keeping them in the backboard

components of patient assessment

• Scene size-up

• primary assessment

• History

• secondary assessment (trauma or medical)

• Reassessment

scene size-up

maintain situational awareness, and identify any hazards on scene. Determine mechanism of injury/nature of illness (MOI or NOI). don any PPE, determine number of patients, additional resources

AVPU

awake/alert, responsive to Verbal cues, responsive to Pain, unresponsive

assessing orientation, ask about

person, place, time, event

primary assessment

• form a general impression

• use AVPU (awake and alert, responsive to verbal, responsive to pain, unresponsive) to assess consciousness. 

  • Assess orientation by asking person, place, time, and event. 

• Identify and treat life threats: DCAP-BTLS

• Assess airway, breathing, circulation

• Assess skin condition 

• Assess and control external bleeding 

• Determine priority of patient care and transport

history taking

• Investigate chief complaint 

• OPQRST: onset, provocation/palliation, quality, region/radiation, severity, timing

• Obtain SAMPLE history: signs, allergies, medications, pertinent past medical history, last oral intake, events leading up to the injury/illness

• Look out for signs of abuse or violence

OPQRST

onset, provocation/palliation, quality, region/radiation, severity, timing

SAMPLE

signs, allergies, medications, pertinent past medical history, last oral intake, events leading up to the injury/illness

secondary assessment

• Systematically assess patient 

• Check respiratory and cardiovascular systems, pupils 

• Do in-depth assessment of chief complaint

reassessment

• Repeat primary assessment (airway, breathing, circulation) to identify/’treat life threatening changes in patient condition 

• Redo vitals (usually every ????? min on non-critical and every 5 for critical patients)

LOC

level of consciousness

high priority transport examples

unresponsive, difficulty breathing, uncontrolled bleeding, altered LOC, severe chest pain, pale skin/poor perfusion, complicated childbirth, severe pain

normal systolic blood pressures for adults, children, and infants

90-120 adults

97-115 for older children

86-106 young child

72-104 infant