Studied by 8 people
who are the least important when trying to organize scene requirements
any type of clean up crew
how is CO2 transported
through red blood cells and plasma
if somebody has vomited, you need to
clear the airway before ventilating
when should you use a BVM on a patient
when the patient cannot control their own airway. Breaths per minute are less than 10 and greater than 25
when to use a NRB mask on a patient
when the PT is breathing inadequate. breaths are between 12 and 20
if a pt’s pulse goes from strong to weak while using a BVM
reduce the volume of O2
what should you do to ensure your safety when you arrive on scene and there is an MOI
size up the scene before helping
what is not required when trying to establish danger zones
the amount of equipment
pathophysiology
study of how disease process affects the function of the body
cell membrane
protects and selectively allows water and other substances into and out of the cell (most vulnerable part of the cell)
endoplasmic reticulum
plays a key role in synthesizing proteins
energy from the cell is produced largely by the
mitochondria
the structures that are responsible for the conversion of glucose and other nutrients into NRG in the form of
ATP (adenosine triphosphate)
without ATP, a specialized mechanism called _______ cannot actively move ions back and forth across the cell membrane
sodium potassium pump
the movement of ions is responsible for generating an electrical charge to cause ____ , which is the stimulus for muscle contraction, including contractions of the heart
depolarization
the conversion of glucose into ATP is an essential process of
Metabolism
without water, the cell will
dehydrate and die
_____, a simple sugar obtained from the foods we eat, is the basic nutrient of the cell
glucose
healthy metabolism requires
oxygen
oxygen is used by the cell to metabolized glucose into NRG
NRG
_____ is removed by exhaling
Carbon dioxide
electrolyte
a substance that when dissolved in water, separates into charged particles
aerobic metabolism
the cellular process in which O2 is used to metabolized glucose
anaerobic metabolism
the cellular process in which glucose is metabolized into NRG without O2
FiO2
fraction of inspired O2; the concentration of O2 in the air we breathe
the most vulnerable part of a cell
cell membrane
typical inhaled air contains mostly, __ but also __
nitrogen (79%); O2 (21%)
how air comes into the body
air follows a path from the openings of the mouth and nose int the pharynx and/or nasopharynx
how air moves through the mouth
air travels to the rear of the throat (or hypo pharynx), then enters the larynx, below which the trachea begins
how air moves passes the trachea
air travels down the trachea to the point where it branches into two large tubes called the mainstream bronchi, one leading to each lung,
how air moves through the bronchi
air follows the paths of the bronchi as they subdivide repeatedly (like branches of a tree) until they reach their endpoints at the multitude of tiny air pockets called the alveoli
how air moves through the alveoli
the exchange of O2 and CO2 with the blood takes place
patent
open and clear; free from obstruction
tidal volume
volume of air moved in one cycle of breathing
minute volume
the amount of air breathed in during each respiration multiplied by the number of breaths per minute
dead air space
air that occupies the space between the mouth and the alveoli but that does not actually reach the area of gas exchange (about 150mL)
the lungs are part of the
lower airway (below the opening of the trachea)
the lungs, together with the diaphragm and the muscles of the chest wall, change their internal pressure to
pull air in or push air out
inhalation is an
active process
exhalation is a
passive process
if bleeding develops within the chest
blood can accumulate in the pleural space and force the lungs to collapse away from the chest wall
if a hole in either the lungs or the chest wall (or both) allows air to accumulate between the lungs and the chest wall
lungs can also be forced to collapse away from the chest wall
permeability of the thin wall that separates the alveoli from the capillary changes and, as a result, diffusion is imparts. When this happens
the blood in the alveolar capillaries can neither receive O2 nor offload CO2 normally. net results of any of these challenges is low O2 (hypoxia) and high CO2 (hypercapnia) within the body
the respiratory system moves air in and out, but to perfuse cells
the air that is breathed in must be matched up with blood
plasma oncotic pressure
the pull exerted by large proteins in the plasma portion of the blood that tends to pull water the body into the bloodstream
specific sensors in the brain and vascular system register
low O2 and high CO2 levels
chemoreceptors
sends messages to the brain that assistance is required
normally respiration or the need breathe is triggered in the brain by changing CO2 levels. When CO2 levels are increased, the brain stimulates the respiratory system to
breathe at an increased rate to expel the excessive CO2
deoxygenated blood that has been returned to the right side of the heart is pumped to the lungs via
pulmonary arteries and arterioles
the balance between the pulling-in force of plasma oncotic pressure and the pushing out force of hydrostatic pressure is
critical to regulating both blood pressure and cell hydration
1
1
hydrostatic pressure
the pressure within the blood vessel that tends to push water out of the vessel
stress receptors
detect the level of internal pressure and transmit messages to the nervous system, which then triggers the smooth muscles in the vessel walls to make any needed size adjustments
loss of tone
major problem with blood vessels occurs when their inability to control their diameter
if blood vessels are unable to constrict when necessary or, worse, if they are forced into an uncontrolled dilation
internal pressure can seriously drop
many conditions can cause this loss of tone. Such as, injuries to
the brain and the spinal cord can cause uncontrolled dilation of the blood vessels (vasodilation). severe systemic infections (sepsis) can also cause vessel dilation. System allergic reactions can cause similar problems
preload
how much blood is returned to the heart prior to contraction
contractility
forced of contraction, that is, how hard the heart squeezes
afterload
function of systemic vascular resistance
stroke volume
the amount of blood ejected from the heart in one contraption
bradycardia
too slow of a heart beat (less than 60)
tachycardia
too fast of a heart beat (greater than 100)
inadequate perfusion is referred to as
hypoperfusion (synonym for shock)
hypovolemic shock
low blood volume, occurs when blood is lost from the cardiovascular system (as in severe bleeding) or when the volume portion of the blood is lost (as in dehydration)
distributive shock
tone is lost
cardiogenic shock
heart fails in its ability to pump blood
obstructive shock
occasionally blood is physically prevented from flowing. In conditions such as tension pneumothorax or pulmonary embolisms, large quantities of blood are prevented from reaching essential organs and vital areas. Hyper profusion offers as these organs and vital areas go without blood they need
signs of shock
slight mental status changes including anxiety and feeling impending doom, increased HR, increased RR, delayed cap refill, pale skin that is cool and moist to the touch (diaphoresis), sweating
when compensatory measures fail, we call it
decompensated shock (or hypotensive shock)
intracelular
70% (water that is inside the cells)
intravascular
5% (water that is in the blood stream)
interstitial
25% (water can be found between cells and blood vessels)
sympathetic nervous response
causes pupils to dilate, and decreases, blood flow to the skin that results in diaphoresis (cool, moist, and pale skin)
total body water
60% of body weight
dehydration
an abnormally low amount of water in the body
edema
swelling associated with the movement of water into the interstitial space
the brain and spinal cord are well protected by bone and muscle. in addition, they are covered by protective layers called
meninges
strokes result from
clots in or bleeding from the arteries that perfuse the brain. Brain cells are deprived of O2 and die
meningitis
infection of the protective layers of the brain and spinal cord
encephalitis
an infection of the brain itself
signs of neurologic impairment
altered mental status, seizures, inability to speak or difficult speaking, visual or hearing disturbance, inability to walk or difficulty walking, paralysis (sometimes limited to one side), weakness (sometimes limited to one side), loss of sensation (sometimes limited to one side or area of the body), pupil changes
endocrine system is made up of variety of glands that secrete chemical messages in the form of hormones
these hormones dictate and control a variety of boy functions, such as glucose transfer and eater absorption in the kidneys among many others
major organs of the endocrine system
the brain and the kidneys
hypersensitivity
an exaggerated response by the immune system to a particular substance (allergy)
histamine
one of the chemicals released that produces edema and, in some cases, a narrowing of the airway because of changes in blood vessels permeability
lower airway
begins below the larynx and is composed of the trachea, bronchial passages and the alveoli
the trachea branches at the ___ and forms two mainstream bronchi
carina
common obstruction in a person with a decreased mental status
tongue (or more precisely, the epiglottis connected to the tongue) this obstruction occurs when a lack of tone causes the tongue to relax and fall back
stridor
high pitched sound generated from partially obstructed airflow in the upper airway
bronchoconstriction
contraction of smooth muscles that lines the bronchial passages that results in a decreased internal diameter of the airway and increased resistance to airflow
airway obstruction can occur acutely, as in choking on foreign body or
can occur over time
burns, blunt force trauma, and certain infections
can cause swelling of the tissues in and around the glottic opening
you can determine the presence of an airway in most PT’s by simply saying
hello
head tilt, chin lift
a means of correcting blockage of the airway by the tongue by tilting the head back and lifting the chin
jaw-thrust maneuver
a means of correcting blockage of the airway by moving the jaw forward without tilting the head or neck
oropharyngeal airway
curved device inserted through the PT’s mouth into the pharynx to help maintain an open airway
nasopharyngeal airway
flexible breathing tube inserted through the PT’s nostril into the pharynx to help maintain an open airway
gag reflex
vomiting or retching that results when something is placed in the back of the pharynx
use an oropharyngeal airway only on a PT with
no gag reflex
the gag reflex causes vomiting or retching when something is placed in the
pharynx
Note
Flashcard