Test 2 (Chapter 7, 9, 10, 11)

who are the least important when trying to organize scene requirements

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

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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