Emergency Care 14th Edition Chapter 7

Aerobic metabolism

The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal waste

Anaerobic metabolism

the cellular process in which glucose is metabolized into energy without oxygen. Energy is produced in an inefficient manner with many waste products.

Cardiac output

the amount of blood ejected from the hear in one minute (heart rate x stroke volume)

Chemoreceptors

chemical sensors in the brain and blood vessels that identify changing levels of oxygen and carbon dioxide

Dead air space

air that occupies the space between the mouth and alveoli

Dehydration

an abnormally low amount of water in the body

Diaphoresis

cool, pale, and moist/sweaty skin; sweating

Edema

swelling associated with the movement of water into the interstitial space

Electrolyte

- A substance that, when dissolved in water, separates into charge particles

The movements of these charged particles(electrolytes) enable the electrical functions of cells, such as:

nerve transmission and cardiac muscle depolarization.

FiO2

fraction of inspired oxygen; the concentration of oxygen in the air we breathe

Hydrostatic pressure

the pressure within a blood vessel that tends to push water out of the vessel

Hypersensitivity

an exaggerated response by the immune system to a particular substance

Hypoperfusion

inability of the body to adequately circulate blood to the body's cells to supply them with oxygen and nutrients. A life-threatening condition. Also called shock.

Metabolism

The cellular function of converting nutrients into energy

Minute volume

The amount of air breathed in during each respiration multiplied by the numbers of breaths per minute

Patent

open and clear; free from obstruction.

Pathophysiology

The study how disease processes affect the function of the body.

Perfusion

The supply of oxygen to and removal of wastes from the cell and tissues of the body as a result of the flow of blood through the capillaries.

Plasma oncotic pressure

the pull exerted by large proteins in the plasma proteins in the plasma portion of the blood that tend to pull water from the body into the bloodstream.

Shock

see hypoperfusion

stretcher receptors

sensors in the blood vessels that identify internal pressure

stroke volume

the amount of blood ejected from the heart in one contraction

systemic vascular resistance

the pressure in the peripheral blood vessels that the heart must overcome to pump blood into the system

tidal volume

the volume of air moved in one cycle of breathing.

V/Q match

ventilation/perfusion match. This implies that the alveoli are supplied with enough air and that the air in the alveoli is matched with sufficient blood in the pulmonary capillaries to permit optimum exchange of oxygen and carbon dioxide

Nucleus

Cellular structure that contains DNA

Cell Membrane

Part of the cell that allows substance in and out of the cell

Endoplasmic Reticulum

Plays a key role in synthesizing proteins

To fuel its most basic functions and to respond to life-threatening challenges, the body requires a balance of:

glucose, oxygen, and water.

When the body is threatened with major challenges, such as blood loss or inadequate oxygen supply, the body systems work together to recognize the threat and take immediate corrective action. These adjustments the body makes to correct imbalances—known as:

compensation

This allows the body to grow, heal, and carry out the normal functions necessary to live life. This is referred to as:

homeostasis

The basic building block of the body is the:

Cell

Energy for the cell is produced largely by the _________________________, the structures that are responsible for the conversion of glucose and other nutrients into energy in the form of adenosine triphosphate (ATP).

mitochondria

without ATP, a specialized mechanism called the ___________________________cannot actively move ions back and forth across the cell membrane.

sodium potassium pump

The conversion of glucose into ATP is an essential process of.

metabolism

The most essential functions of cells rely on some basic requirements, principally:

water, glucose, and oxygen.

A cell needs the correct balance of water between its:

inside and its outside

Without enough water, the cell will:

dehydrate and die.

By contrast, too much water in the cell will cause what?

interrupt basic cellular function

Water levels also influence the concentrations of important chemicals called:

electrolytes

Important electrolytes in the body include:

potassium, sodium, and magnesium.

Levels of water in the body are controlled by the ___________________and ___________________, and the proper function of these systems maintains a balance to provide cells a healthy environment

circulatory and renal systemsg

A simple sugar obtained from the foods we eat, is the basic nutrient of the cell. This is known as:

Glucose

Without glucose, normal energy production within the cell and normal cell function will:

cease.

Most of the body's cells require the presence of ___________ in the blood to help move glucose from the blood into the cells.

insulin

A consistent supply of insulin must match the body's glucose requirements and be present to ensure that:

the energy needs of the cells are met.

Levels of glucose and insulin in the body are controlled by:

the digestive and endocrine systems.

What does a Healthy metabolism require.

oxygen

Oxygen is used by the cell to metabolize glucose into:

energy

All cellular metabolism produces waste products, including carbon dioxide and hydrogen ions, which cause the body to form acids. Aerobic metabolism produces energy with a minimal amount of waste products, which are:

easily managed and removed by the body.

aerobic metabolism yields roughly how many more times more energy than anaerobic metabolism?

16 more times

Without oxygen, metabolism also produces many more waste products. Which are:

Excess carbon dioxide is produced, and hydrogen ions are released and create lactic acid.

Without oxygen, metabolism also produces many more waste products. Excess carbon dioxide is produced, and hydrogen ions are released and create lactic acid. Resulting hypothermia can affect:

blood clotting and many other essential body functions

When the level of carbon dioxide is too high, the body adapts by increasing the respiratory rate to increase:

the rate of carbon dioxide elimination.

High levels of acid in the body affect the oxygen-carrying molecules in the blood, called:

hemoglobin

Hemoglobin's attraction to oxygen is diminished in:

acidotic states.

Hemoglobin's attraction to oxygen is diminished in acidotic states. As a result, less oxygen can be transported by the blood, making it even more difficult to oxygenate tissues. The result is a downward spiral of events in which lack of oxygen creates an acidotic state, decreasing the ability of:

the blood to carry oxygen to the cells and causing an even more severe acidotic state.

the levels of oxygen and carbon dioxide in the body are controlled by

the respiratory and cardiovascular systems.

The oxygen necessary for __________________________is supplied by the respiratory system and carried to the cells by the ____________________________.

aerobic metabolism, cardiovascular system

The process of______________moves oxygen across the thin membrane from the alveoli to the capillaries.

diffusion

To provide adequate quantities of oxygen, inhaled air must reach the ___________________________, and blood must reach the ____________________________.

- alveoli of the lungs

- capillaries that surround the alveoli.

Carbon dioxide follows an opposite pathway to oxygen, being transferred from:

the cells to the blood in the adjacent capillaries, then being off-loaded from the capillaries into the alveoli of the lungs by a similar process of diffusion, then being exhaled.

The removal of carbon dioxide also helps regulate:

acid levels in the body.

Many disease processes alter its permeability:

its ability to effectively transfer fluids, electrolytes, and other substances in and out of the cell

Homeostasis is regulated in:

the brain and is maintained through a delicate balance of nervous system feedback and messaging.

What Key brain structures receive sensory input and recognize challenges such as increasing carbon dioxide levels, hypoxia, and blood loss?

hypothalamus and the medulla oblongata

The central nervous system can be divided into two basic categories:

The parasympathetic nervous system controls “feed or breed” functions, and the sympathetic nervous system responds in “fight or flight” situations

The parasympathetic nervous system controls "feed or breed" functions:

chemical messengers called neurotransmitters regulate functions such as digestion and reproduction. The parasympathetic nervous system dominates when the body is at rest, and is typically responsible for slowing down the heart and reducing blood pressure.

sympathetic nervous system responds in "fight or flight" situations:

has evolved over time to offer protection in times of danger.

Epinephrine and norepinephrine cause bronchial tubes in the lungs to dilate, enabling better gas exchange. They cause the heart to:

pump harder and faster, thereby increasing blood flow to skeletal muscle and vital organs.

Epinephrine and norepinephrine have potent effects on the circulatory system, causing blood vessels to constrict. These effects have:

profound impact with regard to compensation but can also become problems themselves if the body fails to regulate them properly.

Describe Addison's disease :

a state of adrenal insufficiency in which the body essentially lacks sympathetic response. The net result can be crisis states of vasodilation and shock.

Many people take these medications to help regulate high blood pressure, but their presence can impair compensation in times of need. These are known as:

Beta blockers.

- a classification of medication that reduces the effects of epinephrine and norepinephrine on the body.

This is an old saying in EMS, referring to the proper function of the respiratory system and the cardiovascular system.

"Air goes in, air goes out, and blood goes round and round".

The functions and effects of these two systems(The respiratory system and the cardiovascular system), are so intertwined that they are often referred to as a single system:

the cardiopulmonary system.

Typically, inhaled air contains mostly ___________ amount of nitrogen but also ____________ amount of oxygen.

- 79% nitrogen

- 21% oxygen

The lungs (pulmonary system), heart, blood vessels, and the blood itself (cardiovascular system) work in concert to deliver oxygen and nutrients to the cells and to remove waste products from the cells. These basic operations rely on the coordinated movements of:

Blood and Air.

The respiratory system begins at:

the airway

The airway is made up of the structures from the:

mouth and nose to the alveoli of the lungs.

The alveoli are where the exchange of:

oxygen and carbon dioxide with the blood takes place.

Each bronchiole terminates in a tiny air pocket called an:

alveolar sac

The alveoli are encased by networks of capillaries; in which:

oxygen and carbon dioxide are exchanged between the air in the alveoli and the blood in the capillaries.

Moving air in and out of the chest requires an open pathway. In EMS, we refer to this open pathway as a:

patent airway.

Upper-airway (above the trachea) obstructions are common. These obstructions can be caused by:

- foreign bodies (as in a person choking),

- infection (such as in a child with croup), or even by

- trauma or burns causing the soft tissue of the larynx to swell.

The lungs are part of the lower airway which means:

below the opening of the trachea.

The lungs, together with the diaphragm and the muscles of the chest wall, change their internal pressures to:

pull air in or push air out.

We multiply tidal volume by the respiratory rate to obtain:

minute volume

About 150 mL of a normal tidal volume occupies the space between the mouth and alveoli but does not actually reach the area of gas exchange. We refer to this as:

dead air space

A section of the brain called the _____________________________ is the seat of respiratory control

medulla oblongata

What can disrupt the medulla's function and alter the control of effective breathing:

- Medical events such as stroke and infection

- Toxins and drugs such as narcotics

- Brain trauma and intracranial pressure

What large muscle forms its lower boundary just below the rib cage.

the diaphragm

The lungs are in direct contact with the inner walls of the chest. Although they are in contact, there is a slight space between the lung tissue and chest wall called the:

pleural space.

A pleural spaces light negative pressure keeps the lungs:

adhered to the chest wall as it moves

The area between the lung and the chest wall is also a potential space where blood, fluid, and/or air may accumulate as a result of:

chest trauma or other medical conditions.

Ventilation is activated by:

changing pressures within this vault

Inhalation is an:

active process.

To inhale, the diaphragm contracts, the muscles of the chest expand, and a negative pressure is created in the chest cavity and lungs. This negative pressure pulls air in through the trachea. This is known as:

Inhalation(active process)

exhalation is a:

passive process

To exhale, those same muscles relax to make the chest contract, creating a positive pressure that pushes air out. This known as:

Exhalation(passive process)