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What four conditions must be fulfilled for a patient to AMA?

Patient must be legally able to consent, they must be awake and oriented, they must be fully informed, they must be asked to sign a "release" form

In what situations can a patient not AMA?

When they are a threat to themselves or others, when they are intoxicated, as a court order

What is hypovolemic shock?

Condition that occurs when there is an insufficient volume of blood in the circulatory system

What are the two main types of hypovolemia?

Absolute and relative

What is absolute hypovolemia?

Involves the actual loss of blood from the body, such as through internal or external hemorrhage

What is relative hypovolemia?

The blood volume is not lost but is shifted out of the circulatory system. Conditions like dehydration or burns can cause the plasma, the liquid part of the blood, to move out of the blood vessels

What is distributive shock?

Occurs when there is a loss of blood vessel tone, leading to widespread dilation of blood vessels

What can cause distributive shock?

Anaphylaxis, sepsis, neurogenic shock

What is anaphylactic shock?

A severe allergic reaction that causes blood vessels to dilate

What is septic shock?

A severe allergic reaction that causes blood vessels to dilate

What is neurogenic shock?

Often caused by spinal cord injuries, leading to loss of sympathetic nervous system control over blood vessel tone

What are Alpha 1 receptors responsible for?

Vasoconstriction, which increases blood pressure

Which neurotransmitters activate Alpha 1 receptors?

Epinephrine and norepinephrine

What would Alpha 1 blockers do?

Cause vasodilation

What are Beta 1 receptors responsible for?

Increase heart rate and the force of contraction, increased cardiac output

Which neurotransmitters activate Beta 1 receptors?

E and dopamine

What would Beta 1 blockers do?

Parasympathetic response, decreased cardiac output

What are Beta 2 receptors responsible for?

Cause bronchodilation, allowing more air to move through the bronchioles

Which neurotransmitters activate Beta 2 receptors?

E

What would Beta 1 blockers do?

Bronchoconstriction, tightening of the airway

What are the three different layers of the heart?

Pericardium, myocardium, endocardium

What is the pericardium?

The outermost layer, a protective sac that surrounds the heart

What is the myocardium?

The middle layer, the thickest layer, consists of cardiac muscle tissue. Responsible for the heart's pumping action

What is the endocardium?

Innermost layer of the heart, lines the heart chambers and covers the heart valves, providing a smooth surface for blood flow and reducing friction

What are the four steps of the transmission pathway for electrical signals (impulses) in the heart?

Initiation, pathway, transmission, distribution

What happens during the initiation phase of the cardiac impulse pathway?

Impulse begins at the sinoatrial (SA) node, the heart's natural pacemaker. Generates electrical impulses that set the pace for the heart rate

What happens during the pathway phase of the cardiac impulse pathway?

Impulses travel through the atria, causing them to contract and push blood into the ventricles. The impulse then reaches the atrioventricular (AV) node

What happens during the transmission phase of the cardiac impulse pathway?

Impulse moves down the atrioventricular bundle, which splits into right and left bundle branches, directing the impulse to the ventricles

What happens during the distribution phase of the cardiac impulse pathway?

Impulse spreads through Purkinje fibers, ensuring the ventricles contract in a coordinated manner to pump blood out of the heart

What are pacemaker cells?

Specialized heart cells responsible for initiating and regulating the heart's electrical impulses, ensuring a consistent heartbeat

What are the four different nodes/bundles of pacemaker cells?

Sinoatrial (SA) Node, Artioventricular (AV) Node, Bundle of His, Purkinje Fibers

What is the firing rate for the SA node?

60-100 bpm

What is the firing rate for the AV node?

40-60 bpm

What is the firing rate for the Bundle of His and the Purkinje Fibers?

20-40 bpm

What is stable angina?

Ischemic chest pain that occurs predictably with exertion or stress and is relieved by rest or medication like nitroglycerin

How is stable angina managed?

Patients are generally stable, allowing for a slower pace in assessment and treatment. Reassessment is typically done every 15 minutes if the patient remains stable

What is unstable angina?

Ischemic chest pain that occurs unpredictably, even at rest, and may not be relieved by rest or medication. It indicates a higher risk of heart attack

How is unstable angina managed?

Requires rapid assessment and intervention. Patients are considered unstable, necessitating reassessment every 5 minutes and prioritizing rapid transport to a medical facility

What is an abdominal aortic aneurysm (AAA)?

Aneurysm in the abdominal (stomach) section of the aorta, involves a ballooning or weakening of the aortic wall that can rupture suddenly or leak slowly, leading to severe internal bleeding

What is a thoracic aortic aneurysm (TAA)?

Aneurysm in the thoracic (chest) section of the aorta, involves a ballooning or weakening of the aortic wall that can rupture suddenly or leak slowly, leading to severe internal bleeding

What is an aortic dissection?

Inner layer of the aorta begins to tear, which allows blood to flow between the layers of the aorta's wall, rather than through the main channel, can cause the layers to separate further

What are some typical presentations of a MI?

Chest pain, radiating pain to the neck, jaw and arms, dyspnea, nausea, vomiting, syncope, sweating

What are some atypical presentations of a MI?

Absence of chest pain, back pain, hip pain, SOB, weakness, fatigue, no symptoms until cardiac arrest occurs

What are some causes of left-sided heart failure?

Often results from damage to the left side of the heart, such as from a myocardial infarction or chronic hypertension

What are some symptoms of left-sided heart failure?

Leads to pulmonary edema, where fluid accumulates in the lungs, causing difficulty breathing and hypoxia

What happens during left-sided heart failure?

Left side of the heart fails to pump blood efficiently, causing pressure to build up in the pulmonary veins. This pressure forces fluid into the lung tissue and alveoli, impairing gas exchange

What are some causes of right-sided heart failure?

Typically follows left-sided heart failure or is due to pulmonary conditions

What are some symptoms of right-sided heart failure?

Causes systemic edema in the lower legs, abdomen, along with JVD

What happens during right-sided heart failure?

Right side of the heart fails to pump blood efficiently, leading to pressure buildup in the systemic circulation. This results in fluid leakage from capillaries into body tissues

What is the effect of nitroglycerin on the body?

Used to dilate the coronary vessels, which supply blood to the heart muscle. This helps alleviate chest pain, often associated with angina or heart attacks

What is the effect of aspirin on the body?

Reduces the blood's clotting ability, which is crucial in preventing and treating clots during a myocardial infarction. Does not prevent clots from forming, just prevents them from getting bigger

What is pulmonic circulation responsible for?

Responsible for transporting deoxygenated blood from the right side of the heart to the lungs

What is the pathway for pulmonic circulation?

Blood travels from the right ventricle through the pulmonary arteries to the lungs. After oxygenation, it returns to the left atrium via the pulmonary veins

What is systemic circulation responsible for?

Delivers oxygen-rich blood from the left side of the heart to the rest of the body, providing oxygen and nutrients to tissues and organs

What is the pathway for systemic circulation?

Oxygenated blood is pumped from the left ventricle through the aorta and distributed via systemic arteries. Deoxygenated blood returns to the right atrium through systemic veins

What is a normal adult tidal volume?

500 mL

What are chemoreceptors?

Chemoreceptors are specialized chemical sensors located in the brain and blood vessels

What is the primary function of chemoreceptors?

Detect changes in the levels of oxygen and carbon dioxide in the blood, as well as the body's acid-base status (pH). Help initiate compensatory mechanisms, such as increasing heart rate and constricting blood vessels, to improve oxygen delivery and carbon dioxide removal during periods of distress

What is the phrenic nerve and what is it responsible for?

Carries messages to the diaphragm, which is the primary muscle involved in breathing. Originates from the cervical spinal cord, specifically C3, C4 and C5

What is cortisol?

Hormone produced by the adrenal glands, plays a significant role in the body's response to stress and is crucial for maintaining various bodily functions

How does cortisol affect the body?

Helps regulate metabolism, modulates immune system, controls inflammation, cortisol levels increase during periods of stress

What is adrenaline?

Epinephrine, hormone and neurotransmitter that plays a crucial role in the body's "fight or flight" response

How does adrenaline affect the body?

Increases cardiac output, dilates the airways, vasoconstriction, elevates blood sugar

What is an ischemic stroke?

Stroke that occurs when a blood clot or embolism blocks an artery supplying blood to the brain, leading to a lack of oxygen and potential brain tissue damage

What are thrombolytics?

Treatment used for ischemic strokes, involves administering clot-busting drugs to dissolve the clot and restore blood flow to the brain

What is the reticular activating system?

Series of neurologic circuits in the brain that play a crucial role in regulating consciousness

What are the main functions of the reticular activating system?

Staying awake, paying attention, sleeping

What are the different divisions of the cerebrum?

Divided into two hemispheres, includes the sensory cortex, motor cortex, frontal lobe, limbic system, Broca's area, Wernicke's area, and the hippocampus

What is the sensory cortex of the cerebrum responsible for?

Processing sensory information such as touch, sight, hearing, taste, and smell

What is the motor cortex of the cerebrum responsible for?

Initiates, coordinates, and controls voluntary movements in the body

What is the frontal lobe of the cerebrum responsible for?

Higher-level brain functions like thinking, reasoning, memory, problem-solving, and decision-making

What is the limbic system of the cerebrum responsible for?

Plays a significant role in regulating emotions and aspects of personality

What are Broca's area and Wernicke's area of the cerebrum responsible for?

Language comprehension and speech production

What is the hippocampus of the cerebrum responsible for?

Crucial for forming new memories and learning

What is the cerebellum responsible for?

Motor coordination, balance and posture/muscle tone, motor learning, refinement of movement

What is the brainstem responsible for?

Breathing, heart rate and blood pressure, swallowing and digestion, circadian rhythm, reflexes, communication between brain and spinal cord

What components make up the diencephalon?

Thalamus, hypothalamus, epithalamus and subthalamus

What is the thalamus responsible for?

Relay station, receives sensory information and relays it to the appropriate areas of the cerebrum for processing

What is the hypothalamus responsible for?

Homeostasis, endocrine system, emotions and behavior

What is the epithalamus responsible for?

Includes pineal gland, which is involved in regulating sleep patterns by producing melatonin

What is the subthalamus responsible for?

Involved in regulating motor control and is closely connected with the basal ganglia

What are the different layers of the meninges?

Dura mater (outermost), arachnoid mater (middle), pia mater (innermost)

What is a synapse?

Junction between two nerve cells, the space where electrical impulses/neurotransmitters are transmitted from one neuron to another

What are neurotransmitters?

Chemical messengers in the body that play a vital role in transmitting messages between neurons, specifically in the brain

What is an action potential?

A rapid, temporary electrical signal that travels along the axon of a neuron, how neurons send signals over long distances

How do chemical messages enter the neuron?

Neurotransmitter is released form the presynaptic neuron into synaptic cleft, neurotransmitter binds to receptors on postsynaptic neuron, binding causes ion channels to open which initiates a change in electrical potential, may trigger an AP if stimulus is strong enough

Where do neurons process information?

In the cell body where the nucleus is located, which maintains the cell and integrates signals from other neurons, can generate an AP in the axon hillock when stimulated strongly

Where do neurons send information?

Down the axon towards axon terminals which are connected to other neurons, muscle groups, or glands

How do neurons transmit information to other neurons?

When AP reaches axon terminal, it causes the release of neurotransmitters which cross the synapse and bind to receptors on the next neuron which causes the cycle to repeat

What are the two classes of signal that a neurotransmitter can carry to a postsynaptic neuron?

Excitatory and inhibitory

What is serotonin?

Neurotransmitter that is involved in regulating mood, behavior, and various physiological processes. Associated with happiness

Is serotonin excitatory or inhibitory?

Can be both excitatory and inhibitory

What is GABA?

Neurotransmitter that is essential for regulating mood and behavior, and it is often a target for medications that aim to treat anxiety and other related disorders

Is GABA excitatory or inhibitory?

Inhibitory

What is dopamine?

Neurotransmitter that influences mood, motivation, and attention. Associated with pleasure and reward

Is dopamine excitatory or inhibitory?

Can be both excitatory and inhibitory

What is acetylcholine?

Primary neurotransmitter of the PNS

Is acetylcholine excitatory or inhibitory?

Can be both excitatory and inhibitory

What is norepinephrine?

Neurotransmitter that regulates the SNS, produced by adrenal glands and prepares body for action

Is norepinephrine excitatory or inhibitory?

Excitatory