Exam 2
Vital Signs and Measurements ( Part B )
Body measurements
Adults and Teens
Height
Weight
Infants
Length
Weight
Head circumference
Chest circumference
Adults weight
Happens each office visit
Record to nearest quarter of a pound
Height of adults
Initial visit and yearly
Record to nearest quarter of an inch
Kg = lbs / 2.2
Lbs = kg x 2.2
Body mass index (BMI)
Not an indicator of health
Used to correlate risk factors
Based on height
and weight
18.5 - 24.9 - Normal
Over 24.9 - Overweight
Over 30 - Obese
Over 40 - Morbidly obese
High risk for diabetes & heart problems
Measurements Infants
Height, head and chest circumference -
Lay the child on a paper-covered table.
Place mark at top of head and at the heel of the flexed foot.
Measure head circumference at the widest area, across eyebrows.
Measure chest circumference, under arms.
Return infant to caretaker.
Measure marks on the table in inches for height.
Pulse Oximetry
Not normally considered a vital sign.
Reading of oxygen saturation in blood.
Also displays pulse reading (heart rate)
Probe is attached to finger or earlobe to obtain reading.
Nail polish blocks light, interferes with test.
Normal reading - 95% or higher.
Week 2: Intergumentary System
The accessory organs include: hair follicles, fingers and toe nail, skin glands
First line of defense against bacteria, viruses ( UV radiation and Dehydration )
Body Temp: if you're too hot your vessels will dilate, meaning that more blood is sent to the surface so heat escapes. If your too cold your vessels will constrict, meaning it will prevent heat from escaping
1) epidermis
Contains Keratin ( hard protein that makes up hair & nails )
Epithelial tissue, no blood vessels, no bleeding if scraped
Melanocyte ( skin cells ) - makes the pigment melanin
Skin color changes
Erythema ( red ) - flushing of the skin when blushing due to dilated blood vessels
Pallor Pale - anxiety and cold cause blood vessels to constrict
Cyanosis - bluish tint to the skin when it is not getting enough blood
2) Dermis
Contains the following; BV, arteries, veins, capillaries and nerves, sweet glands, hair follicles
3) Subcutaneous layer
Connective tissue
Has adipose tissue ( fatty layer )
Types of Glands
Sudoriferous glands : also known as sweet glands.
Eccrine glands: distributed throughout the body, produce fluid to regulate body temperature
Apocrine glands: axilla and pubic area, break down odor
Sebaceous glands: Secrets an oily substance called sebum, adds a protective layer and prevents fluid loss
Skin lesions
Neoplasm ( new growth )
Petechiae ( Ruptured skin capillaries )
Pediculosis ( lice infestation )
Ringworm ( Tinea corporis ) (( fungus infection, circulars lesions )
Rosacea ( Dilation of facial Blood vessels, redness)
Skins disorders and Diseases
Alopecia - hair loss
Acne Vulgaris - Black heads, white head, pustules
Cellulitis - Bacterial Infection
Dermatitis - Inflammation with rash
Eczema - Itchy, red, scaly rash
Herpes Simplex - Blisters, mouth, lips, face
Impetigo - Bacterial Infection, itchy, oozing skin
Keloid - An overgrowth of scar tissue
Nodule - Small growth under the skin
Basal cell carcinoma - sun exposure, new growth wont heal
Squamous cell carcinoma - sun exposure , spread to surrounding tissue
Malignant melanoma (most aggressive ) - sun exposure, itchy, bleeding mole with changes
Burns
Rules of nines ( % of body that is burned)
1st Degree - superficial ( epidermis ) = pain, redness, swelling ( sunburn
2nd Degree - Partial - thickness = includes subcutaneous tissue, blisters
3rd Degree- Full thickness = all layers of skin, muscle, possible bone
Charred skin
Week 2: Skeletal System and Muscular System
Axial Skeleton- 80 bones ( skull, vertebrae, and ribs )
Appendicular skeleton - 126 bones ( arms, legs, pelvic girdle
Ligaments attached bone to bone for joint stability
Bone shapes
1) Long bones ( has 3 cavities )
Epiphysis ( end part of a long bone )
Diaphysis ( the shaft or central part of a long bone (
Medullary cavity - hollow part of bone that contains bone marrow
Examples of long bones are: femur, humerus, tibia, ulna, radius
2) short bones
Found in wrist and ankles
3) Flat bones
Flat or curved
Found in the skull and ribs
4) Irregular bones
Shape related to the function
Vertebrae, pelvis
The skull has the cranial and facial bones
Facial bones are : mandible ( lower jaw ), maxilla ( upper jaw), Zygomatic ( cheekbone )
The spinal column
Cervical vertebrae= neck
Thoracic vertebrae = chest
Lumbar vertebrae = low back
Sacrum
Coccyx ( tailbone )
Rib cage = sternum ( breastplate ). They attached to the sternum
Shoulders = clavicles - collar bones, scapular - shoulder blade
Arms bones = humerus, radius, Ulna
Hand = carpals, metacarpals, phalanges
Legs bones = femur, patella, tibia, fibula
Hip and pelvis = ilium, sacrum, ischium, pubis, coccyx
Foot bones = Tarsals, metarsals, phalanges
Muscles = 600 total muscle
Skeletal muscle = striated voluntary,
Smooth muscle = found within the walls of hollow organs, involuntary
Cardiac Muscle = in the heart, involuntary
Tendon = located at the ends of skeletal muscles, attach muscles to bone
Arthritis
1) osteoarthritis - “ wear & tear “ , joint stiffness and pain, Degenerative joint Disease
2) Rheumatoid arthritis - autoimmune
Chronic system inflammatory system
Visible joint deformity
Disease and Disorder
Bursitis - joint pain and swelling
Ewing sarcoma- type of tumor that forms in bone or soft tissue, ages 10 - 20 years
Gout - arthritis due to uric acid crystals in joints
Osteogenesis - brittle bone disease, herediary
Osteoporosis - disease of the elderly, causes fractures of the spine, loss of height
Osteosarcoma - bone cancer that usually develops in the cell that form bone, must often in children, adolescent, and young adults
Kyphosis - Hunchback
Lordosis - Swayback
Scoliosis - S - shaped of the spine
Paget’s disease - bone enlarge, becomes deformed, and weak
Fibromyalgia - chronic body pain
Muscular dystrophy - inherited disorder, muscule do not develop properly
Atrophy - Condition where muscles shrink do to lack of nervous stimulation or use
Tendonitis - sports related, pain in joints
Myasthenia gravis - autoimmune disorder double vision, muscle weakness, difficulty chewing and breathing
Tetanus - Muscle spasms in jaw and neck caused by the toxin and cause death ( Clostridium tetani )
Week 2: CardioVascular System
Layers of the heart :
1) Endocardium - Innermost layer, lines the atria and ventricles
2) Myocardium - Muscular layer
3) Pericardium - Outermost are, a membrane that surrounds the heart and secretes pericardial fluid
Four chambers
1) Two atria - upper chambers
2) Two ventricles - lower chambers
Heart valves
Valves between atria and ventricles - AV valves
Tricuspid = between right atrium and right ventricle
Bicuspid ( Mitral ) = Between the left atrium and the left ventricle
Valves between ventricles and arteries - semilunar valves
Pulmonary
Aortic
Artery/Arteriole
Carry blood away from the heart (oxygenated)
Aorta, leaves heart, sends oxygenated blood to the body
Vein/Venule
Carry blood to the heart from the body (deoxygenated)
Superior vena cava - brings blood from the head and arms to the heart
Inferior vena cava - brings blood from the abdomen and legs into the heart.
Gas Exchange:
Pulmonary arteries to lungs
Pulmonary veins from lungs
Capillaries
Smallest blood vessels
Connects arteries to veins
Aid in exchange of oxygen and nutrients between blood and cells
Electrical System of the heart
Heart rate = number of times your heart beats per minute
Heart rhythm = synchronized pumping action of the four heart chamber
SA node = called the pacemaker of the heart, sends out an electrical impulse. Sinoatrial Node = right atrium
The AV node sends an impulse into the ventricles, through the Bundle of His, to the bundle branches, through the Purkinje fibers
One heartbeat = one cardiac cycle
Atrioventricular node = Between atria and just above ventricle, send impulse to the Bundles of His
Bundles of His
Located between ventricles
Right and left bundle branches
Send impulse to purkinje fibers
Purkinje fibers
Lateral walls of ventricles
Ventricles contract
Systole: period during which the chamber is contracting and blood is being ejected.
Diastole: period of relaxation during which the chamber is filling.
Cardiac Output= how fast and strong the heart beats. Including Blood Volume
Vasoconstrication and Vasodilation = Blood viscosity ( thickness )
Disease and Disorders
Chest pain (Angina )
Myocardial infarction = heart attack. Causes of heart attack: coronary artery blockage, atherosclerosis, blood clot, ischemia ( restriction of the flow of oxygen- rich blood to the heart
Atherosclerosis - deposition of plaques of fatty material on the inner walls
Hypertension ( high blood pressure ). Risk factors : obesity, smoking, kidney disease, excessive alcohol intake
Coronary Artery System
Buildup of fat and cholesterol in the arteries, Ischemia = restriction of the flow of oxygen-rich blood to the heart. Risk factors = High fat diet, smoking, obesity, sedentary lifestyle
Aneurysm
A ballooning in the wall of an artery
Causes = atherosclerosis
Risk Factors = obesity, smoking, high cholesterol diet
Congestive heart failure
causes : hypertension, previous heart attack
Risk Factors : high fat diet, smoking, obesity, sedentary lifestyle
Thrombophlebitis
Blood clot forms blocking veins in usually in the legs
Risk factors: prolonged periods of inactivity, hormone replacement therapy, cancer, paralysis
Mitral Valve prolapse
Has backflow of blood
Cardiac causes = unknown, hereditary
Symptoms = None, shortness of breath, Palpitations
Week 2: Blood
4-6 liters per adults, 8% of body weight
The functions: carries oxygen and nutrients. Removes carbon dioxide and wastes. Regulations of body temperature.
Erythrocytes are red blood cells
- stay in the body for only 120 days
- very very smal
RBC
- produced in the red bone marrow
- Erythropoietin is a hormone
4 million and 6 million = rbc count
Anemia is low rbs
Polycthemia = increase in red blood cells, causes blood to be thicker and more dense
Hematocrit
- packed red cell volume
- normally about 45%
Hemoglobin
- carries oxygen to the body
Yellow is plasma, clear is Buffy coat, red is hematocrit
Leukoctyes
White blood cell
immunity / protects the body against infectious disease and foregin invaders
Types of wbc
- neutrophils
55% ( bacterial infections )
- eosinophils
3% ( asthma, allergic reactions and parasite infections )
- basophils
1% ( relasese histamine and heparin)
- lymphocytes
Make antibodies ( T- cells and B - cells )
- monocytes
Largest destroy germs and eliminate infected cells
WBC count is normally 5000 to 10,000
Leukocytosis - high white blood cell count
Leukopenia - low white cell count
Platelets - Thrombocytes ( needed for the clotting process )
- Thrombocytosis - high platelet level
- Thrombocytopenia - low platelet levels
Termonlogy
- Hemostatsis - the control of bleeding stopping of a flow of blood
- Coagulation - process of clotting formation of a blood clot
Thrombus - a stationary clot
Embolus - traveling clot
Plasma
Contains anticoagulant
Laregts portion of blood ( 55% )
Light yellow
Carries water, nutrients, hormones, and proteins to the body
Used to remove waste from the body
Serum
Obtained by collecting blood into a tube without an anticoagulant allowing it to clot and then centrifuging
Rh factor - an inherited protein found on thesurface of red blood cells
- has the protein = Rh positive
Lacks the protein = Rh negative
Dieases and Disorders
- Anemia = decreases rbcs
Leukemia - bone marrow produces a large number of abnormal wbc’s
Sickle cell anemia - rbc’s to change to a sickle shae and cant carry oxygen
Polyctemiavera - disease of the bone marrow that results in an abnormally high number of blood cells
Thalassemia - inherited form of anemia; defective hemoglobin chain causes,small, pale and short- lived rbcs
AB blood type = universal recipient
O blood type = universal donor
Week 2: Lymphatic and Immune System
Lymphatic system
Organs = thymus, spleen ( largest ) , lymph nodes, lymph nodules, interystitital fluid ( adenoids, tonsils )
Lymp flows through = vessles, capillaries, nodes
They also = collfect fluid, start immune response, delivers the fluid, remove pathogen
Lymph nodes
Neck, axilla, groin
Produces and store lymphocytes
Has macrophages
Lymph nodules
Also in spleen and tonsils
Has macrophages and lymphocytes
Immune system
Protects against pathogens
Thymus
- makes T - cells
Larger in children
Assist with production of lymphocytes for the child’s immature immune system
When the thymus is functional then it will become nonexistent
Spleen
Largest lymphatic organ
Has macrophages fliter blood
Upper left quadrant of abdominal cavity
Interstitial fluid
- fluid between cells
T- Cells = attacs cells
B - Cells = make antibodies
Antibodies = ( Y-shaped ) produced to respond to specific antigens
- produces white blood cells to help eliminate diease- casuing microbes from the body
Immunoglobulins - also known as antibodies
Naturally acquired active immunity
- person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the primary immune response. ( chickenpox )
Artificially acquired active immunity
From injection of a vaccination
Naturally acquired passive immunity
Passed along from mother to child
Artifically acquired passive immunity
- patient injected with antibodies by injection or infusion made by someone else
Autoimmune disease = condition in which the immune system mistakenly attacks the body
Examples: graves disease, lupus, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, gullain - barre syndrome
Immnocompetent = normal functioning immune system
Immunodeficient, Immunosuppressed, Immunocompromised
A state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent.
Opens the body up for:
Opportunistic Infections – infections a normal immune system would be able to fight off.
AIDS - development of serve signs and symptoms caused by HIV as it destorys T cells;
Lymphedema - blockage of lymphatic vessels resulting in tissue swelling, can be caused by parasitic infection, trauma, or surgical removal of lymph nodes
Mononucleosis = mono , caused by the epstein barr virus ( EBV )
Systemic lupus erthematosus ( SLE ) -autominne disorder , affetcs way more women than men, casues butterfly rash on face
Celiac disease - chronic digestive and immnue disorder that damages the small intestine
Week 2: The Respiratory System and Special Sense
The organs are: Nose, Pharynx, Larynx, trachea, brohcieal Tree, Lungs
Nose - made of bones, cartilage and skin. Has small hairs ( cilia ) prevent particiles from entering
Pharynx - Back of the throat . Work with digestive system
Larynx - voice box . Epiglottis = flap that diverts throat contents to the trachea or esophagus
Trachea- main airway that extends from larynx and branches into bronchi
Lungs
Bronchi, aleveloi, and BV
Right lung is larger
Surrounded by pleura membrane
Bronchi = two large tubes that carat air from the windpipe to the lungs
Alveoli = air sacs where oxygen and carbon dioxide exchanges
Respiration
External Respiration = exchange of oxygen within lungs
Internal Respiration = exchange of oxygen within hemogolbin of a red blood cell
Volumes
Tidal Volume = nomral breathing
Inspirator volume = forcefully inhaled following a normal inhalation
Expiratory volume = forcefully exhaled following a normal inhalation
Residual volume= air left in the lungs
Vital Capacity = forcefully exhaled after the deepes inhalation possible
Total Lung capacity = total amount of air the lungs can hold
Pulmary function testing = Spirometry , commonly used for COPD, and asthma
Disease and Disorders
Asthma = inflammation in the airways, wheezing, coughing
Atelectasis = the collapse of part or all of a lung, blockage
Bronchitis= inflammation of the bronchi often due to infection: yellow- gray or geen mucus, fever, coughing
COPD- a group of lungs disorders that limit airflow to lungs and usually cause enlargement of the alveoli
Emphysema- Damage to the alveoli from smoking- caused by COPD
Legionnaires diease - bacteria the affect the uppers respiratory system. Caused of contaminated water or air
Intro to Special Senses
Vision
Hearing
Taste
Smell
Touch: eyes, ears, tongue, nose
Structue of the Eyes
Sclera = White portion
Pupil = center opening
Cornea = clear covering in the center
Iris = colored portion
Retina = captures vision input
Conjuctiva= clear coating on the outside of the eye
Lens= allows the yes to focus on objects at varying distance. Behind the iris and in front of the vitreous body. Changes shapes, bends light to focus properly on the retina
Terms
Accomodation - ability of the lens to change shape
Refraction = the bending of the light that enters the eye to focus it on the retina: cornea performs this function
Diease and Disorder of the Eyes
- Astimatsim - cornea or lens has abnormal shape
Myopia - dysfunction of the lens. Nearsighted ( cannot see far away )
Hyperopia - Dysfunction of the lens . Farsighted cannot see close up.
Blepharhits - inflammation of the eyelid
Conjuctivties = pink eye
Strutcure of the Ear
- Pinna - also called the auricle ( outer ear )
Malleus, uncus and stapes = ossicles - bones of the ear
Cochlea - healing receptor
Labyrinth - inner ear
Organ of Corti- organ of hearing
Tympanic Membran = eardrum (sound waves cause it to vibrate) detects balance
Eustachian tube- connects throat to the middle ear.
The Nervous System
Helps to maintain homeostasis in the body system
Spinal Cord
Provides pathway for nerves impulse to and from the brain
Extends from the base ot brain to lumbar vertebrae
Meninges
1) dura mater - outer layer, closet to the skull
2) arachoid mater - middle layer
3) Pia mater - inner layer closest to the brain tissue
Cerebospinal fluid ( CSF)
Brain and spinal cord float in this fluid
Neuron
Functional unit
Dendrites
Tree like structures
Appendages that receive communications from other cells
Axon
Nerve fiber, stores neurotransmitter,
Myelin sheath , protective layer that wraps around the axons . insulates the neuron, controls the number of electrical signals being transmitted
CNS - brain , spinal cord
PNS - nerves found throughout the body. 12 pairs of cranial nerves and 31 pairs of spinal nerves. They can be somatic nervous system and autonomic nervous system.
SNS= neurons carry info, controls the body’s voluntary skeletal muscle
ANS = controls body automatic functions ( breathing , digestion )
Sympathetic branch= controls fight or fight response to stress
Parasympathetic branch = returns body to resting state after stress. ( homeostasis )
Testing
- station
- proprioception
Disease and Disorder
1) Paraplegia - paraylsis of the legs
2) quadriplegia - paraylsis of the arms and legs
3) hemiplegia - paralysis of ½ of the body
4) monoplegia - impact one limb
Neuralgia ( nerve pain )
Amyotrophic lateral sclerosis ( degenerative and fatal disorder of the CNS, lou gehrig’s diease
Parkinsons- progressive and degenerative motor system disorder, casuing tumors
TIA ( transient Ischemic attack ) ( mini stroke
Bell’s Palsy ( weak or paralyzed facial muscles )
Epilepsy ( seizures resulting brusts of electrical signals in the brain
Stroke ( CVA ) - a blood vessel in the brain is either blocked by a clot or bursts. Brain damage
Cluster - form of a headaches that attacks occur in groups
Migraines - most severs form of a headaches. Nausea/ vomiting and light sensitivity
Guillain - Barre Syndrome = autoimmune attacks the PNS
Kinesthesia = awareness of the position and movement of the parts of the body by means of sensory organs in the muscles and joints