CBL Flashcards
1
Q
why do paramedics need CPR
A
- paramedics ability to perform CPR can directly affect the patient’s outcome of survival after cardiac arrest
- survival rates double after rapid initiation of CPR
2
Q
what is the relevance of cell proliferation to paramedics
A
- shows how different tissues are affected by cell death and trauma
- knowing which cells will be able to rapidly proliferate will help paramedics make informed decisions of necessary treatments
- help reduce any long-term problems
3
Q
what cellular process uses oxygen
A
aerobic respiration - use of oxygen and glucose to make water Co2 and ATP
- oxygen is the final electron acceptor
- needed in the continuation of the cycle
4
Q
what cellular processes produce CO2
A
- only released in aerobic respiration
- waste product for the breakdown of glucose when creating pyruvate and NADH
5
Q
is oxygen always good for a cell
A
- O2 binds to haemoglobin to transport it around the body to supply oxygen to body cells
- necessary for cellular respiration
- too much leads to oxygen toxicity, too high a partial pressure leads to hyperoxia
- too high a concentration at high partial pressure, becomes toxic and cells die
- abnormal partial pressures and concentration can be detrimental to cells
6
Q
what are the consequences of having too much carbon dioxide in the blood
A
- too high a blood co2 level triggers the body that there is not enough o2, causing the urge to breath
- leads to hypercapnia, which can result in seizures and death
- also causes a rise in blood ph levels making it more acidic this is academia which can trigger acidosis (can’t balance pH so damages cells)
7
Q
show an understanding of the gross anatomy of the lungs and the lower respiratory tract
A
- trachea is medial in the body, anterior to the oesophagus
- bronchi originate from the trachea and feed the lungs entering the medial portion of the lungs
- bronchopulmonary segments are areas of the lung that are supplied by segmental bronchus at the tertiary stage of division
- apex of lung above clavicle
- lung has a double membrane - parietal pleura and visceral pleura, providing lubrication to reduce friction
- right lung in 3 lobes, left lung in 2 lobes
8
Q
describe the anatomy of the chest wall including osteology, joints, muscles and the neurovascular
A
- bones in thorax: 12 pairs of ribs, 12 vertebrae
- sternum: body, manubrium, xiphoid process, sternal angle and xiphisternal joint
- costovertebral joints connects the ribs and vertebrae
- muscles in thorax aid movement or ribs and provide strength and support in the thorax
- main muscles are the 3 types of intercostal
- diaphragm used in breathing lies under the lungs
- left common carotid artery and left subclavian artery, internal thoracic and pulmonary veins
9
Q
identify the safest location in which a chest drain could be inserted
A
- inserted into the safe triangle: mid-axillary line, lateral boarder of pec major, imaginary horizontal line from the nipple (usually at the 4th/5th/6th intercostal space)
- done here to minimise risk to surrounding structures, it prevents drain being placed too low which could damage spleen and liver, reduces risk to intercostal vessels and nerves inferior to the ribs
10
Q
describe the anatomical differences of a paediatric and adult airway
A
- similar by there are some differences
- child’s airway is smaller in diameter and shorter in length.
- if child has minor injury or slight swelling this can make it very hard for them to breath
- child’s larynx is higher and more anterior
- child’s is made of more soft tissue so there is a higher chance that it will collapse
- epiglottis in child is horseshoe shaped, shorter and stiffer
11
Q
describe the normal values of respiration from neonates to adults
A
- tidal volume: 4-6ml/kg (neonates), 5-10ml/kg (toddlers + children), 6-10ml/kg (teens), 6-8ml/kg (adults + geriatric)
- respiratory rates: 30-60 (neonates), 20-40 (toddlers), 15-30 (children), 15-20 (teens), 12-20 (adults), 15-20 (geriatric)
- vital capacity: 120ml (neonates), 500ml-1.15L (toddlers), 800ml-2.8L (children), 1.3-4L (teens), 3-5L (adults), decrease 0.2L a decade (geriatric)
- peak expiratory flow rate: 87L (neonates), 87-141L (toddlers), 157-254L (children), 276-540L (teens), 400-700L (adults), 300-560L (geriatric)
12
Q
explain whether the cells of an infant or the elderly would be more likely to have mutations
A
- age can be associated with the increase in mutations
- can be due to: sun exposure, higher rates of radiation, ‘somatic mutations accumulate with ageing in normal tissue, even in individuals who are cancer free’
13
Q
what are the consequences of DNA mutation
A
- harmful mutations, beneficial mutations, neutral mutations
- their effect is dependent on size, location and nature
- can lead to genetic disorders, uncontrolled cell division, abnormalities in rates of apoptosis, hypermethylation or hypomethylation - effect gene expression and lead to cancer, affect tumour suppressor gene
14
Q
which body tissues have the greatest cell proliferation? which tissues proliferate the least?
A
- cardiac muscle: in embryonic development differentiate and then retained throughout life of the organism. they cannot be replaced
- skin fibroblasts, smooth muscle cells, endothelial cells that line blood vessels, epithelial cells of internal organs - all proliferate fast
- least proliferation: blood cells, epithelial cells of the skin and epithelial cells of the digestive tract
- most proliferation: intestinal epithelium, turnover of 3-5 days
15
Q
does cell proliferation differ between infants, young adults and the elderly?
A
- with an increase of age cells become larger so are less able to divide and multiply
- cells function less efficiently in older people which could lead to them functioning abnormally
- aging: tissues lose mass and connective tissue - organs and blood vessels may become ridged
- change to cell membrane making it harder to get nutrients and oxygen as well as being harder to remove CO2
16
Q
Do B-cells and T-cells mature in bone marrow?
A
- B cells – produce antibodies to destroy bacteria/ viruses, activated by t cells
- T cells – produce cytokines – which active other parts of the immune system
- They both arise from the bone marrow
- B cells continue to mature in the bone marrow, but t cells migrate to the thymus
- Once they are matured, they enter the blood stream
17
Q
In what part of bone are blood cells made?
A
- Made in the bone marrow
- Bone marrow is made up of stem cells which produce red blood cells, white blood cells and platelets
18
Q
What part/s of bone give long bones their strength?
A
- Parts of bone: epiphysis and diaphysis
- Epiphysis – at the top, filled with spongy bone
- The epiphysis meets the diaphysis at the metaphysis
- Diaphysis – hollow tubular shaft, medullar cavity which is filled with yellow bone
- Outer wall of diaphysis is composed of dense and hard compacted bone, a form of osseous tissue
- Collagen and calcium add to its strength
19
Q
Identify the two different types of bone tissue and the five different classes of bones?
A
- Types of bone tissue: compact bone and cancellous bone
- Compact bone tissue – hard outer layer, strong, dense, provides strength
- Cancellous bone tissue – lighter, less dense, aids in bone compression
- Classes of bone: long, short, irregular, flat, sesamoid
- Long bone example – humerous, fibula
- Short bone example – tarsus and carpus
- Flat bone example – cranium, ribs (replace connective tissue)
- Irregular bone example – pelvic and spine bones
- Sesamoid bone – protect tendons, oval shaped
20
Q
With the aid of a diagram, Identify the major features upper respiratory tract including nasal, oral and laryngopharyngeal structures.
A
- Major features – nose, nasal cavity, mouth, pharynx (throat), larynx (voice box)
- Laryngopharynx: posterior pharyngeal walls, pyriform sinuses, post cricoid area – it allows food to be propelled posteriorly towards the oesophagus
- Epiglottis slops backwards to seal of the larynx
- Upper oesophageal sphincter relaxes allowing entry of food and liquid to the oesophagus
- Oral – lip, hard palate, soft palate, retromolar trigone (behind wisdom teeth), tongue, gums, buccal mucosa, floor of mouth
- Nose – nasal skeleton: vestibule, respiratory region, olfactory region, nasopharynx
21
Q
What is osteoporosis and why is prevalent in older women?
A
- Osteoporosis – bone loss, making bone brittle, making it easier to fracture bones
- Hormonal changes during the menopause affect the bone density
- Oestrogen levels fall allowing osteoclasts to absorb and break down the bone
- Osteoblasts can’t keep up producing enough bone so bone density decreases
- Messaging chemicals stop the maintenance of bone production to bone breakdown levels
22
Q
Why are the bones of a child less suspectable to fracture?
A
- More flexible due to chemical composition
- Have a stronger periosteum layer
- Bones can ‘bow’ up to 45 degrees
23
Q
What proportion of cells are erythrocytes and how would this change in dehydration?
A
- 40-45% of blood volume
- Rest of blood volume is made up of plasma, white blood cells and platelets
- Dehydration – proportion of red blood cells will increase as there is a lower volume of blood plasma
- Levels will appear elevated, but the number of erythrocytes has not changed (only total volume)
24
Q
Identify 11 types of cells derived from haematopoietic stem cells.
A
- Myeloid cells: monocytes, macrophages, neutrophils, basophils, eosinophils, erythrocytes, platelets
- Lymphoid cells: t-cells, B-cells, natural killer cells, dendritic cells
25
Q
Erythrocytes have no mitochondria. Why? and how do erythrocytes get ATP to maintain cellular functions?
A
- Haemoglobin is necessary for the transport of oxygen in erythrocytes
- Large quantity of haemoglobin needed means that mitochondria is absent
- Get ATP from anaerobic conversion of glucose via pyruvate and lactate
26
Q
What proportion of body mass is water and does this differ between young adults, infants, and the elderly?
A
- 60% of body mass is water – around 42L for a 70kg person
- 25l intracellular fluid, 17l extracellular fluid, 3l plasma, 13l interstitial, 1l transcellular
- Increase in age = decrease in proportion of water in body mass
- Percentage of lean tissue like muscle mass decreases and fatty tissue increases with age
- Fatty tissue contains less water
27
Q
Why are action potentials used for long distance communication in the body (over centimeters and meters) and not graded potentials (which are used over micrometres)?
A
- Graded potential – temporary local changes in membrane potential, potential decreases as it moves from trigger
- Action potential – all or nothing, self-propagating meaning as it travels it signals more voltage gated channels to open continuing wave of depolarisation
- Action potentials do not decrease in strength along the length
- Allow rapid transfer of info as they are transient
28
Q
Explain how a synovial joint such as the plane joint in the chest was might change with age (include fragility and ossification)
A
- Synovial fluid lubricates and acts as a shock absorbed
- Hyaline cartilage decreases friction of the bones making movement more smooth
- Aging – production of synovial fluid decreases and cartilage becomes thinner so becomes stiffer
- Could be due to ossification – process of bone formation, process slows down so we can see the slow effect of it making out joints more brittle
- Plane joint – aging they can’t slide over each other as freely and fast as production of synovial fluid is decrease, more friction and less flexible
29
Q
Relevance learning objective: what is the relevance of red blood function to paramedics
A
- Oxygen transport is reliant of rbcs
- Rbcs can give overview of health and abnormalities eg anaemia, internal bleeding
- Signs and symptoms of rbc dysfunction can help paramedics identify illnesses
- Can help to assist in appropriate treatment and helps for patients with major blood loss
30
Q
Describe how the composition of fluid compartments differ from children, young adults, and the elderly
A
- Fluid compartments – extra cellular (17L) and intracellular (25L)
- Infant water body mass = 75%
- Adult water body mass = 50-60%
- Elderly water body mass = 45%
- Changes with development as organ, muscle, fat, bone, and other tissue change with age
- Fat has the greatest effect on the fluid compartments
31
Q
Explain how the drainage of the portal venous system to the liver leads to varices.
A
- Portal venous drainage system – main vessel of venous system that returns blood back from GI tract to liver
- Where toxins are removed
- Varices – veins in distal oesophagus and proximal stomach become permanently dilated due to pressure
- How – increased hypertension in portal vein puts pressure on the veins widening them, blood is redirected to the portosystemic system where vessels over dilate
32
Q
Describe the peritoneal relations and reflections associated with the liver and the other accessory organs of the gut?
A
- Folds of peritoneum reflect off the inferior surface of the diaphragm and attach to the liver
- Peritoneum from diaphragm to liver surface leaves a bare area on liver and diaphragm
- Liver ligaments are double layered folds of peritoneum that attach the liver to surrounding organs or to abdominal wall
- falciform ligament, coronary ligament, right and left triangular ligament
- liver is an intraperitoneal organ
33
Q
Define the organs that make up the foregut, what is the neurovascular supply to the foregut.
A
- Oesophagus – food from pharynx to stomach by peristalsis, mucous membrane
- Stomach – main digestion and food break down
- Duodenum – receives bile and pancreatic juices
- Liver – accessory digestion gland, synthesises bile, stores glycogen, regulates blood sugar, produces clotting factor
- Pancreas – secretes enzymes, hormones, pancreatic juices
- Supplied by coeliac trunk
34
Q
Explain how the molecules bilirubin and biliverdin are continuously made in the body.
A
- Made through the constant destroying and generation of red blood cells
- RBCs broken into heme and globin
- Globin broken down into amino acids
- Heme broken down into iron and the waste product biliverdin
- Biliverdin becomes bilirubin through biliverdin reductase
35
Q
Explain how the liver prevents bilirubin build up in the blood.
A
- Recycling of bilirubin > unconjugated bilirubin > conjugated bilirubin
- Bilirubin is bound to albumin for transport in blood
- Bilirubin is metabolised in the liver so there is no build up in blood
36
Q
What is molecular conjugation any why does the liver perform this function?
A
- Processes of adding another molecules to molecules that are already there to make them water soluble
- Done to ease secretion
- Liver does this to secrete conjugated bilirubin by disrupting the hydrogen bonds
37
Q
Explain how bile is made and why it is needed for digestion.
A
- Bile emulsifies lipids which allow them to be broken down and absorbed
- Gets rid of waster products such as haemoglobin
- Key role in digesting fats
- Mainly needed to break down molecules to be able to be absorbed and to remove toxins and waste products
- How – made from the liver and is made due to osmotic gradients of solutes in the liver
38
Q
Why does a blockage of the sphincter of Oddi cause pale stinky floaters?
A
- Sphincter oddi – muscular valve around the bile duct
- If not opening and closing at right time it backs up the digestive juices
- Stinky floaters as not enough bile and pancreatic enzymes in the small intestine for break down
39
Q
Explain the consequences of reduced liver mass on the health of elderly people?
A
- Liver – carries out immune function, controls chemical levels, produces bile
- Build-up of bilirubin – reduced mass makes it harder to break down
- Bilirubin build up leads to jaundice
- Lack of control of blood clotting – can lead to haemorrhaging
- More likely to get infections
- Can get anaemia as less iron can be stored in the smaller mass of the liver – make elderly more fatigued
