DMMP Topic 1 - A&P Flashcards
EAC and the TM are the same layer of ______.
How many layers does the TM have?
skin
2 - these layers can accumulate fluid between them.
saf
adf
Fx of:
- EAC
- TM
- Malleus, Incus, Stapes
- Cochlea
- acts as conduit of sound waves
- changes sound waves into mechanical movement.
- conducts sound to the oval window
- sends pressure changes therefore endo/perilymph fluid moves along the cochlea stimulating cilia.
Fx of round window
acts as a dampener that allows fluid to move inside the cochlea.
How does air get warmed during ventilation
Your face is very vascular, to include the inside of the oro/nasopharynx. Also the vessels are superficial to allow quicker warming of the air.
Fx of turbinates
Increase surface area which increases vascularity, which warms air and provides resonance to you’re voice.
Lower respiratory begins at the ____
larynx
The only cartilaginous ring of the trachea that forms a full circle?
Cricoid cartilage
What is the reflex if the carina is stimulated?
cough
How does the heimlich maneuver still work if you are chocking on during an exhale?
It doesn’t
anatomy of upper respiratory
askjfs
Define:
- ventilation
- respiration
- external respiration
- internal respiration
- mechanical movement of air/gas
- gas exchange
- gas exchange at the lungs
- gas exchange at the cellular level
6 phases of respiration
1 -ventilation of the lungs with fresh air
2 - exchange of gases between blood and air in the lungs
3 - transportation of gases by blood
4 - exchange of gases between blood and tissue
5 - exchange of gases between tissue and cells
6 - use of and production of gases by cells
define circulatory system
a enclosed system that delivers O2, nutrients, and hormones to every cell and tissue to the body. And carries away CO2, waste chemicals, and heat.
3 main components of the circulatory system
heart
vessels
whole blood
2 types of circulatory circuits
pulmonary
systemic
3 main components of blood vessels
arteries
veins
capillaries
- capillary inside diameter can be as small as one blood cell
whole blood:
- total volume is ~ _____
- 4 componenets
- ~5L
- RBC’s (45%)
WBC’s
Plasma (50%)
Platelets
Average whole blood for adults
- male
- female
Wy do we become clammy during shock
- 5-7L
4-6L
clammy skin occurs like a fogged window.
6 parts to a neuro exam
Mental Status Coordination CN II-XII Motor Sensory DTR's
The ___ is the principle target of DCS.
Nervous system
Goal of a nero exam (4)
- get a thorough hx
- perform a focused exam
- perform a full neuro exam
- perform a focused re-exam (note any changes)
6 parts to a hx
- isolate the CC
- get dive hx/profile (DDTRRS)
- Predisposition of casulty
- progression of sx’s
- previoius hx of same sx’s
- pertinent past/present Med hx
- Isolate the problem (2)
- c/ OPQRST
- ask and numbness, decreased sensation, paraesthesia, hyperesthesia, or weakness
*go back 72hrs, DCS can be insidious.
- Dive Hx DDTRRS
D - dive buddy, if so check him out too. D - depth T - time *chart all dives c/in last 12hrs R - rig R - repet dives last 72 hrs
*any altitude exposure, dangerous marine life, anything abnormal about the dive?
- Predisposition of the casualty
- before
- descent
- bottom
- ascent
- surface
- any environmental exposure, dehydration, fatigue, etc…
- barotrauma, vertigo, hypoxia, O2 hit, etc…
- any CO2 tox, N2 narcosis, trauma, thermal issues, hypoxia, or HPNS
- any POIS, ABV, contaminated gas, hypoxia, O2 Tox
- DCS, AGE, IEB
- Progression of sx’s (3)
- static
- progressive then relapsing
- spontaneous improvement
(common with hypoxia or CO2 tox)
- PMH (2)
- any hx of same sx’s (dive or non dive related)
- SAMPLE
5 rights
Rt Patient
drug/medication
dose
route
time
* EXP, document, and that Pt has the rt to refuse txPrevious hx of AGE or DCS means
___ mimics an AGE
PMH increases susceptibility for another incident. Requires minimum 1 month of No Dive after a TT or up to 6 months NPQ dive
CVA
when performing neuro exams; act as if your Pt is deaf, dumb, and blind.
Don’t demonstrate everything, assess them to apply commands
Just good info
Neuro Exams:
- most diving casualties have ___ mental status
- AMS is more likely to be seen c/ ___ or ___.
- normal
- AGE or Aviation bends
Mental Status (6)
- A&Ox3
- Short term memory
- Long term memory
- reasoning
- alphabet
- arithmatic
- 3 word recall, reassess better, worse, or same
Coordination Exam (7)
- walk normally
- heel-toe-walk
- finger-to-nose
- finger-to-finger
- Rhombergs
- Heel-shin-slide
- rapid movement
- 3 word recall, reassess better, worse, or the same.
CN pics
afa’jf
CN exam (12)
I - Olfactory II - Optic III - Oculomotor IV - Trochlear V - Trigeminal VI - Abducens VII - Facial VIII - Vestibulocochlear IX - Glossopharyngeal X -Vagus XI - Spinal Accessory XII - Hypoglossal
CN I (4)
- olfactory epithelium is @ the roof of the nasal cavity
- provides sense of smell
- not visually tested
- test one nostril at a time
CN II
Fx’s in recognition of light and shade and the perception of objects.
CN III (2)
- Somatic motor controls precise eye movement
- Visceral motor controls pupillary light and accommodation reflexes.
CN IV
- controls superior oblique muscle
- directs depression, inversion, and adduction.
CN VI
- controls lateral rectus muscle
- allows abduction
add eyes pic
aslfk’sadjfa’jsf
CN V
- innervates the forehead and face.
- innervates the tensor tympani
CN VII
- Controls facial muscles, scalp, forehead, eyelids, expressions, cheeks and jaw.
- check for symmetry in nasolabial folds.
CN VIII
controls hearing and balance
CN IX
- sensory from the upper mouth to the throat
- allows gag reflex and constriction of the pharyngeal wall c/ saying “Ahh”
CN X
- controls roof of mouth
- controls vocal cords
Hoarseness in voice suggest ____.
Nasal voice suggest ____.
- Paralysis of voice box
- Paralysis of palate
*also consider POIS’s (Subcutaneous emphysema)
CN XI
- turns head side to side
- shoulder shrugs
Weakness/absence of shoulder shrug or head turn suggest nerve injury to the ___ side.
- affected
CN XII
- controls Pt’s tongue
- deficient response would cause the tongue to twist to the affected side.
Sensory Exam (5)
- torso
- back
- arms, hands, fingers
- junk and trunk
- legs and feet
Strength Exam 0-5
0 - paralysis
1 - profound weakness; flicker or trace movements
2 - severe weakness; cannot move against gravity
3 - moderate weakness; can overcome gravity
4 - mild weakness; resist slight force
5 - normal; equal bilateral strength
DTR’s 0-4
0 - none 1 - hypoactive 2 - normal 3 - hyperactive 4 - clonus
Clonus
rapid spastic movement
Point of interest:
- brain
- spinal cord
Brain:
- DCS - confusion, drowsiness, fatigue
- AGE - CVA c/ focal hemispheric or brain stem sx’s. Seizure, aphasia, hemiparesis, and CV arrest.
- MAY HAVE COMBO OF BOTH.
Spinal:
- Pt can’t urinate
- dermatomal sx’s
- RARE c/ DIVING
Aphasia
Hemiparesis
Hemiplagia
- lack of emotion
- lack of sensation
- paralysis to one side of the body.
