EMT Exam 1 Flashcards
Physical traits of good EMT
- Ability to lift and carry equipment and patients
- Good eyesight
- Good communication skills
Personal traits of good EMT
- Pleasant
- Sincere
- Cooperative
- Resourceful
- Self Starter
- Emotionally Stable
- Leader
- Neat and Clean
Medical Director
A physician that has ultimate responsibility for patient care aspects of EMS system
- All patient care performed under their direction
- Oversees training
- Develops treatment protocols
Examples of off-line medical control
Standing orders, protocols
Examples of on-line medical control
Orders by phone or radio
Pnea
Breath, respiration
Arthr
Joint
Dys
Difficulty
Febrile
Fever
De
Away from
A
Not
Iac
Has
Itis
Inflammatory
Intra
Between
Endo
Within
Infra
Below
Hemato
Pertaining to blood
Nas(o)
Nose
Tachy
Fast
Thorax
Chest cavity
+LOC
Positive loss of consciousness
Extra
Outside
GSW
Gunshot wound
“Fell out”
Lost consciousness
MVC
Motor vehicle collision
Emesis
Vomit
Superior vs Inferior
Top vs Bottom
Mid-axillary
Runs along armpit line
S/P
Status Post
Anatomy
Study of body structure
Physiology
Study of body function
Supine
Lying horizontal with face and torso up
Prone
Face down
Recovery Position
AKA left lateral recumbent position; side (allows things like vomit to drain out of mouth)
Fowler/Semi Fowler
Upright
Three main functions of musculoskeletal system
- Gives the body shape
- Protects internal organs
- Provides for body movement
How many vertebrae do humans start off with in the spinal column vs have in adulthood
33, 24 in adulthood
What is the spinal column essential for
Movement, sensation, and vital functions
What does the thorax contain
Contains the heart, lungs, and major blood vessels
What does the thorax protect
Protects the heart, lungs, and major blood vessels
Parts of the spinal column
Cervical (1-7), Thoracic (1-12), Lumbar (1-5)
Joints
Formed when bones connect to other bones
Types of muscles
Voluntary (skeletal), involuntary (smooth), cardiac
Which two areas does the pharynx include
Oropharynx and the nasopharynx
Larynx
Voice box containing the vocal cords; cricord cartilage forms the lower portion
Is inhalation an active or passive process?
Active
Is exhalation an active or passive process
Passive
Process of inhalation
Diaphragm and intercostal muscles contract, diaphragm moves downward, ribs move upward and outward; negative pressure pulls air into lungs
Process of exhalation
Diaphragm and intercostal muscles relax; positive pressure pushes air out of lungs
How does the process of ventilation occur in lungs?
The alveoli allows for CO2/O2 to exchange
Respiration
Exchange of gases between cells and bloodstream or alveoli and blood
Pathway of blood through heart
Right atrium –> right ventricle –> left atrium –> left ventricle
What is blood made of
Plasma, RBCs, WBCs, platelets
What makes up more than half the volume of blood
Plasma
What do platelets help with
Clotting
Pulse
Pressure wave of blood flowing down an artery when the left ventricle contracts; can be felt by compressing artery over a bone
Blood Pressure
Force blood exerts against the walls of blood vessels
Systolic
Upper blood pressure reading; arterial pressure when left ventricle contracts
Diastolic
Lower blood pressure reading; pressure when left ventricle refills
Perfusion
Adequate circulation of blood and exchange of oxygen and waste products
Hypoperfusion
Shock; when flow becomes inadequate
Functions of lymphatic system
- Captures fluid
- Maintains balance of fluid
Parts of central nervous system
Brain and spinal cord
Parts of peripheral nervous system
Sensory nerves and motor nerves
Parts of autonomic nervous system
Involuntary motor functions
What does the digestive system provide
It provides the mechanism by which food travels through the body and is digested
Functions of the integumentary system
- Protection
- Water balance
- Temp regulation
- Excretion
- Shock impact
Layers of the skin
Epidermis, dermis, subcutaneous layer
Function of endocrine system
Produces hormones that regulate many body activities and functions
What do adrenal glands secrete
Epinephrine
Function of renal system
Helps the body regulate fluid levels, filter chemicals, and adjust body pH
Bladder
Fluid reservoir for urine
Ureters
Transports urine to bladder from kidneys
Urethra
Excretes urine from the bladder to external environment
Pathophysiology
Study of how disease processes affect function of body
Cell membrane
Protects; allows water/other substances in and out of cell
Mitochondria
Converts glucose and other nutrients into ATP; fuel for other cell functions
Glucose
Building block for energy; supply of insulin must match body’s glucose requirement
Aerobic metabolism
Cellular functions using oxygen
Anaerobic metablism
Cellular functions not using oxygen; creates less energy and more waste; body becomes acidic, impairing many body functions
How does disease affect the membrane and therefore the body?
Many diseases alter membrane permeability; allows substances into cell that shouldn’t be there which can interfere with regulation of water
Homeostasis
Regulated in the brain; maintained through nervous system feedback and messaging
Parasympathetic nervous system
- “Feed or breed” functions
- Neurotransmitters regulate digestion and reproduction
- Reduces heart rate and blood pressure
Sympathetic nervous system
- “Fight or flight” response
- Epinephrine and norepinephrine
- Enhances body’s ability to protect itself
- Increase heart rate and blood pressure
Cardiopulmonary system
Respiratory and cardiovascular systems work together to bring oxygen into body, distribute it to cells, and remove waste products; breakdown means system failure
Airway/bronchial tree
Each mainstem bronchus enters a lunch and branches into smaller bronchi, ending with smallest bronchioles
What are the alveoli (airs acs) connected to
Bronchioles
Airways
Must have open (patent) airway for system to function
Tidal volume
Volume of air moving in and out during each breath cycle
Minute volume
Amount of air moved in and our of lungs in one minute
Minute volume equation
Tidal volume * respiratory rate = minute volume
What happens when something interferes with minute volume
Respiratory dysfunction
What part of the brain controls respirations
The medulla oblongata
What can affect minute volume
- Any event impacting function of medulla oblongata such as infection, drugs, toxins, trauma
- Disruption of pressure through thorax being compromised (through punctures, rib fractures); ability to inhale/exhale is impacted and minute volume is reduced
- Air/blood accumulating in chest (pleural space) also compromises respiration
- Disruption of lungs tissue through alveoli being compromised; can result in hypoxia and hypercapnia
Hypoxia
Low oxygen levels
Hypercapnia
High carbon dioxide levels
Respiratory Compensation
-Body attempts to compensate for gas exchange deficits which chemoreceptors detect; body stimulates respiratory system to increase rate/tidal volume
Plasma oncotic pressure
Proteins in plasma attract water away from around cells and pulls it into bloodstream
Hydrostatic pressure
Water pushed out of blood vessels towards cells
True of false: problems with proteins concerning plasma oncotic pressure and hydrostatic pressure can cause an imbalance
True
True or false: without enough blood, oxygen and carbon dioxide can’t be properly moved around
True
What controls pressure in blood vessels
Blood vessels need adequate pressure to make cycle work; pressure controlled by changing diameter of blood vessel
What is blood vessel pressure monitored by
Stretch receptors; pressure can be increased/decreased depending on situation
What causes blood vessel dysfunction
- Loss of tone which affects ability to constrict and dilate
- Pressure drops
- Trauma, infection, allergic reaction
- Excessive permeability; capillaries leak; caused by severe infection, high altitude, disease
- Hypertension caused by abnormal constriction of vessels
- Loss of regulation caused by blockage of chemical signals; can cause shock
Stroke volume
Volume of blood pumped out by left ventricle during each cardiac contraction; usually about 70mL per contraction
Stroke volume is based on
- Preload (amount of blood returning to heart)
- Contractility (how hard heart squeezes)
- Afterload (pressure the heart has to pump against to force blood into system)
Cardiac output equation
Stroke volume * bpm = cardiac output
Pediatric compensation
Fast heart rate indicates compensation
What causes heart dysfunction
- Mechanical problems (physical trauma, squeezing forces, cell death (MI))
- Electrical problems (can’t regulate rate)
What must there be a balance of for cardiopulmonary system to work
Balance between ventilation and perfusion
Hypoperfusion
AKA shock; breakdown in system; can result in death
What are the 4 categories of shock
Hypovolemic, distributive, cardiogenic, obstructive
Hypovolemic Shock
One category of shock; caused by low blood volume
Distributive shock
One category of shock; caused by low blood vessel tone
Cardiogenic shock
One category of shock; caused by failure of heart to pump
Obstructive shock
One category of shock; caused by blood not being able to flow
Signs of compensated shock
- Slight mental status change
- Increased heart rate
- Increased respiratory rate
- Delayed capillary refill time
- Pale, cool, clammy skin
- Sweating
When does decompensated shock occur
When compensatory measures fail; characterized by decreased blood pressure and altered mental status
When does irreversible shock occur
When inadequately perfused organ systems begin to die; death commonly follows
Body fluid precentages
- Body is 60% water
- Intracellular: 70%
- Intravascular: 5%
- Interstitial: 25%
What regulates thirst and elimination of excess fluid
Brain and kidneys
What pulls fluid into the bloodstream
Blood plasma proteins
Disruptions of fluid balance
- Fluid loss/dehydration (decrease in total water volume)
- Poor fluid distribution (water doesn’t go where its supposed to eg. edema)
What are the skull and spine covered by
Several protective layers (meninges) and a layer of shock absorbing fluid (cerebrospinal fluid)
What are the brain and spinal cord protected by
The skull and spine
What causes nervous system dysfunction
- Trauma (mvc, falls)
- Medical dysfunction (strokes, infection, low blood sugar)
What is the purpose of the endocrine system
Glands secrete hormones; hormones sends chemical messages to the body
What causes endocrine system dysfunction
- Organ or gland problems
- Present at birth or result of illness
- Too man hormones (graves disease)
- Problems with heart rate and temp regulation
- Not enough hormones (diabetes)
What is the purpose of the digestive system
Allows food, water, and other nutrients to enter the body
What causes digestive dysfunction
- Gastrointestinal bleeding
- Vomiting and diarrhea may occur
- Impacts hydration levels and nutrient transfer
What is the purpose of the immune system
Responsible for fighting infections; responds to specific invaders by identifying them, marking them, destroying them
Hypersensitivity
AKA allergic reaction; result of exaggerated immune response; results in rapid drop in blood pressure
Why are vital signs important
Outward signs of what goes on in body; can identify conditions/trends in patients
What is reported with pulse
Rate, quality, regularity, equality
Normal findings for pulse
- 60-100 bpm
- Strong (not thready/bounding)
- Regular
- Equality: central and peripheral equal
Tachycardia
Pulse that is too fast
Bradycardia
Pulse that is too slow
Central vs peripheral pulses
- Central: Carotid and femoral
- Peripheral: Radial and brachial
What is reported with respirations?
Rate, rhythm, and quality
Normal findings with respiratory rate
- Around 12-20 breath per minute, above 24 or below 8 are potentially serious findings
- Normal and non-labored
- Regular intervals
Best places to assess skin color
- Nail beds
- Inside of cheek
- Inside of lower eyelids
Normal findings for skin color
Pink
Abnormal findings for skin color
- Pale
- Cyanotic
- Flushed
- Jaundiced
- Mottled/blotchy
How to check skin temperature
Feel back of patient’s hand