EPC Flashcards

1
Q

oxygen levels should be between?

A

92-96%

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2
Q

what does the brain need to survive?

A

oxygen and sugar

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3
Q

what is the major causes of preventable death

A

not having a clear airway

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4
Q

Why is it that having a clear airway is sometimes ignored and causes death?

A

1-basic techniques prevented
2-rush to advanced interventions
3-failure to reassess patients (every 5 minutes or whenever you do an intervention

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5
Q

what does our airway do for us?

A

warm, filter, humidify air

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6
Q

3 structures of airway

A

nasopharynx, oropharynx, laryngopharynx

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7
Q

if foreign object gets into airway it is called

A

aspiration pneumonia

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8
Q

bulls eye test meaning?

A

to check if cerebral spinal fluid is coming out of the nose with blood

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9
Q

what is the most common way of airway obstruction?

A

the tongue

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10
Q

voice box is called?

A

larynx

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11
Q

what do we have to make sure we have in order to ventilate a patient?

A

open airway

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12
Q

intercostal retraction means?

A

breathing through ribs

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13
Q

lean forward is what position

A

tripod position

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14
Q

when someones having intercostal retractions, what immediate management is used?

A

oxygen therpy

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15
Q

/meaning of SAMPLE

A

S-signs and symptoms
A-allergies
M-medications
P-past medical history
L-last intake
E-Events leading to incident

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16
Q

what’s the pathway of oxygen coming into the lungs list them in order

A

trachea
main bronchi
smaller bronchi
bronchioles
alveoli

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17
Q

what do we call a collapsed alveoli?

A

atelactasis

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18
Q

where does most of the gas exchange occur?

A

alveoli

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19
Q

volume of air inhaled or exhaled in a single respiratory cycle in adults? children?

A

adults- 5-7ml per kg
children-6-8ml per kg

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20
Q

After the age of 1, how to calculate weight for a child? (till age of 8)

A

age x 2 +10=____ kg

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21
Q

how to calculate weight for children under 1?

A

by the month so if 7 months then 7 kg

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22
Q

what is the volume of air inhaled or exhaled in a single respiratory cycle called?

A

tidal volume

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23
Q

when the respiratory rate is higher, what is the tidal volume higher or lower?

A

lower

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24
Q

how many breaths a minute is ideal?

A

12 -20

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25
Q

what is expiratory reserve volume?

A

the amount of air that you cn exhale following normal exhalation 1200ml

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26
Q

what is residual volume capacity?

A

The amount of air remaining in the lungs after a forced exhalation 1200 ml

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27
Q

what is FiO2

A

fraction of inspired oxygen, the amount of oxygen in inhaled air, which is usually 21-22%

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28
Q

explain the NRB?

A

non rebreathing mask
10-15 litres of oxyen coming out of the tank per minute
93%

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29
Q

explain BVM

A

bag valve mask
15-20 litres of O2/min
100%

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30
Q

explain face mask

A

6-10 litres of O2/min
60%

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31
Q

explain nasal canula

A

1-6 litres of oxygen/min
24-44%

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32
Q

what is the condition of when body tissues don’t receive enough oxygen?

A

hypoxia

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33
Q

what are the causes of decreased oxygen?

A

-low pressure of atmospheric oxygen
-severe bleeding
-anemia

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34
Q

what are the conditions that reduce the surface air for gas exchange?

A

-flail chest
-diaphragm injury
-pneumothorax (collapsed lung)
-hemothorax (blood accumulates between lungs and chest)
-hemopnemothorax

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35
Q

what is inspiration?

A

process of moving air into the lungs

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36
Q

what is expiration?

A

process of moving air out of the lungs

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37
Q

what are the 2 types of motor nerves that affect breathing

A

phrenic nerve
inercostal nerve

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38
Q

what are the dorsal cavities?

A

cranial and spinal cavities

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39
Q

what are the ventral cavities?

A

mediastinum, plural, abdominal and pelvic cavities

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40
Q

what are the four quadrants?

A

right upper
right lower
left upper
left lower

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41
Q

what does LUQ (left upper quadrant) consist of?

A

-stomach
-spleen
-part of small small intestine
-left kidney
-portions of large intestine
-body and tail of pancreas

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42
Q

what does the RUQ (right upper quadrant) consist of?

A

-liver
-gallbladder
-part of small intestine
-right kidney
-portions of large intestine
-the head of the pancreas

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43
Q

what does the LLQ (left lower quadrant) consist of?

A

-sigmoid colon(s shaped section of large intestine)
-left ovary and fallopian tube
-left uterer
–left kidney
-left bladder

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44
Q

what does the RLQ (right lower quadrant)consist of?

A

-appendix
-part of small intestine
-cecum (first part of large intestine)
-right ovary and fallopian tube
-right urether

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45
Q

the total lung capacity in an average adult is?

A

6 L

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46
Q

what is tidal volume?

A

its a measure of the depth of breathing, is the volume of air that is inhaled and exhaled during a single respiratory cycle

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47
Q

what is inspiratory reserve volume?

A

is the amount of air that can be inhaled in addition to the normal tidal volume.

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48
Q

what is dead space?

A

is any portion of the airway where air lingers but does not participate in gas exchange

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49
Q

what is functional residual capacity

A

the amount of air that can be forced from the lungs in a single exhalation

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50
Q

how does each ventilation cycle work?

A

one ventilation cycle consists of one inspiration which occupies one third of the ventilation cycle and one expiration, which occupies the remaining two thirds.

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51
Q

what do chemoreceptors do?

A

they monitor the levels of O2 and CO2 in the blood and the PH of the CSF (cerebrospinal fluid) and provide feedback to the respiraoty centres to modify the rate and depth of breathing based on the body’s needs. Maintain homeostasis

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52
Q

how does hypoventilation occur?

A

if carbon dioxide production exceeds the body’s ability to eliminate it by ventilation, the level of CO2 rises to produce hypoventilation,

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53
Q

PaCO2

A

partial pressure of carbon dioxide

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54
Q

how does hyperventilation occur?

A

occurs when carbon dioxide elimination exceeds carbon dioxide production

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55
Q

visual observation of patent airway,things to check

A

-How is the patient positioned?
-Is the patient experiencing orthopnea?
-is rise and fall of the chest adequate?
-Is the patient gasping for air
-what is the skin colour?
-is there flaring of the nostrils
-is the patient breathing through pursed lips
-do you note any retractions
-is the patient using accessory muscles to breath
-is the patients chest wall moving symmetrically
is a patient taking quick breaths followed by a prolonged exhalation

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56
Q

what is orthopnea?

A

is shortness of breath that occurs when you lie down, but improves when you sit up or stand

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57
Q

signs of inadequate breathing

A

slow, <12 breaths/min or fast >20 breaths/min
shallow breathing(reduced tidal volume)
Adventitious (abnormal breath sounds)
altered mental status
cyanosis (blue or purple skin)

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58
Q

auscultation meaning

A

listening to breath sounds with a stethoscope

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59
Q

what questions to ask for patients history of present illness

A

-was the onset of the problem sudden or gradual over time
-is there any known cause or trigger of the event
-what is the duration
-does anything alleviate or exacerbate the problem
-are there any other symptoms like a productive cough, chest pain or pressure, or fever
-were any interventions attempted prior to your arrival
-has the patient been evaluated by a physician or been admitted in the hospital in the last year for this condition
-is the patient taking any medication

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60
Q

what are protective reflexes of the airway

A

-coughing
-sneezing
-gagging
-gag reflex
-aspiration
-sighing
-hiccuping

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61
Q

what are 5 abnormal respiratory patterns

A

-Apneustic respirations
-Agonal respirations
-Biot respirations
-Cheyne-stokes respirations
-Kussmaul respirations

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62
Q

explain apneustic respirations

A

prolonged gasping inhalation followed by short exhalation

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63
Q

explain agonal respirations

A

slow shallow, irregular, gasping,may be seen briefly after the heart has stopped

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64
Q

explain Biot respirations

A

irregular pattern, rate, and depth, with intermittent periods of apnea

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65
Q

explain cheyne-stokes respiration

A

is a rhythmic breathing pattern alternating between hyperventilating and period of apnea

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66
Q

explain kussmaul respirations

A

deep rapid respirations seen in patients with diabetic ketoacidosis

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67
Q

circumstances that might produce errors during pulse oximetry

A

-bright ambient light
-patient motion
-poor perfusion
-nailpolish
-venous pulsations
-abnormal hemoglobin

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68
Q

normal PH blood gas value is

A

7.35 - 7.45

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69
Q

what is a capnometer?

A

provides quantitative information, detects and measures exhaled carbon dioxide levels.

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70
Q

what is capnographer

A

provides quantitative,graphic representation of exhaled carbon dioxide levels

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71
Q

what is waveform capnography

A

provides constitutive real time information regarding patients exhaled carbon dioxide levels.

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72
Q

what are causes of airway obstruction

A

-severe allergic reaction
-tongue
-foreign body
-laryngeal spasm or edema
-laryngeal injury
-aspiration
-

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73
Q

How to recognize a severe airway obstruction

A

-patient cant breathe, talk or cough
-gasps at his/her throat
-begins to turn cyanotic
intercostal muscles
-hypoxic

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74
Q

meaning of dyspnea

A

shortness of breath

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75
Q

dyspnea can lead to

A

hypoxemia
hypoxia
anoxia

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76
Q

ICP

A

intracranial pressure

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77
Q

explain P1, P2,P3,P4
(refer to the drawing)

A

P1- Respiratory baseline
P2- Expiratory upstroke
P3- Expiratory plateau (this is where end tidal gets measured)
P4- Inspiratory downstroke

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78
Q

How long do you suction in adults and children?

A

adults - 15 seconds
children - 10 seconds

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79
Q

how do you insert the catheder suction?

A

insert iton your way out not on your way in, in circular or zigzag motion

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80
Q

how much mmHg for oral suctioning for adults, children and infants

A

adults - 500 -550 mmHg
children - 200 -220 mmHg
infants - 80 -100 mmHg

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81
Q

what is a laryngectomy?

A

is a surgical procedure that removes part or all of the larynx

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82
Q

what is tracheostomy?

A

its a surgical procedure that an opening in the neck to help a person breath. A tube is usually inserted

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83
Q

what is a stoma suction valve?

A

its a device that allows air to be released from or added to a stoma pouch. It is used for ballooning or vacuum creation

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84
Q

what is closed suctioning used for?

A

it is used for patients who have had a laryngectomy or a tracheostomy (any artificial airways)

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85
Q

For closed suctioning how much mmHg is used for adults, children and infants?

A

infants - 60 -100 mmHg
1-12 years -100-120 mmHg
12 and over-100-150mmHg

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86
Q

what are the 2 types of choking?

A

-tracheal choking
-esophageal choking

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87
Q

what are airway adjuncts?

A

are devices and techniques that help maintain an open airway

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88
Q

what are the 2 types of airway adjuncts?

A

-Oropharyhngeal airway (OPA)
-Nasopharyngeal airway
(NPA)

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89
Q

what is nasopharyngeal airway NPA?

A

A soft tube that is allows air to flow from the nose to the pharynx. It is used for basic airway management

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90
Q

what is Oropharyngeal airway OPA?

A

a J-shaped device that fits over the tongue to keep it from blocking the pharynx

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91
Q

make sure oxygen cylinders are labelled?

A

medical oxygen

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92
Q

what are the 2 cylinders mostly used?

A

D & M

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93
Q

How much oxygen does the D and the M cylinder contain?

A

D - 350 L
M -3450 L

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94
Q

what do high pressure regulators do?

A

used to transfer cylinder gas from tank to tank

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95
Q

pressure of gas in a full oxygen cylinder is approximately?

A

2000psi

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96
Q

what does a therapy regulator do?

A

controls gas flow from the oxygen cylinder to the patient reduces the gas flow to a safe amount (about 50psi)

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97
Q

what is a flowmeter?

A

usually permanently attached to the therapy regulator delivers oxygen with a range of 1-25 L/min

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98
Q

what’s VT, VD, VA

A

VT: Tidal volume
VD: dead space
VA: alveolar volume

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99
Q

how to calculate alveolar volume?

A

(VT - VD) x breaths per minute = VA
ideal range of alveolar volume is :
(500 -150) x16 =5600 ml VA

This is not good
(250 -150) x14 =1400 ml VA

Basically dead space always remains at 150

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100
Q

What’s the difference between internal and external respiration?

A

1: In external respiration oxygen moves from air into the blood, and carbon dioxide moves from the blood into the air (Happens in alveoli)
2: In internal respiration, oxygen moves from the blood into the cells and carbon dioxide moves from the cells into the blood (occurs within the body tissues)

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101
Q

what’s the difference between oxygenation and ventilation?

A

oxygenation is the process of delivering oxygen to the body tissues, while ventilation is the process of moving air in and out of the lungs

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102
Q

indications and contraindications for an OPA

A

indications:
indicated for unconscious patients with a depressed gag reflex (absent gag reflex)

contraindications:
conscious patients with an intact gag reflex, significant oral trauma

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103
Q

Indications and contraindications for NPA

A

Indications: can be used for semi-consious patients with an intact gag reflex, patients with jaw clenching, less invasive

contraindications:
nasal fractured, facial trauma,skull fracture, nasal obstruction

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104
Q

indications and contraindications for I gel

A

indications:
Used for patients who are unconscious.
patients who 2 unsuccessful endotracheal intubation

contraindications:
patients who are conscious or have an intact gag reflex
Patients with trauma to the trachea

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105
Q

What is an I gel

A

is a supraglottic airway device used to manage airways in emergency care and anestesia, it is used when endotracheal intubation ius unsuccessful

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106
Q

what does EtCO2 do?

A

measures the amount of carbon dioxide exhaled at the end of a breath,providing insight into how well the lungs are exchanging gases

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107
Q

what does a rising EtCO2 indicate?

A

It indicates improved blood flow and can be a key indicator during CPR to monitor the effectiveness of chest compressions and potential return of a spontaneous circulation (ROSC)

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108
Q

where are red blood cells produced

A

bone marrow

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109
Q

what produces white blood cells called lympocytes

A

The spleen

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110
Q

What do platelets help with?

A

Platelets also known as thrombocytes, help prevent and stop bleeding, and are produced in the bone marrow

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111
Q

what do antiplatelet drugs do?

A

prevent blood clots from forming in your arteries and heart EG: ASA (acetylsalicylic acid)

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112
Q

what muscles are voluntary and involuntary?

A

Skeletal muscles are voluntary while smooth muscles and cardiac muscles are involuntary

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113
Q

where are smooth muscles found?

A

digestive, cardiovascular, urinary, respiratory and reproductive systems

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114
Q

what muscles have striations?

A

cardiac and skeletal

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115
Q

How to measure how long oxygen will last in D tank and tank M?

A

Lets say the tank has 1200 psi left, always minus 200, that’s what should be left in the tank, the answer you get multiply it by 0.16 (always for D tank)

1200 - 200=1000
1000 x 0.16=160

if using a nasal cannula at 6, then you:

160 divide by 6=26.67

so tank D will last 26.67 minutes

The exact same formula for tank M but you multiply by 1.56

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116
Q

Everytime you go up a Litre in oxygen tank,, you go up by how much percent in oxygen?

A

4%

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117
Q

CPAP is good to used for patients with?

A

COPD

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118
Q

What does peep stand for?

A

Positive end expiratory pressure
(Used in mechanical ventilation, positive pressure maintained in the airways even after exhalation is complete)

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119
Q

what is positive end expiratory pressure?

A

The positive pressure that remains in the airways at the end of a breath (exhalation) during mechanical ventilation, exceeding atmospheric pressure

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120
Q

Divides the nasopharynx into 2 passages

A

Nasal septum

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121
Q

Are cavities formed by the cranial bones

A

Sinuses

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122
Q

Forms the posterior portion of the oral cavity

A

Oropharynx

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123
Q

Is a large muscle attached to the mandible and hyoid bone

A

Tongue

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124
Q

This bone is horseshoe shaped

A

Hyoid bone

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125
Q

These are lymphatic tissues that filter bacteria

A

Adenoids

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126
Q

This is located in the posterior pharynx and helps trap bacteria

A

Tonsils

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127
Q

This a a soft tissue structure resembling a punching bag

A

Uvula

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128
Q

This is the superior border of the glottic opening

A

Epiglottis

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129
Q

This is a leaf shaped cartilaginous flap

A

Epiglottis

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130
Q

This is an anatomic space or pocket located between the base of the tongue and the epiglottis

A

Vallecula

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131
Q

This is formed by many independent cartilaginous structures. Marks where the upper airway ends and the lower airway begins

A

Larynx

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132
Q

This is a shield shaped structure, it forms the laryngeal prominence known as the Adam’s apple

A

Thyroid cartilage

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133
Q

This forms the lowest portion of the larynx

A

Cricoid cartilage

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134
Q

This is the space between the vocal cords

A

Glottis

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135
Q

This is the narrowest portion of the adults airway

A

Glottis

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136
Q

This cartilage is a pyramid like cartilaginous structures

A

Artenoid

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137
Q

This forms the posterior attachment of the vocal cords. Valuable guide for tracheal intubation

A

Artenoid

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138
Q

These are two pockets of tissue on the lateral border of the larynx

A

Pyriform fossae

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139
Q

This means spasmodic closure of the vocal.cords

A

Laryngospasm

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140
Q

Where does the lower airway externally extend from

A

The fourth cervical vertebrae to the xiphoid process

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141
Q

The lower airway internally spans the?

A

Glottis to the pulmonary capillary membrane

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142
Q

What the windpipe

A

Trachea

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143
Q

This is the channel for air entry into the lungs

A

Trachea

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144
Q

What’s is the tracheas structure and how many cm in length

A

It’s tubular and approximately 10-12cm in length

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145
Q

This is a proteinaceous substance lining the alveoli and decreases surface tension and keeps them expanded

A

Surfactant

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146
Q

The neural control of ventilation involves brain stem respiratory centers that include

A

Medulla and pons

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147
Q

Two types of motor nerves that affect breathing are

A

Phrenic and intercostal

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148
Q

How does increase in the acidity of CSF affect breathing?

A

Increased rate and depth

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149
Q

Inhalation and exhalation which one is active and which one is passive?

A

Inhalation ~ active
Exhalation. ~ passive

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150
Q

External respiration also known as?

A

Pulmonary respiration

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151
Q

Internal respiration also known as ?

A

Internal respiration

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152
Q

Which one is straighter and shorter the right bronchus or the left one?

A

Right bronchus is straighter and shorter. A tracheal tube inserted too far comes out of the right bronchus

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153
Q

All the blood vessels and the bronchi enter each lung at the?

A

Hilum

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154
Q

How many lobes in each lung?

A

Right has 3 and left has 2

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155
Q

The lungs are covered with a thin slippery outer lining called?

A

Visceral pleura

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156
Q

What lines the inside of the thoracic cavity

A

Parietal pleura

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157
Q

These are ballon like clusters of single layer air sacs?

A

Alveoli

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158
Q

What method of exchange is used between the alveoli and the pulmonary capillaries

A

Diffusion

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159
Q

This is a process of gas moving from an area of higher concentration to an area of a lower concentration

A

Diffusion

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160
Q

Dissolved oxygen passes the pulmonary capillary membrane and binds to the?

A

Hemoglobin molecule of red blood cells

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161
Q

Approximately what percent of the body’s oxygen is bound to the hemoglobin

A

97%

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162
Q

This measures the percentage of hemoglobin that is saturated with oxygen

A

Pulse oximetry

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163
Q

Carbon dioxide is transported into the blood in the form of ?

A

Bicarbonate ions

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164
Q

Decreased mechanical effort due to decreased oxygen to the brain are?

A

1: severe chest pain
2: traumatic asphyxia ( body deprived of oxygen)
3: hypoventilation

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165
Q

What are the causes of decreased oxygen in the blood from medical conditions?

A

1: pneumonia, pulmonary edema, COPD
2: non functional alveoli
3: intrapulmonary shunting ( occurs when blood passes through the lungs without participating in gas exchange)

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166
Q

Hypoventilate and hyperventilate what happens to CO2 levels?

A

Hypoventilate ~ CO2 increases
Hyperventilate ~ CO2 decreases

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167
Q

Hypercapnia

A

Body has too much CO2 in the blood

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168
Q

Hypocapnia

A

Condition where the CO2 levels in the blood fall below the normal range of 35 mmHg

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169
Q

This law states that in a mixture of gases , the total pressure is equal tot he sum of the pressures of each gas if they were alone in the same container

A

Dalton’s law of partial pressure

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170
Q

This is a pulse that occurs when the systolic blood pressure drops more than 10 mmHg during inhalation

A

Pulses paradoxus

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171
Q

Two types of hemoglobin normally found are

A

1: oxyhemoglobin (Hbo2)
2: reduced hemoglobin

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172
Q

These detectors, detect the presence of carbon dioxide in exhaled breath

A

ETCO2

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173
Q

These are also known as French catheters . Are soft plastic non rigid catheters placed in the oropharynx or down a tracheal tube

A

Whistle tip

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174
Q

What do we use to visualize the airway?

A

Laryngoscope

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175
Q

Curved forceps

A

Macgill forceps

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176
Q

If you hear gurgling the patient needs?

A

Suctioning

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177
Q

Never insert a suctioning catheter past the?

A

Base of the tongue

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178
Q

This is used primarily to deliver aerosolized medications

A

Nebulizer

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179
Q

In a nebulizer oxygen enters an aerosol chamber that contains how much fluid?

A

3-5 ml

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180
Q

This is a large cranial nerve responsible for sensation in the face and motor functions like chewing? And what number cranial nerve is it?

A

Trigeminal nerve (CN V)
5th cranial nerve

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181
Q

This nerve primarily controls facial muscles for expressions and transmits taste sensations from the anterior two thirds of the tongue? And what number cranial nerve is it?

A

Facial nerve (CN VII)
7th cranial nerve

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182
Q

Calculate tanks D & M. Explain how?

A

D - 0.16
m - 1.56

lets measure the pressure for tank D

lets say tank pressure at the moment is 1200

1200 - 200 = 1000
1000 x 0.16 = 160
if using nasal canula at 6 then:
160 divided by 6 = 26.67 minutes

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183
Q

explain P1 to P4 and when end tidal gets measured?

A

P1 - respiratory baseline
P2 - Expiratory upstroke
P3 - Expiratory plateau (end tidal gets measured)
P4 - inspiratory downstroke

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184
Q

measuring gas exchange per minute

A

you take the end tidal and minus the dead space which is always 150
so lets say end tidal is 500 then:

500 - 150= 350 ml

then you take 350 and multiply it by bpm (breaths per minute)

350 x 12 = 4200 ml/minute
would be the alveolar minute volume

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185
Q

shocking for ages 8+

A

1st shock - 120 J
2nd shock - 150 J
3rd shock - 200 J

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186
Q

shocking for children under the age of 8?

A

eg: shocking for a 4 year old

age x 2 + 10 = kg
4 X 2 + 10 = 18
18 X 2 = 32
therefore you shock at 32 J

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187
Q

This type of pain originates from the internal organs and is felt in the body’s midline

A

Visceral pain

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188
Q

This type of injury encompass damage to the muscles, tendons, ligaments and other tissues. Includes sprains, strains, contusions and tendinitis

A

soft tissue injury

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189
Q

stretching or tearing of ligaments which connect bones to each other

A

sprains

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190
Q

injuries to muscles or tendons which connect muscles to bones caused by overstretching or tearing

A

strains

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191
Q

contusions

A

bruising

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192
Q

tendonitis

A

inflammrion of tendon, a tough band of tissue that connects muscle to bone, often caused by overuse or repetitive movement

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193
Q

What’s the fluid like sac that cushions tendons and muscles and bones near joints

194
Q

What do we use to check temperature

A

tympanic device

195
Q

What do we use to check arterial oxygen saturation

A

pulse oximeter

196
Q

what are 2 forms of stethoscope? and explain how they work?

A

acoustic - simple mechanically based devices that transmit sound directly to the users ears

electronic - use electronic amplification to enhance sounds for clearer listening

197
Q

blood pressure cuff is called?

A

sphygmonometer

198
Q

this device allows you to look into a patients eyes and view the retina

A

opthalmoscope

199
Q

this device evaluates the ears of a patient

200
Q

What are these layers of?
-Skin with hair
-subcutaneous tissue
-galea aponeurotica
-loose connective tissue ( alveolar)
-periosteum

201
Q

How many bones in three anatomic groups ( facial bones)

A

28 total
6 bones ( auditory ossicles), three on each side)
22 Bones ( cranium and face)

202
Q

What are the 8 bones of the cranial vault

A

Parietal ( two each)
Temporal ( two each)
Frontal
Occipital
Sphenoid
Ethmoid

203
Q

This is a large opening at the base of the skull ( in the occipital bone). It allows the brainstem to connect with the spinal cord and serves as a passage for essential blood vessels and nerves

A

Foramen magnum

204
Q

What are the 6 major sutures in the human skull?

A

-Coronal suture ( runs side to side separating 2 frontal bones from the parietal bones)

-Sagittal suture ( runs along the midline of the skull separating the 2 parietal bones)

-lambdoid suture ( separates the occipital bone from the two parietal bones)

-squamous suture ( right and left) - located on each side of the skull separating the temporal bone from the parietal bone

205
Q

Maxilla, vomer, inferior nasal concha, zygomatic, palatine, nasal, lacrimal are what bones?

A

Facial bone
There is 14

206
Q

Ophthalmic and maxillary nerves are sensory or motor?

207
Q

Mandibular nerve is sensory or motor?

A

It’s both sensory and motor

208
Q

Where does the blood supply of the face come from?

A

Primarily through external carotid artery

209
Q

These are branches of what artery?
Temporal artery
Mandibular artery
Maxillary artery

A

External carotid artery

210
Q

These protect the eye and its structures eg: eyeball and muscles that move it, blood vessels, nerves, fat

A

The orbits

211
Q

This on the nose often bulges slightly to one side

A

Nasal septum

212
Q

Frontal, maxillary, ethmoid, sphenoid are what sinuses?

A

Paranasal sinuses

213
Q

The external nose is mostly made of?

214
Q

This is a hinge joint that connects the mandible ( lower jaw) to the temporal bone of the skull. It is located in front of each ear and allows for movement of the jaw

A

Temporomandibular joint ( TMJ)

215
Q

This joint is responsible for mastication ( chewing) speech, opening and closing the mouth, enables talking, yawning, and swallowing

216
Q

What kind of a joint is TMJ?

A

It’s a synovial joint with a cartilage disc that’s cushions movements and prevents friction between the bones

217
Q

This bone is not part of the skull, supports tongue, attachment for neck and tongue muscles

A

Hyoid bone

218
Q

How does vision work?

A

Light through lens to retina
Optic nerve to brain
Brain to visual cortex

219
Q

What kind of vision is this?
You can see objects directly in front, processed by macula ( central portion of retina)

A

Central vision

220
Q

What kind of vision is this?
Let’s you see lateral objects while looking forward, processed by remainder of retina

A

Peripheral vision

221
Q

What does this?
Secretes and drains tears from eye
Tears drain into lacrimal ducts
Then into lacrimal sacs
Through nasolacrimal duct into nasal cavity

A

Lacrimal apparatus

222
Q

What is cushings triad?

A

Cushings triad is a set of three signs that indicate ICP.
1: hypertension
2: Bradycardia ( slow heart rate)
3: irregular respirations

223
Q

How many teeth do adults have?

224
Q

Where are these parts on the ear
1. Pinna
2. External auditory canal
3. Eardrum

A

External ear

225
Q

Where are these parts in an ear?
Tympanic membrane, ossicles ( three small bones)

A

Middle ear

226
Q

Where are these in an ear?
Cochlea, semicircular canals?

227
Q

Pulp cavity is what part of the tooth?

A

The centre of the tooth contains blood vessels, nerves

228
Q

What surrounds the pulp cavity?

A

Dentin and enamel

229
Q

What is the largest mass of tooth?

230
Q

What are the 4 nerves of the mouth?

A

Hypoglossal (12th cranial nerve)
- it’s the motor function of the tongue

Glossopharyngeal ( 9th cranial nerve)
- salivary gland function

Trigeminal ( 5th cranial nerve)
- motor chewing function

Facial nerve ( 7th cranial nerve)
- facial expression

231
Q

What are common mechanisms of penetrating injuries?

A

Gunshot wounds, stabbing and impaled objects

232
Q

If the mechanism of injury is blunt. What kind of injuries are sustained?

A

Soft tissue

233
Q

What occurs when air bubbles enter the blood stream and block blood flow. These bubbles can travel through arteries or veins leading to serious complications by obstructing blood supply to vital organs

A

Air embolism

234
Q

What do you do when someone has an open injury?

A

To prevent air embolism, seal with occlusive dressing immediately

235
Q

When you apply an occlusive dressing what do you apply directly over it?

A

Apply manual direct pressure over occlusive dressing with a bulky dressing

236
Q

These signs and symptoms would be for?
Laboured breathing
Stridor
Hoarseness voice changes
Hemolysis ( coughing up blood)
Subcutaneous emphysema
Swelling edema
Structural irregularity

A

Laryngeal fracture and tracheal transectiom

237
Q

These symptoms would be for?
Gross external bleeding
Signs of shock
Hematoma, swelling, edema
Pulse deficits

A

Vascular injury

238
Q

These would be symptoms for?
Dysphagia ( difficulty swallowing)
Hematemesis
Hemoptysis ( suggests aspiration of blood)

A

Esophageal perforation

239
Q

These would be symptoms of?
Signs of stroke
Paralysis or parenthesis
Cranial nerve deficit
Signs of neurogenic shock

A

Neurological impairment

240
Q

What type of head injury is this?
Most common, associated with blunt trauma, dura mater remains intact, brain tissue not exposed, skull fractures, focal or diffuse brain injuries, often complicated my increased ICP

241
Q

What type of brain injury is this?
Dura mater and cranial contents penetrated, brain tissue open to environment, gun shot wounds are the most common mechanism of injury

242
Q

What’s hypovolemic shock?

A

Significant loss of blood or fluids leading to inadequate circulation and oxygen to the body’s tissues. A shock caused by low blood volume

243
Q

What are 4 types of skull fractures?

A

Linear
Depressed
Basilar
Open

244
Q

What are 2 broad categories of brain injuries?

A

-Primary ( results instantaneously from impact)
-secondary ( consequences of primary injury eg: cerebral edema, intracranial hemorrhage, increased ICP etc

245
Q

What is the brains ability to maintain constant cerebral blood flow (CBF) despite changes in mean arterial pressure ( MAP). This ensures that the brain gets enough oxygen and nutrients even when blood pressure fluctuates

A

Auto regulation in the brain

246
Q

What is it called when brain is forced from cranial vault through foramen magnum?

A

Cerebral herniation

247
Q

What are early signs of brain injury?

A

Vomiting, headache, altered LOC, seizures

248
Q

What are later signs of brain injury?

A

Cushings triad, pupil changes, coma, posturing ( decorticate and decerebrate )

Decorticate ( flexor)
Decerebrate (extensor)

249
Q

This is a severe form of traumatic brain injury ( TBI) caused by widespread shearing and tearing of axons in the brains white matter it typically results from rapid acceleration or deceleration forces such as motor vehicle accidents, falls, shaken baby syndrome

A

Diffuse axonal injury (DAI)

250
Q

This occurs when there is bleeding into where CSF circulates ( bloody CSF). Increased ICP, can cause death. Between arachnoid and pia mater.

A

Subarachnoid hemorrhage

251
Q

Brain injury classification based on the GCS

A

15- no neurological disabilities

13-14 mild traumatic brain injury

9-12 moderate traumatic brain injury

3-8 severe traumatic brain injury

252
Q

How often to assess patients with brain injury?

A

Every 5 minutes

253
Q

Pupil assessment for brain injury, what to look for?

A

Watch for sluggish reaction to light( that’s a indication of cerebral hypoxia or increased ICP)

254
Q

Why do we hyperventilate in cerebral herniation? And how does it help?

A

When the brain is swelling too much ( high ICP) , we need to reduce the swelling quickly to protect the brain. Hyperventilation removes CO2 from the blood, when CO2 levels drop :
1: brain blood vessels shrink ( vasoconstriction)
2: less blood goes to the brain
3:this reduces ICP and swelling

We use this only in emergency when a patient is. Showing signs of brain herniation (blown pupil, irregular breathing, high BP, slow HR)

Hyperventilate at 20 breaths per minute

255
Q

This type of fracture is a straight crack in the skull like a thin line. The bone doesn’t move out of place

A

Linear fracture

256
Q

In the fracture a part of skull is pushed inward like a dent. This can press on the brain

A

Depressed skull fracture

257
Q

In this type of skull fracture there is a break at the base of the skull basically near the eyes, ears or nose. It can cause bruising around the eyes ( periorbital ecchymosis) or behind the ears (battle signs)

A

Basilar fracture

258
Q

Most common mechanisms of injury for skull fractures are

A

Motor vehicle collisions
Significant falls

259
Q

What are signs of shock?

A

Persistent hypotension, tachycardia, diaphoresis

260
Q

To manage circulation in a brain injury. what do we do and why?

A

With a serious braininjury we need to make sure their blood pressure is stable. If the blood pressure drops too low, the brain doesn’t get enough oxygen which can cause more damage.

putting in a large bore IV would help to get fluids in faster. This helps if patient is in shock or bleeding.

DO NOT use dextrose because it can increase brain swelling and may cause blood sugar spikes which may worsen the brain injury

use normal saline or ringers lactate these are fluids that help keep blood pressure stable

261
Q

what’s the 90 - 90 - 9 rule, for trauma patients?

A

oxygen < 90
systolic BP < 90
GCS < 9
Chance of death increases if both hypoxemia and hypotension occur

262
Q

what’s the difference between hypoxia and hypoxemia?

A

Hypoxemia is low oxygen levels in the blood, specifically a reduced partial pressure of oxygen in arterial blood. It can lead to hypoxia, which is inadequateoxygen supply to the tissues.

263
Q

what’s the treatment for open fracture with brain exposed?

A

cover lightly with sterile dressing moistened with sterile saline

264
Q

This system gives the body its shape,, provides support to the soft tissues, enables erect posture and body movement, provides protection to critical underlying organs and structures

A

Musculoskeletal system

265
Q

This occurs in the bone marrow, produced in bone marrow from stem cells, many bones produce new blood cells

A

Hematopoiesis

266
Q

Axis

A

Axial skeleton

267
Q

Cranium, basilar skull, face, inner ear

268
Q

Cervical, thoracic, lumbar, sacral, coccygeal

A

Vertebral column

269
Q

Pectoral girdle, pelvic girdle, upper lower extremities

A

Appendicular skeleton

270
Q

Two scapulae and two clavicles

A

Pectoral (shoulder) girdle

271
Q

This is a flat triangular bone, held to rib cage by powerful muscles

A

Scapulae ( shoulder blade)

272
Q
  • slender S shaped bone
  • articulates with sternum and acrimony
  • acts as a strut to keep the shoulder propped up and as scaffolding on which other muscles of the thoracic pull
A

Clavicle ( collar bone)

273
Q

What’s the primary joint of the shoulder

A

Glenohumeral joint

274
Q

Humerus is the

275
Q

Distal portion of upper extremity contains?

A

Radius and ulna ( articulation of these two occurs at the elbow joint

276
Q

-Larger of two forearm bones
-lies on thumb side of the forearm

277
Q

-The narrow forearm bone
- serves as a pivot around which the radius turns

278
Q

Carpals are

A

Wrist bones

279
Q

Metacarpals are?

A

Hand bones

280
Q

Phalanges are?

A

Finger bones

281
Q

This is a large irregularity shaped bone that forms part of the pelvis, it is formed by fusion of three bones ilium, ischium and pubis

A

Innominate bone

282
Q

Head of femur articulates proximally with ……… of pelvis to form ball and socket joint

A

Acetabulum

283
Q

Neck of femur connects?

A

Head with shaft

284
Q

This is a shin bone and it’s superficial

285
Q

This makes up lateral portion of the lower leg

286
Q

This part of the femur is exposed to force when we land on our feet or fall

A

Femoral neck

287
Q

Tarsals

288
Q

Metatarsals

289
Q

The shaft or central part of the bone, composed mostly of compact bone and containibg
The medullary ( marrow) cavity

290
Q

The ends of the bone which contain spongy bone and are covered with particular cartilage where they form joints

291
Q

This covers the outer surface of bones except at the joints and it’s a dense, fibrous membrane

A

Periosteum

292
Q

This lines the inner surfaces of bones particularly the medullary (bone marrow) cavity, trabeculae ( spongy bone) and the central canals of compact bone

293
Q

This is the hollow, central space inside long bones such as the femur and humerus

A

Medullary canal

294
Q

When bone density decreases there more chances of

A
  • osteoporosis
  • risk of injury increases
  • loss is accelerated after age of 35 and after menopause
  • common injury sites include hip, spine and wrist
295
Q

Where bones articulate

296
Q

Palm facing up ( like holding a bowl of soup)

A

Supination

297
Q

Palm facing down

298
Q

3 types of joints

A

Fibrous
Cartilaginous
Synovial

299
Q
  • synarthroses
  • contain dense tissue
  • do not allow motion eg: skull, distal tibiofibular joint
A

Fibrous joints

300
Q
  • amphiarthroses
  • allow for minimal motion between bones
  • example: pubic symphysis and rib sternum
A

Cartilaginous joints

301
Q

Diarthroses
Most mobile joints

A

Synovial joints

302
Q

This is a small fluid filled sac that acts as a cushion between bones, tendons, muscles and skin, its main function is to reduce friction and allow smooth movement of structures and joints
They contain synovial fluid which lubricates and cushions the surrounding tissue

303
Q

This is an inflammation of a bursa often caused by repetitive movement , trauma or infection

304
Q

-Connects muscles to bones
-Flat, cordlike bands of connective tissue
-have a glistening white appearance

305
Q

-connect bone to bone
-help maintain stability of joints
-Determine degree of joint motion
-have similar structure to tendon

306
Q

-This consists of fibres of collagen embedded in gelatinous substance
-provides smooth surface over bone ends where they articulate
- cushions eg: vertebrae
- provides structure to eg: nose
-serves as model for formation in skeleton of children
-limited nerovascular supply
- does not heal well

307
Q

Three types of muscles are

A
  • smooth
  • cardiac
  • skeletal
308
Q

-This muscle is also called voluntary muscle and striated muscle
-forms the bulk of muscles of arms legs spine and buttocks

A

Skeletal muscle

309
Q

Muscle contraction requires energy from?

A

Glucose metabolism

310
Q

This refers to the nerve supply to a muscle which allows it to contract and function properly. This involves motor neurons transmitting electrical signals from the nervous system to muscle fibers enabling movement and coordination

A

Muscle innervation

311
Q

Two types of innervation

A

Motor and sensory

312
Q

Two types of motor innervation

A

Somatic and autonomic

313
Q

This motor innervation controls skeletal muscles, voluntary movement

314
Q

This motor innervation controls smooth and cardiac muscles, involuntary functions

315
Q

This innervation is when nerves carry information from muscles to the brain about stretch, tension and pain

A

Sensory innervation

316
Q

-This is a network of nerves that originates from spinal cord at C5-T1 levels
-provides innervation for upper extremities

A

Brachial plexus

317
Q
  • this is a network of nerves that originates from the spinal cord at L1-S4 levels
  • provides innervation for lower extremities
A

Lumbar and lambosacral plexuses

318
Q

The upper extremity’s blood supply originates from?

A

The subclavian artery

319
Q

The lower extremity’s blood supply originates from?

A

The external iliac artery

320
Q

What kind of injury force is this? “Injury happens at the impact site”
Eg: A soccer ball hits a players eye

A

Direct force

321
Q

What kind of injury force is this? “Injury happens away from the impact site because the force travels through the body” eg: a player lands awkwardly on their foot, twisting their knee

A

Indirect force

322
Q

Musculoskeletal injuries that occur together. Look for rib fracture, pulmonary contusions , pneumothorax if you find?

A

Scapular fracture

323
Q

Musculoskeletal injuries that occur together. Look for wrist elbow or shoulder fracture if you find?

A

Scaphoid fracture

324
Q

Musculoskeletal injuries that occur together. Look for lumbosacral spine and other long bone fractures, intra abdominal or genitourinary injury if you find?

A

Pelvic fracture

325
Q

Musculoskeletal injuries that occur together. Look for fracture of the acetabulum or femoral head if you find?

A

Hip dislocation

326
Q

Musculoskeletal injuries that occur together. Look for dislocation of ipsilateral hip if you find?

A

Patellar fracture

327
Q

Musculoskeletal injuries that occur together, look for tibial fracture, distal pulse may be absent if you find?

A

Knee dislocation

328
Q

Musculoskeletal injuries that occur together. Look for fracture of the ankle leg, hip, pelvis, lumbar spine, and the other calcaneus if you find?

A

Calcaneal fracture

329
Q

-This is a break in the continuity of a bone
-it may be classified based on the type of displacement

330
Q

This means that each end of the fracture is not aligned in a straight line and an angle has formed between them

A

Angulation

331
Q

-What is it called when a bone is totally displaced from a joint
-articular surfaces are no longer in contact
- joint capsule and supporting ligaments are usually damaged
-severe pain

A

Dislocation

332
Q

A partial or incomplete dislocation of a joint, where the bones are still partially in contact

A

Subluxation ( remember S for slight dislocation)

333
Q

A significant separation of two bones that are normally close together, often due to ligament damage

A

Diastasis (remember D for distance between bones)

334
Q

-This occurs when ligaments are stretched or torn
-results from sudden twisting or overextension at a joint
- causes pain swelling discolouration and unwillingness to use the limb

335
Q

How to treat a sprain

A

Treat like a fracture including
Protect
Rest
Ice
Compression
Elevation
Drugs

336
Q

-this occurs when there is an injury to a muscle or a tendon
-results from violent muscle -contraction, excessive stretching, or repeated overuse
-Characterized by minor swelling and pain, increased with movement

337
Q

-This is a complete or partial tear of the tendon, which connects the calf muscles to the heel bone
-men over 30 are at higher risk
-sports is a cause too

A

Achilles tendon rupture

338
Q

Meaning of PRICED for Achilles tendon rupture management

A

Protection
Rest
Ice
Compression
Elevation
Diagnosis/drugs

339
Q

What is inflammation of a joint called?

340
Q

3 most common types of arthritis

A

Osteoarthritis
Rheumatoid arthritis
Gout

341
Q

Blood collects outside a vessel ( false aneurysm)

A

Pseudo aneurysm

342
Q

Blood clot inside a vessel ( blocks flow)

A

Thrombosis

343
Q

-This occurs when blood vessels are damaged following a musculoskeletal injury
-may result from vascular contusions, lacerations , pseudo aneurysm, thromboses

A

Devascularization

344
Q

Potential blood loss from fracture sites most blood loss to least

A
  • pelvis ( 1500-3000 ml)
  • femur ( 1000-1500 ml)
  • humerus ( 250-500 ml)
  • tibia or fibula (250-500ml)
    -ankle (250-500 ml)
    -elbow (250-500 ml)
    -Radius or ulna (150-250 ml)
345
Q

6 Ps of musculoskeletal injuries

A

-Pain
-Pallor ( skin becomes pale or bluish)
-Paralysis (loss of function/ movement)
-paresthesia (abnormal sensations like tingling or numbness)
-pulselessness
-pressure ( swelling or tightness )

346
Q

Cold packs are useful for decreasing pain and swelling during?

A

The first 48 hours

347
Q

For this kind of injury immobilize the bone ends and the two adjacent joints

A

Fractures (eg: for a broken arm like radius or ulna, immobilize the elbow joint and the wrist joint)

348
Q

For this kind of injury, extend the splint along the entire length of the bone above and the entire length of the bone below the injured joint

A

For dislocations

349
Q

For this kind of injury apply longitudinal traction to attempt to realign bone and restore circulation

A

Severe angulation

350
Q

How to splint knee

351
Q

How to splint elbow

A

At a right angle

352
Q

-These injuries occur when both nerves (neuro) and blood vessels (vascular) are damaged often due to trauma such as fractures, dislocations or crush injuries.
- these injuries can lead to serious complications like loss of sensation, weakness, paralysis, tissue death

A

Neurovascular injuries

353
Q

-This is a serious condition that occurs when increased pressure within a muscle compartment restricts blood flow and damages nerves and tissues
-if left untreated as it can lead to permanent muscle and nerve damage or even limb loss

A

Compartment syndrome

354
Q

What is compartment syndrome caused by

A

Usually cause by trauma, fractures, crush injuries, burns or vascular injures

355
Q

Theses are signs and symptoms of:
- feeling of pressure over joint
- pain
- obvious and significant deformity
- decrease in range of motion ( frozen in place)
- possibly compromised distal PMS

A

Dislocation

356
Q

Compartment syndrome treatment

A

-elevate the extremity to the heart level
- place cold packs over the extremity
- open or loosen tight clothing

357
Q

This refers to conditions caused by blood clots that form in blood vessels and can travel to block blood flow in critical areas

A

Thromboembolic disease (TED)

358
Q

This is a condition when a blood clot forms in a deep vein, usually in the legs

A

Deep vein thrombosis (DVT)

359
Q

This is when a clot travels to the lungs, blocking blood flow

A

Pulmonary embolism

360
Q

How to assess for pulmonary embolism

A
  • sudden onset of dyspnea
  • pleuritic chest pain
    -tachypnea
  • right side heart failure
  • shock
  • cardiac arrest
361
Q

Explain clavicle fractures

A
  • Common in children
  • occur to middle third of bone
  • MOI: falling onto outstretched arm or direct contact

Signs and symptoms:
- pain in shoulder
- swelling
- unwillingness to raise arm
- leaning towards injured side

362
Q

In this fracture the injuries would be in the Glenoid fossa, humeral head and humeral neck

A

Shoulder injury

363
Q

-For this fracture splint wrist at 30 degrees of dorsiflexion
-slightly flex fingers
- secure forearm to rigid splint
-elevate hand

A

Wrist and hand fractures

364
Q

5 types of pelvic fractures

A
  • lateral compression
  • anterior posterior compression
    -vertical shear
  • straddle fracture
  • open pelvic fracture
365
Q

This is a severe pelvic fracture that involves breaks in both public rami (superior and inferior ) on both sides

A

Straddle fracture

366
Q

The paired parietal bones join together at the?

A

sagittal suture

367
Q

After a blow to the back of his head a person may see stars why does that happen?

A

The occipital lobe impacts against the back of the skull, which is in charge of vision

368
Q

The speech center is located in the ……… lobe?

369
Q

The ………. Lobe also controls long term memory, hearing, taste and smell

370
Q

The ……….., which is located between the brainstem and the cerebrum includes thalamus,
subthalamus, hypothalamus and eoithalamis

A

Diencephalon

371
Q

This processes most sensory input and influences mood and general body movements especially those associated with fear and rage

372
Q

This controls motor functions

A

Subthalamus

373
Q

This is vital in the control of many body functions including heart rate, digestion, sexual development, temperature regulation emotions hunger thirst vimiting and regulation of sleep cycle

A

Hypothalamus

374
Q

This is sometimes called the athletes brain because it is responsible for the maintenance of posture, equilibrium and the coordination of skilled movements

A

Cerebellum

375
Q

This consists of the midbrain pons and medulla

376
Q

This is located at the base of the brain and connects the spinal cord to the remainder of the brain

A

Brain stem

377
Q

The mid brain lies immediately below the?

A

Diencephalon

378
Q

The inferior portion of the midbrain, the ………….is continuous inferiority with the spinal cord

379
Q

The …………. Also coordinates heart rate, blood vessel diameter, breathing, swallowing, vomiting, coughing and sneezing.

380
Q

The ………… are protective layers that surround and enfold the entire central nervous system, specifically the brain and spinal cord

381
Q

The outermost layer is a strong fibrous wrapping called ………… and it covers the entire brain

A

Dura mater ( meaning tough mother)

382
Q

A ………….. is a collection of blood between the dura mater and the brain usually caused by trauma

A

Epidural hematoma

383
Q

Is this le fort 1 2 or 3? Horizontal fracture through the maxilla

384
Q

Is this le fort 1 2 or 3? Pyramidal fracture extending into the nasal bridge

385
Q

Is this le fort 1 2 or 3? Complete craniofacial separation

386
Q

This fracture the patient may report double vision and loss of sensation above the eyebrow or over the cheek , it can cause paralysis of the upper gaze so the patients injured eye will not be able to able to follow your finger

A

Orbital fracture (blow out fracture) or zygomatic fracture

387
Q

What kind of fracture is this
- massive facial swelling
- dental malocclusion
- palpable deformities
- anterior or posterior epistaxis

A

Multiple facial bone fractures

388
Q

What kind of fracture is this?
- crepitus and instability
-swelling tenderness, lateral displacement
- anterior or posterior epistaxis

A

Nasal fractures

389
Q

What kind of fracture is this?
- mobility of the midface
- dental malocclusion
- facial swelling

A

Maxillary le fort fractures

390
Q

Blood or CSF drainage from the nose (cerebrospinal ) suggests a?

A

Skull fracture ( do not attempt to control this bleed, it will increase the ICP

391
Q

Eye lacerations are serious injuries that require prompt transport, although bleeding can be heavy do not?

A

Do not Put pressure on the eye, pressure may squeeze the vitreous humour, iris, lens or retina out of the eye

392
Q

When small or moderate objects enter the eye, and when lying on the surface can cause severe irritation. The eye becomes red and inflamed and the eye begins to produce tears to attempt to flush out the object

A

Conjunctivitis

393
Q

When one eye is injured still always cover??

394
Q

Chemical burns in the eye caused by acid or alkaline solutions require ?

A

Flushing the eye with clean water or sterile saline solution

395
Q

Symptoms that may indicate serious ocular injury

A
  • visual loss that does not get better when the patient blinks , may indicate damage to the globe
  • double vision usually points to trauma, fracture of the orbit
  • severe eye pain
  • a foreign body sensation usually indicates a superficial injury to the cornea or the presence of a foreign object trapped behind the eyelids
396
Q

During the physical exam of the eyes evaluate each of the following visible ocular structures

A
  • orbital rim (for ecchymosis swelling , lacerations)
  • eyelids ( for ecchymosis, swelling, lacerations)
  • corneas ( for foreign bodies)
  • conjunctivae ( for redness pus inflammation)

-Globes ( for redness)

  • pupils ( for size shape equality)
  • eye movement in all direction ( for coordination)
397
Q

This is a condition in which the pupils are not of equal size, is a significant finding in patients with ocular injuries or closed head trauma

A

Anisocoria

398
Q

If hyphema or rupture of the globe is is suspected to what do you do?

A
  • take SMR precautions because such injuries indicate significant amount of force was applied to the face and may include cervical spine injury
  • elevate the head of stretcher 30-40 degrees
  • discourage them from coughing or vomiting cause it may increase IOP
399
Q

How long to irrigate the eye if the burn is caused by alkali or a strong acid

A

20 minutes

400
Q

The primary threats from
Penetrating neck trauma are?

A

Massive hemorrhage from major blood vessel disruption and airway compromise

401
Q

To control bleeding from an open neck wound and prevent air embolism what to do?

A

Immediately cover the wound with an occlusive dressing

402
Q

What kind of neck injury has these symptoms?
- laboured breathing or reduced air movement
-stridor
-Hoarseness voice changes
- hemoptysis ( coughing up blood)
-subcutaneous emphysema
- swelling seems
-structural irregularities

A

Laryngeal fracture, tracheal transection

403
Q

What neck injury are these symptoms of?
- gross external bleeding
- signs of shock
-hematoma, swelling , edema
-pulse deficits

A

Vascular injury

404
Q

What neck injury are these symptoms of?
- dysphagia (difficulty swallowing )
- hematemesis
- hemoptysis

A

Esophageal perforation

405
Q

Minimum CPP (cerebral perfusion pressure) required to adequately peruse the brain is?

406
Q

This kind of brain injury is an injury that affects the entire brain

A

Diffuse brain injury

407
Q

This brain injury occurs when the brain is jarred around in the skull. This kind of brain injury is caused by rapid acceleration-deceleration forces such as motor vehicle collision, falls

A

Cerebral concussion

408
Q

What are signs of a concussion?

A
  • transient confusion and disorientation
    -loss of consciousness
  • retrograde amnesia ( loss of memory of events before injury)
    -anterograde amnesia ( loss of memory of events after injury)
409
Q

In this kind of brain injury the brain tissue is bruised and damaged in a local area. And because of the physical damage there is prolonged confusion and loss of consciousness worse than a concussion

A

Cerebral contusion

410
Q

This is an accumulation of blood between the skull and dura mater. It’s nearly always the result of a blow to the head that produces a linear fracture of the thin temporal bone

A

Epidural hematoma

411
Q

the parietal bones abut (meet) the frontal bone at the?

A

coronal suture

412
Q

the occipital bone attaches to the parietal bones at the?

A

lambdoid suture

413
Q

fibrous tissues called …………, which are soft in infants link the sutures

A

fontanelles

414
Q

at the base of each temporal bone is a cone shaped section of bone known as the?

A

mastoid process

415
Q

the chamber inside the nose that lies between the floor of the cranium and the roof of the mouth is?

A

the nasal cavity

416
Q

This is the bone that extends a long the front of the skull below the orbit

A

zygomatic arch

417
Q

Blood supply to the face is provided primarily through the

A

external carotid artery

418
Q

Blood supply to the face is provided primarily through the external carotid artery which arches into the ……………., ……………, ……………arteries. Because the face is highly vascular is tends to………….. when injured

A

temporal
madubular
maxillary
bleed heavily

419
Q

a blow to the eye may result in fracture of the ………… floor because the bone is thin and breaks easily

420
Q

A so called ………… fracture results in transmission of forces away from the eyeball itself to the bone, blood and fat then leak into the maxillary sinus

421
Q

The ……… bone floats in the superior aspect of the neck just below the mandible

422
Q

This bone supports the tongue and serves as a point of attachment for many important neck and tongue muscles

A

hyoid bone

423
Q

The major arteries of the neck the………. and the……….. arteries supply oxygen enacted blood directly to the brain

A

carotid
vertebral

424
Q

The largest portion of the brain is the …………, which is responsible for higher functions such as reasoning

425
Q

The largest part of the cerebrum is the?

A

cerebral cortex

426
Q

The cerebral cortex regulates ………….. movement and the level of awareness

427
Q

Injury to the cerebral cortex may result in?

A

paraesthesia, weakness and paralysis of the extremities

428
Q

The ……… lobe is responsible for important for voluntary motor action and personality traits

429
Q

injury to the frontal lobe may result in?

A

seizures or placid reactions

430
Q

The ………. lobe controls the somatic or voluntary sensory and motor functions for the opposite side of the body as well as memory and emotions

431
Q

This brain injury is an accumulation of blood beneath the dura matter but outside the brain

A

Subdural hematoma

432
Q

This type of brain injury involves bleeding within the brain tissue itself

A

Intracerebral hematoma

433
Q

The most important single sign in the evaluation of a patient with a head injury is?

A

A changing level of consciousness

434
Q

Signs of cerebral herniation? Unresponsive patient with 2 or more of the following:

A

1: asymmetric (unequal) pupils or bilaterally fixed and dilated pupils
2: Decerebrate posturing or no motor response to painful stimuli
3: original GCS of 8 or less or that decreases by 2 or more points from the patients best score

435
Q

Patients with head injury, unlike those with shock can develop a ………………. Body temperature

436
Q

Hyperpyrexia

A

High body temperature

437
Q

These bones are longer than they are wide

A

Long bones ( femur humerus radius ulna metacarpals metatarsals and phalanges )

438
Q

These bones are nearly as wide as they are long

A

Short bones (carpals and tarsals)

439
Q

These bones are thin, broad bones

A

Flat bones (sternum ribs scapulae and skull)

440
Q

These bones do not fit into one of the other categories but rather have a shape that is designed to perform a specific function

A

Irregular bones (vertebral column mandible)

441
Q

These bones are often referred to as Sesamoid bones because of their small size and shape. They are embedded within muscle or tendon

A

Round bone ( patella which is the largest and most well known Sesamoid bone)

442
Q

The portion of the bone that is not covered by the articular cartilage is instead covered by the ?

A

Periosteum

443
Q

Unused muscles quickly shrink or waste away which is called?

444
Q

Physical training increases muscle which is called l?

A

Hypertrophy

445
Q

Fatigue fractures are caused by repetitive stress when they happen in the metatarsals after prolonged walking marching or dancing they are called?

A

March fractures

446
Q

…………. Of a fracture means the ends of the fracture are not aligned in a straight line and that an angle has formed between them

A

Angulation

447
Q

What is an open fracture sometimes called?

A

Compound fracture

448
Q

……….. occurs in fractures when the broken ends of a bone override one another

A

Shortening

449
Q

In a ………….. a bone is totally displaced from the joint and the articular surfaces are no longer in contact

A

Dislocation

450
Q

The partial dislocation of a joint is called a ……………

A

Subluxation

451
Q

When the ligaments that hold two structures in a fixed position to one another are disrupted and the space between them increases, a situation known as ………… occurs

452
Q

The scaphoid is also known as

A

Carpal navicular

453
Q

This is a fracture of the neck of the fifth metacarpal ( small finger). It commonly occurs after punching a hard object

A

A boxers fracture

454
Q

This fracture occurs when a finger is jammed into an object such as a baseball or basketball resulting in an avulsion fracture of the extension tendon

A

Mallet finger (baseball fracture)

455
Q

What type of fracture occurs when the bone is broken into multiple fragments

A

Comminuted

456
Q

Which of the following is the most common type of dislocation in adults?

457
Q

What is scaphoid fracture?

A

A break in the scaphoid bone, one of the eight small carpal bones in the wrist

458
Q

What is a key sign of compartment syndrome

A

Pale swollen limb with extreme pain

459
Q

When should you attempt to realign a deformed extremity

A

Only if there is no distal pulse

460
Q

Which type of fracture is most commonly seen I pediatric patients

A

Greenstick

461
Q

What is the recommended splinting position for a joint dislocation

A

In the position found

462
Q

What is the most critical complication of a femur fracture

A

Severe hemorrhage

463
Q

A patient with a femur fracture is at risk of developing

A

Pulmonary embolism

464
Q

What can cause a pathological fracture

A

Osteoporosis

465
Q

What type of fracture results in the bone being broken at an angle

466
Q

A break in the bony tip of the elbow where the ulna and humerus bones meet

A

Olecranon fracture

467
Q

Which fracture type is most concerning for child abise

468
Q

A fracture that results from minimal trauma due to disease

A

Pathologic fracture

469
Q

What type of wound occurs when layers of skin are scraped away

470
Q

Which soft tissue injury involves the tearing away of skin or tissue

471
Q

When applying tourniquet where should it be placed?

A

2-3 inches above the wound

472
Q

What is the greatest concern for a patient with an open chest wound

A

Pneumothorax

473
Q

Types of primary brain injury

A
  • concussion
  • contusion
  • diffuse axonal injury
  • hematomas
  • penetrating brain injury
474
Q

Which injury is associated with a lucid interval followed by rapid deterioration

A

Epidural hematoma can cause a bites period of consciousness (lucid interval) before ICP increases rapidly due to arterial bleeding

475
Q

What is the typical appearance of a subdural hematoma

A

Gradual onset of symptoms often over hours or days

476
Q

What is the primary function of the brainstem

A

Controls vital functions such as heart rate, blood pressure and breathing

477
Q

What is a hallmark sign for a basilar skull fracture

A

CSF leaking from the nose or ears

478
Q

Epidural and subdural hematoma difference

A

Epidural = emergency ( fast arterial bleeding)

Subdural = slow ( venous blood)

479
Q

What is blood in the anterior chamber of the eye called?