Medicine Flashcards
when was the Crimean war
1853-1556
what was Florence Nightingale’s main views
training of nurses, design of the hospital
What did Florence Nightingale demand
no dirt near patients, nurses need to be organised, clear bedding and good meals, guarantees to reduce death rate from 40% to 2%
What did Florence Nightingale want the hospitals to look like
improved ventilation, open plan hospital, more professional nurses, no pollution
What was ‘Notes On Nursing’ about
training of nurses and making it a proper profession
When was ‘Notes On Nursing’ written
1859
what did Florence Nightingale do
set up Nightingale school in 1860, promoted pavilion style hospitals, rigorous training turned it into a profession, recommended materials for hospitals that can be easily cleaned
How did hospitals change by 1990
split up infectious patients, cleanliness became important, doctors became common, trained nurses lived in nearby houses, became places where sick were treated
in 1799 what did Humphrey Davey discover
nitrous oxide
in 1846 what did William Morton discover
Ether which was a longer lasting anaesthetic
what did James Simpson discover
Chloroform which was a better anaesthetic than Ether
How was Chloroform experimented
inhaling various vapours from various chemicals
Positives of Chloroform
Queen Victoria used in labour in 1853, John Snow developed an inhaler that regulated the dosage and reduced deaths
When did John Snow develop the inhaler
1848
negatives of chloroform
difficult to get dosage correct, affected the heart
Why did people oppose the idea of anaesthetics
interfered with Gods plan, weren’t fully understood, number of deaths after operation using anaesthetics increased
How did Joseph Lister try to reduce death rate from infections from anaesthetics
he became interested in Pasteur’s work the idea of microbes were responsible for infection of a wound
When was carbolic acid discovered and what did it do
1864, used in sewage works in Carlisle to kill parasites
carbolic acid on James Greenlee
1865 testes his ideas on 11 year old boy who had compound fracture on leg, has an open wound and would normally lead to death, Lister soaked bandages in carbolic acid and watched wound, no sign of pus or infection, after 6 weeks fracture healed and wound
3 ways carbolic acid was used to stop spread of infection
clean wounds, clean equipment, bandages
what happened in 1867 with carbolic acid
his wards had been free from sepsis for 9 month
what happened in 1877 with carbolic acid
Lister became Professor of surgery at Kings College hospital, carried out an operation on a kneecap under anaesthetic conditions, operation became widely publicised
Problems with silk stitches and carbolic acid
silk didn’t absorb carbolic acid, thread had to be left dangling so stitches could be removed
Solutions to problems with stitches and carbolic acid
introduced catgut which could be sterilised, developed catgut that would dissolve after several days in the body
what does enlightenment mean
movement stressing the importance reason and critical re-evaluation of existing ideas and social institutions
what does renaissance mean
the period of this revival, roughly the 14th through the 16th century, marking the transition from Medieval to modern times, a rebirth
What does reformation mean
the action of process of reforming an institution or practice
6 key changes in Renaissance period
invention of new weapons led to soldiers getting new wounds, revival of learning universities established schools of medicine, artists revolutionised painting making us see body in more detail, governments were rich people could afford doctors, Columbus discovered america so new food and medicine were brought back, , printing press made new ideas widespread
Impact of the printing press
fast flow of information, books could be read by many people, motivated people to read, educated population, books printed in other languages, encouraged spread of ideas
impact of royal society
more knowledge of anatomy, met weekly to discuss new ideas, spread books and articles, people weren’t afraid to challenge new ideas, new ideas founded, important to be educated, became knowledgeable in science and art.
what did people think caused disease in medieval times
god, imbalance in the 4 humours, astrology, miasmus, star signs
what did Vesalius say
that medical students should perform dissections
impact of Vesalius’ discoveries
produced anatomical charts, performed dissections, proved Galen wrong about astrology, Galen was forced to dissect animals-went against religion, challenged Galen’s ideas about humans as he said they are different to humans
what did william harvey discover
how blood circulated around the body
impact of William Harvey’s discoveries
he used scientific methods, proves Galen wrong about the circulation of blood.
what did William Harvey believe
only veins carry blood, blood is not constantly manufactured by the liver and is not used up as it moves around body, blood must go through tiny blood vessels to move it from the arteries to the veins
why did technology affect Harvey’s ideas
limited technology meant microscopes were not powerful enough to prove his theory correct and it was not until much later that microscopes could do this
why was Harvey’s work limited because his work was based on physiology rather than causes
his work was not seen as particularly relevant because of this to the physicians and the existing problems about disease
why was Harvey’s work limited because people were reluctant to change their views about treatment and illness
doctors still based training on Galens ideas and doctors did not carry out dissections,
Progress in renaissance period withVersailius
Vesalius appointed errors in Galens work, Galen said we have 5 lobes in liver but we have 2, jaw bone is made from 1 bone not 2, breast bone has 3 parts not 7, blood does not flow through holes in septum, opened Galens work to questioning
limitations in renaissance with Versalius
church refused to accept galen had made any errors, doctors refused art in dissections and said art had no place in science, nobody was healthier as a result of versailius’ work, many more discoveries were needed before people would live longer
progress in Renaissance with Thomas Sydenham
focused on observation evidence and keeping records more accurate, identified specific diseases and created treatments, insisted doctors visited patients rather than other way round, published a book which became standard textbook for 2 centuries
limitations in renaissance with thomas sydenham
his clinical description didn’t make him popular with colleagues, he rejected using microscopes on religious grounds, still believed in the 4 humours
when was the germ theory founded
1861
what does vaccine mean
the administration of antigenic material to stimulate an individuals immune system to develop immunity, they can prevent disease.
what does immune mean
resistant to a particular infection
what does inoculation mean
taking a vaccine as a precaution against contracting a disease
problems with inoculation
not everyone could afford to have it done and it wasn’t always effective
what happened 14th May 1796 with Jenner
he took some cowpox from a blister on the arm of Sarah Nelmes and inserted it into cuts on James Phipps arm
what happened on 1st July 1796 with Jenner
he inoculated him with smallpox but no disease followed
What happened with Jenner and smallpox after inoculating James Phipps
several months later he tried again and didn’t develop t but to make sure he vaccinated another 23 people including his 11 month old son
what happened in 1798 with Jenner and Smallpox
he decided to publish his ideas however the royal society refused to publish so he had to pay to do it himself
What happened in 1802 with Jenner and Smallpox
he was awarded 10,000 dollars for his work
positives of Jenner’s vaccination
first time a disease could be safely be prevented, better than inoculation, willing to offer free vaccinations so all could have protection, inspired work of Koch and Pasteur, by 1980 smallpox was wiped out
negatives of Jenner’s vaccination
couldn’t be replicated for other diseases, only after work of Pasteur and Koch could vaccination be developed, , many disliked because it was sometimes incorrectly applied and failed, both a breakthrough and dead end, limited effect until made compulsory in 1871, funding was necessary
what did Pasteur’s germ theory experiments suggest
beer, wine and milk were going sour because of germs in the air
what significant conclusion did Pasteur reveal from Germ theory
that microbes were the cause of disease
why is the germ theory so significant
doctors finally knew the cause of disease in general
what was one major set back of the germ theory
they didn’t know which microbe caused which disease
what happened that made Pasteur investigate germ theory further
his daughter died and an outbreak of cholera
what did Pasteur do to investigate germ theory further
took samples of air from a cholera ward
What did Koch set out to do
find the specific microbe or bacterium causing an individual disease
how did Koch investigate tuberculosis
staining the microbe causing the disease so it stood out under a microscope from other microbes
what diseases were founded using Koch’s staining technique
1882 typhoid, 1883 cholera, 1886 pneumonia, 1887 meningitis, 1894 plague
one limitation of Koch’s work
didn’t save lives on it’s own
3 vaccines Jenner developed
anthrax, chicken cholera, rabies
how did Pasteur create a vaccine for rabies
investigated rabies by testing vaccine on dogs, in 1885 Joesph Miester who had been bitten by a rabied dog was given 13 injections over a 2 week period and he survived
positives of germ theory and identification of microbes
better trained doctor and nurses, more investment in science, higher life expectancy
what were the 2 improvements in technology which assisted the development of DNA
electron microscopes, x rays
what is crystallography
the science of determining the arrangement of atoms in solids
3 things that DNA allowed scientists to identify
eye colour, hair colour, height
what inherited conditions did the discovery of DNA allow scientists to discover
sickle cell ammonia, cystic fibrosis, downs syndrome
2 people who worked together to investigate the stricture of DNA
Francis Crick = physicist
James Watson = chemist
2 people who assisted Crick and Watson with DNA
Maurice Wilkins, Rosalind Franklin
what did one of Franklin’s photographs suggest
that genes were arranged in a double helix structure
what happened in 1953 with DNA
Crick and Watson discovered the structure of DNA
What happened in 1990 with DNA
Human genome project led by Watson set out to map out all the genes in the 23 chromosomes in every cell in the body
what happened in 2000 with DNA
the project involved hundreds of scientists working in 18 teams
outcome of developing DNA
scientists have identified certain genes that pass on specific hereditary diseases/conditions
what did galen believe in, in terms of religion
he believed in a soul and body parts had been created to work together
who does lung cancer mainly affect
people over 40
3 causes of lung cancer
smoking, lung tumours, radon gas
what did british medical council introduce in 1950 and what did it show
aggressive advertising by tobacco companies and showed lung cancer was linked to cigarette smoking
positives and negatives of transplants in lung cancer
can replace cancerous lungs with transplant from a healthy donor, it it fair to give them a new lung if they chose to smoke
what happened in 2007 with smoking
banned in all work places
what happened in 2015
smoking ban in workplaces was extened to cars carrying children under the age of 18
another thing that happened in 2007 with smoking to do with legal age
buying tobacco was raised from 16 to 18
who discovered x rays and when
wilhelm roentgen in 1895
what was the role of x rays in early radiology departments
to locate a needle in a womans hand
4 problems with x rays
health risks weren;t understood, machine contained fragile glass, took 90 mins to complete, big machines were immobile
who did the first experiments on human to human blood transfusions
james blundell
role of Karl Landsteiner
discovered blood groups so donor and patients could be matched
what was the major problem with blood in transfusions
blood couldn’t be stored so it had to be used straight away
role of RAMC
provided medical treatment to the wounded and sick whilst being responsible for keeping the men healthy
role of FANY
the first womens voluntary organisation to send volunteers to the western front , helped by driving ambulances, driving supplies to the frontline, set up mobile bath units that bathed 40 men an hour
4 stages of evacuation route
regimental aid post, dressing station, casulty clearing stations, base hospitals
what happens at regimental aid post
located within 200 metres of frontline, give immediate care, couldnt deal with serious injuries
what happened at dressing stations
provide protection from shelling, could only look after men for a week
what happened at casulty clearing stations
7 miles away from front, close to railway, treated most critical injuries at front to stop gangrene infection so could send men back, had traige system
what happened at base hospitals
situated near ports, had operating theatres, could treat up 2500 patients at once, most patients ent back to england from here
what happened at Arras underground hospital
included waiting rooms, 700 spaces for stretchers, operating theatre, mortuary, electricity and water supply
1914 first battle of ypres
germans attacked british positions, Britian kept ypres but lost 50,000 men. Germans surrounded the salient and kept brits on lower wetter ground
hill 60 battle
april to may 1915 , germans used chlorine gas for first time , brits lost 59,000 men and the germans moved 2 miles closer to town of ypres
the somme 1916
20,000 dead on first day, 57,000 casulties, first use of tanks, use of creeping barrage that moved towards the germans trench
arras 1917
in april british advanced 8 miles into enemy terrtory however in may attack virtually stopped. used tunnels to prepare an attack on german line
cambrai 1917
first large scale attack by british tanks, over 450 used, all land taken by british was lost, no artiliary bombardment was used which suprised germans.
4 parts of trench system
communication, support, frontline, reserve
use of support trench
80 metres behind frontline, troops would retreat if under attack, 10% of time here
use of front line trench
where attacks were made, most dangerous aream 15% of soldiers time here
use of reserve trench
100m behind support trench, where troops would be mobilised to counter attack enemy if they captured front line, 30% of time here
use of communication trench
trenches that run between other trenches linking them together
advantages of trench system
simple and cheap, easy to defend with few men, provided shelter and protection
disadvantages of trench system
hard to attack due to no mans land, very dirty, winter flooding and frostbite
what is the firebay
where troops did their shooting they would be protected by sandbags
what is the duckboards
to prevent soldiers from standing in water, possibly preventing trench foot
what is the firestep
allows the soldiers to fire towards the other trench, 2.5 metres deep
what is the parapet
low protective wall
what is the ammunition shelf
area in which ammo was kept near the firestep
what is the dugout
area dug into side of the trench where men could take protective cover
what is no mans land
dangerous land, men would be collected at night, destroyed terrain was muddy, contained stagnent water filled with craters with rotting corpses
transportation using horse drawn ambulance wagons
could not cope with the number of wounded, shaky transport often made injuries worse, many men were left to die
transportation using motor ambulances
the times appealed for donations, got enough money for 512 ambulances, oct 1914 first one was used, on bad terrain less effective so horses continued to be used
transportation using train, barge and ship ambulances
some contained operating theatres , criticised for blocking supply routes so canals were used which were comfortable and slow
what is trench foot
feet would swell, go numb, skin turns red and blue, lead to gangrene and amputation of limbs from standing in waterlogged trenches
attempted solutions for trench foot
medical officers ordered soldiers to carry 3 pairs of socks and change twice a day, rub whale oil into their feet, attempts were made to pump out trenches and add duckboards
what was trench fever
flu like symptoms with high temp, headache and ching muscles which was spread by lice, could be ill for up to month
attempted solutions for trench fever
delosuing stations were set up on front, clothes were disinfected men were bathed and sprayed with chemicals, was a decline in numbers experiencing this
what was shell shock
tiredness, headaches, nightmares, loss of speech, uncontrollable shaking, mental breakdown
attempted solutions for shell shock
condition was not understood at the time so some soldiers who experienced it were accused of cowardice and were punished, some even shot
what were some new wounds
shrapnel wounds led to amputation, head injuries led to brodie hats,
what did chlorine gas do
caused death by suffocation, before gas masks soldiers soaked pads in urine and put on faces
what did phosgene do
faster acting than chlorine, killed an exposed person in 2 days
what did mustard gas do
odourless gas that worked within 12 hours, caused internal and external blisters and could pass through clothing to burn skin
what was the solution to new gas attacks
soldiers were given gas masks from july 1915
