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Emergency Medical Services > Physiology, Pathophysiology, and Shock > Flashcards

Physiology, Pathophysiology, and Shock Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

Element

A

A pure substance that is entirely comprosed of the same atom

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2
Q

What are atoms comprised of?

A

protons, neutrons, and electrons

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3
Q

Where are protons located?

A

The nucleus

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4
Q

What charge do protons carry?

A

Positive charge

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5
Q

The ____ _____ is the same as the number of protons in the nucleus

A

Atomic number

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6
Q

Where are neutrons located?

A

The nucleus of the atom

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7
Q

What charge are neutrons?

A

Neutral

Hint - neutral, neutron

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8
Q

Purpose of the Neutron

A

Seperate of the (normally) repellant postive charges of protons

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9
Q

How is the atomic weught of an element found?

A

Neutrons + Protons + the atomic weight of the element

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10
Q

Where are electrons found?

A

In constant rotation around the nucleus

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11
Q

What charge do electrons carry?

A

Negative charge

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12
Q

How are ions formed?

A

An atom loses an electron or gains an extra one from another source

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13
Q

Which ion is more stable? A positive ion, a neutral ion, or a negative ion?

A

Neutral ion

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14
Q

What is a molecule?

A

Any structure comprised of 2 or more atoms bonded toether

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15
Q

What is a covalent bond?

A

Each atom paticipating in the formation of a bond provides an electron

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16
Q

What is an Ionic bond?

A

Two charged ions interact and at least one electron is completely donated from one atom to another
- Normally a metal and nonmetal bonding together

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17
Q

Is blood more basic or acidic?

A

Normally slightly basic

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18
Q

What substance has a pH of 7?

A

Water

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19
Q

What is the range for the pH scale?

A

0-14
0 is on the acidic end
14 is on the basic end

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20
Q

Normal pH range of blood

A

7.35-7.45

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21
Q

Blood pH of <7.35 is

A

Acidotic

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22
Q

Blood pH of >7.45 is

A

Alkalotic

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23
Q

What is EtCO2?

A

End-tidal Co2

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24
Q

Common causes of respiratory alkalosis

A

Fever, anxiety, and excessive artificial ventilation

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25
Q

How might a patient with ** respiratory alkalosis** present in terms of EtCO2?

A

Decreased EtCO2, because much of it has been exhaled out of the body

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26
Q

How might a patient with respiratory acidosis present in terms of EtCO2?

A

High EtCO2, due to hyperventilation
After a few good ventilations, this value should assume normal levels

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27
Q

What is the purpose of a buffer?

A

Minimizes the impact on a system’s pH
Buffers are reactions in a dynamic equillibrium that can neutralize bases and acids without meaningfully effecting the pH

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28
Q

Common causes of Respiratory Acidosis

A
  • Hypoventilation
  • Cardiac/Respiratory arrest
  • Asphyxiation
  • Head injury
29
Q

Symptoms of Respiratory Acidosis

A
  • Show/no breathing
  • Flushed skin
  • Headache
30
Q

Symptoms of Respiratory Alkalosis

A
  • Carpal-pedal spasms
  • Flushed skin
  • Shortness of breath
31
Q

Common causes of Metabolic Acidosis

A
  • Diabetic ketoacidosis
  • Antacid overdoses
  • Eating disorders
32
Q

Symptoms of Metablic Alkalosis

A
  • Slow breathing
  • Altered mental status
  • Vomitting
33
Q

What does Respiratory Acidosis result from?

A

A systemic increase in CO2 level

34
Q

What is Respiratory Acidosis?

A

A decrease in blood pH that primarily has a respiratory component
Caused by a retention of CO2

35
Q

What is Respiratory Alkalosis?

A

Increase in pH/decrease in H+ with a primarily respiratory component
Caused by an increase in the exhalation of CO2

36
Q

What is Metabolic Acidosis?

A

A type of acidosis that results primarily from a metabolic disorder or ingestion
The body’s ability to remove acids is overwhelmed, and as a result the body produces more CO2

37
Q

What is Diabetic Ketoacidosis?

DKA

A

Occurs in patients who did not take any or enough of their insulin, causing cells to shift to using fatty acids for fuel

Common cause of metabolic acidosis

38
Q

What is Metabolic Alkalosis?

A

Excess **loss **of acid in the body

39
Q

About how many cells are in the human body?

A

37 trillion

40
Q

Defining characteristic of Eukaryotic cells

A

Contain a true necleus enclosed in a membrane

41
Q

What is the major difference between **Prokaryotic **and Eukaryotic cells?

A

Eukaryotic cells contain a nucleus, Prokaryotic cells do not

42
Q

What does **cytosol **do?

A

Diffuses molecules throughout the cell

43
Q

What is the nucleus?

A

The control center of the cell
- Contains genetic material necessary for replicating the cell

44
Q

What is Ventilation?

A

The act of moving air in and out of the lungs

45
Q

What is respiration?

A

Gas exchange across the alveoli-capillary border

46
Q

What is perfusion?

A

The exchange of gases, nutrients, and water products across the capillary wall into and out of the cell

47
Q

What is Peripheral vascular resistance?

A

The resistance of blood flow through all the vessels of the body, excluding those in the lungs

48
Q

What is Cardiac output?

A

The amount of blood pumped out of the heart in one minute
- the product of stroke volume and heart rate

49
Q

Stroke volume

A

The amount of blood ejected from the left ventricle of the heart with each beat or contraction

50
Q

“Pump”

Preload

A

Blood returns to the heart from the body and must fill and stretch the chambers of the heart

51
Q

“Pump”

Afterload

A

The pressure against which the heart must pump - needs to be lower than the force of the heart’s contraction

52
Q

Cardiogenic shock

A

The heart is no longer strong enough to move blood around the body and through the lungs
- Often results from a heart attack, and/or the cumulative damage of multiple heart attacks

53
Q

Hypovolemic shock

A

Results from low circulation volume
- Can be caused by excessive vomiting, diarrhea
- Poor fluid intake
- Extravasation from burns

54
Q

Hemorrhagic shock

A

Form of hypovolemic shock that occurs due to blood loss
- Can be external or internal

55
Q

Obstructive shock

A

Variety of disorder that hamper preload or elevate afterload to a point where cardiac function is disrupted
- Pulmonary embolism
- Pneumothorax
- Cardiac tamponade

56
Q

Distributive shock

A

Different types of shock that all have displacement of fluid
- Septic shock
- anaphylactic shock
- neurogenic
- psychogenic shock

57
Q

Septic shock

A

Caused by bacterial toxins infiltrating the bloodstream from a local infection or systemic infection

58
Q

Neurogenic shock

A

Results from an injury to the spinal cord
- can be caused by an infection, but typically caused by trauma
- uncontrolled dilation of blood vessels inferior to the injury
- skin near the affected area will appear flushed, while the rest of the body appears white or gray

59
Q

Psychogenic shock

A

The “see blood and faint” type of shock

60
Q

Progression of Shock

A
  1. Compensated shock
  2. Decompensated shock
  3. Irreversible shock
61
Q

Compensated Shock

A

When hypoperfusion is first detected by the body. The body’s main concern is preservation of blood pressure (specifically MAP). The patient in this stage of shock has very few symptoms, and aggressive treatment may slow or stop progression to stage II shock.

MAP must be >60 mmHg

62
Q

MAP Formula

Mean Arterial Pressure

A

Map = [SBP + (2 × DBP)]/3

SBP: Systolic Blood Pressure
DBP: Diastolic Blood Pressure

63
Q

Decompensated shock

A

Methods of compensation begin to fail. The systems are unable to maintain perfusion any longer. Oxygen deprivation in the brain causes the patient to become confused and disoriented.

64
Q

Irreversible shock

A

Organ failure and death have begun. Even with treatment, the end result is patient death

65
Q

ABCDE

A

AIRWAY
BREATHING
CIRCULATION & C-SPINE
DISABILITY
EXPOSE

66
Q

Shock treatment

A

Provide high flow o2
Elevate the legs
Cover with blankets
Rapid transport
Provide IV fluids (saline) warmed if possible

PORK - Position, oxygenate, rapid transport, keep warm

67
Q

What temperature are “warmed” fluids kept at?

A

100 Degrees F

68
Q

Buffer Equilibrium reaction

A
69
Q

A chemical bond formed when an electron is completely donated from 1 atom to another is called a/an:

A

When an atom loses or donates an electron to another atom, an ion is formed. The bond that forms between 2 ions is called an** ionic bond**.

Ionic bond

Emergency Medical Services (4 decks)

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