Theory final exam Flashcards
*Chlamydia:
- Caused by Chlamydia Trachomatis.
- Curable with antibiotics.
- Symptoms: Urethritis, polyuria, pyuria, dysuria.
Gonorrhea:
Caused by Neisseria gonorrhoeae.
- Treatable with antibiotics.
- Symptoms: Pyuria, itching, burning during urination.
Genital Herpes (HSV-2)
- Caused by the herpes virus (HSV-2).
- Incurable; antiviral medication manages outbreaks.
- Symptoms: Sores, bumps, blisters; recurring outbreaks.
Syphilis
Caused by Treponema pallidum.
- Treatable with antibiotics.
- Symptoms: Sores, oval lesions, can affect the entire body
*HIV and AIDS
(Human Immunodeficiency Virus).
- No cure; prevention crucial.
- Symptoms: Extreme weakness, rapid weight loss, fevers, swollen lymph glands, chronic diarrhea, memory loss.
Hepatitis A:
High-risk populations: Household/sexual contacts, international travelers, day care employees.
- Transmission: Oral/fecal route.
- Symptoms: Fever, weakness, abdominal discomfort, jaundice.
- Prevention: Hand hygiene, vaccination.
*Hepatitis B
Transmission: Bloodborne, sexual, perinatal.
- High-risk populations: Health care personnel, IV drug abusers, multiple sex partners.
- Symptoms: Anorexia, fever, abdominal discomfort, joint pain, fatigue, jaundice.
- Prevention: Vaccination, safe sex practices
*Hepatitis C
Transmission: Primarily bloodborne, also sexual, perinatal.
- High-risk populations: IV drug abusers, health care personnel, multiple sex partners.
- Prevention: Avoid sharing needles, safe sex practices.
Meningitis
inflammation of membranes covering the brain and spinal cord.
- Incubation: 2-4 days.
- Types: Bacterial, viral, fungal.
Bacterial Meningitis
Most serious form.
- Symptoms: Headache, nausea, fever, stiff neck, altered LOA.
- Signs: Brudzinski’s sign, Kernig’s sign.
Severe Acute Respiratory Syndrome (SARS)
- Atypical pneumonia from avian population to humans.
- First Canadian death in T.O. (March 2003).
- Worldwide: 2500 infections, 81 deaths.
Symptoms of SARS
- Fever (>38°C), cough, shortness of breath, dyspnea, headache, chills, malaise.
Spread:
- Contact with secretions from mouth, nose, throat.
Treatment:
- Antibiotics available for some forms.
Therapeutic Communication:
A process where the paramedic influences a patient to better understanding through verbal or nonverbal means.
- Strategies: Encouraging expression, conveying acceptance, showing respect.
Building Trust & Rapport
- Professional address.
- Proper voice tone demonstrating concern, confidence, reassurance.
- Explanation of actions using patient-friendly language.
*Effective Communication Styles
Adapt to the situation.
- Maintain calm, moderate volume, and moderate pace.
- Demonstrate concern and compassion.
*Non-verbal Communication:
Gestures, mannerisms, and postures used for communication.
Gestures, mannerisms, and postures used for communication.
Heart Rate (HR):
Number of heartbeats per minute.
Adults: 60-100 bpm.
Measurement: - Palpation of pulse points (radial, carotid).
- Use of a cardiac monitor.
Blood Pressure (BP):**
Force of blood against arterial walls.
Systolic (peak) / Diastolic (rest).
normal bp: 120/80 mmHg.
measurement: - Use of a sphygmomanometer and stethoscope.
- Automated blood pressure monitors.
Respiratory Rate (RR)
Number of breaths per minute.
Adults: 12-20 breaths per minute.
measurement: - Observing chest rise and fall.
- Counting breaths for one minute.
Temperature (T)
Internal body temperature.
Adults: 97.8-99.1°F (36.5-37.3°C).
Measurement: - Oral, axillary, rectal, or tympanic measurements.
- Use of a thermometer.
Oxygen Saturation (SpO2)
Percentage of oxygen saturation in the blood.
Normal Range:** 95-100%.
Measurement: - Use of a pulse oximeter.
- Placing the sensor on the fingertip.
*History Taking
A systematic process of gathering relevant information about a patient’s past and present health status.
GCS scale
Eye Response (E):* (4) Opens spontaneously; (3) Opens to verbal command; (2) Opens to pain; (1) No response.
- Verbal Response (V): (5) Oriented; (4) Confused; (3) Inappropriate words; (2) Incomprehensible sounds; (1) No response.
- Motor Response (M): (6) Obeys commands; (5) Localizes pain; (4) Withdraws from pain; (3) Flexion in response to pain; (2) Extension response to pain; (1) No response.
Crackles (Rales)
Discontinuous sounds, may indicate fluid in the lungs.
*Wheezes
Continuous high-pitched sounds, common in asthma.
Rhonchi
Coarse sounds, often due to mucus or fluid in large airways.
Stridor
High-pitched, often heard in upper airway obstruction.
Blunt Trauma
Injury caused by forceful impact without penetration.
Rib fractures
Rib Fractures:* Breaks in the rib bones, often painful and may lead to respiratory compromise.
-most common cause of pneumos
*Penetrating Trauma (e.g., Gunshot Wounds)
Definition: Injury resulting from an object penetrating tissues.
- Gunshot Wounds: Damage caused by bullets, may result in internal injuries and bleeding.
Flail Chest
Multiple rib fractures causing a segment of the ribcage to move independently.
- Signs: Paradoxical chest movement (moves inward during inhalation, outward during exhalation).
*Pneumothorax
Presence of air in the pleural cavity, leading to lung collapse.
Tension pneumo
Air accumulates under pressure, compressing the lung and affecting blood flow.
causes tracheal deviation, Hypotension, sob, cyanosis, jvd
Hemothorax
Accumulation of blood in the pleural cavity.
- Signs: Decreased breath sounds on the affected side, signs of shock.
Pulmonary Contusion
ruising or bleeding within the lung tissue.
- Signs: Difficulty breathing, coughing blood, chest pain
Traumatic Asphyxia:
Sudden, severe compression of the chest leading to compromised venous return and increased intracranial pressure.
Signs: Cyanosis, distended neck veins, petechiae.
Inhalation Injuries
Damage caused by inhalation of smoke, toxic gases, or steam.
- Signs: Respiratory distress, altered mental status, burns around the face or mouth.
*Diaphragmatic Rupture:**
Tear in the diaphragm muscle.
- Signs: Abdominal contents may enter the thoracic cavity, causing respiratory distress.
Tracheal Injuries:**
Damage to the trachea (windpipe).
- Signs: Subcutaneous emphysema, hoarseness, difficulty breathing.
Esophageal Injuries:*
Damage to the esophagus.
- Signs: Pain, difficulty swallowing, potential mediastinitis.
Cardiac Tamponade
Compression of the heart due to the accumulation of blood or fluid in the pericardial sac.
- Signs: Beck’s triad (hypotension, muffled heart sounds, distended neck veins).
Sprains
Overstretching or tearing of ligaments
Strains
Overstretching or tearing of muscles or tendons
*Fractures
Breaks in bones.
Fracture Types
Open (compound) vs. Closed (simple), Comminuted, Greenstick, Transverse, Oblique.
- Complications: Compartment syndrome, neurovascular compromise.
Asthma
Chronic inflammatory disease causing bronchoconstriction.
- Medications: Bronchodilators (albuterol), Steroids (prednisone).
- Symptoms: Wheezing, dyspnea, use of accessory muscles.
Emphysema:
Lung condition leading to shortness of breath.
- Clinical Features: Barrel chest, pursed lips breathing.
- Symptoms: Chronic cough, weight loss, diminished breath sounds.
PINK PUFFER
Bronchitis:
Inflammation of bronchial tubes.
- Symptoms: Productive cough, chest discomfort, wheezing.
BLUE BLOATER
Heart Rate (HR):
60-100 bpm.
Tachycardia
(>100 bpm
Bradycardia
(<60 bpm),
*Blood Pressure (BP):
120/80 mmHg.
Hypertension:
Systolic > 140 mmHg, Diastolic > 90 mmHg.
Hypotension
Systolic < 90 mmHg, Diastolic < 60 mmHg.
*Respiratory Rate (RR)
Normal range 12-20 breaths per minute.
*Dyspnea
Abnormally high RR (> 24 breaths/minute).
Temperature (Temp):
Normal range 98.6°F (37°C).
fever core temp
100.4°F (38°C).
Hemorrhage:
External Bleeding:* Apply direct pressure, elevate the limb if possible.
- Internal Bleeding: Monitor for signs of shock, such as hypotension and altered mental status.
- Control Methods: Hemostatic agents, tourniquets, pressure dressings.
- Hypovolemic Shock: Complications of severe bleeding.
Heart Anatomy
-
Chambers: Right atrium, right ventricle, left atrium, left ventricle.
- Valves: Tricuspid, pulmonary, mitral, aortic.
- Vessels: Superior and inferior vena cava, pulmonary arteries and veins, aorta.
- Coronary Circulation: Blood supply to the heart muscle.
Prioritizing in Case Scenarios
ABCDE Approach: Airway, Breathing, Circulation, Disability, Exposure.
- Critical Thinking: Identify life threats, treat immediately.
- Decision Making: Choose interventions based on patient condition and severity.
- Considerations: Mechanism of injury, patient age, special populations.
Nitroglycerin:
Vasodilator, reduces chest pain (angina).
- Side Effects: Headache, hypotension.
*Aspirin (ASA)
- Antiplatelet, reduces clot formation.
- Administration: Chewed for rapid absorption.
Morphine
Analgesic, relieves pain.
- Indications: Severe pain unresponsive to nitroglycerin.
*Lasix (Furosemide)
Diuretic, reduces fluid retention.
- Considerations: Monitor electrolytes, especially potassium.
*Anterior MI
Involves the front of the heart.
- Complications: Left ventricular failure, arrhythmias.
Symptoms: Chest pain radiating to jaw or left arm.
Inferior MI
Inferior MI:* Involves the bottom of the heart.
- Complications: Bradycardia, heart block.
Lateral MI
Involves the side of the heart.
- Complications: Left ventricular failure, arrhythmias.
- Symptoms: Left shoulder or arm pain.
Normal Range pH
7.35 - 7.45.
Acidosis: pH
<7.35, can lead to confusion, coma.
Alkalosis:
pH > 7.45,
*Complications with pH
Respiratory (CO2 retention), Metabolic (bicarbonate levels).
Tidal Volume:
- Volume of air inhaled or exhaled during normal breathing.
Inspiratory Reserve Volume
Additional air inhaled after a normal breath.
- *Expiratory Reserve Volume:
Additional air exhaled after a normal breath.
Residual Volume
Air remaining in the lungs after maximal exhalation.
Left-Sided HF
Fluid backs up into the lungs, fails to pump blood forward into the aorta into the arterial system
- Symptoms: Dyspnea, crackles, cough.
*Right-Sided HF
Fluid backs up into the body.
- Symptoms: Peripheral edema, jugular venous distension.
- Complications: Pulmonary edema, systemic edema.
Systemic Circulation
From the left ventricle to the body and back to the right atrium.
Pulmonary Circulation:*
From the right ventricle to the lungs and back to the left atrium.
Internal Hemorrhage
Blood leaks from vessels inside the body; associated with blunt or penetrating trauma.
External Hemorrhage
Lacerations causing blood to escape through an opening.
Intracranial Hemorrhage Types
- Epidural Hematoma
- Subdural Hematoma
- Subarachnoid Hematoma
- Intracerebral Hematoma
Stage 1 Hemorrhage
15% loss of blood volume
- Pale, cool, clammy
- Normal mental status
- Not hypertensive
*Stage 2 Hemorrhage:**
Blood loss of 15-25%
- Thirst, anxiety, restlessness
- Cool, clammy skin
- Increased respiratory rate
*Stage 3 Hemorrhage:**
- 25-35% loss of blood volume
- Decreased LOC
- Weak, thready, rapid pulse
- Signs of shock appear
Stage 4 Hemorrhage:
- Blood loss over 35%
- Barely palpable pulse, ineffective respirations
- Lethargic, confused, moving towards unconsciousness
- Survival is unlikely
Vascular Clotting Phase:
- Smooth blood vessel muscle contracts, reducing vessel lumen.
Platelet Clotting:
Platelets adhere to vessel walls and each other.
Coagulation Phase
Fibrin forms a network around a wound to stop bleeding.
Fibrin:
Tiny fibers that trap blood cells, helping form a blood clot.
Brainstem
Connects cerebrum and spinal cord; responsible for automatic survival functions.
*Midbrain
Relay center for visual/auditory impulses and motor control.
*Pons:
Conduction pathway between brain and other regions; involved in sleep cycle and pain sensation.
*Medulla Oblongata:
Controls rate of breathing, cardiac function, vomiting, coughing, and other autonomic functions.
Cerebral Blood Flow and Pressure:
(CPP):**
The pressure of blood flow through the cranium
Cerebral Blood Flow (CBF)
Amount of blood passing through 100g of brain tissue in 1 minute.
Mean Arterial Pressure (MAP)
Average pressure during a cardiac cycle.
Meninges
Membrane surrounding the spinal cord and brain.
Dura Mater
Thick, dense connective tissue.
- Closest to the periosteum of the skull.
Arachnoid:
- Web-like structure with venous vessels that reabsorb cerebrospinal fluid (CSF).
Pia Mater:
Delicate innermost membrane enveloping the brain and spinal cord.
Cranial Nerves (12 types):
- Olfactory: Smell (sensory).
- Optic: Vision (sensory).
- Oculomotor: Eye movement, pupil constriction, eyelid movement (motor).
- Trochlear: Eye movement (motor).
- Trigeminal: Sensory (face, teeth, tongue), motor (muscles of mastication).
- Abducens: Eye movement (lateral, motor).
- Facial: Facial expression, taste (both).
- Auditory Vestibular: Hearing and balance (sensory).
*Cerebrospinal Fluid (CSF)
- Clear and colorless fluid filling ventricles and canals.
- Coats the brain surface.
- Secreted by the choroid plexus, ependymal cells, and subarachnoid space.
- Functions include cushioning, chemical protection, nutrient exchange, and forming the blood-brain barrier.
Blood-Brain Barrier (BBB):
- Semipermeable membrane maintaining a stable CNS environment.
- Protects the brain from toxins and infections.
Diffuse Axonal Injury
- Involves stretching, shearing, or tearing of nerve fibers.
- Common in vehicle occupants and pedestrians.
*Focal Injury
Restricted to one area of the brain.
Effects of Increased ICP
- Low cerebral perfusion pressure (CPP).
- Compensatory mechanisms attempt to increase MAP.
- Cerebral vasodilation occurs, leading to higher ICP and lower CPP.
Cushing’s Reflex/Triad:
BP rises, bradycardia, irregular respirations, reactive pupils (indicative of increased ICP).
Cheyne-Stokes Respiration
Regular pattern of breathing characterized by gradual increase and decrease, resulting in apnea (indicative of increased ICP).
Penetrating Brain Injury:**
- Types:
Intrinsic Force:** Requires only the force needed to achieve penetration.
- Extrinsic Force: Requires an act of force beyond the physical effort for penetration.
Epidural Hematoma Signs and Symptoms:
- Unconsciousness followed by a lucid interval, rapid deterioration.
- Decreased LOC, headache, nausea, vomiting.
- Hemiparesis.
- Unequal pupils (dilated on the side of the clot).
- Increased BP, decreased pulse (Cushing’s reflex).
- Often involves the temporal region and middle hemiplegia
Subdural Hematoma Signs and Symptoms:
- Slower onset of increased ICP.
- Headache, decreased LOC, unequal pupils.
- Increased BP, decreased pulse.
- Hemiparesis, hemiplegia.
Intracerebral Hematoma Signs and Symptoms:
Usually due to laceration of the brain.
- Bleeding into cerebral substance and associated with other injuries.
- Diffuse Axonal Injury (DAI) - Neuro deficits depend on the region involved and the size.
- Repetitive with frontal lobe involvement and increased ICP.
Dermatomes
Segment of skin supplied by a single spinal nerve.
- Can help localize damage to one or more spinal nerves.
- Involved in referred visceral pain.
Spinal Cord Injury Levels
C1-C4: Diaphragm paresis, intercostal paralysis, flaccid paralysis below the neck, artificial ventilation required.
- C5-C8: Lower cervical and upper limb muscles, paralysis below shoulders and upper arms, loss of sensation in arms, hands, chest, abdomen, and lower extremities.
- T1-T6: Paralysis below the chest.
- T7-T12: Paralysis below the waist.
- L1-L3: Paralysis in most leg muscles and in the pelvis.
- L4-L5: Paralysis in lower legs, ankles, and feet.
- S1-S5: Paralysis of feet and ankles.
Spinal Shock
- Temporary insult to the spinal cord affecting the body below the site of injury.
- Results in temporary flaccid paralysis, loss of feeling, and loss of bowel and bladder control.
Conduction System:
Sinoatrial (SA) Node: Natural pacemaker. 60-100bpm
- Atrioventricular (AV) Node: Delays electrical impulses. 40-60bpm
- Bundle of His: Transmits impulses to ventricles.
- Purkinje Fibers: Distribute impulses throughout the ventricles. 20-40bpm
- Electrical Pathway: SA Node → AV Node → Bundle of His → Purkinje Fibers.
Angina
Chest pain due to reduced blood flow. causes from blockage from plaque in coronary vessels, etc
- Treatment: Nitroglycerin, rest.
Unstable Angina
Worsening chest pain, potential precursor to a heart attack.
- Indications: May not be relieved by rest or nitroglycerin.
- Considerations: High risk of myocardial infarction.
Myocardial Infarctions (MIs):
Definition: Death of heart muscle due to lack of blood flow.
- Signs: Chest pain, shortness of breath, diaphoresis.
- Immediate Treatment: ASA, nitroglycerin, seek definitive care.
- Complications: Arrhythmias, heart failure, cardiogenic shock.
Leukemia
cancer of blood-forming tissues.
- Symptoms: Fatigue, bruising, recurrent infections.
- Subtypes: Acute lymphoblastic, acute myeloid, chronic lymphocytic, chronic myeloid.
*Hodgkin’s Lymphoma:
Cancer of the lymphatic system.
- Symptoms: Painless swelling of lymph nodes, fatigue.
- Reed-Sternberg Cells: Characteristic cells on biopsy.
*Non-Hodgkin’s Lymphoma:
Cancer of lymphocytes.
- Symptoms: Enlarged lymph nodes, night sweats, weight loss.
- Differences from Hodgkin’s: More varied cell types, absence of Reed-Sternberg cells.
Anatomical dead space
the total volume of the conducting airways from the nose or mouth down to the level of the terminal bronchioles, and is about 150 ml on the average in humans.
Physiological dead space
Physiologic or total dead space is equal to anatomic plus alveolar dead space which is the volume of air in the respiratory zone that does not take part in gas exchange. The respiratory zone consists of respiratory bronchioles, alveolar duct, alveolar sac, and alveoli.
Atelectasis
the collapse of part or all of a lung, is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the lung
Pneumonia
brown, green sputum. Not giving NSA or CPAP
The Frank-Starling Law
states that the stroke volume of the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful systolic contraction. This assumes that other factors remain constant.
Angiogram
inds dye to see where blockage is from plaque, inflants vessels and inserts stent to remove blockages
cardiac output
the quantity of blood pumped by the heart in a given period of time, typically measured in liters per minute
