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BOONE COUNTY FIRE PROTECTION DISTRICT EMS EDUCATION DIVISION Assessment For Learning (A4L) KEY MRS. SMITH’S MAJOR BODY SYSTEMS 1. List the three major body systems. Respiratory, Cardiovascular, Neurological 2. What do cells use to make energy (metabolism)? glucose and oxygen (whenever possible) 3. Describe anaerobic metabolism. Cells metabolize glucose to make a small amount of energy. One unit of glucose produces two units of energy. Some lactic acid as an unwanted (waste) by product is produced as well. 4. Describe aerobic metabolism. Cells metabolize glucose (one unit of glucose makes two units of energy) and then additional processes take oxygen and the lactic acid waste / by product from anaerobic metabolism and produce an additional two units of energy in the first part (Kreb’s cycle) followed by another 30 or more units of energy in the second phase (electron transport chain) for a total energy production of 35-38 units of energy----about 19 or 20 times more than would have been produced with only anaerobic metabolism. 5. Does anaerobic metabolism stop during aerobic metabolism? no---anaerobic metabolism continues as long as glucose is available but the by product (lactic acid) builds up in the tissues 6. Why is aerobic metabolism necessary? To make enough energy in an efficient manner. The two units of energy from one unit of glucose in anaerobic metabolism is just not enough to support full cell functioning and it uses a lot of glucose for just a little bit of energy. 7. In order to support aerobic metabolism, what is needed? glucose AND oxygen 8. How do we get oxygen to the cells? The respiratory system brings in air with oxygen in it and then diffuses the oxygen into the bloodstream at the alveoli. From there, the cardiovascular system circulates the oxygen (riding on the hemoglobin on red blood cells) to the cells. The neurological system controls the breathing rate and depth, the heart’s pumping rate and strength and the blood vessels (vascular container) size. 9. What is an alveolus? One of many millions of microscopic air sacs in the lungs. 10. If the respiratory system anatomy is an “upside down tree”, what are the leaves on that tree? alveoli 11. What part of the cardiovascular system is found wrapped around the alveoli? pulmonary capillaries---the smallest and thinnest blood vessels 12. Describe diffusion as it relates to respiration. Diffusion in respiration is the tendency of oxygen to even out (balance) its concentration across a membrane. If that membrane is between the alveolus and the pulmonary capillary, oxygen tends to be in higher concentration in the alveolus than in the pulmonary capillary and so oxygen moves into the blood. The reverse occurs with carbon dioxide (CO2) in the pulmonary capillary since there is less CO2 in the alveolus than in the blood at that point. At the capillary in the systemic circulation (at the tissues of the body), there tends to be more oxygen in the blood than in the cell and there tends to be more CO2 in the cell (it was produced during metabolism as a waste / by product), so oxygen diffuses into the cell from the blood while CO2 diffuses into the blood from the cell. 13. Where does diffusion occur during cellular respiration? In the pulmonary capillaries and in the systemic capillaries (see number 12). 14. What is the role of the respiratory system in maintaining cellular respiration (metabolism)? Bring in O2 and exhale CO2. 15. What is the role of the cardiovascular system in maintaining cellular respiration? Deliver O2 from the lungs to the cells in the body and remove CO2 from the cells and transport it to the lungs. 16. What is the role of the neurological system in maintaining cellular respiration? Control of blood vessel size (muscular tone), control of breathing rate and depth, control of heart pumping rate and strength. 17. What does the prefix “hypo” mean? low 18. What is hypoxia? oxygen levels in the cells 19. What is perfusion? circulation or blood flow to the cells 20. What is hypoperfusion? low blood flow to the cells 21. Describe blood flow from a capillary in the toe all the way through the heart and pulmonary circulation and back to the toe. 22. Define arteries. Vessels with muscular walls that carry blood away from the heart and branch off the aorta. Can constrict or dilate. 23. Define arterioles. Vessels that branch off of arteries and carry blood away from the heart. Can constrict or dilate. 24. Define capillaries. The smallest of vessels that branch off of arterioles and then spread out into the tissues to supply individual cells. Capillaries merge into venules. 25. Define venules. Smallest division of the venous system that carries blood from the capillaries back toward the heart. Can constrict or dilate---has valves to prevent backflow. 26. Define veins. Carries bloods back toward the heart. Can constrict or dilate. Valves prevent backflow. 27. Define aorta. Largest vessel on the arterial side---exits from the heart. Receives blood from the left ventricle. 28. Define vena cava. Largest vessel on the venous side. Empties into the right atrium. 29. Do arteries carry oxygenated or deoxygenated blood? Explain your answer. On the systemic side, arteries carry oxygenated blood but, in the pulmonary circulation, arteries carry deoxygenated blood. In all cases, arteries carry blood away from the heart. 30. What about veins----do they carry oxygenated or deoxygenated blood? Explain. Veins carry blood toward the heart. The pulmonary vein carries oxygenated blood back toward the heart from the lungs. Otherwise, veins carry deoxygenated blood back toward the heart from the systemic circulation. 31. Define atria. Upper chambers of the heart that hold blood until the ventricles have emptied and then contract to push blood into the ventricles thereby providing a small amount of stretching of the ventricular chamber. 32. Define ventricles. Lower chambers of the heart that pump blood from the heart. The RV pumps to the lungs while the LV pumps to the systemic circulation. 33. Describe the arterial and venous circulation in terms of pressure, volume, presence of valves, description of bleeding. Arterial circulation is high pressure and low volume compared to the venous circulation’s low pressure but high volume. The venous side has valves. Arterial bleeding is under pressure and tends to spurt whereas the venous side’s lower pressure provides a “flowing” bleeding. 34. Explain the role of hemoglobin and red blood cells in respiration. Hemoglobin molecules on the red blood cells have sites for oxygen to bind so that oxygen can be carried from the lungs to the systemic circulation to the tissues. 35. Define hematocrit. The percentage of the blood volume taken up by red blood cells. 36. Define plasma. The portion of the blood that is not red blood cells or white blood cells / platelets. Plasma is mostly water and occupies the majority of the volume of the blood in most cases. 37. Define serum. The portion of plasma that is not fibrinogen. Serum does not contain blood cells or clotting factors. Serum does contain electrolytes and proteins. 38. Describe the blood flow through the heart and lungs including the valves. Blood enters the RA from the systemic circulation. The RA dumps blood through the tricuspid valve into the RV which pumps blood through the pulmonic valve to the PA. Blood returns to the heart from the lungs via the PV which dumps into the LA. From the LA, blood flows through the bicuspid valve to the LV which pumps through the aortic valve to the aorta and thus the systemic circulation. Final Summary: Mrs. Smith and her friends and family need to avoid hypoxia in order to live. Hypoxia can come from inadequate O2 in the inspired air, an obstruction in the respiratory system, inadequate blood flow to the pulmonary capillaries, inadequate amount of red blood cells in the blood, inadequate blood flow to the systemic tissues (poor heart function, blood volume loss, vascular container the wrong size). Many things can cause hypoxia and hypoperfusion. EMS professionals must learn to assess hypoxia, troubleshoot its causes and attempt to correct both these killers.