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Paramedic Exam Ch. 7, 8, 9 Directional Terms – Posterior or dorsal: Back Anterior or ventral: Front Inferior: Low Superior: Above Deep: Below skin Superficial: At the skin level Hierarchy of tissue: cell tissues organs organ systems organism Positioning of patients: (Pg 188) Prone – lying face down Supine – lying face up Trendelenburg – supine position on an incline with feet higher than head Shock position – modified Trendelenburg, head and torso are supine, lower extremity is elevated 6-12 inches Fowler position – semi reclining position with the head elevated, knees bent or straight Recovery – maintains airway, left lateral recumbent position, top knee is bent and head on arm Types of Metabolism : Process that uses oxygen is called aerobic metabolism, waste products are carbon dioxide and water Cells in our brain will die within 4-6 mins w/o oxygen ATP is involved in energy metabolism Cells prefer to operate using oxygen b/c it provides 15 times as much as ATP than w/o oxygen Process that kicks in when oxygen is not available is anaerobic metabolism By product is lactic acid which causes muscle burning Can be supported for only 1-3 minutes Structure of Neurons Dendrites receive the impulse in send it into the cell body Axons push it out, axon is covered in myelin sheath Organ quadrants Mnemonic for retropertineal organs S - Suprarenal (adrenal) gland A - aorta/IVC D - duodenum (second and third part) P - pancreas (except tail) U - ureters C - colon (ascending and descending) K - kidneys E - (o)esophagus R - rectum Parts of brain 1. The cerebrum fills up most of your skull. It is involved in remembering, problem solving, thinking, and feeling. It also controls movement. 2. The cerebellum sits at the back of your head, under the cerebrum. It controls coordination and balance “fine body movements” 3. The brain stem sits beneath your cerebrum in front of your cerebellum. It connects the brain to the spinal cord and controls automatic functions such as breathing, digestion, heart rate and blood pressure. Phrenic nerve – C3, C4, C5 keep the diaphragm alive Vagus nerve – cranial nerve 10 provides motor function to soft palate, pharynx, and larynx, also important in taste fibers CNS and PNS Ligands Molecules that bind to receptors in the body to form more complex structures, the examples of this are hormones, neurotransmitters, and electrolytes Osmosis Movement of a solvent (water) from an area of low solute concentration (Ex. Salt) to an area of high concentration through a selectively permeable membrane Reasons for fever: Inhibits bacterial and fungal reproduction and causes increased phagocytosis (macrophages) examples could be a virus or teething. Anything that the body needs to fight a bacteria by raising the internal temp by as little as 1 degree Celsius Aging on organ systems – after 24 organs decrease in effectiveness 1% every year this is the reason people get cancer and are more susceptible to not only injury but infection Primary method for communicating in infants – Screaming : When caring for an infant we have to alter our care such as getting eye level with them, talking in a reassuring voice, telling them when things will hurt, giving them options such as which arm to put the blood pressure cuff, allowing them to think they are in control of the situation. Age vials - Differences between parasympathetic and sympathetic responses Shock – Hypoperfusion, blood and nutrients such as O2 is not getting to vital organs Different types of shock Central shock consists of Cardiogenic (ex AMI, or dysrthmias) and Obstructive (ex. Cardiac tamponade and tension pneumothorax) Peripheral shock consists of Hypovolemic (ex. Hemorrhagic and non-hemorrhagic) and distributive (anaphylaxis, septic, neurogenic) pH scale Receptors Layers of heart – deep to superficial – endocardium, myocardium, epicardium Regulation of heart function Chronotropic effect is the effect of the rate of contraction Dromotropic is the effect of the rate of electrical conduction Inotropic effect is the effect of the strength of contraction Cardiac muscle is unique because it can conduct its own impulse through the SA node or the natural pacemaker of the body also through Starlings Law we know that the heart can be stretched and when it is stretched it contracts with greater force thus increasing the cardiac output Apex – Tip of a structure for example the apex of the heart is at the bottom of the ventricles in the left side of the chest, difference in the lungs the apex is at the top Base – bottom of heart and also in the lungs Homeostasis is always trying to be maintained by increasing or decreasing hormones, contractions, dilation …. And many more things Hypokalemia is defined as the decrease in serum potassium level – show signs of muscle weakness, fatigue, muscle cramps – they need to be given potassium via IV therapy – here potassium is not enough such as with diuretic use, K shifts into the cells, and/or renal potassium losses Hyperkalemia is an elevated serum potassium level – shows signs of muscle weakness and laccid paralysis also ventricular tachycardia – need therapy too – here the body is keeping too much such as not excreted through renal system or potassium shifts from within the cell Some important electrolytes Sodium is the most common cation (Na+) Potassium is a major intracellular cation (K+) Magnesium is second most abundant intracellular cation (Mg++) Calcium is abundant in teeth and bones (Ca++) Phosphate is a primarily an intracellular anion Cl- chloride is an important anion Alpha receptors – induces smooth muscle contraction in blood vessels and bronchioles Beta receptors – respond with relaxation of smooth muscles in blood vessels and bronchioles and have chronotropic and inotropic effects on myocardial cells Cells made easy ADH – When blood osmolarity increases the pituitary or master gland releases ADH thus stimulating the kidneys to resorb water decreasing the osmolarity of the blood, same with if the body has too much fluid ADH will not be released and you will urinate more Coronary arteries supply blood to the heart they originate from the aorta after it leaves the left ventricle, they receive blood during diastolic phase.