Emergency Care Study Guide

Emergency Care and Transportation of the Sick and Injured

• This text is a study guide for a course on emergency medical services (EMS)
• The study guide covers the human body, including anatomy, physiology, and pathophysiology.
• It also covers the skeletal system, including anatomy and physiology; the musculoskeletal system, including anatomy and physiology; the respiratory system, including anatomy and physiology; the circulatory system, including anatomy and physiology; the nervous system, including anatomy and physiology; and the integumentary system, including anatomy and physiology.
• The study guide also covers the life support chain, pathophysiology (including impairment of ventilation, respiration, v/q ratio, effects of respiratory compromise, shock, and impairment of cellular metabolism); and reviews.
• The study guide includes key terms, figures, and diagrams to help students understand the material.

National EMS Education Standard Competencies

• The study guide presents the national EMS education standard competencies
• Competence includes the foundational knowledge of the EMS system, safety/well-being of the emergency medical technician (EMT), medical/legal and ethical issues, and the provision of emergency care.
• Knowledge also encompasses anatomy and physiology of all human body systems in application to EMS practice, the pathophysiology of respiration and perfusion, and the application to patient assessment and management.

Topographic Anatomy

• Topographic anatomy is a study of the human body in anatomic position.
• Patients are positioned standing, facing you, arms at the side, palms forward.

Planes of the Body

• Imaginary straight lines that divide the body
• Three main planes: coronal (frontal), sagittal (lateral), and midsagittal (midline)
• Transverse (axial) plane
• The planes are used to describe locations of body structures.

Cells to Systems

• Cells are the foundation of the human body
• Tissues are cells sharing common function
• Organs are groups of tissues
• Body systems are organs working together

The Skeletal System: Anatomy

• The skeleton provides a recognizable human form.
• The skeleton consists of 206 bones.
• The axial skeleton forms the foundation to which arms and legs attach (includes skull, facial bones, thoracic cage, and vertebral column).
• The appendicular skeleton includes the arms, legs, and their connection points (pectoral girdle, hips, joints, etc).
• The pelvis is part of the appendicular skeleton, formed by the ilium, ischium, and pubis.

Joints

• Joints occur wherever bones make contact.
• Joints consist of the ends of bones and connecting/supporting tissues.
• Two types of joints:
  • Ball-and-socket joints allow for rotation and bending (like the shoulder)
  • Hinge joints allow for flexion and extension (like the elbow).

The Axial Skeleton (Details)

• Skull: cranium (4 bones), face (14 bones)
• Spinal Column: composed of 33 vertebrae, 5 sections (cervical, thoracic, lumbar, sacrum, coccyx)
• Thorax: 12 ribs, 12 thoracic vertebrae.
  • Contains the heart, lungs, esophagus, and great vessels.

The Appendicular Skeleton (Details)

• Upper extremities: pectoral girdle (clavicle, scapula, humerus), arms, forearms, hands, and fingers.
• Lower extremities: femur, knee (patella), tibia, fibula, ankle, foot.
• Foot: 7 tarsal bones, 5 metatarsal bones, 14 phalanges

The Skeletal System: Physiology

• The skeletal system gives the body shape and protects fragile organs.
• It allows movement and stores calcium.
• It aids in creating blood cells.

The Musculoskeletal System: Anatomy and Physiology

• The musculoskeletal system provides form, upright posture, movement, and protection of vital internal organs.
• Types of muscle: skeletal, smooth, and cardiac. -Major muscle groups (e.g., trapezius, deltoid, pectoralis major, gluteus maximus).

The Musculoskeletal System: Physiology

• Contraction and relaxation of muscles enables movement and manipulation.
• A by-product of muscle movement is heat.
• Muscles also protect the structures they support.

The Respiratory System: Anatomy and Physiology

• The structures of the body that deliver oxygen and eliminate carbon dioxide (Includes upper and lower airways including nose, mouth, tongue, jaw, pharynx, larynx, trachea, bronchi, bronchioles, lungs, and alveoli).
• Lungs and Pleurae.

Normal/Inadequate Breathing Patterns

• Normal breathing: regular rate and depth, audible breath sounds, and visible chest and abdominal movement.
• Inadequate breathing: labored breathing, muscle retractions, pale/cyanotic skin, tripod position, and agonal gasps.

The Circulatory System: Anatomy and Physiology

• The circulatory system is a complex arrangement of interconnected tubes (arteries, arterioles, capillaries, venules, veins).
• It includes two circuits, systemic, and pulmonary circulation.

The Heart (Anatomy and Physiology)

• The heart is a hollow muscular organ made of specialized cardiac muscle, functioning as two paired pumps with atria (upper chambers) and ventricles (lower chambers).
• Blood enters and leaves the heart through different pathways and in different states of oxygenation (e.g., oxygenated blood arriving from the lungs in the left atrium).
• Normal heart rate, stroke volume, and cardiac output are described.
• The electrical conduction system of the heart is highlighted.

Vessels (Arteries and Veins)

• Arteries carry oxygenated blood away from the heart
• Veins carry deoxygenated blood back to the heart
• Capillaries connect the small vessels and connect blood to body cells.
• The pulse in the major arteries reflects the forceful pumping action of the ventricles.

The Spleen (Anatomy and Physiology)

• A solid organ located beneath the rib cage, responsible for filtering blood.
• It is vulnerable to blunt trauma.

Blood Composition

• Blood is composed of plasma (liquid), red blood cells (erythrocytes), white blood cells (leukocytes), and platelets.

The Circulatory System: Physiology

• Blood pressure: pressure exerted by blood against artery walls.
  • Systole: ventricular contraction.
  • Diastole: ventricular relaxation
• Normal circulation is automatically adjusted and controlled, providing sufficient blood flow to meet cell needs; inadequate circulation can lead to hypoperfusion.

The Nervous System: Anatomy and Physiology

• The nervous system is complex and comprises two major divisions: central and peripheral nervous systems.
• The central nervous system includes the brain (with subdivisions like cerebrum, cerebellum, brainstem) and spinal cord.
• The peripheral nervous system comprises the somatic nervous system (control of voluntary muscles) and the autonomic nervous system (involuntary actions, further divided into sympathetic and parasympathetic components).
• Two types of nerves within the peripheral system are sensory and motor nerves.

The Integumentary System (Skin): Anatomy and Physiology

• The integumentary system is the skin, composed of two layers: epidermis and dermis, with subcutaneous tissue beneath.
• The skin protects the body, regulates temperature, and transmits environmental information to the brain

The Digestive System: Anatomy and Physiology

• The digestive system comprises the gastrointestinal system, primarily housed in the abdomen (divided into quadrants).
• The study guide details various structures (e.g., mouth, salivary glands, esophagus, stomach, liver, pancreas, small intestine large intestine, appendix, rectum) and specific functions (e.g., enzyme action in digestion, conversion of food to basic components.

The Lymphatic System

• The lymphatic system supports the circulatory and immune systems by transporting fluids, oxygen, and nutrients to cells and removing waste products.

The Endocrine System: Anatomy and Physiology

• The endocrine system includes various glands, releasing hormones into the blood to control several body functions.
• The brain plays a crucial role in hormone release.

The Urinary System: Anatomy and Physiology

• The urinary system controls the discharge of waste products, maintaining fluid balance, filtering and eliminating waste, and maintaining proper pH levels.
• The primary structures are the kidney, ureter, and urinary bladder.

The Genital System: Anatomy and Physiology

• The genital system controls reproductive processes.
• Male structures include the testicles, epididymis, vasa deferentia, prostate gland, seminal vesicles, and penis.
• Female structures include ovaries, fallopian tubes, uterus, cervix, and vagina.

Life Support Chain

• All body cells require oxygen, nutrients, and waste removal.
• The circulatory system carries these items.
• Interference with the chain causes cell damage or death

Pathophysiology

• The study of functional changes when a body reacts to a disease.
• Key aspects of pathophysiology in relation to respiratory impairment, including types of impairments (e.g., blocked airway), impairment of muscles of breathing, airway obstructions, high altitudes, and impairment of gas exchange.

Shock

• Shock occurs when organs/tissues don't receive adequate oxygen due to impaired delivery, leading to cellular hypoxia.
• Shock is categorized by its cause.
• Effects of shock include a decrease in oxygen availability to tissues, triggering anaerobic metabolism, metabolic acidosis, baroreceptor responses (e.g., epinephrine release), increased heart rate, and fluid shifts.

Impairment of Cellular Metabolism

• Inadequate cellular delivery of oxygen/nutrients leads to anaerobic metabolism and metabolic acidosis, potentially causing irreversible cellular injury.

Review Questions and Answers (Details)

• The document includes questions and answers covering various body systems (skeletal, respiratory, circulatory, urinary, endocrine, etc.).
• These questions and answers allow for self-testing and reinforcement of the material.