CHP 8 AMP PDF

V. Cellular Level Cells: Basic unit of life, specialized for functions (movement, secretion, respiration). Cell Membrane: Controls what enters/exits the cell. Essential for maintaining fluid balance, drug interactions. Organelles: ○ Mitochondria: Produce energy (...

V. Cellular Level Cells: Basic unit of life, specialized for functions (movement, secretion, respiration). Cell Membrane: Controls what enters/exits the cell. Essential for maintaining fluid balance, drug interactions. Organelles: ○ Mitochondria: Produce energy (ATP); important for oxygen use. ○ Ribosomes: Protein synthesis, important in tissue repair. Cellular Respiration: ○ Aerobic: Uses oxygen, produces 38 ATP. ○ Anaerobic: No oxygen, produces 2 ATP + lactic acid (leads to acidosis in trauma). Cellular Transport: ○ Osmosis/Diffusion: Passive; important for fluid balance. ○ Active Transport (Sodium-Potassium Pump): Crucial for electrolyte balance, especially in cardiac patients. Electrolytes and pH: ○ Electrolyte Balance: Sodium, potassium, and calcium are essential for cellular function. ○ pH: Maintain 7.35-7.45; critical in addressing acidosis (oxygen deprivation) or alkalosis. VI. Tissue Level Tissue Types: ○ Epithelial: Covers body surfaces, protects, secretes, and allows permeability. Located on skin, organs, and glands. ○ Connective: Supports and protects, stores fat, and produces blood cells. Found in bones, tendons, and ligaments. ○ Muscle: Three types: Skeletal (voluntary movement, attached to bones), Smooth (involuntary, found in organs like intestines), Cardiac (heart muscle, involuntary). ○ Nervous: Sends electrical impulses, communicates with muscles and glands. Found in the brain, spinal cord, nerves. Membranes: ○ Serous Membrane: Lines cavities without external openings (e.g., pleura, pericardium), secretes fluid for lubrication. ○ Mucous Membrane: Lines cavities with external openings (e.g., mouth, nose), secretes mucus. ○ Cutaneous Membrane: Skin—protects body surfaces.  ○ Synovial Membrane: Lines joints, secretes fluid to reduce friction. Key Application for Paramedics: ○ Recognize different tissues and their role in injuries (e.g., muscle tears, nerve damage). ○ Understand membrane types (serous vs. mucous) to assess fluid build-up and trauma impacts. ○ Identify muscle control issues (voluntary vs. involuntary) during patient transport or cardiac emergencies. ○ Be aware of nervous system damage signs (e.g., lack of sensation, motor function loss) in trauma patients. VIII. Homeostasis Homeostasis: Body’s way of maintaining balance (temperature, pH, fluid, and electrolyte levels). ○ Temperature Regulation: Manage hyperthermia with cooling (ice, fans); manage hypothermia with warming (blankets, warm IV fluids). ○ pH Imbalance: Correct acidosis or alkalosis through ventilation or medication (goal pH: 7.35-7.45). ○ Fluid/Electrolyte Balance: Maintain with IV fluids based on patient needs (especially in dehydration, trauma). Key Interventions: ○ Temperature: Apply cooling for heatstroke or warming for hypothermia. ○ Fluids: Monitor intake/output; administer IV fluids for dehydration or electrolyte imbalance. ○ Acid-Base Balance: Ventilation adjustments for respiratory acidosis/alkalosis. Cell Turnover: ○ Apoptosis: Understand normal cell death and turnover (e.g., RBC turnover). ○ Disruption: Be aware of disruptions in conditions like cancer (uncontrolled cell growth). Regulatory Systems: ○ Negative Feedback: Body uses negative feedback to stabilize functions. Recognize loss of regulation (e.g., sepsis, bleeding). ○ Autonomous Dysregulation: Respond to signs of unregulated systems (e.g., shock, organ failure). Quick Assessment: ○ Check vital signs for homeostasis (temperature, pH, fluid balance). ○ Implement interventions to restore balance: IV fluids, temperature regulation, ventilation. Organ Systems: Groups of organs working together to perform complex functions. Key systems:  ○ Integumentary, Skeletal, Muscular, Nervous, Endocrine, Circulatory, Lymphatic, Immune, Respiratory, Digestive, Urinary, Reproductive. Integumentary System: ○ Protection: Prevents injury, infection, and UV damage. ○ Temperature Regulation: Vasoconstriction: Conserves heat in cold environments. Vasodilation: Releases heat in warm environments. ○ Fluid Regulation: Maintains chemical stability and prevents dehydration. ○ Sensation: Transmits sensory information from skin to brain. ○ Inflammatory Response: Promotes healing by responding to injury with redness, swelling, and heat. Skin Structure: ○ Epidermis: Outer layer, provides waterproof protection. ○ Dermis: Below epidermis, contains connective tissue, blood vessels, and nerves. ○ Subcutaneous Tissue: Fat layer beneath dermis, insulates and anchors skin. Accessory Structures: ○ Hair: Protects against injury, UV rays, and particles. ○ Nails: Protect fingertips and toes. ○ Glands: Sebaceous: Secrete oil to maintain skin and hair hydration. Sweat Glands: Regulate body temperature through sweat. Key Points for Paramedics: ○ Skin Assessment: Check for injuries, burns, signs of infection, and temperature dysregulation (hypothermia, hyperthermia). ○ Fluid Regulation: Monitor dehydration and sweating in trauma cases. ○ Inflammation: Identify inflammation and apply first aid to prevent infection. Quick Assessment: ○ Check the skin for trauma, burns, and infections. Recognize depth of injury (epidermis, dermis). Intervention: ○ Apply cooling techniques for heat stroke or warming for hypothermia. ○ Manage fluid loss with IV fluids or oral hydration as needed. Skeletal System Functions: Support: Provides framework for the body and bears weight. Leverage: Facilitates movement through muscle attachments. Protection: Shields internal organs from injury (e.g., skull protects the brain). Calcium Storage: Regulates calcium levels; important for muscle function. Blood Cell Production: Red marrow produces RBCs, WBCs, and platelets. Skeleton Divisions: Axial Skeleton: Skull, vertebral column, thoracic cage—protects brain, heart, lungs, and spinal cord.  Appendicular Skeleton: Shoulder girdle, pelvic girdle, limbs—facilitates movement. Bone Structure: Long Bones: Humerus, femur—important for movement and support. Short Bones: Carpals, tarsals—support fine movements. Flat Bones: Sternum, ribs—protect organs. Irregular Bones: Vertebrae, pelvis—protect the spinal cord and support body structure. Joints: Fibrous Joints: No movement (e.g., skull sutures). Cartilaginous Joints: Slight movement (e.g., intervertebral discs). Synovial Joints: Allow movement (e.g., shoulder, knee). Stabilize to prevent further injury in trauma. Bone Growth and Repair: Ossification: Bone growth and healing occur through ossification; proper immobilization is key for recovery. Calcium Regulation: Parathyroid hormone (PTH) releases calcium from bones when blood calcium is low. Key Points for Paramedics: Skeletal Assessment: Identify fractures, dislocations, and bone deformities in trauma patients. Calcium and Bone Health: Recognize signs of hypocalcemia (muscle cramps) or hypercalcemia (confusion). Joint Injuries: Assess for ligament tears, sprains, and stabilize injured joints. Blood Cell Production: Recognize the role of red marrow in recovery from trauma (anemia, infection). Quick Assessment: Evaluate for fractures, dislocations, and skeletal deformities. Intervention: Stabilize fractures with splints and manage calcium imbalances. Decision-Making: Use skeletal knowledge to assess injury impact and stabilize patients appropriately. Muscle System Functions: ○ Movement and Posture: Muscles contract and relax to facilitate movement and maintain posture.  ○ Joint Stability: Muscles provide support to joints, preventing dislocations. ○ Heat Production: Muscle contractions generate heat (e.g., shivering in cold conditions). Skeletal Muscle: ○ Excitability: Muscles respond to stimuli. ○ Contractility: Muscles shorten to cause movement. ○ Extensibility: Muscles can stretch. ○ Elasticity: Muscles return to their original shape after contraction. Muscle Attachments: ○ Origin: Fixed attachment point. ○ Insertion: Movable attachment point; pulled toward origin during contraction. Muscle Contraction: ○ Motor Neuron: Stimulates muscle contraction. ○ Neuromuscular Junction: Releases acetylcholine (ACh) to activate muscle fibers. ○ Calcium Release: Calcium ions trigger muscle contraction. ○ ATP: Provides energy for muscle contraction and relaxation. Energy Sources: ○ ATP: Main energy source for muscle contraction. ○ Creatine Phosphate: Provides rapid ATP replenishment. ○ Oxygen Debt: Accumulation of lactic acid during anaerobic respiration requires oxygen for recovery. Muscle Fatigue: ○ Caused by lactic acid buildup: Results in an inability to contract effectively. ○ Heat Production: Muscle contractions produce heat, important in regulating body temperature. Key Points for Paramedics: ○ Muscle Injuries: Identify strains, tears, and other muscle injuries. ○ Energy and Fatigue: Recognize muscle fatigue and oxygen debt; manage with proper oxygenation and hydration. ○ Calcium: Monitor calcium levels; important for muscle function (administer as needed in cases of hypocalcemia). ○ Neuromuscular Junction: Understand how ACh stimulates muscles; useful in managing nerve injuries. Quick Identification: ○ Assess muscle injuries and joint stability through examination and patient history. Intervention: ○ Stabilize muscles and joints with splints or braces. ○ Manage oxygen debt and fatigue through oxygen therapy and hydration. Decision-Making: ○ Use musculoskeletal knowledge to determine appropriate emergency treatments for muscle and joint injuries. Nervous System Functions:  Monitoring: Continuously tracks internal and external environments. Sensory Processing: Interprets sensory information (touch, pain, temperature). Response Coordination: Manages both voluntary (muscle movement) and involuntary (heart rate, breathing) responses. CNS (Central Nervous System): Components: Brain and spinal cord. Functions: Controls thought, movement, autonomic functions. Protection: Cranium, meninges, cerebrospinal fluid (CSF), and blood-brain barrier protect CNS from damage. PNS (Peripheral Nervous System): Somatic Nervous System: Regulates voluntary movement. Autonomic Nervous System (ANS): ○ Sympathetic: "Fight or flight" response (e.g., increased heart rate). ○ Parasympathetic: "Rest and digest" (e.g., digestion, lower heart rate). Neurons: Structure: Dendrites receive signals, axons transmit impulses. Motor Neurons: Carry signals from CNS to muscles. Sensory Neurons: Carry signals from body to CNS. Cranial Nerves: Key Functions: Smell (I), vision (II), hearing/balance (VIII), facial expressions (VII). Assessment: Test cranial nerves during patient evaluation for sensory or motor function loss. Pain Types: Somatic: Localized pain from skin, muscles, joints. Visceral: Deep pain from internal organs. Referred: Pain felt in an area away from its source (e.g., heart attack pain in arm). Phantom: Pain felt in amputated body parts. Spinal Cord: Role: Transmits motor and sensory signals between brain and body. Protection: Encased in vertebral column. Key Points for Paramedics: Neurological Assessment: Evaluate consciousness, motor, and sensory function, and test reflexes.  Pain Management: Differentiate between somatic, visceral, and referred pain; manage pain accordingly. Cranial Nerve Assessment: Test vision, hearing, and balance for signs of nerve damage. Spinal Cord Injuries: Stabilize spine, monitor motor/sensory loss. ANS Management: Recognize "fight or flight" responses and manage autonomic symptoms (e.g., heart rate, sweating). Quick Identification: Perform rapid neurological assessments to detect injuries or abnormalities. Intervention: Stabilize head and spine in cases of suspected trauma. Manage pain and autonomic dysfunction with appropriate medications. Decision-Making: Use neural and sensory assessments to determine necessary interventions, such as immobilization or medication. Endocrine System Functions: Hormone Secretion: Glands release hormones into the bloodstream to regulate metabolism, blood glucose, and other body functions. Stress Response: The adrenal glands release cortisol to manage stress (e.g., in trauma). Glucose Management: Insulin and glucagon from the pancreas maintain blood glucose levels. Major Glands: Pituitary Gland (Master Gland): Regulates other glands by releasing hormones like GH (growth), TSH (thyroid-stimulating), and ACTH (adrenal). Thyroid: Controls metabolism (T3, T4) and regulates calcium via calcitonin. Parathyroid: Maintains calcium balance through parathyroid hormone (PTH). Adrenal Glands: Produce cortisol (stress), aldosterone (fluid balance), and adrenaline (fight-or-flight response). Pancreas: Produces insulin (lowers blood glucose) and glucagon (raises blood glucose). Key Hormones: Insulin: Lowers blood glucose by allowing cells to take up glucose. Glucagon: Raises blood glucose by promoting the breakdown of glycogen. Cortisol: Regulates metabolism and manages stress response.  Thyroid Hormones (T3 and T4): Control metabolic rate and energy use. Key Points for Paramedics: Diabetes Care: Monitor blood glucose, recognize hypoglycemia (low sugar) and hyperglycemia (high sugar), and administer insulin or glucose as needed. Adrenal Crisis: Recognize signs of adrenal insufficiency (fatigue, low blood pressure) and manage with corticosteroids if necessary. Thyroid Disorders: Identify symptoms of hypo- (fatigue, cold intolerance) or hyperthyroidism (heat intolerance, weight loss). Temperature Regulation: Manage fevers with antipyretics (e.g., acetaminophen) and treat hypothermia with warming techniques. Hormone Management: Administer hormones or medications to stabilize patients with endocrine disorders (e.g., insulin for diabetes, cortisol for adrenal crisis). Quick Identification: Assess for signs of hormonal imbalances such as thyroid storms, diabetic ketoacidosis, and adrenal insufficiency. Intervention: Administer glucose for hypoglycemia, insulin for hyperglycemia, and corticosteroids for adrenal insufficiency. Decision-Making: Use patient history and symptoms to prioritize hormone-related interventions. Circulatory System: ○ Components: Heart, blood vessels (arteries, veins, capillaries), and blood. ○ Two Circuits: Systemic Circulation: Carries oxygenated blood from the heart to the body and returns deoxygenated blood to the heart. Pulmonary Circulation: Transports deoxygenated blood from the heart to the lungs and back with oxygenated blood. Blood Components: ○ Plasma: Carries water, proteins, nutrients, and hormones. ○ Red Blood Cells (RBCs): Transport oxygen and remove carbon dioxide. ○ White Blood Cells (WBCs): Fight infections (key types: neutrophils, lymphocytes). ○ Platelets: Aid in blood clotting. Heart Anatomy: ○ Four Chambers: Right atrium, right ventricle, left atrium, left ventricle. ○ Valves: Prevent backflow (e.g., tricuspid, mitral, pulmonary, aortic). ○ Blood Flow Pathway: Right atrium → right ventricle → lungs → left atrium → left ventricle → body.  Blood Clotting (Hemostasis): ○ Steps: Vasoconstriction → Platelet plug formation → Coagulation cascade (fibrin stabilizes clot). ○ Clot Breakdown: Fibrinolysis removes the clot after healing. Blood Types: ○ ABO System: Type O: Universal donor. Type AB: Universal recipient. ○ Rh Factor: Rh+ and Rh– must be compatible, especially in transfusions. Key Points for Paramedics: ○ Blood Pressure Monitoring: Check for signs of shock (low BP, fast HR) and intervene early with fluids or medications. ○ Hemostasis: Manage bleeding with direct pressure, tourniquets, or hemostatic agents. ○ Blood Transfusion: Ensure compatibility (ABO and Rh types) to prevent reactions. ○ Cardiac Emergencies: Recognize myocardial infarction symptoms (chest pain, shortness of breath) and act quickly. ○ Shock Management: Provide IV fluids to restore circulation, use vasopressors for blood pressure support. Quick Identification: ○ Assess circulation through pulse, blood pressure, and skin color to detect shock or impaired blood flow. Intervention: ○ Control bleeding with direct pressure and treat shock with IV fluids or blood transfusion. Decision-Making: ○ Recognize signs of poor circulation or blood loss and apply life-saving measures like fluid resuscitation. Respiratory System Functions: ○ Oxygenation: Delivers oxygen to the body. ○ CO₂ Removal: Eliminates carbon dioxide. ○ Protection: Filters air to trap pathogens and particles. Airway Anatomy: ○ Upper Airway: Includes nose, mouth, pharynx, and larynx. Filters, warms, and humidifies air. ○ Lower Airway: Includes trachea, bronchi, and alveoli. Gas exchange occurs in the alveoli. ○ Diaphragm: Main muscle of breathing. Lung Volumes: ○ Tidal Volume (TV): Air moved per breath during normal breathing. ○ Minute Volume (MV): Air moved per minute (TV × respiratory rate). ○ Vital Capacity (VC): Maximum air exhaled after maximum inhalation.  ○ Residual Volume (RV): Air remaining in lungs after exhalation to prevent alveolar collapse. Ventilation and Gas Exchange: ○ Inhalation: Diaphragm contracts, creating negative pressure to draw air into the lungs. ○ Exhalation: Diaphragm relaxes, expelling air from the lungs. ○ Oxyhemoglobin Curve: Shows oxygen binding to hemoglobin. Right shift releases oxygen to tissues; left shift holds oxygen in the lungs. Control of Breathing: ○ Medulla Oblongata: Controls respiratory rate in response to CO₂ levels. ○ Phrenic Nerves: Control the diaphragm for breathing. Key Points for Paramedics: ○ Airway Assessment: Ensure airway is clear and assess for breathing difficulties. ○ Oxygen Therapy: Administer oxygen using nasal cannula or masks depending on SpO₂ levels. ○ Ventilation Management: Use CPAP or BiPAP for patients in respiratory distress or intubation for severe respiratory failure. ○ Recognize Respiratory Distress: Look for signs like accessory muscle use, cyanosis, and altered mental status. ○ Treat Respiratory Emergencies: Administer bronchodilators for asthma, epinephrine for anaphylaxis, and support for pneumothorax or pulmonary embolism. Quick Identification: ○ Assess airway, breathing rate, and effort to detect respiratory distress. Intervention: ○ Administer oxygen and ventilation support based on patient’s oxygen saturation and clinical presentation. Decision-Making: ○ Recognize hypoxia and manage it with appropriate interventions (e.g., oxygen, bronchodilators). Digestive System Key Points Functions: Ingestion, digestion, absorption, and excretion. Alimentary Canal: Mouth → Pharynx → Esophagus → Stomach → Small intestine → Large intestine → Rectum → Anus. Accessory Organs: Salivary glands, liver (metabolism), gallbladder (bile), pancreas (enzymes/insulin). Abdominal Quadrants: ○ RUQ: Liver, gallbladder. ○ LUQ: Stomach, spleen. ○ RLQ: Cecum, appendix. ○ LLQ: Sigmoid colon. Fluid and Electrolyte Management:  ○ Monitor for signs of dehydration: Hypotension, tachycardia. ○ Administer fluids (IV). GI Emergencies: Appendicitis, bowel obstruction, pancreatitis. Airway Management: Prevent aspiration in vomiting patients. Urinary System Key Points Kidneys: Filter blood, balance fluids/electrolytes, regulate pH. Bladder: Stores urine, triggers micturition reflex. Fluid Balance: ○ ADH: Promotes water retention. ○ Thirst Mechanism: Prompts fluid intake. ○ Electrolyte Imbalances: Watch for hyperkalemia, hypokalemia. Key Organs: Kidneys, ureters, bladder, urethra. Male Anatomy: Testes produce sperm; hormones regulate male traits. Pathway: Testes → Epididymis → Vas deferens → Ejaculation. Female Anatomy: Ovaries produce eggs, regulated by hormones. Uterine tubes transport eggs; fertilization happens here. Uterus supports pregnancy. Vagina handles menstruation and childbirth. Key Emergencies: Recognize ectopic pregnancy (severe pain, bleeding), testicular torsion (sudden pain, swelling), and sepsis (fever, pain, altered mental state). Hormonal Management: Monitor for hypo/hypergonadism. Address imbalances with fluids, hormone therapy support. Trauma Management: Stabilize reproductive injuries, manage bleeding, and protect airways in severe cases.