Pages from Mod5 Human Anatomy, Physiology, and Development PDF

4N051, Module 5, Human Anatomy, Physiology, and Development Lesson 1- Human Anatomy and Physiology Lesson 2- Human Development Lesson 1 of 2 Lesson 1- Human Anatomy and Physiology After completing this lesson, the student will be able to identify human anatomy and physiology principles in accordance...

4N051, Module 5, Human Anatomy, Physiology, and Development Lesson 1- Human Anatomy and Physiology Lesson 2- Human Development Lesson 1 of 2 Lesson 1- Human Anatomy and Physiology After completing this lesson, the student will be able to identify human anatomy and physiology principles in accordance with prescribed guidance and publications. Descriptive Terms and Topographic Anatomy Topographic Anatomy – The focus on descriptive terminology is used to define body areas and movements. The use of topographic terminology is very important in the medical profession. Proper use of these terms will ensure that accurate information about patient assessment and care procedures is communicated appropriately. Anatomical Anatomy – Specific terms are used to describe anatomical relationships based on a reference point. For anatomical anatomy the professional world of medicine uses the anatomical position as the reference point which is a diagram of a human body standing upright, arms at the sides and palms facing forward. These terms are used to describe the location of one body part or marking in relationship to another part or marking. The table below lists each of the common terms used in the medical profession to describe body structure and area locations. Term Definition Examples Anterior (ventral) Located at or toward the front of the body or body part. Stomach is anterior to the kidneys. The nose is on the anterior surface of the head. Posterior (dorsal) Located at or toward the back of the body or body part. Spine is posterior to the sternum. The kidneys are posterior to the stomach. Medial Located at or near the midline of the body or body part. Sternum is medial to the ribs. The septum of the heart is medial to the left ventricle. Lateral Located away from the midline of the body or body part and toward the side of the body or body part. Ribs are lateral to the sternum. The left ventricle of the heart is lateral to the septum. Superior Located toward the head or area of the body that is closer to the head. Stomach is superior to the cecum. Eyes are superior to the mouth. Inferior Located toward the feet or area of the body that is closer to the feet. Cecum is inferior to the liver. Proximal Located toward or closer to a given point or origin. Usually in relation to the trunk or midline of the body. Pelvis is proximal to leg. Distal Located father from a given point of origin. Usually used in relation to the trunk or midline of the body. Hand is distal to the elbow. Foot is distal to the knee. C O NT I NU E Body Movement Terminology These are various terms used to describe the movements of body parts. This section contains a list of the terminology used to describe the movement of various body parts in relation to the action that occurs. The tables below refers to common terms used to describe body structure and area locations when referring to the normal anatomical position of the human body, which is standing upright, arms at the sides, palms facing forward. Just as anatomical relationships, there are specific various terms used to describe the general and specific movement of the human body. Term Definition Range of motion The range, measured in degrees of a circle, through which a body part can be rotated, extended or flexed at a joint. Longitudinal axis An imaginary line that passes lengthwise through a portion of the body or a bone. This line divides the part equally and symmetrically. A line projecting at right angles to the plane of motion. The Axis of joint rotation axis of rotation for most joints’ changes with the motion of the joint due to the joint’s structure and the variety of angles in which it can be moved. Specific Body Movements Term Rotation Circumduction Supination Definition A joint motion whereby a part moves or turns about its longitudinal axis. A movement whereby the distal end of a part makes a circle while the proximal portion of the part remains relatively stationary. The movement that rotates the forearm outward so that the palm of the hand faces forward. Pronation Turning the head from side to side. Making circles with the entire arm while it is stretched out. Rotating the palms forward while the arms are hanging loosely at the side. The movement that rotates the Rotating the palms toward the back of forearm inward, causing the back of the hand to face forward. the body while the arms are hanging loosely at the side. A motion described when adjacent body parts approach each other, Flexion Example thereby decreasing the angle between them. More simply stated, flexion is the act of folding, bending or Moving the forearm toward the head by bending the elbow (as in doing a “curl” with a weight). withdrawing a body part. Dorsiflexion A special type of flexion used to describe ankle and foot movement Pointing the toes toward the face. Term Definition Example where the top (dorsal) surface of the foot moves closer to the leg, causing the angle between the anterior surface of the leg and the foot to decrease. Plantar flexion Another type of flexion used to describe ankle/foot movement. The bottom (plantar) surface of the foot moves away from the leg, causing the angle between the anterior surface of Pointing the toes away from the face. the leg and the foot to increase. A movement, which increases the angle Extension between two adjacent, body parts. Refers to a movement that causes the parts of an extremity to line up in a straight manner. Hyperextension Abduction Standing in the normal anatomical position, then moving the head backward (as if looking up in the sky). Movement of a body part away from the midline or medial plane of the Raising an arm from the side to Eversion shoulder level. Movement of a body part toward the Bringing the arm from shoulder level midline or medial plane of the body. back to the side. A special term used to describe the Inversion attention). A type of extension where a body part is extended or stretched beyond its normal anatomical position. body. Adduction Standing with the arms facing outward or forward, then bringing them straight to the side (the position of movement that turns the bottom of the foot inward. A special term used to describe the movement that turns the bottom of the foot outward. Turning the soles of the feet toward each other. Turning the soles of the feet away from each other. Anatomical Position C O NT I NU E Fluids, Electrolytes, and Acid-Base Balance Fluid and Electrolyte Balance – The two main constituents that compose human body fluid are water and electrolytes. Water aides in the transportation of substances through cellular membranes but also throughout the body. Water also aides in regulating body temperatures and balancing hydrogen molecules in the body. During the digestive process, water acts as a medium in support of enzymes breaking down particles. Because of these actions, the human body is about 60% water. Water Electrolytes Fluid Imbalances - Fluids that leave the body do so through respiration, perspiration, urination, and elimination. When there is an imbalance, the patient exhibits signs and symptoms associated with the deficiency or excess. There are two types of fluid imbalances—fluid volume deficit and fluid volume excess. Fluid Volume Deficit Fluid Volume Excess Fluid volume deficit (FVD) is also referred to as hypovolemia. Hypovolemia can be Fluid volume excess (FVE) is also referred to as caused from not taking in enough fluids, or a loss of fluids from sweating, vomiting, hypervolemia. There are a number of disease and diarrhea. Other causes are severe burns, bowel obstructions, excessive processes that cause hypervolemia (e.g., congestive gastrointestinal suctioning, and severe bleeding. Signs and symptoms you’ll notice heart failure, renal failure, cirrhosis, and Cushing’s include poor skin turgor, concentrated urine, which will result in a high specific syndrome). Other causes of FVE include excessive gravity, oliguria (diminished urine output), dry mucous membranes, weak and rapid intake of parenteral fluids, excessive intake of salt, and pulse, orthostatic hypotension, and a low central venous pressure (below four cm of decreased renal function along with an excess or water). normal fluid intake. In severe cases of hypovolemia, confusion and restlessness may be observed. The Signs and symptoms to look for are edema, ascites treatment for hypovolemia is to encourage fluid intake, if the patient is conscious, and (abdominal swelling), and pulmonary edema. The in severe cases, the administration of intravenous (IV) therapy may be necessary. In patient will show a weight gain and distended neck cases of severe bleeding, maintain the patient’s body temperature and give oxygen. veins. The central venous pressure will be high (over 11 cm of water) with a full bounding pulse. If the hypervolemia is due to decreased renal function, the patient will exhibit polyuria and diluted urine. Multiple Response What are the two types of fluid imbalances? hypovolemia hypervolemia hypertension hypotension SUBMIT Complete the content above before moving on. The Importance of Electrolytes, Sodium, Potassium, and Calcium Click on the flip cards below to learn more about electrolytes and the affect of sodium on the human body. Electrolytes - To refresh your memory, an electrolyte is a chemical substance (ion), capable of carrying an electrical charge when it is in water. Electrolytes are found in the body’s extracellular and intracellular spaces. There must be a unique balance between the intracellular and extracellular electrolytes for the proper transmission of electrical impulses across nerve fibers to occur. Although there are many, we’ll discuss three of the major electrolytes that help to keep our many body systems in check—sodium, potassium, and calcium. Remember, as you study electrolyte imbalances, your objective is to be able to recognize the signs and symptoms associated with a deficit or an excess. 1 of 3 Sodium - The sodium (Na) cation (positively charged ion) is the main electrolyte found in extracellular fluid. The importance of this electrolyte cannot be overlooked. It is essential for normal nerve and muscle activity and the regulation of fluid balance. Normal sodium concentration in the blood ranges from 135 to 145 milliequivalent (mEq/L). Any values above or below will cause the patient to have a deficit or an excess. 2 of 3 Sodium Deficit - A sodium deficit is referred to as hyponatremia. Hyponatremia can occur from profuse sweating (diaphoresis), vomiting, loss of gastric secretions from suctioning, and the administration of nonelectrolyte intravenous fluids. Symptoms to look for include confusion, weakness, restlessness, hyperthermia (elevated body temperature), tachycardia, muscle twitching, and abdominal cramping. In severe cases, convulsions and coma can be the complications. The treatment prescribed by the physician for mild cases would be the oral administration of sodium. This is accomplished by providing the patient with foods high in sodium or by having him or her drink salt water. For a moderate deficit, the intravenous route and giving 0.9 percent sodium chloride would be necessary. For severe cases, the physician will order lactated Ringer’s solution intravenously. 3 of 3 Potassium The potassium (K) cation found in intracellular fluids is essential for normal nerve and muscle activity. Potassium has the same functions intracellularly as sodium has extracellularly. Just keep in mind, potassium and sodium have a hateful relationship where sodium goes, potassium leaves. Normal serum potassium ranges from 3.5 to 5.0 mEq/L. Abnormal levels can cause death. If you work with cardiac patients, you may already be aware of the importance of monitoring serum potassium levels. Potassium Deficit - A potassium deficit is referred to as hypokalemia. Hypokalemia can occur with the use of certain diuretics (Lasix), a loss of fluid due to vomiting and diarrhea, and gastric suctioning. Signs and symptoms include fatigue, weakness, anorexia, nausea, vomiting, and dysrhythmias (abnormal heart rate or rhythm). In more severe cases of hypokalemia, hypotension and death caused by cardiac or respiratory arrest can result. Treatment of hypokalemia includes dietary supplements of potassium rich foods (fruits), to administering oral potassium salt. The physician may also order intravenous administration of potassium in severe cases of hypokalemia. Potassium Excess - A potassium excess is referred to as hyperkalemia. Hyperkalemia can result from severe renal failure, severe burns, overuse of potassium supplements, and the over-administration of parenteral potassium. Symptoms associated with hyperkalemia are diarrhea, nausea, muscle weakness, and dysrythmias. Death can occur from cardiac or respiratory arrest due to severe cases of hyperkalemia. The treatment of hyperkalemia ranges from removing potassium from the diet to special medications that help to lower serum potassium levels. Calcium Calcium (Ca) is found mostly in the bones and teeth. Regulated by the parathyroid glands; serum levels of calcium account for only one percent of the body’s calcium level. Calcium is necessary for nerve impulse transmission, blood clotting, and muscle contraction. Normal serum calcium levels range from 8.4 to 10.6 milligrams per decilitre (mg/dL). Calcium Deficit - Referred to as hypocalcemia, calcium deficits can result from an insufficient dietary intake of calcium. Since vitamin D is necessary for the absorption of calcium, a vitamin D deficiency will directly affect calcium levels. Other causes of hypocalcemia may be from metastatic cancer attacking bone. Damage to the parathyroid glands or removal during a thyroidectomy may cause a hormone deficiency that could cause hypocalcemia as a side effect. Calcium Excess - Hypercalcemia is the medical term for calcium excess. Large amounts of calcium in the blood can result from tumors on the parathyroid glands, multiple fractures, excessive doses of vitamin D, prolonged immobilization, and some drugs used to fight cancer (antineoplastics). Symptoms associated with hypercalcemia are deep bone pain, constipation, anorexia, nausea, vomiting, polyuria, polydipsia, fractures, and mental changes. To treat hypercalcemia, the physician would first determine the cause, and then treat it. In mild cases, limiting calcium intake and forcing fluids would be used. In more acute cases of hypercalcemia, the use of intravenous fluids that would increase calcium excretion would be administered. Multiple Choice Which mineral is necessary for nerve impulse transmission, blood clotting, and muscle contraction? Potassium Iron Calcium Electrolytes SUBMIT Complete the content above before moving on. Acid and Base Imbalances Simply speaking, the body’s acid-base balance is essential for life. Have you ever been involved in providing cardiopulmonary resuscitation due to respiratory or cardiac arrest? If you have, you may remember the physician calling out orders for blood gases to be performed. Once the results are obtained, the physician may then give an order for sodium bicarbonate to be given stat. After reading the following lessons regarding acidbase balance, you will understand why the physician ordered the sodium bicarbonate. The symbol pH refers to the percentage of hydrogen ions (atoms) present in a solution. The more hydrogen ions in a solution, the more alkaline it is. The less number of hydrogen ions, the more acidic the solution will be. When a physician requests blood gases to be performed, one of the tests performed on the blood is pH. A normal plasma pH is 7.34 to 7.45, or a slightly alkaline state. With results below 7.34, the patient is considered acidic; with results above 7.45, the patient’s serum is considered alkaline. We will discuss the four types of acid-base imbalance: Metabolic Acidosis, Metabolic Alkalosis, Respiratory Acidosis, Respiratory Alkalosis. Metabolic Acidosis This is a deficit of bicarbonate (base) or a gain in an acid in the body fluid. In most cases, metabolic acidosis results from an imbalance in the metabolism of foods or fluids (e.g., usually diabetes). Some causes of metabolic acidosis include starvation, insulin deficiency resulting in diabetic acidosis, diarrhea, and renal failure. The patient’s serum pH is below 7.34. The treatment for metabolic acidosis is to eliminate the cause and replace the lost fluids and electrolytes. Bicarbonate may also be administered. Metabolic Alkalosis This is an excess of bicarbonate (base) in the body fluids. Metabolic alkalosis can be the result of problems with the gastrointestinal tract (e.g., chronic or excessive vomiting) or the ingestion of too many alkalies (i.e., medications used for acid indigestion, antacids). Excessive gastric suctioning can remove too much hydrochloric acid, resulting in metabolic alkalosis. The treatment for metabolic alkalosis is to eliminate the cause. Respiratory Acidosis This is the result from an excess of carbonic acid in the body fluids. The cause of respiratory acidosis can be any deficiency in respiratory ventilation (e.g., pneumonia, emphysema, asthma, and respiratory obstruction). Treatment depends on the cause of respiratory acidosis, and it is very individualized. Patients who are having difficulty breathing may be given medications (e.g., bronchodilators) to improve respiratory sufficiency. Respiratory Alkalosis This is the result of a deficiency of carbonic acid. In most cases this is due to hyperventilation, the “blowing off” of excessive amounts of carbon dioxide (CO2). Patients hyperventilate because of anxiety, high fevers, and hysteria. Treatment for respiratory alkalosis is to correct the hyperventilation. Rebreathing expired air from a paper bag is one method taught in most emergency medical technician courses. Multiple Choice What is the normal plasma pH? 7.10-7.20 7.34-7.45 7.47-7.85 8.23-8.41 SUBMIT Complete the content above before moving on. Thermal Regulation Thermal regulation of body cells - Body temperature regulation is vital to homeostasis. Even the slightest shift in body temperature can disrupt the rate of the metabolic reactions in the cells functions. Normal body temperature is 98.6 degrees Fahrenheit (F). For the body to maintain this constant temperature it must balance the amount of heat produced through cellular metabolism and the amount of heat lost that is largely regulated through the skin. The cellular metabolic heat produced during physical exercise is released from the muscles to the blood where it is carried away from the muscles to the hypothalamus. In turn the hypothalamus will signal the dermal blood vessel walls of the muscle to relax. As the vessels dilate, more blood enters the vessels and the heat in the blood escapes to the outside. This works at the dermal layer of the skin over the muscles being worked. At the same time, the deeper blood vessels of the active muscle vasoconstrict, diverting the blood to the surface of the skin over the muscle producing redness. This will stimulate the heart to beat faster, moving the blood out of the deeper tissue faster. Hypothalamus The hypothalamus controls the functions to regulate the body temperature; normal regulation of heat loss begins with the blood vessels. As the muscles of the dermal blood vessels contract, this decreases the flow of heat-carrying blood through the skin. The result is a reduction of heat loss by radiation, conduction and convection; it is evidenced by a loss of color to the skin. The body will also signal the sweat glands to remain inactive to reduce the heat loss through evaporation. If the constriction of the blood vessels and inactivating the sweat glands is not enough to stop the heat loss, and the body temperature continues to fall, the nervous system may stimulate muscle fibers to contract slightly. This action will increase the rate of cellular respiration to produce heat at the cellular level. If this response still does not raise the body temperature, then small muscle groups will begin to rhythmically contract to cause a person to shiver, generating more heat. Radiation The primary means of heat loss of the body is radiation. Infrared heat rays escape from warmer surface to cooler surroundings. These rays will release the heat in all directions, much like the bulb from a heat lamp. Conduction and convection also allow the body to release heat, but in lesser amounts. Conduction During conduction, the heat moves from the body directly into the molecules of cooler objects you are in contact with. Example: when you sit on a cold metal bench in the winter. The heat from your body is lost by conduction into the metal seat. Convection Convection is when there is a continuous circulation of cooler air that is warmed over a surface. As the cooler air becomes heated, it moves away from the body carrying the heat along with it. This air is then replaced with cooler air moving toward the body to be warmed. This continuous cycle of air circulated is heat loss through convection. Evaporation There is still one more way the body will lose heat. When the body temperature rises above normal the nervous system stimulates the sweat glands to release sweat onto the skin's surface. When the sweat evaporates, it carries the heat away from the surface to cool the skin. This process is what is called evaporation. Hypothermia Unfortunately, the mechanisms do not always function properly. When the body function fails, the consequences can be dangerous. Hypothermia, an excessively lowered body temperature, can result from prolonged exposure to cold or even as part of an illness. Hypothermia begins with the last normal response to cold—shivering. Hypothermia effects continue with the feeling of coldness, and the progression to mental confusion, lethargy, loss of reflexes and consciousness, and eventually the shutting down of major organs. If the temperature of the body core drops even just a few degrees, respiratory failure or heart arrhythmias may occur. With any disease process, certain people are at higher risk for developing hypothermia. This includes very young, very old, extremely thin individuals and the homeless. The best way to prevent hypothermia is to dress appropriately with layers and stay active in the cold. Any individual being treated, or even just a particular body part, for hypothermia must be warmed gradually. This allows the respiratory, cardiovascular, and circulatory functions to remain stable. Hypothermia is one extreme when the body is unable to regulate the body’s temperature and hyperthermia is the other. Hyperthermia Being able to cool the body temperature is done largely through the dilation of the blood vessels and the secretion of sweat. In extremely humid environments, the body has a difficult time reducing the body temperature. Air can only hold a limited amount of water vapor, so on the hot humid day; the air becomes nearly saturated with water. During this time, the sweat glands may be activated, but the sweat is unable to evaporate quickly so the skin becomes wet, but the individual remains hot and uncomfortable. In high humidity, the body is unable to release the necessary heat through evaporation due to the humidity level. This can also be compounded with a high ambient air temperature. When the air temperature is higher than the body temperature, the body will continue to gain heat from the surroundings causing the core temperature to rise even higher. A high core temperature can result in circulatory system collapse. Fever Hyperthermia is not always to this extreme and not always a life threatening situation. A fever is the body’s attempt to fight an infection by selfinducing a hyperthermic response. In a fever, molecules on the surface of the infectious agent stimulate phagocytes to release a substance called endogenous pyrogen, meaning “fire starters.” The bloodstream carries the endogenous pyrogen to the hypothalamus, where the set point controlling temperature is raised. The body responds by signaling the skeletal muscles to increase the heat production, decrease the blood flow to the skin, and decrease the production of sweat gland secretion. This results in the body temperature rising to the new set point, and the person then has a fever. This increase in the body temperature helps the immune system to kill the pathogens, also making the individual uncomfortable. The immune system is the primary defense the body has to fight disease processes. For the system to work effectively, specific body functions must be working together for the immune system to perform. C O NT I NU E Cellular Metabolism There are two pathways of cell metabolic reactions, anabolism and catabolism. Anabolism is when larger molecules are constructed from smaller ones, requiring input of energy. In catabolism, larger molecules are broken down into smaller ones, releasing energy. Before a cell can perform its function, it must have the energy necessary for the job. Heat is one form of energy (a catalyst) used to increase the rate of chemical reactions in a laboratory. A catalyst is a particular molecule that can change the rate of a reaction without itself being consumed. Heat energy increases the rate at which molecules move and the frequency of the molecular collisions. The temperature of a body cell is usually too mild to promote the reactions of life; the body uses enzymes to make these reactions possible. Enzymes promote specific chemical reactions within cells by lowering the activation energy needed to start these reactions. When the body recognizes a deficiency, the body begins production of the enzyme to produce the necessary molecule product. Enzyme molecule names are often derived from the type of reaction that is catalyzed and has the suffix –ase added. Example, a lipid-splitting enzyme is called lipase, a protein-splitting enzyme is protease, and a starch-splitting enzyme is called amylase. Similarly, there are also sugar sucrose-splitting enzymes that result in sucrase, sugar lactose-splitting enzymes produce lactase, and sugar maltose-splitting enzymes are called maltase. Watch the video below to learn more about these processes. Metabolism - Anabolism and Catabolism Video Transcript.pdf 131.6 KB Multiple Choice Amino acids are made during which phase of metabolism? Anabolism Catabolism SUBMIT Complete the content above before moving on. Oxygenation and Circulation Basic physical needs are essential to maintaining life. The most important of these basic physiological needs is oxygenation. The body must have adequate oxygenation for proper cardiovascular function to supply the tissues with oxygen. Respirations are the source for oxygenation. Everything begins at the cellular level and oxygenation and the circulation of this oxygen is no exception. A patient’s physiological need for oxygenation can be affected by many things, such as altitude and disease processes. Diseases such as emphysema and chronic obstructed pulmonary disease (COPD) are two examples where the physiological need for oxygen could be compromised. In both disease processes the alveoli lose their shape and become floppy. Less air gets in and less air goes out because: 1 The alveoli lose their elasticity (like an old rubber band). 2 The walls between many of the alveoli are destroyed. 3 The walls of the airways become thick and inflamed (swollen). 4 Cells in the airways make more mucus (sputum) than usual, which tends to clog the airways. Signs and symptoms can be monitored through the patient’s use of accessory muscles, monitor tracings, and through bloodwork results. Bloodwork results offer significant clues to a health care provider about the patient’s ability to oxygenate and what treatment to implement for the patient’s recovery. Without circulation, the body can inhale and exhale air all day long, but it will not sustain life. The blood is what transports the oxygen and carbon dioxide between the lungs and the body cells. As these gasses enter the blood, they dissolve in the plasma or combine chemically with other atoms or molecules. The alveoli provide the capillary network necessary for this exchange of gasses. The partial pressure of oxygen (PaO2) is a sensitive and non-specific indicator of the lungs' ability to exchange gases with the atmosphere. The PaO2 determines the amount of partial pressure of oxygen that combines with hemoglobin. The greater the PaO2, the more oxygen that can combine with the hemoglobin for circulation. Almost all oxygen in the body (98 percent) is carried in the blood, where it bonds to the protein hemoglobin in the red blood cells. The remaining two percent is dissolved in the blood plasma. For the circulatory system to carry oxygen to the body tissues, we must be able to produce enough red blood cells (RBC). Good nutrition of an individual greatly increases the body’s ability to produce the RBCs we need to carry the vital oxygen throughout the body. Follow the link below to learn more about PaO2. Understanding the Partial Pressure of Oxygen (PaO2) Test A PaO2 test measures partial pressure of oxygen, or PaO2-the oxygen pressure in arterial blood. The PaO2 reflects how well oxygen is able to move from the lungs to the blood. It is often altered by severe illnesses, with the PaO2 test results used to guide treatment. READ MORE VERYWELL HEALTH  C O NT I NU E Nutrition and Elimination Following closely behind oxygenation and circulation is nutrition and elimination. Good nutrition enables proper body functions and the end result is to help ease recovery time for the patient. Nutrition covers a broad spectrum of vitamins, minerals, chemical reactions with cells, and of course, the ability to eliminate the excess waste the body does not need. Many diseases affect the physiology of the body’s cells and their function. As discussed previously, all things begin at the cellular level. Nutrition is the basis for most cells, acquiring the necessary molecules they need for proper function. The body relies on RBCs to produce hemoglobin for oxygen to bond to. The hemoglobin then is transported to the body tissues and cells in need of the oxygen. The availability of two B-complex vitamins significantly influences RBC production. Vitamin B12 and folic acid are the B-complex vitamins necessary for the production of RBCs. These vitamins are also required for DNA synthesis, thus being needed for the growth and reproduction of all cells. Cellular reproduction occurs at such a high rate in hematopeitic tissues that tissue is extremely vulnerable to the deficiency of either of these vitamins. The lack of B12 is usually due to a disorder or disease process that prevents the stomach lining from absorbing the B12 rather than a dietary deficiency. Along with B-complex vitamins, iron is necessary for hemoglobin synthesis. Iron is absorbed slowly from food in the small intestine. Just a small portion is absorbed even when the food contains an abundance of iron. The rate of absorption is directly related to the amount of iron the body currently has in it. If the body is low on iron, the absorption rate will increase. When a patient is anemic, this reduces the oxygen-carrying capacity of the blood, giving the person a pale appearance and a lack of energy. Nutrients in the plasma portion of the blood are also very important. Plasma nutrients include amino acids, simple sugars, nucleotides, and lipids absorbed through the digestive tract. Blood plasma transports glucose from the small intestine to the liver where it may be stored as glycogen or altered to form fat cells. Amino acids are also carried to the liver where the amino acids are synthesized into proteins to be used as an energy source. Plasma lipids include triglycerides, phospholipids, and cholesterol. Because lipids are not water soluble, the lipids combine with proteins in lipoprotein complexes. Lipoproteins are classified into four groups based on their density, which reflects their composition. Chylomicron consists mainly of triglycerides absorbed from the small intestine. Very low-density lipoproteins (VLDL) consist of a relatively high concentration of triglycerides. Low-density lipoproteins (LDL) consist of a relatively high concentration of cholesterol and are the major cholesterol-carrying lipoprotein. High-density lipoproteins (HDL) consist of a high concentration of protein and a lower concentration of lipids. The following table reviews the characteristics and functions of each of these lipoproteins. Lipoprotein Characteristics Chylomicron High concentration of triglycerides. VLDL Relatively high concentrations of triglycerides; produced in the liver. Functions Transports dietary fats to muscle and adipose cells. Transports triglycerides synthesized in the liver from carbohydrates to adipose cells. Relatively high concentrations of LDL HDL cholesterol; formed from remnants of Delivers cholesterol to various cells, VLDL molecules that have given up their triglycerides. including liver cells. Relatively high concentrations of Transports remnants of chlyomicrons protein and low concentrations of that have given up their triglycerides to lipids. the liver. The chylomicrons transport dietary fats to both muscle and adipose tissues. The chylomicrons are then used as energy or stored as fat. In a similar manner, VLDL transport triglycerides that have been synthesized from excess dietary carbohydrates to adipose cells; the remnants are converted to LDL. Because most of the triglycerides have been removed, the LDL molecules have the higher cholesterol content. Cholesterol content is one of the contributing factors to many coronary disease processes. Human Liver The HDL molecules formed in the liver and small intestine transport the chylomicron remnants back to the liver. The liver disposes of most of the cholesterol by secreting it into the bile. These bile secretions are later reabsorbed largely by the small intestine and back to the liver. The secretion-reabsorption cycle of the cholesterol and bile secretions are constantly repeated. During each cycle some of the by-products of bile salts and cholesterol reach the large intestine and are eliminated with the feces. Matching Match the lipoprotein to the correct function. SUBMIT Complete the content above before moving on. Activity and Rest Rest Rest is something that everyone must do. It is a need that helps the body save energy but also refreshes the individual. Also, when someone is resting their vital signs (blood pressure, pulse, respirations, and temperature) will be much more improved than when they would be awake. During this time the body is also healing and repairing tissue. Overall, after someone wakens, they will feel much better. Factors Impacting Sleep 1 Age – The amount of sleep needed decreases with age. 2 Illness – The need for sleep increases when someone is ill. However, sleep will be interrupted when someone is dealing with pain, vomiting, headaches, chills, difficulty breathing, diarrhea or increased voiding. Sleep will also be impacted when positioned in uncomfortable positions due to medical equipment. 3 Nutrition – Foods with caffeine will decrease the amount of sleep one person gets. Caffeine is a stimulant, preventing any ability to sleep. Foods with tryptophan help aid sleep. 4 Exercise – Exercise stimulates the body and gets your blooding circulating. Any exercise should be avoided 2 hours prior to bed. 5 Environment – People get used to the daily room that they sleep in, such as their beds, pillows, any noises or lighting, or even their sleeping partner. Any changes in any of these examples, change the person’s environment and affect their sleep. 6 Drugs – Some drugs are naturally depressants that will help aid someone with resting. However, some drugs have a side effect that may cause drowsiness that will also help with sleep. Then there are some drugs that are stimulants that speed up the body internally and decrease any sleep for the person. 7 Emotional concerns – Some people struggle with anxiety, depression, fear or worrying. People can be impacted by either staying awake or sleeping too often. 8 Sleep disorders– Insomnia – When an individual cannot sleep or has trouble falling asleep. Insomnia can also be referred to as someone who wakes up early but can no longer fall asleep. Sleep Deprivation – Described as sleep is interrupted and the quality and amount of sleep is decreased. Sleep walking – When someone leaves their bed and is walking around. The person has no recollection of the event, and these events could last up to 4 minutes or longer. The person’s risk of falls is greatly increased as well. C O NT I NU E Human Growth and Development and the Aging Process The terms growth and development are both dynamic processes. Growth refers to the physical changes that can be measured and occur in a steady and orderly manner. Height and weight are two examples. Development relates to changes in psychological and social functioning. Different age groups generally act appropriately for their age. Certain developmental tasks should also be accomplished during each stage. Each stage lays the foundation for the next. Growth and development occur from the moment of fertilization until death. The processes proceed from simple to complex. There is a sequence, order, and pattern to growth and development. This lesson explains nine age groups and the growth and development stages that usually occur in each stage. Though some people may either be slightly ahead of or behind these general expectations, an average view of each group is covered in this lesson. Understanding these expected characteristics is important for those involved in patient care. Knowing appropriate growth characteristics can help to identify abnormalities. Awareness of expected developmental characteristics serves to anticipate behavior for patients of various ages. Lets begin taking a look at each of these developmental stages. Infant Growth and Development (Birth to One Year) Rapid physical, psychological, and social development characterize this period. The developmental tasks that have been identified for this period are developing stable sleep patterns, beginning to have emotional relationships with parents and siblings, beginning to talk and communicate with others, learning to eat solid foods, and learning to walk. Average newborns weigh seven to seven and one-half pounds and are 20–21 inches long. Their birth weight usually doubles by the fifth or sixth month, and by the end of the first year, their weight triples and they should also grow 10– 12 inches in the first year. The newborn’s central nervous system is not well developed. Movements are uncoordinated and generally without purpose. As the nervous and muscular systems develop, the infant develops specific voluntary and coordinated movements. Certain reflexes and involuntary movements normally are present and disappear as the central nervous system develops. Infants can see at birth, but their vision is not clear. They respond to bright objects. They can also hear well and are startled by loud noises and soothed by soft sounds. At birth, they respond to touch and their senses of smell and taste are developed. During the first six months of life, the infant’s diet usually consists of breast milk or formula. Solid foods, such as strained fruits and vegetables, are gradually added to the diet about the sixth month. Around the eighth month, the infant normally advances to junior foods, still remaining on breast milk or formula until one year of age. Table food usually is introduced at the end of the infant stage. Months Infant Development 1 Can hold their head up while lying on their stomach. 2 Can smile and follow objects with their eyes. 3 Can raise their head and shoulders while lying on their stomachs, sit for a short time, and hold an object in their hand. Can roll over, sit-up when supported, and may sleep all 4 night. The Moro and rooting reflexes have disappeared by this time. The infant can hold objects with both hands, puts objects in the mouth, and babbles when spoken to. 5 Can grasp objects and play with their toes. Teeth begin to erupt at this point. Usually have two lower front teeth and begin to chew finger food. They are able to hold a bottle for feeding and can sit 6 alone for short periods of time. By this time, the infant can manipulate small objects and can vocalize one-syllable sounds. Upper teeth begin to erupt. Infants can respond to their name 7 and begin to show a fear of strangers. They can transfer objects from one hand to another. They also begin to imitate simple acts and sounds. Can usually stand while holding onto something, they 8 respond to the word "no" and cry when scolded. They can feed themselves finger foods and reach with open arms to be picked up. At this point, the infant is usually bashful and nervous with strangers. 9 Crawls and can pull to a standing position. They comply with simple verbal commands and can communicate with hand gestures such as waving. They also show a fear of being left alone which may be evident when going to bed. Can walk while holding onto objects, will look under objects 10 11 for a toy and can pull themselves to a sitting position, infants are also aware of their own names by this age. Can stand momentarily and can play interactive games using body language. They also communicate disapproval by shaking their head "no". Begins to walk with help and can hold a cup for drinking. 12 Demonstrates emotions such as anger and affection, and clings to parents in unfamiliar situations. Toddler Growth and Development (One to Three Years) Physical growth is not as rapid during the second year of life as it is during the first year; however, the rate of development increases dramatically. At one year, visual acuity is fairly well established. Between the ages of one and two years, toddlers grow approximately four to five inches. Fine muscle coordination and gross motor skills improve during the toddler years. At about 18 months, they can walk up stairs with assistance and pick up small objects and place them in a receptacle. Several other things also occur with toddlers at the two-year point: Can be expected to weigh four times the birth weight. Lose most of their “baby look;” they are usually chubby, with relatively short legs and a large head. They have a protruding abdomen, which flattens as the child grows and the abdominal muscles develop. Can use a spoon correctly, are able to run, balance on one foot, and ride a tricycle. Toilet training is a major developmental task for the toddler. Bowel and bladder control is directly related to the development of the central nervous system. By three years, most children are toilet trained, although they may still have accidents while playing or during the night. Speech and language skills begin to increase by age three. Speech becomes clearer, and the vocabulary increases as words are learned by imitating others. Toddlers understand more words than they use and are capable of constructing two- to three-word sentences. They begin to play alongside other children but not with them. They are very possessive and do not agree with the concept of sharing. The word “mine” is used frequently. Temper tantrums are the way toddlers deal with frustration. They often respond to discipline by kicking and screaming. At three years, the integration of visual and neuromuscular mechanisms is fairly well developed. This allows a child to look away from an object prior to reaching out and picking it up. Also, the senses of hearing, taste, smell, and touch become more developed and associated with each other. Hearing in the three year old is at adult levels. Touch is extremely important to toddlers; they are often soothed by tactile sensations. Preschool Growth and Development (Three to Six Years) The preschool stage is characterized by less physical growth than the toddler stage. Both gross and fine motor skills are fairly well developed. In this stage, the child shows increased independence and intellectual development. Preschoolers are less quarrelsome than the toddler; they are developing a sense of right and wrong, and they usually try to comply with the rules. Growth is steady but slow at this stage. Height usually increases by two to three inches per year and weight increases about five pounds per year. At three years old, play is very important. They usually play in a group of two or three children and are able to share toys. They play simple games and can follow simple rules. They may create imaginary playmates if there is no one to play with. They may also begin to imitate adults by playing “house” and “dress-up.” Three-year-olds also begin to understand time and begin to speak in the past, present, and future tenses. They become less fearful of strangers and can tolerate separation from their primary caregiver for short periods of time. At age four, children can hop, skip, jump, and catch a ball. They can lace their shoes, draw faces, and try to print letters. Four-year-olds can bathe with supervision and take care of toileting needs with some help. Their vocabulary increases to about 1,500 words. They ask numerous questions and exaggerate when telling stories. They can sing simple songs, count to (at least) three, and name a few colors. At four years, children tend to verbally attack others by teasing or tattling on them. They may also physically attack others. They are proud of their accomplishments but can be very moody. They have a strong preference for the primary caregiver of the opposite sex, and rivalries exist between siblings. At five years, coordination continues to develop. These children can jump rope, skate, dress, and bathe. They can print a few letters, numbers, and their first name. The ability to communicate also increases. Vocabulary consists of about 2,100 words. Sentences now consist of six to eight words, and more meaningful questions are asked. They may request definitions for unfamiliar terms and try to participate in conversations. Five-year-olds can name the days of the week, the months, and four or more colors. They are more responsible, truthful, and quarrel less. They strive to do things the right way and begin to develop manners. These children also enjoy simple games. They enjoy adults during play and have a greater interest in watching television. They also enjoy spending time with their parents as well as activities such as housecleaning, shopping, yard work, and sports. They are more tolerant of younger siblings and are usually protective of them. Although they have fewer fears, they may experience occasional nightmares. Middle Childhood Growth and Development (Six to Eight Years) Physical growth during this stage is rapid. School is the greatest event that takes place during this stage. The child is exposed to a whole new world with new values, ideas, and challenges. Height increases at a rate of one to two inches per year, and weight increases at a rate of three to six pounds per year. Body proportions continue to change and become more adult-like. Body fat decreases and muscle and bone mass increase. Primary teeth are replaced by permanent teeth. At six years, children have a vocabulary of about 2,500 words. They know all the letters of the alphabet and can usually read and spell. They play well with others but prefer playing with children of the same sex. Their play interest includes collections, cards, paints, games, and so forth. At seven years, excellent eye-hand coordination is evident. Children learn to write in cursive rather than print. They enjoy quiet time alone and are more serious and concerned about being liked by other children. They are very sensitive and do not like being teased or criticized; they enjoy school and learning, especially reading; and their play activities include swimming, biking, working puzzles, and playing ball. At eight years, children continue to be physically active. Movements become faster and more graceful. The process of learning continues to develop as they become curious about science, history, geography, and so forth. Social opportunities with peers are enjoyed. This age group has interests in fads, opinions, and activities involving peer groups. Eight-year-olds develop manners, relate well to adults, and participate in adult conversations. They are also friendly and affectionate. Late Childhood Growth and Development (Nine to Twelve Years) Late childhood is also known as preadolescence. During this stage, males grow at a rate of one inch per year and gain about three to four pounds per year. Females grow at a rate of about two inches per year and gain between four to five pounds per year. Body movements are more graceful and coordinated, and there is an increase in physical skill. The developmental tasks are similar to middle childhood; however, the preadolescent is expected to be more mannerly and refined. By age 12, the child uses about 7,000 words and can understand about 50,000 when reading. Interest in science, history, and geography continues and the use of reference books, such as the encyclopedia and dictionary, increases. The preadolescent begins to question the authority of adults and often rebels against authority. The peer group is the center of the preadolescent’s activities. The group influences the attitudes and behaviors of the child. They still prefer companions of the same sex; however, the association between girls is stronger than that of boys. Adolescent Growth and Development (12 to 20 years) Adolescence is the stage of life between school age and adulthood. The adolescent is neither a child nor an adult, yet has characteristics of each. It is a period of growth, change, and emotional crisis. This is usually the period of separation from the parents and the establishment of lifetime goals. Adolescence is the last period of significant physical growth during the lifetime of a person. You grow in height and weight and mature sexually. Usually, females have entered into puberty by age 12, but boys usually enter puberty around age 13. Body changes begin to occur due to the onset of puberty. Girls begin to develop breasts, the pelvis broadens, and fat appears on the hips and chest. Boys show fewer signs of maturing sexually at this time. Some females may experience the onset of puberty as early as 10 years of age; most begin at age 12. This period is marked by menarche, the beginning of menstruation. Secondary sex characteristics appear, including increase in breast size, the appearance of pubic hair, and a slight deepening of the voice. During this stage, girls grow an average total of two to eight inches and gain anywhere from 15–50 pounds. They usually stop growing around age 18, but some will continue to grow until 21 years of age. Puberty in males is signaled by nocturnal emissions, which occurs during sleep when the penis becomes erect and semen is released. Other secondary sex characteristics begin to develop, such as the appearance of facial hair, axillary hair, hair on the arms, chest, legs, and deepening of the voice. During this stage the male will grow an average total of four to twelve inches and gain about 15–60 pounds. The male will usually stop growing around age 21, but some may continue to grow until age 23. The adolescent is often awkward and clumsy. This is due to the uneven growth of muscles and bones. As the muscles and bones develop, so do more graceful and coordinated movements. Emotions vary in the adolescent from high to low. They can be happy one minute and sad the next. Teenagers begin to control their emotions as they progress toward adulthood. Adolescents need to become independent of adults, especially parents. Many work towards adulthood by having a part-time job, baby-sitting, and dating. Adolescents usually begin dating at this time and become more concerned with personal appearance. They spend a lot of time talking to friends on the phone, listening to music, and reading popular magazines. They still need guidance, discipline, and support from parents, although arguments and disagreements are common at this stage of development. Teenagers often would rather be with their peers than with their parents. Adolescents begin to think about careers and college. Their interests and skills influence the choice of further education or seeking employment. Many social factors influence adolescents, such as parents, friends, television, culture, and school. Normally, at the end of this stage, adolescents have developed into young, self-sufficient adults. They usually are totally emancipated from parents and have established goals and individual lifestyles. Young Adult Growth and Development (20-40 Years) During this stage, the young adult continues to mature physically and emotionally. One of the main goals in young adulthood is choosing a career or occupation. Many career choices involve extensive education. The young adult may still be in school when he or she reaches this stage. Education enhances employment opportunities and helps to ensure economic stability. Entering a career usually means starting at the bottom and working upward. The young adult is faced with proving his or her abilities to older adults. Another goal for the young adult is choosing a partner. Most young adults need to feel a sense of love and belonging that comes from having a long-term relationship. Many factors influence the selection of a partner, such as age, interest, religion, and love. During young adulthood many changes occur, both mentally and physically. After age 30, some physical deterioration will start, but it is usually gradual and not very noticeable. At the end of this period, young adults are close to accomplishing the goals of youth. They have made their place in society and are ready to move toward the next stage of life. Middle Adult Growth and Development (40-60 Years) Middle adulthood is usually a time when people look back at the goals that have been accomplished so far. The adult is now mature mentally and physically. He or she has usually met most of his or her goals and now must guide others in doing the same. During this time, many physical changes begin to occur. The hair begins to turn gray. Metabolism slows, resulting in a potential weight problem. Women experience menopause, which is the cessation of menstruation. Calcium loss is common among women in this age group. Men experience a decrease in hormones, which can lead to a decrease in sex drive as well as thinning of the hair. Adults have more time for themselves during this stage. Their children are growing up or have already grown up. Another factor middle adults may have to contend with is caring for elderly parents. This may result in the parents either moving in with them or possibly being relocated to a nursing care center. Late Adult Growth and Development (65+ Years) An increase in life expectancy has led to the creation of gerontology, which is the scientific study of the problems of aging. This science includes biological, psychological, and sociological aspects. A change in the appearance and the texture of the skin is a normal process of growth. The skin of the elderly person is usually thin and delicate and extremely sensitive to trauma. Proper skin care for the elderly is very important. As the aging process occurs, there is a normal loss of subcutaneous (SC) fat near the skin surface. The loss of fat and the hardening of small arterioles cause the skin to become wrinkled. Decreases in blood supply and a gradual atrophy of the sweat glands and excretory functions result in the skin becoming dry and more susceptible to infection. Another physical change is the decline in stamina. With age, all body cells change and undergo progressive deterioration. Body tissues gradually become less active. Unused muscles begin to atrophy and contribute to the decline of physical stamina. There are also changes in the blood vessels. A loss of elasticity and/or the buildup of fatty deposits will limit the amount of oxygen that can get to the cells. The veins lose their strength, and valves weaken and often become distended. The loss of muscle tone and reduced physical activity will also affect the efficiency of the vessels. It is unknown if the changes that occur are due to simple aging or some other pathological cause. Some contributing factors may include trauma, obesity, malnutrition, and stress. Psychologically, the aging adult needs respect, security, and self-esteem. The elderly need to feel appreciated and valued by others. There may be many emotional adjustments that the elderly have to deal with, such as the death of a spouse, children, or friends. Socioeconomic losses and the loss of health are also major psychological adjustments the elderly have to make. Multiple Choice At what age is play very important? 4-6 months 3 years 7 years All of the above SUBMIT True or False: One of the main goals in young adulthood is choosing a career or occupation. True False SUBMIT Multiple Choice At what age does the normal loss of subcutaneous (SC) fat near the skin's surface occur? 50 55 60 65+ SUBMIT E ND O F L E S S O N