Chapter 8 EMT Pathophysiology

Hypercarbia

- a buildup of carbon dioxide in the blood.

Oxyhemoglobin

- a hemoglobin molecule with oxygen

Patent airway

- is one that is open and not obstructed by the blood, secretions, vomitus, tissue, bone, teeth, or any other substance. Typically first step in Emergency Care is to Establish an open airway

Accessory Muscles of Exhalation

Abdominal muscles, Internal Intercostal muscles

Autonomic nervous system controls

Breathing which is mostly an involuntary process. Primarily involuntary control is through the repiratory center located in the brainstem.

Carbon Monoxide affects on blood

Disrupts the ability of the blood to carry adequate amounts of oxygen to the cells.

3 respiratory control centers

Dorsal respiratory, Ventral respiratory group, and the pontine respiratory group.

Difference between FiO2 & FD02

FIO2 is administered to a patient who is breathing spontaneously and inhaling the air on his own effort. FDO2 is delivered by a ventilation device to a patient who is not able to breathe adequately on his own

2 conditions require accessory muscles

Higher airway resistance and poor compliance.

3 receptors in lungs

Irritant receptors, stretch receptors, J-receptors.

Potassium

K+ is also positively charged and is considered the primary intracellular ion. That is, it is FOUND PRIMARILY in the fluid on the INSIDE OF THE CELL.

Sodium

Na+ is a positively charged ion that is FOUND PRIMARILY in the fluid OUTSIDE THE CELL, although some sodium is also found inside the cell. It is considered the primary extracellular ion.

Accessory muscles of inhalation

Sternocleidomastoid muscles, Scalene muscles, Pectoralis minor muscles

Iron sites

a hemoglobin molecule has four of these which allow it to carry up to 4 molecules of oxygen. When it carries 4 molecules of oxygen it is considered to have 100 percent saturation.

Deoxyhemoglobin

a hemoglobin molecule without oxygen

Cellular metabolism

also known as cellular respiration, is the process in which, normally, the body cells break down molecules of glucose to produce energy for the body. There are TWO types of cellular metabolism, AEROBIC and ANAEROBIC

Plasma oncostic pressure

also known as colloid oncotic pressure or oncotic pressure, is responsible for keeping fluid inside the vessels.

Minute ventilation

also known as minute volume is the amount of air moved in and out of the lugns in one minute. It = tidal volume (Vt) x frequency of ventilation (f/minute). An average sized adult has a tidal volume of 500mL and a resting respiratory rate of 12.

Pontine respiratory center

also known as the pneumotaxic center, sends inhibitory impulses to the VRF, to turn off the inhalation

Blood volume

an adult has approximately 70 mL of blood for every kilogram (2.2lb) of body weight.

Irritant receptors

are found in airways and are sensitive to irritating gases, aerosols and particles. Irritant receptors will stimulate a cough, bronchoconstriction, and increased ventilatory rate

J-Receptors

are found in the capillaries surrounding the alveoli and are sensitive to the increases in pressure in the capillary. They stimulate rapid, shallow ventilation.

Stretch receptors

are found in the smooth muscle of the ariways and measure the size and volume of the lungs. These receptors stimulate a decrease in the rate and volume of ventilation when stretched by a high tidal volumes

Peripheral Chemorecptors

are located in the aortic arch and the carotid bodies in the neck. These receptors are most sensitive to the level of oxygen in the arterial blood.

Central Chemoreceptors

are located near the respiratory center in the medulla. These receptors ar most sensitive to carbon dioxide.

Chemoreceptors

are specialized receptors that monitor the pH, carbon dioxide, and oxygen levels in the arterial blood. There are TWO GROUPS of chemoreceptors: CENTRAL and PERIPHERAL.

Frank-Starling law of the heart

as blood fills the left ventricle, the muscle fibers stretch to house the blood. the stretch of the muscle fiber at the end of diastole determines the force available to eject the blood from the ventricle.

Ambient Air

at sea level contains approximately 79% nitrogen, 21%OXYGEN, .9% aragon, and .03 percent carbon dioxide.

Dead air space (Vd)

consists of anatomical areas in the respiratory tract where air collects during inhalation - areas where, however, no gas exchange occurs. In the average sized adult, approximately 150mL is wasted of air.

Cyanide affects on blood

cyanide prevents the oxygen from being used effectively by the cells.

increase in parasympathetic stimulation

decreases the heart rate, and a decrease increases the heart rate.

Ventilation/Perfusion (V/Q) ratio

describles the dynamic relationship between the amount of ventilation the alveoli receive and the amount of perfusion through the capillaries surrounding the alveoli.

Inadequate perfusion can shift cells

from aerobic to anaerobic metabolism

increase in sympathetic stimulation

increases the heart rate. a decrease, decreases the heart rate

Ventral respiratory group

is a column of nerons located in the anterior portion of the medulla

Compliance

is a measure of the ability of the chest wall and lungs to strecht, distend, and expand.

ATP

is an energy source that is required by the cell to release more energy and necessity for cells to carry out certain functions, such as contraction of muscles.

Chin-lift

is designed to lift the epiglottis clear of the glottic opening

Airway resistance

is related to the ease of airflow down the conduit of airway structures leading to the alveoli.

Dorsal Respiratory group

is responsible for initiating the basic rhythm of respiration.

Alveolar ventilation

is the amount of air moved in and out of the alveoli in one minute.

Anaerobic metabolism

is the breakdown of molecules in the cells without the presence of oxygen.

Aerobic metabolism

is the breakdown of molecules such as glucose through a series of reactions that produce energy within the cells in the presence of oxygen.

Hydrostatic pressure

is the force inside the vessel or capillary bed geared by the contraction of the heart and the blood pressure. Hydrostatic pressure exerts a "push" inside the vessel or capillary

Visceral Pleura

is the innermost lining covering the lung tissue.

Edema

is the most common cause of increased airway resistance within the airway structure.

Parietal pleura

is the outermost lining that adheres to the thoracic wall

Preload

is the pressure generated in the left ventricle at the end of diastole

Oxygen delivery

is transported by the blood in two ways: dissolved in plasma and attached to the hemoglobin. 1.5 to 3 percent in plasma and 97-98.5 percent in hemoglobin.

Carbon dioxide transport

is transported in 3 different way. Approximately 7 percent is dissolved in plasma, 23 percent is attached to hemoglobin, and 70 percent is in the form of bicarbonate.

Blood composition

it is composed of FORMED ELEMENTS and PLASMA. The formed elements make up 45 percent. The plasma makes up 55 percent.

Red blood cell volume

make up approximately 48 percent of the blood cell volume in men and 42 percent in women.

Patient concentration of Oxygen

should be at least 21%

Cardiac Output

the amount of blood ejected by the left ventricle in 1 minute. a normal cardiac output for an adult at rest is 5 liters/ minute. it = heart rate x stroke volume

Afterload

the resistance in the aorta that must be overcome by contraction of the left ventricle to eject the blood

Pleural space

the space between the pleura

Boyle's Law

the volume of gas is inversely proportionate to the pressure. An increase in pressure (positive ) will decrease the volume of gas. A decrease in pressure (negative) will increase the volume of gas.

Stroke volume

volume of blood ejected by the left ventricle. Stroke volume is determined by preload, myocardial contractility, and after load.

Glycolysis

when glucose crosses the cell membrane, it is broken down into pyruvic acid molecules. It occurs in the fluid portion of the cell and does not require oxygen.

Hypoxic drive*

when the chemoreceptors rely on a decrease in the oxygen level to stimulate ventilation.

Laryngeal spasm

where the vocal cords spasm and close together, which prevents any air from passing through in the trachea