EMS Chapter 8

decrease

Because of dilation the vascular system in neurogenic shock you would expect the blood pressure to:

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

Carbon dioxide is transported in the blood in three ways:

stroke volume and heart rate

Cardiac output is composed of

Blood loss

A 48-year-old man cut his leg with a chainsaw. You observe a significant amount of blood loss. He is breathing deep at a rate of 22. Which one of the following would MoST likely cause hypoxia?

excessive sugar in the cell.

A disturbance in the normal cell/capillary gas exchange process could result in each of the following EXCEPT

Sodium / potassium pump

A lack of energy at the cellular level will cause the failure of what process within the cellular wall that results in the cell swelling and bursting sting?

To help decrease the development of a positive pressure between the pleural linings

A patient has a hole in the chest wall why does the treatment include sealing the hole with an occlusive dressing?

The blood pressure will decrease

A patient has fallen and suffered an injury that caused a drop in the body's systemic vascular resistance. What will this do to the patients blood pressure?

The patient is having wasted alveolar perfusion.

According to the V/Q ratio, why might a patient with an inhalation injury from a burn have poor cellular oxygenation?

minute volume.

An EMT student who is completing his ride-along time is at the station working on his class workbook He has a definition of a term, but he cannot remember the name of the term, so he asks you what is defined as the amount of air that moves into and out of the airways in a minute. You respond:

500

An average-sized adult has a tidal volume of approximately how many mL?

pneumothorax.

An example of a patient having respiratory compromise due to disruption of pleural linings would include

by hemoglobin.

Approximately 23 percent of carbon dioxide is transported

Collapse of the lung with a change in alveolar ventilation

If a bleb on a lung tissue ruptures and air accumulates in the pleural space, what is the MOST likely result of this?

It will increase airway resistance.

If a patient has an asthma attack with severe bronchoconstriction, what effect can it have on his ablity to ventilate the alveoli?

Because of sympathetic nervous system stimulation

If a patient is in shock, why does his pulse increase?

21 %

If a patient was breathing ambient aic, how would you document the amount of oxygen present for alveolar ventilation in percentage form?

The systolic pressure would increase and the pulse pressure would narrow

If the body releases hormones to constrict the blood vessels, this would have what change to the patient's blood pressure?

It will decrease

If the heat rate slows, how will this affect the cardiac output?

Peripheral perfusion will likely drop

If the patient has a drop in the preload to the heart, what will be the effecti the patient's peripheral perfusion status?

expand.

If too much sodium accumulates inside the cell, the cell begins to

Hypoxia

If you are ventilating a patient with a puncture hole to the lung following a stabbing, what negative outcome may you actually produce or contribute to?

wasted ventilation.

In the apexes, the amount of available ventilation in the alveoli exceeds the amount of perfusion through the pulmonary capillaries. This situation is best described as:

larger tidal volume

Inadequate ventilation and cellular hypoxia can occur from each of the following, EXCEPT

lung collapse

Increased negative pressure in the pleural space will lead to:

oxyhemoglobin

Oxygen that is bound to hemoglobin is called

left ventricle with each contraction .

Stroke volume is traditionally defined as the amount of blood ejected from the

required for normal cell metabolism.

The EMT should know that the role of oxygen in the body

Hypoxia can occur at the cellular level.

The EMT should recall that if the patient has a mismatch between the ventilation and perfusion of the lungs, what negative outcome could happen?

red blood cells .

The MOST abundant formed element of blood is:

Boyle's law

The ability of the body to ventilate is an example of what law of physics?

alveolar ventilation

The amount of air moved in and out of the alveoli in one minute is called the:

cardiac output

The amount of blood that is ejected by the left ventricle in one minute is called

Six

The average-sized adult has a minute ventilation of how many liters per minute?

glucose.

The basic primary fuel for the cellis:

plasma.

The component of whole blood that is primarily composed of water is the:

local tissue needs.

The distribution of blood flow through the microcirculation is primarily responsive to:

shift to anaerobic metabolism

The lack of oxygen at the cellular level causes the cells to:

By the bloodstream as a bicarbonate ion

The majority of carbon dioxide is transported in the body by which mechanism?

compliance.

The measure of the ability of the chest wall and lungs to stretch, distend, and expand is referred to as:

Local influences

The moment-to-moment control of microcirculation is provided by what mechanism?

alveolar / capillary exchange .

The passage of oxygen and carbon dioxide gases between the alveoli and the capillaries of the lungs is referred to as:

Dead space

The tidal volume is comprised of alveolar ventilation and what other volume of air?

stroke volume.

To calculate the cardiac output the EMT knows to multiply the heart rate by

depth of ventilations

To ensure adequate breathing in a patient, the patient must have both an adequate rate of ventilations and an adequate

Medulla, to stimulate the sympathetic nervous system

the baroreceptors in the aortic root sense a drop in aortic root systolic pressure, they will send an impulse to what region of the brain, and for what purpose?

4.2L

the tidal volume is 500 mL and the dead space is 150 mL, then how much alveolar ventilation is there in a minute, assuming the patient is breathing about 12 times per minute and the patient weighs 80kilograms

The cell will swell

Failure of the sodium-potassium pump may lead to what detrimental cellular change?

oncotic pressure must equal hydrostatic pressure

For the body to remain within normal limits of fluid balance between capillary and interstitial compartments:

Inability to oxygenate the blood and remove carbon dioxide

From what negative affect regarding gas diffusion in the alveoli would a patient with pulmonary edema suffer?

350 ml

How much of the normal tidal volume does the alveolar ventilation account for?

The patient may not be able to constrict the blood vessels

How would a damaged sympathetic nervous system contribute to the development of poor microcirculation of peripheral tissues?

Decreased oxygen transport

How would bronchiole constriction lead to a ventilation/perfusion mismatch

02-

Peripheral chemoreceptors are MOST sensitive to changes in

98 percent

The percentage of oxygen that is carried in the body attached to hemoglobin is approximately

perfusion

The process whereby blood travels to the cells of the body to deliver oxygen and nutrients is referred to as:

energy

Ultimately, the sodium-potassium pump in the cell will fail because of lack of

Minute ventilation

Wat is the name of the ventilatory volume that is calculated by multiplying the tidal volume by the frequency of ventilation?

Heart rate x the stroke volume

What are the determining factors for the cardiac output?

Stroke volume and heart rate

What are the factors that determine cardiac output?

Water and proteins

What are the main constitutes of plasma?

Oxygen and carbon dioxide

What are the two primary gases that are exchanged during the process of cellular respiration?

Effect of the large proteins in the bloodstream

What causes the pressure change known as plasma oncotic pressure?

will decrease lung compliance

What effect on lung compliance will occur if a patient has a traumatic lung injury that is causing the pleural cavity to fill with blood?

The B / Pincreases

What effect would systemic vasoconstriction have on the blood pressure (B/P)?

21 percent

What is the approximate percentage of oxygen in the inspired air?

It is a force that pushes fluid out of the vessel or capillary bed

What is the basic function of hydrostatic pressure?

The sodium/potassium pump fails and causes cellular death

What is the effect of poor perfusion at the cellular level?

Tidal volume

What is the name of the amount of air breathed in and out with each individual breath?

An end product of normal cell metabolism

What is the process that produces carbon dioxide in the body?

Oxyhemoglobin

What is the term used to describe what a hemoglobin molecule is when it binds with an oxygen molecule?

They can stimulate the sympathetic nervous system if carbon dioxide levels rise.

What role do chemoreceptors in the body play in the regulation of blood pressure?

Baroreceptors

What sensory structures are the FIRST to detect arterial blood pressure changes?

Both should increase.

What should happen to cardiac output and systolic blood pressure if there is an increase in heart rate from 86 per minute to 94 per minute?

Aerobic

What type of metabolic activity occurs during the production of energy when there is a sufficient amount of oxygen present?

758 mmHg

What value does the intrathoracic pressure drop to during inhalation?

The heart rate and stroke volume will attempt to increase.

What would be the expected result of the body when a patient has massive vasodilation secondary to a severe blood infection?

the very limited amount of time for the ventricles to fill.

When a patient has a heart irregularity that causes a very fast pulse, this can lead to shock due to:

bronchoconstriction.

When a patient has a lower airway obstruction, the MOST likely problem is

rapid , shallow ventilation

When activated, J-receptors stimulate:

contracts more forcefully.

When an increase of blood in the left ventricle causes stretching of the ventricle, the heart:

inhales

When the diaphragm contracts, the patient

minute volume.

When the tidal volume is multiplied by the ventilation rate, this gives you the

Cells become hypoxic and rely on anaerobic metabolism, which is harmful to the cells.

When there is inadequate blood flow to the tissues of the body, shock develops. If left untreated, why can shock lead to death?

Nitrogen

Which gas is most abundant in ambient air?

Sodium

Which ion will start to accumulate within the cell should the sodium-potassium pump fail following a period of hypoxia?

Glucose level

Which of the folloving does not have a direct influence on normal perfusion?

White blood cells

Which of the following formed elements in the bloodstream would likely be elevated in a patient with a severe infection to his leg?

As the volume of a closed container decreases, the pressure inside increases.

Which of the following is a good description of what Boyle's law is?

Ventral respiratory group

Which of the following is solely responsible for sending the nerve impulses to the spinal cord to be transmitted to the diaphragm and external intercostal muscles,causing them to contract?

Hypoxia

Which of the following may be caused by a disturbance in the cell/capillary gas exchange process of peripheral tissue during an episode of hypotension?

The alveoli located in the apexes are larger

Which of the following statements is accurate with regard to the ventilation/perfusion ratio?

Increased rate and increased depth of respiration

Which of the following will occur if central chemoreceptors detect an increase in CO?

The potential space between the pleura maintains a negative pressure.

Which one of the following is correct in regard to the pleural space?

The drug in a bronchodilator will make it easier to breathe by reducing airway resistance.

Why is it advisable to assist a patient with using his bronchodilator when he has obvious signs and symptoms of lower airway obstruction due to asthma?

To minimize the cell hypoxia

Why is it important administer oxygen to the patient with respiratory compromise?

lungs will collapse if air gets between the two pleural membranes.

Why is it so important for the EMT to seal any open penetrations into the chest as quickly as possible?

Gravity pulls blood downward.

Why is less pressure required to perfuse the lower lobes compared to the upper lobes of the lungs?

More oxygen in the inspired air will increase the amount absorbed by the blood

Why should EMS providers administer oxygen to a patient suspected of hypoxia?

The patient may be hypoxic at the cellular level.

Why should the patient who is in shock be administered oxygen?

The thorax will increase in size with each inhalation.

You are treating a patient with a gunshot wound on his right chest. What will occur if this injury causes a break in the continuity of the parietal pleura?

Decrease

You are treating a patient with a lung injury that results in a drop in his tidal volume.What will be the clinical effect on the amount of air that is available for gas exchange in the alveoli?

Increased heart rate

in an attempt to raise blood pressure, chemoreceptors may initiate which of the following?