EMT Chapter 8
If a patient is in shock, why does his pulse increase?
Because of sympathetic nervous system stimulation
The ability of the body to ventilate is an example of what law of physics?
Boyles law
The majority of carbon dioxide is transported in the body by which mechanism?
By the bloodstream as a bicarbonate ion
What is the approximate percentage of oxygen in the inspired air?
21 percent
Red blood cells comprise about what percentage of blood volume in men?
48 percent
An average-sized adult has a tidal volume of approximately how many mL?
500
The normal minute volume is about:
6000 mL
During exhalation, what is the approximate pressure in the thorax?
761 mmHg
If there is an increased stretch to the baroreceptors above normal, what will be the response?
A message will be sent to the brainstem to increase parasympathetic tone.
From what negative affect regarding gas diffusion in the alveoli would a patient with pulmonary edema suffer?
Inability to oxygenate the blood and remove carbon dioxide
Which of the following will occur if central chemoreceptors detect an increase in CO2?
Increased rate and increased depth of respiration
What is the basic function of hydrostatic pressure?
It is a force that pushes fluid out of the vessel or capillary bed.
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?
It will decrease lung compliance.
If the heart rate increases slightly, how will this affect the cardiac output?
It will enhance cardiac output.
Why would understanding how the body responds in a disease state be beneficial to the EMT?
It will help the EMT to better recognize and understand presenting signs and symptoms.
A patient has sustained significant blood loss due to an injury. Why does this lead to shock?
Loss of blood causes diminished cellular perfusion
Why should EMS providers administer oxygen to a patient suspected of hypoxia?
More oxygen in the inspired air will increase the amount absorbed by the blood.
Peripheral chemoreceptors are MOST sensitive to changes in
O2
Which of the following cellular effects will NOT likely happen to a patient who is breathing in toxic gases?
Oxygen will take on a toxic effect in the body and cause cellular death.
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?
The drug in a bronchodilator will make it easier to breathe by reducing airway resistance.
What would be the expected result of the body when a patient has massive vasodilation secondary to a severe blood infection?
The heart rate and stroke volume will attempt to increase.
What are the main constitutes of plasma?
water and proteins
If 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?
Medulla; to stimulate the sympathetic nervous system
You are caring for a patient who was involved in a farming accident where he was exposed to insecticides used on vegetation. You contact the Poison Control Center, which advises you that the chemical will have significant parasympathetic effects on the body. What would you expect this to mean to the patient's body?
The patent may experience significant hypotension.
What is the effect of poor perfusion at the cellular level?
The sodium/potassium pump fails and causes cellular death
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?
The thorax will increase in size with each inhalation.
According to the V/Q ratio, why might a patient with a partial airway occlusion from a severe allergic reaction suffer from hypoxia?
They are having wasted alveolar perfusion.
What type of metabolism is responsible for the largest creation of ATP?
aerobic
A 25-year-old male has a stab wound on his left upper chest. What will occur if this wound breaks the continuity of the parietal pleura?
air will draw into the pleural space
The restriction of airflow that is related to the diameter of the airways is called the:
airway resistance
You are treating a patient with respiratory distress secondary to COPD. The patient has a low pulse ox and presents as hypoxic. What type of cellular metabolism will occur if you cannot correct the patient's hypoxia?
anaerobic
What sensory structures are the FIRST to detect arterial blood pressure changes?
baroreceptors
In a healthy adult, the respiratory rate and depth is regulated primarily by detecting the level of what in the blood stream?
carbon dioxide levels
The inability to maintain a patient's airway or ventilatory status can lead to what detrimental cellular event?
cellular death
If a patient has multiple ribs fractured that alter his ability to increase his intrathoracic volume, what kind of ventilatory disturbance would this be?
change in compliance
What generates the force that results in hydrostatic pressure?
contraction of the left ventricle
The area in the respiratory passages that CANNOT participate in gas exchange is called:
dead space
For the appropriate V/Q ratio, the patient will need to have each of the following, EXCEPT:
decreased fluid volume traveling to the bottom lung fields
Which of the following situations could cause poor tissue oxygenation of the extremities despite the arterial blood being oxygenated?
dropping systolic blood pressure
The EMT should know that the role of oxygen in the body is:
required for normal cell metabolism
The lack of oxygen at the cellular level causes the cells to:
shift to anaerobic metabolism
Which ion will start to accumulate within the cell should the sodium-potassium pump fail following a period of hypoxia?
sodium
Cardiac output is composed of:
stroke volume and heart rate
What effect would systemic vasoconstriction have on the blood pressure (B/P)?
the BP increases
If the patient experiences a drop in the respiratory rate due to a drug overdose, what will be the effect on the patient's minute ventilation?
the minute volume will decrease
A patient has an initial blood pressure of 120/78, with a heart rate of 86 per minute. Five minutes later his blood pressure is 128/92, with a heart rate of 82 per minute. Which of the following statements about the change in the vitals is MOST correct?
the patient has experiences an increase in his systemic vascular resistance
When a patient has a heart irregularity that causes a very fast pulse, this can lead to shock due to:
the very limited amount of time for the ventricles to fill
What is the name of the amount of air breathed in and out with each individual breath?
tidal volume
What causes the pressure change known as plasma oncotic pressure?
Effect of the large proteins in the bloodstream
Why would a hypoxic patient who has severe bleeding NOT benefit that greatly from the administration of supplemental oxygen?
People who have lost blood have also lost the hemoglobin that carries oxygen.
If the patient has a drop in the preload to the heart, what will be the effect in the patient's peripheral perfusion status?
Peripheral perfusion will likely drop
According to the V/Q ratio, why might a patient with an inhalation injury from a burn have poor cellular oxygenation?
The patient is having wasted alveolar perfusion
Why should the patient who is in shock be administered oxygen?
The patient may be hypoxic at the cellular level.
Which one of the following is correct in regard to the pleural space?
The potential space between the pleura maintains a negative pressure.
During the relaxation of the diaphragm and intercostal muscles, what happens to the intrathoracic size and pressure?
The size decreases and the pressure increases.
The distribution of blood flow through the microcirculation is primarily responsive to:
local tissue needs
When a patient is severely burned over MOST of his body, the cellular and vascular damage created by the burn results in large protein molecules leaving the vascular space. As a result of this, which of the choices will the patient experience?
low oncotic pressure
While working with an ALS partner, you observe her starting an IV on a trauma patient with an arterial bleed. You know that this is beneficial because:
extra fluid will increase the preload to the heart.
One of the fundamental underlying causes of respiratory compromise is:
failure of the alveolar/capillary exchange of gases.
Why is less pressure required to perfuse the lower lobes compared to the upper lobes of the lungs?
gravity pulls blood downward
Which of the following factors is not considered to be a determinant of stroke volume?
heart rate
If a patient develops shock due to a severe traumatic injury and loses a large amount of blood, each of the following may occur EXCEPT the:
heart rate will initially decrease
Oxygen is transported through the blood by binding to:
hemoglobin
Which one of the following is MOST likely to lead to anaerobic metabolism?
hypoventilation
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?
hypoxia
When the diaphragm contracts, the patient:
inhales
During anaerobic metabolism in cells, what is responsible for creating the acidic state of the blood?
lactic acid accumulation
What is the name of the ventilatory volume that is calculated by multiplying the tidal volume by the frequency of ventilation?
minute ventilation
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:
minute volume
Ambient air contains MOSTLY:
nitrogen
What are the two basic molecules that are necessary for normal cell metabolism, energy creation, and function?
oxygen and glucose
The peripheral chemoreceptors are MOST sensitive to:
oxygen concentration???
Oxygen that is bound to hemoglobin is called:
oxyhemoglobin
What two divisions of the nervous system help to control blood flow through the arterioles?
parasympathetic and sympathetic
You are treating a patient who has lost a significant amount of blood volume after a traumatic injury, and his systolic pressure is low. What body function will NOT be part of the compensatory mechanism trying to maintain a normal perfusion pressure?
parasympathetic stimulation
The process whereby blood travels to the cells of the body to deliver oxygen and nutrients is referred to as:
perfusion
The component of whole blood that is primarily composed of water is the:
plasma
Which of the following elements, if diminished or absent in a patient's bloodstream, could cause uncontrolled bleeding?
platelets
An accumulation of air in which space can disrupt the negative pressure normally present and lead to hypoventilation?
pleural space
Pressure and volume of blood in the left ventricle at the end of diastole is called:
preload
