Paramedic Exam Ch.

7, 8, 9
Directional Terms
Posterior or dorsal: Back
Anterior or ventral: Front
Inferior: Low
Superior: Above
Deep: Below skin
Superficial: At the skin level
Hierarchy of tissue: cell tissues organs organ systems organism
Positioning of patients: (Pg 188)
Prone lying face down
Supine lying face up
Trendelenburg supine position on an incline with feet higher than head
Shock position modified Trendelenburg, head and torso are supine, lower extremity is elevated
6-12 inches
Fowler position semi reclining position with the head elevated, knees bent or straight
Recovery maintains airway, left lateral recumbent position, top knee is bent and head on arm
Types of Metabolism :
Process that uses oxygen is called aerobic metabolism, waste products are carbon dioxide and
water
Cells in our brain will die within 4-6 mins w/o oxygen
ATP is involved in energy metabolism
Cells prefer to operate using oxygen b/c it provides 15 times as much as ATP than w/o
oxygen
Process that kicks in when oxygen is not available is anaerobic metabolism
By product is lactic acid which causes muscle burning
Can be supported for only 1-3 minutes
Structure of Neurons
Dendrites receive the impulse in send it into the cell body
Axons push it out, axon is covered in myelin sheath
Organ quadrants

Mnemonic for retropertineal organs
S - Suprarenal (adrenal) gland
A - aorta/IVC
D - duodenum (second and third part)
P - pancreas (except tail)
U - ureters
C - colon (ascending and descending)
K - kidneys
E - (o)esophagus
R - rectum

Parts of brain
1. The cerebrum fills up most of your skull. It is involved in remembering, problem
solving, thinking, and feeling. It also controls movement.
2. The cerebellum sits at the back of your head, under the cerebrum. It controls
coordination and balance fine body movements
3. The brain stem sits beneath your cerebrum in front of your cerebellum. It connects the
brain to the spinal cord and controls automatic functions such as breathing, digestion,
heart rate and blood pressure.
Phrenic nerve C3, C4, C5 keep the diaphragm alive
Vagus nerve cranial nerve 10 provides motor function to soft palate, pharynx, and larynx,
also important in taste fibers

CNS and PNS

Ligands
Molecules that bind to receptors in the body to form more complex structures, the examples of
this are hormones, neurotransmitters, and electrolytes
Osmosis
Movement of a solvent (water) from an area of low solute concentration (Ex. Salt) to an area of
high concentration through a selectively permeable membrane


Reasons for fever: Inhibits bacterial and fungal reproduction and causes increased phagocytosis
(macrophages) examples could be a virus or teething. Anything that the body needs to fight a
bacteria by raising the internal temp by as little as 1 degree Celsius
Aging on organ systems after 24 organs decrease in effectiveness 1% every year this is the
reason people get cancer and are more susceptible to not only injury but infection
Primary method for communicating in infants Screaming : When caring for an infant we have
to alter our care such as getting eye level with them, talking in a reassuring voice, telling them
when things will hurt, giving them options such as which arm to put the blood pressure cuff,
allowing them to think they are in control of the situation.
Age vials -


Differences between parasympathetic and sympathetic responses

Shock Hypoperfusion, blood and nutrients such as O2 is not getting to vital organs
Different types of shock
Central shock consists of Cardiogenic (ex AMI, or dysrthmias) and Obstructive (ex. Cardiac
tamponade and tension pneumothorax)
Peripheral shock consists of Hypovolemic (ex. Hemorrhagic and non-hemorrhagic) and
distributive (anaphylaxis, septic, neurogenic)
pH scale


Receptors
Layers of heart deep to superficial endocardium, myocardium, epicardium
Regulation of heart function
Chronotropic effect is the effect of the rate of contraction
Dromotropic is the effect of the rate of electrical conduction
Inotropic effect is the effect of the strength of contraction
Cardiac muscle is unique because it can conduct its own impulse through the SA node or the
natural pacemaker of the body also through Starlings Law we know that the heart can be
stretched and when it is stretched it contracts with greater force thus increasing the cardiac
output
Apex Tip of a structure for example the apex of the heart is at the bottom of the ventricles in
the left side of the chest, difference in the lungs the apex is at the top
Base bottom of heart and also in the lungs
Homeostasis is always trying to be maintained by increasing or decreasing hormones,
contractions, dilation . And many more things
Hypokalemia is defined as the decrease in serum potassium level show signs of muscle
weakness, fatigue, muscle cramps they need to be given potassium via IV therapy here
potassium is not enough such as with diuretic use, K shifts into the cells, and/or renal potassium
losses
Hyperkalemia is an elevated serum potassium level shows signs of muscle weakness and laccid
paralysis also ventricular tachycardia need therapy too here the body is keeping too much
such as not excreted through renal system or potassium shifts from within the cell
Some important electrolytes
Sodium is the most common cation (Na+)
Potassium is a major intracellular cation (K+)
Magnesium is second most abundant intracellular cation (Mg++)
Calcium is abundant in teeth and bones (Ca++)
Phosphate is a primarily an intracellular anion
Cl- chloride is an important anion
Alpha receptors induces smooth muscle contraction in blood vessels and bronchioles
Beta receptors respond with relaxation of smooth muscles in blood vessels and bronchioles and
have chronotropic and inotropic effects on myocardial cells
Cells made easy

ADH When blood osmolarity increases the pituitary or master gland releases ADH thus
stimulating the kidneys to resorb water decreasing the osmolarity of the blood, same with if the
body has too much fluid ADH will not be released and you will urinate more
Coronary arteries supply blood to the heart they originate from the aorta after it leaves the left
ventricle, they receive blood during diastolic phase.