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NREMT (Crash Course NREMT (Crash Course
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frontal (coronal) plane - Correct answer front and back halves sagittal plane - Correct answer left and right halves transverse horizontal plane - Correct answer top and bottom halves anterior (ventral) - Correct answer front of the body posterior (dorsal) - Correct answer back of body superior - Correct answer higher on the body, nearer to the head inferior - Correct answer lower on the body, farther from the head medial - Correct answer toward the midline lateral - Correct answer away from the midline proximal - Correct answer closer to point of attachment distal - Correct answer farther from point of attachment abduction - Correct answer movement away from the midline superficial - Correct answer near the surface extension - Correct answer straightening the joint (increasing the angle) flexion - Correct answer bending the joint (decreasing the angle) adduction - Correct answer movement toward the midline deep - Correct answer away from the surface prone - Correct answer lying face down supine - Correct answer lying face up
fowler's position - Correct answer semi reclining, head elevated (in b/t sitting up and lying down flat), helps patient breathe better and to control the airway trendelenburg position - Correct answer supine w/their feet at an incline shock position - Correct answer modified trendelenburg (feet elevated 12in), keeps blood flow to core/brain organs in right upper quadrant of abdomen - Correct answer liver, gall bladder, portion of the colon, bile duct, pancreas organs in the left upper quadrant of the abdomen - Correct answer stomach, spleen, portion of the colon, pancreas organs in the right lower quadrant of the abdomen - Correct answer two portions of the large intestine - cecum (where small intestine (ileum) opens into) and ascending colon, appendix (attached to lower border of cecum) organs in the lower left quadrant of the abdomen - Correct answer descending portion of large intestine, rectum cervical spine (vertebraes) - Correct answer top 7 vertebrae (C1-C7) thoracic spine (vertebraes) - Correct answer 12 vertebrae below cervical spine (one pair of ribs attached to each) lumbar spine (vertebraes) - Correct answer 5 vertebrae below thoracic spine sacrum (vertebraes) - Correct answer 5 vertebrae (below lumbar spine) fused together, joined to iliac bones of pelvis coccyx (vertebraes) - Correct answer last 4 vertebrae fused together cranium - Correct answer skull, composed on thick bones fused together frontal bone - Correct answer forehead
ball and socket joint - Correct answer joint where the distal end can move freely (ex: shoulder and hip) hinge joint - Correct answer joint where bones can move uniaxially (ex:elbow and knee) smooth muscle - Correct answer involuntary muscle located within the blood vessels and digestive tract (ex: intestines) skeletal - Correct answer voluntary muscle that attaches to the skeleton biceps - Correct answer anterior humerus triceps - Correct answer posterior humerus pectoralis - Correct answer anterior chest latissimus dorsi - Correct answer posterior chest rectus abdominis - Correct answer abdominal muscles quadriceps (4 muscles) - Correct answer anterior femur biceps femoris - Correct answer posterior femur, part of hamstring muscle gluteus (3 muscles) - Correct answer buttocks ligament - Correct answer connects bone to bone tendon - Correct answer connects muscle to bone cartilage - Correct answer connective tissue that allows smooth movement of joints upper airway - Correct answer -nose and mouth -nasopharynx (upper part of throat, behind nose) -oropharynx (area of throat behind mouth) -larynx (voice box)
-epiglottis (valve that protects opening of trachea) lower airway parts - Correct answer -trachea -carina (where trachea branches into left and right mainstem bronchi) -left and right mainstem bronchi (primary branches of trachea leading to left and right lungs) -bronchioles (smaller branches of bronchi) -alevoli alevoli - Correct answer tiny sacs in lungs which gas exchange occurs pleura - Correct answer double-layered membrane surrounding each lung (visceral pleura lines outer surface of lungs, parietal pleura lines inside surface of chest cavity) inhalation - Correct answer active, diaphragm contracts exhalation - Correct answer passive, diaphragm relaxes cellular respiration - Correct answer uses oxygen to break down glucose to create energy carbon dioxide drive - Correct answer primary mechanism of breathing for most, brainstem monitors CO2 levels in blood and CSF, too much CO2 - stimulate increase in respiratory rate and tidal volume hypoxic drive - Correct answer backup to CO2 drive (bc less effective); sensors in brain, aorta, cartodi arteries monitor oxygen levels; low oxygen - stimulate breathing parts of the nervous system control of breathing - Correct answer dorsal respiratory group, ventral respiratory group, pneumotaxic (pontine) center, apneustic center, hering-breuer inflation reflex, hering-breuer deflation reflex residual volume - Correct answer amount of air in lungs after completely exhaling (keeps lungs open)
atrioventricular (AV) node - Correct answer backup pacemaker, generates electrical impulses 40-60 per minute bundle of His - Correct answer final pacemaker for heart, generates impulses 20-40 per minute cardiac output (circulation) - Correct answer circulation will stop if the heart can't generate electrical impulses or if the heart muscle is too damaged to respond to the impulses myocardial contractility - Correct answer the heart's ability to contract systolic blood pressure - Correct answer pressure created in the arteries when the left ventricle contracts and forces blood out into circulation; indicates heart pumping effectiveness and blood available to the heart (higher number) diastolic blood pressure - Correct answer the pressure in the arteries when the left ventricle is refilling/relaxing, indicates adequacy of blood vessel contraction and amount of blood within blood vessels (lower number) electrical conduction system in the body - Correct answer electrical impulse begins high in atria at sinoatrial node→travels to atrioventricular node and bundle of His→moves through purkinje fibers→to ventricles (movements produces flow of electricity) major pulse points - Correct answer -carotid: neck -femoral: groin area -radial: wrist -brachial: elbow area/medial portion of upper arm -dorsalis pedis: top of foot components of blood - Correct answer -plasma: liquid part, mostly made of water -red blood cells (enthrocytes): carry oxygen -white blood cells (leukocytes): fight infection by defending against invading organisms -platelets: form clots to stop bleeding
pulse pressure - Correct answer difference b/t systolic and diastolic BP, shows how body responds to stress preload - Correct answer the precontraction pressure in the heart based on the amount of blood coming back to the heart, increased preload - increased stretching of ventricles and myocardial contractility afterload - Correct answer resistance the heart must overcome during ventricular contraction, increased afterload - decreased cardiac output systemic vascular resistance (SVR) - Correct answer resistance to blood flow within all of the blood vessels, constriction (increases SVR and blood pressure), dilation (decreases SVR and blood pressure) parts of the central nervous system - Correct answer brain, brain stem, spinal cord parts of the somatic/peripheral nervous system - Correct answer nerves that connect all parts of the body to the brain (sensory, motor, somatic, autonomic) sensory nervous system - Correct answer conducts sensory info from sense organs and other internal organs to the CNS motor nervous system - Correct answer made up of motor fibers that conduct nerve impulses from CNS to muscles and glands somatic nervous system - Correct answer conducts nerve impulses from CNS to muscles (voluntary) autonomic nervous system - Correct answer conducts nerve impulses from CNS to organs and glands (involuntary) sympathetic nervous system - Correct answer activates body during emergency situations parasympathetic nervous system - Correct answer controls nonemergency functions
endocrine system - Correct answer glands that secrete hormones into the blood to help regulate body functions (produces insulin and regulates blood glucose) male reproductive system - Correct answer testicles, penis, sperm, prostate gland female reproductive system - Correct answer ovaries, fallopian tubes, vagina physiology of inhalation - Correct answer diaphragm and intercostal muscles contract, intrathoracic pressure decreases, vacuum created - thorax enlarges, air goes from upper airway to lower airway into alveoli physiology of exahalation - Correct answer diaphragm and intercostal muscles relax, thorax gets smaller, air compressed out of lungs hypoxia - Correct answer not enough oxygen delivered to cells early signs: restlessness, anxiety, irritability, dyspnea (difficulty breathing), tachycardia late signs: altered/decreased LOC, severe dyspnea, cyanosis, bradycardia wheezing - Correct answer high pitched sound heard on exhalation rales - Correct answer "wet" or "crackling" sounds stridor - Correct answer high pitched sound from partial upper airway obstruction apnea - Correct answer no breathing at the moment hypoventilation - Correct answer breathing too slow or too shallow compression rates for CPR (adult, children/infants, newborns) - Correct answer adults: 30 compression and 2 breaths children/infants: 15 compressions and 2 breaths newborns: 3 compressions and 1 breath
special considerations for children supine - Correct answer should provide padding behind the shoulder when supine bc child heads are much larger in proportion to the body ventilating patients w/stoma or tracheostomy tube - Correct answer use pediatric mask, seal mouth and nose during ventilation to prevent air escape, release during exhalation chief complaint - Correct answer patient's main reason for calling EMS history of present illness (HPI) - Correct answer -basic info: age, sex, weight -more info about chief complaint -associated signs/symptoms -general healths tatus -past medical history (meds, allergies) SAMPLE - Correct answer -signs (what you see/feel/hear) and symptoms (patient tells you) -allergies -medications -past pertinent history -last oral intake -events leading to incident OPQRST - Correct answer -onset: what were you doing when the symptoms started? -provocation: does anything make your symptoms better or worse? -quality: how would you describe the pain? -radiation: does the pain go anywhere? -severity: how would you rate the pain on a scale of 1-10? -time: when did the symptoms start? pulse pressure - Correct answer difference b/t systolic and diastolic pressures normal pulse pressure - Correct answer greater than 25% but less than 50% of systolic pressure
-route -time -medication -documentation activated charcoal - Correct answer -if ingested poisons/toxins -binds to drugs/chemicals to prevent them from being absorbed in the gastrointestinal tract -contras: decreased LOC, can't swallow, ingested acids, alkalis, or hydrocarbons -dose: 1 g per kg of body weight, pediatric=25-50g -route: PO aspirin - Correct answer -chest pain -blood thinner and anti-inflammatory -contras: recent bleeding, allergic -dose: 4 baby aspirin, less than 325mg total -route: PO albuterol - Correct answer -difficulty breathing -bronchodilator -contras: hypersensitive, tachycardia (over 140 bpm) -dose: 1-2 puffs -route: inhalation epi-pen - Correct answer -allergic reaction -vasoconstrictor and bronchodilator -dose: 0.3mg for adult and 0.15 for pediatrics -route: IM naloxone - Correct answer -for suspected opioid/narcotic overdose -reverses effects of opioid/narcotic medications -dose: IM if autoinjector or IN if nasal spray nitroglycerin - Correct answer -chest pain -vasodilator -contras: 53 BASH - 5 min b/t doses, 3 doses max in 24 hrs, sys BP less than 100, altered LOC, sexual enhancement drugs, head injury -dose: 0.3-0.4mg
-route: SL oral glucose - Correct answer -low blood sugar, altered LOC, dizzy/confused -raises blood glucose levels -contras: can't swallow/decreased LOC, nausea -dose: half a tube -route: PO (inside cheek) trending - Correct answer changes in a patient's condition over time, such as slowing respirations or rising pulse rate, that may show improvement patient assessment - Correct answer -scene size up -primary assessment -patient history -secondary assessment -reassessment signs/symptoms of cardiogenic shock - Correct answer -hypotension -cardiac history -chest pain -respiratory distress -pulmonary edema -altered LOC signs/symptoms of cardiac tamponade - Correct answer beck's triad -JVD -muffled heart sounds -narrowing pulse pressure/hypotension signs/symptoms of tension pneumothorax - Correct answer -JVD -respiratory distress -diminished/absent lung sounds -can't ventilate patient w/BVM -tracheal deviation (late sign) neurogenic shock - Correct answer caused by spinal cord damage (typically in cervical region) - leads to vasodilation below level of injury
-thirst -delayed capillary refill (over 2 sec) signs/symptoms of decompensated shock - Correct answer -falling blood pressure -irregular breathing -mottling or cyanosis -absent peripheral pulses treating shock - Correct answer -put patient supine -cover w/blanket or keep warm -control bleeding rate and depth of compressions (adults and pediatric) - Correct answer rate: 100-120/min depth: 2-2.4in (adults), 1/3 chest (pediatrics) chronic obstructive pulmonary disease (COPD) - Correct answer -chronic disease that obstructs and damages lower airways and alveoli (include chronic bronchitis and emphysema), commonly due to smoking -signs/symptoms: chronic cough, prolonged exhalation, abnormal lung sounds, sometimes on home/portable oxygen congestive heart failure (CHF) - Correct answer -cardiac emergency where heart doesn't pump effectively - causes backup of fluid and pulmonary edema -signs/symptoms: edema, rales, paroxysmal nocturnal dyspnea (SOB usually after 1-2 hrs of sleep) croup - Correct answer -inflammation of pharynx, larynx, and trachea -highly infection and usually in children up to 3 yrs old -signs/symptoms: barking cough, stridor cystic fibrosis (CF) - Correct answer -genetic disorder causing thick mucus production and chronic lung infections -signs/symptoms: asthma-like symptoms and gastrointestinal problems pneumonia - Correct answer -bacterial infection of the lungs
-signs/symptoms: history of chronic illness, productive cough, weakness, chest pain, fever, low pulse ox reading pulmonary edema - Correct answer -accumulation of fluid in lungs -can be caused by CHF, toxic inhalation, disease, trauma -signs/symptoms: cardiac history, rales, swelling in feet/ankles (pedal edema), difficulty breathing while lying down (orthopnea) pulmonary embolism (PE) - Correct answer -blockage of pulmonary artery due to blood clot/obstruction -signs/symptoms: recent surgery or long bone fracture, chest pain, tachypnea, tachycardia, hemoptysis (spitting of blood from lungs), sudden cardiac arrest respiratory syncytial virus (RSV) - Correct answer -respiratory infection common in infants/children -extremely contagious -signs/symptoms: cold-like symptoms, poor fluid intake, signs of dehydration acute coronary syndrome (ACS) - Correct answer caused by myocardial ischemia (poor blood supply) - includes angina pectoris and acute myocardial infarction angina pectoris - Correct answer -chest pain caused by lack of oxygen to the heart muscle -caused by atherosclerosis (build up of plaque in blood vessel - obstructs blood flow) -usually occurs during physical activity/stress and resolves w/rest, oxygen, or nitroglycerin acute myocardial infarction (AMI/MI) - Correct answer -heart attack, death to an area of the myocardial muscle caused by not enough oxygenated blood flow through the coronary arteries -signs/symptoms: chest pain, nausea, weakness/fatigue, dyspnea (difficulty breathing), diaphoresis, abnormal vital signs, sudden cardiac arrest, feeling of impending doom
cincinnati prehospital stroke scale - Correct answer -facial droop: ask patient to smile, abnormal=facial droop present -arm drift: ask patient to close eyes while holding arms out front, abnormal=one arm drifts -speech: ask patient to repeat a sentence, abnormal=slurred speech, unable to speak transient ischemic attack (TIA) - Correct answer mini stroke, signs/symptoms self-correct in 24 hours, warning sign of impending stroke seizures - Correct answer disorganized electrical activity within the brain generalized/grand mal seizures - Correct answer patient is unresponsive and experiences full-body convulsions absence/petit mal seizures - Correct answer patient doesn't interact w/their environment but no convulsive activity partial seizures - Correct answer -simple partial seizure: no change in LOC, possible twitching/sensory change, no full-body convulsions -complex partial seizure: altered LOC, isolated twitching and sensory changes possible status epilepticus - Correct answer prolonged seizure (about 30 min) or recurring seizures w/o patient regaining consciousness in b/t, very dangerous phases of seizure - Correct answer -aura: patient may sense onset of seizure -tonic: muscle rigidity, possible incontinence -tonic-clonic: uncontrolled muscle contractions and relaxation, may be apneic -postictal: LOC improves over about 30 min syncope - Correct answer fainting, caused by loss of blood flow to the brain, usually regain consciousness once supine (blood flow returns to the brain)
insulin - Correct answer pancreatic hormone that lowers blood glucose levels by moving glucose out of the bloodstream and into cells to provide energy type 1 diabetes/insulin-dependent diabetes mellitus (IDDM) - Correct answer -inject supplemental insulin -genetic and usually develops in pediatric patients -at high risk for ketoacidosis (DKA) and insulin shock type 2 diabetes/non-insulin-dependent diabetes melitus (NIDDM) - Correct answer -don't require supplemental insulin -more common than type 1 -caused by lifestyle and genetics, controlled through lifestyle and meds three P's of diabetes - Correct answer -polyuria: excessive urination -polydipsia: excessive thirst -polyphagia: excessive hunger due to cell starvation hypoglycemia - Correct answer -blood glucose below 60mg/dL w/signs/symptoms or below 50mg/dL regardless if signs/symptoms -more common in type 1 than 2 -can lead to altered LOC, seizures, coma, brain death -insulin shock: severe hypoglycemia w/signs/symptoms insulin shock - Correct answer can be caused by... -taking regular insulin but not eating -extreme physical activity w/o adjusting insulin level or food intake -insulin overdose signs/symptoms of hypoglycemia/insulin shock - Correct answer -lower blood glucose level -altered LOC -seizures or coma -restlessness, anxiousness, irritability -diaphoresis -tachycardia -pale, cool skin -tremors