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EETC - Ventilation, Perfusion and Shock: Understanding Pathophysiology PT1

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Emergency Care CHAPTER Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe THIRTEENTH EDITION Ventilation, Perfusion, and Shock: Understanding Pathophysiology 7
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Multimedia Directory Slide 15 Cell Structure Video Slide 47 Transport of Carbon Dioxide Animation
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Topics • The Cell • The Cardiopulmonary System • Shock • Pathophysiology of Other Systems
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Introduction to Pathophysiology • Study of how disease processes affect function of body • Understanding helps you recognize changes patient is going through due to illness or injury
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell • Cell membrane protects and selectively allows water and other substances in and out of the cell • Mitochondria convert glucose and other nutrients into adenosine triphosphate (ATP).  Fuel for cell functions  Without ATP, many of the cell's specialized structures cannot function.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell The cell.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Water and the Cell • Cells need the correct balance of water inside and outside.  Too little water • Cell dehydrated and dies  Too much water • Basic cellular function interrupted • Water also affects levels of electrolytes.  Impacts electrical functions
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Think About It • Draw an analogy between cell metabolism and how a refinery turns crude oil into gasoline for use in automobiles.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Glucose and the Cell • Building block for energy • Supply of insulin must match the body's glucose requirement.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell • Aerobic metabolism  Cellular functions using oxygen • Anaerobic metabolism  Cellular functions not using oxygen • Creates much less energy and much more waste • Body becomes acidic, impairing many body functions.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell Aerobic metabolism. Glucose broken down in the presence of oxygen produces a large amount of energy (ATP).
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell Anaerobic metabolism. Glucose broken down without the presence of oxygen produces acidic by-products and only a small amount of energy (ATP).
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Vulnerability of Cells, Organs, and Organ Systems • Many diseases alter the permeability of membrane. • Ineffective cell membrane can allow substances into the cell that should not be there. • These substances can interfere with the regulation of water.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cell Structure Video Click on the screenshot to view a video on the topic of cell structure. Back to Directory
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System • Respiratory and cardiovascular systems work together.  Bring oxygen into body  Distribute to cells  Remove waste products • Any breakdown can result in system failure.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway The bronchial tree. Each mainstem bronchus enters a lung then branches into smaller and smaller bronchi, ending in the smallest bronchioles.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway (A) Each bronchiole terminates in a tiny air pocket called an alveolar sac. (B) The alveoli are encased by networks of capillaries; oxygen and carbon dioxide are exchanged between the air in the alveoli and the blood in the capillaries.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway • Must have an open (patent) airway for system to function • Upper airway obstructions are common.  Caused by foreign bodies, infection, or trauma
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Lungs • Part of lower airway • Tidal volume  Volume of air moving in and out during each breath cycle • Tidal volume × respiratory rate = minute volume  Amount of air moved in and out of lungs in one minute continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Lungs • Any change in tidal volume or respiratory rate reduces minute volume. • Respiratory dysfunction occurs any time something interferes with minute volume.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of respiratory control  Respirations controlled in brain by the medulla oblongata  Any event impacting function of the medulla oblongata can affect minute volume • Infection, drugs, toxins, trauma continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of pressure  If wall of thorax is compromised (punctures, rib fractures), ability to inhale and exhale is impacted and minute volume is reduced.  Air or blood accumulating in chest (pleural space) also compromises respiration. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of lung tissue  Trauma or medical problems can compromise the ability of alveoli to exchange gases.  Less oxygen gets in; less carbon dioxide gets out.  Can result in low oxygen levels (hypoxia) and high carbon dioxide levels (hypercapnia)
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Compensation • Body attempts to compensate for gas exchange deficits. • Chemoreceptors detect changing oxygen and carbon dioxide levels. • Brain stimulates respiratory system to increase rate and/or tidal volume.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood • Four parts  Plasma (liquid)  Red blood cells • Contain oxygen-carrying hemoglobin  White blood cells • Fight infection  Platelets • Form clots continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood • Plasma oncotic pressure  Proteins in plasma attract water away from are around cells and pulls it into bloodstream. • Hydrostatic pressure  Water pushed back out of blood vessels towards cells. • Problems with these proteins can cause an imbalance.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Dysfunction • Without enough blood, oxygen and carbon dioxide cannot be properly moved around.  Bleeding  Dehydration  Anemia  Liver failure
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels The network of arteries, veins, and capillaries.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels • Take oxygenated blood from lungs via heart to capillaries • Where gas exchange takes place  Between cells and capillaries • Return blood to lungs via heart for gas exchange  Between capillaries and alveoli continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels • Need adequate pressure to make cycle work • Pressure controlled by changing diameter of blood vessels • Stretch receptors monitor pressure. • Pressure can be increased or decreased depending on situation.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Loss of Tone  Vessels lose ability to constrict and dilate.  Pressure drops  Causes • Trauma • Infection • Allergic reaction
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction Dilated blood vessel.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Excessive permeability  Capillaries leak fluid out their walls.  Caused by severe infection (sepsis), high altitude, and certain diseases
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction Increased permeability allows too much fluid to escape through capillary walls.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Hypertension  Systemic vascular resistance (SVR)  Pressure inside vessels  Various conditions lead to abnormal constriction of vessels, leading to dangerously high pressures (hypertension).  Major risk factor in stroke and heart disease
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Heart • Pump with average stroke volume (output) of about 70 mL blood per contraction continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Heart • Stroke volume is based on:  Preload • Amount of blood returning to heart  Contractility • How hard heart squeezes  Afterload • Pressure the heart has to pump against to force blood out into the system
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Output • Stroke volume × beats per minute = cardiac output • Slowing heart rate or decreasing stroke volume reduces cardiac output. • Very fast heart rates reduce cardiac output.  Inadequate time for heart to refill between contractions
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Heart Dysfunction • Mechanical problems  Physical trauma  Squeezing forces  Cell death (heart attack) • Electrical problems  Damage to heart's ability to regulate rate
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System: Putting It All Together • Entire cardiopulmonary system must work together to maintain life. • Must be a balance between ventilation (V) and perfusion (Q) for system to work properly  V/Q match • Any breakdown in system impacts ratio causing possible life-threatening situation.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Shock
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Shock • Perfusion  Regular delivery of oxygen and nutrients to cells and removal of waste products • Hypoperfusion  Breakdown in system • Can result in death of patient
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Four Categories of Shock • Hypovolemic • Distributive • Cardiogenic • Obstructive
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Recognizing Compensation • When problems arise, body attempts to compensate. • Signs of compensated shock  Slight mental status changes  Increased heart rate  Increased respiratory rate  Delayed capillary refill time  Pale, cool, clammy skin  Sweating
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Transport of Carbon Dioxide Animation Click on the screenshot to view an animation on the subject of the transport of carbon dioxide. Back to Directory
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Pathophysiology of Other Systems
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance • Body is 60 percent water.  Intracellular (70 percent)  Intravascular (5 percent)  Interstitial (25 percent)
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance Water comprises approximately 60 percent of body weight. The water is distributed into three spaces: intracellular, intravascular, and interstitial.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance • Brain and kidneys regulate thirst and elimination of excess fluid • Blood plasma proteins pull fluid into the bloodstream • Cell membrane and capillary permeability regulate flow in and out
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Disruptions of Fluid Balance • Fluid loss (dehydration)  Decrease in total water volume • Poor fluid distribution  Water not getting to where it needs to go  Edema • Too much water in some parts of the body
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Nervous System • Brain and spinal cord are well-protected by skull and spine.  Covered by several protective layers (meninges) and a layer of shock- absorbing fluid (cerebrospinal fluid)  Still subject to damage from trauma or disease
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Nervous System Dysfunction • Trauma  Motor-vehicle crashes  Falls  Diving accidents continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Nervous System Dysfunction • Medical dysfunction  Strokes  Infection (meningitis, encephalitis)  Disease (Lou Gehrig disease, MS)  Low blood sugar (hypoglycemia)
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Endocrine System • Glands secrete hormones. • Hormones send chemical messages to the body to control body functions. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Endocrine System • Major organs of system  Brain  Kidneys  Pancreas  Pituitary gland  Thyroid gland  Adrenal glands
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Endocrine System Dysfunction • Organ or gland problems • Present at birth or result of illness • Too many hormones  Graves' disease (too much thyroid hormone)  Problems with heart rate and temperature regulation • Not enough hormones  Diabetes
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Digestive System • Allows food, water, and other nutrients to enter the body • Major organs of system  Esophagus  Stomach  Intestines
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Digestive Dysfunction • Impacts hydration levels and nutrient transfer • Gastrointestinal bleeding  Can be slow • Chronic bleeding  Can be massive, with rectal bleeding and/or vomiting blood continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Digestive Dysfunction • Vomiting and diarrhea  Most common disorders  Variety of causes  May result in malnutrition and dehydration
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Immune System • Responsible for fighting infection • Responds to specific body invaders by identifying them, marking them, and destroying them
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Hypersensitivity (Allergic Reaction) • Allergic reaction to certain food, drugs, other substances • Result of exaggerated immune response • Chemicals affect more than just invader. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Hypersensitivity (Allergic Reaction) • Produces edema • Results in a rapid drop in blood pressure • Can be life threatening
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Pathophysiology allows us to understand how negative forces impact the normal function of the body. • Pathophysiology helps us understand how common disorders cause changes in the body. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Understanding how the body compensates for insults sheds light on the signs and symptoms we may see during assessment. • Understanding what compensation looks like helps us rapidly identify potentially life-threatening problems.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Cellular metabolism requires a constant supply of oxygen and glucose. Absence of either component disrupts normal metabolism. • Cardiopulmonary system combines the functions of respiratory and cardiovascular systems to provide oxygen at the cellular level. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Shock occurs when the cardiopulmonary system fails and cells become hypoperfused. • The body is composed primarily of water, and this fluid is distributed throughout the body systems.
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Questions to Consider • When evaluating a patient with a cardiac problem, consider the impact on the respiratory system. When evaluating a patient with a respiratory problem, consider the impact on the cardiovascular system. What impacts do problems in these systems have on each other? continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Questions to Consider • Shock must be recognized immediately. What is the pathophysiology of shock?
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Critical Thinking • You are treating a patient who was recently released from the intensive care unit with a massive infection (sepsis). This has impaired the patient's ability to regulate the size of the blood vessels. continued on next slide
Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Critical Thinking • How might this affect the patient's ability to compensate for any additional illnesses? What steps should you take to help this patient compensate?

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Ch07 shock

  • 1. Emergency Care CHAPTER Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe THIRTEENTH EDITION Ventilation, Perfusion, and Shock: Understanding Pathophysiology 7
  • 2. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Multimedia Directory Slide 15 Cell Structure Video Slide 47 Transport of Carbon Dioxide Animation
  • 3. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Topics • The Cell • The Cardiopulmonary System • Shock • Pathophysiology of Other Systems
  • 4. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Introduction to Pathophysiology • Study of how disease processes affect function of body • Understanding helps you recognize changes patient is going through due to illness or injury
  • 5. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell
  • 6. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell • Cell membrane protects and selectively allows water and other substances in and out of the cell • Mitochondria convert glucose and other nutrients into adenosine triphosphate (ATP).  Fuel for cell functions  Without ATP, many of the cell's specialized structures cannot function.
  • 7. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cell The cell.
  • 8. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Water and the Cell • Cells need the correct balance of water inside and outside.  Too little water • Cell dehydrated and dies  Too much water • Basic cellular function interrupted • Water also affects levels of electrolytes.  Impacts electrical functions
  • 9. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Think About It • Draw an analogy between cell metabolism and how a refinery turns crude oil into gasoline for use in automobiles.
  • 10. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Glucose and the Cell • Building block for energy • Supply of insulin must match the body's glucose requirement.
  • 11. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell • Aerobic metabolism  Cellular functions using oxygen • Anaerobic metabolism  Cellular functions not using oxygen • Creates much less energy and much more waste • Body becomes acidic, impairing many body functions.
  • 12. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell Aerobic metabolism. Glucose broken down in the presence of oxygen produces a large amount of energy (ATP).
  • 13. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Oxygen and the Cell Anaerobic metabolism. Glucose broken down without the presence of oxygen produces acidic by-products and only a small amount of energy (ATP).
  • 14. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Vulnerability of Cells, Organs, and Organ Systems • Many diseases alter the permeability of membrane. • Ineffective cell membrane can allow substances into the cell that should not be there. • These substances can interfere with the regulation of water.
  • 15. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cell Structure Video Click on the screenshot to view a video on the topic of cell structure. Back to Directory
  • 16. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System
  • 17. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System • Respiratory and cardiovascular systems work together.  Bring oxygen into body  Distribute to cells  Remove waste products • Any breakdown can result in system failure.
  • 18. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway The bronchial tree. Each mainstem bronchus enters a lung then branches into smaller and smaller bronchi, ending in the smallest bronchioles.
  • 19. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway (A) Each bronchiole terminates in a tiny air pocket called an alveolar sac. (B) The alveoli are encased by networks of capillaries; oxygen and carbon dioxide are exchanged between the air in the alveoli and the blood in the capillaries.
  • 20. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Airway • Must have an open (patent) airway for system to function • Upper airway obstructions are common.  Caused by foreign bodies, infection, or trauma
  • 21. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Lungs • Part of lower airway • Tidal volume  Volume of air moving in and out during each breath cycle • Tidal volume Ă— respiratory rate = minute volume  Amount of air moved in and out of lungs in one minute continued on next slide
  • 22. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Lungs • Any change in tidal volume or respiratory rate reduces minute volume. • Respiratory dysfunction occurs any time something interferes with minute volume.
  • 23. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of respiratory control  Respirations controlled in brain by the medulla oblongata  Any event impacting function of the medulla oblongata can affect minute volume • Infection, drugs, toxins, trauma continued on next slide
  • 24. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of pressure  If wall of thorax is compromised (punctures, rib fractures), ability to inhale and exhale is impacted and minute volume is reduced.  Air or blood accumulating in chest (pleural space) also compromises respiration. continued on next slide
  • 25. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Dysfunction • Disruption of lung tissue  Trauma or medical problems can compromise the ability of alveoli to exchange gases.  Less oxygen gets in; less carbon dioxide gets out.  Can result in low oxygen levels (hypoxia) and high carbon dioxide levels (hypercapnia)
  • 26. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Respiratory Compensation • Body attempts to compensate for gas exchange deficits. • Chemoreceptors detect changing oxygen and carbon dioxide levels. • Brain stimulates respiratory system to increase rate and/or tidal volume.
  • 27. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe
  • 28. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood • Four parts  Plasma (liquid)  Red blood cells • Contain oxygen-carrying hemoglobin  White blood cells • Fight infection  Platelets • Form clots continued on next slide
  • 29. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood • Plasma oncotic pressure  Proteins in plasma attract water away from are around cells and pulls it into bloodstream. • Hydrostatic pressure  Water pushed back out of blood vessels towards cells. • Problems with these proteins can cause an imbalance.
  • 30. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Dysfunction • Without enough blood, oxygen and carbon dioxide cannot be properly moved around.  Bleeding  Dehydration  Anemia  Liver failure
  • 31. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels The network of arteries, veins, and capillaries.
  • 32. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels • Take oxygenated blood from lungs via heart to capillaries • Where gas exchange takes place  Between cells and capillaries • Return blood to lungs via heart for gas exchange  Between capillaries and alveoli continued on next slide
  • 33. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Blood Vessels • Need adequate pressure to make cycle work • Pressure controlled by changing diameter of blood vessels • Stretch receptors monitor pressure. • Pressure can be increased or decreased depending on situation.
  • 34. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Loss of Tone  Vessels lose ability to constrict and dilate.  Pressure drops  Causes • Trauma • Infection • Allergic reaction
  • 35. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction Dilated blood vessel.
  • 36. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Excessive permeability  Capillaries leak fluid out their walls.  Caused by severe infection (sepsis), high altitude, and certain diseases
  • 37. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction Increased permeability allows too much fluid to escape through capillary walls.
  • 38. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Blood Vessel Dysfunction • Hypertension  Systemic vascular resistance (SVR)  Pressure inside vessels  Various conditions lead to abnormal constriction of vessels, leading to dangerously high pressures (hypertension).  Major risk factor in stroke and heart disease
  • 39. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Heart • Pump with average stroke volume (output) of about 70 mL blood per contraction continued on next slide
  • 40. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Heart • Stroke volume is based on:  Preload • Amount of blood returning to heart  Contractility • How hard heart squeezes  Afterload • Pressure the heart has to pump against to force blood out into the system
  • 41. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Output • Stroke volume Ă— beats per minute = cardiac output • Slowing heart rate or decreasing stroke volume reduces cardiac output. • Very fast heart rates reduce cardiac output.  Inadequate time for heart to refill between contractions
  • 42. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Heart Dysfunction • Mechanical problems  Physical trauma  Squeezing forces  Cell death (heart attack) • Electrical problems  Damage to heart's ability to regulate rate
  • 43. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Cardiopulmonary System: Putting It All Together • Entire cardiopulmonary system must work together to maintain life. • Must be a balance between ventilation (V) and perfusion (Q) for system to work properly  V/Q match • Any breakdown in system impacts ratio causing possible life-threatening situation.
  • 44. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Shock
  • 45. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Shock • Perfusion  Regular delivery of oxygen and nutrients to cells and removal of waste products • Hypoperfusion  Breakdown in system • Can result in death of patient
  • 46. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Four Categories of Shock • Hypovolemic • Distributive • Cardiogenic • Obstructive
  • 47. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Recognizing Compensation • When problems arise, body attempts to compensate. • Signs of compensated shock  Slight mental status changes  Increased heart rate  Increased respiratory rate  Delayed capillary refill time  Pale, cool, clammy skin  Sweating
  • 48. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Transport of Carbon Dioxide Animation Click on the screenshot to view an animation on the subject of the transport of carbon dioxide. Back to Directory
  • 49. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Pathophysiology of Other Systems
  • 50. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance • Body is 60 percent water.  Intracellular (70 percent)  Intravascular (5 percent)  Interstitial (25 percent)
  • 51. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance Water comprises approximately 60 percent of body weight. The water is distributed into three spaces: intracellular, intravascular, and interstitial.
  • 52. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Fluid Balance • Brain and kidneys regulate thirst and elimination of excess fluid • Blood plasma proteins pull fluid into the bloodstream • Cell membrane and capillary permeability regulate flow in and out
  • 53. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Disruptions of Fluid Balance • Fluid loss (dehydration)  Decrease in total water volume • Poor fluid distribution  Water not getting to where it needs to go  Edema • Too much water in some parts of the body
  • 54. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Nervous System • Brain and spinal cord are well-protected by skull and spine.  Covered by several protective layers (meninges) and a layer of shock- absorbing fluid (cerebrospinal fluid)  Still subject to damage from trauma or disease
  • 55. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Nervous System Dysfunction • Trauma  Motor-vehicle crashes  Falls  Diving accidents continued on next slide
  • 56. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Nervous System Dysfunction • Medical dysfunction  Strokes  Infection (meningitis, encephalitis)  Disease (Lou Gehrig disease, MS)  Low blood sugar (hypoglycemia)
  • 57. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Endocrine System • Glands secrete hormones. • Hormones send chemical messages to the body to control body functions. continued on next slide
  • 58. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Endocrine System • Major organs of system  Brain  Kidneys  Pancreas  Pituitary gland  Thyroid gland  Adrenal glands
  • 59. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Endocrine System Dysfunction • Organ or gland problems • Present at birth or result of illness • Too many hormones  Graves' disease (too much thyroid hormone)  Problems with heart rate and temperature regulation • Not enough hormones  Diabetes
  • 60. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Digestive System • Allows food, water, and other nutrients to enter the body • Major organs of system  Esophagus  Stomach  Intestines
  • 61. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Digestive Dysfunction • Impacts hydration levels and nutrient transfer • Gastrointestinal bleeding  Can be slow • Chronic bleeding  Can be massive, with rectal bleeding and/or vomiting blood continued on next slide
  • 62. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Digestive Dysfunction • Vomiting and diarrhea  Most common disorders  Variety of causes  May result in malnutrition and dehydration
  • 63. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe The Immune System • Responsible for fighting infection • Responds to specific body invaders by identifying them, marking them, and destroying them
  • 64. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Hypersensitivity (Allergic Reaction) • Allergic reaction to certain food, drugs, other substances • Result of exaggerated immune response • Chemicals affect more than just invader. continued on next slide
  • 65. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Hypersensitivity (Allergic Reaction) • Produces edema • Results in a rapid drop in blood pressure • Can be life threatening
  • 66. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review
  • 67. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Pathophysiology allows us to understand how negative forces impact the normal function of the body. • Pathophysiology helps us understand how common disorders cause changes in the body. continued on next slide
  • 68. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chapter Review • Understanding how the body compensates for insults sheds light on the signs and symptoms we may see during assessment. • Understanding what compensation looks like helps us rapidly identify potentially life-threatening problems.
  • 69. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Cellular metabolism requires a constant supply of oxygen and glucose. Absence of either component disrupts normal metabolism. • Cardiopulmonary system combines the functions of respiratory and cardiovascular systems to provide oxygen at the cellular level. continued on next slide
  • 70. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Remember • Shock occurs when the cardiopulmonary system fails and cells become hypoperfused. • The body is composed primarily of water, and this fluid is distributed throughout the body systems.
  • 71. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Questions to Consider • When evaluating a patient with a cardiac problem, consider the impact on the respiratory system. When evaluating a patient with a respiratory problem, consider the impact on the cardiovascular system. What impacts do problems in these systems have on each other? continued on next slide
  • 72. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Questions to Consider • Shock must be recognized immediately. What is the pathophysiology of shock?
  • 73. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Critical Thinking • You are treating a patient who was recently released from the intensive care unit with a massive infection (sepsis). This has impaired the patient's ability to regulate the size of the blood vessels. continued on next slide
  • 74. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Critical Thinking • How might this affect the patient's ability to compensate for any additional illnesses? What steps should you take to help this patient compensate?

Editor's Notes

  1. These videos appear later in the presentation; you may want to preview them prior to class to ensure they load and play properly. Click on the links above in slideshow view to go directly to the slides.
  2. Planning Your Time: Plan 120 minutes for this chapter. The Cell (20 minutes) The Cardiopulmonary System (60 minutes) Shock (20 minutes Pathophysiology of Other Systems (20 minutes) Note: The total teaching time recommended is only a guideline. Core concepts: The cell, cellular metabolism, and results of the alteration of cellular metabolism The cardiopulmonary system and its combined respiratory and cardiovascular functions The respiratory system and the importance of oxygenation and ventilation The cardiovascular system and the movement of blood The principles of perfusion, hypoperfusion, and shock Disrupted physiology of major body systems
  3. Covers Objective: 7.1
  4. Teaching Time: 20 minutes Teaching Tips: The cell is a difficult concept to apply to everyday life. Consider using multimedia presentations to add visual context. The most important part of this lesson is the discussion of metabolism. It lays the groundwork for an understanding of respiration and perfusion. Spend time in this section.
  5. Covers Objective: 7.2 Point to Emphasize: Metabolism is the process of turning nutrients into energy at the cellular level. Under normal circumstances, this process requires glucose and oxygen. Discussion Topic: Explain how a diminished supply of glucose alters metabolism.
  6. Covers Objective: 7.2 Point to Emphasize: There are a variety of structures within a cell. Each has a specific function. Common cell structures include the nucleus, the endoplasmic reticulum, and the mitochondria. Discussion Topic: Describe the structures of a cell.
  7. Covers Objective: 7.3 Knowledge Application: Have students work in small groups. Assign each group a disorder (such as dehydration) and ask group members to research and report on how that condition might impact metabolism. Discuss their findings. Critical Thinking: Diabetics occasionally suffer from a condition called hyperglycemia. How might this condition affect metabolism?
  8. Covers Objective: 7.3 Talking Points: Think of glucose as crude oil, and the mitochondria as the refinery that makes it into ATP (gasoline) with the help of oxygen and water. Without ATP, the cell cannot function effectively and may stop working (die).
  9. Covers Objective: 7.3
  10. Covers Objective: 7.3 Point to Emphasize: Anaerobic metabolism occurs when oxygen is depleted or absent. It is a very inefficient method of creating energy. Discussion Topic: Discuss how the body adapts to altered metabolism. Describe the changes that occur.
  11. Covers Objective: 7.3 Knowledge Application: Assign homework. Have students research the concept of anaerobic metabolism. Ask them to discuss the effects of anaerobic metabolism on at least three body systems.
  12. Covers Objective: 7.3 Knowledge Application: Assign homework. Have students research the concept of anaerobic metabolism. Ask them to discuss the effects of anaerobic metabolism on at least three body systems.
  13. Covers Objective: 7.3
  14. Covers Objectives: 7.2 and 7.3 Video Clip Cell Structure List the three basic structures of a cell. What is the purpose of the nucleus? Discuss why it is necessary for an EMT to understand how a cell functions. What is the purpose of the cell membrane? What does RNA stand for?
  15. Teaching Time: 60 minutes Teaching Tips: Cardiopulmonary function is a large lesson, but it has many smaller elements. Teach it in a developmental manner. Use small building blocks to create the larger structure. This lesson will be made easier because students have completed the anatomy lessons of Chapter 6. Build upon previously discussed concepts. Use real-life examples and "war stories" to illustrate complex points. This section lends itself well to multimedia graphics. Use video clips and graphics to demonstrate body systems.
  16. Covers Objective: 7.4
  17. Covers Objective: 7.4
  18. Covers Objective: 7.4
  19. Covers Objective: 7.5
  20. Covers Objective: 7.5 Point to Emphasize: Alveolar ventilation is related to both rate and volume of respiration.
  21. Covers Objective: 7.5 Point to Emphasize: Respirations can be disrupted by obstruction or by destruction of the key anatomical structures. Discussion Topic: Explain how bronchospasm might impact rate, tidal volume, and alveolar ventilation.
  22. Covers Objective: 7.5 Knowledge Application: Have students work in small groups. Assign a specific disease or injury to each group and have the group report on how that disease or injury might impact normal function.
  23. Covers Objective: 7.5
  24. Covers Objective: 7.5 Discussion Topic: Discuss how sepsis might interfere with oxygen delivery to the cells.
  25. Covers Objective: 7.6
  26. Covers Objective: 7.9
  27. Covers Objective: 7.9
  28. Covers Objective: 7.7 Point to Emphasize: The heart, blood vessels, and blood combine to provide oxygen to the cells. Disruption at this level interrupts perfusion.
  29. Covers Objective: 7.7
  30. Covers Objective: 7.7
  31. Covers Objective: 7.9
  32. Covers Objective: 7.9
  33. Covers Objective: 7.9
  34. Covers Objective: 7.9
  35. Covers Objective: 7.9
  36. Covers Objective: 7.5
  37. Covers Objective: 7.5
  38. Covers Objective: 7.5 Discussion Topic: Describe how an extremely fast heart rate might actually drop cardiac output.
  39. Covers Objective: 7.5
  40. Covers Objective: 7.7 Knowledge Application: Ask students to define the necessary components of perfusion. What elements must function in order for perfusion to occur? Discuss.
  41. Teaching Time: 20 minutes Teaching Tips: Emphasize that shock is the inability to meet the oxygen demands of the tissues and that it may result from many types of conditions; medical and traumatic alike.
  42. Covers Objective: 7.7 Point to Emphasize: Shock occurs when cells lack the oxygen they need for metabolism. Discussion Topic: Define shock. Class Activity: Have students work in small groups. Assign each group a key component of the cardiopulmonary system. Have the groups present the role of their components to the class. Discuss how the components work together.
  43. Covers Objective: 7.9
  44. Covers Objective: 7.8 Knowledge Application: List different types of shock. Have students discuss which part of the cardiopulmonary system each type of shock disrupts. Critical Thinking: Now that you understand how perfusion is disrupted, discuss how the cardiopulmonary system might change in response to hypoperfusion. How might you tell, from external signs, that these changes are occurring?
  45. Covers Objective: 7.7 Animation Transport of Carbon Dioxide What happens to carbon dioxide when it leaves the tissues? What is the Bohr shift? How is carbon dioxide transported within the blood?
  46. Teaching Time: 20 minutes Teaching Tips: This lesson is designed to provide only a brief overview. Pathophysiology is a much larger topic. Discuss how students can continue to learn in this area. Use real-life examples. Adults grasp pathophysiology best when they can apply it to actual situations. For each subsection of disorder, discuss actual examples and move from theory to reality. Link dysfunction of the nervous, endocrine, digestive, and immune systems to your previous discussions of normal function.
  47. Covers Objective: 7.9 Point to Emphasize: The body is 60% water. Several factors cause the distribution of fluid throughout the body. Critical Thinking: A burn can lead to severe fluid imbalances. How do burns affect fluid levels?
  48. Covers Objective: 7.9 Point to Emphasize: The body is 60% water. Several factors cause the distribution of fluid throughout the body. Critical Thinking: A burn can lead to severe fluid imbalances. How do burns affect fluid levels?
  49. Covers Objective: 7.9 Discussion Topic: Explain how fluid is distributed throughout the body.
  50. Covers Objective: 7.9
  51. Covers Objective: 7.11 Point to Emphasize: Nervous system injuries can be devastating and life threatening; they can affect the airway, breathing, and circulation. Knowledge Application: Have students work in small groups. Assign a specific pathophysiology. Have the groups research their dysfunction and present their findings to the class. Findings should include a discussion of how their dysfunction interferes with normal function of the specific body system.
  52. Covers Objective: 7.11 Discussion Topic: Discuss the impact of nervous system dysfunction on the body systems.
  53. Covers Objective: 7.11 Discussion Topic: Discuss the impact of nervous system dysfunction on the body systems.
  54. Covers Objective: 7.13a Point to Emphasize: The endocrine system controls body functions through chemical messages.
  55. Covers Objective: 7.13a
  56. Covers Objective: 7.13a Discussion Topic: Explain how endocrine dysfunctions might impact other body systems.
  57. Covers Objective: 7.13b
  58. Covers Objective: 7.13b Point to Emphasize: The digestive system allows nutrients to enter the body and waste products to leave.
  59. Covers Objective: 7.13b
  60. Covers Objective: 7.13c Point to Emphasize: Hypersensitivity reactions are an exaggerated immune response. Discussion Topic: Discuss how allergic reactions are related to the immune system.
  61. Covers Objective: 7.13c Point to Emphasize: Hypersensitivity reactions are an exaggerated immune response. Discussion Topic: Discuss how allergic reactions are related to the immune system.
  62. Talking Points: The lungs (pulmonary system), heart, blood vessels, and the blood itself (cardiovascular system) work in concert to perform cardiopulmonary functions. The primary function of the cardiopulmonary system is to deliver oxygen and nutrients to the cells and to remove waste products from the cells. These basic operations rely on the coordinated movements of blood and air. Interruption of any part of this balance results in a compromise to, or even a failure of, the system.
  63. Talking Points: Shock occurs when the regular delivery of oxygen and nutrients to cells and the removal of their waste products is interrupted. Without a regular supply of oxygen, cells become hypoxic and must rely on anaerobic metabolism. Lactic acid and other waste products accumulate and harm the cells. Without the removal of carbon dioxide, the buildup of harmful waste products is accelerated. Unless it is reversed, shock will kill cells, organs, and eventually the patient.
  64. Talking Points: The patient's sepsis will affect the body's ability to dilate and constrict blood vessels, thereby decreasing it's ability to regulate blood pressure in response to any additional illnesses or injuries. BLS care for shock should be initiated to include oxygen, warmth, and a position of comfort. ALS should be considered for fluid therapy.