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BASIC DIVING MEDICINE
Terms in this set (111)
The Respiratory System is
The system which brings air into and out of the body providing a constant supply of O2 while removing CO2
Lungs contain _______, ________, and ________.
Bronchi, Bronchioles, and Alveoli
Alveoli small air sacs at the ends of the bronchioles. Present a large surface area for ________.
As air enters the lungs it comes into contact with ______ ________.
_____ is diffused from the alveolar air into the alveolar capillary beds of the lungs due to ________ ______.
O2, Higher ppO2
The elevated ppCO2 in the plasma is driven into the lungs where CO2 is at a lower partial pressure. This is the practical application of _______ and _____ gas laws.
Henry's and Dalton's
______ takes place in the opposite direction than it did in the lungs.
Cells utilize the oxygen during metabolism and produce ______ as a biproduct.
The Circulatory System- A closed system that brings oxygen, nutrients, and hormones to every cell and tissue of the body and carries away _______, ________, and _______.
CO2 waste, Chemicals, and Heat
Piping system that carries blood from the heart to all tissues and organs of the body.
Arteries carry blood _____ from the heart.
____ diminish in size and increase in number as they get further from the heart.
The smallest Arteries are called _______.
Veins are blood vessels that ________ blood to the heart.
________ increase in size and diminish in number as they return to the heart.
________ are the smallest and most numerous of the blood vessels.
_________ ______ are the site of the O2/CO2 exchange.
________ Carries O2 to every tissue of the body.
Blood is comprised of ______ and ________.
Red Blood Cells (RBC) and Plasma
________ is a protein on the RBC that attracts O2.
________ is the fluid portion of blood that carries CO2 from the tissues to the lungs.
Veins carry blood from body tissues to the right side of the heart. This blood is ______ and ______. Color is ______.
O2 poor, CO2 rich, Blue
Blood is then pumped from the heart through the capillary beds of the _______.
CO toxicity characteristics _________, _________, and _________ gas.
Colorless, Odorless, and tasteless gas.
Mechanisms of CO toxicity bind with _________ in the red blood cells, displacing and blocking the pickup of O2.
Factors of CO absorption include _______, _________, and _________.
Diver's physical activity level, Ambient levels of CO, and Duration of exposure.
Primary symptoms of CO toxicity include __________, __________, ___________, and ____________.
Headache/Tightness across forehead, Pounding in the temples, Nausea/Vomiting, Unconsciousness ( May occur without other symptoms being noticed due to rapidly occurring toxicity).
Diagnosis of CO toxicity will be present during ________ or _______.
During ascent or on the surface.
Treatment of CO toxicity is ____________, _____________,___________, and ________.
1) Remove patient from CO exposure 2) 100% O2 by mask 3) Medical/DMO evaluation 4) Hyperbaric oxygen therapy may be necessary.
The condition that arises as a result of deminished O2 to the tissues, also called O2 deficiency.
Causes of Hypoxia. ________, __________, _______________, ____________.
1) Air supply failure 2) Diver loses his mouthpiece (SCUBA) 3) Insufficient O2 in the diver's breathing media I.e. LAR-V or MK 16 (If O2 falls below .16 ata, hypoxia symptoms will begin to occur on the surface (16%)) 4) Utilization (depletion) of available O2 within a confined space (Hperbaric chamber) (Inadequate ventilation space)
Hypoxia symptoms include ________, _________, ________, ___________, ___________, _________, _________, _________, ____________, and ___________.
1) LACK OF CONCENTRATION 2) LACK OF MUSCLE CONTROL 3) INABILITY TO PERFORM DELICATE OR SKILL REQUIRING TASKS 4) DROWSINESS 5) WEAKNESS 6) CYANOSIS (BLUE FACE) 7) DIZZINESS/LIGHTHEADED 8)EUPHORIA 9) LOSS OF CONSCIOUSNESS 10)AGITATION
Treatment for Hypoxia in water and on surface.
In water: perform EPs for rig. On surface: administer 100% O2 by mask, CPR if necessary, Hospital/Medical/DMO
_______ is an abnormally high level of carbon dioxide in the tissues.
Carbon Dioxide Toxicity (CO2)
Causes of CO2 Toxicity includes _______, _______, and _______.
1)Skip breathing 2)Excessive work at depth 3)Over-breathing diving apparatus capacity
Symptoms of CO2 Toxicity includes ________, _______, ________, ________, ________, __________, _________, _________.
1)Headache- worse after exposure 2)Shortness of breath 3)Increased respiratory rate 4)Increased heart rate 5)Felling of euphoria 6)Confusion 7)Unconsciousness (may be first sign) 8)Drowsiness NOTE: Symptoms usually become apparent when divers attempt heavy work at depths deeper than 120' fsw on air.
Treatment of CO2 Toxicity in water.
1)Ventilate the helmet 2)Notify buddy 3)Decrease work 4)Breath normally 5)Abort dive (if necessary 6)Seek medical attention
Treatment of CO2 Toxicity on surface.
1)Remove Diver's dive apparatus 2)100% O2 by mask 3)Transport to Medical for DMO evaluation.
_________ is a narcotic feeling caused by the effects of inert gases on the Central Nervous System (CNS)
Use of ______ as a diluent will eliminate nitrogen's effect during deep dives.
Onset of Nitrogen Narcosis generally begins around ______ ata.
4 ata (99 fsw)
Two types of O2 Toxicity are _________ and ________.
CNS O2 Toxicity and Pulmonary O2 Toxicity
Central Nervous System (CNS) O2 Toxicity is usually not encountered unless ppO2 reaches or exceeds ___ ata, but may be encountered as low as _____ ata. (Dalton's Law)
Symptoms of CNS O2 Toxicity (VENTID-C)
1)Vision- Blurred, tunnel vision 2)Ears- Ringing or Roaring 3)Nausea- May be intermittent 4)Twitching/Tingling- Appears in lips/facial muscles or muscles of the extremities 5)Irritability- Change in behavior 6)Dizziness- Include clumsiness, incoordination and fatigue 7)Convulsions- May be first sign (sudden onset)
Treatment of CNS O2 Toxicity during dive operations and during chamber operations.
During dive operations- Conduct EP's for the respective diving apparatus. During Chamber operations- Treat IAW the U.S. Navy Diving Manual chapter 20+21.
Pulmonary O2 Toxicity occurs during or after ___________ to increased partial pressure of O2.
Three symptoms of pulmonary O2 toxicity after long exposure.
1)Coughing 2)Burning 3)Dyspnea
When the core temperature of the body drops below ____*F, it can be considered hypothermic.
External Insulation recommendations. Neoprene wet suit ______, Dry suit _____, Hot water suit _______.
Neoprene wet suit <80
F Dry suitn<60
F Hot water suit <40*F
Symptoms of mild hypothermia.
1) complains of cold 2) shivering 3) slurred speech 4) poor judgment
Treatment of MIld Hypothermia (until sweating)
PASSIVE REWARMING 1) dry clothes 2) warm environment 3) blankets 4) hot soup/drink 5) Avoid caffeine/alcohol/tobacco, these cause dehydration.
ACTIVE REWARMING 1) warm shower or bath 2) place in a very warm space
Symptoms of Moderate Hypothermia.
1) apathy 2) mild confusion 3) slurred speech 4)uncontrollable shivering 5) will have an "ashen" (gray) appearance 6) slow pulse
Treatment of Moderate Hypothermia.
ACTIVE EXTERNAL RE-WARMING 1) warm bath 100-110*F 2) if re-warming in bath, ensure extremities are left out of the water 3) re-warming of extremities causes peripheral vasodilation and therefore dumps all cold shunted blood back into the core. This can cause a rapid drop in core temperature, which may worsen the situation. 4) adequate re-warming has been achieved at the onset of sweating 5) use warm shower only if left in wetsuit due to the evaporative cooling of a shower 6) seek medical help PASSIVE EXTERNAL RE-WARMING 1) prevent further heat loss 2) warm clothes 3) allow body to recover on its own
Symptoms of Severe Hypothermia.
1) motor functions impaired 2) shivering stops 3) irregular heartbeat/shallow pulse 4) decreased/loss of consciousness
Treatment of Severe Hypothermia.
1) Passive external re-warming ONLY 2) prevent exertion 3) prevent further heat loss 4) no oral intake 5) seek medical help
Cause of Shallow Water Blackout?
Hyperventilation decreases _____ levels in the blood, prolonging the body's urge to breathe during breathhold diving.
_____ concentration in the blood is the mechanism for respiratory activity while awake.
Treatment of Shallow Water Blackout?
1) Remove victim from water 2) CPR if needed 3) Administer 100% O2 by mask 4) Transport to medical
Suffocation by immersion in a liquid, with the victim being successfully resuscitated.
All victims of near drowning must be evaluated by a medical officer. The possibility of ________ is the greatest risk and can develop several days after revival.
Treatment of Near Drowning?
1) Remove victim from water 2) CPR as necessary 3) 100% O2 by mask 4) Transport to medical
External ear, Canal, and Tympanic membrane (TM) are all apart of the ______ _______ _______.
Outer Ear Anatomy
___ ______ acts as a conduit (channel) of sound and protects TM.
___ changes sound waves into mechanical movement.
______ ________ ________ is the gas-filled space between the external auditory canal and the inner ear.
Middle Ear Anatomy
Middle ear contains the three bones of conductive hearing ______, _______, and __________.
Malleus (hammer), Incus (anvil), Stapes (stirrup)
_______ ______ connects the middle ear to the back of the throat.
The middle ear contains two fibrous windows on opposite side of TM called the ______ _____ and _____ _____.
Oval Window and Round Window
The Inner Ear is connected to the middle aer by the round and oval windows and contains ____ _____ ______.
Fluid filled space (Cereval Spinal fluid and various fluids)
Organ of hearing and snail shaped organ?
Organ of Balance?
Inner ear fluid moves across nerve sensors stimulating _____ and _______.
hearing and balance
_______ is affected by movement of inner ear fluid in vestibular apparatus.
_____ is affected by movement of inner ear fluid in cochlea.
Damage to body tissues caused by changes in ambient pressure is ___________.
Essential ingredients in a Barotrauma ________, ________, __________, _________, _________.
1) Gas filled space 2) Rigid walls 3) Ambient pressure change 4) Vascular penetration 5) Enclosed space
Barotrauma on descent is called a _______.
Barotrauma on ascent is called a ______ _______.
A Barotrauma may be caused by ______ on ascent or forceful ______ on descent.
Types of squeezes?
1) External ear squeeze 2) Middle ear squeeze 3) Sinus squeeze/Reverse squeeze 4) Others
External ear squeeze occurs if external auditory canal is blocked by ______, _________, ________.
Wax, Tight wetsuit hood, Ear infection.
______ _____ ______ is the most common type of squeeze.
Middle Ear Squeeze (occurs most often during descent due to blocked Eustachian tube)
Caloric Vertigo is caused by ____ ______ stimulating one ear to a greater degree than the other, which induces vertigo.
cold water (most common on descent)
Alternobaric Vertigo is caused by ________ ________ between the middle ear spaces resulting in vertigo.
________ ______ ______ is an injury caused by the expansion of gas trapped in the lungs during ascent.
Pulmonary Over Inflation (POIS)
POIS Tree? (4)
1) Arterial Gas Embolism (AGE) 2) Mediastinal Emphysema 3) Subcutaneous Emphysema 4) Pneumothorax
_____ ______ _____ is Alveolar rupture, air bubbles enter the capillaries of the lungs, travel to the heart, then are distributed throughout the body, usually to the brain (CNS) but can be the heart.
Arterial Gas Embolism (AGE)
AGE is caused by the lungs ____ ________ and air is forced into capillaries and pumped into the arteries.
AGE is caused by ______, which accumulate and lodge in narrowing vessels, and form a plug.
______ is the most significant site for bubbles for an AGE.
Mediastinal Emphysema results when gas expansion forces gas into the loose mediastinal tissues in the ______ of the chest.
Mediastinal Emphysema symptoms include chest pain behind the _______.
_____ _______ results from expansion of gas, which has leaked from the mediastinum into the subcutaneous tissues of the neck.
Subcutaneous Emphysema (SUB-Q)
________ is over inflation of the lung causing air to enter space between the lung covering and lining of the chest wall causing air to enter into the chest, partially collapsing the lung.
Two types of Pneumothorax?
simple and tension
1 time leakage of air from the lung into the chest, PARTIALLY collapsing the lung.
Lung allows air to enter but not exit the plural space. If uncorrected, the lung will collapse pushing the heart and lung to the opposite side of the chest cavity impairing respiration and circulation.
Symptoms of Pneumothorax
1) Chest pain 2) rapid and shallow breathing 3) Diver may guard affected side 4) Diver may appear pale
A diver's blood and tissues absorb additional nitrogen (or helium) from the lungs when at depth and if a diver ascends too fast this excess gas will separate from solution and form bubbles. This is also known as ______ ________.
Decompression Sickness (DCS)
DCS is generally divided into two categories, ______ and ______.
Type 1 and Type 2
The 3 types of DCS Type 1?
1) Limb pain 2) Cutis Marmorata (Marbling) 3) Lumphatic Bends (Swelling)
_____ ______ is the most common symptom of DCS Type 1.
The hallmark of Type 1 pain is a ___ _____ pain usually near a joint that cannot be pinpointed by the patient.
Dull Achey (The pain can progress from a dull ache and intensify to a deep ache)
Cutis Marmorata (Marbling) is diagnosed as Type __ DCS but is treated as Type ___ DCS
Type 1 DCS but is treated as Type 2 DCS
Painful, swollen node, tissue swelling are characteristics of what Type 1 DCS?
Lymphatic Bends (swelling)
Type 2 DCS is EXTREMELY SERIOUS, it can be ____ _______ or permanently disabling.
The most common site of Type 2 DCS in divers is the _____ ______.
Any neurological symptom that appears _____ ten minutes on the surface is Type 2 DCS.
Any back or trunk pain that cannot clearly be related to a painful hip or shoulder joint or that radiates or encircles an extremity must be considered _____ __ _____ by non-medical personnel and treated as such
Type 2 DCS
Six parts to a Neurological exam.
1) Mental status 2) Coordination 3) Motor (strength) 4) Cranial nerves 5) Sensory 6) Deep tendon reflexes
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