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AEMT NREMT PRACTICE
Terms in this set (132)
when the placenta lies near or over the cervix--partially or completely blocking the exit of the baby.
The second trimester is the most hazardous time because this is when the cervix initially begins to soften in preparation for dilation, which can begin separation of the overlying placenta, resulting in painless bleeding.
is the separation of the placenta before the baby is delivered. Again, life-threatening bleeding for both mother and baby.
a designation that signifies a seizure has taken place.
As expected, __________ is a condition of pregnancy with an increased risk of progressing on to convulsions (eclampsia). That is, ______________is a high-risk condition in which actual eclampsia hasn't happened...yet!
What consists of the 4 warning signs and symptoms:
hypertension (usually +30/+15 mm. Hg. above the baseline blood pressure of early pregnancy;
edema, more ominous if facial (pedal edema can be quite normal);
hyperreflexia, exhibited by very brisk patellar reflexes and ankle clonus;
proteinuria--spilling protein in the urine.
Often, preeclampsia becomes a contest between getting the baby to maturity for safe delivery before the preeclampsia becomes life-threatening to the mother. Typically, it is a risk that increases the further into the pregnancy the woman is. (It is not seen in the first or early second trimester, except with twins). Prior to maturity, preeclampsia is often temporized with _____________________ to mitigate seizure risk and bring down blood pressure.
magnesium sulfate (MgsO4)
_______________ occurs when the adrenal glands do not produce enough steroid hormones, specifically cortisol and aldosterone. This causes the slow-onset of symptoms such as:abdominal pain,
weight loss and
darkening of the skin.
occurs with prolonged exposure to excess levels of cortisol. It may present with
high blood pressure,
reddish stretch marks,
round red face ("moon facies"),
weakened muscles and bones,
is hyperthyroidism due to autoimmune antibodies that attack the TSH receptors, stimulating them to overproduce thyroid hormones. As opposed to classic hyperthyroidism, swelling of the neck and protrusion of the eyes ("exophthalmos") are seen
A _____________ is enlargement of the thyroid that can be seen in the anterior neck. Thyroxine, if in short supply in the body, does not participate in the negative feedback system in the pituitary, causing increased production of pituitary thyroid-stimulating hormone (TSH) which over-stimulates the cells of the thyroid to grow in a failed attempt at getting T4 produced.
also caused by a deficiency in thyroid hormone, causes severely stunted physical and mental growth, usually due to maternal hypothyroidism.
the swelling of the skin and underlying tissues that creates a waxy skin consistency that is also associated with hypothyroidism.
periumbilical bruising that can be present with internal hemorrhage.
bruising on the side above the hip and below the ribs that may indicate retroperitoneal hemorrhage.
GREY TURNER'S SIGN:
vomiting blood. If fresh, it can be bright red; if older (has remained in the stomach for some time before vomiting, it can assume an appearance of coffee grounds
passage of fresh blood from the anus, usually bright red, indicating recent or current lower GI bleeding.
passage of dark, black, or tarry stools from the anus, indicating old blood or bleeding from higher up the intestinal tract.
What are caused by an infection of H. pylori bacteria in the GI tract. Ulcers are formed when the protective layer of mucus that lines the GI tract is damaged. Ulcers are prone to present as emergency upper GI bleeding, especially with alcohol abuse
A __________________ occurs when a weakness in the wall of the esophagus or stomach finally ruptures. When this happens, massive bleeding and shock is likely to occur
what are blood vessels near the lower end of the esophagus that become inflamed, dilated, and eventually rupture causing significant bright red bleeding from the mouth. Alcoholism is the most common cause
Usually if the blood from the rectum is bright red--_______________--this indicates lower GI bleeding since blood from higher up would have darkened by the time it had reached the rectum.
Slow bleeds are not visible within the stool and are usually only identified by fecal tests. Such blood identified is called ________________
dark blood from the rectum indicating the likelihood of older blood from higher sources.
occurs when small sacs (diverticula) develop in the wall of the GI tract.
Lower GI bleeds are primarily caused by _______________
When the sacs/out pockets of diverticulosis get inflamed or infected, it is called _____________. The most common area for diverticula to form is in the left side of the large intestine, so pain in the left lower quadrant (LLQ) of the abdomen associated with lower GI bleeding can be a tip-off that the cause is ________________.
_______________ are a rupture of inflamed varicose veins around the anus and can also be the cause bright red lower GI bleeding, usually seen as bright red streaks on the stool.
What position should a patient with GI bleeding be placed in
A position of comfort
is a painful inflammation of the gallbladde
is inflammation of the pancreas, usually when its digestive enzymes begin to digest the organ itself.
is a serious chronic inflammatory disease of the large intestine and primarily the rectum.
serious chronic inflammatory disease that affects the colon and/or the small intestine.
is associated with generalized pelvic pain and tenderness, a purulent vaginal discharge, and/or fever. Exposure of the internal pelvis to infection and purulent (pus) exudate creates a dramatic level of inflammation.
PID: Pelvic Inflammatory Disease.
Moving in short, shuffling steps is one of the main symptoms of PID.
the fertilized egg implants in tissue other than the uterus--that is, in tissue not designed to expand with its growth, and sooner or later rupture at the implant site will occur.
What injuries are caused when the explosion occurs, a wall of air pressure quickly expands outward in all directions. Anyone close to the explosion will be struck by the pressure wave causing blunt injuries to the inside of the body, especially to hollow organs.
PRIMARY BLAST INJURIES:
What are injuries that occur immediately following the primary wave is all the debris from the explosion.
SECONDARY BLAST INJURIES:
What injuries occur if the force of the explosion is great enough, victims can be thrown to the ground (ground shock) or into other solid objects, causing additional blunt and penetrating injuries.
TERTIARY BLAST INJURIES:
These injuries occur from events that happen during the explosion and include all explosive-related injuries or illnesses not caused by primary, secondary, or tertiary mechanisms.
QUARTERNARY BLAST INJURIES:
is a sudden and sustained ventricular fibrillation triggered by a blow to the chest, resulting in sudden death, sometimes without obvious damage to the ribs or sternum.
is the filling of the lungs of the chest cavity with blood
Is a true emergency, and results from a hole in the lung or chest wall acting as a one-way valve, allowing air to enter the thorax with inspiration and preventing it from exiting with expiration.
What causes the mediastinal deviation and pressure work together to decrease venous return to the heart, dramatically dropping preload and leading to distention of the neck veins, weak pulses, and hypotension. Eventually, the dramatic mediastinal shift leads to a deviation of the trachea away from the affected side. This combination of insults to the cardio-respiratory system leads to dramatic hypoxia and obstructive shock.
dull (hypo-resonance) to percussion.There is no JVD (neck veins are flat).
tympanic (hyper-resonance) to percussion. Unless there is hypovolemia, there is JVD (distended neck veins).
What occurs when sudden and severe crushing forces on the chest results in reverse flow of blood from the right side of the heart through the superior vena cava and into the large veins of the neck and head.
The clinical exam of the patient with ________________ will reveal upper-extremity cyanosis, bilateral sub-conjunctival hemorrhage, edema, bright red face, and a swollen tongue. Impaired cerebral blood flow may result in neurologic deficits, altered mental status, altered level of consciousness or seizure.
A ___________________ is an accumulation of blood in the pericardium, resulting in compression of the heart, impaired cardiac filling and reduces cardiac output
Sets the incident objectives, strategies, and priorities and has overall responsibility for the incident.
Monitors costs related to the incident. Provides purchasing and accounting support.
Provides resources and needed services to support the achievement of the incident objectives.
Conducts operations to reach the incident objectives. Establishes the tactics and directs all operational resources.
Supports the incident action planning process by tracking resources, collecting/analyzing information, and maintaining documentation.
Provides resources and needed services to support the achievement of the incident objectives.
When an incident occurs within a single jurisdiction and without jurisdictional or functional agency overlap, the appropriate authority designates a _______________ who has overall incident management responsibility. In some cases, where incident management crosses jurisdictional and/or functional agency boundaries, the various jurisdictions and organizations may still agree to designate a _________________
single Incident Commander
As a team effort, _______________ allows all agencies with jurisdictional authority or functional responsibility for an incident to jointly provide management direction to the incident.
The ___________ interfaces with the public, media, and/or with other agencies with incident-related information needs. The _____________ gathers, verifies, coordinates, and disseminates accessible, meaningful, and timely information on the incident for both internal and external audiences.
Public information officer
The ___________________ monitors incident operations and advises the Incident Commander/Unified Command on all matters relating to operational safety, including the health and safety of emergency response personnel.
The _________________ is the incident command's point of contact for representatives of governmental agencies, jurisdictions, NGO's, and private sector organizations that are not included in the Unified Command.
is cranial nerve 1, and is the nerve that facilitates the sense of smell.
CN I: The OLFACTORY NERVE
is a paired nerve (one for each eye) known as cranial nerve 2 that transmits information to the brain from the retina at the back of the eye and facilitates sight.
CN II: The OPTIC NERVE
is cranial nerve 3 and controls some movement of the eyes.
CN III: The OCULOMOTOR NERVE
is cranial nerve 4 and has specific control over the superior oblique muscle that connects to the eye and allows for the ability to look up and down.
CN IV: The TROCHLEAR NERVE
is cranial nerve 5 and is responsible for sensation in the face and motor functions such as biting and chewing. As the name implies, it has 3 parts:
CN V: The TRIGEMINAL NERVE
is cranial nerve 6 and allows for movement of the eye outward.
CN VI: The ABDUCENS NERVE
CN VII: The ____________ is cranial nerve 7 and controls facial expression and the sense of taste.
CN VII: The FACIAL NERVE
CN VIII: The __________________ is cranial nerve 8 and is responsible for transmitting sound (via its cochlear nerve branch) and equilibrium information from the inner ear (via its vestibular nerve branch) to the brain.
CN VIII: The VESTIBULOCOCHLEAR NERVE
is known as cranial nerve 9 and is responsible (along with the facial nerve) for the sense of taste, as well as the function of swallowing. It provides the sensory stimulation for the gag reflex (CN X provides the motor portion of the gag reflex).
CN IX: The GLOSSOPHARYNGEAL NERVE
is known as cranial nerve 10 and is responsible for the sensory, motor and autonomic functions of the organs including glands, digestion, and heart rate.
CN X: The VAGUS NERVE
is known as cranial nerve 11 and controls the sternocleidomastoid muscle and the trapezius muscles that allow movement of the head.
CN XI: The ACCESSORY NERVE
is known as cranial nerve 12 and controls the muscles of the tongue and allows for tongue movement.
CN XII: The HYPOGLOSSAL NERVE
Also known as "pink eye," this is an infection of the clear covering that protects the sclera or "white" of the eye. It presents with itching, swelling, mild pain, and production of pus. This can rarely evolve to more serious infections that involve the eye itself.
Scratches to the clear covering over the pupil. Usually exquisitely painful with tearing, runny nose, and an extreme desire to rub the eye. Universally caused by trauma or a foreign object in the eye; diagnosed by staining the cornea with a special temporary dye.
: Any object in the eye, a foreign body reaction in the eye begins with a vague discomfort that can evolve to pain if the object is large/sharp or left in the eye for a long period of time. It is a common industrial accident with metalworkers, initially managed in the field with irrigation of the eye with sterile saline.
inflammation of the eyelid or swelling of the oil glands in the eyelid. Rarely may result in the eye swelling shut; most concerns are cosmetic. Must be differentiated from peri-orbital cellulitis which is a medical emergency:
a collection of blood inside the eye in the anterior chamber. Impossible to miss, there will be a clear line of blood that may be below the pupil or obstructing some of it. Can result from trauma or infections of the inner eye. In children, suspect abuse.
________________ and defect: Defects of "scotomas" in the visual field are essentially dark spots. Patients with acute scotomas will notice the defect; patients with slowly developing chronic ones may not.
is a dreaded complication of facial wounds near the eye. If the infection gets into the tissue around the eye it can rapidly disseminate to the venous system of the brain. The key sign is swelling and redness involving the area around the eye that is not limited to the eyelid
Cellulitis of the orbit:
What are defined as hard masses formed in the kidneys, typically consisting of insoluble calcium compounds
RENAL CALCULI: (kidney stones)
state of decreased blood flow TO the kidneys.
period of disease or damage from insufficient blood flow.
Intrarenal (intrinsic renal):
blockage in the urine collecting system.
As examples: atherosclerosis would be a ____renal condition, tubular necrosis would be _______renal disease, and a kidney stone would be a ________renal condition.
pre, intra, post
is the name given to the breakdown of muscle tissue due to dehydration, exertion, or prolonged period of immobility.
refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow. The plaque can burst, triggering a blood clot
It can treat fluid retention (edema) and swelling caused by congestive heart failure, liver disease, kidney disease, and other medical conditions
The main function of Nitroglycerin in the treatment of an Mi is:
Chest pain ____________ can be caused by decreases in blood supply to part of the heart muscle.
means not enough oxygenated blood is being delivered to the tissue.
In ________________, the heart fails as a pump because the muscle fibers are contracting at a random intervals and is not contracting in an orderly way as to sent blood out through the aorta.
is when there's no electricity or movement in your heart. That means you don't have a heartbeat.
How often should epi be given in cardiac arrest
1 mg IV every 3-5 minutes
is when the heartbeat contracts and pumps blood from the chambers into the arteries.
is when the heart muscle relaxes and allows the chambers to fill with blood.
______________ pulses are found in the extremities.
___________ pulses are located directly off the carotid or subclavian arteries (i.e. the neck).
Cardiac Output = ______________x _______________
Heart Rate x Stroke Volume
The ___________ pumps deoxygenated blood to the RIGHT VENTRICLE.
The ____________ pumps oxygenated blood to the LEFT VENTRICLE.
Right Atrium → [through tricuspid atrioventricular valve] → Right Ventricle → [through Pulmonary semilunar valve]
Left Atrium → [through mitral "bicuspid" atrioventricular valve] → Left Ventricle → [through Aortic (bicuspid, or semilunar) valve] → REST OF THE BODY + THE HEART ITSELF (Coronary Arteries)
This is called the "First Heart Sound," and for this reason it is designated S1. It represents the simultaneous closure of the left and right atrioventricular valves (the mitral and tricuspid valves), respectively. Since it occurs first, it represents the beginning of atrial diastole and the initiation of ventricular systole.
This is called the "Second Heart Sound," and for this reason it is designated S2. It represents the closure of the Pulmonary and Aortic Valves. (These two components separate a bit on inspiration, but a wide split indicates a conduction-type arrhythmia or hemodynamic causes.)
These are extra sounds heard different from the S1 and S2 and can be described in relation to both heart sounds. They are the result of turbulence of flow of blood within the heart chambers and are useful in diagnosing the valvular diseases that create them. (Turbulence of flow within arteries are called bruits--pronounced "BRU'-eez.")
the pressure that blood exerts against the walls of the vessel.
the force that tends to pull water into the circulatory system and prevents it from leaving.
MEAN ARTERIAL PRESSURE: determined either directly by catheterization or estimated with a formula:
Diastolic Pressure + 1/3 x (Systolic Pressure - Diastolic Pressure).
EXAMPLE: with 120/80, the mean arterial pressure is 80 + 1/3 (40) = ~93.
is a complex condition that can be summed up as "insufficient cardiac output to support healthy circulation."
is a parasympatholytic (anticholinergic): directly blocks the acetylcholine receptors
name of common nerve agent chemical in auto injector kit
(Stage I of labor is up to the time of complete cervical dilation; Stage II is from complete dilation to delivery of the infant; Stage III is from delivery of the infant to delivery of the placenta.)
_______________ is a condition related to pregnancy, thought to be a complicated immunological reaction.
____________ is infection of the endometrium--the lining of the uterus.
_________________ ("vertex") presentation is the normal head-first position of the baby during delivery and is the safest and most common presentation.
20% of all deliveries involve a single ___________ in which the umbilical cord wraps around the baby's neck once (or shoulder), noted at the time of delivery of the head.
The _______________ sends oxygen-rich blood from the fetal umbilical vein to the inferior vena cava, bypassing the liver.
The ductus venosus sends oxygen-rich blood from the fetal umbilical vein to the inferior vena cava, bypassing the liver. After birth, it atrophies to become the _____________________ is the fibrous remnant of the ductus venosus of the fetal circulation.
: the amount of air that enters the lungs during a normal breath at rest.
The average tidal volume is approximately ___________ ml in adults. The same amount of air leaves the lungs during resting exhalation.
(Tidal volume x Respiratory Rate) Defines the volume of air that either enters or exits the lungs per minute.
MINUTE RESPIRATORY VOLUME:
is defined as the ability of the lungs to stretch in response to movement of the diaphragm and chest wall. Low compliance is generally only seen in smokers and patients with severe lung diseases that slowly damage the tissue
is the blockage of the pulmonary arteries by a blood clot that has traveled there from another location in the body, most often the lower legs (
Pulmonary embolism (PE)
An imbalance in the blood flow and the air flow to the lungs,
V/Q (Ventilation/Perfusion) MISMATCH:
The __________ is the main ventilatory muscle, when it contracts it pulls itself downward creating negative pressure in the chest which causes air to rush into the lungs. When it relaxes, it is pulled upwards by the lungs natural recoil (springlike nature) which causes air to rush out of the lungs like a collapsing balloon.
Beck's triad is a set of signs that are considered the classic presentation of tamponade, consisting of
distant/muffled heart sounds,
1 ______, 2_______, 3__________
distant/muffled heart sounds,
hypotension (i.e., lower systolic, narrowing the pulse pressure).
A drop in blood pressure of greater than 10 torr is termed ___________.
deep, slow or rapid, gasping breathing, commonly found in diabetic ketoacidosis
progressively deeper, faster, breathing alternating gradually with shallow, slower breathing , indicating brainstem injury
Cheyne stroke respirations
Irregular pattern of rate and depth with sudden periodic episodes of apnea, indicating increased intercranial pressure
deep rapid respirations indicating increased intercranial pressure
central neurogenic hyperventilation
Shallow slow or infrequent breathing, indicating brain anoxia
a course rattling noise heard on inspiration, associated with inflammation, mucus, or fluid in the bronchioles
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