Anatomy and Physiology for the EMT-Basic

1. Anatomy and Physiology for the EMT-Basic

2. Learning Objectives • Identify the following terms: medial, lateral proximal, distal, superior, inferior, anterior, posterior, midline, right, left, bilateral, mid-clavicular, mid-axillary • Describe the anatomy and function of the following major body systems: respiratory, circulatory, musculoskeletal, nervous, and endocrine.

3. Introduction • As a EMT-B you will be faced with patients that complain of a wide variety of illnesses and injuries. • To adequately asses and treat the sick or injured patient, the EMT-B must have a basic knowledge of where the structures of the body are (anatomy) and how they work (physiology).

4. You have to be able to speak the language…

5. 4-1.jpg Anatomical Terms • Normal anatomical position • The position that a patient is in when determining terms. • Person standing, facing forward • Palms facing forward Looks something like this:

6. Anatomical Planes • Midline • Imaginary line drawn vertically through the middle of the body (Nose to umbilicus (belly button)) that divides the body into right and left • Mid-axillary • Imaginary line drawn vertically from the middle of the armpit to the ankle dividing the body into anterior and posterior (front and back).

7. Proximal Distal Anatomical Planes Midline Lateral Medial • Medial • Toward midline • Lateral • Away from midline • Proximal • Toward center of the body • Distal • Away from center of body Right Left Mid-clavicular

8. Anatomical Planes Mid-axillary line • Superior • Means something higher (closer to the head) • Inferior • Lower, away from head • Anterior • Front • Posterior • Back Anterior (ventral) Posterior (dorsal) Superior Inferior

9. Anatomical Planes • Right and Left • Your patient’s right and left! • Mid-clavicular • Line that runs down the middle of the clavicle (the nipple of the breast usually is mid-clavicular) • Bilateral • Both sides • Dorsal • Back side, or top (dorsal fin of fish) • Ventral • Opposite of Dorsal, front side

10. Dorsal Having a bad day Ventral

11. Anatomical Planes-Descriptive Terms • Plantar • NO, not one who plants…but rather the bottom of the foot • Palmar • Gee, Mr. Obvious…I never made the connection • Supine • Lying down on back • Prone • Lying down on front • Fowler’s • Seated, head up- 45-60 degrees

12. Anatomical Planes-Descriptive Terms • Trendelenburg • Supine, feet elevated, head down • Shock position • Modified Trendelenburg, supine with legs elevated 12-16” • Lateral recumbent • “recovery position”, laying on side

13. Body Systems

14. MusculoskeletalSystem

15. Musculoskeletal System • Function • Gives body shape • Protects vital organs • Provides for body movement • Components • Bones, joints, connective tissues and muscles

16. Bones • Skull-houses and protects the brain • Face • Orbit • Nasal bone • Maxilla • Mandible • Zygomatic bones (cheeks) • Spinal Column (33 vertebrae) • Cervical (neck) 7 vertebrae • Thoracic (upper back) 12 vertebrae • Lumbar (lower back) 5 vertebrae • Sacral (back wall of pelvis) 5 vertebrae • Coccyx (tail bone) 4 vertebrae

17. Bones • Thorax • Ribs • 12 pairs • Attached posterior to the thoracic vertebrae • Pairs 1-10 attached anterior to the sternum • Pairs 11 and 12 are “floating” • Sternum (breast bone) • Manubrium (superior portion of sternum) • Body (middle part) • Xiphoid process (inferior portion of sternum)

18. Bones • Pelvis • Iliac crest (wings of pelvis) • Pubis (anterior portion of pelvis) • Ischium (inferior portion of pelvis) • Lower extremities • Greater trochanter (ball) and acetabulum (socket of hip bone) make up hip joint • Femur (thigh) • Patella (kneecap) • Tibia (shin, lower leg) • Fibula (lower leg) “tell a little fib”

19. Bones • Medial and lateral malleolus are surface landmarks of ankle joint • Tarsals and metarsals • Calacneus • Phalanges • Upper extremities • Clavicle (collar bone) • Scapula (shoulder blade) • Acromion (tip of shoulder) • Humerus (superior portion of upper extremity) • Olecranon (elbow)

20. Bones • Radius (lateral bone of the forearm) • Ulna (medial bone of the forearm) • Carpals (wrist) • Metacarpals (hand) • Phalanges

21. Joints • Where bones connect to other bones • Ball and socket • Hinge • Fixed

22. Now it’s your turn!

23. Connective Tissue • Ligaments • Hold joints together • Tendons • Attach muscle to bone

24. Muscle Types • Voluntary (skeletal) • May also attach muscles to bones • Form major muscle mass in the body • Under control of the nervous system and the brain; can be contracted and relaxed by the will of the patient • Responsible for movement

25. Muscle Types • Involuntary (smooth) • Found in the walls of the tubular structures of the gastrointestinal tract and the urinary system as well as blood vessels and bronchi • Control the flow of blood through these structures • Carry out automatic muscular functions of the body • Patients have no direct control over these muscles • Respond to stimuli such as stretching, heat and cold

26. Types of muscle • Cardiac • Found only in the heart • Involuntary muscle • Has its own supply of blood through the coronary artery system • Can tolerate interruption of blood supply for only very short time periods • Automaticity-has the ability to contract on its own

27. Respiratory System

28. Respiratory System • Nose and mouth • Pharynx • Oropharynx • Nasopharynx • Epiglottis-leaf shaped structure that prevents food and liquid from entering trachea during swallowing • Trachea (windpipe) • Cricoid cartilage-firm cartilage ring forming the lower portion of the larynx

29. Respiratory System • Larynx (voice box) • Bronchi-two major branches of the trachea to the lungs which subdivide into smaller passages ending in the alveoli • Lungs

30. Respiratory System • Diaphragm • Inhalation (active) • Diaphragm and intercostal muscles contract increasing size of the thoracic cavity • Diaphragm moves slightly downward, ribs move upward/outward • Air flows into lungs • Exhalation • Diaphragm and intercostal muscles relax decreasing the size of the thoracic cavity • Diaphragm moves upward, ribs move downward/inward • Air flows out of the lungs

31. Respiratory Physiology • Alveolar/capillary exchange • Oxygen right air enters the alveoli during each inspiration • Oxygen poor blood in the capillaries pass into the alveoli • Oxygen enters the capillaries as carbon dioxide enters the alveoli • Capillary cellular exchange • Cells give up carbon dioxide to the capillaries • Capillaries give up oxygen to the cells

32. Infant and Child considerations • Mouth and nose are smaller and more easily obstructed • Pharynx • tongues take up proportionally more space than adults • Trachea • Narrower, more easily blocked • Softer and more flexible • Diaphgram • chest wall is softer, depend more on diaphragm for breathing

33. Cardiovascular System

34. Circulatory (Cardiovascular) • Heart • Structure/function • Atrium • Right-receives blood from the veins of the body and heart, pumps oxygen poor blood into right ventricle • Left-receives blood from the pulmonary veins (lungs), pumps oxygen right blood to left ventricle • Ventricle • Right-pumps blood to lungs • Left-pumps blood to body • Valves-prevent backflow of blood

35. Cardiac Conduction System • Heart is more than a muscle • Specialized contractile and conductive tissue in the heart • Electrical impulses • Automaticity

36. Arteries • Carry blood away from the heart to rest of the body • Major arteries • Coronary arteries-supply the heart with blood • Aorta-major artery supplies other vessels with blood, originates from the heart lying in front of the spine in the thoracic and abdominal cavities and divides at the level of the navel into the iliac arteries

37. Arteries • Pulmonary-originates at right ventricle and carries oxygen poor blood to the lungs • Carotid-major artery of the neck, supplies head with blood, pulsations can be palpated on either side of the neck • Femoral-major artery of the thigh, supplies groin and lower extremities with blood, pulsations can be palpated in groin area • Radial-major artery of the lower hand, pulsations can be palpated at the wrist thumb side

38. Arteries • Brachial-an artery of upper arm, pulsations on inside of the arm between elbow and shoulder, used with determining blood pressure • Posterior tibial-pulsations can be palpated on the posterior surface of the medial malleoulus • Dorsalis pedis-an artery in the foot, pulsations can be palpated on the anterior surface of the foot • Arterioles are the smallest branch of an artery leading to capillaries

39. Capillaries • Tiny blood vessels that connect arterioles to venules • Found in all parts of the body • Allows for the exchange of nutrients and waste at the cellular level • Venules are the smallest branch of the veins leading to the capillaries

40. Veins • Carry blood back to the heart • Major veins: • *Pulmonary vein-carries oxygen rich blood from the lungs to the left atrium • Venae cavae • Superior • Inferior • Carries oxygen poor blood back to right atrium

41. Blood composition • Red blood cells • Give blood their color • Carry oxygen to organs • Carry carbon dioxide away from organs • White blood cells-part of the body’s defense against infections • Plasma-fluid that carries blood cells and nutrients • Platelets-essential for the formation of blood clots

42. Physiology • Pulse • L ventricle contracts, sending a wave of blood through arteries • Can be palpated anywhere an artery passes near the skin surface and over a bone • Peripheral pulses • Radial • Brachial • Posterior tibial • Dorsalis pedis • Central • Carotid • Femoral

43. Blood Pressure • Systolic-the pressure exerted against the walls of the artery when the L ventricle contracts • Diastolic-pressure exerted against the walls of the artery when L ventricle is at rest

44. Inadequate circulation/shock • Hypoperfusion resulting in profound depression of vital processes of the body • Characterized by these signs and symptoms: • Pale, cyanotic (blue colored), cool, clammy skin • Rapid, weak pulse • Rapid, shallow breathing • Restlessness, anxiety or mental dullness • Nausea and vomiting

45. Perfusion • Defined: circulation of blood through an organ • Perfusion is the delivery of oxygen and other nutrients to the cells of all organ systems and the removal of waste products • Hypoperfusion is the inadequate circulation of blood through an organ

46. Hypoperfusion/Shock • Reduction in total blood volume • Subnormal temperature

47. Nervous System

48. Nervous system • Controls the voluntary and involuntary activity of the body • Components • Central nervous system • Brain-located within cranium • Spinal cord-located in spine from brain to lumbar vertebrae • Peripheral nervous system • Sensory nerves carry info from body to brain and spinal cord • Motor nerves carry info from the brain and spinal cord to the body

49. Endocrine System

50. Endocrine System • Secretes chemicals (hormones), responsible for regulating body activities such as reproductive changes and regulation of metabolism • Organs include the hypothalamus in the brain, pituitary gland, thyroid and parathyroid glands, adrenal glands, and parts of the pancreas