Anatomy and Physiology for the EMT-Basic

1. Anatomy and Physiology for the EMT-Basic James Sargent, NREMT-B, EMSI

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. 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. Anatomical Planes Medial Toward midline Lateral Away from midline Proximal Toward center of the body Distal Away from center of body

8. Anatomical Planes Superior Means something higher (closer to the head) Inferior Lower, away from head Anterior Front Posterior Back

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

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

51. DigestiveSystem

52. Gastrointestinal System Responsible for the digestion of food Chemicals aiding in digestion produced by liver, gallbladder and parts of pancreas

53. Genitourinary system Organs include reproductive organs and those organs responsible for the production and secretion of urine Located close together in abdomen and pelvis because of shared functions

54. Skin Integumentary system Protects body from environment, bacteria, and other organisms Helps regulate body temperature Senses heat, cold, touch, pressure, and pain-transmits this information to brain and spinal cord

55. Layers of the Skin Epidermis-outermost layer of skin Dermis-deeper layer of skin containing sweat and sebaceous glands, hair follicles, blood vessels, and nerve endings Subcutaneous layer

56. ANYQUESTIONS ???