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anatomy.json
knowledge
anatomy
how does the urinary system regulate arterial blood pressure?
urine formation renin-angiotensin system
anatomy.json
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anatomy
cns
central nervous system - responsible for thought, feeling, perception, and autonomic body functions
anatomy.json
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anatomy
pns
peripheral nervous system - responsible for transmitting information from brain to body and from body to brain
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anatomy
occipital lobe of brain function
vision, and visual memory storage
anatomy.json
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anatomy
parietal lobe of brain function
storage of tactile memories, sense of touch and texture
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anatomy
temporal lobe of brain function
hearing and smell language center storage of sound and odor memories
anatomy.json
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anatomy
frontal lobe - motor cortex function
voluntary muscle control storage of spatial memories
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anatomy
frontal lobe - prefrontal cortex function
site of abstract intellectual functions judgement and prediction of consequences
anatomy.json
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anatomy
limbic system function
basic emotions basic reflexes
anatomy.json
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anatomy
thalamus (within the diencephalon) function
relay center for sensory and motor signals, allowing prioritization of important messages
anatomy.json
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anatomy
hypothalamus (within the diencephalon) function
anatomy.json
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anatomy
introduction
the human nervous system is broken up into the peripheral nervous system and the central nervous system. the brain, along with the spinal cord, is part of the central nervous system. there are two types of cells in the brain, nerve cells, and glial cells. nerve cells send and receive messages via nerve pathways and gli...
anatomy.json
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anatomy
anatomy and physiology review
the skull protects the brain matter. the skull is made up of the cranium and the bones of the face. between the skull and the brain there are three layers of tissue. starting with the layer furthest from the brain they are the dura mater, the arachnoid mater, and the pia mater. the space between the dura mater and the ...
anatomy.json
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anatomy
recognition
though there are entire courses on the brain and brain anatomy, not all of that information is needed for ems professionals. when there is an issue with the brain, it generally presents as altered mental status (ams). sometimes the reason for the ams is obvious such as the patient was hit in the head with a baseball ba...
anatomy.json
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anatomy
aeiou-tips pneumonic
a: alcoholism or acidosis e: environmental exposure, epilepsy, electrolytes, encephalopathy, endocrine disease i: infection o: oxygen deficiency, overdose u: underdose, uremia t: trauma i: insulin, intestinal p: psychogenic, poisons s: stroke, shock
anatomy.json
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another pneumonic
oxygen: check oxygen saturation glucose: check blood sugar pump: check heart rhythm, rate, and 12 lead ecg s: structural such as stroke or trauma i: infection such as sepsis t: toxin such as drug overdose s: social or psych after all other causes have been thoroughly vetted
anatomy.json
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treatment
treatment for ams starts with identifying the cause of the altered state of the patient. from that point on treatment can go from oxygen therapy to iv dextrose to rapid sequence intubation.
anatomy.json
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anatomy
scenario
you are called to a public park where there is a young man unconscious on the ground. he appears to be in his mid-twenties and there are two empty beer cans lying next to him. the scene is safe and controlled. what do you do first? after bsi and scene safety, a primary survey should be conducted. the patient is found t...
anatomy.json
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anatomy
final thoughts
use family and friends as a resource for patients who are exhibiting ams. they can be a wealth of knowledge for when the change in a patient occurred and/or the events going on when the patient's mentation changed. they can also answer questions like has this ever happened before? using these resources are key because ...
anatomy.json
knowledge
anatomy
introduction
the nervous system is one of the most complex systems in the body. it is responsible for our ability to interpret both internal needs and environmental stimuli. due to the complexity of the nervous system, it is subdivided to understand its various responsibilities better. the first two divisions are the central and pe...
anatomy.json
knowledge
anatomy
ans overview
so…what is the ans? ans stands for the autonomic nervous system. the ans comprises the organs and muscles that are "automatic" or involuntarily controlled by our pns. what does the ans encompass? ans is responsible for involuntary functions like heart, digestive, and respiratory rates. it is broken down into two catego...
anatomy.json
knowledge
anatomy
key terms
neuron - nerve cells that act as "messengers" by sending and receiving information throughout the body. axon - a long fiber that is an extension of the neuron. it is responsible for electrical impulses that leave the neuron. dendrites - branch-like structures that are part of the neuron. they receive information from o...
anatomy.json
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anatomy
lessons and concepts
neurons are the foundational cells of the nervous system and are broken down based on their role and how they transmit information, i.e.: sensory or afferent neurons are found in the pns. they detect and relay information from both inside and outside the body to the cns. motor or efferent neurons are found in the cns. ...
anatomy.json
knowledge
anatomy
sympathetic and sympathetic divisions of the ans
the sympathetic division is responsible for the "fight-or-flight" response. increases heart and respiratory rate and prepares muscles for activation. decreases digestion. norepinephrine is the primary neurotransmitter of the sympathetic nervous system. it is both a hormone and a neurotransmitter and helps to elevate bo...
anatomy.json
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anatomy
effects of the ans on organs/organ systems
eyes: sympathetic response causes dilation of pupils to help with vision. parasympathetic response cause tear production, improves close vision, and constricts pupils. skin: sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels. cardiovascular system: medulla helps regulate arter...
anatomy.json
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anatomy
autonomic dysfunction or dysautonomia
dysautonomia or autonomic neuropathy is common though the severity and onset can vary from person to person. men and women are equally affected, and symptoms may be present at birth or develop later in life. primary dysautonomia occurs when autonomic dysfunction is the main disease process. secondary dysautonomia occur...
anatomy.json
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anatomy
treatment and management of dysautonomia
prioritize needs. patients experiencing dizziness or hypotension may be at greater risk for falling when standing and, therefore, may require additional resources to move/transport. initial actions: assess and manage airway, breathing, and circulation as needed. based on patient presentation, als may be necessary, so c...
anatomy.json
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anatomy
the peripheral nervous system
to have an even better understanding of the pns, we can break it down even further. we know that some of our organs are "involuntary" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs are innervated by the autonomic nervous system or ans. an ...
anatomy.json
knowledge
anatomy
the autonomic nervous system
the ans can again be divided into two more categories: the parasympathetic (pans) and sympathetic (sans) nervous systems.
anatomy.json
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what is the ans?
ans stands for the autonomic nervous system. the ans makes up the organs and muscles that are "automatic" or involuntarily controlled by our pns
anatomy.json
knowledge
anatomy
what does the ans encompass?
the ans is responsible for involuntary functions, including heart rate, digestive function, and respiratory rate. it is broken down into two categories: the parasympathetic and sympathetic nervous systems
anatomy.json
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the parasympathetic nervous system
the parasympathetic nervous system is responsible for the relaxation - or slowing - of these involuntary processes
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anatomy
the sympathetic nervous system
the sympathetic nervous system is responsible for the "fight-or-flight" response, meaning it "speeds up" many involuntary processes
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anatomy
neuroglial cells
there are four types of neuroglial cells: astrocytes, ependymal cells, microglial cells, and oligodendrocytes
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nerve impulses
nerve impulses are electrical signals that tell neurons to react to a stimulus. for example, you naturally withdraw from painful stimuli
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membrane potential
membrane potential is the difference between the electrical charge on the inside versus the outside of the cell
anatomy.json
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depolarization
depolarization (first half of action potential) occurs when potassium leaves the cell, and sodium and calcium enter the cell.
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repolarization
repolarization (second half of action potential) occurs when sodium and calcium leave the cell and potassium enters the cell.
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impulse transmission
impulse transmission occurs in two different ways depending on how fast or slow the messages need to be sent and received
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anatomy
distribution pattern of spinal nerves
sensory pathways. the posterior column pathway - also called the dorsal columns medial lemniscus pathway, is responsible for touch and pain sensations; it also allows for the conscious sensation of where the body is in space
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motor pathways
pyramidal system - travel through pyramids of the medulla, responsible for the voluntary control of muscles
anatomy.json
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anatomy
sympathetic division of the autonomic nervous system
"fight-or-flight" increases heart rate and respiratory rate and prepares muscles for activation
anatomy.json
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anatomy
parasympathetic division of the autonomic nervous system
"rest & digest" promotes digestion. decreases heart rate and allows for a restful state
anatomy.json
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anatomy
effects of the sympathetic and parasympathetic divisions of the ans
eyes. the sympathetic response causes dilation of pupils to help with vision. the parasympathetic response cause tear production, improves close vision, and constrict pupils
anatomy.json
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anatomy
autonomic dysfunction aka dysautonomia
damage to nerves of the ans may result in malfunction in the pans, sans, or both
anatomy.json
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anatomy
symptoms
bladder control and sensation issues. frequent urination or incontinence. difficulty regulating temperature, heart rate, and blood pressure
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anatomy
treatment and management
prioritized needs: patients who are experiencing dizziness or hypotension may be at greater risk of falling when standing; therefore, you may need additional resources to help when moving the patient
anatomy.json
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anatomy
scenario
dispatch info: you are dispatched to the local high school for a 16-year-old female who had a syncopal episode.
anatomy.json
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anatomy
key takeaways
the initial presentation of the patient was stable, with no indications of acute distress. the patient's recent history during volleyball practice and the events surrounding her syncopal episode prompted ems involvement.
anatomy.json
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anatomy
tips and tricks
body functions that take place without any thought are "automatic" and therefore controlled by your autonomic nervous system
anatomy.json
knowledge
anatomy
the autonomic nervous system (ans)
to have an even better understanding of the pns, we can break it down even further. we know that some of our organs are "involuntary" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs are innervated by the autonomic nervous system or ans. an ...
anatomy.json
knowledge
anatomy
the ans and its categories
the ans can again be divided into two more categories: the parasympathetic (pans) and sympathetic (sans) nervous systems.
anatomy.json
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anatomy
types of neuroglial cells
there are four types of neuroglial cells: astrocytes, ependymal cells, microglial cells, and oligodendrocytes microglia - immune cells for the cns. they target invaders and remove debris within the cns astrocytes - specialized glial cells that are the most abundant in the cns ependymal cells - secrete cerebrospinal flu...
anatomy.json
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anatomy
neurons
neurons, the foundational cells of the nervous system, are broken down based on their role within the nervous system and how they transmit information. for example: sensory neurons, also known as afferent neurons, are found in the pns and respond to sensory information inside and outside the body. they are responsible ...
anatomy.json
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anatomy
nerves
nerves are groupings of neurons that direct a signal to a target location sensory nerves are responsible for your ability to sense the world around you through sight, taste, sound, touch, and smell motor nerves send signals from the cns to the muscles in the body to prompt movement mixed nerves can send both sensory an...
anatomy.json
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anatomy
nerve tracts
nerve tracts are found in the cns, more specifically in the white matter of the brain, which is located deep to the grey matter and also makes up most of the brain tissue nerve tracts are classified into three categories based on what they connect commissural fibers connect the right and left hemispheres of the brain a...
anatomy.json
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anatomy
action potential
depolarization (first half of action potential) occurs when potassium leaves the cell, and sodium and calcium enter the cell. this action potential causes normal body functions to occur, such as a heartbeat repolarization (second half of action potential) occurs when sodium and calcium leave the cell and potassium ente...
anatomy.json
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anatomy
effects of the sympathetic and parasympathetic divisions of the ans on various organs and systems of the body
eyes the sympathetic response causes dilation of pupils to help with vision the parasympathetic response cause tear production, improves close vision, and constrict pupils skin the sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels
anatomy.json
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anatomy
cardiovascular system
the medulla helps regulate arterial pressure through sympathetic and parasympathetic nerves baroreceptors are part of a negative feedback system that helps regulate arterial pressure. there are two sites for arterial baroreceptors carotid sinus is located at the bifurcation of the external and internal carotids. small ...
anatomy.json
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anatomy
symptoms of dysautonomia
bladder control and sensation issues frequent urination or incontinence difficulty regulating temperature, heart rate, and blood pressure orthostatic hypotension syncope fatigue vertigo forgetfulness increase or lack of sweating chest pain shortness of breath migraines with possible noise and light sensitivity cardiac ...
anatomy.json
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anatomy
ongoing treatment/treatment goals
iv/io access may be necessary for administering medications to help with blood pressure or heart rate continual cardiac monitoring (4 or 12-lead) etco2 and/or spo2 monitoring maintain/improve vital signs to within normal limits
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transport considerations
consider facilities with cardiac and stroke capabilities when patients present with acute cardiac disturbances or neurological deficits patients with difficult airways may require transport to the closest facility
anatomy.json
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anatomy
introduction
a&p of the upper and lower airway
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anatomy
anatomy of the upper airway
the upper airway serves as a passageway for food, liquids, and air. it also heats, humidifies, and filters the air. the upper airway provides a path for coughing, swallowing, and speech.
anatomy.json
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anatomy
structures of the upper airway
pharynx: refers to the mouth, nasal cavity, and portion of the upper airway which all connect and lead to the esophagus and trachea. oropharynx: mouth and throat. nasopharynx: nasal cavity leading to throat. laryngopharynx: found beneath the hyoid bone, branching area where food and air pass to either the esophagus or ...
anatomy.json
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common airway terms
epiglottic vallecula: depression at the root of the tongue between tongue and epiglottis. traps food, liquids, and saliva to prevent the swallowing reflex. epiglottis: flap of elastic cartilage connected at the root of the tongue. responsible for opening and closing the entrance to the windpipe as a means to prevent as...
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movement of air
air passes from the upper airway and into the lower airway. it is then directed into one of two main airways, the right and left main bronchi. next, it will move into smaller passages called bronchioles, and finally into the terminal ends of the airway. the lower airway terminates in extremely small sacks where gas exc...
anatomy.json
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anatomy
gas exchange
gas exchange occurs by diffusion, which is molecules moving from high concentrations to low concentrations. for example, when blood reaches the pulmonary capillaries, it contains minimal amounts of oxygen and high amounts of carbon dioxide. the alveoli contain high amounts of oxygen and minimal amounts of carbon dioxid...
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lower airway structures
trachea: wind-pipe or a cartilaginous structure leading from the larynx down to the carina where it further splits into the lungs. carina: cartilaginous structure between the trachea and primary bronchi, produces a branching area separating the left and right lung. bronchus: larger airways composed primarily of cartila...
anatomy.json
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physiology
remember that the main goal of the respiratory system is gas exchange. a disruption in either the movement of air (ventilation) or gas exchange (respiration) will result in poor or inadequate perfusion. perfusion refers to an adequate volume of oxygen in the bloodstream and the ability of that oxygen to reach vital tis...
anatomy.json
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anatomy
common physiology terms
ventilation: process of moving air in and out of the lungs. respiration: process of gas exchange across the alveoli. tidal volume: amount of airway moved in or out of the lungs in one breath, or with each respiratory cycle (inhalation or exhalation). respiratory rate: count of breaths taken per minute. perfusion: passa...
anatomy.json
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anatomy
introduction
anatomy and physiology overview of the cranial nerves. the human brain has 12 cranial nerves. there are three general types of cranial nerves, afferent nerves, efferent nerves, and mixed nerves. afferent nerves receive sensory input from the body and move it to the central nervous system (cns) and brain. efferent nerve...
anatomy.json
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cranial nerves
i: olfactory nerve. (sensory) receives sensory input from the molecules in the nose and sends neural messaging back to the olfactory bulb. ii: optic nerve. (sensory) receives sensory input from eyes via nerves that meet at the optic chasm. input is sent back to the opposite side of the brain from the eye the sensory in...
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prehospital assessment and treatment
in patients with suspected cranial nerve damage or head injury, a prehospital crania nerve assessment can be very useful for helping make a clinical impression of the injury and track changes in the patient's neurologic deficits. the cranial nerve assessment is less useful for massive head trauma or an obvious stroke w...
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cranial nerve assessment
pupils: use penlight to confirm pupillary response. eyes: test eye motion to all fields of direction. eyelids: have the patient close their eyes and try to keep them closed. using your fingers lightly, try to push the eyelids up so the eyes are open. they should not be able to open their eyes. ears: compare hearing in ...
anatomy.json
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scenario
you are dispatched to some sort of accident on the road. when you arrive, it looks like an electric scooter had hit a pothole at around 20 mph and the rider is sitting on the curb. there is a helmet sitting next to the rider with a solid dent in it. when making patient contact, the patient is a/o x4, gcs 15, but very s...
anatomy.json
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anatomy
final thoughts
the brain is the most important part of the body and also one that is so protected it can be hard to assess. due to this, conducting cranial nerve assessments can be an extremely valuable resource to assess brain injury, but also track changes in condition of patients with a brain injury. consistent assessments of the ...
anatomy.json
knowledge
anatomy
introduction
the nervous system is one of the most complex systems in the body. it is responsible for our ability to interpret both internal needs and environmental stimuli. due to the complexity of the nervous system, it is subdivided to understand its various responsibilities better. the first two divisions are the central and pe...
anatomy.json
knowledge
anatomy
ans overview
so…what is the ans? ans stands for the autonomic nervous system. the ans comprises the organs and muscles that are "automatic" or involuntarily controlled by our pns. what does the ans encompass? ans is responsible for involuntary functions like heart, digestive, and respiratory rates. it is broken down into two catego...
anatomy.json
knowledge
anatomy
key terms
neuron - nerve cells that act as "messengers" by sending and receiving information throughout the body. axon - a long fiber that is an extension of the neuron. it is responsible for electrical impulses that leave the neuron. dendrites - branch-like structures that are part of the neuron. they receive information from o...
anatomy.json
knowledge
anatomy
lessons and concepts
neurons are the foundational cells of the nervous system and are broken down based on their role and how they transmit information, i.e.: sensory or afferent neurons are found in the pns. they detect and relay information from both inside and outside the body to the cns. motor or efferent neurons are found in the cns. ...
anatomy.json
knowledge
anatomy
sympathetic and sympathetic divisions of the ans
the sympathetic division is responsible for the "fight-or-flight" response. increases heart and respiratory rate and prepares muscles for activation. decreases digestion. norepinephrine is the primary neurotransmitter of the sympathetic nervous system. it is both a hormone and a neurotransmitter and helps to elevate bo...
anatomy.json
knowledge
anatomy
effects of the ans on organs/organ systems
eyes: sympathetic response causes dilation of pupils to help with vision. parasympathetic response cause tear production, improves close vision, and constricts pupils. skin: sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels.
anatomy.json
knowledge
anatomy
autonomic dysfunction or dysautonomia
dysautonomia or autonomic neuropathy is common though the severity and onset can vary from person to person. men and women are equally affected, and symptoms may be present at birth or develop later in life. primary dysautonomia occurs when autonomic dysfunction is the main disease process. secondary dysautonomia occur...
anatomy.json
knowledge
anatomy
treatment and management of dysautonomia
prioritize needs. patients experiencing dizziness or hypotension may be at greater risk for falling when standing and, therefore, may require additional resources to move/transport. initial actions: assess and manage airway, breathing, and circulation as needed.
anatomy.json
knowledge
anatomy
scenario
dispatch info - you are dispatched to the local movie theater for a 28-year-old pregnant female who had a syncopal episode. scene info - when you arrive, her friends wave you into a theatre and tell you that after the movie, your patient passed out almost immediately upon standing up to exit.
anatomy.json
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anatomy
key takeaways
the initial presentation of the patient was that she was stable and in no acute distress. event and patient history, specifically her pregnancy are vital to painting the complete picture of what is possibly going on with this patient.