Lesson Plan Session Title: Human Anatomy and Physiology Time Required: 6 hours Materials: PPT Virtual man program Torso manikin Heart model Skeleton References: National EMS Education Standards Aehlert, B. (2011). Emergency Medical Technician; EMT in Action (Second Edition). New York, NY: McGraw-Hill. Pollak, A. N. (2011). Emergency Care and Transportation of the Sick and Injured (Tenth Edition). Sudbury, MA: Jones and Bartlett Publishers. Prepared By: Revised By: Chris Cruzan Chris Cruzan, Roy Ramos, Travis Smith, Jeri Price, Don Stroup Date: 12/09 Revised Date: 11/21/11, 1/13
Preparation / Set: Lecture set up Attention / Motivation: Knowledge of human anatomy is essential for the EMT student. It sets a foundation for the remainder of the course. Every call you respond to, patient you treat, report you write and every call you make to the hospital will require you to understand, speak, and practice anatomy. Objectives: At the conclusion of this lesson the learner will be able to: Cognitive: 1. Define anatomy 2. Define physiology 3. Define pathophysiology 4. Define homeostasis 5. Define the following terms: a. medial b. lateral c. proximal d. distal e. superior f. inferior g. anterior h. posterior i. midline j. midclavicular k. midaxillary l. bilateral m. dorsal n. ventral o. plantar p. palmar q. superficial r. deep s. prone t. supine u. fowlers v. semi fowlers w. lateral recumbant x. trendelenburg y. shock position 6. Describe the different types of metabolism (i.e. cellular, aerobic and anaerobic). 7. Explain the importance of water to the function of the body.
8. Name the body cavities. 9. Identify the organs and their functions that reside in each of the body cavities. 10. Name the major body systems. 11. Describe the anatomy of the following eight major body systems: a. respiratory b. circulatory c. musculoskeletal d. nervous e. integumentary f. digestive g. reproductive h. endocrine i. urinary 12. Describe the function of the previous eight major body systems. Psychomotor: None Affective: None Session Overview: Define anatomy, physiology and homeostasis Discuss the life support chain Utilizing power point photos, manikins and models provide names and functions for all of the major body systems and their components. o Skeletal o Muscular o Respiratory o Circulatory o Nervous o Integumentary o Digestive o Endocrine o Renal o Reproductive
Instructor Notes Direct instruction: Use PPT, diagrams, manikins, and/or virtual sim man to discuss the structures, components and function of each body system. Outline I. Definitions A. Anatomy-structure of the body, the parts that the body is made of B. Physiology-the function of the living body-how the parts of the body work C. Homeostasis-steady state, organ systems relying on each other to maintain a constant internal environment and perform the required functions of the entire body II. Life support chain A. Fundamental elements 1. Oxygenation a. Alveolar/capillary gas exchange i. external respiration b. Cell/capillary gas exchange i. internal respiration 2. Perfusion a. Oxygen b. Glucose c. Removal of carbon dioxide and other waste products 3. Cell environment a. Aerobic metabolism-occurs in the presence of oxygen i. high ATP (energy) production ii. byproduct of water and carbon dioxide b. Anaerobic metabolism-does not require oxygen i. low ATP (energy) production ii. byproduct of lactic acid c. Water-most abundant component of body fluid i. provides base necessary for chemical reactions, body secretions, and excretions ii. two main compartments a) intracellular-within the cells b) extracellular-outside
the cells i) intravascularplasma ii) interstitialwithin the tissues B. Issues impacting fundamental elements 1. Composition of ambient air 2. Patency of the airway 3. Mechanics of ventilation 4. Regulation of respiration 5. Ventilation/perfusion ratio 6. Transport of gases 7. Blood volume 8. Effectiveness of the heart as a pump 9. Vessel size and resistance (systemic vascular resistance) 10. Effects of acid on cells and organs III. Anatomic terminology A. Anatomical planes 1. Frontal or coronal plane a. Also known as mid-axillary b. Divides the body into anterior and posterior 2. Sagittal or lateral plane a. Also known as midline b. Divides the body into left and right 3. Transverse or axial plane-cross section a. Divides the body into superior(upper) and inferior(lower) B. Anatomic positions 1. Normal anatomic position a. Person standing, facing forward b. Palms facing forward c. Used as a common starting point so that everyone is referring to the body in the same way 2. Prone-lying face down 3. Supine-lying face up 4. Fowlers-reclining with head elevated 5. Lateral recumbent-recovery position, 6. Trendelenburg- supine on an incline with the feet higher than the head 7. Shock position- lower extremities are elevated 6 to 12 inches C. Standard descriptive anatomic terms
Explain that the thoracic and abdominal cavities are divided by the diaphragm. 1. Medial-closer to the midline 2. Lateral-further from the midline 3. Proximal-closer to the trunk or point of attachment 4. Distal-further from the trunk or point of attachment 5. Superior-nearer to the head from a specific reference point or the relationship of one structure to another a. top, above, higher than b. knee is superior to the foot 6. Inferior-nearer to the feet from a specific reference point or the relationship of one structure to another a. beneath, lower than b. the knee is inferior to the pelvis 7. Anterior-front, used more frequently than ventral 8. Posterior-rear, used more frequently than dorsal 9. Midclavicular-a sagittal plane through the middle of the clavical 10. Bilateral-on both left and right sides of a reference point-usually the midline 11. Dorsal-back, posterior 12. Ventral-front, anterior 13. Plantar-the bottom of the foot 14. Palmar-the palm of the hand 15. Superficial- closer to or on the skin 16. Deep-farther inside the body or away from the skin 17. Left-the patient s left 18. Right-the patient s right D. Movement terms 1. Flexion-the bending of a joint 2. Extension-the straightening of a joint 3. Adduction-motion toward the midline 4. Abduction-motion away from the midline IV. Anatomy and body functions E. Body cavities 1. Thoracic a. contains the heart, lungs and great vessels 2. Abdominal a. contains major organs of digestion
and excretion i. stomach, liver, spleen, pancreas, gall bladder, small and large intestines, appendix, rectum 3. Pelvic a. contains the internal reproductive organs i. male-prostate gland, seminal vesicles, vas deferens ii. female-ovaries, fallopian tube, uterus, cervix, vagina 4. Retro peritoneal space a. Contains the kidneys, ureters, urinary bladder, portion of urethra F. Body systems 1. Skeletal a. Function i. shape ii. protection iii. movement iv. production of blood cells in certain types of bones (flat and large long bones) b. Components i. skull a) houses and protects the brain b) comprised of the frontal, temporal, parietal, and occipital bones ii. face a) orbit-around the eye b) nasal-nose c) maxilla-face d) mandible (jaw) e) zygomatic arch (cheeks) iii. vertebral column a) cervical (neck) 7 b) thoracic (upper back) 12 c) lumbar (lower back) 5
d) sacral (back wall of pelvis) 5 e) coccyx (tailbone) - 4 iv. thorax a) ribs 12 pair i) attached posterior to the thoracic vertebrae ii) pairs 1 10 attached anterior to the sternum iii) pairs 11 and 12 are floating b) sternum (breastbone) i) manubrium (superior portion of sternum ii) body (middle) iii) xyphoid process (inferior portion of sternum c) scapula (shoulder blade) d) clavicle (collar bone) v. pelvis a) ilium b) iliac crest (wings) c) ischium (inferior) d) pubis (anterior) d) pubic symphysis e) acetabulum (socket for greater trochanterfemoral head) vi. upper extremities a) humerus(upper arm) b) radius c) ulna d) carpals (wrist)
See Special patient populations Activity One-providing flipcharts or large paper with crayons, markers or pens, have students draw the organs within the chest and abdominal cavities and state the function of each. e) metacarpals (hand) f) phalanges (fingers) vii. lower extremities a) femur (thigh bone) b) patella (knee cap) c) tibia (shin bone) d) fibula e) tarsals (ankle) f) metatarsals (foot) g) calcaneous (heel) h) phalanges (toes) c. Joints-where bones connect to other bones i. ball and socket a) hip, shoulder ii. hinged a) elbow, knee, fingers d. connective tissues i. ligaments-connect bone to bone ii. tendons-connect muscle to bone 2. Muscular a. Function i. shape ii. protection iii. movement b. Types i. skeletal a) movement b) voluntary ii. smooth a) organs b) involuntary iii. cardiac a) automaticity-creates its own electrical impulses b) involuntary 3. Respiratory system a. Structures i. upper airway a) nose b) mouth/teeth c) tongue/jaw
d) pharynx i) nasopharynx ii) oropharynx e) epiglottis i) leaf-shaped structure that prevents food and liquid from entering the trachea during swallowing f) larynx voice box ii. lower airway a) trachea windpide i) cricoid cartilage ring forming the lower portion of the larynx b) bronchi i) large main airways from the trachea to each lung and to each lobe of the lungs c) bronchioles i) air passages that get smaller and smaller from the bronchus to the alveoli d) alveoli i) air sacs where gas exchange occurs ii) terminal ends of the bronchioles iii. structures that support ventilation a) chest wall i. ribs ii. muscles b) pleura-two linings which creates a
potential space in between the two i) visceral-lines the lungs ii) parietal-lines the thoracic cavity iii) fluid in between allows the layers to slide over one another c) diaphragm-both a voluntary and involuntary muscle i) flexion changes size and pressure in the chest drawing air in ii) divides the thoracic and abdominal cavities c) intercostal muscles i) between ribs e) phrenic nerve f) pulmonary capillaries i) single cell thick ii) allows for exchange of oxygen and carbon dioxide b. Anatomic differences between pediatric and adult airway anatomy and respiration i. children have larger tongues proportionally ii. child airway is higher and more anterior iii. trachea is flexible-cartilage is soft iv. narrower at cricoid cartilage ring v. tissues are more sensitive more prone to swelling
vi. increased risk for FBAO vii. depend more heavily on diaphragm for breathing viii. chest wall is softer c. Function i. ventilation a) the movement of air into and out of the lungs b) adequate breathing i) adult 12-20 per minute ii) child 15-30 per minute iii) infant 25-50 per minute c) rhythm i) regular ii) irregular d) quality i) breath sounds present and equal ii) chest expansion - adequate and iii) equal effort of breathing no use of accessory muscles, no increased work of breathing e) depth (tidal volume) i) adequate rise and volume f) inadequate breathing i) outside of normal rate ranges ii) rhythm irregular
iii) diminished or absent breath sounds iv) unequal or inadequate chest rise v) increased effort of breathing vi) inadequate or shallow depth vii) skin may be pale or cyanotic, cool and clammy viii) retractions above the clavicles, between the ribs and below the rib cage ix) nasal flaring (especially in children) x) seesaw breathing in infants xi) agonal respirations ii. respiration a. external i) gas exchange in the alveoli ii) oxygen moves from alveoli to capillaries iii) carbon dioxide moves from capillaries to alveoli b. internal i) gas exchange at the cells ii) cells give up
iii) carbon dioxide to the capillaries capillaries give up oxygen to the cells iv. buffer 4. Circulatory system a. Structures i. heart a) chambers i)right atria receives blood from the veins of the body and heart, pumps oxygen poor blood to the right ventricle ii) left atria receives blood from the pulmonary veins (lungs), pumps oxygen-rich blood to the left ventricle iii) right ventricle pumps blood to the lungs iv) pumps blood to the body b) valves prevent backflow of blood i. tricuspid between right atria and right ventricle ii. pulmonary between right ventricle and pulmonary artery iii. mitral
(bicuspid)- between left atria and left ventricle iv. aortic between left ventricle and aorta c) coronary arteries i) feed the heart tissue ii)fed directly from aorta d) automaticity i) pacemaker cells sinus node, AV node, perkinje fibers ii. arterial-carries blood away from the heart a) aorta major artery from the heart, lying in front of the spine in the thoracic and abdominal cavities divides at the level of the naval into the iliac arteries b) arteries i) pulmonary carries oxygen poor blood from the right ventricle to the lungs ii) carotid major artery of the neck, supplies head with blood, pulses can be felt on either side of the neck iii) femoral major artery of the thigh, supplies lower extremities with
blood, pulses felt in the groin (crease between abdomen and thigh) iii) Radial major artery of the lower arm, pulses felt at the thumb side of the wrist iv) brachial artery of the upper arm, pulses felt on inside of arm between the elbow and the shoulder v) posterior tibialpulses felt on the posterior surface of the medial malleolus vi) dorsalis pedisartery of the foot, pulses felt on anterior surface of the foot c) arterioles smallest branch of an artery leading to the capillaries iii. capillaries tiny blood vessels that connect arterioles to venules, found in all parts of the body a) pulmonary i) exchange of oxygen and carbon dioxide b) tissue/cells i) exchange of nutrients and waste iv. venous-carries blood
toward the heart a) venae cava i) superior return blood from head and arms ii) inferior return blood from the body below the heart b) veins carry blood back to the heart i) pulmonary vein carries oxygen rich blood from the lungs to left atrium ii) vena cava carries oxygen poor blood back to right atrium c) venules smallest branch of a vein leading from the capillaries b. Blood components i. red blood cells a) carry hemoglobin which transports oxygen ii. white blood cells a) part of immune system to fight infection iii. clotting factors a) platelets b) fibrinogen iv. plasma a) the liquid portion of blood that also carries nutrients c. Function i. perfusion ii. tissue/cell gas exchange iii. reservoir iv. blood buffer
v. infections response vi. coagulation 5. Nervous system a. Structural division i. central nervous system (CNS) a) brain b) spinal cord ii. peripheral nervous system (PNS) b. Functional i. autonomic a) sympathetic i) fight or flight ii) increased heart rate, respirations, blood pressure and dilated pupils b) parasympathetic i) feed or breed ii) decreased heartrate, respirations, blood pressure and smaller pupils c. Functions of the nervous system i. consciousness a) cerebral hemispheres b) reticular activating system (center of consciousness) ii. sensory function iii. motor function iv. fight-or-flight response 6. Integumentary (skin) a. Structures i. epidermis ii. dermis iii. subcutaneous layer b. Functions of the Skin i. protection ii. temperature control 7. Digestive system
a. Structures i. esophagus ii. stomach iii. intestines a) large b) small c) colon iv. liver v. pancreas 8. Endocrine system a. Structures i. pancreas a) insulin ii. adrenal glands a) epinephrine b) norepinephrine b. Function i. control of blood glucose level ii. stimulate sympathetic nervous system a) receptors b) beta 2 stimulation 9. Renal system a. Structures i. kidneys ii. bladder iii. urethra b. Function i. blood filtration ii. fluid balance iii. buffer 10. Reproductive system a. Male i. structures a) testicles b) penis ii. functions a) reproduction b) urination c) hormones b. Female i. structures a) ovaries b) fallopian tubes c) uterus
d) vagina ii. functions a) reproduction b) hormones III. Age-related variations for pediatrics and geriatrics Summary: This information will provide a foundation which will enable the EMT to build the essentials of quality patient assessment and management. Evaluation Written: Module exam 1 Practical: None