Emergency Topic Notes

Triage
THE ROLE OF TRIAGE
 Triage is a system of sorting
o Based on giving treatment first to patients with most critical issues
 Triage nurse performs brief assessment before classing patient
 Patients not always taken to treatment in order of arrival

CELL THEORY
 The cell theory consists of three parts
o 1. All living things are made of cells (plants, animals, fungi,
bacteria etc.)
o 2. Cells are the smallest building blocks of life
o 3. All cells come from pre-existing cells
 Robert Hook was the first person to observe cells under a microscope (he
observed cork)
 He named them cells after the organisation/shape which looked like small
blocks
 Robert Brown discovered the nucleus of cells
 Schleiden and Schwann understood that cells were the smallest building
blocks of living things
MITOSIS
 Mitosis is a form of cell division
o Produces new body cells for growth and repair
 One cell produces two new ones
 Each cell is identical to the “parent’ cell
 There are 46 chromosomes in a human
 Before mitosis each chromosome within the cell is doubled so it has 2
chromatids
 Then chromatids are divided into two sides of the cell
 Cell splits into 2 new cells with normal amount of chromosomes
 Mitosis does not produce sexual cells (ie. Not sperm or ovules)
o This is produced through meiosis
 New cells are called daughter cells
 Cancer occurs due to uncontrolled mitosis
CELL REQUIREMENTS
 Cellular respiration occurs in all cells in your body
o Inside mitochondria
 Glucose and oxygen react to form water, carbon dioxide and energy
 RESPIRATION ≠ BREATHING
o Respiration is a chemical reaction that occurs in mitochondria
o Breathing is performed by multicellular organisms that have
lung/gills to exchange gases (taking in oxygen, expelling carbon
dioxide)
o glucose + oxygen  carbon dioxide, water, energy (ATP)
 Cells require:
o Oxygen
o Glucose
o Water
o Vitamins + minerals
o Removal of carbon dioxide
o Removal of nitrogenous wastes
CELL ORGANISATION
 Groups of similar cells make up tissue (skin cells make skin, liver cells
make the liver tissue etc.)
 Tissues grow together to make organs
 A group of organs working together is called a system (e.g. excretory
system, digestive system, skeletal system etc.)
  Group of systems makes an organism
 Human body systems:
o Digestive system – allows processing of food and releases its
energy into body
o Circulatory system – pumps blood around body, carries oxygen
and nutrients to cells, carbon dioxide and waste away from them
o Respiratory system - oxygen into blood and expels carbon dioxide
from it
o Skeletal system – protects organs and allows movement
 Systems work together to allow cell requirement and removal of waste ie.
Function of the body
Cardiovascular System
The role of the cardiovascular system is to distribute and carry nutrients,
hormones, and oxygen around your body and well as remove waste products.
 Circulatory means something going around in a circle/loop
 Blood circulates nutrients, oxygen and hormones around the body
 Oxygen enters the blood from the lungs
 There are two loops in the circulatory system
o 1 takes blood from the heart and distributes it around the body
(arteries)
o 1 takes blood back to the heart (veins)\
 It takes 20 seconds for one red blood cell to go around the body
 Your heart is the size of your fist
 Blood enters form the body into the right side of the heart
 Blood exits around your body from the left side of the heart
 Each atrium is separated from its ventricle by a valve, which close as the
ventricle contracts to prevent blood flowing backwards
o When the ventricles contract they pump blood into the arteries
 The pulmonary artery goes from the right ventricle to the lungs
 The pulmonary vein goes from the lungs back into the left atrium
 Arteries are the big, structured
o Thick walls
o Round
 Veins are smaller than arteries
o Thin walls
o Irregular shape
 Capillaries are tiny
o One cell thick walls
o roundish
BLOOD CELLS
 Plasma:
o 55% of blood
o Contains water, proteins, gases, nutrients, waste, mineral
 Fibrinogen (found in plasma)
o Clots blood
 Red blood cells
o 45% of blood
o No nucleus
o Cytoplasm with haemoglobin
o Function: carries oxygen and carbon dioxide
 White blood cells
o Less than 0.1% of blood
o Has nucleus
o Colourless cytoplasm
o Function: defence against disease
 Platelets
o Less than 0.01% of blood
o Function: aids in blood clotting
DISEASES RELATED TO THE HEART
 High blood pressure
o Makes the heart work harder than normal, causes it to enlarge and
weaken
o No specific symptoms/warning signs
o Blood pressure = pressure of blood against walls of arteries
 Smoking
o Risk of heart attack if you’re a smoker is more than 2x that of non-
smokers
o Second hand smoking also raises risk of heart disease and stroke
o Nicotine and carbon in tobacco smoke reduce amount of oxygen in
the blood
 High cholesterol
o Risk of Coronary Heart Disease rises as blood cholesterol increases
o No symptoms
 o Cholesterol = soft, waxy substance found among fats in blood
stream
o When too much unhealthy fat (typically from animal products) is
eaten, the lipids deposit onto the walls of the arteries and hardens,
causing the lumen to become smaller (hole in the centre of the
vessel) and therefore blood pressure increase
o Can cause burst arteries = stroke
 Physical inactivity and obesity
o Increase risk of CHD
o People with too much excess body fat are at higher risk for health
problems
STEM CELLS
 A stem cell is a cell that can become any other type of cell in the body
(e.g. skin, liver, bone etc.)
 They are found in your bone marrow
 When babies are born they have a very high amount of stem cells, this
number decreases as age increases
 Adults have tissue-specific stem cells, which are the same but can only
become different cells within the tissue they came from
 Stem cell therapy is being developed as a potential alternative to
transplant surgery
Digestive System
The role of the digestive system is to break down food into parts small enough
for your body to absorb and use, and to remove waste products.
 Letter on Organ Function
diagram

A Oral cavity Physical breakdown: Bites and chews food into smaller pieces
Chemical breakdown: Breaks down starch into simple sugars (by
enzymes in saliva)

B Squeezes the food down from the mouth to the stomach by muscular
Oesophagus contractions called peristalsis

C stomach P: Churns and mixes food

C: Releases enzymes that begin to break down proteins
Releases hydrochloric acid (low pH) which provides the correct
environment for the enzymes and destroys unwanted bacteria

D C: releases enzymes that digest food in the small intestine

pancreas Produces insulin to control blood sugar levels
Neutralises the effect of acid from the stomach (higher pH)

E C: releases enzymes that (with pancreatic enzymes and bile) complete

Small intestine the digestion of food (very first part only)
food is absorbed into the bloodstream from the small intestine

F Large intestine Water and minerals are absorbed into the bloodstream

G controls glucose levels and stores some glucose when converted into
liver glycogen
P: makes bile which breaks up the lipids into smaller molecules so that
they can be digested by enzymes
breaks down toxins

H stores bile
gallbladder

1. Teeth perform physical digestion and break up pizza into smaller pieces
2. Saliva begins to chemically digest the pizza (saliva comes from salivary glands)
3. Pizza travels down oesophagus in the form of a bolus (over the epiglottis which stops
food going down the windpipe)
4. Pizza goes into stomach where enzymes break molecules into simpler forms, making
it easier to chemically digest
5. Food is churned up physically in stomach
6. Food goes through duodenum where bile
7. (+enzymes) is added from the gallbladder (chemical digestion)
8. Food goes through small intestines where nutrients are absorbed
9. Food goes through large intestine where waste and water is removed
10. Waste is temporarily stored in rectal cavity
11. Waste goes out from the anus as poo

CHEMICAL VS PHYSICAL DIGESTION

 Physical digestion
o When food is mechanically broken down to smaller pieces
o E.g. in your oral cavity by your teeth
  Chemical digestion
o When gastric acid, bile and enzymes break up complex, long food
molecule chains into smaller and simpler chains, making it easier
to digest
o E.g. in your stomach by the gastric acid
STOMACH ULCERS
 Barry Marshall wanted to prove that stomach ulcers weren’t caused by
stress
o After researching he realised they are caused by an infection of
Helicobacter pylori bacteria
o He drank some of the bacteria and within days had stomach ulcers
Respiratory System

The role of the respiratory system is to inhale and distribute oxygen into the
blood vessels and remove waste gases.

After entering your body, the air moves past the nasal or oral cavity, through the pharynx and
larynx. At the top of the larynx is the epiglottis. The epiglottis is a flap of tissue that acts as a switch
to either allow air into the lungs or to allow food into the stomach. The larynx also includes the vocal
folds/cords, where air rushing past the extremely rapid opening and closing of the vocal folds causes
noise.

Then the air moves into a tube ringed with cartilage called the trachea which is more commonly
known as the windpipe.
This divides into two narrower tubes called the bronchi (singular: bronchus). Each of these tubes leads
to a lung. Inside the lung, each tube divides into many smaller tubes called bronchioles. These branch
out, getting smaller and smaller until they end at thousands of tiny air sacs called alveoli.
In the alveolus there is a high concentration of oxygen, and a low concentration of carbon dioxide.
In the blood capillaries nearby, there is a low concentration of oxygen and a high concentration of
carbon dioxide.
A process called DIFFUSION occurs - this is where substances move from high concentration to low
concentration so…
The high concentration oxygen in the alveolus moves to the low concentration in the capillary blood.
The low concentration in the capillary blood moves into the low concentration carbon dioxide in the
alveolus.
This means oxygen enters the body and carbon dioxide exits the body.

There are many small blood vessels called capillaries that run over the surface of the alveoli. The walls
of the alveoli and the walls of the capillaries are very close. Oxygen passes through these walls from
the alveolus into the blood. Carbon dioxide goes in the opposite direction.

In the alveolus there is a high concentration of oxygen, and

a low concentration of carbon dioxide.
In the blood capillaries nearby, there is a low concentration
of oxygen and a high concentration of carbon dioxide.
A process called DIFFUSION occurs - this is where
substances move from high concentration to low
concentration so…
The high concentration oxygen in the alveolus moves to
the low concentration in the capillary blood.
The low concentration in the capillary blood moves into
the low concentration carbon dioxide in the alveolus.
This means oxygen enters the body and carbon dioxide
exits the body.
Breathing in:
 To take air in, the diaphragm contracts and flattens and the muscles around the ribs
pull the rib cage outwards.
 Since the lungs are attached to the diaphragm and ribs, the lungs are pulled outwards
and downwards i.e. they increase in size. This means that there is now a lower
pressure inside the lungs than there is outside the lungs. Thus, particles from outside
the lungs rush to enter the lungs so that the pressure can be equalised. (Remember the
egg experiment where when we caused a lower pressure inside a conical flask, there
was so much pressure from the particles outside the flask that it pushed an egg
through the neck of the flask? It is the same process happening here).

i.e. We have breathed in (or, more realistically, air has pushed itself inside us)

Breathing out:
 To remove the air, we repeat the process in reverse.
 The diaphragm relaxed i.e. arches upwards and the muscles of the ribs pull the rib
cage inwards
 The lungs have been pushed into a smaller size
 They now have a higher pressure compared to outside the body
 Particles rush out of the lungs to try and equalise the pressure

i.e. We have breathed out (or, more realistically, air has rushed out of us)

The Musculoskeletal System

The adult human skeletal system consists of 206 bones, as well as a network of tendons,
ligaments and cartilage that connects them. The skeletal system performs vital functions —
support (the body’s soft tissues against the force of gravity), movement (the skeleton
provides points of attachment for muscles. Muscles provide the power to move bones, which
act as levers), protection (of delicate internal organs from injury e.g. the rib cage protects the
heart and lungs), blood cell production, calcium storage and endocrine/hormone
regulation.

Animals with internal skeletons made of bone, called vertebrates, are actually the minority,
as 98 percent(!!!) of all animals are invertebrates, meaning they do not have internal
skeletons or backbones.

Human infants are born with 300 to 350 bones, some of which fuse together as the body
develops. By the time most children reach the age of 9 they have 206 bones.

The skeletons of adult males and females have some variation, primarily to accommodate
childbirth. The female pelvis is more round and proportionally larger. A male's pelvis is
about 90 degrees or less of angle, whereas a female's is 100 degrees or more.

While they become brittle when outside of the body, bones are very much alive inside the
body, being fed by a network of blood vessels from the cardiovascular system and nerves
from the nervous system.
A typical bone has a dense and tough outer layer (compact bone). Next is a layer of spongy
bone, which lighter and slightly flexible. In the middle of some bones is jelly-like bone
marrow, where new cells are constantly being produced for blood.

The skeletal system has two distinctive parts: the axial skeleton and the appendicular
skeleton.
The axial skeleton, with a total of 80 bones, consists of the vertebral column, the rib cage and
the cranium. The axial skeleton transmits the weight from the head, the trunk and the upper
extremities down to the lower extremities at the hip joints, which help humans maintain our
upright posture.
The main functions of the skeleton are:
 Support
 Protection
 Movement
 Makes blood

MUSCLES, TENDONS AND LIGAMENTS

Tendons are hard, strong fibres that attach muscles to bones.

Ligaments are strong ribbons of tissue that hold joints together. They attach bones to bones.

Muscles make bones move. Muscles can only pull bones, not push them. When a muscle
pulls on a bone, it becomes shorter and fatter. This is called muscle contraction, as the muscle
contracts, it pulls on the bone and the bone moves. Muscles work in pairs. One muscle makes
the bone move in one direction, and the
partner makes the bone move in the
other direction.