Anatomy and Physiology
for the EMT-Basic
James Sargent, NREMT-B, EMSI
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.
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).
You have to be able
to speak the
language…
Anatomical Terms
• Normal anatomical
position
Upper extremity
Shoulder
Thorax
Torso
– The position that a
patient is in when
determining terms.
– Person standing,
facing forward
– Palms facing forward
Face
Mandible
Neck
Arm
Elbow
Abdomen
Forearm
Wrist
Hand
Pelvis
Knee
Leg
4-1.jpg
Ankle
Foot
Lower extremity
Thigh
Looks something like this:
Head
Cranium
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).
Anatomical
Planes
Midline
Lateral
Medial
• Medial
– Toward midline
• Lateral
– Away from midline
• Proximal
– Toward center
of the body
• Distal
Right
– Away from center of
body
Mid-clavicular
Left
Anatomical Planes
Mid-axillary line
• Superior
– Means something
higher
(closer to the head)
• Inferior
– Lower,
away from head
• Anterior
– Front
• Posterior
– Back
Anterior
(ventral)
Superior
Inferior
Posterior
(dorsal)
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
Dorsal
Having a bad day
Ventral
Anatomical PlanesDescriptive 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
Anatomical PlanesDescriptive Terms
• Trendelenburg
– Supine, feet elevated, head down
• Shock position
– Modified Trendelenburg, supine with
legs elevated 12-16”
• Lateral recumbent
– “recovery position”, laying on side
Body Systems
Musculoskeletal
System
Musculoskeletal System
• Function
– Gives body shape
– Protects vital organs
– Provides for body movement
• Components
– Bones, joints, connective tissues
and muscles
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
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)
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”
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)
Bones
– Radius (lateral bone of the forearm)
– Ulna (medial bone of the forearm)
– Carpals (wrist)
– Metacarpals (hand)
– Phalanges
Joints
• Where bones connect to other
bones
– Ball and socket
– Hinge
– Fixed
Now it’s
your turn!
Connective Tissue
• Ligaments
– Hold joints together
• Tendons
– Attach muscle to bone
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
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
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
Respiratory System
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
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
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
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
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
Cardiovascular System
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
Cardiac Conduction
System
• Heart is more than a muscle
– Specialized contractile and conductive
tissue in the heart
– Electrical impulses
• Automaticity
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
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
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
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
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
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
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
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
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
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
Hypoperfusion/Shock
• Reduction in total blood volume
• Subnormal temperature
Nervous System
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
Endocrine System
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
Digestive
System
Gastrointestinal System
• Responsible for the digestion of food
• Chemicals aiding in digestion
produced by liver, gallbladder and
parts of pancreas
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
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
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
ANY
QUESTIONS
???