Ch. 6 The Human Body (Case Study) Questions and Answers

Ch. 6 The Human Body (Case Study) Questions and Answers PART !: Why is knowledge of anatomy important in determining potential sources of pain? Back pain may be due to trauma, muscle pulls, slipped spinal discs, or kidney stones, among other causes. Understanding human anatomy and physiology helps to direct the assessment; is there pain on palpitation or with movement; is the pain constant or intermittent; is it localized or widespread, etc. The assessment findings combined with the history of the pain's onset and the EMS provider's knowledge of which anatomical structures cause which symptoms will help determine the best management and transport plan for the patient. PART 2: Where are the kidneys located in the body? Are there any other organs in the same area? The kidneys are retroperitoneal — behind the abdominal cavity — above the umbilicus. Since this patient is experiencing right back pain, the liver, gallbladder, and part of the large intestine also may be considered as pain sources. In addition, the adrenal glands sit on top of each kidney and the pancreas also is retroperitoneal. PART 2: Given the location of the kidneys and other components of the urinary system, what other complaints might this patient express? Kidney pain can radiate along nearby nerves so that it can be felt in the abdomen, the side (or flank), the back, or the groin. Kidney stones may migrate down the ureters, causing changes in the pain as the ureters move the kidney stone along, and potentially some hematuria (blood in the urine) due to irritation of the ureter. The pain and stress often cause nausea or vomiting as well. The patient may be anxious and move around trying to find a comfortable position. PART 3: If you are unfamiliar with human anatomy, how could your lack of knowledge significantly affect the quality and the timeliness of your patient care? Lack of knowledge about human anatomy and physiology could significantly delay an assessment of the potential cause of the patient's pain both in the field and at the receiving hospital, as the hospital staff would have to begin the assessment on the patient's arrival. You would not be able to focus your assessment and might not start the appropriate treatment, or may even treat the patient incorrectly. For example, immobilizing a patient for back pain that you assume is due to an unknown injury could potentially increase the level of pain for a patient with kidney stones. PART 4: How can your knowledge of anatomy and correct use of medical terminology when speaking to other professional health providers affect their opinion of you, your agency, and emergency service professionals in general? Showing knowledge of the appropriate anatomy and physiology and sharing a common terminology with other medical provider increase effective communication, enhances effective patient care, and tends to increase the level of trust and respect of medical providers in you as a prehospital provider. PART 5: How can your documentation skills and use of correct anatomic terminology assist medical professionals reading your report who were not on the call? In addition to providing the statistical info needed for the patient's hospital medical record, you can "paint a picture" of how you found the patient at the scene and other details at the scene that are otherwise not available to hospital staff caring for the patient. Your assessment findings can help facilitate prompt care. Info about the treatment provided by EMS and the response of the patient to treatment, as well as changes in the patient's vital signs during transport are key pieces of info for hospital providers to consider while providing continued care to the patient. PART 5: What clues were available to you from the scene, history, signs, and symptoms that may have helped you determine what was wrong with your patient? The patient's behavior, appearance, and verbal comments at the scene helped to confirm that the patient was in severe pain. The location of the pain, especially during palpitation, helped to localize the pain to the patient's flank. The fact that it was spasmodic in quality helped to point to pain due to a kidney stone. Although the patient thought he might have hurt his back, he was not aware of any circumstances causing him to have a traumatic injury. Since the pain started rather abruptly and increased over time, this pointed toward a presentation common with kidney stones versus a traumatic injury. PART 5: Had you not realized the cause of his condition, would it have altered your management? If kidney stones were not determined to be the cause of the pain, then spinal immobilization or other management more appropriate to spinal trauma may have been utilized rather than position of comfort. Pain management and ALS care, including starting an IV, may also have been delayed, if the cause was thought to be traumatic based solely on the patient's original complaint. PART 5: In what body system are the kidneys, what other structures are in that system, and what is the function of the system? The kidneys are the most superior portion of the urinary system and they filter blood, producing urine. Each kidney connects to a ureter that leads into the urinary bladder. The bladder empties to the outside through the urethra which is located in the penis of a male, while there is a separate opening in front of the vagina in a female. The urinary system controls fluid balance in the body, filters and eliminates waste products through the urine produced by the kidneys, and controls the body pH balance. Summary: Lessons Learned From This Case - The reasons why knowledge of anatomy and physiology is important to an EMS provider - Putting all the clues together to better understand a patient's problem and make decisions about treatment - Sources of info that can help an EMT better evaluate a patient's condition. For example, noting that a patient is taking a cardiac medications can provide clues to the fact that the patient has a cardiovascular problem, but also may help to explain why a patient has certain signs of symptoms and whether they are new onset or may be chronic changes for the patient.