Transcript AP-Chapter-2 - McLaren

ESSENTIALS OF A&P
FOR EMERGENCY CARE
CHAPTER
2
The Human Body:
Reading the Map
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Multimedia Asset Directory
Slide 15
Slide 16
Slide 17
Slide 18
Slide 19
Slide 20
Slide 21
Slide 37
Slide 38
Slide 39
Slide 60
Fowlers Positioning Video
Lateral Positioning Video
Dorsal Positioning Video
Prone Positioning Video
Lithotomy Positioning Video
Sims Positioning Video
Supine Positioning Video
Magnetic Resonance Imaging Video
Ultrasound Video
Radiologic Technology Video
Surgical Team Video
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Introduction
• This chapter will provide you with the major
external map of the human body.
• Future chapters will get into more depth for each
particular area and begin to provide a detailed
map of the interior regions.
• The medical directional terms and body
locations will serve as a foundation upon which
to build.
• By the time you finish your journey through this
book you will know your own body like “the back
of your hand.”
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Learning Objectives
• List and describe the various body positions.
• Define the body planes and associated
directional terms.
• Locate and describe the body cavities and
their respective organs.
• List and describe the anatomical divisions of
the abdominal region.
• Identify and locate the various body regions.
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Pronunciation Guide
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abdominopelvic cavity (ab DOM ih noh PELL vik)
antecubital (an tee CUE bi tal)
buccal (BUCK al)
caudal (KAWD al)
cephalic (seh FAL ik)
coronal plane (koh ROH nal)
cranial (KRAY nee al)
distal (DISS tal)
dorsal (DOR sal)
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Pronunciation Guide
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gluteal (GLOO tee al)
mediastinum (ME dee ah STY num)
midsagittal plane (mid SAJ ih tal)
pleural cavities (PLOO ral)
superficial (SOO per FISH al)
thoracic cavity (tho RASS ik)
transverse (tranz VERS)
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Map of the Human Body
• Directional terms, like north, south, east,
or west, are needed for reading a map.
• Maps representing a specific region have
more detail, making it easier to explore.
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Map of the Human Body
• Likewise, scientists have created
standardized body directional terms,
splitting the body into distinct regions,
sections, and cavities to more clearly and
rapidly locate and discuss anatomical
features.
• Anatomical landmarks serve as the
needed points of reference.
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Importance of Mapping
• Does a statement “I have pain in my
stomach” tell you a lot about exact
location?
• Location of pain can be a determining
factor in diagnosis.
• Questions about type of pain, exact
location, and intensity of pain can help
determine etiology.
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Body Positions
• The body can assume many position and
therefore have different orientations.
• To standardize the orientation for the
study of anatomy, scientists have
developed the anatomical position.
• The anatomical position is that in which
the human being is standing erect, face
forward, with feet parallel, arms hanging at
the sides, and palms facing forward.
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Figure 2-1 The anatomical position.
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Other Important Body Positions
• Supine position – laying face upward, on
your back
• Prone position – laying face downward, on
your stomach
• Fowler’s position – sitting in bed with the
head of the bed elevated 45–60 degrees
– Facilitates breathing and comfort of the
bedridden patient
• Trendelenburg position – the head of the
bed is lower than the patient’s feet
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Figure 2-2 Common patient positions.
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Figure 2-2 (continued) Common patient positions.
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Directional Terms
• Directional terms are used to navigate the
body.
• Superior (cranial or cephalic) means
toward the head or upper body.
• Inferior (caudal) means away from the
head or toward the lower part of the body.
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Directional Terms
• Anterior or ventral refers to body parts
towards or on the front of the body.
• Posterior or dorsal refers to body parts
towards or on the back of the body.
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Directional Terms
• Proximal refers to body parts close to a
point of reference of the body.
• Distal refers to body parts away from a
point of reference.
• External means toward the outside.
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Directional Terms
• Internal means on the inside.
• Superficial means toward or at the body
surface.
• Deep means away from the body surface.
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Directional Terms
• Central refers to locations around the
center of the body.
• Peripheral refers to the extremities or
outer regions.
• Medial refers to body parts located near
the middle or midline of the body.
• Lateral refers to body parts located away
from midline.
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Figure 2-4 Body directional terms.
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Figure 2-5 Contrast of central versus peripheral cyanosis.
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FROM THE STREETS
• Current Slant on the Trendelenburg
Position
– For years, the Trendelenburg position was
used in emergencies to increase blood return
to the body's core.
– Research over the last two decades has
found the position relatively ineffective and
may sometimes worsen conditions such as
spinal fractures.
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FROM THE STREETS
• Current Slant on the Trendelenburg
Position
– Although now rarely used in EMS, you may
still encounter it since laypersons still believe
it is appropriate care.
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Body Planes
• A plane is an imaginary line drawn through the
body or organ to separate it into specific
sections.
– Transverse or horizontal plane – divides the body into
superior (top) and inferior (bottom) sections; also
referred to as cross-sectioning the body
– The median or midsagittal plane divides the body into
right and left halves.
– Sagittal plane – divides body into right and left
sections.
– The frontal plane or coronal plane divides the body
into front and back sections.
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Figure 2-6 Transverse plane and a cross-sectional view of the upper abdominal region.
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Figure 2-7 Midsagittal or median plane along with a sagittal view of the head.
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Figure 2-8 Frontal or coronal plane along with a coronal view of the chest and stomach.
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Applied Science: X-rays,
CT Scans, and MRI’s
• X-rays are beams of high energy radiation that
penetrate the body and give a two-dimensional
view of bones, air, and tissues.
• Enhancing an x-ray with computers gives much
better detail, contrast, and a three-dimensional
view – often called a CT (computerized
tomography) scan or CAT scan
• An MRI (magnetic resonance imager) gives
even greater detail of tissue structures, even
down to individual nerve bundles, with no
radiation exposure.
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Body Cavities
• The body has two large open spaces called
cavities that house and protect organs.
– The dorsal (posterior) cavity is located on the
back of the body.
– The larger ventral (anterior) cavity is located on
the front of the body.
 Divided into two smaller cavities called the thoracic and
abdominopelvic cavities. These two smaller cavities are
divided by the diaphragm that is used for breathing.
 The abdominopelvic cavity can be further divided into
the abdominal and pelvic cavities.
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Thoracic Cavity
• The thoracic cavity contains
– The heart
– The lungs
– Large blood vessels
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Abdominal Cavity
• The abdominal cavity contains the
digestive organs such as the
– Stomach
– Intestines
– Liver
– Gallbladder
– Pancreas
– Spleen
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Pelvic Cavity
• The lower portion of the abdominopelvic
cavity contains the
– Urinary organs
– Reproductive organs
– Large part of the large intestine
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Dorsal Cavity
• The dorsal cavity is located in the back of
the body and consists of two cavities.
• The cranial cavity houses the brain.
• The spinal (vertebral) cavity contains the
spinal cord.
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Figure 2-9 Main body cavities.
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Smaller Cavities
• There are many smaller cavities that
designate specific areas.
– The nasal cavity is the space behind the
nose.
– The buccal cavity is the space within the
mouth.
– The orbital cavity houses the eyes.
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Clinical Application: The Central
Landmark – The Spinal Column
• The spinal or vertebral column is a major
centrally located anatomical landmark.
• There are five sets of vertebrae labeled for
their locations in the body.
– 7 cervical (or C) vertebrae in the neck
– 12 thoracic (or T) vertebrae in the chest
– 5 lumbar (or L) vertebrae in the lower back
– 5 fused sacral vertebrae
– 1 coccyx or tailbone
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Figure 2-10 The spinal column.
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Abdominal Regions
• The umbilical region is located in the center,
with the right and left lumbar regions located
laterally.
• The epigastric region (epi = above, gastric =
stomach) is located superior to the umbilical
region with the right and left hypochondriac
regions located on either side.
• The hypogastric region lies inferior to the
umbilical area, with the right and left iliac or
inguinal areas flanking it.
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Figure 2-11 The nine divisions of the abdominal region.
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Clinical Application: Hernias
• You may have heard of umbilical or inguinal
hernias and now you know where these would
be located.
• A hernia is a tear in the muscle wall that allows a
structure to protrude through.
• Hernias can be a minor nuisance or they can
become very dangerous if blood flow is
restricted to the portion of the organ that is
protruding. This can lead to death of the tissue,
called necrosis, and serious consequences.
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Figure 2-12 Illustrations of the inguinal and umbilical hernias.
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Abdominal Quadrants
• A simpler way to compartmentalize the
abdominal region is to separate it into
anatomical quadrants.
• This is very helpful in describing the
location of abdominal pain.
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Abdominal Quadrants
• Knowing the organs located in the
quadrant where the pain is arising can
give you a clue as to what type of problem
the patient has.
– RLQ (right lower quadrant) pain – appendicitis
– RUQ (right upper quadrant) pain – liver or
gallbladder problems
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Figure 2-13 The clinical division of the abdominal region into quadrants with related organs
and structures.
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Additional Body Regions
• There are additional body regions that
help to further aid in locating areas or
structures. Examples include the
– Axillary region
– Brachial region
– Femoral region
– Pubic region
– Patellar region
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Figure 2-14 Anterior and posterior body regions.
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Table 2-2
Examples of Body Regions and Their Locations.
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Table 2-2 (continued)
Examples of Body Regions and Their Locations.
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FROM THE STREETS
• A thorough knowledge of anatomical
landmarks is important in explaining the
location and severity of trauma injuries.
• Using appropriate terminology facilitates
effective communication between prehospital and in-hospital health care teams.
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FROM THE STREETS:
Surface Anatomy
Figure 2-15 Gunshot wound to the chest.
© Edward T. Dickinson, MD
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Snapshots from the Journey
• The body can assume many different
positions. To standardize it, we use the
anatomical position facing forward with
arms at the side and palms facing forward.
Other positions such as prone, supine,
Trendelenburg, and Fowler’s position can
be used in health care settings.
• The body can be divided by the use of
planes into different sections, including the
transverse, midsagittal, and frontal planes.
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Snapshots from the Journey
• Directional terms, such as anterior and
posterior, superior and inferior, and
internal and external help us to navigate
the body. It is important to always
remember that directions such as right and
left are referenced from the patient’s
perspective and NOT yours.
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Snapshots from the Journey
• The body has several cavities that house
anatomical structures (mainly organs) and
specific regions that are all important to
know so that health care professionals can
communicate in specific terms that leave
no room for confusion.
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Case Study
A 50-year-old female patient presents with
sternal pain radiating to the left brachial area.
Peripheral cyanosis is noted in the digital
areas, and she exhibits pedal edema. No
epigastric pain is noted. She reports that she
became dizzy and had fallen, bruising the right
orbital region, and she received superficial cuts
to the right patellar region. The physician
ordered an IV to be started in the left
antecubital space. Please answer the following
questions in common lay terms.
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Case Study Questions
• Where would you suggest placing a
bandage?
• Where did her pain begin?
• Where does the pain move to?
• Does she have stomach pain?
• Where will the IV be started?
• What part of her body is swollen?
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FROM THE STREETS
You are called to the scene of a 50-year-old
male unrestrained driver in a motor vehicle
collision (MVC). Upon arrival you find the
patient lying supine on the street with lower
back pain, a deep laceration to his left thigh
area, and abdominal pain around his belly
button. His distal pulses are rapid and weak
and cyanosis to his hands and feet is
observed.
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From the Street Questions
• In lay terms describe the position in which the
driver was found.
• Using body region terms, describe the location of
the patient’s back pain.
• Using body region terms, describe the specific
location of the patient’s abdominal pain.
• Using directional terms, describe the location of
the patient’s bluish-colored skin.
• Describe the location of the patient’s distal pulses.
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From the Street Questions
• In lay terms describe the position in which the
driver was found. Laying face upward, on his back
• Using body region terms, describe the location of
the patient’s back pain. Lumbar
• Using body region terms, describe the specific
location of the patient’s abdominal pain. Umbilical
region
• Using directional terms, describe the location of the
patient’s bluish-colored skin. Peripheral cyanosis
• Describe the location of the patient’s distal pulses.
Radial and Pedal pulses (the most distal)
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End of Chapter
Review Questions
1. A massage therapist would ask you to
assume which position for a back
massage?
a. Prone
b. Supine
c. Fowler’s
d. Lotus
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Review Questions
2. Which of the following is NOT in the
abdominopelvic cavity?
a. Stomach
b. Liver
c. Reproductive organs
d. Heart
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Review Questions
3. Carpal tunnel syndrome occurs in what
region of the body?
a. Head
b. Cheek
c. Armpit
d. Wrist
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Review Questions
4. The midsagittal plane divides the body
into
a. superior and inferior
b. anterior and posterior
c. cranial and caudal
d. left and right
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Review Questions
5. An organ contained in the RLQ would be:
a. Appendix
b. Heart
c. Lungs
d. Brain
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
End of Chapter
Review Questions
6. A motorcyclist collides with a car and is
bleeding profusely from a deep cut on
the thigh. What artery is most likely
damaged.
a. Radial
b. Brachial
c. Patellar
d. Femoral
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
End of Chapter
Review Questions
1. A standard position in which a human
stands erect, face forward, with feet
parallel, arms at the side with palms
forward is called the
_________________ position.
2. The ________ position is laying face
upward and on your back.
3. The mouth is located __________ to the
nose, whereas the nose is located
_____________ to the mouth.
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
End of Chapter
Review Questions
4. The organ found in the cranial cavity is
the ____________.
5. ____________ indicates blueness of the
extremities and therefore would affect
the peripheral areas of the body.
6. A coroner needs to examine the third
ventricle, a structure located in the
midline of the brain. A ___________
section would be most useful.
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
End of Chapter
Review Questions
1. List the organs located in the abdominal
cavity.
2. Compare and contrast the prone, supine,
and Fowler’s positions.
3. List and describe the location of the nine
abdominal regions using directional
terms.
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.