Collapsed man

Collapsed man

1. terminology

   • uncounscious
     • comatose
       • coma is a state of unconsciousness in which a person: cannot be awakened; fails to respond normally to painful stimuli, light, or sound; lacks a normal wake-sleep cycle; and does not initiate voluntary actions
     • syncope(fainting)
       • A syndrome loss of consciousness which is: Relatively sudden, Temporary Self-terminating, Usually rapid recovery
     • Collapse
       • Collapse is a sudden and often unannounced loss of postural tone (going weak), often but not necessarily accompanied by loss of consciousness.

2. Anatomy of thoracic cage

   • THORACIC CAGE formed by
     • thoracic vertebrae posteriorly,
     • twelve pairs of ribs posterolaterally ,anterolaterally
       • True ribs (1st - 7th )
       • False ribs (8th - 10th )
       • Floating ribs (11th – 12th )
     • sternum in the midline anteriorly
       • Manubrium
       • Body
       • Xiphoid Process
     • thoracic inlet
     • Thoracic outlet
     • Intercostal Muscles
       • External intercostal muscle
       • Internal intercostal muscle
       • Innermost intercostal muscle
     • Intercostal Nerves
       • (2) special nerves(1st ,12th )
       • (5) Typical intercostal nerves (2nd- 6th )
       • (5) Atypical intercostal nerve (7th- 11th )
     • Intercostal Arteries
       • upper nine intercostal spaces contain three arteries per space,one posterior and one anterior
       • The 10th & 11th spaces contain a single posterior intercostal artery

3. physiology of the heart

   • Action Potentials in the heart
     • Non-pacemaker potentials in the atria and ventricles
       • Phase-0 (Depolarization)
       • Phase-1 (Initial repolarization)
       • Phase-2 (plateau).
       • Phase-3 (Final repolarization)
       • Phase-4 (Restoration of resting membrane potential).
     • Pacemaker potentials in the SA and AV-nodes
       • phase 0 rapid depolarization
       • phase 3 repolarization
       • phase 4 slow depolarization

4. pathology

   • sick sinus syndrome
     • Causes
       • damage or scarring of the heart’s electric system
       • scar tissue from a past heart surgery
       • certain medications, such as calcium channel blockers or beta blockers
       • the breakdown of heart muscle due to age
     • Symptoms
       • fainting or fainting sensations
       • fatigue
       • dizziness
       • palpitations..etc
     • disorders that characterize SSS
       • sinus bradycardia
       • sinus arrest or sinus pause
       • sinoatrial block
       • tachycardia-bradycardia

5. treatment

   • pharmacology
     • antiarrhythmic
       • Class I (Na channel blockers):A,B&C
       • Class II:decrease phase 4 slope
       • Class III:K + channel blockers.
       • Class IV:calcium channel blockers.
   • FIRST AID
     • including mnemunic DR ABC.danger,response,airway, breathing & circulation&call an ambulance
     • CPR
       • chest compression 100-120 per minute
       • rescue breaths. every 30 chest compressions give 2 breaths