Apply Newtons First Law Of Motion Biology Essay

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Newtons first law of motion states that 'If no net force acts on a body it will move in a straight line at constant velocity, or will stay at rest if initially at rest' (Mansfeild & O'Sullivan, 2012). When applying Newton's first law of motion to a trauma patient when a vehicle strikes a pole, it can aid in determining the mechanism of injury that occurs (Rahm & Pollak, 2004). Three impacts occur. Initially when the car hits the pole, the pole exerts the force that brings the vehicle to rest. The second impact is the occupant continues moving forward at the same speed the car was going until colliding with the structure of the car that brings the body to rest. The third impact is the internal organs that continue moving forward and compressing within the body (Sanders, 2007).

In a frontal impact, the occupant continues moving at the same speed of the car until the anterior surface of the body hits the steering wheel. The posterior body continues moving forward and the organs compress. The occupant(s) normally follow one of two path ways, the up-and-over or the down-and-under. In up and over with a frontal chest impact to the steering wheel and potential head impact on the windshield, potential injuries can include myocardial contusions, pneumothorax, flail chest, pulmonary contusions, overpressure injury in the abdomen, lacerated liver and/or spleen, cervical spine injury and brain injury. Down and under potential injuries includes fractures of the lower extremities, facial injuries and cervical spine injuries (Sanders, 2007).

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Lateral impacts with poles involve the region of the body which is closest to the impact being injured directly, while those of the opposite side may be injured if they come into contact with the other side of the vehicle. Suspected injuries can be to the clavicle, chest wall and thoracic cavity and abdominal cavity and pelvis, rotational spinal injuries (Rahm & Pollak, 2004).

Apply the conservation of energy law to a trauma patient when a vehicle hits a wall.

The law of conservation of energy states that 'energy may neither be created or destroyed, only transferred from one object to another (Mansfeild & O'Sullivan, 2012). Injuries are caused by a transfer of energy from some external source to the human body. The extent of the injury is determined by the type of energy transferred, how rapidly it occurs, and the part of the body to which the energy is applied to (Sanders, 2007).

When vehicle that strikes a solid object, for example a wall, the mechanical energy of motion is potentially converted into thermal energy if the breaks are applied (Curtis & Ramsden, 2011). Upon impact with the wall, the kinetic energy dissipates into mechanical energy by bending solid parts of the vehicle such as the frame as the car crumples. Any remaining kinetic energy dissipates into the occupants and their skeletal mass and internal organs (Curtis & Ramsden, 2011).

Vehicles are designed with safety in mind. Airbags absorb energy if the occupant is restrained correctly and seatbelts keep the occupant in place preventing a steering wheel deformation against the torso. Interior structures such as roll bars, crumple zones and bumper absorb energy and minimise the abrupt transmission of energy to the occupants in the vehicle (American Academy of Orthopaedic Surgeons, 2010).

WORD COUNT: 532

Bibliography

American Academy of Orthopaedic Surgeons. (2010). Nancy Caroline's Emergency Care in the Streets. USA: Jones & Bartlett Learning.

Curtis, K., & Ramsden, C. (2011). Emergency and Trauma Care for Nurses and Paramedics. Sydney: Elsevier Health Sciences.

Mansfeild, M., & O'Sullivan, C. (2012). Understanding Physics. United States: John Wiley & Sons.

Rahm, S., & Pollak, A. (2004). Trauma Case Studies for the Paramedic. USA: Jones & Bartlett Learning.

Sanders, M. (2007). Mosby's Paramedic Textbook. St Louis: Elsevier .

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Andy Symons

Lecture 2

Briefly explain why the physiological changes in the Cushing's Reflex occur in severe head injured patients.

Many physiological changes, ranging from compensatory to lifesaving, occur when trauma occurs in any part of the body. Cushing's reflex or triad is one of those changes that occur in severe head injuries. It is caused by increased intracranial pressure, resulting in increased systolic pressure, widened pulse pressure and decrease in the pulse and respiratory rate first described by an American neurosurgeon, Harvey Cushing in 1901 (Cushing, 1901).

The normal range of intracranial pressure is between 0-15 mm Hg (Sanders, 2007).When the intracranial pressure rises above the normal range, the ability to maintain cerebral perfusion pressure is compromised and cerebral blood flow is diminished. Rises intracranial pressure can be caused by brain oedema or expanding haematoma, abscesses, generalized brain swelling and obstruction in CSF flow and/or absorption (Rahm & Pollak, 2004).

Prehospitally, the level of intracranial pressures cannot be calculated and prehospital care must concentrate on maintaining cerebral perfusion pressure and cerebral blood flow, while mitigating intracranial pressure. This involves closely monitoring the symptoms as the symptoms that develop depend on the amount of pressure inside the skull, and the involvement of the brainstem. Early symptoms of raised intracranial pressure include; vomiting, headache, an altered level on consciousness and seizures (American Academy of Orthopaedic Surgeons, 2010).

As intracranial pressure rises, the body attempts to compensate for the decline in cerebral perfusion pressure by rising mean arterial pressure, bradycardia and irregular respirations, the Cushing's reflex involving a series of physiological changes. As intracranial pressure increases, cerebral blood flow decreases leading to ischemia and an increased level of CO2 and decreased O2 levels in the blood. The hypoxia and hypercapnea stimulates the vasomotor centre in the medulla oblongata which regulates blood pressure. The increased sympathetic signals from the vasomotor centre causes; arteriolar constriction which increases the systemic blood pressure, vasoconstriction which decreases blood stored in the venous reservoir and increases venous reservoir. It also leads to an increased heart rate and an increase in the force of contraction (Khurana, 2008). This results in the increased blood pressure and widened pulse pressure in the Cushing's reflex.

The increased blood pressure also causes reflex bradycardia via a baroreceptor response. Baroreceptors are located in the walls of the heart and large blood vessels such as the aortic arch and the carotid sinus. They are stimulated by distension of the structures in which they are located and they signal at an increased rate when the pressure in their structure rises. They signal an inhibition of tonic discharge of vasoconstrictor nerves and excitation of vagal innervation of the heart resulting in bradycardia (Khurana, 2008).

The control centre for involuntary breathing is located in the medulla and pons of the brain stem. As the intracranial pressure increases, the brain stem can become distort and its actions as the respiratory control centre are compromised (Khurana, 2008). This results in the irregular pattern of breathing, the final phase in Cushing's Triad. If the rise in intracranial pressure remains unresolved, the brain ruptures and herniated (Sanders, 2007).

Protective physiological mechanism exists to protect the homeostasis of the body after a trauma has occurred. Cushing's triad, composing of; hypertension, bradycardia and irregular respirations, is a last attempt by the body's sympathetic nervous system to compensate for the raise in intracranial pressure.

WORD COUNT: 539

Bibliography

American Academy of Orthopaedic Surgeons. (2010). Nancy Caroline's Emergency Care in the Streets. USA: Jones & Bartlett Learning.

Cushing, H. (1901). Concerning a definite regulatory mechanism of the vasomotor centre which controls blood pressure during cerebral compression. Johns Hopkins Hosp Bull, 12:290-292.

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Khurana. (2008). Essentials Of Medical Physiology. Dehli: Elsevier India.

Rahm, S., & Pollak, A. (2004). Trauma Case Studies for the Paramedic. USA: Jones & Bartlett Learning.

Sanders, M. (2007). Mosby's Paramedic Textbook. St louis: Elsevier .

Sherwood, L. (2007). Human Physiology: Fromcells to System 6th Ed. USA: Thomson.

Portfolio Part One Marking Guide

Student Name Rebecca Boughton

Student Number:10233505

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Marking guide; title page; table of contents; page numbers; correct margins; correct spacing; correct font; correct headings; paragraph format (see ECU Assignment Guidelines)

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Logical and clear; well structured sentences; correct spelling (Australian); grammatically correct; use of the third person, passive style.

CRITICAL THINKING QUESTIONS:

Identify the relevant theories which are reflected in each discussion

Explain the relevant theories which are reflected the topic.

Depth of understanding & quality of content

REFERENCES:

Correct format for in-text reference and end-text reference list in accordance with APA. Minimum FIVE (5) references per question (journal articles, textbooks, and credible websites - .gov .org .ecu).

References need to be less than nine years old

WORD COUNT: Is the word count within +/- 10% of limit? (500 words per Clinical Thinking Question

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Andy Symons

Lecture 3 Spinal Trauma

Briefly define the following syndromes associated with spinal cord injury:

Anterior Cord Syndrome

Anterior cord syndrome occurs when bony vertebral fragments or pressure compresses the vascular system that supplies the anterior spinal cord. It often results from hyper flexion injuries or fractures (Rahm & Pollak, 2004). The anterior spinal artery provides blood to the anterior two thirds of the spinal cord (American Academy of Orthopaedic Surgeons, 2010). The interruption of blood supply damages both the motor and sensory pathways in the anterior part of the spine, which allow patients to feel crude sensation (Elliott, Aitken, & Chaboyer, 2006). The posterior cord functions such as sensory response to light touch and proprioception are not affected (Rahm & Pollak, 2004).

Central Cervical Cord Syndrome

Central cervical cord syndrome occurs as a result of flexion or hyperextension injuries in patients with increased susceptibility to injury secondary to the development or degenerative narrowing of the spinal canal. It is often a result of contusion within the spinal cord (Rahm & Pollak, 2004). The injury arises in the centre of the cervical cord and due to the distribution of the motor fibres, more cervical and thoracic motor and sensory tracts than in the periphery of the cord, if produces characteristic symptoms (American Academy of Orthopaedic Surgeons, 2010). These include; weakness, paralysis and sensory defects greater in the upper extremities than the lower extremities (Sanders, 2007).

Brown-Séquard syndrome

Brown-Séquard syndrome is a hemitransection of the spinal cord (Sanders, 2007). It is a less common type of incomplete spinal injury in which one half of the cord is affected (Rahm & Pollak, 2004). It may result from a ruptured inter vertebral disk or the pushing of a fragment of vertebral body on the spinal cord. It can also result from external factors such as knife or missile injuries (Sherwood, 2007). Movement is lost below the level of injury on the injured side, but pain and temperature sensation is lost on the contralateral side (Elliott, Aitken, & Chaboyer, 2006).

Horner's syndrome

Horner's syndrome was first described in animals by J. F. Horner and is characterized by constricted pupil, ptosis and absence of sweat gland activity on the affected side of the face (Elliott, Aitken, & Chaboyer, 2006). Horner's syndrome can result from a legion anyway along a three-neuron sympathetic pathway. Interruption of the sympathetic pathways between the hypothalamus and spinal cord cause the first order of Horner's. The second order neuron lies at the ciliospinal center at C8-T2. The third order neuron lies in the superior ganglion, a lesion at or distal to this neuron results in third order Horner's syndrome. When this occurs, the final neuron in the pathway dies and its peripheral processes atrophy and die (Campbell, 2005).The causes of Horner's syndrome are legion and include; brainstem legions, cluster headache, internal carotid artery thrombosis or dissection, cavernous sinus disease, aptical lung tumours, and neck trauma (Campbell, 2005).

WORD COUNT:462

Bibliography

American Academy of Orthopaedic Surgeons. (2010). Nancy Caroline's Emergency Care in the Streets. USA: Jones & Bartlett Learning.

Campbell, W. (2005). DeJong's The Neurologic Examination. USA: Lippincott Williams & Wilkins.

Elliott, D., Aitken, L., & Chaboyer, W. (2006). ACCCN's Critical Care Nursing. Sydney: Elsevier Australia.

Rahm, S., & Pollak, A. (2004). Trauma Case Studies for the Paramedic. USA: Jones & Bartlett Learning.

Sanders, M. (2007). Mosby's Paramedic Textbook. St louis: Elsevier .

Sherwood, L. (2007). Human Physiology: Fromcells to System 6th Ed. USA: Thomson.

Portfolio Part One Marking Guide

Student Name Rebecca Boughton

Student Number:10233505

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Marking guide; title page; table of contents; page numbers; correct margins; correct spacing; correct font; correct headings; paragraph format (see ECU Assignment Guidelines)

WRITING SKILLS:

Logical and clear; well structured sentences; correct spelling (Australian); grammatically correct; use of the third person, passive style.

CRITICAL THINKING QUESTIONS:

Identify the relevant theories which are reflected in each discussion

Explain the relevant theories which are reflected the topic.

Depth of understanding & quality of content

REFERENCES:

Correct format for in-text reference and end-text reference list in accordance with APA. Minimum FIVE (5) references per question (journal articles, textbooks, and credible websites - .gov .org .ecu).

References need to be less than nine years old

WORD COUNT: Is the word count within +/- 10% of limit? (500 words per Clinical Thinking Question

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Andy Symons

Lecture Four Thoracic Trauma

Haemothorax is associated with a higher mortality rate than a simple pneumothorax. Why is that the case?

Both haemothorax and pneumothorax are considered intermediate life threatening conditions in the pre-hospital environment as they both directly cause breathing complications (Curtis & Ramsden, 2011). However, haemothorax is associated with a higher mortality rate as it also causes circulatory complications.

Pneumothorax refers to air or gas in the pleural cavity. There are many different kinds of pneumothorax, ranging from closed, tension, and open pneumothorax. Pneumothorax occurs when the chest wall is punctured and air flows down its pressure gradient from the higher atmospheric pressure and rushes into the plural space. The intra-pleural and intra-alveolar pressure are equilibriated with atmospheric pressure, and the transmural pressure gradient is lost across either the lung wall or the chest wall, which can result in a collapsed lung (Sherwood, 2007). Its causes can range from traumatic, occurring after rib fractures that puncture the lung or spontaneous or malignant, caused by an underlying diesease (Kumar, Abbas, Fausto, & Aster, 2010). All pneomothorax are treated with high concentrations of oxygen and airway management. Open pneumothorax must have the chest wound closed (3 sides of the dressing taped), to aid venting and allows spontaneous decompression of a potentially developing tension pneumothorax. Tension pneumothorax may require a needle decompression (Sanders, 2007).

Haemothorax has a higher mortality rate than pneumothorax as it affects more than one system. An escape of blood into the pleural cavity is defined as a haemothorax. It is diagnosed when the hematocrit of the pleural fluid is greater than 50% of the peripheral hematocrit. The majority of haemothorax are due to trauma, but they can also be caused spontaneously due to other malignancies or underlying diseases (George, Light, Matthay, & Matthay, 2005). It can be a fatal complication of a ruptured aortic aneurysm or vascular trauma (Kumar, Abbas, Fausto, & Aster, 2010). Each side of the chest can hold 30-40% of the patient's blood volume, that can accumulate to 2000-3000mL (Sanders, 2007). Blood can accumulate in the thoracic cavity and depending on the amount can displace the lung tissue leading to impaired oxygenation and hypoxemia. The build up of blood in the lung also means that it is lost from the circulatory system causing hypovolemia and leads the patient into hypovolemic shock (George, Light, Matthay, & Matthay, 2005).When treating patients presenting with a haemothorax both the respiratory and circulatory complications must be treated. High concentration oxygen with ventilation support would be administered to treat the respiratory problems and administration of volume-expanding fluids to treat the hypovolemia. They would also be transported rapidly to hospital (Sanders, 2007).

Concluding in simple terms, the mortality rate of pneumothorax is lower than haemothorax as pneumothorax affects the 'B' of ABCDE, the respiratory system. On the other hand, haemothorax affects both 'B' and 'C' of ABCDE, compromising the respiratory system and the circulatory system, resulting in a higher mortality.

WORD COUNT: 463

Bibliography

Curtis, K., & Ramsden, C. (2011). Emergency and Trauma Care for Nurses and Paramedics. Sydney: Elsevier Health Sciences.

Elliott, D., Aitken, L., & Chaboyer, W. (2006). ACCCN's Critical Care Nursing. Sydney: Elsevier Australia.

George, R. B., Light, R. W., Matthay, M. A., & Matthay, R. A. (2005). Chest Medicine: Essentials of Pulmonary and Critical Care Medicine. USA: Lippincott Williams & Wilkins.

Kumar, V., Abbas, A., Fausto, N., & Aster, J. C. (2010). Robbins and Cotran Pathological Basis of Disease. China: Saunders Elsevier.

Sanders, M. (2007). Mosby's Paramedic Textbook. St louis: Elsevier .

Sherwood, L. (2007). Human Physiology: Fromcells to System 6th Ed. USA: Thomson.

Portfolio Part One Marking Guide

Student Name Rebecca Boughton

Student Number:10233505

CRITERIA FOR ASSIGNMENT

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Average

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Good

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PRESENTATION:

Marking guide; title page; table of contents; page numbers; correct margins; correct spacing; correct font; correct headings; paragraph format (see ECU Assignment Guidelines)

WRITING SKILLS:

Logical and clear; well structured sentences; correct spelling (Australian); grammatically correct; use of the third person, passive style.

CRITICAL THINKING QUESTIONS:

Identify the relevant theories which are reflected in each discussion

Explain the relevant theories which are reflected the topic.

Depth of understanding & quality of content