Newbie question

[heatherabel3]

I'm sure you have all had questions from students that made you think "really?!", and even though I'm hoping this isn't gonna be one of them, just a heads up...it might be.

So, I've been reading in my textbook trying to get a leg up before class starts and tonight I was in the A&P chapter reading about the respritory system. One of the new things I learned is that the diaphragm is an involuntary muscle of sorts and is what is responsible for your breathing in your sleep. (I assumed you kept breathing in your sleep cause your brain told you to) So, my question is, if a person dies in their sleep people assume their heart stopped. Could it not actually be that their heart was fine, but it was actually their diaphragm that stopped?

 

[JPINFV]

Well, if you stop breathing your heart follows along soon enough.


...but yes, and it's one of those disorders that carries an awesome name. Ondine's Curse.

 

[CANDawg]

Well, if you stop breathing your heart follows along soon enough.


...but yes, and it's one of those disorders that carries an awesome name. Ondine's Curse.

Or less awesomely, either congenital central hypoventilation syndrome (CCHS), or primary alveolar hypoventilation.

 

[JPINFV]

Given all of the other eponymous names in medicine, I'll give Odine's Curse a pass. At least it isn't one of those, "Let's cram 2 or 3 names together with dashes to make it extra hard to learn." In fact, my goal is to invent or discover something just so I can torture generations of medical students with having to learn how to spell my last name.

...and yes, I'm looking at you, Mr. Osler-Weber-Rendu syndrome, as well as all of the God-forsaken biochem disorders.

 

[heatherabel3]

That is kind of an awesome name.

So, then, is it reasonable to think that's what happens with SIDS?

 

[EEMMTT]

Great that you have such a detailed interest in Physiology but my 2 cents for your sanity's sake (and that of your instructors/class mates) is try to let it go or it's going to be a long course. Stuff like that really isn't important to know at EMT level.

However good to see fellow EMTLIFErs helping out with their knowledge.

 

[JPINFV]

Great that you have such a detailed interest in Physiology but my 2 cents for your sanity's sake (and that of your instructors/class mates) is try to let it go or it's going to be a long course. Stuff like that really isn't important to know at EMT level.

However good to see fellow EMTLIFErs helping out with their knowledge.

WRONG!

You can learn a lot, including important things, by going, "Wait, how does _____ work? Can _____ happen?"


Oh, but right, this is EMS. Science is too advance for EMS.

 

[heatherabel3]

I know there's no need to go that in depth during class, that's why I have you guys.
I also know that I won't use that as a basic but I think those who learn only what they have to without questioning anything outside of that are doing a disservice to themselves.

 

[Aidey]

Given all of the other eponymous names in medicine, I'll give Odine's Curse a pass. At least it isn't one of those, "Let's cram 2 or 3 names together with dashes to make it extra hard to learn." In fact, my goal is to invent or discover something just so I can torture generations of medical students with having to learn how to spell my last name.

...and yes, I'm looking at you, Mr. Osler-Weber-Rendu syndrome, as well as all of the God-forsaken biochem disorders.

There is a list of eponymous diseases on wikipedia. It is an interesting read if you have a couple hours to kill. The Chiari family really mucked things up.

 

[Tigger]

Great that you have such a detailed interest in Physiology but my 2 cents for your sanity's sake (and that of your instructors/class mates) is try to let it go or it's going to be a long course. Stuff like that really isn't important to know at EMT level.

However good to see fellow EMTLIFErs helping out with their knowledge.

That is a terrible attitude to have. EMT class is short and skimpy enough on A&P as it is. OP if you have a question about physiology ask away in class or here. Odds are other people are wondering similar things and it'll get the class thinking. While I suppose you could get by with barely learning any physiology, it is a lot easier to attempt to care for someone when you have some sort of grasp of what's going on with them. Otherwise EMS becomes "see symptom x, apply treatment z. Transport."

 

[DPM]

Given all of the other eponymous names in medicine, I'll give Odine's Curse a pass. At least it isn't one of those, "Let's cram 2 or 3 names together with dashes to make it extra hard to learn." In fact, my goal is to invent or discover something just so I can torture generations of medical students with having to learn how to spell my last name.

...and yes, I'm looking at you, Mr. Osler-Weber-Rendu syndrome, as well as all of the God-forsaken biochem disorders.

I just found the eponymously named diseases wiki page and the first thing I clicked on was Babington Disease... or Hereditary hemorrhagic telangiectasia... better known as Osler-Weber-Rendu disease... spooky!

 

[medichopeful]

Great that you have such a detailed interest in Physiology but my 2 cents for your sanity's sake (and that of your instructors/class mates) is try to let it go or it's going to be a long course. Stuff like that really isn't important to know at EMT level.

Seriously?

 

[Doczilla]

There's SO many factors that play into someone dying in their sleep.

To cover one in particular, have you ever seen or heard of going to a "cardiac arrest" where the spouse finds their partner cold and stiff in the bed? Your blood pressure is at its lowest two hours after you fall asleep. People with comorbidities (diseases that pile up on each other) and possibly medications (nitrates, phosphodiesterase inhibitors (viagra, cialis, levitra) beta blockers calcium channel blockers, etc) can actually die from sheer hypotension when the stars align and their bodies enter power-save mode.

When they open then up for the autopsy they either conclude "hemhorragic" infarct, or in this case "pale" infarct because they see evidence of global ischemia in the brain or heart. Thats where the question "when did he/she go to bed" ? Comes into play. If they went to bed at 10:00, time of death is assumed to be at midnight because of the reason i mentioned before.

 

[bobbyd3423]

I just recently finished class and my two cents would be to do whatever it is that helps you to understand the subject. But when it comes time to test be careful! You don't want to over analyze the questions. Remember not to add anything to them and take them for face value. They are not trying to trick you! and when in doubt.... high flow O2.

 

[nekogirl]

Great that you have such a detailed interest in Physiology but my 2 cents for your sanity's sake (and that of your instructors/class mates) is try to let it go or it's going to be a long course. Stuff like that really isn't important to know at EMT level.

However good to see fellow EMTLIFErs helping out with their knowledge.

It's all important. Just because you aren't going to use that skill at a certain level doesn't mean it isn't important to learn more about it. You don't have to master it or even become proficient in it. But having a better understanding of something will only strengthen those skills you can use. That is what learning is really about. This is why college core classes are important to take because they build a solid foundation of learning and understanding for future skill sets.

People who make comments like this are those people in my class that are there to train for a pay check. They are always the ones who are whining and crying to leave class early, get annoyed anytime someone asks a question that is a bit out of the scope or could push our thinking, show up late, only does "what is required" of them and nothing beyond that. You limit yourself when you do this.

Why not ask "the who's, the why's, and the how's"...if someone is there willing to teach it to you!

 

[firetender]

Hold on here...

the diaphragm is an involuntary muscle of sorts and is what is responsible for your breathing in your sleep. (I assumed you kept breathing in your sleep cause your brain told you to) So, my question is, if a person dies in their sleep people assume their heart stopped. Could it not actually be that their heart was fine, but it was actually their diaphragm that stopped?

The diaphragm is no less independent from the brain than the heart is.

Being an involuntary muscle does not mean it has a mind of its own. The SA node of the heart recieves impulses; from where? The Medulla Oblongata, which also sends the juice to the diaphragm to make it work. Take that out and everything else goes with it. The impulses start there.


Respiration is an involuntary process, that means you don't have to think to breathe, it just happens; just like with your heart. But the impulses to make it happen must come from somewhere. None of our organs are independent from our control tower.


Whales and porpoises are called "conscious breathers" in that they have to make a choice to breathe. When you go to sleep and forget everything else, breathing is not forgotten.

We normally describe death by "heart attack"; the heart stops. Ever hear of fatal "diaphragm attack"? Were that the case someone would have invented the diaphragmatic defibrillator to get that de-railed muscle pumping again!

Good question, especially since everyone accepted what you said as truth.

 

[Doczilla]

The heart can continue to beat independant of the brain , just from automacity. Problem is, without cranial nerves X and IX, you beat at an intrinsic rate which may not meet the systemic needs at the moment.

Also, cocominant brain injuries mess with BP as well, so a fixed heart rate moving against low PVR will cause a pale heart attack.

If the brain stem is damaged, you WILL go apneic, which leads to cardiac arrest. There's no voluntary influence when you're in a coma. Both voluntary and involuntary mechanisms make you breath- but without the brain stem in the picture ,( or the spinal cord for that matter) you will die without mechanical ventilation

 

[heatherabel3]

Thanks for all the positive feedback guys.
I am definitely that person in class that people get annoyed with because I will keep asking questions as long as the instructor will let me. For me, the whole picture makes the basics a lot easier.
Anyway, just wanted to thank those who took the time to answer and help me understand why or why not the diaghragm is possible.