# data[].attributes.body
CIRCULATORY SYSTEM

Organs:
1. Heart - pumps blood to the body through a network of arteries and veins (blood vessels).
2. Blood vessels - are the network of tubes through which blood is pumped around the body.
3. Blood - the fluid that circulates in the heart, arteries, capillaries, and veins of a vertebrate animal carrying nourishment and oxygen to and bringing away waste products from all parts of the body.v

Function:
The circulatory system’s function is to move blood throughout the body. This blood circulation keeps organs, muscles and tissues healthy and working to keep you alive.

The circulatory system also helps your body get rid of waste products. This waste includes:

• Carbon dioxide from respiration (breathing).
• Other chemical byproducts from your organs.
• Waste from things you eat and drink.

Assessments and Labs/testing- what are the normal lab values or a normal test looks like and what an abnormal lab or test may indicate:

1. Capillary Refill Time
• Normal CRT: 1 – 2 seconds
• A CRT longer than 2 seconds suggests poor perfusion due to peripheral vasoconstriction. Peripheral vasoconstriction is an appropriate response to low circulating blood volume and reduced oxygen delivery to vital tissues. This may cause hypoxia due to peripheral vasoconstriction, which will then respond to low circulating blood volume and reduced oxygen delivery to vital tissues.

2. Edema
• Normal: Not dyspneic, tachypnic and no crackles.
• Plain radiograph
o upper lobe pulmonary venous diversion (stag's antler sign)
o increased cardiothoracic ratio/cardiac silhouette size: useful for assessing for an underlying cardiogenic cause or association
o features of pulmonary interstitial edema:
 peribronchial cuffing and perihilar haze
 septal (Kerley) lines
 thickening of interlobar fissures
o features of pulmonary alveolar edema:
 air space opacification classically in a batwing distribution
 may have air bronchograms
o pleural effusions and fluid in interlobar fissures (including 'vanishing' pulmonary pseudotumor)

• CT
o ground glass opacification
o bronchovascular bundle thickening (due to increased vascular diameter and/or peribronchovascular thickening)
o interlobular septal thickening

3. Jugular Venous Pulse
• Normal: Normally there is either no rise or only a transient (i.e., 2 to 3 sec) rise in mean jugular venous pressure.
• Elevated jugular venous pressure is a manifestation of abnormal right heart dynamics, mostly commonly reflecting elevated pulmonary capillary wedge pressure from left heart failure. This usually implies fluid overload, indicating the need for diuresis.

# data[].attributes.body
Nervous System

Organs used in the nervous system:

1. Brain: The brainstem controls respiratory rhythm

2. Nerves: Network in which electrical signals are sent from the brain to other parts of the body

The parafacial respiratory group (includes lateral and ventral part) is responsible for generating the rhythm for the expiratory phase of breathing. It is also responsible for detecting changes of pCO2 and pH in the blood

The pontine respiratory group is a collection of nerves that is responsible for coordinating respiratory muscles during breathing

The phrenic nerve is responsible for movement of the diaphragm

Function:

The nervous system controls all functions in the body. It does this by taking signals from the brain and sending those messages throughout the body.

Tests:

1. Esophageal Balloon

An esophageal balloon can be used to assess diaphragmatic activity. It does this by measuring esophageal pressure. Normal esophageal pressure during a breath hold at maximum capacity ranges from 20-25 cmH₂O

2. Edi Catheter

More recently we use an Edi Catheter. This is a catheter that is inserted into the esophagus placed at the same level as the diaphragm. Here it can detect the diaphragm's electrical activity, the detected waves being called an Edi signal (waveform). In a healthy person, the peak of the waveform should be between 0 and 10 ɰV. The minimum would be 0 ɰV.

3. Ultrasound

Phrenic nerve damage can be evaluated using an ultrasound. With an ultrasound, the thickness of the diaphragm is evaluated. In a healthy individual the diaphragm is between .22 to .28 cm thick. In patients with diaphragmatic paralysis, the diaphragm is between .13 and .19 cm thick.

4. Sniff Test

The sniff test is another method to see if the diaphragm is functioning. With this test, the patient is guided through breath and during these breaths chest radiographs are taken to confirm diaphragm movement. In a healthy patient, both sides of the diaphragm should move together, the diaphragm should move down during inspiration and upwards during expiration. For normal breaths the diaphragm should move 1-2.5 cm and for deep breath it should move 3.6-9.2 cm. In an unhealthy pt, the diaphragm does not move and paradoxical motion can occur.