1. PART !: Why is knowl- Back pain may be due to trauma, muscle pulls, slipped spinal discs, or
edge of anatomy im- kidney stones, among other causes. Understanding human anatomy and
portant in determin- physiology helps to direct the assessment; is there pain on palpitation
ing potential sources or with movement; is the pain constant or intermittent; is it localized or
of pain? widespread, etc. The assessment findings combined with the history of
the pain's onset and the EMS provider's knowledge of which anatomical
structures cause which symptoms will help determine the best management
and transport plan for the patient.
2. PART 2: Where are the The kidneys are retroperitoneal — behind the abdominal cavity — above
kidneys located in the the umbilicus. Since this patient is experiencing right back pain, the liver,
body? Are there any gallbladder, and part of the large intestine also may be considered as pain
other organs in the sources. In addition, the adrenal glands sit on top of each kidney and the
same area? pancreas also is retroperitoneal.
3. PART 2: Given the lo- Kidney pain can radiate along nearby nerves so that it can be felt in the
cation of the kidneys abdomen, the side (or flank), the back, or the groin. Kidney stones may
and other compo- migrate down the ureters, causing changes in the pain as the ureters move
nents of the urinary the kidney stone along, and potentially some hematuria (blood in the urine)
system, what other due to irritation of the ureter. The pain and stress often cause nausea or
complaints might this vomiting as well. The patient may be anxious and move around trying to
patient express? find a comfortable position.
4. PART 3: If you are un- Lack of knowledge about human anatomy and physiology could significantly
familiar with human delay an assessment of the potential cause of the patient's pain both in the
anatomy, how could field and at the receiving hospital, as the hospital statt would have to begin
your lack of knowl- the assessment on the patient's arrival. You would not be able to focus your
edge significantly af- assessment and might not start the appropriate treatment, or may even treat
fect the quality and the patient incorrectly. For example, immobilizing a patient for back pain
the timeliness of your that you assume is due to an unknown injury could potentially increase the
patient care? level of pain for a patient with kidney stones.
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