Muscle Physiology

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Study Tools For Muscle Physiology

Smooth Muscle (Image)
Sarcomere Muscle Contraction (Image)
Neuromuscular Contraction (Image)
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Outline

Overview

  1. Muscle physiology
    1. “Motor unit”
      1. 1 nerve cell and all muscles cells that it innervates
        1. 2-2,000 muscle cells
    2. Isolated muscle contraction
      1. Types
        1. Isotonic contraction
          1. When stimulated, muscle moves and changes shape
          2. Can do work since free end can move
            1. W = F x D
            2. 5 lbs x 4 ft. = 20 ft. lbs of work
          3. Movement
        2. Isometric contraction
          1. When stimulated, cannot move, shorten, or change
          2. Can’t do work
          3. For stability, rigidity, and maintenance of posture
    3. Phases of contraction
      1. Latent/Resting phase
        1. No (or weak) stimulus, no contraction
      2. Depolarization/Contraction phase
        1. Strong enough stimulus initiates a contraction
      3. Relaxation/Repolarization phase
        1. Calcium leaving cell, cells begin relaxing
      4. Refractory phase
        1. A new stimulus will NOT produce a new contraction
      5. Return to Latent phase

Nursing Points

General

  1. Stimulus leads to twitch
    1. Threshold stimulus (liminal)
      1. Lowest stimulus that causes a reaction
    2. Simple summation
      1. 2 consecutive stimuli
        1. Not during refractory period or after relaxation
      2. Second twitch superimposed and stronger
        1. 1st twitch overcomes 100% of elastic forces
        2. 2nd twitch has less forces to overcome
  2. Tetanus
    1. Conditions – Multiple rapid stimuli
    2. Incomplete tetanus
      1. Constant contraction interrupted by partial relaxations
    3. Complete tetanus
      1. Frequency of stimuli is so great that muscle is in sustained contraction without relaxation
      2. Muscles in body
      3. Tetanic
  3. Fatigue
    1. Complete fatigue
      1. Overstimulation of muscle
      2. Muscle loses:
        1. Irritability (doesn’t react to stimulus)
        2. Conductivity (no action potentials)
        3. Contractility
      3. In real life – complete fatigue doesn’t usually occur
    2. Chemicals in cells converted to fatigue substances
      1. Glycogen → Pyruvic acid
      2. Glucose → Lactic acid
      3. ATP → ADP + Pi
      4. Creatine Phosphate → Creatine
      5. Oxygen → Carbon Dioxide
  4. Muscle tonus
    1. Spinal cord sends continual action potentials to muscles
      1. Slight state of tension
    2. Increase tonus
      1. Anxiety, fear, stress
    3. Decrease tonus
      1. Sleep

References
Betts, J.G., et al. (2017). Anatomy and physiology. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

All right guys in this lesson, we’re going to talk about muscle physiology and how it works at a microscopic level

So, before we get started we have to understand this concept of motor units. What a motor unit is, is that it’s that you can have one particular nerve cell that comes in and innervates a specific number of muscle cells. So you can have like maybe two muscle cells that it’s innervating or you can even have up to like 2,000 muscle cells that it innervates, so you have all these muscle cells here. So if you look at this image here here’s a good example so you can this nerve coming in and it’s actually innervating it all these specific different types or different areas of those muscle fibers. Now just because that one thing happened what what you are getting is one specific motor unit.

Looking at different types of muscle contractions, we have to that we’re going to compare. You have an isotonic and then you have something called an isometric. Now, the difference between isotonic and isometric is that first off we’re looking at shape. There’s another lesson that talks about this specifically but when you have muscle fibers that are going to shorten what happens is they move towards the center of the cell which is right here. So that means that the length is actually going to get shorter in the diameters going to get wider. So here if you look at this bicep muscle every time the muscle contracts, it gets actually get shorter at the same time it’ll execute wider. The other thing about isotonic contractions is that the work requires movement. So here we’re looking at the articulation of the elbow as a arm moves and the forearm moves up and down your actually getting this movement. You have this free end, so imagine that this person here has a dumbbell and every time they lift it the dumbbell is moving in so it’s got a free end. When you’re looking at isometric contractions are quite the opposite. The muscles aren’t going to shorten it where they’re going to change shape so you’ll stay the contraction that happens but there’s no movement that’s actually occurring. This is really important for things like stability, rigidity, maintenance of posture. If you look at this person they’re doing a plank, you’re actually going to get shortening in the contraction of like the abdominal muscles to the erector muscles in the back, You’re can get some contraction to the glutes and the quads. But all of these are for stability and rigidity and it’s helping to to create that that core support here.

Another important thing to think about are the phases of contraction. When we look at the phases of contraction we also look at the action potential. We have four different ones we’ve got. Latent which is resting, depolarization and that’s where contraction actually happens. You’ve got relaxation which is a repolarization and then you got the refractory period and we’re going to go through each one of these. When we’re talking about the latent phase, we are talking about that there’s no or there’s a weak stimulus and so no contractions going to happen. The important thing here too, is when we’re talking about the action potential there’s a certain threshold that has to be met by the by the action potential and if it doesn’t pass the threshold no stimulus is going to occur. So this is where we talked about a weak stimulus. When we move along to depolarization where the contraction phase is which is right here basically we hit this threshold and the depolarization happens and there’s a strong enough stimulus to initiate the contraction.

Once we get that contraction what’s going to happen is it you’re going to have the relaxation and repolarization. So you going to have the calcium that leaves the cell. Calcium is in the in the cell doing its job working with the myosin and actin to create those the shortening of sarcomeres. There’s an excellent lesson on that and I encourage you to check that out and see how calcium plays in all of that but when calcium leaves the cell, the muscles going to begin to relax and then you’re going to get this repolarization here. In the refractory period is really important because what’s going to happen is you’re actually going to hit this this bottoming out and what happens if there’s there’s no new stimulus it’s going to override this. So even if you have all the all cylinders firing in terms of the nerve stimulus is just not going to happen and it’s not going to happen until you get back to this resting state and the latent phase.

We have several different concepts of muscle stimulus and so the first one to talk about is simple summation. Basically you get the you got that threshold stimulus I talked about in the previous slide where basic lowest stimulus that can cause a reaction. If we don’t hit that threshold there’s going to be no muscle contraction. But with a simple summation what happens is you’ll get a contraction and then before you get complete relaxation you’re going to have another full contraction. So you get these two consecutive stimuli. The important thing to know here is that that second stimuli can’t happen during that refractory period. But you’ll get that one contraction, and just as you start to rest, you’ll get another one. The idea behind it is called a second twitch and they’re superimposed and it creates a stronger stronger contraction. First twitch is going to overcome 100% of that elastic force and the second twitch has actually less of a resistance to overcome and you’re going to create a much stronger contraction.

This is another type of contraction that you’re going to see and it’s basically this idea multiple rapid stimuli. What’s happening is you get this. There two types of we look at. With the incomplete tetanus and complete tetanus is as it goes along you’re eventually going to hit complete tetanus unless you get this for relaxation. But what happens in incomplete tetanus is you get this constant contraction of these partial relaxations so you’ll get this the contraction that are relaxed just a little and then go get another one and then another one and they started firing rapid sequence. And then finally you get to the point where the frequency of that stimuli is so great and there’s no way for the muscle to relax that it ends up basically locking out and you’re going to get this sustained contraction which is here, which is known as complete tetanus

Then there’s a concept of fatigue and so you have basically you have the normal twitch you’ll get contraction-relaxation contraction-relaxation contractions-relaxation. But at some point there’s not going to be any ATP and is going to be no energy for use and you’re going to get this complete fatigue and happens is just as overstimulation of this muscle. So as muscles lose their irritability, they lose their conductivity and they lose a contractility. If you look here you’ll get you’ll get kind of the normal contraction-relaxation contraction-relaxation and you finally get to the point where you have there at this heat buildup in and the residual calcium. Then finally in once you get to the point where hey I can’t I there’s absolutely no way for me to contract this muscle any longer and you’re going to have no ATP here. You’re going to have this is a phase of incomplete fatigue. So basically you’re really weak and then you got complete fatigue. There are a couple things to think about. Number one you’ve got “in real life” because there’s constant circulation in the removal of waste. You have all these waste products and build up these fatigue substances and what happens is you’re going to get the circulation comes in a removes the waste and then it also brings a new ATP and calcium. It brings in new wastes for these muscles to to happen to a real life it’s just it’s not a possibility but it’s part of the theory of fatigue. The other thing that’s really important and I encourage you to check this out in some of the resources we talked about this fatigue substances. So your energy products essentially get converted to fatigue substances and what happens if one of these fatigue substances buildup that’s going to contribute to fatigue.

We have this idea of muscle tonus and what muscle tonus is that you have the spinal cord so you have the brain here and you have the spinal cord. And you’re going to be sending out constantly signals to the whole body because what happens is if you didn’t have this idea muscle tonus what happened was you would have met you never have the idea of proprioception, so where you are in space you would never have the idea of you need to be upright, you need to be sitting down. These are all kind of innate processes that we don’t think about but something that the body immediately does. So the spinal cord is going to constantly send out these continual action potentials to muscles and it helps keep us upright, right? So we have this slight state of tension and all of our muscles all the time for them to be on the ready to move

We know we’re going to grab something our body can automatically reach over. And if we know we are about to fall or so start to lean forward we know that our back muscles can try to pull us back and keep us up in space. Now there’s a couple of different ideas behind this that kind of the going either spectrum if you will. Let’s say you have you have normal tonus here and then you have increased tonus and then you have decreased tonus. Well, an increased tonus basically it’s an increase in the the action potential so they’re being stimulated in and kicked out even more frequently. This is caused by increased anxiety, fear or stress. If you are constantly anxious or do you feel like you have to you know your your fight-or-flight response is a little bit more heightened all the time and that’s going to increase the overall tonus.

Then you have decreased one is which happens during sleep. When we’re sleeping our muscles need to relax as much as possible for repair and restoration and that’s what happens during decreased tonus.
Okay so let’s recap.

When we’re talking about contraction we’re talking about two different types of contraction. We have the isometric and isotonic. With your isometric, this is the one where you have movement and you have a shortening and a change the muscle where isotonic doesn’t and isotonic is also responsible for stability.

Then you have the phases of contraction. You get the resting, the depolarization, repolarization and refractory. Remember nothing can happen during the refractory; there’s no stimulus that is going to be able to overcome that

When you have summation, you have basically two consecutive stimuli that is going to make that overall contraction greater.

With tetanus, you get the multiple stimuli resulting in that sustained contraction. Basically this is that lock out that we talked about.

When you have fatigue you have is overstimulation in the muscle. You’re going to have that decreased irritability, decreased conductivity and the decrease contractility. What happens is the muscle just overwhelmed with the amount of stress and is not going to work. Remember that this doesn’t happen in real life because we have a circulation which helps in that. But it’s important to understand because muscles do get fatigued and at some point they do need to to rest and relax and restore themselves. But you’re never going to get complete fatigue.

That’s it for our lesson on muscle physiology. Make sure you check out all the resources attached to this lesson. Now, go out and be a best selves today and as always happy nursing.

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Study Plan Lessons

05.03 Jaundice for CCRN Review
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placenta for Certified Emergency Nursing (CEN)
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Adult Vital Signs (VS)
Alpha-fetoprotein (AFP) Lab Values
Ampicillin (Omnipen) Nursing Considerations
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Anti-Infective – Aminoglycosides
Anti-Infective – Lincosamide
Aspiration for Certified Emergency Nursing (CEN)
Babies by Term
Behind The Red Line – Live Tutoring Archive
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Glucose Monitoring
Blood Transfusions (Administration)
Body System Assessments
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Certified Nurse Midwife
Chorioamnionitis
Clindamycin (Cleocin) Nursing Considerations
Congestive Heart Failure (CHF) Labs
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Dexamethasone (Decadron) Nursing Considerations
Direct Bilirubin (Conjugated) Lab Values
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Emergent Delivery (OB) (30 min)
Emergent Delivery for Certified Emergency Nursing (CEN)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Eye Prophylaxis for Newborn (Erythromycin)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Family Planning & Signs of Pregnancy – Live Tutoring Archive
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Environment
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Furosemide (Lasix) Nursing Considerations
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemodynamics
Hemoglobin A1c (HbA1C)
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hydralazine (Apresoline) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperemesis Gravidarum for Certified Emergency Nursing (CEN)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Inserting a Foley (Urinary Catheter) – Female
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Isotonic Solutions (IV solutions)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant
Lung Surfactant for Newborns
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Methylergonovine (Methergine) Nursing Considerations
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
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Nursing Care Plan (NCP) for Chorioamnionitis
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Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
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Nursing Care Plan (NCP) for Hyperemesis Gravidarum
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Nursing Care Plan (NCP) for Incompetent Cervix
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Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
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Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
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Nursing Case Study for Maternal Newborn
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Nutrition in Pregnancy
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OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Course Introduction
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetric Trauma for Certified Emergency Nursing (CEN)
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Pediatric Vital Signs (VS)
Physiological Changes
Phytonadione (Vitamin K)
Phytonadione (Vitamin K) for Newborn
Placenta Previa
Placenta Previa for Certified Emergency Nursing (CEN)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Physiological Maternal Changes
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia (45 min)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preload and Afterload
Premature Rupture of the Membranes (PROM)
Preterm Labor
Preterm Labor for Certified Emergency Nursing (CEN)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Process of Labor – Live Tutoring Archive
Process of Labor 2 – Live Tutoring Archive
Prolapsed Umbilical Cord
Promethazine (Phenergan) Nursing Considerations
Prostaglandins
Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tips & Advice for Newborns (Neonatal IV Insertion)
Tocolytics
Tocolytics
Top 5 Misunderstood OB Concepts – Live Tutoring Archive
Transient Tachypnea of Newborn
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
What the Heck is Antepartum Testing? – Live Tutoring Archive
54 Common Medication Prefixes and Suffixes
Alpha-fetoprotein (AFP) Lab Values
Carboxyhemoglobin Lab Values
Cardiac Terminology
Diagnostic Testing Course Introduction
Diagnostics Terminology
Digestive Terminology
Gamma Glutamyl Transferase (GGT) Lab Values
Growth Hormone (GH) Lab Values
Hematology Oncology & Immunology Terminology
Integumentary (Skin) Terminology
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Medical Terminology Course Introduction
MedTerm Basic Word Structure
MedTerm Body as a Whole
MedTerm Prefixes
MedTerm Suffixes
Metabolic & Endocrine Terminology
Methemoglobin (MHGB) Lab Values
Musculoskeletal Terminology
Myoglobin (MB) Lab Values
Neuro Terminology
Pharmacology Terminology
Prealbumin (PAB) Lab Values
Procedural Terminology
Psychiatry Terminology
Reproductive Terminology
Respiratory Terminology
Sensory Terminology
Urinary Terminology
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
02.07 Reading “A, C, V Waves” & PAWP Waveforms for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
07.02 Neuro Anatomy for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
ABG Course (Arterial Blood Gas) Introduction
Adrenal Gland
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Anatomy & Physiology Course Introduction
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Arterial Blood Gases Nursing Mnemonic (ROME)
Arterial Pressure Monitoring
Atropine (Atropen) Nursing Considerations
Autonomic Nervous System (ANS)
Autonomic Nervous System (ANS)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Blood Grouping
Blood Plasma
Blood Pressure (BP) Control
Blood Vessels
Bone Structure
Bowel Elimination
Breathing Control
Breathing Movements
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Calculating Heart Rate
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Cycle
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Connective Tissues
Cranial Nerves
Development of Bones
Digestion & Absorption
Digestive System Anatomy
Drawing Blood
Drawing Blood from the IV
EKG (ECG) Course Introduction
EKG (ECG) Waveforms
EKG Basics – Live Tutoring Archive
Electrical A&P of the Heart
Electrical Activity in the Heart
Electroencephalography (EEG)
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Electrolytes Involved in Cardiac (Heart) Conduction
Electromyography (EMG)
Epithelial (Skin) Tissues
Esophagus
Female Reproductive Anatomy (Anatomy and Physiology)
Fluid & Electrolytes Course Introduction
Fluid Volume Deficit
Formation & Excretion of Urine
Gastrointestinal (GI) Course Introduction
Glands
Health Assessment Course Introduction
Hygiene
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Increase MAP Nursing Mnemonic (VAK)
Inserting a Foley (Urinary Catheter) – Male
Intro to Circulatory System
Intro to Health Assessment
Introduction to Health Assessment
Joints
Large Intestine
Liver & Gallbladder
Male Reproductive Anatomy (Anatomy and Physiology)
Membrane Potentials
Membranes
Mouth & Oropharynx
Muscle Anatomy (anatomy and physiology)
Muscle Contraction
Muscle Cytology
Muscle Physiology
Nerve Transmission
Nervous System Anatomy
Neuro Assessment Module Intro
Normal Sinus Rhythm
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Fluid Volume Deficit
Order of Lab Draws
Oxygen Delivery Module Intro
Pancreas
Parasympathomimetics (Cholinergics) Nursing Considerations
Pituitary Gland
Renal (Kidney) Acid-Base Balance
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System
Renin Angiotensin Aldosterone System (RAAS)
Respiratory A&P Module Intro
Respiratory Functions of Blood
Respiratory Structure & Function
Selecting THE vein
Sensory Basics
Skeletal Anatomy
Skeletal Muscle
Skin Structure & Function
Small Intestine
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)
Spinal Cord
Stomach Video
Tattoos IV Insertion
The EKG (ECG) Graph
The Heart
Thyroid Gland
Tonicity of Solutions – Live Tutoring Archive
Trach Care
Trach Suctioning
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Types of Epithelial (Skin) Tissue
Urinary Elimination
Urinary System Anatomy (Anatomy and Physiology)
12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anesthetic Agents
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Bariatric: IV Insertion
Basics of Calculations
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations