Tuesday, April 12, 2016

ATI Wisdom Booklet 1: Medical Portion - Fight or Flight

Today, we learn about the fight-or-flight response.  Well, kind of.

I taught a basic (~9th grade) human anatomy course for 5 years in various formats.  ATI/ATIA has taken on a huge subject in this section.  To effectively describe how the adrenal glands work, the students need to have a solid understanding of the divisions of the nervous system, how different sections of the brain work, and a refresher on feedback loops.  Since this is the first booklet, all of this information would need to be covered at once.  That sounds like a trainwreck in the making since I spent six weeks on brain structure and function, divisions of the nervous system, and reflex arcs and other spinal cord controlled nervous system functions alone before spending an additional 6 weeks on the endocrine system.
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  • Yeah, physical strength and vision are not directly related.  
  • The hypothalamus does trigger adrenaline release, but there is a gland that actually produces and releases the adrenaline into the bloodstream.  Wonder how long it will take for the booklet to name that gland?
  • Fight-or-flight can increase strength and stamina, but there are still upper limits based on the physical fitness of the person.  For example, my strength increases noticeably in an emergency, but I still have overly tight muscles.  I might be able to jump higher to reach the roof of that building and pull up using my arms during fight-or-flight, but my legs will still have limited range of mobility to kick a leg up to the edge of the burning roof.

  • If you are that close to a black bear sow and her cub, you are going to win a Darwin award.  Dude would have been better off using his normal eyesight and talking loudly.
  • The section on the nervous system isn't wrong, but it is missing entire chunks.   Let me see if I can straighten it out with some oversimplification.
    • The nervous system has two divisions: the central nervous system and the peripheral system. 
      •  The central nervous system (CNS) consists of the brain and spinal cord. 
        • The brain can be roughly divided into three areas - the front brain, the midbrain and the hindbrain. 
          • The front brain handles cognitive tasks like "I can write a blog post!" or "That picture seems to be of a black bear, not a grizzly bear."
          • The midbrain handles emotion, memory and routing information to the correct section of the front brain.
          • The hind brain handles automatic bodily functions that are critical for life like breathing, blood pressure, heart-rate, etc.
      •  The peripheral system (PNS) is the nerves outside of the brain and spinal cord.
    • The PNS has two divisions: the somatic nervous system and the autonomic nervous system.  
      • The somatic nervous system deals with skeletal muscles.  
      • The autonomic nervous system deals with smooth muscles (which are involuntary muscles in the body), organs and glands.  
    • So, a more accurate way of describing control would be "The front brain handles conscious decision making while the autonomic prepares the body for action."  This becomes important later in the lesson.

  • Interesting and important side note: Fight-or-flight doesn't protect your body from negative side-effects like injuries, but rather numbs the pain reflex until the danger passes or your body gives out.  Arnold could certainly lift a large amount of weight during fight-or-flight, but that doesn't mean that that wouldn't potentially cause another heart attack or damage to his heart.
  • A few years ago, I'd joke about the 1,800 pound pipe as hyperbole, but not anymore.  Two years ago, we had a cow that had gotten trapped lying on her side in a ditch.  (Cows can't stand up if their spine is lower than their legs.  You'd think that would prevent them from rolling around in ditches.  It doesn't. )  There was only me and another farmhand.  We needed to roll the cow over her back so that her legs were below her spine and she could stand up before she developed pneumonia.  I was mentioning to the farmhand that he should lift the front legs while I lifted the back legs when he lifted her back legs to vertical.  I quickly crouched and flipped the front end of the cow.  See, the reason I wanted him to do the front is that 60% of the cow's weight is there compared to 40% on the back end.  My husband estimated that I lifted 600 pounds.  Since I normally struggle to lift 100 pounds of rigid weight, 600 pounds of rigid weight was a pure fight-or-flight response.  If Arnold could lift 300 pounds normally, he might be able to lift 1,800 pounds in fight-or-flight.  The good news was that I lifted with legs to protect my back.  The bad news was that my legs hurt for a week.
  • First, I don't think the pineal gland is visible in that cross-section of the brain.  Regardless, the pointer for the pineal gland is substantially off.  Here's a better cross-section:

  • I think the pointer for the pituitary gland is in the right place on the Wisdom Booklet, but it's confusing because the artist included a detail from the brainstem (part of the hindbrain) that looks like the pointer continues way deeper into the brain than it should.
  • The Booklet section is also a poor choice for details between the thalamus and hypothalamus - but I don't know why the thalamus is included anyway.  It's irrelevant in this discussion.
The next section lays out the seven different effects that fight-or-flight has on the body.  Some of the effects are straightforward  like pallor (pale skin), dilated pupils, and racing heart.  Some are less noticeable but valid like body hair becoming erect (goosebumps), the digestive system shutting down, and dry mouth.    The inclusion of "second wind" is a bit shaky.
The fight-or-flight response triggers a fast burst of energy.  The "second wind" most people think of is actually related to the release of stored energy when the liver breaks down fat.  The problem?  This "second wind" occurs after 20 minutes or so of aerobic activity in normal humans and a bit faster in highly trained athletes.  It's not going to help you outrun a bear; it will help you exhaustion hunt a deer.

On the positive side, the term "adrenal gland" is finally introduced - when there's about 5 paragraphs left in the section.  Poor planning since the adrenal gland produces adrenaline.

For the section on the control of adrenaline flow, the first paragraph needs to be rewritten or discarded because your body doesn't turn on and off; the rate of activities is faster or slower.   The second paragraph is much better and more accurate.

I hate this drawing for a number of reasons.  It gives no information about what "speeding the liver up" or any other organ you pick means.  The kidney on the right side is detached from the bladder.    If you look carefully at the kidney, you'll notice that the adrenal gland is controlled by the sympathetic nervous system on the right and....not controlled by the parasympathetic nervous system on the right.    So, according to this Wisdom Booklet, the adrenal gland can be up-regulated, but has NO system of down-regulation.  (In real life, the down-regulation is a process of breaking down neurotransmitters and rather complicated.)

  • This is a great little explanation of the hypothalamus and a fun diagram to boot!  What I don't understand - at all - is why it's located as the absolute end of the lesson.  This should have been at the beginning right next to the mis-labeled brain picture.  The diagram of the guys running is nice; it has nothing to do with the hypothalamus, but it's a nice picture.
I don't know if this clarifies it or makes it worse, but that's my take on the subject.

They missed a few fun facts like the fact that adrenaline is used as a medication when trying to restart the heart and as a temporary antidote to severe allergic reactions.  Sharing those kinds of tidbits was my favorite part of this class.  I'd also teach a few stress-relief techniques like deep breathing and progressive muscle relaxation which I think most ATI followers need badly.

Next up, ATI's take on how humanism has warped academic subjects...and my take on how ATI has warped academic subjects.

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