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Patho Exam 3
Shock
| Term | Definition |
|---|---|
| Shock involves compensatory mechanisms | which become less effective if the event continues. |
| Underlying problem with all forms of shock | impaired tissue damage |
| No oxygen available= | cells convert pyruvate to lactate |
| Lactate accumulation in the blood | is a measure of significant tissue hypoxia |
| hypoxia | deficiency in the amount of oxygen reaching the tissues |
| reperfusion injury | oxygen free radicals are produced when oxygen is restored to cells; ongoing and occurs after ischemic event is over |
| Early detection of shock | decrease level of consciousness; thirst, restlessness, dilated pupils; release of ADH; increase heart rate; increase respiratory rate; decrease urine output; increase specific gravity; cool, clammy, bluish or gray color; decrease capillary refill; |
| Early detection of shock 2 | hypotension (SBP <90 mm Hg); decreased pulse pressure; release of aldosterone and cortisol; constriction of splanchnic vessels - nausea, abdominal pain |
| Later stages of shock | clotting cascade; vascular system begins to fail; organs fail; widespread tissue damage; acute renal failure |
| types of shock | cardiogenic, obstructive, hypovolemic, distributive |
| cardiogenic shock = | myocardial failure; results from severe dysfunction of the left, right, or both ventricles |
| pump failure | often not reversible |
| cardiogenic shock clinical manifestations: | sympathetic stimulation occurs, narrowed pulse pressure, tachycardia, cool, clammy skin, deep and rapid respirations, coarse crackles in lung fields, decreased urine output, confusion |
| Obstructive shock | heart is prevented from pumping due to a mechanical obstruction of blood flow |
| Obstructive shock; obstructions include | pulmonary embolism; tension pneumothorax |
| Hypovolemic shock: internal losses | internal hemorrhage; fraction of long bones; interstitial leakage |
| Hypovolemic shock: external losses (most common) | external hemorrhage; burns; severe vomiting, diarrhea; diuresis |
| Hypovolemic clinical manifestations: | tachycardia; preload and CO are low |
| Distributive shock types | anaphylactic, neurogenic, and septic |
| Anaphylactic shock | antigen/antibody reaction on surface of mast cells and basophils |
| anaphylactic shock type 1 reactions: | histamine release |
| neurogenic shock | brain trauma, spinal cord injury, drug overdose |
| septic shock | associated with gram-negative bacteria: E. coli. |
| Multiple Organ Dysfunction Syndrome (MODS) | develops when 2 or more systems develop organ dysfunction |
| Primary MODS | occurs when injury occurs, such as major trauma |
| Secondary MODS | develops days to weeks after the primary insult |
Created by:
katelynreid
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