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Patho Exam 3


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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