10- Shock Flashcards
What does the PNS do to the circulatory system and “with what”
- Slow rate
- Vagus nerve
What does the SNS do to the circulatory system and “with what”
- Increase rate
- Cardiac plexus
What is stroke volume
Amount of blood ejected from the heart in a single beat
What is preload
Amount of ventricle stretch as blood enters
What is ventricular filling
Amount of blood that enters a ventricle before contraction
What is the frank-starling mechanism
Rubber band effect
What is after load
The force the heart must contract to send blood out
What is the formula for cardiac output
Stroke volume x Heart rate
What is the fick principle
Perfect O2 take in and off load to tissues
Describe shock in 1 word
Hypoperfusion
What is hypoperfusion and 5 possible problems that cause it
-Inadequate tissue perfusion
1 Pump problem 2 Volume problem 3 Container problem 4 Obstruction problem 5 Respiratory problem
What are the 3 stages of shock
1 Compensated
2 Decompensated
3 Irreversible
What are the 5 signs of compensated shock
- Pulse rate increase
- Pulse strength decrease
- Skin may become cool and clammy
- Progressive anxiety, restlessness, combativeness
- Thirst, weakness, eventual air hunger
What are the 4 signs of decompensated shock
- Pulses become unpalpable
- Blood pressure drops precipitously
- Patient become unconscious
- Respiration’s slow or cease
What is irreversible shock
Irreversible damage, cells die, tissues dysfunction and the patient dies
What happens to the BP in compensated vs decompensated shock
Comp - Maintains
Decomp - Drops
What is the formula for BP
BP = Cardiac output x peripheral vascular resistance PVR
What does PVR determine
After load
What is pulse pressure
Difference between the systolic and diastolic
Ex. Which does each BP possibly indicate
70/40
70/60
70/30
70/40 - Normal BP, need fluid
70/60 - Pump problem (weak heart)
70/30 - Container problem (vasodilated, fluid problem)
What are the 5 compensatory mechanisms in order
- Baroreceptors
- Renin-angiotensin-aldosterone
- Chemoreceptors
- ADH (anti diuretic hormone)
- Fluid return
Where are Baroreceptors located and their effect on SNS (3) and PNS (2)
Location - Atria, vena cava, aortic arch (Most), carotid sinus
SNS effect
- Stimulates arenalglands
- Secrete Epi and norepi
- Aalpha and beta effects
PNS
- Stops signal to vagus nerve
- Increase HR and vasoconstriction
What are the 5 steps of the renin-angiotensin-aldosterone compensatory mechanism
- BP drops
- Renin is released from the kidneys
- Renin + blood (plasma) = Angiotensin 1
4, ACE (angiotensin converting enzyme) converts angiotensin 1 to angiotensin 2
-Angiotensin 2 vasoconstricts
- Aldosterone is released by adrenal cortex
- Stimulates kidneys to reabsorb sodium to decrease ursine output and maintain fluids
What is the role of chemoreceptors and what is the bodies response to acidosis
Monitor pH and in turn signal to breath more or less
In acidosis the rate and depth of respiration’s increase to blow off CO2