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Cardio > Cardiovascular Response to Shock > Flashcards

Cardiovascular Response to Shock Flashcards

1
Q

What is shock?

A

An abnormality of the circulatory system resulting in inadequate tissue perfusion and oxygenation

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2
Q

Results of shock?

A 
Inadequate tissue perfusion 
Inadequate oxygenation
Anaerobic metabolism
Accumulation of metabolic waste products 
Cellular failure
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3
Q

MAP equation

A

Cardiac Output (CO) x Systemic Vascular Resistance (SVR)

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4
Q

What does adequate tissue diffusion depend on?

A

Adequate BP

Adequate Cardiac output

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5
Q

Cardiac output equation?

A

SV x HR

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6
Q

Things that affect Stroke volume?

A

Myocardial contractility - how strong heart contracts
Afterload - resistance
Preload-venous return

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7
Q

Different types of shock?

A

Cardiogenic
Obstructive
Hypovolaemic
Distributive

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8
Q

Patients can have different types of shock at the same time. True or False?

A

True

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9
Q

Hypovolaemic shock? Flow diagram

A 
Loss of blood volume 
                    |
Decreased blood volume 
                    |
Decreased venous return
                    |
End diastolic volume 
                    |
Decreased Stroke volume 
                    |
Decreased CO and Decreased BP
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10
Q

What is cardiogenic shock?

A

Sustained hypotension caused by decreased cardiac contractility

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11
Q

Cardiogenic shock flow diagram?

A 
Decreased cardiac contractility 
|
Decreased stroke volume 
|
Decreased cardiac output 
|
Inadequate tissue perfusion
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12
Q

Flow diagram of tension pneumothorax (obstructive shock?

A 
Increased intrathoracic pressure (in pleural cavity)
|
Decreased venous return (pressure gradient has changed)
|
Decreased EDV 
|
Decreased SV 
|
Decreased CO and decreased BP 
|
Inadequate tissue perfusion
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13
Q

Neurogenic shock flow diagram?

A

Loss of sympathetic tone to blood vessels and heart
|
Massive venous and arterial vasodilation- affects heart rate
|
Decreased venous return & decreased SVR (TPR)
|
Decreased HR (UNLIKE other types of shock)
|
Decreased CO & decreased BP

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14
Q

Why is neurogenic shock unique?

A

It causes a decreased HR which is unlike other types of shock. This is because there is loss of sympathetic tone to blood vessels and heart

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15
Q

Vasogenic shock flow diagram?

A 
Release of vasoactive mediators 
|
Massive venous & arterial vasodilation- also increased capillary permeability 
|
Decreased venous return & decreased SVR (TPR)
|
Decreased CO & decreased BP
|
Inadequate tissue perfusion
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16
Q

4 general steps to treatment of shock?

A

1) ABCDE approach
2) High flow Oxygen
3) Volume replacement - EXCEPT cardiogenic
4) Call for help early

17
Q

Treatment of cardiogenic shock?

A

Inotropes

18
Q

Treatment for tension pneumothorax?

A

Immediate chest drain

19
Q

Treatment for anaphylactic shock?

A

Adrenaline

20
Q

Treatment for septic shock?

A

Vasopressers

21
Q

Causes of hypovolaemic shock?

A

Haemorrhage- trauma, surgery, GI haemorrhage

22
Q

What does haemorrhage result in?

A

Decrease in blood volume, decreased Cardiac output, circulatory shock (reduced MAP)

23
Q

haemorrhage shock response?

A

Compensatory mechanisms can maintain BP until more than 30% of blood volume is lost

24
Q

What is observed in haemorrhagic shock?

A

Tachycardia
Small volume pulse
Cool peripheries
Decreased MAP (if blood loss is more that 30%)

25
Q

Types of hypovolaemic shock?

A

Haemorrhagic and non-haemorrhagic

26
Q

Types of cardiogenic shock?

A

Acute myocardial infarction

27
Q

Types of obstructuve shock?

A

Cardiac temponade
Tension pneumothorax
Pulmonary embolism
Severe aortic stenosis

28
Q

Types of distributive shock?

A

Neurogenic- eg spinal cord injury

Vasoactive- eg septic shock, anaphylactic shock

29
Q

Caused of decreased blood volume?

A

Haemorrhage
vomiting
Diarrheoa
Excessive sweating

30
Q

Why does tachycardia occur?

A

Increased HR due to baroreceptor reflex

31
Q

What could happen when there is small volume pulse and tachycardia?

A

Cardiac output could be decreased

32
Q

What causes cool peripheries?

A

Increased systemic vascular resistance via baroreceptor reflex

Cardio (36 decks)

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