circulatory shock

Question 1

neurogenic shock

Answer 1

wide spread vasodilation which causes a rapid drop in bp which leads to reduced cerebral blood flow which leads to fainting/syncope
this is due to trauma/intense pain
a life threatening vivid experience

Question 2

results of neurogenic shock

Answer 2

light headiness, loss of consciousness, interrupts when emotional stimulus blocks the ANS
normal functions return when interrupted

Question 3

other factors that can make neurogenic shock serious

Answer 3

CNS depression
brain damage
spinal cord injury or excess spinal anethesia

Question 4

secondary shock

Answer 4

more common, signs and symptoms develop slower

involves a combo of CNS depression, spinal cord injury, and brain damage

Question 5

most common cause of cardiogenic shock

Answer 5

left ventricular failure

if over 80% of death= fatal

Question 6

other causes of cardiogenic shock

Answer 6

cardiomyopathies 
bacterial toxins, weaken myocardium
narcotic drugs
high levels of k 
mural thrombi 
cardiac tamponade 
tension pneumo 
extensive PE 
cardiac arrhythmia 
hemorrhage shock

Question 7

damage to capillary walls

Answer 7

increased permiability which leads to increased fluid shifting/loss

Question 8

thrombo embolism and cardiogenic shock

Answer 8

caused by blockage of venous return

Question 9

gradual vs rapid loss

Answer 9

gradual is better because it allows tie for compensatory echanis to kick in

Question 10

septic shock

Answer 10

caused by vasodilation which is caused by endotoxins in blood from uncontrolled infection, histamine and kinins are release, tissue damage makes cells less able to deliver nutrients from decreased blood supply and causes further complications

Question 11

toxic shock

Answer 11

toxins are not from bacterial origin, caused by drugs or liver damage

Question 12

anaphylactic shock

Answer 12

immune response following a second exposure to a forgein antigen
histamine released from mast cells
caused by blood transfusions, drugs , insect bites, foods

Question 13

compensation response in shock

Answer 13

barorecpetors in aortic arch and carotid sins
sense pressure changes
sends to medula causes effector cells to adjust BP
effectors= heart and blood vessels (controls Co and constirction of vessels)

Question 14

dermal and splachnic arterioles

Answer 14

directs blood fro skin to abdominal visceral (brain and heart)
this method functions during normal activity
can result in the doubling of blood volume loss tolerated before hypovolemic shock occurs

Question 15

central NS ischemic response

Answer 15

when cardiovascular system becomes directly affected by ischemia
get intense increase in sympathetic output
raise bp and avoid anoxic damage

Question 16

movement from fluid to tissues `

Answer 16

BP is a major moving force
if bp decreases less fluid goes into tissues which causes a drop in BP
as BP decreases even more, this drraws tissues into blood and increases plasma volume while raising BP

Question 17

kidney compensation in shock

Answer 17

BP- vasoconstriction, less blood to kidneys
activated kidneys water mechanism increase ADH release
increase levels of angiotensin 2 which causes increased secretion of aldosterone and water retention and vasoconstriction

Question 18

therapy

Answer 18

restore adequate blood flow, second eliminate cause of shock and deal with secondary long ter effects

Question 19

drugs

Answer 19

whole blood or plasma
norepinephrine (vasoconstriction- use in neurogenic or vascular shock, cannot use in cardiogenic shock (increase work load on heart)
isoproterenol- increases heart rate and contractility, use in cardiogenic shock

Question 20

shock

Answer 20

antibiotics, used more often to treat secondary effect

Question 21

shock lung

Answer 21

respiratory infection after one goes through cardiogenic shock

Question 22

secondary effects of shock

Answer 22

shock lung
kidney problems
pH imbalances (metabolic or respiratory acidosis)
all 3 must be considered when treating shock

Question 23

kidney problems

Answer 23

reflex vasoconstriction
which causes renal ischemia (decreased bf, uo) possible renal necrosis, increased toxins in bloods and electrolyte imbalances

Question 24

in circulatory shock

Answer 24

if ntreated leads to death

3 stages

Question 25

non progressive shock

Answer 25

therapy and compensatory mechanisms= recovery

Question 26

progressive shock

Answer 26

tissue hypoperfusion
BP flow and steadily decrease, hypoxic cell injury to multiple organs, less initation of positive feedback cycle, increases tissue daage and decreases chance of compensation

Question 27

positive feedback of progressive shock

Answer 27

depressed cardiac function, leads to positive feed back, decreased bp = myocardial damage/dysfunction, further decreases CO, further decreases BP

Question 28

hypoperfusion in shock

Answer 28

decreased autonomic impulses to the heart and arterioles, decrease bp, further hypoperfusion

Question 29

release of myocardial depressive factor

Answer 29

released by B ischemic pancreas , acts to comprise myocardial contractility

Question 30

peripheral pooling

Answer 30

reduces venous return
which causes shift to anerobic metabolism which leads to vasoconstriction, blood accumulates in veins, which leads to reduced sympathetic output from cardiovascular cents, dilation, pooling, functional deterioration of vessels, due to increased work load from compensatory mechanisms

Question 31

progressive shock

Answer 31

deteriorating Co, positive feedback, signs of progressive shock, other factors that contribute, thrombosis which increases there permeability, fluid loss into tissues.

Question 32

irreversable shock

Answer 32

no therapeutic support, seen with severe or acute shock, impossible to interrupt positive feedback cycle, prognosis is poor and may have no effect