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BAMS Human Systems > ES. Haemostasis, Haemorrhage and shock > Flashcards

ES. Haemostasis, Haemorrhage and shock Flashcards

1
Q

why is excessive blood loss a medical emergency?

A

decreased blood volume results in fall in blood pressure and impaired delivery of nutrients to cells which is called shock

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2
Q

what is the immediate physiological response to blood less?

A

stop the bleeding

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3
Q

what is short term physiological response to blood loss?

A

restore blood pressure

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4
Q

what is the medium term physiological response to blood loss?

A

restore fluid volume

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5
Q

what is the long term physiological response to blood loss?

A

replace blood constituents

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6
Q

what components are involved in an immediate response to blood loss?

A

vascular response
platelet response
plasma response (coagulation)

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7
Q

what is the vascular response of smooth muscle during blood loss?

A

spasm due to trauma
- myogenic response
- humoral factors (vasoconstrictors)

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8
Q

what is the vascular response of endothelium during blood loss?

A
  • platelet adhesion and aggregation
  • anticlotting and fibrinolysis
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9
Q

how do platelets respond to blood loss?

A

damage to blood vessels therefor turbulent blood flow
platelets come into contact with vessel wall (collagen)

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10
Q

what is it called when platelets adhere and clump together in response to blood loss?

A

aggregate

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11
Q

what do platelets do in positive feedback when there is blood loss?

A

release chemicals that cause further aggregation and form platelet plug

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12
Q

how is a blood clot formed?

A

plasma proteins and tissue components combine to convert fibrinogen to fibrin to form the blood clot

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13
Q

where are clotting factors formed for coagulation in blood loss?

A

liver

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14
Q

how are clotting factors synthesised and activated?

A

synthesised upon presence of vitamin c
activated in an enzyme cascade

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15
Q

what does a platelet plug do?

A

seals small blood vessels

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16
Q

what factor converts soluble fibrin to insoluble fibrin?

A

factor XIIIa

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17
Q

…….^

A
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18
Q

how do the extrinsic and intrinsic pathway need to convert factor X to factor Xa?

A

phospholipid and calcium ion

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19
Q

what is the intrinsic pathway in coagulation?

A

vascular damage
contact activation
factors = XII, XI, IX, VIII

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20
Q

what is the extrinsic pathway in coagulation?

A

tissue damage
(tissue factors eg. tissue thromboplastin)
factors = VII

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21
Q

is the intrinsic or extrinsic pathway more important in initiating blood clotting?

A

extrinsic

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22
Q

what pathway (intrinsic or extrinsic) maintains the process in coagulation?

A

intrinsic

23
Q

what is thrombosis?

A

intrinsic system of coagulation where a blood clot forms inside an intact blood vessel

24
Q

what is fibrinolysis?

A

when blood clot has saved its purpose it is dissolved

25
Q

how is fibrinolysis undertaken?

A

by enzyme called plasmin

26
Q

what converts plasminogen to plasmin?

A

plasminogen activator

27
Q

what are the short term bodily reaction to loosing blood pressure?

A
  • loss of blood volume/pressure
28
Q

what mechanisms help to restore the blood pressure in the short term?
what triggers it?

A

compensatory mechanisms triggered by arterial baroreceptors

29
Q

what are the medium term responses to restore blood volume in blood loss?

A
  • shifting interstitial fluid back into blood vessels
  • decreasing fluid loss in kidney
  • increasing fluid intake
30
Q

through baroreceptor reflexes, low arterial blood pressure has what effect on arterioles?

A

vasoconstriction
- increases total peripheral resistance
- decreased capillary blood pressure

31
Q

through baroreceptor reflexes, low arterial blood pressure has what effect on hydrostatic pressure?

A

decreases it pushing fluid out of the capillary

32
Q

haemorrhage causes a reduction in capillary pressure, what happens to our reabsorption/filtration when we are trying to recover?

A

more reabsorption than filtration

33
Q

how do we decrease fluid loss in the kidney?

A

decrease the glomerular filtration
increase reabsorption of na and h2o

34
Q

how do we increase the reabsorption of na and h20 in the kidney?

A

stimulate the release of renin-angiotensin- aldosterone and antidiuretic hormone

35
Q

how do vasoconstrictors facilitate the process of decreasing fluid loss in the kidney?

A

they increase peripheral resistance

36
Q

what does the presence of resin do in the kidney?

A

converts angiotensinogen to angiotensin I

37
Q

what does angiotensin converting enzyme do in the kidney?

A

converts angiotensin I to angiotensin II

38
Q

what structure in the kidney facilitates the release of increased aldosterone?

A

adrenal cortex

39
Q

what does aldosterone do in the kidney?

A

increases sodium and water reabsorption by the distal convoluted tubes and cortical collecting ducts

40
Q

what does secretion of the antidiuretic hormone do to plasma ?

A

reduces volume
increases osmolarity

41
Q

what does antidiuretic hormone secretion do to the baroreceptors and the osmoreceptors?

A

decreases their effect and increases effect of osmoreceptor activation

42
Q

what stimulates thirst?

A

increased plasma osmolarity and decreased extracellular volume
angiotensin II promotes thirst
dry mouth

43
Q

what receptors in the stomach suppress drinking?

A

stretch receptors

44
Q

in long term responses to blood loss how long does it take restore the plasma proteins?

A

released from the liver in 3 to 4 days

45
Q

in long term responses to blood loss how long does it take to replace the blood cells?

A

2-3 months

46
Q

how are blood cells returned to normal after blood loss?

A

erythropoiesis
- regulated by erythropoietin
- EPO released from kidney
stimulates RBC production in bone marrow

47
Q

how is shock characterised in tissues?

A

inadequate blood flow to tissues

48
Q

how is shock characterised in tissues?

A

inadequate blood flow to tissues

49
Q

what is shock associated with in term of blood?

A

decreased cardiac output
decreased blood or ECF volume

50
Q

give features of hypovolaemic shock?

A

decreased ECF volume due to:
haemorrhage, sweating, diarrhoea or burns

51
Q

give examples of low resistance shock?

A

decreased peripheral resistance, due to widespread vasodilation

52
Q

give an example of when lo resistance shock would occur?

A

anaphylactic shock

53
Q

what is cardiogenic shock ?

A

heart fails as a pump

54
Q

when would cariogenic shock occur?

A

heart attack

BAMS Human Systems (33 decks)

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