Hemodynamic Disorders (4) - Emboli/Shock Flashcards
Most often, where does a pulmonary embolus begin?
A Deep Vein Thrombosis in the LE dislodges and travels to pulmonary circulation
The effects and symptoms of a pulmonary embolism depend on?
Size of the embolus
Saddle emboli
Lodge in the pulmonary trunk bifurcation and block blood supply to both lungs
Saddle emboli usually results in?
Instant death due to right sided heart failure
A saddle emboli involves what size of embolus?
LARGE
Medium size pulmonary emboli symptom and why?
Shortness of breath because the embolus makes it into pulmonary circulation
Small size pulmonary emboli symptom?
Asymptomatic
What are Lines of Zahn?
Alternating red and white lines on a clot
What can Lines of Zahn tell you?
If the clot occurred during active blood flow (while the person was still alive)
What makes up the Lines of Zahn?
White - platelets
Red - RBCs
If a clot has Lines of Zahn then you know that the clot occurred when?
While the person was still alive (antemortem)
What do post-mortem clots look like?
Red pooled blood that did NOT cause the person to die
What causes a fat/marrow emboli?
Bone fracture or soft tissue injury
What is introduced into circulation with a fat/marrow emboli?
Bone marrow and fat
How will a fat/marrow emboli present?
A few days after bone injury, patient presents with respiratory distress and mental changes
Air embolism
Introduction of air into the blood stream that obstructs blood flow
What are 2 examples of when an air embolism can occur?
- Cardiac Catheterization
2. When a scuba diver ascends too quickly - bends/decompression sickness
An Amniotic Fluid Embolism introduces what things into maternal blood stream?
Amniotic fluid
Fetal tissue
Squamous cells
An Amniotic fluid embolism presents similarly to anaphylactic shock. What are the symptoms?
Sudden severe shock, dyspnea, cyanosis
– very fatal
Infarct
Area of ischemia necrosis of tissue due to an occlusion of an artery
What normally causes an infarct?
Thrombosis
Area of ischemic necrosis of tissue due to occlusion
Infarct
Red and White infarcts - location
Red - venous circulation
White - arterial circulation
Red and White infarcts - tissue blood supply
Red - dual blood supply
White - 1 vessel supply
If the rate of occlusion of a vessel is SLOW, the infarct will be ____ likely to occur
LESS
If the rate of occlusion of a vessel is FAST, the infarct will be _____ likely to occur
MORE
Increased Hypoxemia will _____ chances of an infarct in the tissue
INCREASE
What are 3 types of shock?
Cardiogenic
Hypovolemic
Systemic Inflammatory Response Syndrome
What is shock?
INADEQUATE oxygen and nutrient delivery!!
Cardiogenic shock
Decreased cardiac output causes decreased blood, oxygen and nutrient delivery
Hypovolemic shock
Decreased blood volume causes decreased blood, oxygen and nutrient delivery
Septic shock
Dysregulated host response to infection that causes decreased oxygen and nutrient delivery and clot
Steps of septic shock
- Inflammatory response
- PAMPS cause cytokine release
- Activation of complement - Endothelial activation
- Edema and Vasodilation
- PROcoagulant state
Results of septic shock?
Hypotension, hypovolemia, clot formation, decreased O2
What organs start to fail with septic shock?
Heart, kidneys, lungs
