Hemodynamic Disorders, Thrombosis, and Shock

Question 1

an increase in interstitial fluid (within the tissues) is called

Answer 1

edema

Question 2

severe generalized edema is called

Answer 2

anasarca

Question 3

when fluid collects in body cavities

Answer 3

effusion

Question 4

fluid collection in the peritoneal cavity

Answer 4

ascites

Question 5

protein poor edema or effusion with a specific gravity of less than 1.012

Answer 5

transudate

Question 6

protein rich edema or effusion fluid with a specific gravity of more than 1.020

Answer 6

exudate

Question 7

approximately _____ % of lean body weight is water

Answer 7

60%

Question 8

____ of the body water resides inside the cells and ____ is extracellular

Answer 8

2/3 inside the cells

1/3 extracellular

Question 9

only about ___ % of total body water is in the blood plasma

Answer 9

5%

Question 10

fluid balance is maintained by what 2 things

Answer 10

• vascular hydrostatic pressure

- plasma colloid osmotic pressure

Question 11

increased intravascular pressure typically comes from:

Answer 11

impaired venous return

obstruction of venous flow, congestive heart failure

Question 12

reduced plasma osmotic pressure is most commonly due to a:

Answer 12

decrease in serum albumin

liver failure, nephrotic syndrome

Question 13

other causes of edema include

Answer 13

• increased vascular permeability as in inflammation or trauma
• renal sodium (and water) retention
• lymphatic obstruction

Question 14

hyperemia’s cause and effects (coloration)

Answer 14

• comes from arteriolar dilation and increased blood flow

- tissue tends to be pink or red

Question 15

congestion cause and effects (coloration)

Answer 15

• comes from impaired venous return

- tissue tends to have a blue or purplish color due to cyanosis

Question 16

blood leaking out of blood vessels is called a

Answer 16

hemorrhage

Question 17

accumulation of blood in the tissues is called a

Answer 17

hematoma

Question 18

1-2mm hemorrhages into skin are called

Answer 18

petechiae

Question 19

slightly larger (3-5mm) areas of skin hemorrhage

Answer 19

purpura

Question 20

medical term for a bruise (typically less than 1 inch)

Answer 20

ecchymosis

Question 21

a healthy individual can lose ____ % of their blood volume before there is much impact on normal homeostasis

Answer 21

20

Question 22

3 key elements in the development of the final clot

Answer 22

1. endothelium and vascular wall
2. platlets
3. the coagulation cascade

Question 23

damage of the endothelial lining can result in

Answer 23

promotion of a cascade of events that leads to formation of a hemostatic plug at the site of injury

Question 24

the prothrombin (PT) clinical lab test monitors the impact of the ____ pathway of the coagulation cascade

Answer 24

extrinsic

Question 25

the partial thrombosis (PTT) test monitors the impacts of the _____ pathway of the coagulation cascade

Answer 25

intrinsic

Question 26

the anticoagulant medication Heparin is monitored with the ____ test

Answer 26

PTT

Question 27

the anticoagulant medication Coumadin (or warfarin) with the ____ test

Answer 27

PT

Question 28

two important enzymes that limit the size of the clot and stop it from progressing to the rest o the vasculature

Answer 28

antithrombin and plasmin

Question 29

three important factors that contribute to the formation of a thrombus

Answer 29

- endothelial injury - abnormal blood flow - hypercoagulable states

Question 30

how does stasis and turbulence of blood flow contribute to thrombus formation

Answer 30

it allows platelets to come in greater contact with the endothelium, and allows the build up of activated clotting factors that would normally be washed away with the steady, rapid flow of blood

Question 31

an embolism occurs when

Answer 31

a substance other than liquid blood (solid, semisolid, liquid or even gas) is transported in the vascular system

Question 32

the vast majority of emboli are portions of a

Answer 32

thrombus | thus, they are called thromboembolism

Question 33

most pulmonary emboli (PE) are from:

Answer 33

thrombi in the deeps veins of the leg and pelvis

Question 34

when a large embolus blocks the bifurcation of the pulmonary arteries we call it:

Answer 34

saddle embolus

Question 35

systemic thromboemboli usually arise in the ______

Answer 35

heart chambers

Question 36

systemic thromboemboli can lead to

Answer 36

tissue damage and infarction in whichever arterial supply becomes occluded

Question 37

an infarction is

Answer 37

an area of tissue death due to lack of arterial supply, but can be due to inhibited venous drainage

Question 38

the extent of damage to tissue in an infarction depends on what factors?

Answer 38

- sie of artery occluded - sensitivity of the particular tissue to hypoxia - rate of development of the occlusion

Question 39

if there is a lot of hemorrhage at the site of infarction it is called a

Answer 39

red infarct

Question 40

if there is a little hemorrhage at the site of infarction it is called a

Answer 40

white infarct

Question 41

the definition of shock is

Answer 41

system wide inadequate blood supply (hypo perfusion) to meet the metabolic demands of the tissues

Question 42

results of shock can be

Answer 42

- hypotension - impaired tissue perfusion - cellular hypoxia

Question 43

the 3 main categories of shock are

Answer 43

- cardiogenic - hypovolemic - septic

Question 44

cardiac shock develops from failure of

Answer 44

the heart to pump sufficient blood to the tissues

Question 45

hypovolumetric shock is the result of

Answer 45

massive blood or fluid loss

Question 46

cardiac shock can be due to a

Answer 46

- massive heart attack (infarction) - arrhythmia - cardiac compression (tamponade) - outflow obstruction

Question 47

how can septic shock develop?

Answer 47

due to a severe infection

Question 48

in septic shock, the response to microbial elements results in

Answer 48

1. release of multiple inflammatory mediators and activation of the complement system 2. endothelial cell activation and injury which in turn causes increased vascular permeability, vasodilation, and thrombosis

Question 49

what is DIC (disseminated intravascular coagulation) ?

Answer 49

where there are widespread tiny clots in the microcirculation that clog up the blood flow and use up the clotting factors and actually provoke bleeding problems because the clotting factors are all used up

Question 50

neurogenic shock results from:

Answer 50

the loss of vascular tone (such as seen after a spinal cord injury)

Question 51

anaphylactic shock develops from:

Answer 51

massive vasodilation and increased vascular permeability after an IgE based reaction to an antigen

Question 52

clinical signs of cariogenic or hypovolemic shock

Answer 52

- hypotension - rapid weak pulse - increased respiratory rate - ashen grey color - cool, clammy skin

Question 53

clinical sign difference for septic shock

Answer 53

-skin may be warm and flushed due to vasodilation