Hemodynamics Flashcards
Cardiogenic shock results from _____ and/or to generate an adequate blood pressure to perfuse distal tissues.
failure of the heart to pump an adequate amount of blood
Infarcts are areas of tissue death (necrosis) caused by _____.
ischemia
A red infarct includes a _____, a _____, and ____ tissue that permits movement of blood from adjacent areas into the necrotic area.
venous occlusion; a dual blood supply; loose
Heart failure, fluid overload, venous obstruction or compression, or arteriolar dilation can all cause ____.
increased hydrostatic pressure
______ in the arterial system most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.
Thrombosis
Thrombosis in the arterial system most commonly occurs due to ______ and _____, often associated with atherosclerosis.
endothelial injury; turbulent blood flow
What can cause abnormal blood flow?
stasis (a-fib, bed rest), turbulence (atherosclerosis)
Hydrostatic pressure “pushes” fluid from the capillary into the interstitial space on the _____.
arterial end
What is an active increase in blood flow due to arteriolar dilation called?
hyperemia
What is a thromboemboli?
an emboli that was a thrombus or part of one
____ often presents clinically with anemia, respiratory insufficiency, convulsions, acute renal failure, and shock.
DIC
______ most commonly occur in the coronary, cerebral, and femoral arteries.
Arterial thrombi
Patients with hypovolemic and cardiogenic shock typically present with ____, _____, and _____.
coolness and pallor of their skin, tachycardia, and decreased urine output
Where do transudates typically occur?
in intact vessel walls under increased pressure
As the thrombus propagates, additional layers of platelets, red cells and fibrin added to the thrombus become less stable and are prone to fragmentation, forming _______.
thromboemboli
Hypovolemic shock occurs when _____, and the cardiac output decreases because there is low blood return to the heart.
there is not enough blood volume to widely perfuse all tissues
_____ occurs when there is not enough blood volume to widely perfuse all tissues, and the cardiac output decreases because there is low blood return to the heart.
Hypovolemic shock
What happens when a clot lodges in the brain?
stroke
Shock occurs when the circulating blood volume or blood pressure is ____.
not adequate to perfuse body tissues
____ occurs when the circulating blood volume or blood pressure is not adequate to perfuse body tissues.
Shock
Name 2 ways fluid inappropriately accumulates in the tissues.
1) damage to capillary walls 2) inadequate lymphatic drainage
_____ typically initially presents with warm, flushed skin and fever.
Septic shock
What is DIC?
hemorrhage and thrombosis occurring simultaneously and systemically
The _____ can be caused by any underlying condition that results in release of procoagulants.
systemic activation of thrombin
Fluid movement into the body cavity is called ____.
effusion
Damage to capillary walls or inadequate lymphatic drainage can cause _____.
fluid to inappropriately accumulate
Emboli in the _____ most commonly lodge in the lungs.
venous/right sided system
_____ results from failure of the heart to pump an adequate amount of blood and/or to generate an adequate blood pressure to perfuse distal tissues.
Cardiogenic shock
_____ is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.
Septic shock
What can cause fluid overload?
infusions or renal failure
What is hyperemia?
an active increase in blood flow due to arteriolar dilation
What happens when a clot lodges in the kidney?
acute kidney injury
Emboli in the venous/right sided system most commonly lodge in the ____.
lungs
Fluid is “pulled” back into the capillary on the venous end to balance ______.
the protein concentration
Amniotic fluid emboli are highly correlated to ____.
DIC
Septic shock is a subtype of shock due to _____, occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.
systemic inflammation (SIRS)
What happens when a clot lodges in the lungs?
respiratory insufficiency, chest pain
_____ are due to an arterial blockage of a single blood supply in a dense tissue that limits accumulation of blood in the necrotic areas.
White infarcts
What 2 things cause increased osmotic pressure?
1) protein loss 2) low protein production
Bleeding typically dominates in _____ of DIC, and thrombosis dominates with _____ DIC.
acute onset; chronic
DIC often presents clinically with ____, ____, ____, _____, and _____.
anemia; respiratory insufficiency; convulsions; acute renal failure; shock
When would low protein production occur?
in liver disease or malnutrition
A _____ can form after an arterial occlusion if blood flow is subsequently reestablished and damaged vessels allow movement of blood into the necrotic area
red infarct
What is congestion?
a pathologic accumulation of blood due impaired outflow of venous blood
_____ “pushes” fluid from the capillary into the interstitial space on the arterial end.
Hydrostatic pressure
White infarcts are due to an _____ blockage of a ____ in a ____ tissue that limits accumulation of blood in the necrotic areas.
arterial; single blood supply; dense
______ typically dominates in acute onset of DIC, and ____ dominates with chronic DIC.
Bleeding; thrombosis
Protein loss or low protein production can cause ____.
increased osmotic pressure
What is the purpose of hyperemia?
to bring oxygenated blood into the tissues b/c of inflammation or exercise demand
Fluid movement into the adjacent tissues is called ____.
edema
Infarcts can be classified as red (____) or white (____).
hemorrhagic; anemic
What is edema?
fluid movement into the adjacent fluid
Emboli in the arterial/left sided system can affect any organ, but most commonly travel to the ____.
legs or brain
What can cause protein loss occur?
the kidneys or GI tract
Where is thrombosis more likely to occur and why?
in the venous system b/c of slower blood flow
Infarcts can be classified as ____ (hemorrhagic) or ____(anemic).
red; white
A ____ includes venous occlusion, a dual blood supply, and loose tissue that permits movement of blood from adjacent areas into the necrotic area.
red infarct
_____ are areas of tissue death (necrosis) caused by ischemia.
Infarcts
Arterial thrombi most commonly occur in the _____, _____, and _____ arteries.
coronary; cerebral; femoral
As the thrombus propagates, additional layers of _____, _____, and _____ added to the thrombus become less stable and are prone to fragmentation, forming thromboemboli.
platelets; RBCs; fibrin
Septic shock typically initially presents with _____.
warm, flushed skin and fever
What is an embolus?
A free floating, intravascular mass of a solid, liquid or gas
Patients with ______ typically present with coolness and pallor of their skin, tachycardia, and decreased urine output.
hypovolemic and cardiogenic shock
What does hyperemic tissue look like and why?
red (erythemic) b/c of increased oxygenated blood
What can cause endothelial injury?
hypercholesterolemia, inflammation
What happens when a clot lodges in the joints?
the Bends
Emboli in the _____ can affect any organ, but most commonly travel to the legs or brain.
arterial/left sided system
Name things that can be emboli.
fat, atherosclerotic debris, gas bubbles, bone marrow, tumor fragments, amniotic fluid, or foreign material
What happens when a clot lodges in the GI tract?
pain and bleeding
What happens when a clot lodges in the legs?
swelling, necrosis
Name 4 causes of increased hydrostatic pressure.
1) heart failure 2) fluid overload 3) venous obstruction or compression 4) arteriolar dilation
What is a pathologic accumulation of blood due impaired outflow of venous blood called?
congestion
Where do exudates typically occur?
damaged vessels due to inflammation and WBCs
What is the Virchow triad?
3 basic factors that promote thrombosis: endothelial injury, abnormal blood flow, and hypercoagulability
What happens when a clot lodges in the heart?
myocardial ischemia
Thrombosis in the ______ most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.
arterial system
Fluid is “pulled” back into the capillary on the _____ to balance the protein concentration.
venous end
Septic shock is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to ____, ____, and ____.
widespread arterial vasodilation, vascular leakage, and venous blood pooling
What can cause hypercoagulation?
inherited disorders (factor V Leiden), acquired disorders (disseminated cancer)
How does congested tissue look and why?
red-blue b/c of accumulated deoxygenated blood
Name 3 causes of lymphatic obstruction.
1) inflammation, infection 2) neoplasms 3) post surgery or irradiation
What is effusion?
fluid movement into the body cavity
The systemic activation of thrombin can be caused by any underlying condition that results in _____.
release of procoagulants
Inflammation, infection, neoplasms, post surgery, or irradiation can all cause ____.
lymphatic obstruction
