Lecture 10 - Fluid & Hemodynamic Pathologies Flashcards
Fluid & Hemodynamic Pathologies
Circulatory Shock
Description: a life threatening condition where the body is not getting enough blood flow, meaning not enough oxygen or nutrients. This damages organs and tissues. There are many types, classified by cause:
Obstructive: blocked artery-blood can’t get to where it needs to go
Cardiogenic: damage to heart-unable to pump sufficiently
Distributive: blood vessels lose tone-become open and floppy
Anaphylactic: severe allergic reaction
Septic: blood poisoning usually be bacteria
Neurogenic: damage to CNS, usually spinal cord, dilates vessels
Hypovolemic: not enough blood, caused by severe blood loss
Etiology: severe allergic reaction, significant blood loss, heart failure, blood infection, dehydration, poisoning or burns.
Pathogenesis: heart and vessels are unable to supply the oxygen via blood that it requires
Clinical Features: low blood pressure, rapid, weak or absent pulse, irregular heartbeat, shallow rapid breathing, lightheadedness, cool clammy skin, dilated pupils, chest pain, nause, confusion, anxiety, thirsty, dry mouth, lack of urine, low blood sugar and loss of consciousness.
Treatment: emergency treatment, CPR, hospitalization
Edema - Cardiac
Description: left ventricle of the heart is overworked or diseased and unable to pump out enough blood, causing the left ventricle to hold an excess amount of fluid (blood) which causes it to swell
Etiology: most common: cardiomyopathy, CAD, valve disease, HBP
Pathogenesis: imbalance of fluids
Clinical Features: difficulty breathing when lying supine, shortness of breath, lower extremity swelling, fatigue, rapid weight gain.
Treatment: medications (diuretics, beta blockers)
Fluid & Hemodynamic Pathologies
Blood Vessels - Infective Arteritis
Description: inflammation of the walls of arteries often caused by infection or an autoimmune response.
Three types:
Takayasu arteritis: large vessels (aorta and large branches), may cause aneurysm, causes loss of vision, heart disease, hypertension, joint & muscle pain, fatigue, fever, night sweats
Giant Cell arteritis or Temporal arteritis: infection of the superficial temporal artery and other arteries that supply the head, eyes and jaw, causes flu like symptoms, headache, fever, aches and pains, loss of appetite, malaise, possible vision loss.
Polyarteritis nodosa: medium sized vessels, may affect CNS, PNS, kidneys, GI tract, muscles and heart, may cause headache, fever, muscle and joint pain, fatigue, weakness and loss of appetite, skin rash or sores, pain, burning, numbness and weakness, renal failure if kidneys involved.
Etiology: unknown, autoimmune disorder
Pathogenesis: immune cells attack the walls of blood vessels causing nodules and granulomas to form, these block blood flow through arteries.
Clinical Features: variable depending which artery is involved: headache, sweating, loss of appetite, malaise, inflammation, fever, increase in RBC production, limping, reduced pulse
Treatment: steroids, immune suppressors, if infected-antibiotics.
Fluid & Hemodynamic Pathologies
Frostbite
Description: freezing of the skin and underlying tissue, common in fingers, toes, nose, ears, cheeks and chin. Frostnip is a milder form of frostbite, that does not cause permanent damage to the skin.
Etiology: freezing tissue
Pathogenesis: freezing tissue leads to cellular death, rewarming tissue causes more damage
Clinical Features: cold skin, prickling feeling, numbness, red, white, bluish-white or grayish-yellow skin, hard or waxy looking skin, underlying joint and muscle stiffness, blistering.
Treatment: requires medical attention, rewarm skin, analgesics, protection, debridement (removal of damaged, dead tissue), infection fighting medications, wound care.
Fluid & Hemodynamic Pathologies
Decompression Illness
Description: nitrogen dissolved in the blood and tissues by high pressure (like a scuba diver under deep water that is high pressure) forms bubbles as the pressure decreases (as the diver ascends-pressure decreases). These bubbles can act as embolisms blocking or obstructing arteries.
Etiology: ascending too quickly from deep high pressure water to shallower lower pressure water causing bubbles to form
Pathogenesis: bubbles act like an embolism and obstruct arteries
Clinical Features: fatigue, muscle and joint pain, variable depending on which arteries are blocked: may have symptoms of stroke (numbness, tingling, weakness, vertigo, difficulty breathing and chest pain), may have nervous system or spinal cord symptoms (headache, confusion, trouble speaking or double vision).
Treatment: oxygen, hyperbaric chamber, 80% recover completely.
Fluid & Hemodynamic Pathologies
Decubitus Ulcers
(bed sores, or pressure ulcers)
Description: an open wound where the pressure from your body weight presses the skin against a firm surface like a bed or wheelchair. This pressure cuts off the blood supply to the skin and injures the cells. Often occurs on skin that covers bones like hips, shoulder blades, spine, backs of arms or legs or tailbone or buttocks. Occurs in people who are in bed or in a wheelchair for extended periods.
Etiology: limited blood flow due to pressure causes necrosis and death of skin tissue
Pathogenesis: ischemia causes death of skin cells and no regeneration
Clinical Features: skin colour and texture change, swelling, pus like drainage, feels cool or warm to touch, tender to touch.
Treatment: reduce pressure, nursing care, wound care, analgesics and prevention of infection.
Fluid & Hemodynamic Pathologies
Vasculitis
Description: an autoimmune disease where immune cells attack the walls of blood vessels causing inflammation and subsequent narrowing. May affect arteries, veins or capillaries. If severe may cause organ or tissue damage. Affects large, medium and small sized vessels.
Etiology: autoimmune disease
Pathogenesis: immune cells attack the epithelial cells of blood vessel walls, damaging them and causing inflammation
Clinical Features: general: fever, loss of appetite, weight loss, fatigue, aches and pains, may affect any tissue depending on which blood vessels are involved. May affect skin, joints, lungs, GI tract, sinuses, eyes, brain and nerves. May lead to organ and tissue death.
Treatment: DMARDS, corticosteroids
Fluid & Hemodynamic Pathologies
Diabetic Microangiopathy
Description: thickening and weakening of the basement membrane in the capillary, this slows the blood flow in general leading to hypoxia and damage to tissues, this is widespread in diabetics. A form of arteriosclerosis that causes a lack of oxygen and nutrient and delivery.
Etiology: unknown, genes
Pathogenesis: clogs the small vessels, less gas and nutrient exchange
Clinical Features: seen later in diabetes and is the most serious complication causing mortality.
Treatment: medications
