Metabolic Response To Injury Flashcards
Definition of metabolic response to injury
The body responds to trauma with local and systemic reactions that attempt to contain and heal the tissue damage ,and to prptect the body while it is injured
What causes the initiation of metabolic response to injury
PVU STI
Pain
Volume loss
Under perfusion
Starvation
Tissue damage
Invasive infection
How many phase we have in metabolic response ?
Ebb phase
Flow phase
In ebb phase (at the time of injury) , what happen ?
in term of metabolism , temperature ,stress hormone , blood glucose
-decrease metabolism
-decrease core temperature
-increase stress hormone
-decrease blood glucose
In flow phase , what happen ?
in term of metabolism , temperature , insulin ,catecholamine , glucose ,lactate
-increase metabolism
-increase core temperature
-increase insulin but decreased respone
-increase glucose
- increase lactate
In flow phase , it is further divided into 2 . What are they?
Catabolic and Anabolic
In anabolic phase , what happen ?
Anabolic phase = building up the body
-Normal metabolism
-Protein , Fat and Glycogen restored
-Body weight gain
If there is excessive response metabolic , what will happen ?
systemic Inflammatory response syndrome (SIRS)
Criteria of SIRS
-abnormal body temperature (high /low )
-Tachycardia
-Tachypnea
-abnormal WBC (high / low)
4 systems control the metabolic response (SAVE)
-Sympathetic nervous system
-acute phase response
-endocrine response
-vascular endothelium
Sympathetic nervous system response
-gastrointestinal motility reduced
-increased bladder sphincter tone
-mydriasis , increased visual field
-uterine contraction and relaxation
-insulin production reduced and increased glucagon
-increased glycogenolysis -> hyperglycemia
-increased lipolysis -> ketogenesis
Acute phase response
-inflammation -> vasodilation -> increased permeability -> migration of neutrophil and monocytes
-coagulation system activated
-complement system activated
-proliferation of endothelial cells and fibroblast
-outflow of cytokines into systemic circulation is important factor in SIRS
-cytokines stimulate the production of acute phase proteins
What are positive acute phase proteins
-CRP
-Fibrinogen
-complement C3
-haptoglobin
-alpha-antichymotripsin
-caeruloplasmin
Endocrine response 1
Hypothalamus ,pituitary ,adrenal axis
-ACTH ,cortisol increase
-catabolic actions increase protein breakdown
-insulin antagonism by cortisol -> reduced insulin -> hyperglycemia
-cortisol’s anti inflammatory action -> reduced vascular permeability
Endocrine response 2
-aldosterone increase Na+ reabsorption
-vasopressin increase water reabsorption
-total T4 ,total and free T3 levels are reduced
-histamine increase vascular permeability