P5 - Fluids and Vascular Disorders Part 3

Question 1

how is blood flow controlled by heart and nervous system (3)

Answer 1

• baroreceptors
• left atrial volume receptors
• Osmoreceptors in hypothalamus

Question 2

role of epinephrine in blood distribution

Answer 2

• acts on B2 receptors -> vasodilation -> increase flow

Question 3

role of norepinephrine in blood distribution

Answer 3

• acts on A receptors -> vasoconstriction -> reduce flow

Question 4

vasodilation causes

Answer 4

• hyperemia
• engorgement of arterioles and capillaries
• increased metabolic activity

Question 5

congestion of vessels

Answer 5

• passive engorgement of vascular bed

- decreased outflow

Question 6

right-sided heart failure causes what kind of congestion

Answer 6

• hepatic

Question 7

obstruction of venous outflow as a result of (4)

Answer 7

• neoplastic mass
• inflammatory mass
• displacement of organ
• fibrosis resulting from healed injury

Question 8

nutmeg liver

Answer 8

• alternating tan (normal) and red (congested) areas

- hypoxia in centrilobular areas

Question 9

left-sided heart failure causes what kind of congestion

Answer 9

• pulmonary

Question 10

vessel occlusion results in

Answer 10

• acute infarction of dependent tissue

Question 11

venous infraction due to

Answer 11

• congested intestinal loops that impinge on vessels and veins

Question 12

pathogenesis after prolonged ischemia

Answer 12

• ATP degraded to adenosine (potent vasodilator to relieve ischemia) -> blood return causes fluid to move into interstitium -> high tissue pressure -> compression of veins (inhibits local blood return) -> blood vessel hemorrhage -> TF released secondary hemostasis and thrombosis

Question 13

progression of infraction (tan infracts)

Answer 13

• become tan and pale over time as cells swell and tissue becomes necrotic and blood is forced out of infracted area

Question 14

types of sock (3)

Answer 14

• cardiogenic
• hypovolemia
• blood maldistribution

Question 15

cardiogenic shock

Answer 15

• myocardial infraction
• dilated or hypertorphic cardiomyopathy
• outflow obstruction

Question 16

hypovolemia shock

Answer 16

• low volume due to hemorrhage or fluid loss

Question 17

types of blood maldistribution shock (3)

Answer 17

• anaphylactic
• neurogenic
• septic

Question 18

anaphylactic shock

Answer 18

• histamine and other vasoactive mediators released -> vasodilation
• increased vascular permeability
• smooth muscle contraction

Question 19

neurogenic shock

Answer 19

• electrochock -> autonomic discharges

Question 20

septic shock

Answer 20

• due to infectious pathogens

Question 21

stages of shock (3)

Answer 21

• nonprogressive
• progressive (cardiac damage)
• irreversible

Question 22

clinical signs of chock (6)

Answer 22

• hypotension
• weak pulse
• tachycardia
• hyperventilation with pulmonary rales
• reduced urine output
• hypothermia

Question 23

nonprogressive stage of shock

Answer 23

• compensatory mechanisms counter decreased blood volume and peripheral pressure

Question 24

progressive stage of shock

Answer 24

• cardiac damage leads to decreased output, blood pooling and tissue hypoperfusion

Question 25

irreversible stage of shock

Answer 25

• anaerobic metabolism inhibits cellular enzymes for energy production
• multiorgan failure