Pathophysiology of Shock Flashcards
What is the main goal of the neuroendocrine response to hemorrhage?
maintain perfusion to heart and brain
What is the initial stimulus for the neuroendocrine response during hemorrhagic shock?
loss of circulating blood volume
Afferent pain signals transmit via the ______ resulting in activation of the hypothalamic-pituitary adrenal axis as well as activation of ANS to induce direct sympathetic stimulation of adrenal medulla to release _______
spinothalamic tract, catecholamines
Baroreceptors are found in _____, ______ and _____
atria, aortic bodies, carotid bodies
T/F Normally the baroreceptors inhibit the ANS (sympathetic tone). When activated, they disinhibit ANS, causing vasoconstriction
T. baroreceptor activation -> diminished baroreceptor output -> disinhibition of ANS -> increased peripheral vasoconstriction
T/F arotic and carotid bodies do not have chemoreceptors
F. They have chemoreceptors that detect O2 concentrations
Give 3 cardiovascular responses to diminshed venous return and decreased CO due to hemorrhage
increased cardiac heart rate (1) and contractility (2), venous and arterial vasoconstriction (3)
Heart rate and contractility is increased by which adrenergic receptors?
beta-1
arteriolar vasoconstriction is brought about by activation of which adrenergic receptors?
alpha-1
What is the effect of sympathetic output on the adrenal medulla?
release of catecholamines
What is the effect of cortisol to gluconeogenesis and insulin
stimulatory to gluconeogenesis, inhibitory to insulin (insulin resistance)
What horomones are released by the ff. organs during shock?
Hypothalamus -
Kidney -
Pituitary
H: ACTH
K: Renin
P: ADH
Adverse effect of ADH to intestine
intestinal ischemia
Primary determinant of preload
venous return
The law states stating that the force of ventricular contraciton is a function of its preload
Frank-Starling Law
