Physiology, Pathophysiology, and Shock Flashcards
Element
A pure substance that is entirely comprosed of the same atom
What are atoms comprised of?
protons, neutrons, and electrons
Where are protons located?
The nucleus
What charge do protons carry?
Positive charge
The ____ _____ is the same as the number of protons in the nucleus
Atomic number
Where are neutrons located?
The nucleus of the atom
What charge are neutrons?
Neutral
Hint - neutral, neutron
Purpose of the Neutron
Seperate of the (normally) repellant postive charges of protons
How is the atomic weught of an element found?
Neutrons + Protons + the atomic weight of the element
Where are electrons found?
In constant rotation around the nucleus
What charge do electrons carry?
Negative charge
How are ions formed?
An atom loses an electron or gains an extra one from another source
Which ion is more stable? A positive ion, a neutral ion, or a negative ion?
Neutral ion
What is a molecule?
Any structure comprised of 2 or more atoms bonded toether
What is a covalent bond?
Each atom paticipating in the formation of a bond provides an electron
What is an Ionic bond?
Two charged ions interact and at least one electron is completely donated from one atom to another
- Normally a metal and nonmetal bonding together
Is blood more basic or acidic?
Normally slightly basic
What substance has a pH of 7?
Water
What is the range for the pH scale?
0-14
0 is on the acidic end
14 is on the basic end
Normal pH range of blood
7.35-7.45
Blood pH of <7.35 is
Acidotic
Blood pH of >7.45 is
Alkalotic
What is EtCO2?
End-tidal Co2
Common causes of respiratory alkalosis
Fever, anxiety, and excessive artificial ventilation
How might a patient with ** respiratory alkalosis** present in terms of EtCO2?
Decreased EtCO2, because much of it has been exhaled out of the body
How might a patient with respiratory acidosis present in terms of EtCO2?
High EtCO2, due to hyperventilation
After a few good ventilations, this value should assume normal levels
What is the purpose of a buffer?
Minimizes the impact on a system’s pH
Buffers are reactions in a dynamic equillibrium that can neutralize bases and acids without meaningfully effecting the pH
Common causes of Respiratory Acidosis
- Hypoventilation
- Cardiac/Respiratory arrest
- Asphyxiation
- Head injury
Symptoms of Respiratory Acidosis
- Show/no breathing
- Flushed skin
- Headache
Symptoms of Respiratory Alkalosis
- Carpal-pedal spasms
- Flushed skin
- Shortness of breath
Common causes of Metabolic Acidosis
- Diabetic ketoacidosis
- Antacid overdoses
- Eating disorders
Symptoms of Metablic Alkalosis
- Slow breathing
- Altered mental status
- Vomitting
What does Respiratory Acidosis result from?
A systemic increase in CO2 level
What is Respiratory Acidosis?
A decrease in blood pH that primarily has a respiratory component
Caused by a retention of CO2
What is Respiratory Alkalosis?
Increase in pH/decrease in H+ with a primarily respiratory component
Caused by an increase in the exhalation of CO2
What is Metabolic Acidosis?
A type of acidosis that results primarily from a metabolic disorder or ingestion
The body’s ability to remove acids is overwhelmed, and as a result the body produces more CO2
What is Diabetic Ketoacidosis?
DKA
Occurs in patients who did not take any or enough of their insulin, causing cells to shift to using fatty acids for fuel
Common cause of metabolic acidosis
What is Metabolic Alkalosis?
Excess **loss **of acid in the body
About how many cells are in the human body?
37 trillion
Defining characteristic of Eukaryotic cells
Contain a true necleus enclosed in a membrane
What is the major difference between **Prokaryotic **and Eukaryotic cells?
Eukaryotic cells contain a nucleus, Prokaryotic cells do not
What does **cytosol **do?
Diffuses molecules throughout the cell
What is the nucleus?
The control center of the cell
- Contains genetic material necessary for replicating the cell
What is Ventilation?
The act of moving air in and out of the lungs
What is respiration?
Gas exchange across the alveoli-capillary border
What is perfusion?
The exchange of gases, nutrients, and water products across the capillary wall into and out of the cell
What is Peripheral vascular resistance?
The resistance of blood flow through all the vessels of the body, excluding those in the lungs
What is Cardiac output?
The amount of blood pumped out of the heart in one minute
- the product of stroke volume and heart rate
Stroke volume
The amount of blood ejected from the left ventricle of the heart with each beat or contraction
“Pump”
Preload
Blood returns to the heart from the body and must fill and stretch the chambers of the heart
“Pump”
Afterload
The pressure against which the heart must pump - needs to be lower than the force of the heart’s contraction
Cardiogenic shock
The heart is no longer strong enough to move blood around the body and through the lungs
- Often results from a heart attack, and/or the cumulative damage of multiple heart attacks
Hypovolemic shock
Results from low circulation volume
- Can be caused by excessive vomiting, diarrhea
- Poor fluid intake
- Extravasation from burns
Hemorrhagic shock
Form of hypovolemic shock that occurs due to blood loss
- Can be external or internal
Obstructive shock
Variety of disorder that hamper preload or elevate afterload to a point where cardiac function is disrupted
- Pulmonary embolism
- Pneumothorax
- Cardiac tamponade
Distributive shock
Different types of shock that all have displacement of fluid
- Septic shock
- anaphylactic shock
- neurogenic
- psychogenic shock
Septic shock
Caused by bacterial toxins infiltrating the bloodstream from a local infection or systemic infection
Neurogenic shock
Results from an injury to the spinal cord
- can be caused by an infection, but typically caused by trauma
- uncontrolled dilation of blood vessels inferior to the injury
- skin near the affected area will appear flushed, while the rest of the body appears white or gray
Psychogenic shock
The “see blood and faint” type of shock
Progression of Shock
- Compensated shock
- Decompensated shock
- Irreversible shock
Compensated Shock
When hypoperfusion is first detected by the body. The body’s main concern is preservation of blood pressure (specifically MAP). The patient in this stage of shock has very few symptoms, and aggressive treatment may slow or stop progression to stage II shock.
MAP must be >60 mmHg
MAP Formula
Mean Arterial Pressure
Map = [SBP + (2 × DBP)]/3
SBP: Systolic Blood Pressure
DBP: Diastolic Blood Pressure
Decompensated shock
Methods of compensation begin to fail. The systems are unable to maintain perfusion any longer. Oxygen deprivation in the brain causes the patient to become confused and disoriented.
Irreversible shock
Organ failure and death have begun. Even with treatment, the end result is patient death
ABCDE
AIRWAY
BREATHING
CIRCULATION & C-SPINE
DISABILITY
EXPOSE
Shock treatment
Provide high flow o2
Elevate the legs
Cover with blankets
Rapid transport
Provide IV fluids (saline) warmed if possible
PORK - Position, oxygenate, rapid transport, keep warm
What temperature are “warmed” fluids kept at?
100 Degrees F
Buffer Equilibrium reaction
A chemical bond formed when an electron is completely donated from 1 atom to another is called a/an:
When an atom loses or donates an electron to another atom, an ion is formed. The bond that forms between 2 ions is called an** ionic bond**.
Ionic bond
