Session 6 - Organ Failure

Question 1

What is the characteristics of blood flow in capillaries?

Answer 1

Cross sectional area is huge

Flow is slow

Question 2

What are the characteristics of lymphatics?

Answer 2

Blind ended capillaries in the interstitium

Question 3

Where does the components of the lymph system dump into?

Answer 3

Venous system

Question 4

What is the characteristics of flow through the lymphatic vessels?

Answer 4

Low pressure, w/ valves

Need muscles contractions to aid in flow

Question 5

What is the interstitium?

Answer 5

Space between cells and microcirculation

Question 6

What are the three important tissue components the interstitium responsible for?

Answer 6

Structural + Absorptive + Adhesive

Question 7

What are the structural components of the interstitium?

Answer 7

Collagen + Elastin

Question 8

What are the absorptive cells found in the interstitium?

Answer 8

Glycosaminoglycans + Proteoglycans

Question 9

What are the adhesive cells found within the interstitium?

Answer 9

Fibronectin + Laminin

Question 10

What % of body weight is fluid?

Answer 10

60%

Question 11

What % of body weight, from fluid, is found in the ICF?

Answer 11

40%

Question 12

What are the two components of ECF?

Answer 12

Plasma + Interstitium

Question 13

What % of body weight, from fluid, is located in the plasma?

Answer 13

4 to 5%

Question 14

What % of the body weight, due to fluid, is found in the interstitium?

Answer 14

16%

Question 15

What two hormones does renin stimulate?

Answer 15

Aldosterone + AngII

Question 16

What does AngII do?

Answer 16

Thirst + ADH release

Question 17

What does aldosterone do?

Answer 17

Water retention + Potassium loss

Question 18

What cells release renin?

Answer 18

Juxtaglomerular

Question 19

What two things does water retention cause?

Answer 19

Increase circulating volume + preload

Increased venous filling

Question 20

What are the results of increased circulating volume + preload due to water retention?

Answer 20

CO increases

Question 21

What are the results of increased venous filling pressure due to water retention?

Answer 21

Fluid accumulates in cavities + interstitium

Question 22

What is triggered (aka what receptors and down stream effects) occur with blood volume expansion?

Answer 22

Arial myocyte stretch
ANP released from heart + brain
Water excretion

Question 23

What type of receptors stimulate ANP release in the brain?

Answer 23

Baroreceptors

Question 24

What occurs with hyperosmolarity + dehydratio, in regards to rectors and downstream effects?

Answer 24

Osmoreceptors + Barroreceptors stimulate ADH release + Oxytocin
Water retention + Vasocontriction

Question 25

What is another name for ADH?

Answer 25

Vasopressin

Question 26

What does NO cause?

Answer 26

Vasodilation

Question 27

What does EPI do? Via what receptor?

Answer 27

Vasodilation, via Beta-2

Question 28

What does NE do? Via what receptor?

Answer 28

Increases MAP via vasocontriction | via alpha receptors

Question 29

What is shock?

Answer 29

Systemic hypoperfusion due to macro or microcirculatory failure

Question 30

What is the outcome of shock?

Answer 30

Hypotension followed by impaired tissue perfusion + cellular hypoxia

Question 31

What is function of capillaries?

Answer 31

Nutrient + Waster transition

Question 32

What are the two types of macro circulatory shocks?

Answer 32

Cardiogenic + Hypovolemic

Question 33

What can cause hypovolemic shock?

Answer 33

Severe dehydration + Massive blood loss

Question 34

What are things that can cause cardiogenic shock?

Answer 34

``` Excessive myocardial tissue loss Arrhythmia CO obstruction Altered balance btwn colloid forces Capillary hydrostatic pressure ```

Question 35

What are kinds of microcirculatory shock?

Answer 35

Anaphylaxis + Neurogenic + Anesthetic + Septic

Question 36

What type of hypersensitivity is anaphylactic shock?

Answer 36

Type 1

Question 37

What is the mechanism of anaphylactic shock?

Answer 37

Mast cells degranulate + Histamine leads to systemic vasodilation + increased vascular permeability + BP drops + Hypoperfusion

Question 38

What is anaphylactic shock mediated by?

Answer 38

IgE

Question 39

What is lost in neurogenic shock?

Answer 39

SNS

Question 40

What is dominating in neurogenic shock?

Answer 40

PNS

Question 41

What causes neurogenic shock?

Answer 41

Trauma to spinal cord + Fear + Electricity

Question 42

What happens in neurogenic shock?

Answer 42

Trigger generalized ANS discharge disruption SNS lost/PNS dominates Mass peripherial vasodilation + Bradycardia Hypoperfusion

Question 43

What causes septic shock?

Answer 43

Toxin - normally LPS from a gram-negative bacteria

Question 44

How does LPS lead to septic shock?

Answer 44

Forms complex w/ blood proteins that 1) bind to leukocytes + endothelial cells 2) Circulate and trigger vasoactive mediators

Question 45

What does low qualities of LPS cause?

Answer 45

Local inflammation

Question 46

What does moderate quantities of LPS lead to?

Answer 46

Systemic effects - fever and acute phase protein reactions

Question 47

What does high quantities of LPS cause?

Answer 47

Septic shock - Low CO + Low peripheral resistance + DIC + ARD

Question 48

What is stimulated to be released in high quantities of LPS? What do they promote

Answer 48

``` TNF IL-1 + IL-6/8 NO PAF Systemic vasodilation + increased capillary permeability ```

Question 49

What is DIC?

Answer 49

Disseminated intravascular coagulopathy

Question 50

What is DIC?

Answer 50

Small blood clot forming inside blood vessels throughout body Consumes all proteins and platelets Disruption of normal coag pathway Clots lead to infarctions

Question 51

What does ARDS stand for?

Answer 51

Multifactorial source of injury to respiratory capillary endothelium and epithelium

Question 52

What do you see histologically with ARDS?

Answer 52

Damaged vessels within lung tissue Fibrin + Fluid leakage into aveoli Formation of hyaline membranes

Question 53

What is within a hyaline membrane?

Answer 53

Protein + Fibrin + Surfactant + Cell debris

Question 54

How is resolution in the lung carried out for ARDS?

Answer 54

Scarring

Question 55

What are the three stages to shock?

Answer 55

Compensation + Progression + Irreversible

Question 56

What occurs during the compensation portion of shock?

Answer 56

HR + BP increases Vasoconstriction in the periphery ADH + AngII released Blood to vital tissues

Question 57

What occurs during the progressive phase of shock?

Answer 57

Anaerobic metabolism + Acidosis | Peripheral vasodilation - cannot maintain constriction

Question 58

What occurs during the irreversible stage of shock?

Answer 58

``` Cell + Tissue necrosis Coagulation activation Myocardial pump failure Multi-organ failure Death ```

Question 59

What is considered "cause of death"?

Answer 59

Injury or Disease that began sequence of events leading to death For example, heat stroke, gunshot wound, AIDS

Question 60

What is considered "Mechanism of death"?

Answer 60

Biochemical or Physiological abnormality resulting in death | For example, shock, cerebral edema, V. Fib, etc