Shock Flashcards
Clinical condition of organ dysfunction resulting in an imbalance between cellular oxygen supply and demand
Shock
Compensatory mechanisms in shock
Arteriolar vasoconstriction
Increase HR and contractility
Constriction of venous capacitance vessels
Release of vasoactive hormones to increase vessel tone
Release of ADH and activation of RAAS
Four major types of shock
Distributive
Cardiogenic
Hypovolemic
Obstructive
Major types of distributive shock
Septic
Neurogenic
Shock characterized by increased mVO2, decreased PVR, decreased LVEDP, decreased CVP, decreased SVR, increased CO, and increase pulse pressure.
Septic shock (distributive)
Shock characterized by low CO, normal or high CVP, increased afterload, increased LVEDP, increased PVR, increased SVR, and decreased mVO2.
Cardiogenic shock
Shock characterized by decreased LVEDP, increased PVR, decreased mVO2, increased SVR, and decreased CO
Hypovolemic shock
Shock characterized by increased CVP, decreased or increased PCWP, decreased CO, and increased SVR
Obstructive
Shock with no SyNS compensation
Neurogenic
Affect of shock on adrenal glands
Cortical cell lipid depletion
Hemorrhagic necrosis
Affect of shock on kidneys
Acute tubular necrosis –> swelling and degeneration of tubular epithelium
Affect of shock on lungs
Diffuse alveolar damage if septic or traumatic shock
Firm and congested lungs
Frothy fluid from cut surface
Alveoli lined with hyaline membranes
Affect of shock on GIT
Gastric mucosal erosion
Superficial ischemic necrosis in intestines
Diffuse GI hemorrhage
Affect of shock on liver
Enlarges
Mottled cut surface (nutmeg liver)
Centrilobular congestion and necrosis
Affect of shock on pancreas
Ischemia to exocrine pancreas –> unleashes activated catalytic enzymes –> acute pancreatitis
