shock 2 Flashcards
shocks of the airway
respiratory shock
anaphylactic shock
inhalation begins
with the nose, but can start with the mouth
after air being inhaled in the nose
in the nasal cavity.. air is warmed and moistened
what is after the nasal cavity
the pharynx
pharynx function
holds food and air
what is after the pharynx
epiglottis
epiglottis function
directs food down the esophagus and air down the larynx
what is after the epigottis»_space;> larynx
trachea
trachea is heavily coated in
in mucus and cilia and filters the air before it enters the lungs
at the entrance of the lungs….
the trachea splits into left and right bronchi
bronchi split into
smaller and smaller bronchioles»_space;> which then break into alveoli
what happens in the alveoli
gas exchange
bronchi can be categorized
based on how many branches have aready occured
at the base of the trachea there is …
division into left and right primary bronchi
the _____ bronchus is significantly bigger
right
all immediate divisions from the primary bronchi
secondary bronchi
how many secondary bronchi in the left lung
two
how many secondary bronchi in the right lung
three
which part of the lung has 3 lobes
right
branches from secondary bronchi
tertiary bronchi
branches after tertiary brinchi
4th order, 5th order etc….
when do bronchi become bronchioles…
no cartilage in the walls … only elastin
respiratory shock
failure of gas exchange in the lung
respiratory shock is typically caused by
trauma to the lungs or airway
respiratory shock happens because
pleural effusion
atelectasis
pulmonary edema
pleural effusionn
pleural cavity has been compromised
atelectasis
air is not making it to the alveoli
pulmonary edema
alveoli are filled with fluid
each lung is surrounded by
two concentric sacs, together called the pleurae
more deep of sacs surrounding the lungs
visceral pleura
more superficial of sacs surrounding the lungs
parietal pleura
there should usually be what between pleurae and lungs
few millimeters of pleural fluid to lubricate (otherwise empty)
pneumothorax
air gets trapped in the pleural cavity
hemothorax
blood gets trapped in the pleural cavity
hemopneumothorax
Blood and air gets trapped in the pleural cavity
hydrothorax
water gets trapped in the pleural caviy
urinothorax
urine gets trapped in the pleural cavity
pyothorax
pus gets trapped in the pleural cavity
tension pneumothorax
special pneumothorax… pressure builds up in the pleura and pushes heart to the side… causing drop in blood pressure
pleural effusion
any of the things where there is fluid in the lungs
tension pneumothorax can be
immediately life-threatening… by causing other types of shock
pneumothorax.. hemothorax and hemopneumothorax are called
punctured lunsg
how to treat punctured lungs
inserting a chest tube
atelectasis is a blockage
of the lungs, preventing air from making to the alveoli
where does atelectasis usually happen
in bronchi or bronchioles
reason 1 for atelectasis
mucus plug blocks the airway
treatment for mucus plug blocking the airway
percussion on the chest
reason 2 for atelectasis
physical blockkages (i=kids inhaling toys)
treatment for physical blockages
bronchoscopy
reason 3 for atelectasis
tumor in the lungs
treatment for a tumor in the lungs
removal
note atelectases
not all are that bad
pulmonary edema is the buildup
buildup of fluid (most often blood ) in the lungs
why is pulmoary edema different from a pleural effusion
pleural effusion is a buildup of fluid around the lungs
two categories of pulmonary edema
cardiogenic
noncardiogenic
cardiogenic edema
caused by low-functioning heart
noncardiogeic edema
caused by variety of other factors
in both cardiogenic and noncardiogenic edema….
alveoli fill with fluid and cannot facilitate the exchange of oxygen and carbon dioxide
anaphylactic shock
deficiency in perfusion due to anaphylaxis
anaphylaxis
severe allergic reaction
people with allergies,…..
have immune systems that recognize mostly harmless substances, such as pollen, as danger
in an allergic reaction.. the body releases
histamine
histamine functions
as a neurotransmitter or hormone to activate many different responses in the body
example of receptor histamine binds to
periphery receptor; caused bronchoconstriction»can’t breathe>shock
histamine binds to
variety of receptors
symptoms of histamine binding to receptors
Hives Vomitting Diarrhea Light-Headedness Swelling of mouth / air way shortness of breath low blood pressure abnormally slow or fast heart rate
worst of histamine symptoms
swelling of the airway»> can’t inhale or exhale.» cant breathe» death
antihistamines
antagonists for histamine receptors
by blocking histamine receptors
block them from sending danger signals and inhibit stuff
antihistamines specifically target which receptors
H1 receptors
H1 receptors are found
in the peripheral NS and central NS
first-generation antihistamines
passed through blood brain barrier and blocked H1 receptors everywhere
H1 receptors in the CNS
wakefullness, appetite,
second-generation antihistamines
can no longer pass through the blood brain barrier because they are lipophobic
what particles are best at passing through the blood brain barrier
small, lipophilic, uncharged
antihistamines are usually….
small. uncharged, mostly lipophilic
distributive shock
failure of blood vessels to bring blood to the right place
circulatory system can be broken into …
the pump, the container, the stuff
distributive shock is a problem with
the container… it is too big
what types of shock are caused by distributive shock
anaphylactic shock
neurogenic shock
Psychogenic Shock
Septic Shock
Anaphylactic shock
deficiency in perfusion due to to anaphylaxis
another important function of periphery H1 receptors
vasodilation
H2 receptors are primarily
involved in vasodilation
second scariest of symptoms cause by histamine
low blood pressure …. if it drops too low… a patient is at risk for distributive shock (even though the respratory shock is fixed)
neurogenic and psychogenic shock come from
failure of the nervous system to control muscles that regulate blood vessels
three types of muscle tissues
skeletal
smooth
cardiac
skeletal muscle
can be voluntarily controlled and is found in and round important organs
smooth muscle
cannot be voluntarily controlled and is found in and around important organs
cardiac muscle
cannot be voluntarily controlled and is found only in the heart
smooth muscles are found….
in blood vessels and control vasoconstriction or vasodilation
vasodilation and vasoconstriction
crucial for blood pressure
too much dilation
blood pressure drops
too much contriction
blood pressure spikes
distributive shock is caused by
excessive vasodilation
how are smooth muscles controlled
not by CNS, by hormones
the sympathetic pathway of smooth muclses releases
epinephrine and norepinephrine
sympathetic pathway
- Also called the “fight or flight” response
- Causes many effects, including vasoconstriction across most blood vessels and an increase in heart rate
time sympathetic pathway
-Acts and dissipates in seconds
parasympathetic pathway releases
acetylcholine (ACh)
parasympathetic pathway
Also called the “feed or breed” response-Causes many effects, including vasodilation across most blood vessels and a decrease in heart rate-
parasympathetic pathway time
acts and dissipates in minutes – longer
signals for each the parasympathetic and sympathetic responses are carried from
the brain down the spinal cod to reach blood vessels i abdomen and legs
when the spinal cord is severed..
each system is wiped out and the body loses control of all smooth muscles
since the parasympathetic nervous system takes so long to dissipate
we see extreme vasodilation
failure of nervous system to regulate_____
failure to regulate blood pressure… neurogenic shock
vagus nerve
long nerve in the body responsible for stimulation of parasympathetic nervous system
vagus nerve is stimulated
by many things
….. each released ACh and causes vasoldilation and slowed heart rate
when the vagus nerve is triggered,,,,
vasovagal response
vasovagal response
-results in low blood pressure, short term deficiency of oxygen to the brain»> syncope
is the vasovagal response dead
almost always not
syncope
fainting
important chemical released in response to infection and help fight it
cytokines
too big infection
too many cytokines released»> bad stuff
usually cytokines are made to…
recruit white blood cells, which release more cytokines in a positive feedback loop
cytokine positive feedback loop is supposed
to stay localized and get shutoff at a certain point
in an infection gets too big…
the body does not shut down cytokines…. cytokine stor
result of cytokine storm
widespread inflammation
widespread inflammation from cytokine storm can lead to
ARDS» which can lead to death
ARDS
acute respiratory distress syndrome
cytokine storms can also lead to
severe damage to blood vessels when they dilate too much and for too long»>
svsere damage to blood vssels leads to
blood spilling int the extracellular space
blood spilling into the extracellular space causes
reddish slotches on the skin»_space; petechiae
blood spilling into extracellular space also leads to
decreased oxygen delivery to cells»> shock