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pathophysiology > shock 2 > Flashcards

shock 2 Flashcards

1
Q

shocks of the airway

A

respiratory shock

anaphylactic shock

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2
Q

inhalation begins

A

with the nose, but can start with the mouth

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3
Q

after air being inhaled in the nose

A

in the nasal cavity.. air is warmed and moistened

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4
Q

what is after the nasal cavity

A

the pharynx

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5
Q

pharynx function

A

holds food and air

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6
Q

what is after the pharynx

A

epiglottis

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7
Q

epiglottis function

A

directs food down the esophagus and air down the larynx

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8
Q

what is after the epigottis&raquo_space;> larynx

A

trachea

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9
Q

trachea is heavily coated in

A

in mucus and cilia and filters the air before it enters the lungs

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10
Q

at the entrance of the lungs….

A

the trachea splits into left and right bronchi

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11
Q

bronchi split into

A

smaller and smaller bronchioles&raquo_space;> which then break into alveoli

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12
Q

what happens in the alveoli

A

gas exchange

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13
Q

bronchi can be categorized

A

based on how many branches have aready occured

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14
Q

at the base of the trachea there is …

A

division into left and right primary bronchi

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15
Q

the _____ bronchus is significantly bigger

A

right

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16
Q

all immediate divisions from the primary bronchi

A

secondary bronchi

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17
Q

how many secondary bronchi in the left lung

A

two

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18
Q

how many secondary bronchi in the right lung

A

three

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19
Q

which part of the lung has 3 lobes

A

right

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20
Q

branches from secondary bronchi

A

tertiary bronchi

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21
Q

branches after tertiary brinchi

A

4th order, 5th order etc….

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22
Q

when do bronchi become bronchioles…

A

no cartilage in the walls … only elastin

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23
Q

respiratory shock

A

failure of gas exchange in the lung

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24
Q

respiratory shock is typically caused by

A

trauma to the lungs or airway

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25
Q

respiratory shock happens because

A

pleural effusion
atelectasis
pulmonary edema

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26
Q

pleural effusionn

A

pleural cavity has been compromised

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27
Q

atelectasis

A

air is not making it to the alveoli

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28
Q

pulmonary edema

A

alveoli are filled with fluid

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29
Q

each lung is surrounded by

A

two concentric sacs, together called the pleurae

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30
Q

more deep of sacs surrounding the lungs

A

visceral pleura

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31
Q

more superficial of sacs surrounding the lungs

A

parietal pleura

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32
Q

there should usually be what between pleurae and lungs

A

few millimeters of pleural fluid to lubricate (otherwise empty)

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33
Q

pneumothorax

A

air gets trapped in the pleural cavity

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34
Q

hemothorax

A

blood gets trapped in the pleural cavity

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35
Q

hemopneumothorax

A

Blood and air gets trapped in the pleural cavity

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36
Q

hydrothorax

A

water gets trapped in the pleural caviy

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37
Q

urinothorax

A

urine gets trapped in the pleural cavity

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38
Q

pyothorax

A

pus gets trapped in the pleural cavity

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39
Q

tension pneumothorax

A

special pneumothorax… pressure builds up in the pleura and pushes heart to the side… causing drop in blood pressure

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40
Q

pleural effusion

A

any of the things where there is fluid in the lungs

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41
Q

tension pneumothorax can be

A

immediately life-threatening… by causing other types of shock

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42
Q

pneumothorax.. hemothorax and hemopneumothorax are called

A

punctured lunsg

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43
Q

how to treat punctured lungs

A

inserting a chest tube

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44
Q

atelectasis is a blockage

A

of the lungs, preventing air from making to the alveoli

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45
Q

where does atelectasis usually happen

A

in bronchi or bronchioles

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46
Q

reason 1 for atelectasis

A

mucus plug blocks the airway

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47
Q

treatment for mucus plug blocking the airway

A

percussion on the chest

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48
Q

reason 2 for atelectasis

A

physical blockkages (i=kids inhaling toys)

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49
Q

treatment for physical blockages

A

bronchoscopy

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50
Q

reason 3 for atelectasis

A

tumor in the lungs

51
Q

treatment for a tumor in the lungs

A

removal

52
Q

note atelectases

A

not all are that bad

53
Q

pulmonary edema is the buildup

A

buildup of fluid (most often blood ) in the lungs

54
Q

why is pulmoary edema different from a pleural effusion

A

pleural effusion is a buildup of fluid around the lungs

55
Q

two categories of pulmonary edema

A

cardiogenic

noncardiogenic

56
Q

cardiogenic edema

A

caused by low-functioning heart

57
Q

noncardiogeic edema

A

caused by variety of other factors

58
Q

in both cardiogenic and noncardiogenic edema….

A

alveoli fill with fluid and cannot facilitate the exchange of oxygen and carbon dioxide

59
Q

anaphylactic shock

A

deficiency in perfusion due to anaphylaxis

60
Q

anaphylaxis

A

severe allergic reaction

61
Q

people with allergies,…..

A

have immune systems that recognize mostly harmless substances, such as pollen, as danger

62
Q

in an allergic reaction.. the body releases

A

histamine

63
Q

histamine functions

A

as a neurotransmitter or hormone to activate many different responses in the body

64
Q

example of receptor histamine binds to

A

periphery receptor; caused bronchoconstriction»can’t breathe>shock

65
Q

histamine binds to

A

variety of receptors

66
Q

symptoms of histamine binding to receptors

A 
Hives
Vomitting
Diarrhea
Light-Headedness
Swelling of mouth / air way
shortness of breath
low blood pressure
abnormally slow or fast heart rate
67
Q

worst of histamine symptoms

A

swelling of the airway»> can’t inhale or exhale.» cant breathe» death

68
Q

antihistamines

A

antagonists for histamine receptors

69
Q

by blocking histamine receptors

A

block them from sending danger signals and inhibit stuff

70
Q

antihistamines specifically target which receptors

A

H1 receptors

71
Q

H1 receptors are found

A

in the peripheral NS and central NS

72
Q

first-generation antihistamines

A

passed through blood brain barrier and blocked H1 receptors everywhere

73
Q

H1 receptors in the CNS

A

wakefullness, appetite,

74
Q

second-generation antihistamines

A

can no longer pass through the blood brain barrier because they are lipophobic

75
Q

what particles are best at passing through the blood brain barrier

A

small, lipophilic, uncharged

76
Q

antihistamines are usually….

A

small. uncharged, mostly lipophilic

77
Q

distributive shock

A

failure of blood vessels to bring blood to the right place

78
Q

circulatory system can be broken into …

A

the pump, the container, the stuff

79
Q

distributive shock is a problem with

A

the container… it is too big

80
Q

what types of shock are caused by distributive shock

A

anaphylactic shock
neurogenic shock
Psychogenic Shock
Septic Shock

81
Q

Anaphylactic shock

A

deficiency in perfusion due to to anaphylaxis

82
Q

another important function of periphery H1 receptors

A

vasodilation

83
Q

H2 receptors are primarily

A

involved in vasodilation

84
Q

second scariest of symptoms cause by histamine

A

low blood pressure …. if it drops too low… a patient is at risk for distributive shock (even though the respratory shock is fixed)

85
Q

neurogenic and psychogenic shock come from

A

failure of the nervous system to control muscles that regulate blood vessels

86
Q

three types of muscle tissues

A

skeletal
smooth
cardiac

87
Q

skeletal muscle

A

can be voluntarily controlled and is found in and round important organs

88
Q

smooth muscle

A

cannot be voluntarily controlled and is found in and around important organs

89
Q

cardiac muscle

A

cannot be voluntarily controlled and is found only in the heart

90
Q

smooth muscles are found….

A

in blood vessels and control vasoconstriction or vasodilation

91
Q

vasodilation and vasoconstriction

A

crucial for blood pressure

92
Q

too much dilation

A

blood pressure drops

93
Q

too much contriction

A

blood pressure spikes

94
Q

distributive shock is caused by

A

excessive vasodilation

95
Q

how are smooth muscles controlled

A

not by CNS, by hormones

96
Q

the sympathetic pathway of smooth muclses releases

A

epinephrine and norepinephrine

97
Q

sympathetic pathway

A
  • Also called the “fight or flight” response

- Causes many effects, including vasoconstriction across most blood vessels and an increase in heart rate

98
Q

time sympathetic pathway

A

-Acts and dissipates in seconds

99
Q

parasympathetic pathway releases

A

acetylcholine (ACh)

100
Q

parasympathetic pathway

A

Also called the “feed or breed” response-Causes many effects, including vasodilation across most blood vessels and a decrease in heart rate-

101
Q

parasympathetic pathway time

A

acts and dissipates in minutes – longer

102
Q

signals for each the parasympathetic and sympathetic responses are carried from

A

the brain down the spinal cod to reach blood vessels i abdomen and legs

103
Q

when the spinal cord is severed..

A

each system is wiped out and the body loses control of all smooth muscles

104
Q

since the parasympathetic nervous system takes so long to dissipate

A

we see extreme vasodilation

105
Q

failure of nervous system to regulate_____

A

failure to regulate blood pressure… neurogenic shock

106
Q

vagus nerve

A

long nerve in the body responsible for stimulation of parasympathetic nervous system

107
Q

vagus nerve is stimulated

A

by many things

….. each released ACh and causes vasoldilation and slowed heart rate

108
Q

when the vagus nerve is triggered,,,,

A

vasovagal response

109
Q

vasovagal response

A

-results in low blood pressure, short term deficiency of oxygen to the brain»> syncope

110
Q

is the vasovagal response dead

A

almost always not

111
Q

syncope

A

fainting

112
Q

important chemical released in response to infection and help fight it

A

cytokines

113
Q

too big infection

A

too many cytokines released»> bad stuff

114
Q

usually cytokines are made to…

A

recruit white blood cells, which release more cytokines in a positive feedback loop

115
Q

cytokine positive feedback loop is supposed

A

to stay localized and get shutoff at a certain point

116
Q

in an infection gets too big…

A

the body does not shut down cytokines…. cytokine stor

117
Q

result of cytokine storm

A

widespread inflammation

118
Q

widespread inflammation from cytokine storm can lead to

A

ARDS» which can lead to death

119
Q

ARDS

A

acute respiratory distress syndrome

120
Q

cytokine storms can also lead to

A

severe damage to blood vessels when they dilate too much and for too long»>

121
Q

svsere damage to blood vssels leads to

A

blood spilling int the extracellular space

122
Q

blood spilling into the extracellular space causes

A

reddish slotches on the skin&raquo_space; petechiae

123
Q

blood spilling into extracellular space also leads to

A

decreased oxygen delivery to cells»> shock

pathophysiology (24 decks)

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