Shock Trauma Flashcards

1
Q

Shock state:

↑ CVP (Right ♡ preload pressure)
↑JVP (distended R neck vein)
NO RESPIRATORY DISTRESS

A

Cardiac Tamponade

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2
Q

Shock state:

↑ CVP (Right ♡ preload pressure)

RESPIRATORY DISTRESS
Decreased breath sounds
hyper-resonant on percussion

A

Tension Pneumothorax

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3
Q

If Pericardial Tamponade is suspected what imaging is used to confirm?

A

U/S

aka ECHOcardiograph

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4
Q

Hypovolemic shock:

Loss of intravascular fluid volume →

↓ CVP, ↓ PCWP & ↓ Stroke Volume →

resulting in _ CO →

compensatory ↑ SVR & ↑ HR

A

↓ CO

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5
Q

Hypovolemic shock:

Loss of intravascular fluid volume →

_ CVP, _ PCWP & _ Stroke Volume →

resulting in ↓ CO →

compensatory ↑ SVR & ↑ HR

A

↓ CVP (R ♡ Preload)
↓ PCWP (L ♡ Preload)
↓ Stroke Volume

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6
Q

Hypovolemic shock:

Loss of intravascular fluid volume →

↓ CVP, ↓ PCWP & ↓ Stroke Volume →

resulting in ↓ CO →

_ SVR & _ HR

A

compensatory
↑ SVR
↑ HR

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7
Q
Underlying event causes ♡ dysfunction →
\_\_ cardiac contractility →
↓ CO, \_\_ Stoke Volume, ↓ BP →
↑ catecholamine release →
↑ SVR & ↑ ♡ O2 demand →
↑ RAAS causes Na+/water retention & ↑ SVR →
shunts blood to brain & vital organs →
resulting in insufficient perfusion of peripheral organs
A

↓ Cardiac Contractility

↓ Stroke Volume

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8
Q
Underlying event causes ♡ dysfunction →
↓ cardiac contractility →
_ CO, ↓ Stoke Volume, _ BP →
↑ catecholamine release →
↑ SVR & ↑ ♡ O2 demand →
↑ RAAS causes Na+/water retention & ↑ SVR →
shunts blood to brain & vital organs →
resulting in insufficient perfusion of peripheral organs
A

↓ CO

↓ BP

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9
Q

Cardiogenic shock:

Underlying event causes ♡ dysfunction → 
↓ cardiac contractility →
↓ CO, ↓ Stoke Volume, ↓ BP →
↑  \_\_\_ release → 
↑ SVR & ↑ ♡  O2 demand → 
↑ \_\_\_ causes Na+/water retention & ↑ SVR →
shunts blood to brain & vital organs →
resulting in hypoperfusion of peripheral organs
A

↑ catecholamines

↑ renin-angiotensin-aldosterone system

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10
Q
Underlying event causes ♡ dysfunction →
↓ cardiac contractility →
↓ CO, ↓ Stoke Volume, ↓ BP →
↑ catecholamine release →
↑ SVR & ↑ ♡ O2 demand →
↑ RAAS causes Na+/water retention & ↑ SVR →
shunting of \_\_\_\_\_\_ →
resulting in insufficient perfusion of peripheral organs
A

shunting of blood to the brain and vital organs

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11
Q
Cardiogenic Shock
Underlying event causes ♡ dysfunction →
↓ cardiac contractility →
↓ CO, ↓ Stoke Volume, ↓ BP →
↑ catecholamine release →
_ SVR & ↑ ♡ O2 demand →
↑ RAAS causes Na+/water retention & _ SVR →
shunts blood to brain & vital organs →
resulting in \_\_\_
A

↑ SVR (Vasoconstriction)

hypoperfusion of peripheral organs (ischemia)

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12
Q

Obstructive shock

obstruction of the ___ or ___ →
inability of the heart to circulate blood →
↓ CO →
compensatory ↑ SVR

A

heart or its great vessels

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13
Q

Elevation and equalization of pressures in all the cardiac chambers is seen in ___

A

cardiac tamponade

unlike all other causes of obstructive shock

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14
Q

Obstructive shock (TPX, Tamponade)

obstruction of the heart or its great vessels →
inability of the heart to circulate blood →
_ CO →
compensatory ↑ SVR

A

↓ CO

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15
Q

Obstructive shock

obstruction of the heart or its great vessels →
inability of the heart to circulate blood →
↓ CO →
compensatory ↑ __

A

↑ SVR

systemic vasocontriction

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16
Q

Septic shock

Dysregulated ______ →

capillary leakage and systemic vasodilation →

acute organ dysfunction

A

host immune response to infection

17
Q

Septic shock
Dysregulated host immune response to infection →

capillary leakage & __ SVR → __ CO →

acute organ dysfunction

A

↓ SVR (systemic vasodilation)

↑ CO

18
Q

Neurogenic shock

Damage of ___ pathways →

loss of sympathetic vascular tone →

unopposed vagal tone →

↓ SVR (peripheral vasodilation) →

pooling of peripheral blood

19
Q

Neurogenic shock

Damage of autonomic pathways →
 loss of \_\_\_\_ →
 unopposed vagal tone →
↓ SVR (peripheral vasodilation) →
 pooling of peripheral blood
A

↓ sympathetic vascular tone

20
Q

Neurogenic shock

Damage of autonomic pathways →

loss of sympathetic vascular tone →

unopposed ___ →

↓ SVR (peripheral vasodilation) →

pooling of peripheral blood

A

vagal tone

{Parasympathetic tone}

21
Q

Neurogenic shock

Damage of autonomic pathways →
 loss of sympathetic vascular tone →
 unopposed vagal tone (PSNS) →
_ SVR & _ Cardiac Index/Output  →
 pooling of peripheral blood
A

↓ SVR (peripheral vasodilation)

↓ CO/CI

22
Q

Anaphylactic shock

immunologic anaphylaxis 
(HSR Type _; Ig_ mediated) 
degranulation of mast cells →
 massive histamine release →
↓ SVR (systemic vasodilation) and ↑ capillary leakage
A

type I

IgE

23
Q

Causes of obstructive shock
↓ ___ filling → cardiac tamponade
↓ ____ return → TPX
↑ Ventricular ____ → massive PR or Aortic Dissection

A

↓ Diastolic filling
↓ Venous return
↑ Ventricular afterload

24
Q

Anaphylactic shock

immunologic anaphylaxis (type I HSR; IgE-mediated) or nonimmunologic anaphylaxis (not IgE-mediated) →
degranulation of ___ cells →
massive release of ____ →
_ SVR and ↑ capillary leakage

A

mast
histamine
↓ SVR (systemic vasodilation)

25
List 3 types of Distributive shock
Septic shock Anaphylactic shock Neurogenic shock
26
cause of Septic shock
Infection/ bacteremia | especially gram-negative bacteria
27
Causes of Anaphylactic shock – Food allergies (e.g. peanuts) – –
``` Drug reactions (e.g. sulfa drugs) Insect stings or bites (e.g. bee stings) ```
28
causes of Neurogenic shock (2)
Spinal cord injury | Traumatic brain injury/Cerebral hemorrhage
29
↑ Lactate indicated global ____
hypoperfusion/ ischemia
30
One imaging study to consider for hypovolemic shock
``` FAST exam (to assess for intraperitoneal hemorrhage) ```
31
3 Studies to consider for cardiogenic shock
EKG Echo cardiac markers (Troponin)
32
Imaging studies to consider for obstructive shock | 3
ECHO aka U/S ( r/o Cardiac Tamponade) CXR ( r/o TPX) CTA (pulm) or V/Q scan ( r/p PE & aortic dissection)
33
Causes of obstructive shock ↓ Diastolic filling → ____ ↓ Venous return → ____ ↑ Ventricular afterload → ____ or ____
Cardiac tamponade Tension pneumothorax Massive pulmonary embolism (PE) or Aortic dissection