Svensson Lec 2 Flashcards
State the three key elements of shock.
Shock is a life threatening condition of circulatory failure that results in inadequate oxygenation of body tissues
Identify the component of gram negative bacteria that mediates septic shock.
endotoxin
Define edema.
Accumulation of fluid in interstitial space of body tissues
Describe the role of adrenomedullin in modulating vascular function.
In intravascular space enhances the endothelial barrier, reducing movement of solutes out of vascular space. When it does this ADM enters the interstitial space and mediates the relaxation in vascular smooth muscle, resulting in lower BP (vasodilation)
State the primary drivers of the movement of fluid into and out of vascular space.
- Hydrostatic pressure
–> Drives fluid out of vascular space - colloid osmotic pressure
–> Draws fluid back into vascular space
what are common clinical causes of edema.
- Increased capillary permeability
- Increased capillary hydrostatic pressure
- Decreased capillary oncotic pressure
- Lymphatic obstruction (lymphedema)
what is transudate
protein poor
what is exudate
protein rich
describe the mechanism of Increased capillary permeability
- Local causes: cellulitis
- Systemic causes: sepsis, hypersensitivity reactions
describe the mechanism of Increased capillary hydrostatic pressure
- Local causes: compartment syndrome, chronic venous insufficiency
- Systemic causes: heart failure, renal failure, pregnancy
describe the mechanism of Decreased capillary oncotic pressure
- Systemic causes: protein deficient states (nephrotic syndrome cirrhosis)
describe the mechanism of Lymphatic obstruction (lymphedema)
- Local causes: tumor, trauma, infection (filariasis)
Name the 4 main types of shock and their most common causes.
- distributive
- hypovolemic
- cardiogenic
- obstructive
what are the causes of distributive shock
- Sepsis
- Anaphylaxis
- Neurogenic
what are the causes of hypovolemic shock
- Hemorrhage
- Severe burns
- Severe vomiting, diarrhea
what are the causes of cardiogenic shock
- Myocardial infarction
- Ventricular arrhythmia
- Cardiomyopathy
- Valvular disease
what are the causes of obstructive shock
- Cardiac tamponade
- Pulmonary embolism
- Pneumothorax
describe distributive shock
- Normal/high output SvO2
1. Symptoms: - hypovolemia and hypotension that leads to vasodilation in the release of inflammatory response
2. Echocardiographic signs - Normal cardiac chambers and preserved contractility
describe hypovolemic shock
- Low SvO2 and low venous pressure
1. Symptoms: - leads to loss of plasma or blood volume
2. Echocardiographic signs - Small cardiac chambers and normal or high contractility
–> Triad with hypothermia → coagulopathy → acidosis
describe cardiogenic shock
- Low SvO2 and high venous pressure
1. Symptoms: - deals with cardiogenic shock and everything related to your heart
2. Echocardiographic signs - Large ventricles and poor contractility
describe obstructive shock
- Low SvO2 and high venous pressure
1. Symptoms: - obstructive shock is characterized by a blockage in blood flow caused by (causeson other slide)
2. Echocardiographic signs - Depends on the cause
