Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK final > the systemic response to trauma > Flashcards

the systemic response to trauma Flashcards

1
Q

what is shock?

A

poor perfusion of organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

inadequate ____ delivery at the tissue level makes ____ _____ difficult to impossible, in shock

A
  • oxygen

- aerobic metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

types of shock

A
  • hypovolemic
  • cardiogenic
  • neurogenic
  • septic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

immediate physiologic changes in shock

A

hypovolemic hemorrhagic shock

  • decreased perfusion of target tissues
  • myocardial dysfunction (decrease pumping efficiency)
  • decreased oxygen delivery
  • increased peripheral vascular resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CO (increases or decreases) with severe hypovolemia

A

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

peripheral vascular resistance PVR must ____ to maintain blood pressure and for perfusion of heart and brain

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

systolic BP will remain normal as long as the ________ are adequate to compensate for the loss of blood colume

A

compensatory mechanisms

  • increase HR
  • increase PVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what percentage of blood volume must be lost before SBP changes significantly?

A

30-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the lethal triad?

A

sequela of hemorrhage in trauma patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

components of lethal triad

A
  • acidosis
  • hypothermia
  • coagulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

acidosis in trauma works synergistically with _____ to worsen coagulation

A

hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pH < 7.2 associated with

A
  • vasodilation
  • hypotension
  • decreased CO
  • decreased cardiac contractility
  • increased dysrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

administration of sodium bicarb in acidotic patient

A

won’t improve survival, they are acidotic because losing blood, so treat that cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

independent predictor off mortality after major trauma

A

core temp <35 C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

loss dilution

A

from bleeding and fluid resuscitation - alters platelet function and coagulation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common times with biggest temp loss

A

scene, ED, OR with open peritoneum

17
Q

excessive activation from endothelial injury leads to _________________

A

inflammatory reaction/tissue factor and factor VII release

18
Q

hyperfibrinolysis

A

rise in PT time, factor VII release excessive activation of inflammatory cascade

19
Q

hemorrhagic shock categories of interest

A

3 and 4 are decreased BP

20
Q

neuroendocrine response to trauma occurs ___ and lasts ___

A

within minutes to hours and lasts 2-4 days

21
Q

neuroendocrine response to trauma means

A

multiple hormones are released simultaneously

22
Q

2 main neural responses in traumatic injury

A
  • afferent nerve stimulation (pain is the primary stimulant)

- hypovolemia (baroreceptors in atria and great vessels)

23
Q

hormone thought to modulate endocrine response

A

ACTH - Adrenocorticotropic hormone

24
Q

tonic inhibition of ____ (hormones) in traumatic injury

A

ACTH and ADH in traumatic injury

25
Q

hormones released from neuroendocrine response in trauma

A
  • renin
  • aldosterone
  • epinephrine
  • norepinephrine
  • vasopressin (ADH)
  • Growth hormone
  • glucagon
26
Q

systemic effects of hormone regulation in neuroendocrine response in trauma

A
  • conservation of H2O and Na+
  • maintenance of BP
  • mobilization of carbohydrates
  • lipolysis
  • delivery of nutrients to end organs
27
Q

lab findings in trauma patients

A

K+ is usually elevated bc of lysis of cells

28
Q

fat embolism

A

when a bone breaks, fat is inside bone marrow, and could lead to a fat embolism

29
Q

local mediators released at the site of injury include

A
  • Histamine, serotonin
  • Prostaglandins
  • ADP
  • Collagen
  • Complement cascade
  • Endotoxins, kinins
  • Potassium
30
Q

negative effects of local mediators in trauma patients

A

may have negative systemic side effects

  • disseminated intravascular coagulation (DIC)
  • hypoxemia
  • acidosis
  • cellular damage
31
Q

metabolic responses to injury

A
  • hyperglycemia
  • catabolism
  • marked fatty acid mobilization
  • increased extracellular osmolality
  • increased oxygen consumption
  • Acidosis
32
Q

final common pathway of shock

A

hypovolemia and hypoxemia

33
Q

physiologic and metabolic effects last for weeks, longer if _______

A

critically ill

34
Q

the body’s responses to injury optimize the provision of ____ and ___ to vital organs

A

oxygen and nutrients

MSK final (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions