20005 > shock > Flashcards

shock Flashcards

(52 cards)

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1
Q

what is perfusion

A

the adequate delivery and removal of gasses, minerals and other nutrients to and from body tissues

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2
Q

what factors ensure correct tissue perfusion

A
  • functioning heart
  • functioning lungs
  • intact vessels
  • adequate blood volume
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3
Q

what is shock

A

an inadequate tissue perfusion doe to acute circulatory failure leading to cellular hypoxia and inability of the cells to utilise oxygen

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4
Q

what are causes of shock

A
  • improper function of the heart
  • inadequate fluid
  • vessel failure
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5
Q

what causes improper function of the heart

A
  • blunt chest trauma
  • tamponade
  • drugs
  • electrical function
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6
Q

what causes inadequate fluid

A
  • dehydration
  • burn injuries
  • profuse bleeding
  • excessive environmental temperature
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7
Q

what causes vessel failure

A
  • neurological dysfunction causing dilation
  • severe allergic reactions
  • massive infection
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8
Q

what are the 3 stages of shock

A
  1. compensated
  2. decompensated
  3. irreversible
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9
Q

what is compensated shock

A

the body is able to compensate for decreased perfusion

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10
Q

what is decompensated shock

A

the body is unable to adequately perfuse its cells

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11
Q

what are the compensatory mechanisms in compensated shock

A
  • increase in HR and contraction
  • increase in RR to increase arterial oxygenation
  • vasoconstriction to improve perfusion to vital organ
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12
Q

what is the SNS response in compensated shock

A
  • increase SNS activity
  • increases Na release
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13
Q

what is the RAAS response in compensated shock

A
  • increased RAAS
  • increased AgII release
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14
Q

what is the adrenal response in compensated shock

A
  • increased adrenal response
  • increase Ad and Na release
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15
Q

what is the pituitary response in compensated shock

A
  • increased pituitary response
  • increase ADH
  • increase vasopressin release
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16
Q

what are the signs and symptoms of compensated shock

A
  • normal/ increasing HR
  • tachypnoea
  • normal BP
  • normal pupil
  • clammy
  • pallor
  • nausea/ vomiting
  • thirst
  • restlessness
  • anxiety
  • agitation
  • impending doom
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17
Q

what are the mechanisms on decompensated shock

A
  • BP and vascular tone decreased
  • dysfunctioning organs
  • anaerobic metabolism = lactic acidosis
  • compensatory mechanisms are no longer available
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18
Q

what are the signs and symptoms of decompensated shock

A
  • rapid, weak, thready pulse
  • shallow laboured breathing
  • decreased BP
  • dilated pupils
  • clammy hands and feet
  • pallor with cyanosis
  • extreme weakness
  • altered mental status
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19
Q

what are the mechanisms of irreversible shock

A
  • blood shunted from liver, kidney, lung
  • brain and heart perfused
  • metabolic acidosis
  • postcapillary sphincters release stagnant and coagulated blood
  • cell death
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20
Q

what are the signs and symptoms of irreversible shock

A
  • bradycardia
  • apnoea
  • profound hypotension
  • fixed and dilated pupil
  • unresponsive
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21
Q

what are the different types of shock

Study These Flashcards
A
  • hypovolemic
  • distributive
  • obstructive
  • cardiogenic
22
Q

what are the types of hypovolemic shock

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A
  • haemorrhagic
  • non-haemorrhagic
23
Q

what are the types of disruptive shock

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A
  • septic
  • anaphylactic
  • neurogenic
24
Q

what causes hypovolemic shock

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A
  • loss of blood or bodily fluids
  • diminished COP and inadequate O2 delivery
  • causes low cardiac output
25
what causes haemorrhagic shock
- traumatic injuries - dissected aortic aneurysm - ectopic pregnancy - GI bleeding
26
what are the results of haemorrhagic shock
O2 carrying capacity diminished as RBCs are depleted
27
what are causes of non-haemorrhagic shock
- vomiting - diarrhoea - significant burns
28
what are the signs and symptoms of hypovolemic shock
- increased RR - tachycardia - weak thready pulse - hypotension - cool clammy skin - thirst - oliguria - mental status deterioration
29
what is obstructive shock
when blood flow in the great vessels or heart is occluded
30
what are the causes of obstructive shock
- acute pericardial tamponade - massive pulmonary embolus - tension pneumothroax
31
what are the signs and symptoms of obstructive shock
- tachypnoea - tachycardia - shortness of breath - hypotension - cyanosis - anxiety
32
what is disruptive shock
inadequate volume of blood to fill vascular space due to an increased vascular capacity - capillary leakage into extravascular and interstitial spaces
33
what are the cardiac effects of disruptive shock
- decreased PVR - decreased preload - decreased COP
34
what is septic shock
- an infection causing sepsis - multiple organ dysfunction syndrome - massive systemic inflammatory response to infection
35
what is the pathophysiology of septic shock
1. macrophages 2. IL, TNFa, NO 3. SIRS, leading to sepsis 4. vasodilation, hypertension, tissue inflammation 5. myocardial depression 6. multiple organ dysfunction
36
what are the signs and symptoms of septic shock
- tachypnoea - tachycardia - pyrexial, rigors - warm - nausea + vomiting - high WBC
37
what is anaphylactic shock
extreme widespread hypersensitivity reaction
38
what is the pathophysiology of anaphylactic shock
1. antigen and antibodies 2. histamine, kinins, and PG release 3. bronchoconstriction, laryngospasm 4. vasodilation 5. relative hypovolemia 6. decreased COP 7. decreased tissue perfusion
39
what are the signs and symptoms of anaphylactic shock
- cutaneous manifestations (histamines) - respiratory compromise - circulatory collapse - vomiting, nausea + diarrhoea
40
what is neurogenic shock
result of widespread vasodilation from imbalances between parasympathetic and sympathetic stimulation
41
what are causes of neurogenic shock
- trauma to spinal cord or medulla - drugs - severe emotional stress and pain
42
what are the signs and symptoms of neurogenic shock
- hypotension - bradycardia - pink warm skin
43
what is cardiogenic shock
decreased cardiac output and evidence of tissue hypoxia with adequate intravascular volume
44
what are the causes of cardiogenic shock
- MI - congestive heart failure - dysrhythmias - acute valvular dysfunction - cardiac tamponade - drug toxicity
45
what is the pathophysiology of cardiogenic shock
1. decreased cardiac output 2. compensatory RAAS and catecholamine 3. increased SVR and increase blood volume 4. increase preload, stroke volume, HR 5. increase myocardial O2 needs 6. decrease cardiac output and ejection fraction 7. decrease tissue perfusion 8. impaired cellular metabolism 9. myocardial dysfunction
46
what are the signs and symptoms of cardiogenic shock
- increased RR - crackles, pulmonary oedema - bradycardic - weak thready pulse - chest pain - SOB - MAP <70
47
what are some complications of shock
- acute renal failure - acute respiratory distress syndrome - hepatic dysfunction - coagulopathies - multiple organ dysfunction
48
what cause acute renal failure in shock
lack of perfusion so insufficient oxygenation
49
what causes acute respiratory distress syndrome in shock
- increased capillary permeability - fluids build up in alveoli - impaired ventilation and inadequate oxygenation
50
what cause hepatic dysfunction in shock
ischemic liver from high liver transaminases and serum bilirubin
51
what causes coagulopathies in shock
- overstimulation of clotting cascade - clotting and bleeding occur simultaneously - clots clog blood vessels and cut off supply - clotting factors are exhausted, increasing bleeding
52
what causes multiple organ dysfunction syndrome in shock
- combined failure of 2 or more organs - mainly seen in septic shock
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