0
Q
Laplace Law
A
- The thicker the wall and greater the wall tension and smaller the radius the greater the contraction
1
Q
Frank-Sterling Law
A
- The greater the stretch from preload blood volume, the stronger the contraction.
2
Q
Factors Affecting Blood Flow
A
- Poiseuille Law (Viscosity of Fluid)
- Pressure
- Resistance
3
Q
Shock
-Underlying Problem
A
- Inadequate tissue perfusion
2. Leads to microcirculatory failure and ultimately organ failure
4
Q
Types of Shock
A
- Hypovolemic - Volume
- Cardiogenic - Pump
- Distributive - Plumbing
5
Q
Hypovolemic Shock
-External
A
- GI losses
- Loss of limb
- Vessel disruption
- Diabetes Insipidus
- DKA
- Burns & Trauma
6
Q
Hypovolemic Shock
-Internal
A
- Dissecting Aorta
- Retroperitoneal bleed
- Hemothorax
- Splenic rupture
- Third spacing
7
Q
Cardiogenic Shock
Pump Failure
A
- > 40% muscle mass loss from? (80% of pts)
- If Pt loses ventricle muscle, it is much more serious - Papillary muscle rupture
- Cardiac Tamponade
- Tachyarrhythmias & Bradyarrhythmias
- Drugs
8
Q
Distributive Shock
A
- Anaphylactic
- Neurogenic
- Septic
9
Q
Distributive Shock
-Anaphylactic Shock
A
- Systemic allergic reaction
- Drugs
- Food
- Insect bites or stings
- Chemicals
10
Q
Distributive Shock
-Neurogenic Shock
A
- Damage or dysfunction of the SNS
- Spinal cord injury
- Head injury
- Anesthesia
11
Q
Distributive Shock
-Septic Shock
A
- Release of inflammatory mediators that result in massive vasodilation
- E Coli **
12
Q
Cells in Shock
-What happens?
A
- Anaerobic metabolism only
- Decrease in ATP (2 moles vs 36 moles)
- Increase in lactic acid
- Failure of sodium-potassium pump
- Endothelial cells swell, decreasing blood flow
- Fluid leaks from vessels to tissue (third spacing)
- Cell autolyses w/ release of vasoactive metabolites & phagocytic enzymes
13
Q
Stages Of Shock
A
- Compensatory (initial)
- Decompensated (Progressive)
- Refractory (Irreversible)
14
Q
Compensated Shock
-What happens?
A
- Catecholamines released
- Systemic venous constriction
- Systemic artery constriction
15
Q
Compensatory Shock
-Clinical Presentation
A
- Anxiety, Fear, Restless & beginning to be confused
- Thirst
- Tachycardia & Tachypnea
- Cool, clammy skin
- Decreased Bowel sounds but present
16
Q
Decompensated Shock
-What Happens?
A
- Blood flow to vital organs reduced
- Decreased O2 delivery and/or uptake
- Cerebral & myocardial ischemia
- Increased lactic acid
- Ischemia of tissues
17
Q
Decompensated Shock
-Clinical Presentation
A
- Hypotension w/ tachycardia
- Dyspnea
- Agitation, lethargy, coma
- Cardiac Rhythm changes
18
Q
Refractory Shock
-What happens
A
- Profound hypotension
- Refractory to therapy - Leaky, porous capillaries
- Passive dilation of arteries and veins
- Decreased venous return and cardiac output
19
Q
MODS
A
Multiple Organ Dysfunction Syndrome
- Progressive dysfunction of 2 or more organ systems resulting from an uncontrolled inflammatory response to severe illness or injury
- 4 or more organs = 100% mortality
20
Q
Most Common Cause of MODS
A
- Sepsis and septic shock are the most common cause of MODS
2. MODS is the most common cause of death in ICU patients
Pathophysiology Test 3
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