Aemt Shock (Mwn)

Front 1

Perfusion

Back 1

circulation of an adequate amount of blood to meet the cells’ current needs

Front 2

_________________ regulate blod flow through capillary beds

Back 2

Capillary sphincters

Front 3

Cardiac output determined by

Back 3

– Myocardial contractility
– Preload
– Afterload

Front 4

Cardiac output =

Back 4

Heart Rate × Stroke Volume

Front 5

Blood Pressure =

Back 5

Cardiac Output × Systemic Vascular Resistance

Front 6

“Perfusion triangle”

Back 6

– Pump (heart)
– Set of pipes (blood vessels and arteries)
– Contents (the blood)

Front 7

As perfusion decreases, ______________________ nervous system is stimulated

Back 7

sympathetic

Front 8

Multiple-organ dysfunction syndrome (MODS)

Back 8

– Progressive failure of several organs (eg, lungs, liver, kidney) and some clotting mechanisms
– Occurs after severe illness or injury
– Major cause of death following septic, traumatic, and burn injuries
– Injury or infection triggers massive systemic immune, inflammatory, and coagulation response.
– Organs experience cell and tissue hypoxia.
– Typically develops hours to days following resuscitation

activation of
-complement system
-coagulation system
-kallikrein-kinin system (release of bradykinin - powerful vasodilator)

Front 9

Common examples of mechanical obstruction of the cardiac muscle afecting pump function

Back 9

cardiac tamponade and tension pneumothorax

Front 10

Cardiac tamponade

Back 10

– Collection of fluid between the pericardial sac and the myocardium
– Caused by blunt or penetrating trauma
– Can progress rapidly
– Signs and symptoms are referred to as Beck’s triad.

Front 11

Tension pneumothorax

Back 11

– Caused by damage to lung tissue
– The air normally held within the lung escapes into the chest cavity.
– This air applies pressure to the organs, including the heart.

Front 12

Septic shock

Back 12

– Occurs as a result of severe infections
– Toxins damage vessel walls, causing increased cellular permeability.
– Vessel walls leak and are unable to contract well.
– Almost always complication of very serious illness, injury, or surgery

Front 13

Neurogenic shock

Back 13

– Usually a result of injury to the part of the nervous system that controls the size and muscle tone of the blood vessels
– Causes include damage to the spinal cord, brain conditions, tumors, pressure on the spinal cord, and spina bifida.
– Muscles in the blood vessel walls are cut off from nerve impulses that cause them to contract.

Front 14

Anaphylactic shock

Back 14

– Develops within minutes or even seconds of contact with substance
– Signs are very distinct.
– Cyanosis (bluish color of skin) is a late sign.

Front 15

Distributive Shock

Back 15

• Result of an inadequate amount of fluid or volume in the system
• Hemorrhagic causes and nonhemorrhagic causes
• Occurs with severe thermal burns

Front 16

Psychogenic shock

Back 16

Psychogenic shock
– Caused by sudden nervous system reaction
– Produces temporary vascular dilation
– Results in fainting (syncope)
– Life-threatening causes include irregular heartbeat and brain aneurysm.
– Non–life-threatening causes include receiving bad news, seeing something unpleasant.

Front 17

________________may be the last measurable factor to change in shock.

Back 17

Blood pressure

Front 18

Aggressive fluid therapy is not appropriate in

Back 18

cardiogenic shock or massive internal bleeding

Front 19

Signs of compensated shock include all of the following, EXCEPT:
A. restlessness or anxiety.
B. pale, cool, clammy skin.
C. a feeling of impending doom.
D. weak or absent peripheral pulses.

Back 19

D. weak or absent peripheral pulses

Front 20

A 60-year-old woman presents with a
BP of 76/42 mm Hg, a pulse rate of
120 beats/min, mottled skin, and a temperature of 103.9ºF. She is MOST likely experiencing

Back 20

septic shock

Rationale: In septic shock, bacterial toxins damage the blood vessel walls, causing them to leak and rendering them unable to constrict. Widespread dilation of the vessels, in combination with plasma loss through the injured vessel walls, results in shock. A high fever commonly accompanies a bacterial infection.

Front 21

A patient with neurogenic shock would be LEAST likely to present with:
A. tachypnea.
B. hypotension.
C. tachycardia.
D. altered mentation.

Back 21

tachycardia

Rationale: In neurogenic shock, the nerves that control the sympathetic nervous system are compromised. The nervous system is responsible for secreting the hormones epinephrine and norepinephrine, which increase the patient’s heart rate, constrict the peripheral vasculature, and shunt blood to the body’s vital organs. Without the release of these hormones, the compensatory effects of tachycardia and peripheral vasoconstriction are absent.

Front 22

A 20-year-old man was kicked numerous times in the abdomen during an assault. His abdomen is rigid and tender, his heart rate is 120 beats/min, and his respirations are 30 breaths/min. You should treat this patient for:

Back 22

hypovolemic shock

Front 23

in most people a BP of ___ is sufficient to perfuse the brain and other vital organs

Back 23

80-90 mm Hg

Front 24

Obstructive shock occurs when

Back 24

the heart is physically restricted from pumping efficiently

Front 25

A Patient who is hypotensive with JVD and rapid irregular pulse has what type of shock?

Back 25

Cardiogenic

Front 26

Neurogenic shock differs from hypovolemic shock....

Back 26

In neurogenic shock the the blood vessels are cut off from the sympathetic NS - this prevents release of catecholamines as happens in hypovolemic shock

Front 27

Long term control of blood pressure is regulated by

Back 27

the renal system