Chapter 10

Front 1

Shock (hypoperfusion)

Back 1

Describes a state of collapse and failure of the cardiovascular system.
-a condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function.

Front 2

Cardiovascular system:
"Perfusion Triangle"

Back 2

1. Pump (heart)
2. set of pipes (blood vessels or arteries)
3. Contents (blood)

Front 3

Three basic causes of shock and impaired tissue perfusion:

Back 3

1. pump failure- cause heart attacks, trauma to heart, obstructive causes
2. low fluid volume- trauma to vessels or tissues, fluid loss from GI tract
3. poor vessel function- cause infection, drug overdose(narcotic), spinal cord injury, anaphylaxis

Front 4

Causes of shock

1. Pump Failure

Back 4

- Cardiogenic shock

-Obstructive shock

Front 5

Causes of shock

2. Poor Vessel Function

Back 5

Distributive Shock:
-Septic shock
-Neurogenic shock
-Anaphylactic Shock
-Psychogenic Shock

Front 6

Causes of shock

3. Low Fluid Volume

Back 6

Hypovolemic Shock
-hemorrhagic schock
-non hemorrhagic shock

Front 7

Cardiogenic Shock

Back 7

Shock caused by inadequate function of the heart, or pump failure.
-cannot maintain cardiac output.
-may result from low cardiac output due to high afterload, low preload, poor contractility, or combination of the 3.

Front 8

Obstructive Shock

Back 8

shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the bodys tissues.

-cardiac tamponade & tension pneumothorax

Front 9

cardiac tamponade

Back 9

a collection of fluid between the pericardial sac and the myocardium.
also called pericardial tamponade
-caused by blunt or penetrating trauma

Front 10

Signs & Symptoms of cardiac tamponade

Back 10

reffered to as Becks Triad:
-JVD
-Muffled heart sounds
- systolic and diastolic merging

Front 11

Tension pnueomothorax

Back 11

is caused by the damage to the lung tissues. Air escaping into chest cavity.
serious & life-threatening event.

Front 12

Signs & symptons of Tension pneomothorax

Back 12

patient becomes anxious and short of breath
-heart rate and respiratory rate increase and become shallower
-blood pressure drops
-affected side will have decreased or absent lung sounds
-will become cyanotic
-late sign is tracheal deviation.

Front 13

Distributive shock

Back 13

a condition that occurs when there is a widespread dilation of the small arterioles, small venules, or both.

Front 14

Septic Shock

Back 14

shock caused by sever infection, usually bacterial infection.
Toxins damage vessel walls, causing increased cellular permeability.
-complications of a very serious illness, injury, or surgery.

Front 15

Neurogenic Shock

Back 15

Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilations; seen in patients with spinal cord injuries
ex. spina bifida

Front 16

Signs of neurogenic shock

Back 16

absence of sweating below the level of injury and normal warm skin.

Front 17

Anaphylactic shock

Back 17

sever shock caused by an allergic reaction.
occurs when person reacts violently to a substance in which they have been sensitized.

-develops within mins or seconds
-no blood loss, no mechanical vascular damage, and only a slight possibility of direct cardiac muscular injury.

Front 18

anaphylaxis

Back 18

An unusual or exaggerated allergic reaction to foreign protein or other substance.

Front 19

Causes of severe allergic reactions:

Back 19

- Injections (tetanus, antitoxins, penecillin)

- Stings (honeybee, wasp, hornet..)

- ingestion (shellfish, fruit, medications)

- inhalation (dust, pollen)

Front 20

SKIN :
Signs of Anaphylactic Shock

Back 20

- flushing, itching, or burning, especially face and upper chest
-Urticaria(hives)
-Edema, especially of the face, tongue, lips
-Pallor
-Cyanosis about the lips

Front 21

CIRCULATORY:
sings of Anaphylactic Shoack

Back 21

-Dilation of peripheral blood vessels
-increases vessel permeability
-drop in blood press.
-weak, thready pulse
-dizziness
-fainting (syncope) and coma

Front 22

RESPIRATORY SYSTEM:

SIgns of Anaphylactic shock

Back 22

-sneezing, itching in nasal passages
-tightness in chest, with a persistent dry cough
-wheezing & dyspnea
-secretions of fluid and mucus into bronchial passages, alveioli, and lung tissue, causing coughing
-forced expiration
-cessation of breathing

Front 23

What causes shock through the body

Back 23

Electrical current

Front 24

Early stage of shock body will maintain....

Late stage...

Back 24

1. homeostasis

2. blood circulation will slow and eventually cease

Front 25

Perfusion

Back 25

Circulation of blood within an organ or tissue in adequate amouts to meet the cells current needs for oxygen, nutrients, and waste removal.

Front 26

what is the circulatory system composed of?

Back 26

connecting tubes:
-arteries
-arterioles
-cappilaries
-venules
-veins

Front 27

2 circuits in the body;

1. Systemic circulation
2. Pulmonary circulation

Back 27

1. carries the Oxygen-rich blood from the left ventricle through the body and back to the right atrium
-
2.

Front 28

How does the body compensate to protect vital organs?

Back 28

By directing blood flow from organs that are more tolerant of low flow ( such as skin and intestines) to organs that cannot tolerate low blood flow (such as heart, brain, and lungs).

Front 29

Function:
Red blood cells
White blood Cells
Platelets

Back 29

- carry O2

-Fight infection

-form blood clots

Front 30

Blood clots for depending on what principles?

Back 30

- retention of blood due to blockage in blood circulation (Blood statis)
- change in the vessel walls (such as a wound)
- and the bloods ability to clot (as a result of a disease process or medication)

Front 31

Fibrinogen

Back 31

when blood cells begin to clump fibrinogen reinforces the red blood cells. final step

Front 32

Capillary Hydrostatic pressure

Back 32

tends to force fluids through capillary walls, whereas interstitial fluid hydrostatic pressure pushes fluids back into the cells.

Front 33

How is blood flow through capilaries regulated ?

Back 33

by the capillary sphincters, circular muscular walls that constrict and dilate. - respond to stimuli such as heat, cold, the need for oxygen, and waste removal.

Front 34

Sphincters

Back 34

Circular muscles that encircle and, by contracting, constrict a duct, tube, or opening.

Front 35

Autonomic nervous system

Back 35

the part of the nervous system that regulates involuntary functions, such as heart rate, blood press, digestion, and sweating.
-comes within seconds- it is the response that causes all signs and symptoms of shock in a patient.

Front 36

Regulation of blood flow is determined by cellular needs and is accomplished by....

Back 36

vessel constriction and dilation, together with sphincter constriction or dilation.

Front 37

Autonomic nervous system :

1. sympathetic side

Back 37

1.responsible for fight-or-flight response, will assume more control of the bodys function during a state of shock

Front 38

Autonomic nervous system:

2. parasympathetic

Back 38

2. controls involuntary function by sending signals to cardiac, smooth, and glandular muscles.
releases hormones such as epinephrine and norepinephrine.
these hormones can increase in heart rate, strengthen cardiac contractions, and vasoconstrict in nonessential areas such as skin & GI tract.

Front 39

Psychogenic shock:

Back 39

shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope).

Front 40

aneurysm

Back 40

a swelling or enlargment of a part of an artery, resulting from weakening of the arterial wall.

Front 41

Hypovolemic shock

Back 41

shock caused by fluid or blood loss.

can be hemorrhagic (injuries)
or non-hemorrhagic (diarrhea/vomiting)
-also occurs with sever thermal burns.

Front 42

Dehydration

Back 42

the loss of water or fluid from the body tissues, can cause or aggravate shock.

Front 43

Compensate shock

Back 43

the early stages of shock, in which the body can still compensate for blood loss.
-agitation/anxiety
-restlessness
-feeling of impendent doom
-altered mental status
-weak, thready pulse
-clamy skin
-pallor, cyanosis around lips
-shallow,rapid breathing
-air hunger
-nasea/ vommiting
-cap refil longer that 2sec in children
-marked thirst

Front 44

Decompensated shock

Back 44

late stage of shock when blood press is falling
-fallling blood press. (systolic 90mmhg or lower in adult)
-labored or irregular breathing
-ashen, mottled, cyanotic skin
-thready or absent peripheral pulses
-dull eyes, dilated pupils
-poor urinary output