Response to Hemorrhage

Question 1

What causes
1. Left
2. Right
shoulder pain?

Answer 1

1. Ruptured spleen

2. CO2 in the abdomen

Question 2

4 types of shock

Answer 2

Hypovolemic
Distributive (vascular volume isnt distributed correctly)
Cardiogenic (heart suddenly cant pump enough blood)
Obstructive (something is blocking blood flow)

Question 3

Causes of hypovolemic shock

Answer 3

Hemorrhage (main one)
Burns
Other forms of fluid loss (vomiting, diarrhea, bowel obstruction, 3rd space losses)

Question 4

3rd spacing

Answer 4

When fluid is retained inside the intestine

Can cause hypovolemic shock

Question 5

3 main body systems involved in combatting hypovolemic shock

Answer 5

Cardiovascular
Pulmonary
Renal

Question 6

What is the primary thing being measured that is going to activate the autonomic NS in hemorrhage?

Answer 6

Low BP!

Baroreceptors throughout the circulatory system can sense the drop in BP

Question 7

Why do people get restless as they are sliding into shock?

Answer 7

Part of the compensatory system

Heart senses that its not getting enough preload, tells you to move your muscles to increase return

Question 8

Activation of the sympathetic NS results in what 2 main things

Answer 8

Constriction of the peripheral vessels in extremities, skin, muscle, organs
Increased HR and contractility

Question 9

Effects of hemorrhage on

1. CO
2. BP

Answer 9

Decreases both

Question 10

How does the CV system initially respond to hypovolemic shock?

Answer 10

Increases the HR
Increases myocardial contractility
Constricts peripheral blood vessels

Question 11

How is the respiratory system affected by hemorrhage?

Answer 11

Low pH (from a drop in O2 and increased CO2) drives increase in respiration
Via chemoreceptors in the medullar
Increases respiratory centre activation and sympathetic drive

Question 12

How does the renal system respond to hemorrhagic shock?

Answer 12

Stimulates an increase in renin secretion from the juxtaglomerular apparatus
Makes more AII

Question 13

2 main effects of angiotension 2

Answer 13

Vasoconstriction

Stimulation of aldosterone secretion (increases Na reabsorption)

Question 14

How does the neuroendocrine system respond to hemorrhage?

Answer 14

Causes an increase in circulating ADH
Released in response to a decrease in BP and decreased in Na concentration
Leads to an increased absorption of water and salt

Question 15

2 things the hematologic system does in response to acute severe blood loss

Answer 15

Activates the coagulation cascade

Contracts the bleeding vessels

Question 16

Thromboxane A2

Answer 16

Causes constriction of bleeding vessels and platelet activation