Hemodynamic Disorders (4) - Emboli/Shock

Question 1

Most often, where does a pulmonary embolus begin?

Answer 1

A Deep Vein Thrombosis in the LE dislodges and travels to pulmonary circulation

Question 2

The effects and symptoms of a pulmonary embolism depend on?

Answer 2

Size of the embolus

Question 3

Saddle emboli

Answer 3

Lodge in the pulmonary trunk bifurcation and block blood supply to both lungs

Question 4

Saddle emboli usually results in?

Answer 4

Instant death due to right sided heart failure

Question 5

A saddle emboli involves what size of embolus?

Answer 5

LARGE

Question 6

Medium size pulmonary emboli symptom and why?

Answer 6

Shortness of breath because the embolus makes it into pulmonary circulation

Question 7

Small size pulmonary emboli symptom?

Answer 7

Asymptomatic

Question 8

What are Lines of Zahn?

Answer 8

Alternating red and white lines on a clot

Question 9

What can Lines of Zahn tell you?

Answer 9

If the clot occurred during active blood flow (while the person was still alive)

Question 10

What makes up the Lines of Zahn?

Answer 10

White - platelets

Red - RBCs

Question 11

If a clot has Lines of Zahn then you know that the clot occurred when?

Answer 11

While the person was still alive (antemortem)

Question 12

What do post-mortem clots look like?

Answer 12

Red pooled blood that did NOT cause the person to die

Question 13

What causes a fat/marrow emboli?

Answer 13

Bone fracture or soft tissue injury

Question 14

What is introduced into circulation with a fat/marrow emboli?

Answer 14

Bone marrow and fat

Question 15

How will a fat/marrow emboli present?

Answer 15

A few days after bone injury, patient presents with respiratory distress and mental changes

Question 16

Air embolism

Answer 16

Introduction of air into the blood stream that obstructs blood flow

Question 17

What are 2 examples of when an air embolism can occur?

Answer 17

1. Cardiac Catheterization

2. When a scuba diver ascends too quickly - bends/decompression sickness

Question 18

An Amniotic Fluid Embolism introduces what things into maternal blood stream?

Answer 18

Amniotic fluid
Fetal tissue
Squamous cells

Question 19

An Amniotic fluid embolism presents similarly to anaphylactic shock. What are the symptoms?

Answer 19

Sudden severe shock, dyspnea, cyanosis

– very fatal

Question 20

Infarct

Answer 20

Area of ischemia necrosis of tissue due to an occlusion of an artery

Question 21

What normally causes an infarct?

Answer 21

Thrombosis

Question 22

Area of ischemic necrosis of tissue due to occlusion

Answer 22

Infarct

Question 23

Red and White infarcts - location

Answer 23

Red - venous circulation

White - arterial circulation

Question 24

Red and White infarcts - tissue blood supply

Answer 24

Red - dual blood supply

White - 1 vessel supply

Question 25

If the rate of occlusion of a vessel is SLOW, the infarct will be ____ likely to occur

Answer 25

LESS

Question 26

If the rate of occlusion of a vessel is FAST, the infarct will be _____ likely to occur

Answer 26

MORE

Question 27

Increased Hypoxemia will _____ chances of an infarct in the tissue

Answer 27

INCREASE

Question 28

What are 3 types of shock?

Answer 28

Cardiogenic Hypovolemic Systemic Inflammatory Response Syndrome

Question 29

What is shock?

Answer 29

INADEQUATE oxygen and nutrient delivery!!

Question 30

Cardiogenic shock

Answer 30

Decreased cardiac output causes decreased blood, oxygen and nutrient delivery

Question 31

Hypovolemic shock

Answer 31

Decreased blood volume causes decreased blood, oxygen and nutrient delivery

Question 32

Septic shock

Answer 32

Dysregulated host response to infection that causes decreased oxygen and nutrient delivery and clot

Question 33

Steps of septic shock

Answer 33

1. Inflammatory response - PAMPS cause cytokine release - Activation of complement 2. Endothelial activation - Edema and Vasodilation - PROcoagulant state

Question 34

Results of septic shock?

Answer 34

Hypotension, hypovolemia, clot formation, decreased O2

Question 35

What organs start to fail with septic shock?

Answer 35

Heart, kidneys, lungs