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Flashcards in Pathophysiology of Shock Deck (20)
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1

What is the main goal of the neuroendocrine response to hemorrhage?

maintain perfusion to heart and brain

2

What is the initial stimulus for the neuroendocrine response during hemorrhagic shock?

loss of circulating blood volume

3

Afferent pain signals transmit via the ______ resulting in activation of the hypothalamic-pituitary adrenal axis as well as activation of ANS to induce direct sympathetic stimulation of adrenal medulla to release _______

spinothalamic tract, catecholamines

4

Baroreceptors are found in _____, ______ and _____

atria, aortic bodies, carotid bodies

5

T/F Normally the baroreceptors inhibit the ANS (sympathetic tone). When activated, they disinhibit ANS, causing vasoconstriction

T. baroreceptor activation -> diminished baroreceptor output -> disinhibition of ANS -> increased peripheral vasoconstriction

6

T/F arotic and carotid bodies do not have chemoreceptors

F. They have chemoreceptors that detect O2 concentrations

7

Give 3 cardiovascular responses to diminshed venous return and decreased CO due to hemorrhage

increased cardiac heart rate (1) and contractility (2), venous and arterial vasoconstriction (3)

8

Heart rate and contractility is increased by which adrenergic receptors?

beta-1

9

arteriolar vasoconstriction is brought about by activation of which adrenergic receptors?

alpha-1

10

What is the effect of sympathetic output on the adrenal medulla?

release of catecholamines

11

What is the effect of cortisol to gluconeogenesis and insulin

stimulatory to gluconeogenesis, inhibitory to insulin (insulin resistance)

12

What horomones are released by the ff. organs during shock?
Hypothalamus -
Kidney -
Pituitary

H: ACTH
K: Renin
P: ADH

13

Adverse effect of ADH to intestine

intestinal ischemia

14

Primary determinant of preload

venous return

15

The law states stating that the force of ventricular contraciton is a function of its preload

Frank-Starling Law

16

Force that resist myocardial work during contraction

Afterload

17

In neurognic shock and sepsis, the microvessels
a. vasodilate
b. vasoconstrict

A

18

In hemorrhagic shock and sepsis, the microvessels
a. vasodilate
b. vasoconstrict

B

19

T/F
In hemorrhagic shock, correction of hemodynamic parameters and restoration of O2 delivery does not lead to restoration of tissue O2.

F; it generally does

20

T/F
In septic shock, correction of hemodynamic parameters and restoration of O2 delivery does not lead to restoration of tissue O2.

T; regional tissue dysoxia persists