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Flashcards in Shock Deck (30)
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1

what is the definition of shock

ineffective delivery of oxygen to the tissue infective perfusion

2

what is the goal with shock

to optimize oxygen delivery amount

3

what are the 4 types of shock

hypovolemic, cardiogenic, obstructive, dstributive

4

what is hypovolemic shock

inadequate circulating volume -> decreased perfusion

5

what are common causes of hypovolemic shock

hemorrhage, v/d, third spacing loss

6

what is cardiogenic shock

results from heart failure, exclude factors outside the heart (only the heart this deals with)
-pumping function is severely impaired -> circulatory failure

7

what are some factors of cardiogenic shock

structural problems, arrhythmias, ineffective forward flow

8

what are the structural problems of cardiogenic shock

valvular insufficiency (back flow)
HCM - felines, diasystolic failure
DCM - canines, weakened contractions, poor contractility

9

what is obstructive shock

obstruction of blood flow from/returning to the heart -? diminished blood volume

10

what are some causes of obstructive shock

GDV, caval syndrome, pulmonary embolism, pericardial effusion/pneumothorax

11

what is distributive shock

flow maldistribution - vascular compartment expands (hypoperfusion despite adequate blood volume)
-loss of vessel tone
-injected mm

12

what are some potential causes of distributive shock

sepsis, SIRS, anaphylaxis, neurogenic disorder

13

what is SIRS

systemic inflammatory reponse

14

what are the clinical signs of systemic inflammation in response to infectious or noninfectious insults

trauma, pancreatitis, burns, venom, neoplasia, heart stroke

15

what is sepsis

the clinical syndrome caused by infection and the host's systemic inflammatory response to it
(may be bacterial, viral, protozoal, or fungal origin)

16

what are the perfusion parameters

mentation, mm/crt, HR, pulse quality, extremity temp, BP

17

how is the shock index calculated

HR over systolic blood pressure, higher than 1 = patient in shock

18

what are the stages of shock

compensatory stage, early decompensatory stage, decompensatory stage (terminal)

19

what si the compensatory stagge

animal attempts to maintain O2 delivery to the tissue

20

what are the 2 responses in the compensatory stage

sympathetic and neurohormal

21

what is the sympathetic response in the compensatory stage

increased CO by increased HR and SV

22

what is the neurohormonal response in the compensatory stage

water retention and fluid shift from interstitial to intravascular space

23

what may happen in the compensatory stage

splenic contraction may occur to increase number of circulating RBCS, more RBCS = more oxygen to be able to be carried

24

what are the clinical signs of the compensatory stage

tachycardia, tachypnea, normal rec temp, normal to slow hypertensive, pink mm, cool extremities, normal mentation, prolonged CRT

25

if the compensatory stage is untreated due to inadequate intravasculcar volume what happens

decreased systemic vascular resistance, cardiac dysfunction, patient goes into early decompensatory

26

what are the clinical signs of the early decompensatory stage

tachycardia, prolonged CRT, weak pulse, pale mm, possible decrease in temp, decreasing BP< dull mentation (caused by lacatate acidosis)

27

what are the clinical signs of terminal stage/ late decompensatory stage

as a result of organ failure - bradycardia, pale/cyanotic mm, absent CRT, weak or no pulse, hypotheromic, anuria

28

what is the terminal stage

happens with the stage before is not treated effectively, severe intravascular volume loss, autoregulatory escape, multi-organ failure, sympathetic center of the brain doesnt work

29

what is the autoregulatory escape

local responses override sympathetic response, massive vasodilation in all organ - complete circulatory collapse

30

what is the early decompensatory stage

redistribution of blood flow to preferred organs (heart and brain), overwhelmed liver, myocardial depressant factor, hypoxia,lactic acid production