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Clinical Life Sciences 2 > Shock > Flashcards

Shock Flashcards

1
Q

What is the definition of blood pressure?

A

The pressure exerted on vessel walls by the blood

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2
Q

How is blood pressure generated?

A

By the ventricles ejecting blood into the arteries

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3
Q

What vessels are used to measure B.P.

A

Large systemic arteries such as the brachial

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4
Q

What is the main characteristic of B.P.?

A

It is pulsatile

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5
Q

What 3 main factors affect B.P?

A
  1. Blood Volume
  2. Vascular Resistance
  3. Venous Return
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6
Q

Blood volume of an adult?

A

Approximately 5litres

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7
Q

What are Baroreceptors?

A

Pressure/Stretch Receptors

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8
Q

Where are the main baroreceptor bodies?

A
  1. Aortic Arch

2. Carotid Arteries

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9
Q

Where is the B.P. Control centre?

A

Brainstem (medulla oblongata)

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10
Q

What are the two main ‘effectors’ for a change in B.P.

A
  1. Heart

2. Vasculature

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11
Q

What are the 3 other B.P. Inputs?

A
  • Cerebral cortex
  • Limbic System
  • Hypothalamus
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12
Q

What nerve is innervated to control heart rate and what nervous system is used?

A

Vagus nerve via parasympathetic inputs

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13
Q

What nerves increase heart rate and contractility? What Nervous system is used?

A

Cardiac accelerator nerves via the sympathetic nervous system

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14
Q

What nerves constrict blood vessels and what nervous system is used?

A

Vasomotor nerves via the sympathetic nervous system

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15
Q

What are the 4 main inputs to the CV control centre?

A
  1. Higher brain centres
  2. Propriceptors
  3. Baroreceptors
  4. Chemoreceptors
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16
Q

What do chemoreceptors monitor?

A

Gas levels in blood and CSF

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17
Q

What 3 main things do chemoreceptors monitor for?

A
  1. Oxygen
  2. Carbon Dioxide
  3. pH
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18
Q

What do changes in blood composition trigger?

A

Homeostatic responses

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19
Q

What would an increase in CO2 and a decrease in O2 and pH result in?

A

Increased RR –> Increased minute ventilation to ‘blow off’ excess CO2 to reduce blood pH

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20
Q

What are the 5 main hormonal influences on B.P?

A
  1. Sympathetic nervous system
  2. ADH
  3. ANP
  4. RAA system
  5. Erythropoietin
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21
Q

What effect does SNS innervation have on homeostatic mechanisms

A
  1. Increases CO

2. Peripheral vasoconstriction

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22
Q

How does ADH attempt to conserve blood pressure?

A

Leads to vasocontriction –> less fluid output

23
Q

How does ANP attempt to influence BP?

A

Vasodilation –> salt and water loss in urine

24
Q

How does the RAA system attempt to conserve BP?

A

Aldosterone promotes water and sodium reabsorption in the kidneys which leads to an increase in vascular volume
Vasoconstriction

25
What does Erythropoietin do to conserve BP long term?
- increases RBC production | - increases blood viscocity
26
What reflex is used short term to correct BP?
Barorecpetor reflex
27
What manages BP long term?
Endocrine response
28
In blood vessels what exerts pressure inwards?
Plasma proteins
29
What process occurs at the arterial end of blood vessels?
Filtration
30
What process occurs at the venous end of blood vessels?
Reabsorption
31
In the first stages of Haemorrhage what does the body do to compensate?
Increases reabsorption to increase plasma volume
32
What maladaptive response develops when tissues become hypoxic? What is the effect of this?
Capiliary permeability increases. This leads to loss of plasma volume which leads to decrease BP as colloid osmotic pressure decreases
33
What is the definition of CV shock?
The failure of the CV system to meet the needs of tissues metabolic needs
34
What can tissue hypoxia lead to the damage of?
Cells, Tissues, Organs and Organ systems
35
What is the severity of shock dependent on?
The extent and duration of shock
36
What are are the 4 types of shock?
1. Cardiogenic 2. Distributive 3. Hypovolaemic 4. Obstructive
37
Name 3 causes of Distributive shock?
1. Neurogenic (such as spinal injury) 2. Septic shock 3. Anaphylaxis
38
How does spinal injury cause shock?
It leads to a lack of vascular tone and reduced sympathetic innervation which causes a drop in BP and a loss of CO
39
What 'type' of allergic reaction leads to anaphylaxis?
Type I
40
Which immune cells degranulate releasing chemical mediators to cause the symptoms?
Mast cells
41
What in the body causes septic shock?
Bacteria releasing toxins that cause a widespread systemic inflammatory response.
42
Name some of the symptoms potentially seen in septic shock. (6)
1. Reduced BP 2. Loss of GCS 3. Increased HR 4. Urinary Retention 5. Acidosis 6. Peripheral vasoconstriction (Central Vasodilation?)
43
What does endothelial damage in septic shock lead to? (3)
1. Vasodilation 2. Complement activation 3. Procoagulation (in small vessels)
44
What are some of the symptoms seen due to the release of chemical mediators in anaphylaxis? (7)
1. Rhinitis 2. Bronchospasm 3. Urticaria 4. Hypotension 5. Tachycardia 6. GI symptoms 7. Coagulopathy
45
Name a cause of cardiogenic shock and the result
aMI - reduced myocardial perfusion
46
Name a cause of obstructive shock and the result
Pericarditis/Tamponade - Affects pumping and filling of heart (output)
47
Name a cause of hypovolaemic shock and the result
Haemorrhage/Burns - Loss of vascular volume
48
Name a cause of distributive shock and the result
Anaphylaxis/Septic shock - Excessive vasodilation and possible arryhthmia (action of inflammatory mediators)
49
Where is renin produced?
Kidneys
50
Where is angiotensinogen converted to angiotensin I?
bloodstream
51
Where is angiotensin I converted to angiotensin II?
lungs
52
What catalyses the conversion of angiotensin I>II?
ACE (angiotensin converting enzyme)
53
What does angiotensin II stimulate to produce aldosterone?
The adrenal cortex
54
What does aldosterone do in the kidneys?
Increase H20 and Na+ reabsorption

Clinical Life Sciences 2 (7 decks)

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