Volume 4 Chapter 4

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Volume 4 Chapter 4
2011-01-23 10:27:43
Volume Chapter

Volume 4 Chapter 4
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  1. Hemorrhage
    An abnormal internal or external discharge of blood
  2. Homeostasis
    The natural tendency of the body to maintain a steady and normal internal environment
  3. Shock
    A state of inadequate tissue perfusion
  4. Parasympathetic Nervous System
    Division of the autonomic nervous system that is responsible for controlling vegetative functions
  5. Sympathetic Nervous System
    Division of the autonomic nervous system that prepares the body for stressful situations
  6. Stroke Volume
    The amount of blood ejected by the heart in one cardiac contraction
  7. Preload
    The pressure within the ventricles at the end of diastole. The volume of blood delivered to the atria prior to ventricular diastole
  8. Cardiac Contractility
    Ability of the heart to contract. Strength of the hearts contraction
  9. Starling's Law of the Heart
    The law that an increase in cardiac output occurs in proportion to the diastolic stretch of the heart muscle fibers
  10. Arteries
    Vessels that carry blood from the heart to the tissue
  11. Afterload
    The resistance a contraction of the heart must overcome in order to eject blood. AKA peripheral vascular resistance
  12. Cardiac Output
    The amount of blood pumped by the heart in 1 minute (computer as stroke volume X heart rate)
  13. Microcirculation
    Blood flow in the arterioles, capillaries and venules
  14. Tunica Adventitia
    Outer fibrous layer of the blood vessels that maintains their maximum size
  15. Tunica Media
    The middle, muscular later of the blood vessels that controls lumen size
  16. Arteriole
    A small artery
  17. Peripheral Vascular Resistance
    The resistance of the vessels to the flow of blood. Increases when vessels constrict and decreases when vessels relax
  18. Tunica Intima
    Smooth interior layer of the blood vessels that provide for the free flow of blood
  19. Capillary
    One of the minute blood vessels that connect the ends of arterioles with the beginnings of venules. Where oxygen is diffused to body tissue and products of metabolism enter bloodstream
  20. Interstitial Space
    Space between cells
  21. Vein
    A blood vessel that carries blood toward the heart
  22. Erythrocyte
    Blood cell that contains hemoglobin, responsible for transport of oxygen
  23. Hemoglobin
    An iron based compund found in red blood cells that binds with oxygen and transports it to body cells
  24. Hematocrit
    Percentage of the total blood volume consisting of the red blood cells
  25. Platelet
    Fragment of cytoplasm that circulates in the blood and works with components of coagulation system to promote clotting. Also release serotonin which causes vasoconstriction
  26. Leukocyte
    A white blood cell
  27. Types of Hemmorhage
    • Capillary
    • Venous
    • Arterial
  28. Phases of Clotting Process
    • Vascular
    • Platelet
    • Coagulation
  29. Clotting
    Three step response to blood loss
  30. Vascular Phase
    Smooth blood vessel muscle contracts reducing vessel lumen size
  31. Aggregate
    To cluster or come together
  32. Platelet Phase
    Second step in clotting process in which platelets adhere to vessel walls and each other
  33. Coagulation
    Third step in the clotting process. Formation of protein called fibrin. Fibrin forms network around wound to stop bleeding and start repair process
  34. Fibrin
    Protein fibers that trap red blood cells as part of clotting process
  35. Factors Hindering the Clotting Process
    • Movement of wound
    • Aggressive fluid therapy
    • Low body temperature
    • Blood thinning medications
  36. Direct Pressure
    Method of hemorrhage control that relies on the application of pressure to the actual site of bleeding
  37. Tourniquet
    A constrictor used on an extremity to apply circumfrential pressure on all arteries to control bleeding
  38. Lactic Acid
    Compound produced from pyruvic acid during anaerobic glycolysis
  39. Anaerobic
    Able to live without oxygen
  40. Fascia
    A fibrous membrane that covers, supports and seperates muscles and may also unite the skin with underlying tissue
  41. Hematoma
    Collection of blood beneath the skin or trapped within a body compartment
  42. Epistaxis
    Bleeding from nose resulting from injury, disease or environment factors
  43. Hemoptysis
    Coughing up blood
  44. Esophageal Varices
    Enlarged and tortuous esophageal veins
  45. Hematemesis
    Vomiting of blood
  46. Melena
    Black, tar-like feces due to GI bleeding
  47. Anemia
    A reduction in the hemoglobin content in the blood to a point below that required to meet the oxygen demands of the body
  48. Location of Fluid in the Body
    • Cells: 62%
    • Interstitial space: 26%
    • Vasculature: 7% (about 5 liters in adult)
    • Other spaces (ventricles, brain): 4-5%
  49. Pulse Pressure
    Difference between the systolic and diastolic pressures
  50. Catecholamine
    A hormone such as epinephrine or norepinephrine that strongly effects nervous and cardivascular systems, metabolism, temperature and smooth muscle
  51. Stages of Hemorrhage
    • Stage 1
    • -Blood loss up to 15%. Nervousness, cool skin, pallor.

    • Stage 2
    • -Blood loss 15-20%. Thirst, anxiety, restlessness, cool clammy skin, increased respiratory rate

    • Stage 3
    • -Blood loss 25-35%. Air hunger, Dyspnea, severe thirst, anxiety, restlessness, survival unlikely without intervention

    • Stage 4
    • -Blood loss >35%. Loss of pulses, respirations ineffective, lethargy, confused, unresponsive, survival unlikely
  52. Injuries That Can Cause Significant Blood Loss
    • Fractured pelvis: 2,000 mL
    • Fractured femur: 1,500 mL
    • Fractured tibia/fibula: 750 mL
    • Fractured humerus: 750 mL
    • Large contusion: 500 mL
  53. S/S of Internal Hemorrhage
    • Early:
    • Pain, tenderness, swelling, discoloration at injury site
    • Bleeding from associated orifices
    • Vomiting of bright red blood
    • Tender/rigid/distended abdomen

    • Late:
    • Anxiety, restlessness, combativeness, AMS
    • Weakness, faintness, dizziness
    • Vomiting of blood colored like dark coffee grounds
    • Thirst
    • Melena
    • Shallow, rapid breathing
    • Rapid, weak pulse
    • Pale, cool, clammy
    • Capillary refill > 2 secs
    • Dropping BP
    • Dilated unresponsive/sluggish pupils
    • N/V
  54. Hematochezia
    Passage of stools containing red blood
  55. Orthostatic Hypotension
    Decrease in blood pressure that occurs when a person moves to an upright position
  56. Tilt Test
    Drop in systolic BP of 20mmhg or an increase in pulse of 20 bpm or more when a patient is moved to an urpight position indicating relative hypovolemia
  57. Metabolism
    Total changes that take place in an organism during physiological processes
  58. Glycolyis
    First state of the process in which the cell breaks apart an energy source, commonly glucose, and relases a small amount of energy
  59. Anaerobic Metabolism
    First state of metabolism which does not require oxygen in which breakdown of glucose produces pyruvic acid and yields limited energy
  60. Aerobic Metabolism
    Second stage of metabolism requiring oxygen in which the breakdown of glucose yields a high amount of energy. Uses the Krebs cycle.
  61. Krebs Cycle
    Process of aerobic metabolism that uses carbohydrates, proteins and fats to release energy to the body. AKA citric acid cycle
  62. External Respiration
    Movement of oxygen from the alveolus to the red blood cell
  63. Internal Respiration
    Movement of oxygen from the blood into the cell
  64. Portal System
    Part of the circulatory system consisting of the veins that drain some of the digestive organs. Delivers blood to the liver
  65. Glucagon
    Hormone that increases the blood glucose level by stimulating the liver to change glycogen into glucose
  66. Insulin
    Pancreatic hormone needed to transport simple sugars from the interstitial spaces into the cells
  67. Systolic Blood Pressure
    Pressure exerted against the arterial walls during the contraction of the left ventricle
  68. Diastolic Blood Pressure
    Pressure exerted against the arterial walls during relaxation of the left ventricle
  69. Histamine
    Substance relased during the degranulation of mast cells and basophils that increases blood flow to the injury site due to vasodilation and increased capillary permeability
  70. Thoracoabdominal Pump
    Process by which respirations assist blood return to the heart by causing thoracic expansion and allowing more blood to enter
  71. Baroreceptor
    Sensory nerve ending found in the walls of the atria of the heart, vena cava, aortic arch, and carotid sinus that is stimulated by changes in pressure
  72. Chemoreceptor
    Sense organ or sensory nerve ending located outside the central nervous system that is stimulated by and reacts to chemical stimuli
  73. Cardioacceleratory Center
    Sympathetic nervous system center in the medulla oblongata, controlling release of epinephrine and norepinephrine
  74. Cardioinhibitory Center
    Parasympathetic center in the medulla oblongata controlling vagus nerve
  75. Vagus Nerve
    10th cranial nerve that monitors and controls the heart, respiration and much of the abdominal viscera
  76. Vasomotor Center
    Center in the medulla oblongata that controls arterial and to a degree, venous tone
  77. Antidiuretic Hormone
    Hormone released by the posterior pituitary that induces an increase in peripheral vascular resistance and causes kidneys to retain water decreasing urine output and also causes splenic vascular contriction
  78. Angiotensin
    A vasopressor hormone that causes contraction of the smooth muscles of arterioles and arteries produced when renin is released from the kidneys. Angiotensis I is a physiologically inactive form, while angiotensin II is an active form
  79. Aldosterone
    Hormone secreted by the adrenal cortex that increases sodium reabsorption by the kidneys. Plays a part in regulation of blood volume, BP, and blood levels of pottasium, chloride and bicarbonate
  80. Glycogen
    A polysaccharide. One of the forms in which the body stores glucose
  81. Glycogenolysis
    Process by which the body converts glycogen into glucose
  82. Adrenocorticotropic Hormone
    Hormone secreted by the anterior pituitary that is essential to the function of the adrenal cortex, including production of glucocorticoids
  83. Glucocorticoids
    Hormones released by the adrenal cortex that increase glucose production and reduce the body's inflammatory response
  84. Growth Hormone
    Hormone secreted by the anterior pituitary gland that promotes the uptake of glucose and amino acids in the muscle cells that stimulates protein synthesis
  85. Erythropietin
    One of a specialized group of proteins that is produced by the kidneys and spurs production of red blood cells in the bone marrow
  86. Ischemia
    A blockage in the delivery of oxygenated blood to the cells
  87. Hydrostatic Pressure
    Pressure of liquids in quilibrium. The pressure exerted by or within liquids
  88. Rouleaux
    Group of red blood cells that are stuck together
  89. Washout
    Release of accumulated lactic acid, carbon dioxide, potassium and rouleaux into the venour circulation
  90. Stages of Shock
    • Compensated
    • Decompensated
    • Irreversible
  91. Compensated Shock
    Hemodynamic insult to the body which the body responds effectively. Signs and symptoms are limited and the human system functions normally
  92. Decompensated Shock
    Continuing hemodynamic insult to the body in which the compensatory mechanisms break down. The signs and symptoms become very pronounced and the patient moves rapidly toward death
  93. Types of Shock
    • Hypovolemic
    • Distributive
    • -Anaphylactic
    • -Septic
    • Obstuctive
    • Cardiogenic
    • Respiratory
    • Neurogenic
  94. Irreversible Shock
    Final stage of shock in which organs and cells are so damaged that recovery is impossible
  95. Hypovolemic Shock
    Shock caused by loss of blood or body fluids
  96. Distributive Shock
    Shock that results from mechanisms that prevent the appropriate distribution of nutrients and removal of metabolic waste
  97. Anaphylactic Shock
    Form of distributive shock in which histamine release causes vasodilation, precapillary sphincter dilation, capillary engorgement, and fluid movement into the intersititial space
  98. Septic Shock
    Form of distributive shock caused by massive infection in which toxins compromise the vascular systems ability to control blood vessels and blood distribution
  99. Obstructive Shock
    Shock resulting from interference with the blood flowing through the cardiovascular system
  100. Cardiogenic Shock
    Shock resulting from failure to maintain the blood pressure because of inadequate cardiac output
  101. Respiratory Shock
    Shock resulting from failure of the respiratory system to supply oxygen to the alveoli or remove CO2 from them
  102. Neurogenic Shock
    Type of shock resulting from an interruption in the commuication pathway between the central nervous system and the rest of the body leading to decreased vascular resistance
  103. Overdrive Respiration
    Positive pressure ventilation provided to a breathing patient
  104. Pneumatic Anti-Shock Garment
    Garment designed to produce uniform pressure on the lower extremities and abdomen. Used with shock and hemorrage patients in some EMS systems