patho ch 18

related to the sympathetic nervous system transmitters, norepinephrine (noardenaline) and epinephrine (adrenaline)

a connection between two blood vessels or tubes

repair of a blood vessel

listening for sounds, perhaps with a stethoscope, within the body, eg. lungs, heart, intestines.

automatic regulation or reflex control of blood flow in an area depending on the local needs

a sensory nerve receptor that is stimulated by a change in pressure, perhaps blood pressure

abnormally slow heart rate

a heart that is larger than normal size

a reversal of charges at a cell membrane; an electrical change in an excitable cell in which the inside of the cell becomes positive (less negative) in relation to the outside. This is the opposite of polarization and is caused by a rapid overflow of sodium ions.

away from the normal position, displaced

an electrical terminal or lead, a conductive medium, in electrotherapy, an instrument with a point or surface from which to discharge current to the patient's body

removal of the intima and any obstructive material in an artery

frothy sputum containing streaks of blood, usually bright red; spitting up blood.

blood flow in the very small vessels, arterioles, capillaries and venules

an abnormal sound heard in the heart, caused by a defective valve or opening in the heart

difficult or labored breathing when recumbent that is usually relieved by an upright position

a furrow, groove, depression, or fissure, esp. of the brain

fainting, temporary loss of consciousness

a combination of substances or agents that produce an effect greater than expected

excessively rapid heartbeat

shock occurs when there is inadequate perfusion of body tissues, perfusion depends on : an effective heart pump, an intact vascular system, tissues are able to use O2 and nutrients

severe prolonged relaxation of arteries and veins, decreased arterial pressure and venous pooling at capillary level, hypoxia and accumulation of products of cellular damage, increased capillary permeability and formation of clots, shifting of intravascular volume to tissues

sympathetc responses, vasoconstriction (baroreceptors and chemoreceptors), absorption of fluid form interstitial spaces, conservation of Na and H2O, renin angiotensin mechanism (ADH), all of these responses are short term. (citric acid cycle, cells use anaerobic pathway as alternative way to conserve energy)

• hypovolemic, obstructive, distributive (neurogenic, anaphylactic, and septic)
• identification is key to recovery

characterized by decreased blood volume, states of hypovolemic shock: 1. initial-blood volume decreases. 2. compensatory- maintain perfusion and BP, no cell damage. 3. progressive- decompensation, blood flow impaired, capillary permeability increased, blood flow sluggish to organs, enzyme changes and damage. 4. irreversible- VS changes, death, even if blood flow is restored- it's too late.

thirst (baroreceptors and chemoreceptors sense fluid changes, hypothalamus), Increased HR (working hard to get oxygenated blood to tissues), cool and clammy skin, decreased BP (lack of volume in area=less pressure), change in mentation (lack of), Oliguria (100-400 mL passed in 24 hours b/c of aldosterone RAS), restless/apprehension.

O2, monitoring cardiac, restore vascular volume, fluids (LRs, artificial blood, plasma expanders, and blood), CVP and PCWP (pressures in the heart), Vasoactive drugs (increase perfusion) and dopamine (increase BP).

is circulatory shock that results from mechanic obstruction of flow of blood through the central circulation (heart), results in increased right heart pressure, and decreased venous return to heart, may have increased CVP and JVD.

loss of blood vessel tone leading to enlargement of vascular compartment and displacement of vascular volume, three shock state fall into this pattern; neurogenic shock, anaphylactic shock, septic shock.

decreased sympathetic control of blood vessel tone due to defective vasomotor center in the brain. (hypoxic, low insulin or glucose (hypoglycemic), HR low, skin dry and warm.)

characterized by massive vasodilation and pooling of blood in peripheral BVs, caused by an immune mediated reactions where vasodilator substances like histamine are released in the blood, common causes-antibiotics, bee stings.

associated most often by b-bacteremia although can be caused by other organisms such as gram+ bacilli, and fungi with even greater mortality, associated with patho. complications such as pulm. insufficiency, DIC, and MODS. septicemia-fever vasodilation, warm flush skin, mild hyperventilation, behavioral changes. (antibacterials, vasopressors, dopamine, fluids). find causative agent with cultures.

acute resp. distress syndrome, acute renal failure, GI complications (bleeding), disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome (MODS).