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A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion.
Shock
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A balance of all systems of the body.
Homeostasis
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Circulation of blood within an organ or tissue in adequate amounts to meet the cell's current needs.
Perfusion
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1) Adequate concentration of inspired O2.
2) Appropriate movement of O2 across the alveolar-capillary membrane into the arterial bloodstream.
3) Adequate # of RBC to carry O2
4) Proper tissue perfusion
5) Efficient off-loading of 02 at the tissue level
Fick Principle
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A passive process in which molecules move from an area with a higher concentration of molecules to an area with a lower concentration.
Diffusion
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Circular muscles that encircle and, by contracting, constrict a duct, tube, or opening.
Sphincters
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The part of the nervous system that regulates involuntary functions, such as heart rate, BP, digestion, and sweating.
Autonomic Nervous System
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The volume of blood that the heart can pump per minute.
Cardiac Output (CO)
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The ability of the heart muscle to contract.
Myocardial Contractility
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The precontraction pressure in the heart as the volume of blood builds up.
Preload
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The force or resistance against which the heart pumps.
Afterload
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What is one of the initial signs of hypoperfusion?
Altered Mental Statue (AMS)
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Resistance to blood flow within all of the blood vessels except the pulmonary vessels.
Systemic Vascular Resistance (SVR)
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What is the formula to determine Cardiac Output?
- Cardiac Output = Heart Rate x Stroke Volume
- CO = HR x SV
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What is the formula to determine Blood Pressure?
- Blood Pressure = Cardiac Output x Systemic Vascular Resistance
- BP = CO x SVR
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The BP required to sustain organ perfusion in the average person.
Mean Arterial Pressure (MAP)
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What is the mean arterial pressure in the average person?
60 mm Hg
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What is the formula to determine Mean Arterial Pressure?
- Mean Arterial Pressure = (Cardiac Output x Systemic Vascular Resistance) + Central Venous Pressure
- MAP = (CO x SVR) + CVP
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What is the perfusion triangle?
- The heart
- The blood vessels
- The blood
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Receptors in the blood vessels, kidneys, brain, and heart that respond to changes in pressure in the heart or main arteries to help maintain homeostasis.
Baroreceptors
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A decrease in systolic pressure to less than ___ mm Hg stimulates the vasomotor center to increase arterial pressure by constricting vessels.
80
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Receptors in the blood vessels, kidneys, brain, and heart that respond to changes in chemical composition of the blood and help maintain homeostasis.
Chemoreceptors
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Where are the main baroreceptors located?
- Carotid arteries
- Aortic arch
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Where are the main chemoreceptors located?
- Carotid arteries
- Aortic arch
- Medulla oblongata
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Metabolism that can proceed only in the presence of O2.
Aerobic Metabolism
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The metabolism that takes place in the absence of O2.
Anaerobic Metabolism
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Affecting the heart's rate of contraction.
Chronotropic effects
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Affecting the heart's velocity of conduction.
Dromotropic effect
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Affecting the contractility of the heart muscle.
Inotropic effect
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A progressive condition usually characterized by combined failure of several organs, such as the lungs, liver, and kidney, along with some clotting mechanisms, which occurs after severe illness or injury.
Multiple-organ dysfunction syndrome (MODS)
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Shock caused by inadequate function of the heart, or pump failure.
Cardiogenic Shock
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The presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
Edema
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Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.
Obstructive Shock
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Compression of the heart caused by a buildup of blood or other fluid in the pericardial sac.
- Cardiac Tamponade
- Pericardial Tamponade
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What is Beck's triad?
- Jugular Vein Distention (JVD)
- Muffled heart sounds
- Narrowing pulse pressure
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What is Beck's triad indicative of?
Cardiac Tampinade
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The difference between the systolic and diastolic pressures.
Pulse pressure
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An accumulation of air or gas in the pleural space that progressively collapses the lung with potentially fatal results.
Tension Pneumothorax
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What is a late sign of a tension pneumothorax?
Tracheal deviation
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What are the two most common types of obstructive shock?
- Cardiac Tamponade
- Tension Pneumothorax
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A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.
Distributive Shock
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What are the four most common types of distributive shock?
- Septic Shock
- Neurogenic Shock
- Anaphylactic Shock
- Psychogenic Shock
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Shock caused by severe infection, usually a bacterial infection.
Septic Shock
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Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in pt. with spinal cord injuries.
Neurogenic Shock
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Severe shock caused by an allergic reaction.
Anaphylactic Shock
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Shock caused by a sudden, temporary reduction in blood supply to the brain that causes syncope.
Psychogenic Shock
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A condition in which the internal body temperature falls below 95oF (35oC), usually as a result of prolonged exposure to cool or freezing temperatures.
Hypothermia
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At what temperature does the body enter hypothermia?
95oF (35oC)
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An unusual or exaggerated allergic reaction to foreign protein or other substances.
Anaphylaxis
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Developing a sensitivity to a substance that initially caused no allergic reaction.
Sensitization
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Name the four categories of allergic reactions.
- Injections
- Stings
- Ingestion
- Inhalation
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Bluish color of the skin resulting from poor oxygenation of the circulating blood.
Cyanosis
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A swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall.
Aneurysm
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Shock caused by fluid or blood loss.
Hypovolemic Shock
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The loss of water from the tissues of the body.
Dehydration
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Name the three stages of shock.
- Compensated
- Decompensated
- Irreversible
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The early stage of shock, in which the body can still compensate for blood loss; also called nonprogressive shock.
Compensated shock
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The late stage of shock when the BP is falling; also called progressive shock.
Decompensated shock
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The final stage of shock, resulting in death.
Irreversible shock
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The narrowing of pulse pressure is seen in what stage of shock?
Compensated
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Assessing V/s in two different pt. positions to determine the degree of hypovolemia; positive results include a increase in pulse rate and a decrease in systolic BP when changing from a lying position to a standing position.
Orthostatic Vital Signs
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A drop in BP indicates the pt. has entered what stage of shock?
Decompensated
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Most physician Dx is based on what?
Hx
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If a pt. has a carotid pulse then they have a BP of at least ___.
60 mm Hg systolic
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If a pt. has a femoral pulse then they have a BP of at least ___.
70 mm Hg systolic
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If a pt. has a radial pulse then they have a BP of at least ___.
80 mm Hg systolic
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