Hemorrhage - Book 4

State of inadequate tissue perfusion

(The transition between normal function and death)

The pressure exerted by blood as it returns from the venous system (pressure within the ventricles at the end of diastole)

Preload serves to fill the empty heart

Increase in cardiac contractility due to myocardial muscle stretching

Def: An increase in cardiac output occurs in proportion to the diastolic stretch of the heart muscle fibers

Resistance by the arteries to the heart's pumping

Def: The resistance a contraction of the heart must overcome in order to eject blood (the tension of cardiac muscle during systole)

5

• Stroke Volume x Heart Rate = Cardiac Output
• ex: 70 mL x 70bpm = 4,900 mL (4.9L)

Blood flow in the arterioles, capillaries and venules (the smallest of vessels)

Outer layer of artery (blood vessel) that determines the artery's max diameter

The middle layer of artery that controls the vessel lumen size (diameter) - hence the flow of blood through the artery

Smooth interior layer of artery that provides for free flow of blood

A molecule to which oxygen attaches when red blood cells pass through the pulmonary circulation

Def: An iron-based compound found in red blood cells that bind with oxygen and transport it to body cells

Percentage of total blood volume that consists of red blood cells

Small, irregular shaped cytoplasm fragment that is important for clotting and the repair of blood vessels

Capillary: slow, even flow. Bright red color

Venous: Steady, slow flow. Dark red color

Arterial: Spurting blood. Pulsating flow. Bright red color.

Vascular phase: 1st step- Smooth blood vessel muscle contracts, reducing vessel lumen and flow of blood through it

Platelet Phase: 2nd step - platelets adhere to blood vessel walls and to each other (aggregate)

Coagulation: 3rd step - formation of protein called fibrin that forms a network around a wound to stop the bleeding, ward off infection and lay a foundation for healing and repair of the wound.

Protein fibers that trap red blood cells as part of the clotting process.

Compound produced from pyruvic acid during anaerobic glycolysis

Able to live without oxygen

Nose bleed

Coughing up blood

Enlarged and tortuous esophageal veins

Black, tar like feces due to gastrointestinal bleeding

(blood remaining in the bowel for some time)

Reduction in the hemoglobin content in the blood to a point below that required to meet oxygen requirements of the body

60%

• Blood loss up to 15%
• Patient may display some nervousness and marginally cool skin with slight pallor

A hormone, such as epi or norepi, that strongly affects the nervous and cardiovascular systems, metabolic rate, temperature and smooth muscle

Blood loss of 15-25%

Patient displays thirst, anxiety, restlessness, cool clammy skin, increased respiratory rate

Blood loss between 25-35%

• Pt experiences air hunger, dyspnea, severe thirst, anxiety, restlessness
• Survival unlikely without rapid intervention

Blood loss greater than 35%

Pulse barely palpable, respirations ineffective, patient lethargic, confused, moving towards unresponsiveness

Survival unliklely

• Fractured Pelvis - 2,000mL
• Fractured Femur - 1,500mL
• Fractured Tibia/fibula - 750mL
• Fractured Humerus - 750mL
• Large Contusion - 500mL

Stool with frank blood in it - reflects active bleeding in the colon or rectum

A decrease in blood pressure that occurs when a person moves from a supine to an upright position

Drop in systolic BP of 20 mmHg or an increase in the pulse rate of 20bpm when a patient is moved from supine to sitting

= suggestive of relative hypovolemia