Volume 4 Chapter 4

An abnormal internal or external discharge of blood

The natural tendency of the body to maintain a steady and normal internal environment

A state of inadequate tissue perfusion

Division of the autonomic nervous system that is responsible for controlling vegetative functions

Division of the autonomic nervous system that prepares the body for stressful situations

The amount of blood ejected by the heart in one cardiac contraction

The pressure within the ventricles at the end of diastole. The volume of blood delivered to the atria prior to ventricular diastole

Ability of the heart to contract. Strength of the hearts contraction

The law that an increase in cardiac output occurs in proportion to the diastolic stretch of the heart muscle fibers

Vessels that carry blood from the heart to the tissue

The resistance a contraction of the heart must overcome in order to eject blood. AKA peripheral vascular resistance

The amount of blood pumped by the heart in 1 minute (computer as stroke volume X heart rate)

Blood flow in the arterioles, capillaries and venules

Outer fibrous layer of the blood vessels that maintains their maximum size

The middle, muscular later of the blood vessels that controls lumen size

A small artery

The resistance of the vessels to the flow of blood. Increases when vessels constrict and decreases when vessels relax

Smooth interior layer of the blood vessels that provide for the free flow of blood

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

Space between cells

A blood vessel that carries blood toward the heart

Blood cell that contains hemoglobin, responsible for transport of oxygen

An iron based compund found in red blood cells that binds with oxygen and transports it to body cells

Percentage of the total blood volume consisting of the red blood cells

Fragment of cytoplasm that circulates in the blood and works with components of coagulation system to promote clotting. Also release serotonin which causes vasoconstriction

A white blood cell

• Capillary
• Venous
• Arterial

• Vascular
• Platelet
• Coagulation

Three step response to blood loss

Smooth blood vessel muscle contracts reducing vessel lumen size

To cluster or come together

Second step in clotting process in which platelets adhere to vessel walls and each other

Third step in the clotting process. Formation of protein called fibrin. Fibrin forms network around wound to stop bleeding and start repair process

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

• Movement of wound
• Aggressive fluid therapy
• Low body temperature
• Blood thinning medications

Method of hemorrhage control that relies on the application of pressure to the actual site of bleeding

A constrictor used on an extremity to apply circumfrential pressure on all arteries to control bleeding

Compound produced from pyruvic acid during anaerobic glycolysis

Able to live without oxygen

A fibrous membrane that covers, supports and seperates muscles and may also unite the skin with underlying tissue

Collection of blood beneath the skin or trapped within a body compartment

Bleeding from nose resulting from injury, disease or environment factors

Coughing up blood

Enlarged and tortuous esophageal veins

Vomiting of blood

Black, tar-like feces due to GI bleeding

A reduction in the hemoglobin content in the blood to a point below that required to meet the oxygen demands of the body

• Cells: 62%
• Interstitial space: 26%
• Vasculature: 7% (about 5 liters in adult)
• Other spaces (ventricles, brain): 4-5%

Difference between the systolic and diastolic pressures

A hormone such as epinephrine or norepinephrine that strongly effects nervous and cardivascular systems, metabolism, temperature and smooth muscle

• 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

• Fractured pelvis: 2,000 mL
• Fractured femur: 1,500 mL
• Fractured tibia/fibula: 750 mL
• Fractured humerus: 750 mL
• Large contusion: 500 mL

• 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

Passage of stools containing red blood

Decrease in blood pressure that occurs when a person moves to an upright position

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

Total changes that take place in an organism during physiological processes

First state of the process in which the cell breaks apart an energy source, commonly glucose, and relases a small amount of energy

First state of metabolism which does not require oxygen in which breakdown of glucose produces pyruvic acid and yields limited energy

Second stage of metabolism requiring oxygen in which the breakdown of glucose yields a high amount of energy. Uses the Krebs cycle.

Process of aerobic metabolism that uses carbohydrates, proteins and fats to release energy to the body. AKA citric acid cycle

Movement of oxygen from the alveolus to the red blood cell

Movement of oxygen from the blood into the cell

Part of the circulatory system consisting of the veins that drain some of the digestive organs. Delivers blood to the liver

Hormone that increases the blood glucose level by stimulating the liver to change glycogen into glucose

Pancreatic hormone needed to transport simple sugars from the interstitial spaces into the cells

Pressure exerted against the arterial walls during the contraction of the left ventricle

Pressure exerted against the arterial walls during relaxation of the left ventricle

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

Process by which respirations assist blood return to the heart by causing thoracic expansion and allowing more blood to enter

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

Sense organ or sensory nerve ending located outside the central nervous system that is stimulated by and reacts to chemical stimuli

Sympathetic nervous system center in the medulla oblongata, controlling release of epinephrine and norepinephrine

Parasympathetic center in the medulla oblongata controlling vagus nerve

10th cranial nerve that monitors and controls the heart, respiration and much of the abdominal viscera

Center in the medulla oblongata that controls arterial and to a degree, venous tone

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

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

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

A polysaccharide. One of the forms in which the body stores glucose

Process by which the body converts glycogen into glucose

Hormone secreted by the anterior pituitary that is essential to the function of the adrenal cortex, including production of glucocorticoids

Hormones released by the adrenal cortex that increase glucose production and reduce the body's inflammatory response

Hormone secreted by the anterior pituitary gland that promotes the uptake of glucose and amino acids in the muscle cells that stimulates protein synthesis

One of a specialized group of proteins that is produced by the kidneys and spurs production of red blood cells in the bone marrow

A blockage in the delivery of oxygenated blood to the cells

Pressure of liquids in quilibrium. The pressure exerted by or within liquids

Group of red blood cells that are stuck together

Release of accumulated lactic acid, carbon dioxide, potassium and rouleaux into the venour circulation

• Compensated
• Decompensated
• Irreversible

Hemodynamic insult to the body which the body responds effectively. Signs and symptoms are limited and the human system functions normally

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

• Hypovolemic
• Distributive
• -Anaphylactic
• -Septic
• Obstuctive
• Cardiogenic
• Respiratory
• Neurogenic

Final stage of shock in which organs and cells are so damaged that recovery is impossible

Shock caused by loss of blood or body fluids

Shock that results from mechanisms that prevent the appropriate distribution of nutrients and removal of metabolic waste

Form of distributive shock in which histamine release causes vasodilation, precapillary sphincter dilation, capillary engorgement, and fluid movement into the intersititial space

Form of distributive shock caused by massive infection in which toxins compromise the vascular systems ability to control blood vessels and blood distribution

Shock resulting from interference with the blood flowing through the cardiovascular system

Shock resulting from failure to maintain the blood pressure because of inadequate cardiac output

Shock resulting from failure of the respiratory system to supply oxygen to the alveoli or remove CO2 from them

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

Positive pressure ventilation provided to a breathing patient

Garment designed to produce uniform pressure on the lower extremities and abdomen. Used with shock and hemorrage patients in some EMS systems