297418
Descrição
Mapa Mental por melian.yates, atualizado more than 1 year ago
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Criado por melian.yates
aproximadamente 11 anos atrás
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Shock
- Types
- Cardiogenic
- Failure of the heart to pump properly
- Causes:
- Death of Cardiac muscle
- Ex. Disease of blood vessels
- Thrombosis
- Thrombosis
- Ex. Disease of blood vessels
- Arrhythmia
- Obstruction of blood flow leaving heart
- Ex. PTE (Pulmonary
thromboembolism)
- Ex. PTE (Pulmonary
thromboembolism)
- Primary Cardiac Disease
- Ex. DCM, HCM
- DCM: Dogs
- HCM: Cats
- DCM: Dogs
- Cardiomegaly
- Tricuspid valve dysplasia
- Myocardial fibrosis
- Myocardial fibrosis
- Tricuspid valve dysplasia
- Ex. DCM, HCM
- Death of Cardiac muscle
- Decrease in SV & CO
- Causes:
- Failure of the heart to pump properly
- Hypovolemic
- Shock due to reduced circulating blood volume
- Causes:
- Blood Loss
- Haemorrhage
- Blood volume = 7% of BW
- Ex. 5kg Cat: 5 *.07
= 0.35L = 350mL blood
- Ex. 5kg Cat: 5 *.07
= 0.35L = 350mL blood
- Blood volume = 7% of BW
- Haemorrhage
- Fluid loss
- Vomiting, Diarrhea, Burns
- Vomiting, Diarrhea, Burns
- Blood Loss
- Hypotension & Hypoperfusion
- Recovery possible
under certain
circumstances
- If caught early => Fluid Therapy
- Can lose 10% of fluid volume
- If caught early => Fluid Therapy
- Causes:
- Shock due to reduced circulating blood volume
- Blood Maldistribution
- Blood pools in peripheral
tissues due to a decrease in
peripheral resistance in blood
vessels
- Blood volume is unchanged, but the
VASCULAR SPACE increases so that
effective circulating blood volume decreases
- Types:
- Neurogenic Shock
- Damage to CNS
(usually spinal cord)
- Loss of autonomic
signals to smooth
muscle in blood
vessel walls
- Vasodilation
- Blood pooling in veins
- Need resistance to
keep blood flowing
- Need resistance to
keep blood flowing
- Blood pooling in veins
- Vasodilation
- Loss of autonomic
signals to smooth
muscle in blood
vessel walls
- Damage to CNS
(usually spinal cord)
- Anaphylactic Shock
- Food
- Pollen
- Bee stings
- Bee stings
- Pollen
- Mast cell degranulation
- Histamine
- Leaky dilated blood vessels
- Drop in BP & Reduced perfusion
- Hypovolemia &
Hypoperfusion
- Hypovolemia &
Hypoperfusion
- Oedema
- Drop in BP & Reduced perfusion
- Leaky dilated blood vessels
- Histamine
- Food
- Septic Shock
- Most common form of
maldistributive shock
- Mediated by vascular &
inflammatory mediators
in response to bacterial
& fungal infection
- Trigger: Gram -ve
Bacteria => LPS
(Endotoxin)
- Binds TLR4 & CD14
(Monocyte derived cells:
Dendritic cells &
Macrophages)
- Cytokine release: IL-1 & IL -6
- Cytokine release: IL-1 & IL -6
- Factor XII
- Coagulation
- Thrombosis +
- Thrombosis +
- Coagulation
- Low Dose:
- Activation of
Macrophages,
Endothelial cells &
Complement
- Activation of
Macrophages,
Endothelial cells &
Complement
- Medium Dose:
- Raised TNF & IL-1
=> Pyrexia
- Raised TNF & IL-1
=> Pyrexia
- High Dose:
- Vasodilation,
Hypotension, Reduced
myocardial contractility
(Reduced CO) &
Hypoperfusion
- BV injury (release of
too many cytokines)
- => DIC
- => DIC
- BV injury (release of
too many cytokines)
- Vasodilation,
Hypotension, Reduced
myocardial contractility
(Reduced CO) &
Hypoperfusion
- Binds TLR4 & CD14
(Monocyte derived cells:
Dendritic cells &
Macrophages)
- Trigger: Gram -ve
Bacteria => LPS
(Endotoxin)
- Most common form of
maldistributive shock
- Neurogenic Shock
- Blood volume is unchanged, but the
VASCULAR SPACE increases so that
effective circulating blood volume decreases
- Pooling, stagnation, Hypoxia
- Blood pools in peripheral
tissues due to a decrease in
peripheral resistance in blood
vessels
- Cardiogenic
- Stages
- 1) Compensated
- Increase in CO &
Vasoconstriction to
maintain BP & tissue
oxygenation
- Tachycardia
- Via Stimulation of SNS
- Adrenaline
- Adrenaline
- Tachycardia
- Control of H2O balance
- GRF drops =>
Increase H2O
absorption
- RAAS
- ADH
- ADH
- RAAS
- GRF drops =>
Increase H2O
absorption
- Increase in CO &
Vasoconstriction to
maintain BP & tissue
oxygenation
- 2) Progressive
- Compensatory Mechanisms
cannot cope with prolonged
or severe drop in blood
volume
- Hypoperfusion & Cell injury
- Low O2 => Cell
metabolism shifts to
Anaerobic respiration
- Lactic Acid
production &
reduced ATP
- Cell membrane
damage,
Lysosomal
enzyme release
- => Tissue Necrosis
- => Tissue Necrosis
- ATP needed to
maintain cellular
membranes
- Cell membrane
damage,
Lysosomal
enzyme release
- Lactic Acid
production &
reduced ATP
- Low O2 => Cell
metabolism shifts to
Anaerobic respiration
- Hypoperfusion & Cell injury
- Compensatory Mechanisms
cannot cope with prolonged
or severe drop in blood
volume
- 3) Irreversible
- Mechanisms aimed
at Vasoconstriction
are overwhemled
- Widespread
Vasodilation &
Organ failure
- Widespread
Vasodilation &
Organ failure
- Mechanisms aimed
at Vasoconstriction
are overwhemled
- 1) Compensated
- Clincal Features
- Hypotension
- Weak pulse & Tachycardia
- Hyperventilation
- Decreased urine production
- Peripheral vasoconstriction
(During compensation)
- Lesions
- Congestion & pooling of blood
- Oedema & Haemorrhage
- Petechial
- Ecchymotic
- Petechial
- Thromobosis (Microscopic)
- Coagulation cascade
- Coagulation cascade
- Cellular Necrosis (Microscopic)
- Ex. Myocardial
cells, Neurons,
Hepatocytes, Renal
Tubules
- Ex. Myocardial
cells, Neurons,
Hepatocytes, Renal
Tubules
- Congestion & pooling of blood
- Hypotension
Anexos de mídia
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