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Cardiovascular Physiology ALL AZ

Cardiovascular Physiology ALL AZ

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Published by Sherwan R Shal
Full VardioVascular System Physiology
Full VardioVascular System Physiology

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Categories:Types, School Work
Published by: Sherwan R Shal on Mar 30, 2010
Copyright:Attribution Non-commercial

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05/13/2013

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A reduction in blood volume sufficient to cause
shock can occur in other ways that don't
involve

hemorrhage

For

example,
dehydration resulting from any number of
causes can reduce the blood volume enough
to induce hypovolemic shock.
Vomiting and/or diarrhea, particularly in
infants, can quickly result in dangerous
degrees of dehydration.

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234

D- Dehydration 2

This is why cholera is such a deadly disease. The
cholera bacterium, to facilitate its spread to
other hosts, produces a toxin that does nothing
more than make the capillaries of the intestinal
tract lining highly permeable to water.
This results in massive efflux of water from the
blood into the lumen of the intestine which, in
turn, induces severe diarrhea.
The resulting water losses are so rapid that it's
very difficult to replace them quickly enough to
prevent death due to dehydration.

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Signs and Symptoms Hemorrhagic Shock

1- Palpitations.
2- dizziness.
3- tachycardia.
4- Cold clammy skin.
5- Sweating.
6- oliguria.
7- breathing difficulty.
8- Anuria ( = no urine production)
Deficient blood supply to brain and heart
Brain and heart damage leading to death.

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3- Distributive Shock

•As the term “distributive” implies, this form of
shock develops when the cardiac output
(which is usually normal in this case) is not
being distributed properly to the organs that
need it.
•There are a variety of causes of distributive
shock, but they all have one thing in
common:

- a massive dilation of the blood vessels –
especially the veins – throughout the body,
with the result that blood tends to pool in the
vessels an not reach the capillaries rapidly
enough.

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•In addition, certain causes of distributive
shock also trigger mechanisms that make
the capillaries very leaky to plasma (the
liquid fraction of the blood).
•This results in a significant fraction of the
plasma leaking out into the extracellular
spaces ( = edema), where it’s no longer
available for circulation by the heart. The
resulting hypovolemia makes the situation
even worse.

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Causes of Distributive shock

a- Septic Shock

•The most common form of distributive shock is
septic shock, which results directly from some
sort of infection, usually bacterial (sepsis means “a
toxic condition resulting from infection”). In some
cases, the body responds to sepsis with a massive
reaction that is essentially allergic in nature. Cells
throughout the body release a variety of
compounds that trigger the general vasodilatation
and plasma loss that produce the shock state.

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b- Anaphylactic Shock

•Anaphylactic shock is similar to septic shock
in that it also involves the generalized
vasodilatation and increased capillary
permeability that severely reduces blood
supply to the tissues, but the cause is not
a bacterial infection.
•The most common causes of anaphylaxis
and the resulting shock are foods (especially
peanuts), drugs (especially penicillin and
aspirin), insect stings (especially bees,
wasps, and ants), blood transfusions, and
even exercise.

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c- Neurogenic Shock

•This form of shock involves the nervous system.
•The basic cause

of neurogenic shock is
generally a massive inhibition of both the
Excitatory and Inhibitory portions of the Vasomotor
Center. Now,
•Well, the problem is that inhibition of the Excitatory
Portion of the
•Vasomotor Center also results in vasodilatation
throughout the body,

due to

inactivation

of the tonic vasoconstrictor neurons that

are
normally being stimulated by the Excitatory
Vasomotor Center

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•This vasodilatation, coupled with the
decreased cardiac output, typically results
in a drastic reduction in blood flow to the
brain, a reduction sufficient to lead to
damage within a relatively short time.
•The two principal causes of neurogenic
shock are trauma to the medulla (say,
from a head injury), spinal cord injuries,
and general anesthetics.

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4- Obstructive Shock

•This is an unusual form of shock that results
when pressure on the heart prevents it from
filling or pumping effectively.
•The most common causes of obstructive
shock are pneumothorax (air in the chest
cavity) or cardiac tamponade (compression
of the heart by fluid or blood in the pericardial
space)

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