1) 50-year-old man is kicked by a horse and suffers acute and severe blood loss.

Describe the physiological responses that occur. How do these differ from a patient
with septic shock?

Hypovolaemia
- Pulse – high pulse rate
- Blood pressure
- Skin – cold to the skin or plae due to decrease circulation
- capillary refill – prolonged capplary refill time
- alertness – drowsy
- headache, fatuf=gue, weakness, thrist and dizziness
- oliguria, cyanosis, abdominal and chest pain, hypotension and tachycardia

1) A 50-year-old man that is kicked by a horse, suffering from acute and severe blood
loss, would show a case of hypovolaemia which is the decreased blood volume of the
plasma. Hypovolaemia triggers a range of physiological responses as a fight against
the decrease in blood circulation. In comparison, septic shock

immediate response to blood loss – atrial baroreceptors – stretch receptors in aorta and
carotid bodies – baroreceptor reflexes that occur
- mainting stable blood pressure levels or homeostasis – provides a negtiave feedback
loop – elavted blood pressure caused heart rate to decrease
- when a person has a sudden drop in blood pressure – the decreased blood pressure is
sensed by baroreceptors as a decrease in tension – baroreceptors fire at a lower than
normal rate – the information is transmitted into the NTS – the NTS reacts b
inbitbiting the parsympathetic PSNS snd activating sympathetic SNS
- sns releases neuronepithemrine acts on the SA node to increase heart rate on the
cardiac myocytes to increase stroke volume on smooth muscle cells for
vasocontriction – this raises blood pressure

- hypovaleamic patient – the brain stem increases the sympathic drive to the organs –
for vessels to vasoconstrict and blood pumsp harder and faster – flight or fight

- chronotropuy and inotropy

- deprving brain of circulation – could lead to a stroke

intermediate reponse – slower responses – kidneys

renal response
- blood supply to the kidneys reduced
- renin is released as a response to lower blood pressure – converts angiotensinogen to
angiotensin 1 is converted to angiotensin ii by angiotensin-converting enzyme
- ace inhibtors – antihypotensive drugs – stops the convertion of ang I to ang ii
commonly done in the lung
- ang II causes vasocontrction, salt and water retention- boost the volume, increase
aldosterone release and respoprtion of the kidney and sympathetic fight or flight
response
 - leads to increase blood pressure because of vasoconstriction
- increased retention of sodium and hence water
- increase in the sympathetic activity fight or flight

hypotension
hormonal – atrial naturetic peptide ANP
ANP- atria of the heart due to stretch in the atrium-full circulation – try to lose fluid through
urination
anti diuretic hormone adh or vasopressin – in the hypothalamus – increase retains water and
salt = boosts ciruclationa dn vasoconstrictor

how does it differ from septic shock

Hypovolemia is caused by a trauma or accident, in this case, the old man was kicked by a
horse causing the loss of blood and lower blood plasma volume. This differs from apateint
experiencing a septic shock. Septic shock occurs due to an infection in the bloodstream, it is
a body-wide inflammatory response to an infection, it results in severe vasodilation, leading
to dangerously low blood pressure. Although physiologically similar to hypovolaemia, septic
shock patients have normal blood volume levels. In reponse to septic shock, instead of
barorecptors, the body release inflammatory medaitors as a counteract which increase
cytokine levels there would a continued activaton

- septic shock is due to an infection in the blood stream – body-wide inflammatory

resonse to an infection – sevre vasodilation despite normal blood voume results in
improper distribution of the blood floow
- body rlease inflammatory mediators to counteract this threat
- induces a state of increased cardiac output, increasing the renal and heptic flow
- inflammaroy mediators causes dilation of the blood vessels = decrease in blood
pressure – decreased blood pressure impairs the delivery of blood to tissure orgams
to decrease tissue perfusion
- fever or hypothermia, tachycardia, tachypnea – the fever due to the reponse f the
infection would make the patient warm to touch compared to hypovolemaic
pateints which are cold to touch due to
- intense body pain – develop pain with joints of the wrist, elbows, back and hips
knewws and ankles = skeletal muscle weakness due to impaired mitochondrial
acticty and persisgtent protein eoxidative damage
- rapid breathing r
- rash on their skin – reddish discourlation or small red dots seen throughout the body
- decreased urination due to poor kidney perfusion