MindMap Gallery Pathophysiology 10th Edition Chapter 13 Shock
Pathophysiology 10th Edition Chapter 13 Shock Mind Map, the definition of shock: a disease that occurs when the body is invaded by various harmful factors and is characterized by a decrease in the effective circulating blood volume throughout the body, a decrease in tissue blood perfusion, and then tissue cell deficiency. Blood, hypoxia, functions of important vital organs, pathological processes of metabolic disorders and structural damage.
Edited at 2024-11-28 14:26:15CBT cognitive behavioral therapy, cognitive therapy, psychological counseling, CBT basic concept: ideas determine emotions, experience determines ideas, experience requires comparison to be meaningful, and there are individual differences in experience.
Psychological perception, perception is generated on the basis of sensation. It is the response of the human brain to the objective things and overall attributes that directly act on the sensory organs. The introduction is detailed, students in need can save it.
心理學知覺,知覺在感覺的基礎上產生它是人腦對直接作用於感覺器官的客觀事物,整體屬性的反應。介紹詳細,有需要的同學,可以收藏喲。
CBT cognitive behavioral therapy, cognitive therapy, psychological counseling, CBT basic concept: ideas determine emotions, experience determines ideas, experience requires comparison to be meaningful, and there are individual differences in experience.
Psychological perception, perception is generated on the basis of sensation. It is the response of the human brain to the objective things and overall attributes that directly act on the sensory organs. The introduction is detailed, students in need can save it.
心理學知覺,知覺在感覺的基礎上產生它是人腦對直接作用於感覺器官的客觀事物,整體屬性的反應。介紹詳細,有需要的同學,可以收藏喲。
shock
shock
Definition of shock: A condition that occurs when the body is invaded by various harmful factors. It is characterized by a decrease in effective circulating blood volume throughout the body and a decrease in tissue blood perfusion, resulting in ischemia and hypoxia of tissue cells, dysfunction of important life organs, and metabolic disorders. and pathological processes of structural damage
The most important point is that the effective circulating blood volume is reduced and the blood perfusion of tissues and organs is insufficient.
Causes and classification of shock
Cause
decreased blood volume
blood and fluid loss
burn
trauma
Increased vascular bed capacity
Infect
allergy
intense nerve stimulation
cardiac dysfunction
cardiogenic shock
obstructive shock
Classification
Classification by cause: hemorrhagic shock, burn shock, traumatic shock, septic shock, anaphylactic shock, cardiogenic shock, neurogenic shock
Classification by moving parts
Hypovolemic shock: refers to shock caused by reduced blood volume in the body, mainly including hemorrhagic and fluid loss shock and traumatic shock. Typical clinical manifestations are three highs and one low, central venous pressure, cardiac output, and arterial blood pressure. , peripheral resistance increases
Vasogenic shock: including septic shock, anaphylactic shock, and neurogenic shock. The main cause is peripheral blood vessel dilation, increased vascular volume, and reduced tissue perfusion.
Cardiogenic shock: Due to heart pumping dysfunction, cardiac output is sharply reduced, resulting in a significant decrease in effective circulating blood volume and microcirculatory tube flow.
The pathogenesis of shock
Microcirculation: Excitation of the sympatho-adrenal system and insufficient microcirculatory perfusion, causing cell damage and organ dysfunction.
Cellular mechanism: shock-causing factors act directly or indirectly on tissues and cells, causing metabolism and dysfunction of certain cells, and even structural damage.
Nerves-humoral factors: The overflow of pro-inflammatory and anti-inflammatory humoral factors directly causes microcirculation disorders and damage to cells, tissues and organs.
The development of shock
ischemia-hypoxia period
Characteristics: less perfusion and less flow, less perfusion than flow, and the tissue is in a state of ischemia and hypoxia.
Mechanism of change: Strong excitement of the sympathoadrenal medullary system and an increase in vasoconstrictor substances
The compensatory significance of microcirculatory changes: 1. It helps to maintain arterial blood pressure and can increase the amount of blood returned to the heart. It is the first line of defense to increase the amount of blood returned to the heart. It plays the role of self-infusion; increases cardiac output; increases peripheral resistance. ; 2. Helps blood supply to the heart and brain
Clinical manifestations: generally pale face, clammy limbs, cold sweats, accelerated pulse, decreased pulse pressure, decreased urine output, and irritability.
Congestion-hypoxic period
It is also called the microcirculatory congestion phase, decompensation phase, and shock phase; during this phase, blood flow slows down significantly, red blood cells and platelets aggregate, and hypoxia becomes more severe.
Characteristics: irrigation but little flow, irrigation greater than flow, tissue showing congestion and hypoxia state
Change mechanism: 1. Microvascular dilation mechanism and blood stasis mechanism
Decompensation and the creation of a vicious cycle
The amount of blood returned to the heart decreases sharply: arterioles and arterioles dilate, and true capillaries open in large numbers.
Self-infusion stopped
Decreased cardiac and cerebral blood perfusion
Clinical manifestations: blood pressure drops significantly, pulse is thin, and veins collapse 2. Patient is apathetic or even comatose 3. Renal blood flow is severely insufficient, with oliguria or even anuria 4. Microcirculatory congestion, cyanosis or mottling of skin and mucous membranes
exhaustion stage
Microcirculatory failure stage or refractory stage, also known as irreversible stage DIC stage
Characteristics of changes: capillaries undergo paralytic dilation, blood vessels lose their responsiveness to catecholamines, and microthrombi form without perfusion.
Mechanism of change: release of tissue factor into blood, endotoxin
Serious consequences: extensive bleeding
Linchuan manifestations: 1. Circulatory failure 2. Complicated DIC 3. Vital organ disorders
Functional metabolic changes of the body
Substance metabolism disorder
During shock, microcirculation is severely disrupted, tissue perfusion is low, and cells are hypoxic.
Electrolyte and acid-base disorders
metabolic acidosis
respiratory alkalosis
hyperkalemia
organ dysfunction
changes in kidney function
acute renal failure
The incidence is second only to the lungs and liver, with clinical manifestations such as oliguria or anuria, azotemia, hyperkalemia, acid metabolism, etc.
Mechanism: Sharp decrease in blood volume, continuous ischemia and hypoxia, release of toxins leading to the production of inflammatory mediators
changes in lung function
changes in heart function
changes in brain function
Several common functional characteristics of shock
septic shock
High dynamic shock
Fever, increased cardiac output, decreased peripheral resistance, and increased pulse pressure
low dynamic shock
Cardiac output decreases, peripheral resistance increases, and pulse pressure decreases significantly
cardiogenic shock
anaphylactic shock
neurogenic shock
Pathophysiological basis of prevention and treatment
Increase microcirculatory perfusion flow
Expand blood volume
How much supplement is needed, crystal after crystal is found
correct acidosis
Rational use of vasoactive drugs
Fully expanded
Inhibit excessive inflammatory response
cell protection