Term
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Definition
| characterized by systemic hypoperfusion caused by reduction either in cardiac output or effective circulating blood volume |
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Term
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Definition
| hypotension ,impaired tissue perfusion ,cellular hypoxia |
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Term
| Cardiogenic shock definition |
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Definition
failure of myocardial pump resulting from 1.intrinsic myocardial damage
2.extrinsic pressure/obstruction of outflow |
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Term
| Cardiogenic shock causative examples |
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Definition
| myocardial infarct ,ventricular rupture ,arrythmia, cardiac tamponade, pulmonary embolism |
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Term
| Hypovolemic shock definition |
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Definition
| decrease in blood/plasma volume due to loss of fluid in the intravascular compartment |
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Term
| Hypovolemic shock causative examples |
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Definition
| haemorrhage(trauma) ,burns , vomiting +diarrhea |
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Term
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Definition
| peripheral vasodilation +pooling of blood due to endothelial injury/activation resulting from overwhelming infection by gram +ve/-ve bacteria |
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Term
| Septic shock causative examples |
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Definition
| Overwhelming microbial infection ,super antigens (induce high levels of cytokines) |
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Term
| Neurogenic Shock definition |
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Definition
| resulting from loss of vascular tone +peripheral pooling of blood |
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Term
| Neurogenic Shock characteristics |
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Definition
| hypotension +bradycardia due to interruption of descending sympathetic tracts after severe CNS damage |
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Term
| Neurogenic Shock causative examples |
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Definition
| anesthetic injury, spinal chord injury |
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Term
| Anaphylactic shock definition |
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Definition
| systemic vasodilation and increased vascular permeability resulting into tissue hypoperfusion +hypoxia |
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Term
| Anaphylactic shock causative examples |
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Definition
| IgE mediated hypersensitivity reactions(vasodilatory hemodynamic changes in response to a particular allergen) |
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Term
| pathogenesis of septic shock |
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Definition
| caused by gram-ve bascilli lipopolysaccharides which are released on bacterial cell wall degradation |
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Term
| Septic shock shock components involved in immune response |
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Definition
marcrophages+moncytes
Cytokines (interlukin 1-6)
tumour necrosis factor |
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Term
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Definition
1.Systemic vasodilation + ↓myocardial contractility +widespread endothelial injury
2. pulmonary alveolar damage=acute resp distress syndrome
3.Activation of coagulation system (DIC) |
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Term
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Definition
1. initial non progressive phase
2.Progressive
3. Irreversible |
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Term
| Initial no progressive phase of shock |
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Definition
| reflex compensatory mechanisms are activated+perfusion of vital organs is maintained |
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Term
| Progressive stage of shock |
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Definition
| tissue hypoperfusion +onset of worsening circulatory +metabolic imbalances + acidosis |
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Term
| irreversible stage of shock |
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Definition
| sets in after body has incurred severe tissue injury. correction of hemodynamic defects is futile . survival is not possible |
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Term
| Brain macroscopic features of shock |
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Definition
| ischemic encephalopathy ,brain swelling ,gyri widened, sulci flattened,dusky discolouration ,softening ,poor grey white matter demarcation |
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Term
| Brain microscopic features of shock |
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Definition
| changes in localized areas of selective vulnerability . cortical laminar necrosis |
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Term
| Heart Macroscopic features of shock |
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Definition
focal/widespread coagulation necrosis
circumfrential subendocardial infarction
contraction bud necrosis |
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Term
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Definition
| "shock lung" shock caused by bacterial sepsis/trauma changes of diffuse alveolar lung |
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Term
| Lung Microscopic features of shock |
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Definition
| congestuion/intralveolar +interstitial edema |
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Term
| Lung Macroscopic features of shock |
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Definition
| Heavy firm ,red,boggy,beefy lungs |
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Term
| Adrenal glands morphological features of shock |
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Definition
| Cortical lipid depletion +haemorrhage due to DIC . inactive vacuolated cells become metabolically active cells that utilize stored lipids for synthesis of steroids |
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Term
| Kidney Macroscopic features of shock |
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Definition
| enlarged kidney ,pale swollen cortex, congested medulla |
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Term
| Kidney Microscopic features of shock |
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Definition
| degeneration/necrosis of the individual tubular epithelial cells+coagulation necrosis+casts within the renal tubules |
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Term
| Tubular ischemic Injury(acute tubular necrosis) results in ? |
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Definition
| oliguria(<500ml passed) anuria(<50ml passed)+electrolyte disturbances |
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Term
| types of casts formed in tubular ischemic injury |
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Definition
| hyaline ,pigmented,eosinophilic,cellular,granular debris |
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Term
| Pituitary gland features of shock |
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Definition
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Term
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Definition
| hypopituitarism → partial /complete loss of pituitary hormones |
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Term
| Liver Microscopical features of shock |
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Definition
| fatty changes , centrilobular necrosis |
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Term
| Liver Macroscopical features of shock |
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Definition
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Term
| GIT Microscopical features of shock |
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Definition
| Mucosa necrosis, hyperaremic submucossa +muscularis submucossa+muscularis viable |
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Term
| GIT Macroscopical features of shock |
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Definition
| patchy mucosal heamorrhages+ necrosis . ischemic enteritis |
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Term
| Skin morphological features of shock |
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Definition
| petechial hemorrhages on serosal surface of skin due to consumption of platelets +coagulation factors |
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Term
| Clinical features of shock |
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Definition
| low bp(weak+rapid pulse), subnormal temp(skin cold clammy) colour(pale and may be cyanotic) breathing(fast +increase depth of resp)little or no urine ,mentally (drowsy,coma/confused) |
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