Hemodynamic 3
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Questions and Answers

Which type of infarct is most likely to occur in lung tissue?

  • White infarct
  • Necrotic infarct
  • Ischemic infarct
  • Red infarct (correct)
  • What is a potential consequence of systemic hypoperfusion of tissues?

  • Increased oxygenation in organs
  • Reduced risk of organ failure
  • Impaired tissue perfusion (correct)
  • Enhanced cellular metabolism
  • Which factor is NOT a cause of cardiogenic shock?

  • External blood loss (correct)
  • Pulmonary embolism
  • Ventricular arrhythmias
  • Myocardial damage
  • What characterizes septic shock?

    <p>Arterial vasodilation and venous pooling (C)</p> Signup and view all the answers

    Which type of infarct is associated with arterial occlusions in solid organs?

    <p>Anemic infarct (B)</p> Signup and view all the answers

    What percentage of individuals with severe skeletal injuries show clinical findings of fat embolism syndrome?

    <p>10% or less (C)</p> Signup and view all the answers

    Which of the following is NOT a symptom of fat embolism syndrome?

    <p>Hypotension (A)</p> Signup and view all the answers

    What is the typical onset time for clinical signs and symptoms of fat embolism syndrome after injury?

    <p>1 to 3 days (A)</p> Signup and view all the answers

    Which procedure is most likely to introduce air into the circulation, potentially causing decompression sickness?

    <p>Obstetric procedures (D)</p> Signup and view all the answers

    What leads to the condition known as 'the bends' in deep-sea divers?

    <p>Rapid ascent causing nitrogen to come out of solution (B)</p> Signup and view all the answers

    Which of these conditions is a direct result of ischemic necrosis?

    <p>Cerebral infarction (C)</p> Signup and view all the answers

    What is a common cause of arterial infarctions?

    <p>Arterial thrombosis (C)</p> Signup and view all the answers

    What treatment is typically required for acute decompression sickness?

    <p>Placing the individual in a compression chamber (D)</p> Signup and view all the answers

    Flashcards

    Red Infarct

    An infarct where blood flow is re-established after tissue damage, leading to a red coloration due to blood filling the damaged area.

    White Infarct

    An infarct where blood flow is completely cut off, resulting in a pale appearance due to lack of blood.

    Shock

    A state of low blood flow throughout the body, resulting in inadequate oxygen supply to tissues.

    Cardiogenic Shock

    Shock caused by a weakened heart that cannot pump blood effectively.

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    Hypovolemic Shock

    Shock caused by a loss of blood volume, often due to bleeding or dehydration.

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    Fat Embolism Syndrome

    A condition that occurs when fat globules enter the bloodstream, often after a long bone fracture, and block small blood vessels in the lungs and brain. This can lead to respiratory distress, neurological problems, and even death.

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    Pulmonary Insufficiency (in Fat Embolism Syndrome)

    A severe consequence of fat embolism syndrome where the lungs are unable to function properly due to blocked blood vessels.

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    Decompression Sickness (The Bends)

    A condition that occurs when individuals are exposed to sudden changes in atmospheric pressure, causing nitrogen gas to form bubbles in the blood and tissues.

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    The Bends

    A painful condition that affects skeletal muscles and tissues surrounding joints, caused by the formation of gas bubbles during rapid decompression.

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    The Chokes

    A severe respiratory complication of decompression sickness caused by gas bubbles blocking blood vessels in the lungs, leading to fluid buildup and bleeding.

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    Ischemic Necrosis (Infarction)

    Tissue death caused by a lack of blood supply, often due to a blockage in an artery.

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    Arterial Thrombosis

    A blockage in an artery caused by a blood clot.

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    Arterial Embolism

    A blockage in an artery caused by a blood clot that travels from another location.

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    Study Notes

    Hemodynamic Disorders, Thromboembolism, and Shock

    • Fat Embolism:
      • Occurs in 90% of individuals with severe skeletal injuries (long bone fracture) but less than 10% show clinical findings.
      • Fat microemboli occlude pulmonary and cerebral microvasculature.
    • Fat Embolism Syndrome:
      • Pulmonary insufficiency
      • Neurological symptoms
      • Anemia
      • Thrombocytopenia
      • Diffuse petechial rash
      • Fatal in 10% of cases
      • Signs and symptoms appear 1 to 3 days after injury
      • Sudden onset of tachypnea, dyspnea, tachycardia, irritability, and restlessness, which can progress to delirium or coma.

    Air Embolism

    • Gas bubbles within the circulation can coalesce and obstruct vascular flow, causing distal ischemic injury.
    • Air may enter the circulation during obstetric procedures, chest wall injuries, or due to decompression sickness.
    • Decompression sickness occurs in individuals exposed to sudden changes in atmospheric pressure.
    • Deep-sea divers and underwater construction workers are at risk.
      • Breathing air at high pressure (e.g., during a scuba dive) increases gas amounts (particularly nitrogen) dissolved in blood and tissues.
      • If the diver ascends too rapidly (depressurizes), nitrogen bubbles form, causing gas emboli, which can induce focal ischemia in tissues such as the brain and heart.
      • Rapid formation of gas bubbles in skeletal muscles and joints leads to the painful condition called "the bends."
      • In the lungs, gas bubbles cause edema and hemorrhaging, leading to respiratory distress ("the chokes").
    • Treatment for decompression sickness involves a compression chamber to increase barometric pressure forcing gas bubbles back into solution.

    Infarction

    • Ischemic necrosis caused by occlusion of the vascular supply to affected tissue.
    • Examples include myocardial, cerebral, pulmonary, and bowel infarction, and ischemic necrosis of distal extremities (gangrene), especially in diabetics.
    • Causes:
      • Arterial thrombosis or arterial embolism (most common)
      • Less common causes include vasospasm, expansion of an atheroma, extrinsic compression of a vessel (by tumor), venous thrombosis (only in organs with a single efferent vein, e.g., testis, ovary).
    • Types of infarcts:
      • Red (hemorrhagic): In venous occlusions (e.g., ovarian torsion); loose tissues (e.g., lung); tissues with dual circulations (e.g., lung, small intestine); previously congested tissues (sluggish venous outflow); when flow is re-established after infarction.
      • White (anemic): In arterial occlusions in solid organs with end-arterial circulations (e.g., heart, spleen, kidney); ischemic coagulative necrosis; in the central nervous system, liquefactive necrosis.
      • White infarcts are often wedge-shaped with the occluded vessel at the apex and organ periphery forming the base.
    • Most infarcts are replaced by scar tissue.

    Shock

    • Characterized by systemic hypoperfusion of tissues.
    • Causes:
      • Diminished cardiac output
      • Reduced effective circulating blood volume.
    • Consequences: Impaired tissue perfusion, cellular hypoxia (organ failure).

    Forms of Shock

    • Cardiogenic shock: Low cardiac output due to myocardial pump failure.
      • Can be caused by myocardial damage (infarction), ventricular arrhythmias, extrinsic compression (cardiac tamponade), or outflow obstruction (e.g., pulmonary embolism).
    • Hypovolemic shock: Low cardiac output due to loss of blood or plasma volume (e.g., hemorrhage, severe burns).
    • Septic shock: Arterial vasodilation and venous blood pooling due to systemic immune response to microbial infection (commonly gram-positive bacteria).

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    This quiz covers the key concepts related to hemodynamic disorders, specifically focusing on fat and air embolism. Learn about the clinical findings, symptoms, and underlying mechanisms of these conditions. Perfect for students and professionals in the medical field.

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