Shock occurs when the metabolic needs of cells are not being met because of inadequate blood flow. In effect, there is a reduction in blood circulating, in blood pressure and in cardiac output. This causes hypoxia, and inadequate supply of nutrients and the accumulation of waste products.
A number of different types of shock are described:
💠 Hypovolaemic Shock
💠 Cardiogenic Shock
💠 Septic
💠 Neurogenic
💠 Peritoneal
HYPOVOLAEMIC SHOCK
The volume of blood in circulation is reduce sufficiently to causes shock following :
Severe hemorrhage -- whole blood is lost
Extensive superficial Burns -- serum is lost and blood cells at the site of the burns are destroyed
Severe vomiting and diarrhea -- water and electrolytes are lost
Severe injury -- water is lost via the kidneys when excess waste materials from cells breakdown is excreted.
CARDIOGENIC SHOCK
This occurs in acute heart disease when the cardiac output is suddenly reduced. e.g., in myocardial infarction.
SEPTIC SHOCK
This resembles hypovoleamic shock but is more prolonged and those not respond so readily to treatment. It is cause by severe infections in which endotoxins are release from dead Gram-negative bacteria, e.g., Entorobacteria, pseudomonas.
The mode of action of toxins is not readily understood. It might be that they cause and apperent reduction in the blood volume because of vasodilation and pooling of blood in the large veins. This deduces the venous returns to the heart and cardiac output.
NEUROGENIC SHOCK (VASO-VAGAL ATTACK, FAINTING)
The causes include sudden acute pain and severe emotional experience. Nerve impulse reduces the heart rate, reducing the cardiac output. The venous return may also reduce by the pooling of blood in dilated veins. This changes effectively reduces blood supply to the brain, causing fainting. The period of unconciousness is usually of short duration.
PERITONEAL SHOCK
This occurs when there is a break in the wall of abdominal organs and it contents enters the peritoneal cavity. The peritoneum becomes acutely inflamed, the blood vessels dilate and excess serous fluid is secreted. It may occur following :
Perforation of gastric or deudonal ulcer
Hemorrhagic pancreatis
Perforation of ulterine tube
Rapture of spleen, liver and uterus.
CHANGES TAKING PLACE DURING SHOCK
In the short term this are associated with the physiological attempts to restore an adequate blood circulation. If the state of shock persist, the longer term changes may be irreversible.
IMMEDIATE CHANGES
As the blood pressure falls, a number of reflexes are atimulated and homorne secretion increased. This raise the blood pressure by increasing blood volume and the cardiac output. The changes include:
- Vasoconstriction following :
a. Stimulation of the baroreceptors in the aorta and carotid sinuses.
b. Sympathetic stimulation of the adrenal glands which cause increased secretion of adrenaline
c. Stimulation of the renin/anhiotensin system by diminished blood flow to the kidneys.
Increase heart rate following sympathetic stimulatiom
Water retention by the kidney, following increase release of antidiuretic hormone by the posterior lobe of the pituitary gland.
In shock of moderate severerity the circulation to the heart and brain is maintained, by the short term. If shock is very severe there may not be time for the above changes to be effective. The severe hypoxia that occurs disrupt cell metabolism. Large amount of lactic acid are formed and hydrogen ion accumulate, reaching dangerous levels in a few minutes. This are the changes that led to the severe metabolic acidosis which occur immediately following cardiac arrest.
LONG TERM CHANGES ASSOCIATED WITH SHOCK
If the state of shock is not reverse, hypoxia and low blood pressure cause irreversible brain damage and a vicious cycle of events is established.
👉 Hypoxia. When this persist they is cell damage and a release of chemical substance that increase the permeability of the cappilaries. More fluid enters the interstitial spaces leading to further hypovolemia, further reduction in blood pressure and increase hypoxia.
👉 Low blood pressure. As the blood pressure continues to fall, cerebral and myocardial hypoxia becomes progressively more marked and the reduce blood flow encourages the formation of infarcts and thrombi. There is a marked reduction in the secretion of urine, leading to the retension of damaging metabollic waste products. If effective treatment is not possible these irreversible changes bexomes progressively more severe and eventually may cause death.
Preach it bro.
We sure needed an info like this.
🍻
Dang shock is scary. Thanks for the informative article. What recoveries are there from shock and what prompted you to write this?
Thank you for your comments @jfitmisc
From my bio above my first area of interest is writing educative post. So the post about shock is just to educate steemians, making them to have a knowledge of shock and it different types.
This post has received a 0.13 % upvote from @drotto thanks to: @banjo.
Cheers
Very very educating....Reminds me of my level couse
Thank you @ikecheta
Please which course are you reading?
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