病理生理英文课件

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1、DevelopmentofshocktheoryDevelopmentofshocktheory1Shock-1743,firstputforward2Manifestation,firstdefined,18953Circulationaldisturbance-WWI,II4Microcirculationfailure-1960s5Cellular&molecularchanges-1980s&beyondWhatisShock???WhatisShock???Shockisafailureofthecirculatorysyst

2、emtoShockisafailureofthecirculatorysystemtomaintainadequateperfusionofvitalmaintainadequateperfusionofvitalorgans.organs.cellularhypoxiaanaerobiccellularmetabolismaccumulationofwasteproductsincellscellulardeathTypesofShockTypesofShockHypovolemicHypovolemicShockShockCardi

3、ogenicCardiogenicShockShockDistributive(Distributive(vasogenicvasogenic)Shock)Shock––NeurogenicNeurogenicshockshock––SepticshockSepticshock––AnaphylacticshockAnaphylacticshockSepticshockHypovolemicHypovolemicShockShockoccurswhenthereisalargereductioninoccurswhenthereisal

4、argereductioninthecirculatingbloodvolume.thecirculatingbloodvolume.----ActualActualhypovolemichypovolemicshockshock--lossofblood/fluidlossofblood/fluid----RelativeRelativehypovolemichypovolemicshockshock--internalfluidinternalfluidshiftsfromintravasculartointerstitialspa

5、ce.shiftsfromintravasculartointerstitialspace.Bp=COBp=CO××SVRSVRpressure(%ofnormal)Cardiacoutputandarterial%oftotalbloodremovedSVR:systemicvascularresistanceSVR:systemicvascularresistanceDistributiveShockDistributiveShockoccursasaresultofinadequatevascularoccursasaresult

6、ofinadequatevasculartone.tone.neurogenicneurogenicshockshocksepticshocksepticshockanaphylacticshockanaphylacticshocknormalHypovolemicHypovolemicshockdecreasedbloodbloodvolumevolumeVasogenicVasogenicshocknormalintravascularnormalcompartmentspaceintravascularcompartmentspa

7、cenormalbloodvolumeenlargedintravascularcompartmentspaceOutcomeofvesselenlargementCardiogenicCardiogenicShockShockoccurswhentheheartisunabletooccurswhentheheartisunabletofunctionadequatelyresultinginfunctionadequatelyresultingininsufficientbloodflowtotissueandinsufficien

8、tbloodflowtotissueandorgans.organs.myocardialinfarctionmyocardialinfarctionobstructionofbloodflowobstru