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Clinical vignette 1 
Multiple injury 
Hwmo 
Maryam AL-Qahtani. 
G:3
Hemorrhagic shock 
is a condition of reduced tissue perfusion, 
resulting in the inadequate delivery of oxygen 
and nutrie...
Objectives: 
Describe in detail how this patient's body 
would compensate for his primary problem. 
Is this patient's ur...
How this patient's 
body would 
compensate for his 
primary problem?
The body’s response: 
Compensated Shock. 
Decompensated Shock. 
Irreversible Shock.
Compensated Shock. 
These are the main mechanisms used 
to compensate the patient’s condition 
: 
1- The baroreceptor refl...
Compensated Shock. 
Baroreceptor reflex: 
Blood volume 
Systemic arterial blood 
pressure
Increased sympathetic nervous system stimulation helps 
to maintain systemic blood pressure in the following 
ways: 
1/ In...
3/This increases the resistance ....> 
raising blood pressure. 
4/contraction of smooth muscle in the 
systemic veins........
Renin-angiotensin-aldosterone 
(R-A-A) 
axis.
Urinary Output 
(Normal or abnormal)
Case: 
Urinary output =20ml per hour. 
Normal 
value: 
Range of 30- 50 ml per hour.
In general : 
hemorrhagic shock 
Reduce blood flow to the kidneys 
Making it difficult for the kidneys to cleanse the 
blo...
Quiz
One of these body response is not one of 
compensate for hemorrhagic : 
Increase heart rate 
Increase blood pressure 
Decr...
Normal value of urinary output 
=
Compensated Shock: 
Early stages of shock where the body’s compensatory 
mechanisms are able to maintain normal perfusion ...
Guyton & Hall. Text book of Medical physiology . 
.Merck Manual. 
.Up to data. Website 
http://classes.midlandstech.edu/ca...
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
trauma and bleeding (hemorrhagic shock)
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trauma and bleeding (hemorrhagic shock)

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hemorrhagic shock

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trauma and bleeding (hemorrhagic shock)

  1. 1. Clinical vignette 1 Multiple injury Hwmo Maryam AL-Qahtani. G:3
  2. 2. Hemorrhagic shock is a condition of reduced tissue perfusion, resulting in the inadequate delivery of oxygen and nutrients that are necessary for cellular function.
  3. 3. Objectives: Describe in detail how this patient's body would compensate for his primary problem. Is this patient's urinary output normal?
  4. 4. How this patient's body would compensate for his primary problem?
  5. 5. The body’s response: Compensated Shock. Decompensated Shock. Irreversible Shock.
  6. 6. Compensated Shock. These are the main mechanisms used to compensate the patient’s condition : 1- The baroreceptor reflex. 2- Increased sympathetic nervous system stimulation. 3- Renin-angiotensin-aldosterone (R-A-A) axis.
  7. 7. Compensated Shock. Baroreceptor reflex: Blood volume Systemic arterial blood pressure
  8. 8. Increased sympathetic nervous system stimulation helps to maintain systemic blood pressure in the following ways: 1/ Increasing the contractility of the heart....> increasing stroke volume. 2/ Increasing the frequency of action potentials ......> increasing the heart rate.
  9. 9. 3/This increases the resistance ....> raising blood pressure. 4/contraction of smooth muscle in the systemic veins.....> increasing the rate of return of venous blood to the heart( increases the pre-load and thus stroke volume of the heart.)
  10. 10. Renin-angiotensin-aldosterone (R-A-A) axis.
  11. 11. Urinary Output (Normal or abnormal)
  12. 12. Case: Urinary output =20ml per hour. Normal value: Range of 30- 50 ml per hour.
  13. 13. In general : hemorrhagic shock Reduce blood flow to the kidneys Making it difficult for the kidneys to cleanse the bloodstream of waste products and to obtain enough oxygen and nutrients for its own metabolic needs.
  14. 14. Quiz
  15. 15. One of these body response is not one of compensate for hemorrhagic : Increase heart rate Increase blood pressure Decrease stroke volume
  16. 16. Normal value of urinary output =
  17. 17. Compensated Shock: Early stages of shock where the body’s compensatory mechanisms are able to maintain normal perfusion . .Normal range of urinary output 30-50 ml per hour.
  18. 18. Guyton & Hall. Text book of Medical physiology . .Merck Manual. .Up to data. Website http://classes.midlandstech.edu/carterp/Courses/bio211/chap19/ chap19.html http://www.ccmtutorials.com/cvs/shock/page_5.5.htm

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