1
TCRN Review - Special Situations
(Shock, Psychosocial Issues Related
to Trauma, SIRS & MODS)
Describe the process of Obstructive Shock. - Correct
answer- Myocardium contracts against high afterload ->
Sympathetic over activity leads to vasoconstriction in order
to maintain BP -> Despite normal BP, organs are poorly
perfused due to a reduction in blood flow -> Back pressure
leads to venous congestion
List the 4 Classifications of Shock - Correct answer-
Hypovolemic
Distributive
Cardiogenic
Obstructive
Describe hypovolemic shock - Correct answer- Lack of
Volume
1
, 2
Describe distributive shock - Correct answer- Mal-
distribution of blood (vasodilation)
Describe cardiogenic shock - Correct answer- Inadequate
cardiac output
Describe obstructive shock - Correct answer- Inability of
blood to enter or exit the heart adequately
What is another name for early hypovolemic shock? -
Correct answer- Compensatory Shock
The adrenergic system is active during the _____ phase of
shock. - Correct answer- Compensatory
The _____ system is active after the phase of shock has
passed to bring the body back to a state of homeostasis. -
Correct answer- Cholinergic
Another name for the sympathetic system is _____. -
Correct answer- Adrenergic system
Another name for the parasympathetic system is _____. -
Correct answer- Cholinergic system
2
, 3
What is the name of the process in which glycogen stores
in the liver are broken down into glucose? - Correct answer-
Glycogeonolysis
What is the process in which glucose in the serum is
converted to glycogen for storage in the liver? - Correct
answer- Glyconeogenesis
What is the term for the speed at which electricity moves
through the heart? - Correct answer- Automaticity
What is the role of alpha receptors in the adrenergic
(sympathetic) system? - Correct answer- Vasoconstriction,
Glycogeonolysis, Diaphoresis
What is the role of the alpha receptors in the cholinergic
(parasympathetic) system? - Correct answer- Vasodilation,
Glyconeogenesis, Dry Skin
Sympathetic vs. Parasympathetic is also known as what? -
Correct answer- Fight or Flight; respectively
3
, 4
What is the role of Beta-One receptors in the adrenergic
(sympathetic) system? - Correct answer- Increased: heart
rate, contractility, automaticity
What is the role of Beta-One receptors in the cholinergic
(parasympathetic) system? - Correct answer- Decreased:
heart rate, contractility, automaticity
What is the role of Beta-Two receptors in the adrenergic
(sympathetic) system? - Correct answer- Increased
respiratory rate
Bronchodilation
What is the role of Beta-Two receptors in the cholinergic
(parasympathetic) system? - Correct answer- Decreased
respiratory rate
Bronchoconstriction
What is another term for late shock? - Correct answer-
Decompensated shock
What occurs during late or decompensated shock? -
Correct answer- Activation of the inflammatory system
4
TCRN Review - Special Situations
(Shock, Psychosocial Issues Related
to Trauma, SIRS & MODS)
Describe the process of Obstructive Shock. - Correct
answer- Myocardium contracts against high afterload ->
Sympathetic over activity leads to vasoconstriction in order
to maintain BP -> Despite normal BP, organs are poorly
perfused due to a reduction in blood flow -> Back pressure
leads to venous congestion
List the 4 Classifications of Shock - Correct answer-
Hypovolemic
Distributive
Cardiogenic
Obstructive
Describe hypovolemic shock - Correct answer- Lack of
Volume
1
, 2
Describe distributive shock - Correct answer- Mal-
distribution of blood (vasodilation)
Describe cardiogenic shock - Correct answer- Inadequate
cardiac output
Describe obstructive shock - Correct answer- Inability of
blood to enter or exit the heart adequately
What is another name for early hypovolemic shock? -
Correct answer- Compensatory Shock
The adrenergic system is active during the _____ phase of
shock. - Correct answer- Compensatory
The _____ system is active after the phase of shock has
passed to bring the body back to a state of homeostasis. -
Correct answer- Cholinergic
Another name for the sympathetic system is _____. -
Correct answer- Adrenergic system
Another name for the parasympathetic system is _____. -
Correct answer- Cholinergic system
2
, 3
What is the name of the process in which glycogen stores
in the liver are broken down into glucose? - Correct answer-
Glycogeonolysis
What is the process in which glucose in the serum is
converted to glycogen for storage in the liver? - Correct
answer- Glyconeogenesis
What is the term for the speed at which electricity moves
through the heart? - Correct answer- Automaticity
What is the role of alpha receptors in the adrenergic
(sympathetic) system? - Correct answer- Vasoconstriction,
Glycogeonolysis, Diaphoresis
What is the role of the alpha receptors in the cholinergic
(parasympathetic) system? - Correct answer- Vasodilation,
Glyconeogenesis, Dry Skin
Sympathetic vs. Parasympathetic is also known as what? -
Correct answer- Fight or Flight; respectively
3
, 4
What is the role of Beta-One receptors in the adrenergic
(sympathetic) system? - Correct answer- Increased: heart
rate, contractility, automaticity
What is the role of Beta-One receptors in the cholinergic
(parasympathetic) system? - Correct answer- Decreased:
heart rate, contractility, automaticity
What is the role of Beta-Two receptors in the adrenergic
(sympathetic) system? - Correct answer- Increased
respiratory rate
Bronchodilation
What is the role of Beta-Two receptors in the cholinergic
(parasympathetic) system? - Correct answer- Decreased
respiratory rate
Bronchoconstriction
What is another term for late shock? - Correct answer-
Decompensated shock
What occurs during late or decompensated shock? -
Correct answer- Activation of the inflammatory system
4
