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Areas of the brain susceptible to ischemia:
Answer- ACA / MCA / PCA boundary areas. The
watershed areas, or border zones, receive dual blood
supply from most distal branches of two arteries.
However, systemic hypo perfusion may cause ischemia in
these areas. **Hypoxic ischemic encephalopathy affects
pyramidal cells of the hippocampus and Purkinjie cells of
the cerebellum.
Areas of heart:
Answer- Sub endocardium (LV)
Areas of kidney:
Answer- Straight segment of the proximal tubule
(medulla) and thick ascending loop (medulla).
,Areas of liver:
Answer- Area around central vein (zone III)
Areas of colon:
Answer- splenic flexure, colon
Red infarct:
Answer- Occur in loose tissues with multiple blood
supplies such as liver, lung, intestines.
Pale infarcts:
Answer- Occur in solid tissues with a single blood supply
such as heart, kidney and spleen.
,What is the first sign of shock?
Answer- tachycardia.
Shock in the setting of DIC (disseminated intravascular
coagulation) secondary to trauma is likely due to...?
Answer- sepsis
What are the types of distributive shock?
Answer- septic, neurogenic, anaphylactic
Describe distributive shock:
Answer- high output failure (low TPR, high CO, high
VR). Low PCWP. Vasodilation (warm, dry skin). Failure
to increase BP with fluids IV.
Describe hypovolemic / cardiogenic shock:
, Answer- LOW output failure (low CO, low VR, high
TPR). HIGH PCWP in cardiogenic but LOW PCWP in
hypovolemic. Vasoconstriction (cold, clammy skin). *BP
restored with IV fluids*
Define atrophy:
Answer- reduction in size and / or number of cells
What are causes of atrophy?
Answer- low endogenous hormones (post-menu ovaries).
High exogenous hormones (fictitious thyrotoxicosis,
steroid use). Low innervation (motor neuron damage).
Low blood flow / nutrients. Low metabolic demand
(prolonged hospitalization or paralysis). High pressure
(nephrolithiasis). Occlusion of secretory ducts (cystic
fibrosis).
What fundamentally characterizes inflammation?
Answer- rub or, dolor, color, tumor, function lease.