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Vasodilatory Shock
Vasodilatory shock, vasogenic shock, or vasoplegic shock is a medical emergency belonging to shock along with cardiogenic shock, septic shock, allergen-induced shock and hypovolemic shock. Vasodilatory shock occurs when the blood vessels relax too much, leading to extreme vasodilation. This reduces blood pressure, preventing blood flow and therefore oxygen delivery to the body's organs. If vasodilatory shock lasts more than a few minutes, the lack of oxygen starts to damage the organs. Vasodilatory shock must be treated quickly to avoid permanent organ damage or death from multiple organ dysfunction. Treatment typically involves uses of vasopressors, inotropes, fluid boluses, and introduction of resuscitation. If vasodilatory shock does not respond to high doses of vasopressors (≥ 0.5 mg/kg/min norepinephrine-equivalent dose), it is called refractory vasodilatory shock or simply refractory shock. Adjunctive therapies include angiotensin II, hydrocortisone, thiamine, cat ...
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Emergency Medicine
Emergency medicine is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (or "ER doctors") specialize in providing care for unscheduled and undifferentiated patients of all ages. As frontline providers, in coordination with emergency medical services, they are responsible for initiating resuscitation, stabilization, and early interventions during the acute phase of a medical condition. Emergency physicians generally practice in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics. Sub-specialties of emergency medicine include disaster medicine, medical toxicology, point-of-care ultrasonography, critical care medicine, emergency medical services, hyperbaric medicine, sports medicine, palliative care, or aerospace medicine. Various models for emerg ...
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Angiotensin II
Angiotensin is a peptide hormone that causes vasoconstriction and an increase in blood pressure. It is part of the renin–angiotensin system, which regulates blood pressure. Angiotensin also stimulates the release of aldosterone from the adrenal cortex to promote sodium retention by the kidneys. An oligopeptide, angiotensin is a hormone and a dipsogen. It is derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver. Angiotensin was isolated in the late 1930s (first named "angiotonin" or "hypertensin", later renamed "angiotensin" as a consensus by the 2 groups that independently discovered it) and subsequently characterized and synthesized by groups at the Cleveland Clinic and Ciba laboratories. Precursor and types Angiotensinogen Angiotensinogen is an α-2-globulin synthesized in the liver and is a precursor for angiotensin, but has also been indicated as having many other roles not related to angiotensin peptides. It is a me ...
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Neurogenic Shock
Neurogenic shock is a distributive type of shock resulting in hypotension (low blood pressure), often with bradycardia (slowed heart rate), caused by disruption of autonomic nervous system pathways. It can occur after damage to the central nervous system, such as spinal cord injury and traumatic brain injury. Low blood pressure occurs due to decreased systemic vascular resistance resulting from loss of sympathetic tone, which in turn causes blood pooling within the extremities rather than being available to circulate throughout the body. The slowed heart rate results from a vagal response unopposed by a sympathetic nervous system (SNS) response. Such cardiovascular instability is exacerbated by hypoxia, or treatment with endotracheal or endobronchial suction used to prevent pulmonary aspiration. Neurogenic shock is a potentially devastating complication, leading to organ dysfunction and death if not promptly recognized and treated. It is not to be confused with spinal s ...
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Distributive Shock
Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs. It is one of four categories of shock, a condition where there is not enough oxygen-carrying blood to meet the metabolic needs of the cells which make up the body's tissues and organs. Distributive shock is different from the other three categories of shock in that it occurs even though the output of the heart is at or above a normal level. The most common cause is sepsis leading to a type of distributive shock called septic shock, a condition that can be fatal. Types Elbers and Ince have identified five classes of abnormal microcirculatory flow in distributive shock using side stream dark field microscopy. *Class I: all capillaries are stagnant when there is normal or sluggish venular flow. *Class II: there are empty capillaries next to capillaries that have flowing red blood cells. *Cla ...
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Nerve
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerve impulses called action potentials that are transmitted along each of the axons to peripheral organs or, in the case of sensory nerves, from the periphery back to the central nervous system. Each axon is an extension of an individual neuron, along with other supportive cells such as some Schwann cells that coat the axons in myelin. Each axon is surrounded by a layer of connective tissue called the endoneurium. The axons are bundled together into groups called Nerve fascicle, fascicles, and each fascicle is wrapped in a layer of connective tissue called the perineurium. The entire nerve is wrapped in a layer of connective tissue called the epineurium. Nerve cells (often called neurons) are further classified as either Sensory neuron, sens ...
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Human Brain
The human brain is the central organ (anatomy), organ of the nervous system, and with the spinal cord, comprises the central nervous system. It consists of the cerebrum, the brainstem and the cerebellum. The brain controls most of the activities of the human body, body, processing, integrating, and coordinating the information it receives from the sensory nervous system. The brain integrates sensory information and coordinates instructions sent to the rest of the body. The cerebrum, the largest part of the human brain, consists of two cerebral hemispheres. Each hemisphere has an inner core composed of white matter, and an outer surface – the cerebral cortex – composed of grey matter. The cortex has an outer layer, the neocortex, and an inner allocortex. The neocortex is made up of six Cerebral cortex#Layers of neocortex, neuronal layers, while the allocortex has three or four. Each hemisphere is divided into four lobes of the brain, lobes – the frontal lobe, frontal, pa ...
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Nervous System
In biology, the nervous system is the complex system, highly complex part of an animal that coordinates its behavior, actions and sense, sensory information by transmitting action potential, signals to and from different parts of its body. The nervous system detects environmental changes that impact the body, then works in tandem with the endocrine system to respond to such events. Nervous tissue first arose in Ediacara biota, wormlike organisms about 550 to 600 million years ago. In Vertebrate, vertebrates, it consists of two main parts, the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS consists of the brain and spinal cord. The PNS consists mainly of nerves, which are enclosed bundles of the long fibers, or axons, that connect the CNS to every other part of the body. Nerves that transmit signals from the brain are called motor nerves (efferent), while those nerves that transmit information from the body to the CNS are called sensory nerves (aff ...
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Systemic Inflammatory Response Syndrome
In immunology, systemic inflammatory response syndrome (SIRS) is an inflammation, inflammatory state affecting the whole body. It is the body's Immune response, response to an infectious or noninfectious Insult (medical), insult. Although the definition of SIRS refers to it as an "inflammatory" response, it actually has pro- and anti-inflammatory components. Presentation Complications SIRS is frequently complicated by failure of one or more organs or organ systems. The complications of SIRS include * Acute kidney injury * Shock (circulatory), Shock * Multiple organ dysfunction syndrome Causes The causes of SIRS are broadly classified as infectious or noninfectious. Causes of SIRS include: * bacterial infections * severe malaria * Physical trauma, trauma * burn (injury), burns * pancreatitis * ischemia * hemorrhage Other causes include: * Complications of surgery * Adrenal insufficiency * Pulmonary embolism * Complicated aortic aneurysm * Cardiac tamponade * Anaphylaxis * Dru ...
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Anaphylaxis
Anaphylaxis (Greek: 'up' + 'guarding') is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of the use of emergency medication on site. It typically causes more than one of the following: an itchy rash, throat closing due to swelling that can obstruct or stop breathing; severe tongue swelling that can also interfere with or stop breathing; shortness of breath, vomiting, lightheadedness, loss of consciousness, low blood pressure, and medical shock. These symptoms typically start in minutes to hours and then increase very rapidly to life-threatening levels. Urgent medical treatment is required to prevent serious harm and death, even if the patient has used an epinephrine autoinjector or has taken other medications in response, and even if symptoms appear to be improving. Cause, mechanism, and diagnosis Common causes include allergies to insect bites and stings, allergies to fo ...
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Allergic Reaction
Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include Allergic rhinitis, hay fever, Food allergy, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include allergic conjunctivitis, red eyes, an itchy rash, sneeze, sneezing, coughing, a rhinorrhea, runny nose, shortness of breath, or swelling. Note that food intolerances and food poisoning are separate conditions. Common allergens include pollen and certain foods. Metals and other substances may also cause such problems. Food, insect stings, and medications are common causes of severe reactions. Their development is due to both genetic and environmental factors. The underlying mechanism involves immunoglobulin E antibodies (IgE), part of the body's immune system, binding to an allergen and then to FcεRI, a receptor on mast cells or basophils where it triggers ...
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Bacterial Infection
Pathogenic bacteria are bacteria that can cause disease. This article focuses on the bacteria that are pathogenic to humans. Most species of bacteria are harmless and many are beneficial but others can cause infectious diseases. The number of these pathogenic species in humans is estimated to be fewer than a hundred. By contrast, several thousand species are considered part of the gut flora, with a few hundred species present in each individual human's digestive tract. The body is continually exposed to many species of bacteria, including beneficial commensals, which grow on the skin and mucous membranes, and saprophytes, which grow mainly in the soil and in decaying matter. The blood and tissue fluids contain nutrients sufficient to sustain the growth of many bacteria. The body has defence mechanisms that enable it to resist microbial invasion of its tissues and give it a natural immunity or innate resistance against many microorganisms. Pathogenic bacteria are speci ...
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Ascorbic Acid
Ascorbic acid is an organic compound with formula , originally called hexuronic acid. It is a white solid, but impure samples can appear yellowish. It dissolves freely in water to give mildly acidic solutions. It is a mild reducing agent. Ascorbic acid exists as two enantiomers (mirror-image isomers), commonly denoted "" (for "levo") and "" (for "dextro"). The isomer is the one most often encountered: it occurs naturally in many foods, and is one form (" vitamer") of vitamin C, an essential nutrient for humans and many animals. Deficiency of vitamin C causes scurvy, formerly a major disease of sailors in long sea voyages. It is used as a food additive and a dietary supplement for its antioxidant properties. The "" form ( erythorbic acid) can be made by chemical synthesis, but has no significant biological role. Etymology The term ''ascorbic'' means antiscruvy and denotes the ability to fight off scurvy. It is related to combating Vitamin C deficiency. History The antiscor ...
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