00:01
Okay this question says, a patient who has been in a car accident is bleeding or is being treated in your hospital.
00:11
The accident was a takeable one but there is no obvious sign of external bleeding in a patient.
00:16
However, on the way to the emergency room the patient has a rapid pulse, fast degree of breathing and her blood pressure falls to very low levels.
00:24
So this patient may have a hypovolemic shock because of too much blood loss.
00:34
Even when this patient does not have any sign of external bleeding, this patient may have internal bleeding.
00:41
So in this case, it says she is confused and not responding to verbal instructions.
00:47
What do you think the patient has in the pathophysiologic changes that caused the changes observed in this patient? so in this case, this patient may have hypovolemic shock because of hemorrhage.
01:03
And this is a life condition that occurs when the body loses a significant amount of blood or other fluids.
01:10
This hypovolemic shock, specifically hemorrhagic shock, can be caused by various factors such as severe trauma, internal bleeding, that is the most likely case in this case, ruptured blood vessels or bleeding disorders.
01:22
But all of this is going to cause a decrease in the blood pressure because of the cardiac output.
01:41
And the cardiac output depends on the volume or the fluid volume that you have in your body.
01:46
So you're going to have a decrease in the blood pressure that is equal to hypotension and also decreased oxygen delivery to vital organs.
01:55
So you have decreased oxygen delivery to vital organs.
02:03
The rapid pulse, the fast rate of breathing, confusion and unresponsiveness observed in the patient are signs of the body's compensatory mechanisms in response to the decreased oxygen delivery.
02:14
The rapid pulse and fast breathing are attempts by the body to increase oxygen delivery, while the confusion and unresponsiveness are signs of the brain's decreased oxygen supply.
02:24
The pathophysiological changes that occur during hemorrhagic shock involve a complex interplay of various physiological systems in the body.
02:30
For example, the loss of blood or fluids leads to a decrease in the volume of circulating blood, which causes a decrease in the blood pressure, as i already said.
02:39
This decrease in the blood pressure triggers the activation of the sympathetic nervous system.
02:46
And this sympathetic nervous system is going to release hormones such as epinephrine, epinephrine or norepinephrine, that is going to increase the heart rate and also cause vasoconstriction.
03:00
Vasoconstriction in order to maintain a normal blood vessel or in an attempt to increase the blood pressure back to normal.
03:11
In addition, the decrease in blood pressure is also going to trigger this system here that is for the guanine -angiotensin -aldosterone system, that is going to lead to the production of angiotensin -angiotensin -2...