Hemorrhage And Its Effect

Hemorrhage And Its Effect

Question 1. Discuss hemorrhage and its effect.
Answer:

Hemorrhage is the escape of blood from blood vessels. The bleeding may occur externally or internally.

• The extravasation of blood into tissue with resultant swelling is known as “Hematoma”
• Large extravasation of blood into the skin and the mucous membrane is called as ecchymoses.
• A small area of hemorrhage is known as “petechiae”.

Cause of Hemorrhage

• Trauma
• Spontaneous hemorrhage: Septicemia, acute leukemias and bleeding diathesis
• Inflammatory lesion: Bleeding from chronic peptic ulcer, thyroid ulcer.
• Neoplastic invasions: Carcinoma of the tongue
• Vascular disease: Atherosclerosis
• Elevated pressure within vessels: Cerebral and retinal hemorrhage.

Hemorrhage pathology

Effects of Hemorrhage

The effect of blood loss depends upon.

• Amount of blood loss
• Speed of blood loss
• Site of hemorrhage.
  • Loss up to 20% of blood volume suddenly or slowly generally has little clinical effects because of compensatory mechanisms.
  • A sudden loss of 33% of blood volume may cause death.
  • While loss up to 50% of blood volume over a period of 24 hours may not be necessarily fatal.
  • Chronic blood loss generally produces iron deficiency anemia.
  • Acute hemorrhage may lead to hypovolemic shock.

Types of hemorrhage

Question 2. Write a short note about the classification of shock.
Answer:

Shock is defined as a clinical state of cardiovascular collapse characterized by an acute reduction of effective circulatory blood volume and inadequate perfusion of cells and tissues.

Classification of Shock

• Hypovolemic shock
• Cardiogenic shock
• Septic (Toxemic) shock
• Other types
  • Traumatic shock
  • Neurogenic shock
  • Hypoadrenal shock
• Hypovolemic shock is due to a reduction in the blood volume. It is caused by severe hemorrhage and fluid loss.
• Cardiogenic shock is an acute circulatory failure with a sudden fall in cardiac output due to acute diseases of the heart without a reduction in blood volume. It is caused due to myocardial infarction, cardiac arrhythmias, and pulmonary embolism.
• Septic shock is due to bacterial infections which release toxins leading to shock. It is of two types based on the Gram staining of the organism, i.e. Gram-negative septicemia and Gram-positive septicemia.
• Traumatic shock results from trauma is due to hypovolemia but even after hemorrhage is controlled such patients continue to suffer the loss of plasma volume into the
  interstitium of injured tissue.
• Neurogenic shock: It results from the causes of interruption of sympathetic vasomotor supply.
• Hypoadrenal shock: It results from unknown adrenal insufficiency in which the patient fails to respond normally to the stress of trauma, surgery, or illness.