HEMORRHAG
WHAT..?
ss blood loss through rupture of blood vessels
HOW..?
1. Accidental hemorrhage 4. Postpartum hemorrhage
*Primary
5. Hemorrhage due to
*Secondary
premature detachment
2.Capillary hemorrhage of placenta
3. Internal hemorrhage
EFFECT..!
Acute hemorrhage
:-: causes HYPOVOLEMIC SHOCK
ronic hemorrhage
:-: Internal bleeding occurs in conditions like ulcer
:-: External bleeding occurs in conditions like hemophilia , menorr
Compensatory effect
:-:Immediate & Delayed
IMMEDIATE COMPENSATORY EFFECT
:-: On cardio vascular system :-:
:-: On skin :-:
:-: On tissue fluid :-:
:-: On kidneys :-:
:-: On renin secretion :-:
:-: On secretion of antidiuretic hormone :-:
:-: On secretion of catecholamines :-:
:-: On respiration :-:
:-: On nervous system :-:
1. On cardiovascular system
Mechanism involved in maintenance of blood pressure:
When blood pressure increases
The carotid & aortic baroreceptors are stimulated
Impulses to the brain
BP decreases
When arterial blood pressure falls,
Baroreceptors get inactivated and stop discharging impulses
This increases vasoconstriction
This type of reflex vasoconstriction occurs in all regions of the body
except brain and heart.
Vasoconstriction increase the peripheral resistance
Loss of blood causes reflex constriction of veins
Venoconstriction enhances the venous return, ventricular filling & stroke volume
because of increased peripheral resistance and stroke volume the arterial blood
pressure is restored
Vasoconstriction occurs in the organs having
Reservoir function such as skin, liver and spleen.
Blood from these organs is directed into systemic circulation.
This may compensate the blood volume which is lost during hemorrhage
During severe hemorrhage
Blood loss about 1,500 to 2,000 mL of blood,
The arterial blood pressure falls because of decreased venous return and stroke
volume
In the heart Tachycardia increases the quantity of metabolic products in
myocardium. These metabolic products cause coronary vasodilatation.
2. On Skin
Decreases the cutaneous blood flow & It increases the deoxygenation of blood
and large quantity of reduced hemoglobin is accumulated in cutaneous blood
vessels.
Results in greyish pallor color of skin
Sometimes cyanosis develops in certain areas of the body
Skin becomes cold due to less blood flow
Sweating is decreased
3. On Tissue Fluid
Arteriolar constriction decreases the capillary pressure
Tissue fluid enters capillaries
It helps to compensate the blood loss
It also causes hemodilution.
4. On Kidneys
Constriction of afferent and efferent arterioles after hemorrhage decreases the
GFR
The blood level of nitrogenous substances, particularly urea, increases resulting
in uremia.
Severe hemorrhage leads to fall in arterial BP and damage of renal tubules
resulting in acute renal failure
5. renin secretion
Blood loss stimulates the renin-angiotensin-aldosterone system (RAAS).
Renin is released from the kidneys, leading to the formation of angiotensin II.
Angiotensin II causes vasoconstriction and increases aldosterone secretion,
which in turn retains sodium and water, ultimately raising blood pressure.
6. On secretion of antidiuretic hormone
ADH is released to retain water and restore blood volume.
7. On respiration
Hemorrhage causes hypoxia, stimulating increased respiratory rate and
catecholamine release.
8. On nervous system
Hemorrhage affects the nervous system. Despite vasoconstriction in other
organs, the brain experiences vasodilation due to sympathetic activity.
Autoregulation helps maintain brain blood flow.
Catecholamines stimulate the reticular activating system, causing restlessness
and anxiety.
Severe hemorrhage can lead to fainting and cerebral ischemia due to decreased
brain blood flow.
Delayed compensatory effects of hemorrhage
Plasma volume restoration, plasma protein replenishment, and red blood cell
count and hemoglobin restoration.
Tissue fluid enters the blood to increase plasma volume, but this leads to
hemodilution.
The liver mobilizes stored proteins and synthesizes new ones to restore
plasma proteins.
Hypoxia stimulates erythropoietin secretion, leading to increased red blood
cell production.
Complete restoration of red blood cells and hemoglobin takes several weeks,
requiring adequate iron and protein intake.
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