metabolic response to injury-1

metabolic response to injury-1 - THE METABOLIC THE RESPONSE...

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Unformatted text preview: THE METABOLIC THE RESPONSE TO INJURY RESPONSE INTRODUCTION INTRODUCTION Accidental/Deliberate Injury Series Of Changes At Site Of Injury & Within The Body Generally Restore The Body To Its Pre­injury Condition FACTORS MEDIATING THE METABOLIC RESPOSE TO INJURY METABOLIC •ACUTE INFLAMMATORY RESPONSE ­Inflammatory cells (macrophages, monocytes, neutrophils) ­Proinflammatory cytokines & other inflammatory mediators •ENDOTHELIAL CELL ACTIVATION ­Adhesion of inflammatory cells ­Vasodilatation ­Increased Permeability •AFFERENT NERVE STIMULATION •RELEASE OF STRESS HORMONES •BACTERIAL INFECTION&ENDOTOXIN SOME CYTOKINES INVOLVED IN THE ACUTE INFLAMMATORY RESPONSE ACUTE Cytokine Relevant actions TNF-α Proinflammatory, release of leukocytes by bone marrow, Proinflammatory, Activation of leukocytes and endothelial cells Activation IL-1 Fever, T-cell and macrophage activation Fever, IL-6 Growth and differentiation of lymphocytes, activation of Growth Lymphocytes, activation of the acute-phase protein response Lymphocytes, IL-10 Inhibits immune function URINARY CHANGES DURING THE METABOLIC RESPONSE TO INJURY METABOLIC Reduced urine volume in response to Reduced hypovolaemia and ADH release. hypovolaemia Low urinary Sodium and Increased Urinary Low Pottasium excretion due to Aldosterone release Pottasium Increased urinary Nitrogen excretion due to the Increased catabolic response to injury. catabolic CONSEQUENCE OF THE METABOLIC RESPONSE TO INJURY METABOLIC Sodium & water retention in response to Sodium Hypovolaemia, Aldosterone &ADH release Hypovolaemia, Pyrexia for 24-48 hours Increase energy expenditure Increase glucose & fat turnover Breakdown of adipose tissue as principal energy Breakdown source source Catabolism of skeletal muscle to provide amino acid Catabolism for gluconeogenesis & hepatic synthesis of acutefor phase proteins. FACTORS MODIFYING THE RESPONSE RESPONSE TO INJURY RESPONSE Severity of injury Nature of injury Infection Genetic factors Nutritional status Coexisting diseases Ambient temperature Anaesthesia & drugs Anaesthesia ANABOLISM ANABOLISM Process of regaining weight,restoring skeletal muscle mass& strength and replenishment of fat stores Hormones contributing to the process of anabolism include insulin,GH,insulin like growth factors,androgens& 17­ ketosteroids. METABOLIC METABOLIC RESPONSE TO INJURY RESPONSE Discussions How do the acute inflammatory cells,which appear at the side of an injury mediate their effects at the site of wounding Describe the nature of the redistribution of the circulation which occurs to maintain central blood pressure after severe flood loss. Why does the patient lose a considerable amount of weight in the few weeks after a severe accident? what is the mechanism of this weightloss In what way does the adrenal cortex become involved in the hormonal response to severe injury/in what clinical situation or disease will this mechanism fail? ...
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This note was uploaded on 01/12/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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