SYSTOLIC DYSFUNCTION
refers to when the heart isn't able to adequately pump blood forward. Primary examples include myocardial infarction, blunt cardiac trauma, cardiomyopathy (disease that affect the structure and function of the myocardium),pulomary hypertension and myocardial depression resulting from impairment of the metabolism.

DIaSTOLIC DYSFUNCTION:
caused when the heart isnt able to fill properly decreasing stroke volume. Examples include cardiomyopathy, ventricular-hypertrophy ( enlargement and thickening of the left ventricular walls), cardiac temponade ( fluid accumulation in the pericardium or constriction of the pericardium).

Arrhythmias:
Bradyarrythmias or tachyarrthmias.

Structural changes:
valvular stenosis (narrowing of the valves), ventricular septial rupture (laceration) or tension pneumothorax (collection of air in the plural space between the lung and chest wall).

OBSTRUCTIVE SHOCK: occurs due a physical obstruction or restiction to the blood flow occurs and a decrease in cardiac output. Can happen due tp resticted diastolic dilling of the right ventricle as a result of compression e.g tension pnuemothroax, cardiac temponade. Can also be caused by decreased blood circulation to the lunchs and blood returning to the right atrium as a result of a pulmonary embolism. Can also be caused by a abdominal compartment syndeom due an increased level of abdominal pressure, it caues the interior veen cava to compress decreasing the venour return to the heart.

Hypovolmic Shock: occurs when there is a loss of intravascular fluid, and the volume isn't enough to fill a corrosponding space. it is characterised with circulatory dysfunction that typically results in inadequate tissue perfusion and possible organ failure after loss of 20% of intravascular blood, plasma, or fluids.

ABSOLUTE HYPOVOLAEMIA:
occurs when external whole blood loss happens as a result of hemorrhaging from trauma, surgery and GI bleeding.

Distributive shock: caused by a maldistribution of circulation flow and volime

Neurogenic Shock:
Happens within 30 minutes of a spinal cord injury at the T5 or above, and is referred to as a hemodynamic phenomenon. The trauma caused severe vasodilation that is uncompensated, this causes pooling of blood in the blood vessels leading to tissue hyperperfusion and insufficient cellular metabolism.

Anaphylactic Shock: Is an acute serious/life-threatening hypersensitivity /allergic reaction to a substance e.g food, medication, insect bites, pollen. The reaction to the allergen fastly causes mass vasodilation, a release of vasoactive mediators along with n increase in capillary permeability, the increase in permeability leads to fluids leaking from the vascular space to interstitia space. Severe bronchospasm, laryngeal edema, and respiratory distress results from the increased vasodilation. A patient can experience anaphylaxis from inhalation, ingestion and injection with an antergen that the individual has previously been sensitive to.

Septic shock
happens when sepsis is present and hypotension despite sufficient fluid administration, along with poor tissue perfusion causing hypoxic tissues. Causes include both Gram-negative/ positive bacteria, infections such as pneumonia, the presence of parasites, fungi and parasites. Spetic shock the body's inflammatory response is hypersensitised and exagerated. Septic shock causes maldistribution in the blood flow, vasodilation, and myocardial depression. The incease in capillary permeability causes a leakage of plasma thus causing hypovolemia.

Signs and Symptoms
Dizziness, chest pain, swelling of lips and toungue, wheezing & stridor. Skin changes: flushing, pruritus, irticaria and angeo odema. Anxiety, confusion, a sense of impending doom

Signs and Symptoms: tachycardia, tachypnea, narrowed pulse pressure, hypotension after fluids, decreased capillary refill time, confusion, pale on appearance, motled skin, hperventilation, oliguira & fever

Signs and Symptoms:
Cardiac: decreased blood pressure, decreased preload.
Pulmonary tachypnea leading to bradypnoea (late).
Renal:
decreased urine output
Neurological:
Flacid paralysis below the level of lesion, loss of reflex activity.
Gastrointestinal:
Bowel disfunction

Treatments: maintain airways and intubate if needed, oxygen therapy, treat what is csuing the obstruction in order to restore blood flow, fluid resusitation

Contemporary stage: here the body tries to override metabolic changes and maitain homeostasis this is done through the actication of neural, hormonal, and biochemical compensatory mechanisms. one of the first symptoms is a drop in blood pressure as a result of decreased cardiac output and the narrowing of pulse pressure. Carptod and aortic barroreceptors are activated within the symapthetic nervous system to trigger/stimulate the realease of vasoconstrictors, adrenaline and noreadrenaline, restoring blood flow the vital organs such as the heart and brain

Progressive Stage: when contempoary recovery mechanism fails, this stage is initiated, alterations in mental state of patients is quite common during this stage of shock. there will be a a decrease in caridac output thus causing a reduction in blood pressure and also drecasing cellular perfusion and capillary permeability. The alteration in capillary permeability allows for the leakage of fluids from the vascular space into the intersistial space, thus decreasing circulation colume affecting the body's solid organs e.g lungs, liver. Perfusion to periphial tissues is also decreased

Irreversible stage: refered to the final stage of shock, is characterised by an exacerbaion of anerobic metabolism, decrease in perfusioh, drop in cardiac output along with a decline in vasoconstriction. The patient will typically exprience extensive hypotension and hypooxemia due to a loss of intravascular fluid . Lactic acid will acumulate resulting in increased cappillary permeablility and dilation, allowing fluid to exsit the vasvular space and move into the intersitial spacing. the patient is likely to go int omulti organ failure, recomver due to this is unlikely to the bodys' inhability to compensate.