SHOCKING EFFECTS

2. LOCAL INJURY EFFECTS
2.1. The most significant effect of injury, to any part of the
body, is a decrease of circulating body fluid volume due to
-Blood loss,
-Edema fluid loss.

2.2. The tissues in the part that receives the physical injury
will initiate an inflammatory response.

2.3 Inflammation starts with an increased capillary permeability
in the injured area, resulting in exudation of the edema fluid in
the interstitial space.

2.4. If the injured part is considerable in size, there will be a
considerable retention of the fluid in this injured area creating
a third space, besides the intracellular and extra cellular spaces.

3. THE PERFUSION PUMP FACTORS
The principal central physiological factors that affect our
circulation is the following:-

3.1 Pre-load or the initial cardiac muscle fiber stretch, just
before contraction is an important determinant of cardiac muscle
functions (Starlings Law).
This is the end diastolic volume (filling) of the ventricle.

3.2 After-load. Cardiac function is affected by the
resistance, against which the heart muscle has to work in both
the pulmonary and systemic circuits.
This is the arterial resistance (pressure)

3.3 Contractility of cardiac muscle.
This is the reserve ability of the heart muscle to work efficiently
under conditions of pre-load and after-load.

3.4 Lastly it is the Heart rate.
The rate increases the cardiac output without increase in the
stroke volume.
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