Physiology - How a Woman\'s

Physiology - How a Woman's Various Organs and Systems Respond to Trauma

The purpose of this paper is to explain how a woman's various organs and systems respond to trauma, and how many of those actions can result in minimizing chances of organ destruction and increasing the victim's chances of surviving the accident. In addition, some actions taken by the woman's body can actually be deleterious to her chances for survival.

This woman presented upon arriving in the ER with several broken ribs, which resulted in a bruising of the liver and kidneys and a ruptured spleen. The first diagnostic signs were: low blood pressure, low respiration and low urine output.

The woman's reaction to the accident constitutes the classic demonstration of shock symptoms. Of the various first diagnoses, that of the ruptured spleen is of the most concern. The spleen acts as a major filter of blood, as well as a repository for discarded red blood cells. Its rich blood supply foretells a large loss of blood into the abdominal cavity. The woman's reaction to this blood loss is to repress metabolism in order to reduce blood flow; of course, part of this reaction is due to the blood loss, which results in a self-supporting cycle of continually lowering blood pressure which corresponds to the loss of blood from the circulatory system. The rupture of many capillaries and arterioles results in the immediate release of thrombus-attractant enzymes, which assure that platelets rush to the scene to help staunch blood flow (Gando). As we will see later, this rush of platelets also creates subsequent problems.

A further result of shock is that the woman's overall slowdown in metabolism and specific actions result in a reduction in temperature, which further reduces metabolism and protects the brain and other vital organs for a longer period of time than if they had been at normal body temperature.

The broken ribs result in the release of several products into the surrounding blood stream, including type-2 cytokines (from the spleen and other organs) (V. E. Mack). These cytokines cause an inflammatory reaction which attracts liquids and T-cells to the injury site, in order to reduce the woman's chances of infection, and to aid the healing process.

In addition, thrombin is released from the broken cells, which results in the activation of platelet response (Dubois). These platelets first move to the richly-supplied ribs, then also arrive at the sites of the injured spleen, kidneys and liver.

With a massive injury as in this case, the sudden rush of platelets can result in a thrombocytopenia, which means that the patient is more likely to bleed uncontrollably, which will exacerbate blood loss and further depress blood pressure due to volumetric effects.

The woman's kidney function is decreased due to lowered blood pressure, which affects the rate that the kidneys are able to filter waste products from the blood. In an acute shock situation, the body shuts down many of its functions in the interest of addressing the patient's most-urgent problem.

In addition to reduced kidney function, the patient's brain function slows down; she may appear lethargic, have difficulty talking, and eventually lapse into a coma. This is due to the body's diverting blood supply from the brain, which typically takes 20% of oxygen and nutrition, to other areas which require it most.

The woman's broken cells will put out markers for tissue injury: in the case of the liver, the SGPT and SGOT enzymes will be elevated, indicating liver damage. General enzyme levels indicating systemic injury will also climb, including myoglobin, various tissue factor antigens, endotoxins and a series of other enzymes which are released upon cell destruction. If the initial concern was the spleen, kidney and liver, it may also make sense for the attending ER physician to check pancreatic, stomach, heart- and lung-specific enzymes to monitor additional damage.

As mentioned previously, the woman's response can result in actions deleterious to her prognosis. These include: