Chapter 3 Flashcards by Taylor Myers

too little hemodynamic homeostasis causes:

bleeding and shock

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too much hemodynamic homeostasis cause:

clots (thrombus)

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2 examples of increased blood volume

hyperemia and congestion

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hyperemia

active process which dilates the arterioles
causes redness (erythema)
can occur during exercise or inflammation

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congestion

passive process which obstructs veins
causes blueness (cyanosis)
DVT or CHF

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Examples of congestion

acute respiratory distress syndrome
chronic pulmonary congestion
congestive hepatopathy

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examples of congestive hepatopathy

chronic passive liver congestion
cetrilobular hepatic necrosis
hemosiderin-laden macrophages

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Edema

abnormal accumulation of interstitial fluid

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examples of localized edema

lower extremities, hydrothorax, ascites

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hydrothorax is localized edema of _____?

the pleural cavity

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ascites is localized edema of _____?

the peritoneal cavity

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fluid balance is maintained by what 2 factors?

hydrostatic pressure and osmotic pressure

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increased hydrostatic pressure is the result of…

impaired venous flow

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localized impairment of venous flow can be caused by

deep vein thrombosis

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generalized impairment of venous flow can be caused by

congestive heart failure

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reduced osmotic pressure can be the result of…

too few plasma proteins (albumin) caused by reduced production or increased loss

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fluid imbalance can be caused by the following 5 factors

too much hydrostatic pressure
too little osmotic pressure
lymphatic obstruction
retention of sodium or water
inflammation

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lymphatic obstruction is the result of…

inflammation/ fibrosis or tumors

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sodium & water retention is the result of…

increased blood volume

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2 causes of increased blood volume

acute renal failure and high salt diet

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dependent edema is dependent on what factor?

gravity

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mobile patients develop dependent edema in what area of the body?

feet and ankles

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immobile patients develop dependent edema in what area of the body?

sacrum & lumbar

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pitting edema is due to the accumulation of _______

transudate

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non-pitting edema is due to the accumulation of ________

exudate

hemorrhage is defined as...

extravasation of blood from vessels

severity of hemorrhage is based on what 2 factors?

total blood volume lost and rate at which blood is lost

4 types of hemorrhage

hematoma petechiae purpura ecchymosis/contusion

petechiae are usually ___mm

1-2mm

purpura are usually ___mm

3-5mm

3 common causes for thrombosis (Virchow's triad)

endothelial injury abnormal blood flow hypercoagulability

common causes for endothelial injury

atherosclerotic plaques, hypertension, high cholesterol, vasculitis, sepsis

common causes for abnormal blood flow

turbulence (aneurysm, varicosity) | stasis (arrhythmia, immobility, valve stenosis)

4 options for the fate of a thrombus

dissolve enlarge embolize organization

dissolution of a thrombus

caused by plasminogen activator exogenous form (t-PA) can be given to break up clots

enlargement or propogation of a thrombus

will always propogate towards the heart

which way will an arterial thrombus grow?

against the flow of blood

which way will a venous thrombus grow?

with the flow of blood

what is embolization?

detached intravascular mass (moving thrombus)

where will venous emboli usually end up?

usually lodge in the lungs causing pulmonary embolism

where will arterial emboli end up?

can lodge in kidney, CNS, or extremities

what will a renal arterial embolism cause?

renal infarction ---> ischemia and coagulative necrosis

what will a CNS arterial embolism cause?

Cerebral Vascular Accident (CVA or stroke) | ---> ischemia and liquifactive necrosis

what will an arterial embolism in an extremity cause?

ischemia and coagulative gangrenous necrosis

recanalization

occurs during organizaton of a thrombus | eventual formation of new circulatory canals to keep blood flow

features of venous thrombus

low pressure and slow moving blood | congestion, tenderness, pitting edema

features of an arterial thrombus

infarction --> tissue death

Causes of DIC

crush injury, sepsis, obstetric complications

DIC causes _____

widespread thrombosis

DIC results in: (2)

ischemia/infarction (rapidly fatal) | Hemorrhage (from exhausted clotting factors)

3 types of embolism

solid liquid gas

types of solid emboli

fat, plaque debris, or tumor fragments

how are fat emboli formed?

broken long bones expose yellow (fatty) bone marrow stored in marrow cavity

Most common liquid embolism?

amniotic fluid which can cause DIC

Examples of Gas emboli?

air (injections) nitrogen (scuba diving rapid ascent) called Bends or Caisson's Disease

80% of pulmonary emboli are ___

clinically silent | lungs have collateral blood supply so little to no tissue death

Saddle embolism

occurs at the pulmonary artery bifurcation | can cause rupture of the right ventricles since it is pumping against a road block

95% of PE are from

deep vein thrombosis

systemic thromboembolism

clot in the peripheral arterial system

80% of systemic thromboembolism are from

cardiac thrombi

2/3 of systemic thromboembolism are from

the left ventricle

Paradoxical embolism are weird because they ____

cross from venous to arterial system

paradoxical emboli begin as

deep vein thrombosis

Paradoxical emboli are able to cross due to

atrial septal defects or ventricular septal defects

infarction is defined as...

death of a tissue, due to obstruction of blood supply

red infarction

hemorrhagic (tissue has a collateral blood supply)

white infarction

pale/anemic (tissue has no collateral blood supply)

shock

inadequate blood supply (perfusion) to tissues, resulting in cellular injury, dysfunction, & possibly death

traditional shock are types with _______

peripheral vasoconstriction

examples of traditional shock

cardiogenic | hypovolemic

traditional shock symptoms

increased respiration, HR, cold clammy hands, decrease consciousness

treatments for traditional shock

defibrillation, CPR, limit blood loss, elevate legs, IV fluids

Distributive shock are types with ______

peripheral vasodilation

examples of distributive shock

septic neurogenic (spinal cord injury) anaphylactic

treatment for distributive shock

vasoconstrictive meds (EpiPen)

3 stages of shock

non-progressive (SNS compensation) progressive (hypoperfusion, glycolysis, acidosis) irreversible (widespread membrane damage, organ failure)

shock index

HR / systolic BP = shock index

normal shock index

0.5 - 0.8

Red infarctions are usually found:

Lungs and small intestine

White Infarctions are usually found:

Heart, spleen, kidney

Chapter 3 Flashcards

(80 cards)