circulation I: disorders of circulation and fluids

Question 1

edema

Answer 1

presence of excessive fluid in a tissue or a body cavity

Question 2

pitting edema

Answer 2

can press and make a pit in the skin

Question 3

anasarca

Answer 3

widespread swelling of skin

Question 4

dependent edema

Answer 4

clinically detectable increase in ECFV in dependent area (limb) causing pitting or swelling

Question 5

ascites

Answer 5

serous fluid in peritoneal cavity

Question 6

4 mechanisms of edema formation

Answer 6

1 - increased intravascular pressure (heart failure or venous obstruction)
2 - decreased serum oncotic pressure (low protein synthesis, protein loss)
3 - increased permeability of blood vessels (burns, inflammation, chemical injury)
4 - lymphatic obstruction or destruction (neoplasia, post-surgery, parasites)

Question 7

gross morphologic changes with edema

Answer 7

• swelling of organ or tissue

- increased mass of organ or tissue

Question 8

microscopic morphologic changes with edema

Answer 8

• separation of tissue elements by pale, pink, protein-containing fluid
• no new cellular elements in the tissue

Question 9

unilateral limb edema

Answer 9

• lymphatic obstruction
• most likely parasitic filariasis
• possibly tumor

Question 10

pulmonary edema

Answer 10

• increased hydrostatic pressure

- infarction in left ventricle

Question 11

hyperemia

Answer 11

increase volume of blood within a specific vascular bed

Question 12

active hyperemia

Answer 12

increased flow into area

Question 13

passive hyperemia

Answer 13

decreased outflow from area

Question 14

morphology of hyperemia

Answer 14

• organ or tissue appears red
• blood remains within blood vessels
• vessels dilated by not damaged
• edema not necessary

Question 15

hyperemia in lung

Answer 15

might be secondary to left-sided heart failure

Question 16

hemorrhage

Answer 16

flow of blood from the vascular compartment

Question 17

petechiae

Answer 17

Minute hemorrhagic spots, of pinpoint to pinhead size, in the skin, which are not blanched by pressure.

Question 18

purpura

Answer 18

do not blanch when pressure is applied

Question 19

hematoma

Answer 19

localized mass of extravascular blood confined to a tissue, organ, space, or potential space

Question 20

hemoptysis

Answer 20

Spitting of blood derived from the lungs or bronchial tubes as a result of pulmonary or bronchial hemorrhage.

Question 21

hematemesis

Answer 21

vomiting of blood

Question 22

melena

Answer 22

blood in stool

Question 23

ischemia

Answer 23

reduction or loss of blood supply to a tissue or organ, major problem being oxygen but potentially glucose and other blood constituents as well

Question 24

infarction

Answer 24

death of cells, a tissue or an organ due to insufficient or absent blood supply

Question 25

gross morphology of infarction

Answer 25

bland: tissue is pale or white
hemorrhagic: bleeding into dead tissue

Question 26

microscopic morphology of infarction

Answer 26

• coagulative necrosis
• cells become eosinophilic, nuclei shrink, become hyper chromatic, less distinct, and then break up
• infiltration of neutrophils to digest dead tissue
• macrophages appear to remove debris
• scarring in organs other than the brain

Question 27

backward heart failure

Answer 27

failure to pump blood out of the veins, often called “congestive failure”

Question 28

forward heart failure

Answer 28

failure to pump blood into the arteries with enough pressure to perfuse organs, can cause ischemia

Question 29

global heart failure

Answer 29

diffusely diseased myocardium exhibiting both forward and backward elements of heart failure

Question 30

heart failure can cause congestion in:

Answer 30

lungs or liver

Question 31

heart failure may cause edema in:

Answer 31

lungs, liver, or limbs

Question 32

unusual manifestations of heart failure

Answer 32

pleural effusion, ascites, dyspnea at rest

Question 33

results of congestive heart failure

Answer 33

chronic congestion of liver or increased venous pressure leading to dependent edema

Question 34

is a thrombus a clot?

Answer 34

no

Question 35

what does a thrombus have in common with a clot?

Answer 35

both coagulated blood

Question 36

thrombus

Answer 36

coagulation within the cardiovascular system