Circulatory Disturbances- Dr. Llanes

Question 1

Edema

Answer 1

Abnormal accumulation of excess extracellular water in interstitial spaces or in body cavities

or fluid outside of the vascular and cellular water compartments

Question 2

Pathomechanisms of edema

Answer 2

1. increased blood hydrostatic pressure
2. decreased plasma colloidal osmotic pressure
3. lymphatic obstruction
4. increased vascular permeability

Question 3

2 types of edema

Answer 3

Inflammatory & non-inflammatory

Question 4

Inflammatory edema characteristics

Answer 4

referred to a exudate
Increased vascular permeability
Edema fluid is protein rich
High specific gravity
Less than 7000 nucleated cells per uL

Question 5

Non-Inflammatory edema characteristics

Answer 5

Referred to as transudate
Edema fluid is protein poor
Low specific gravity
Less than 1500 nucleated cells per uL

Question 6

Gross descriptors of edema

Answer 6

• wet
• gelatinous
• heavy
• swollen organs
• fluid weeps from cut surfaces
• may be yellow

Question 7

histological appearance of edema

Answer 7

• Clear or pale eosinophilic staining depending on inflammatory or non
• spaces are distended
• blood vessels may be filled with RBC’s
• lymphatics are dilated
• collagen bundles are separated

Question 8

pitting edema

Answer 8

When pressure is applied to an area of edema a depression or dent results as excessive interstitial fluid is forced to adjacent areas

Question 9

Hydrothorax

Answer 9

fluid in the thoracic cavity

Question 10

Pericardial effusion

Answer 10

• Mulberry heart disease
• type of inflammatory edema
• note fibrin strands and cloudy appearance of the pericardial fluid

Question 11

Ascites or hydroperitoneum

Answer 11

fluid (transudate) in the peritoneal cavity

Question 12

anasarca

Answer 12

generalized edema with profuse accumulation of fluid within the subcutaneous tissue

Question 13

Submandibular edema- common name

Answer 13

Bottle jaw

Question 14

Clinical significance of edema

Answer 14

• Depends on the extent, location and duration

- Tissue can become firm and distorted due to fibrous connective tissue buildup

Question 15

Pulmonary edema

Answer 15

• Non-inflammatory is associated with left-side congestive heart failure
• Inflammatory due to damage to pulmonary capillary endothelium (such as pneumonia)

Question 16

Chronic pulmonary edema

Answer 16

• associated with heart failure
• fibrosis can occur in alveolar walls
• accumulation of heart failure cells

Question 17

Hyperemia

Answer 17

Local increase in blood volume and flow resulting in engorgement of vascular bed with oxygenated blood

Question 18

Congestion

Answer 18

• passive engorgement of vascular bed

- similar to hyperemia, however due to decreased outflow instead of increased flow

Question 19

Causes of physiological hyperemia

Answer 19

• digestion
• exercise
• heat dissipation
• neurovascular (blushing)

Question 20

pathological hyperemia

Answer 20

• underlying pathological process (generally inflammation)
• arteriolar dilitation secondary to inflammatory stimulation
• reddening caused by inflammation and edema

Question 21

Gastrointestinal congestion due to twisting which cuts off blood flow

Answer 21

-Gastric or intestinal volvulus

Question 22

Pulmonary congestion is usually caused by

Answer 22

heart failure

Question 23

Subacute to chronic hepatic congestion is usually the result of

Answer 23

Right-side congestive heart failure

Question 24

Common name for chronic hepatic congestion

Answer 24

nutmeg liver

Question 25

Hemorrhage

Answer 25

- the escape of blood from vasculature | - can be internal or external

Question 26

Causes of Hemorrhage

Answer 26

-trauma -sepsis viremia, bacteremia, toxins -abdominal neoplasia -coagulation dysfunction

Question 27

Clinical significance of hemorrhage is determined by

Answer 27

location and severity

Question 28

largest concern in acute hemorrage

Answer 28

hypovolemic shock

Question 29

Hemopericardium

Answer 29

blood in the pericardial cavity

Question 30

Hemorrhage per rhexis

Answer 30

Hemorrhage caused by substantial tear in vascular or cardiac wall

Question 31

Hemorrhage per diapedesis

Answer 31

- caused by a small defect in the vessel wall | - caused by RBC's passing through vessel wall in cases of inflammation or congestion

Question 32

Hemorrhagic diathesis

Answer 32

Increased tendency to hemorrhage from normally insignificant injuries

Question 33

Hemothorax

Answer 33

blood in the thoracic cavity

Question 34

Hemoarthrosis

Answer 34

blood within a join space

Question 35

hemoptysis

Answer 35

- coughing up of blood | - blood-stained sputum from lungs or airways

Question 36

Epistaxis

Answer 36

bleeding from nose

Question 37

Petechia

Answer 37

small hemorrhagic foci on an organ

Question 38

Ecchymosis

Answer 38

larger hemorrhagic foci

Question 39

Agonal Hemorrhages

Answer 39

petechiae and ecchymoses associated with terminal hypoxia

Question 40

Suffusive Hemorrhages

Answer 40

Larger than ecchymosis and contiguous

Question 41

Methods of hemorrhage resolution

Answer 41

- reabsorption - phagocytosis - organizing hematoma

Question 42

Stages of hematoma

Answer 42

1. Hemoglobin (red-blue) 2. Bilirubin (blue-green) 3. Hemosiderin (yellow-brown)

Question 43

Hemostasis

Answer 43

Arrest of hemorrhage by physiological or surgical means

Question 44

Pathological hemostasis

Answer 44

thrombosis- unnecessary activation of physiological hemostatic agents forms a clot

Question 45

Components necessary for normal hemostsis or thrombosis to occur

Answer 45

- vascular wall - platelets - coagulation cascade

Question 46

Which vasoconstrictor is the first to be released when injury occurs?

Answer 46

endothelin

Question 47

What causes platelets to adhere to von Willebrand factor and be activated?

Answer 47

glycoprotein lb (Gplb)

Question 48

Activated platelets undergo a shape change from ______ to _________.

Answer 48

Small and rounded Flat plates with increased surface area

Question 49

During platelet activation _____ and _____ are releases which leads to platelet aggregation via ___________.

Answer 49

ADP, TXA2 Fibrinogen binding to Gplb-llla Receptors

Question 50

At the end of primary hemostasis we are left with a _______ in the affected area.

Answer 50

Hemostatic plug

Question 51

Pathogenesis of Thrombosis (Virchow triad)

Answer 51

1. endothelial injury 2. Alterations in blood flow 3. Hypercoagulability

Question 52

Verminous thrombosis

Answer 52

Thrombus in cranial mesenteric artery of horses with Strongylus vulgaris infection

Question 53

Potential outcomes of thrombus

Answer 53

- lysis - propagation - embolization/recanalization

Question 54

Embolism

Answer 54

Passage through the cardiovascular system of any material capable of lodging in the lumen of a vessel.

Question 55

Thromboembolism

Answer 55

Embolism caused by pieces of a thrombus

Question 56

Disseminated Intravascular Coagulation

Answer 56

Generalized activation of blood coagulation system

Question 57

DIC can lead to________ and _________.

Answer 57

Consumptive coagulopathy, hemorrhagic diathesis

Question 58

Infarction

Answer 58

Localized area of ischemic necrosis in a tissue or organ caused by occlusion of the cardiovascular system.

Question 59

Types of Shock (Cardiovascular collapse)

Answer 59

1. Cardiogenic 2. Hypovolemic 3. Anaphylactic 4. Neurogenic 5. Septic

Question 60

Most common cause of septic shock

Answer 60

Endotoxin producing gram- bacilli