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Flashcards in Disorders of Circulation Deck (33):
1

Hematoma

It is a localized collection of blood outside the blood vessels.

2

Hemothorax

It is a type of pleural effusion in which blood accumulates in the pleural cavity.

3

Hemopericardium

Hemopericardium refers to blood in the pericardial sac of the heart.

4

Hemoperitoneum

Hemoperitoneum (sometimes also hematoperitoneum) is the presence of blood in the peritoneal cavity.

5

Hemarthrosis

Hemarthrosis (or haemarthrosis, plural h(a)emarthroses) is a bleeding into joint spaces.

6

Petechiae

It is a red or purple spot on the skin, caused by a minor bleed (from broken capillary blood vessels).

7

Purpura

They are a rash of purple spots on the skin caused by internal bleeding from small blood vessels and are larger that petechiae.

8

Ecchymosis

Nonraised skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels.

9

What is hyperemia and what is the cause?

Hyperemia (active hyperemia) occurs with dilatation of an artery or arteriole and increased blood flow into the capillaries. Hyperemia is caused by sympathetic neurogenic discharge or chemical mediators.

10

What are examples of hyperemia?

Clinical Example: Acute inflammation of tissue, blushing, body’s need to dissipate heat. Hyperemia of the skin appears red (oxygenated blood).

11

What is congestion and what is the cause?

Congestion (passive hyperemia) occurs because of impaired venous drainage. The veins do not dilate because of the active influence of a sympathetic discharge or chemical mediator.

12

What is an example of congestion?

Clinical Example: Chronic passive congestion is a form of long standing congestion which produces characteristic changes in the lungs, liver and spleen. The congestion occurs because of right heart failure.

13

What is edema?

Accumulation of abnormal amounts of fluid in interstitial spaces or body cavities.

14

What are the 2 types of edema?

Inflammatory
Non-inflammatory

15

What is the cause of inflammatory edema?

Tissue injury alters blood flow and vascular permeability as a result of increased interendothelial space. This process is modulated by a variety of chemical mediators.

16

What is the cause of non-inflammatory edema?

Fluid accumulates in the interstitium as a consequence of changes in hydrostatic pressure and colloid osmotic pressure.

17

What is hemorrhage?

Hemorrhage is a flow of blood from a ruptured blood vessel. The blood may flow into tissue, into a body cavity or outside the body.

18

What is thrombosis?

Formation of thrombus (blood clot) within an uninterrupted vascular system. It is considered a pathologic process.

19

What are the 3 mechanisms for thrombosis?

1. Endothelial injury
Clinical examples: Inflammation; advanced atherosclerosis

2. Altered blood flow: turbulence vs. stasis
Clinical example: atrial fibrillation, bed rest

3. Hypercoagulable state: Predisposition to easy clot formation
Clinical examples: Protein C deficiency; woman who smokes and uses oral contraceptives.

20

What is Virchow's Triad?

1. Endothelial injury

2. Altered blood flow

3. Hypercoagulable state

21

What is an embolism?

An embolus is an intravascular substance (solid, liquid, gas) which is carried by blood from a point of origin to a distant site.

22

What is infarction?

An infarct is an area of ischemic necrosis within tissue or an organ, produced by occlusion of either its arterial supply or venous drainage. The majority of infarcts are associated with thromboembolism and involve arterial occlusions.

23

What is the cause of white infarct?

Ischemic, usually arterial occlusion

24

What is the cause of red infarct?

Hemorrhagic, usually venous occlusion

25

What are some tissues that experience white infarct?

Solid organ with end‐ arterial circulation like heart, liver, spleen and kidney

26

What are some tissues that experience red infarct?

Tissues with dual circulations like lung and small intestine

27

What are the possible fates of a venous thrombus?

-Resolution
-Embolization
-Propagation
-Organization

28

What is Cardiogenic Shock?

Results from low cardiac output due to myocardial pump failure

29

What is Hypovolemic Shock

Results from low cardiac output due to loss of blood or plasma volume

30

What is Septic Shock?

Results from arteriolar vasodilatation and venous blood pooling that stems from systemic immune response to microbial infection.

31

56‐year old woman develops a popliteal venous thrombosis after hip replacement surgery. She recovers and returns to her job as a teacher. Three months later, which of the following term would describe the process mostly likely seen in the popliteal vein?

A. Acute inflammation
B. Granulomatous inflammation
C. Embolization
D. Organization
E. Propagation

D. Organization

32

A 65‐year old previously healthy man is hospitalized for bilateral pneumonia. On hospital day #8 he is found to have swelling and tenderness of his left leg. An ultrasound examination reveals findings consistent with acute left common femoral vein thrombus. Which of the following conditions is most likely to have contributed the most to this finding?

A. Protein C deficiency
B. Prolonged immobilization
C. Hypertension
D. Left ventricle mural thrombus E. Chronic alcohol use

B. Prolonged immobilization

33

On sectioning of an organ from a 69‐year old woman at the time of autopsy, a focal wedge‐shaped area that is firm is accompanied by extensive hemorrhage, giving it a red appearance. The lesion has a base on the surface of the organ. In which of the following situations did this lesion most likely develop?

A. Spleen with embolized mural thrombus
B. Kidney with septic embolus
C. Liver with hypovolemic shock
D. Heart with coronary thrombosis
E. Lung with pulmonary thromboembolism

E. Lung with pulmonary thromboembolism

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