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Human Pathology Hemodynamic Disorders Flashcards

(75 cards)

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1
Q

Hyperemia

A

Active Process
Increased blood flow
Arteriolar Dialation
Produces redness in the affected tissue

Example: Blushing

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2
Q

Congestion

A

Passive Process
Impaired flow of venous blood
Affected tissues have blue or red color

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3
Q

Morphology of Congestion

A

Distended venules , sinusoids
Microscopic hemorrhages
Hemosiderin laden macrophages

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4
Q

Edema

A

Edema is defined as increased fluid in the interstitial tissues.

Abnormal accumulation of fluid within interstitial spaces or body cavities

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5
Q

How much of the body is water?

A

60%

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6
Q

Anasarca

A

Severe generalized edema

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7
Q

Ascities

A

Collection of fluid in the abdominal cavity

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8
Q

Pleural Effusion

A

Collection of fluid in the pleural cavity. Also called Hydrothorax

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9
Q

Pericardial Effusion

A

Collection of fluid in the pericardial sac. Also called hydropericardium

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10
Q

Transudate

A

Edema fluid occurring with volume or fluid overload or with reduced plasma protein.

Liver not making enough protein or kidney pee out proteinWhat

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11
Q

Left sided heart failure causes congestion in which organ?

A

Lung

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12
Q

Right sides heart failure causes congestion in which part of the body?

A

Systemically

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13
Q

Localized Edema

A

An organ or extremity

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14
Q

Blood in pleural space is called

A

hemothorax

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15
Q

What causes edema?

A

An increase in hydrostatic pressure and reduced oncotic pressure

Sodium retention
Lymphatic obstruction

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16
Q

How does congestive pericarditis cause edema?

A

Impaired blood flow to the heart due to opening of superior vena cava come into right atrium which impairs filling of heart

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17
Q

What is the systemic cause of edema?

A

Impaired venous return

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18
Q

What is the cause of Ascities?

A

Impaired blood flow through the liver which cause an accumulation of edema within the abdominal cavity.

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19
Q

What medical condition caused localized edema?

A

Thrombosis Cause edema in a localized fashion

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20
Q

How can external pressure mass affect edema?

A

Tumor can impair lymph flow and it impair venous return as it gets bigger because it press on veins which do not resist the pressure to keep open.

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21
Q

Hypoproteinemia

A

Losing protein due to reduced plasma osmotic pressure

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22
Q

How does malnutrition affect development of edema?

A

You do not have enough amino acids from broken down food to contribute to the synthesis of proteins/

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23
Q

Protein losing gastroenteropathy

A

Losing protein through the GI tracr

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24
Q

How does neoplastic affect edema?

A

Obstruct lymphatics or veins

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25
Post surgical and radiation can affect edema in which way?
Removal or scarring of lymphatics by radiation
26
How does renal hypoperfusion affect the development of edema?
The kidney is not getting enough blood and it thinks the body is dehydrated and hypovolemic so it reabsorb sodium to give more blood volume because water follows sodium
27
Which vein allows the fluid that does not get absorbed by the oncotic pressure at the venous end of the capillary, to flow back into systemic circulation?
Left Subcalvian vein
28
The main cause of left heart failure is ..
Right heart failure
29
What does heart failure affect?
Decreased renal blood flow Retention of sodium and water Increase in blood volume
30
What is subcutaneous edema?
Pitting edema How long does it take for tissue to bounce back
31
Dependent Edema
Occur in lower areas of the body. Happen when standing
32
If a patient is within a nursing home and lying in bed, where do you look for edema?
Near the sacrum. | The part of the body that is lowest in the bed
33
Pulmonary Edema
Fill alveoli with fluid. impair patient ability to oxygenate
34
Edema within the brain
Can be fatal. | Swelling of brain reduced brain function
35
What are the visceral edemas
Brain | Pulmonary Edema
36
Hemorrhage
Exravasation of blood due to rupture of the vessel
37
What are the types of hemorrhages?
Petechiae which are 1 to 2mm that are in the skin, mucus membranes Purpura slightly larger 3 to 5 mm
38
What are bruises classified as ?
Ecchymoses
39
What causes iron deficiency?
Chronic blood loss
40
What causes epidermal hemmorhage?
Bleeding of middle menigeal artery | Blood on top of dura
41
Shock
A final common pathway for potentially lethal events. It is systemic hypoperfusion in either cardiac output or in the effective circulating blood volume. Results in hypoxic injury to cells
42
What conditions cause shock?
Severe Hemorrhage Extensive Trauma or burns Large myocardial infarction due to effective heart volume decrease which leads to decrease in perfusion of tissues
43
What are the categories of shock?
cadiogenic hypovolemic'septic neurogenic anaphylatic
44
What causes cardiogenic shock?
Due to myocardial infarction or arrythmia which prevents the heart from pumping blood. Extrinsic Compression which is called tamponade or outflow obstruction such as pulmonary embolism
45
What is hypovolemic shock?
Loss of blood or plasma volume caused by hemorrhage, fluid loss , severe burns, trauma
46
What is septic shock?
Microbial infection by an endotoxin from gram negative bacteria or just a gram positive bacteria.
47
What metabolic imbalance do you get when you go through shock?
Lactic acidosis
48
What is neurogenic shock?
Anesthetic shock or spinal injury | Loss of vascular tone with peripheral pooling of blood
49
Anaphylactic Shock
Initiated by generalized IgE mediated hypersensitivity response Systemic vasodialation and increased vascular permeability
50
What are the stages of shock?
Nonprogressive Stage and Progressive Stage
51
Which organ is the last to be affected by ischemia?
Brain
52
A person who has died of shock has certain characteristics morphologically?
Brain- ischemic encephalopathy Kidney- acute tubular necrosis Heart- contraction band necrosis or coagulative necrosis Lungs- Adult Respiratory distress syndrome called Acute
53
What characterizes the progressive stage of shock?
Widespread tissue hypoxia Intracellular aerobic respiration is replaced by anaerobic glycolysis which produces lactic acid production and lactic acidosis blunts vasomotor response resulting in peripheral pooling of blood.
54
What are the characteristics of an irreversible stage of shock?
Leakage of lysosomal enzymes Increased NO synthesis Ischemia of organs Worsen myocardial contractile function
55
What is normal hemostasis?
Maintenance of the blood in a fluid clot free state in normal vessels
56
What are the components of hemostasis?
Vascular Wall Platelets Coagulation Cascade
57
Thrombosis
The formation of a clotted mass of blood constituents in the uninterrupted vascular system
58
What are the effects of a thrombosis?
decrease vascular flow Embolize Obstruct blood flow-infarction
59
What causes thrombosis?
Endothelial injury Lamellar blood flow change Hypercoagulability
60
What causes endothelial injury?
Ulcerated arthersclerotic plaques Myocardial infarction Inflammatory cardiac valve disease Hypertension due to greater pressure Turbulence due to arthersclerosis Bacterial toxins Immunologic injury
61
What impacts changes in laminar blood flow?
Stasis due to the activation of platlets and cause slower rate of blood flow which retards dilution of activated factors and hepatic clearance. Stasis retards inflow of inhibitors. Turbulence activates platelets and cause endothelial injury and retard flow of inhibitors
62
Hypercoagulability
Altered state of blood requiring less than normal clot promoting activities to produce thrombosis
63
What causes hypercoagulability
Mutation in Factor 5 Prothrombin mutation Antithrombin 2 deficiency Protein C or S deficiency Defects in fibrinolysis when you cant break down the clot Tissue damage Myocardial infarction Oral contraceptives due to estrogen leveles Heparin Induced thrombocytopenia Lupus anticoagulant Late Pregnancy and following delivery because baby press on inferior vena cava and trauma to tissue in delivery with the high estrogen levels
64
How can you tell if a clot is pre-mortem ?
Pre mortem have the Lines of Zahn. Mass of platlets, RBC and fibrin Attached to underlying vessel wall
65
What does a clot look like post mortem?
Soft and rubbery No lines of Zahn Chicken fat or current jelly Mural Thrombus Occur in large diameter vessels or heart Do not fill entire lumen
66
Arterial Thrombus
Usually occlusive Usually associated with athersclerotic plaque Most common site is coronary, cerebral and femoral arteries
67
What is vegetation of thrombus?
Thrombosis of cardiac valve
68
What happens to a thrombus over time?
It can embolize which means it breaks off and travels downstream. Dissolution by the process of Fibrinolysis can break it down to become Propagate which means it can get bigger Organize in which it incorporate into blood vessel wall
69
Embolism
A detached intravascular solid, liquid, or gaseous mass that is carried by the blood to a site distant from its point of origin.
70
Which veins of the lower leg embolize, superficial or deep?
Deep and it wind up in lung
71
When do we see small emboli?
When more than 60% of the pulmonary circulation is obstructed
72
How much are small emboli are silent?
60 to 80 percent
73
What are systemic thromboemboli?
Arterial Emboli which originate from intracardiac mural thrombi 80 percent of the time. Sites: Lower extremities 75% Brain 10% these give stroke
74
What are the characteristics of Fat Embolism Syndrome?
Begins 1 to 3 days following injury Sudden onset of dyspena, tachypnea and tachycardia Neurologic symtoms which are irritability, restlessness which can progress to a coma. Diffuse petechial rash, thrombocytopenia Full blown form is fatal in 10%
75
Air Embolism
Gas bubbles in the circulation can coalesce causing obstruction of vascular flow

Pathology (10 decks)

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