lecture 1- hemodynamic disorders

Question 1

delivers oxygen and nutrients to tissues

wastes are removed

Answer 1

circulation

Question 2

blood clotting that prevents excess bleeding after blood vessel damage

Answer 2

hemostasis

Question 3

inappropriate clotting

Answer 3

thrombosis

Question 4

migration of clots

Answer 4

embolism

Question 5

active process, arteriolar dilation and increased blood inflow

Answer 5

hyperemia

Question 6

oxygenated hemoglobin

Answer 6

red color (hyperemia)

Question 7

passive process, impaired outflow of venous blood from a tissue

Answer 7

congestion

Question 8

deoxygenated hemoglobin

Answer 8

blue/red (cyanosis) (congestion)

Question 9

__% of body weight is water
2/3 intracellular

only ___% blood plasma

Answer 9

60% water
5% blood plasma

Question 10

accumulation of interstitial fluid in tissue

Answer 10

edema

Question 11

two types of edema

Answer 11

effusions
anasarca

Question 12

extravascular fluid that collects in body cavities

pleural cavity- hydrothorax
pericardial cavity- hydropericardium
peritoneal cavity- hydroperitoneum or ascites

Answer 12

effusions

Question 13

seve generalized edema due to fluid retention in tissues and cavities

Answer 13

anasarca

Question 14

vascular hydrostatic pressure and colloid osmotic pressure (plasma proteins) dictate fluid movement between vascular and interstitial spaces

Answer 14

capillary fluid movement

Question 15

in capillary fluid movement, arterial outflow is normally balanced by:

this results in small net outflow of fluid in interstitial space-> drained by_____

Answer 15

inflow at the venous end

drained by lymphatics

Question 16

this is usually caused by disorders that impair venous return

Answer 16

increased hydrostatic pressure

(deep venous thrombosis, congestive heart failure

Question 17

may result from loss in circulation or reduced synthesis

Answer 17

reduced plasma albumin concentration
(reduced plasma osmotic pressure)
-nephrotic syndrome, severe liver disease

Question 18

compromises resorption of fluid from interstitial spaces-> leads to ___

Answer 18

this is lymphatic obstruction

-> leads to edema

Question 19

1. inflammatory conditions (bacterial/parasitic infection)
2. neoplastic condition (breast cancer)
3. congenital lymphedema

Answer 19

lymphatic obstructions

Question 20

extravasation of blood from vessels

Answer 20

hemorrhage

Question 21

defective clot formation, trauma, atherosclerosis, inflammatory, neoplastic conditions, inherited/acquired defects

Answer 21

hemorrhages

Question 22

4 types of hemorrhage manifestations

Answer 22

hematoma
ecchymoses
purpura
petechiae

Question 23

large collection of hemorrhage in a tissue

Answer 23

hematoma

Question 24

1-2cm subcutaneous hemorrhage (bruises)

Answer 24

ecchymoses

Question 25

3-5mm hemorrhages

Answer 25

purpura

Question 26

1-2mm minute hemorrhage -often consequences of thrombocytopenia, vitamin C deficiency

Answer 26

petechiae

Question 27

these cells are the primary regulators of hemostasis through changes in expression of procoagulant factors

Answer 27

endothelial cells (clot formation)

Question 28

clot formation steps

Answer 28

1. vasoconstriction 2. platelet plug forms 3. fibrin deposition 4. clot stabilization

Question 29

disk shaped, anculeate fragments of megakaryocytes

Answer 29

platelets

Question 30

platelet adhesion is mediated by

Answer 30

von willenbrand factor

Question 31

congenital deficiency of receptors or molecules may lead to bleeding disorders

Answer 31

platelets

Question 32

series of amplifying enzymatic reactions that lead to the deposition of an insoluble fibrin clot -secondary hemostasis

Answer 32

coagulation cascade

Question 33

spontaneous, internal to vascular endothelium what pathway for coagulation cascade

Answer 33

intrinsic pathway

Question 34

activated by external trauma what pathway for coagulation cascade

Answer 34

extrinsic pathway

Question 35

this evaluates intrinsic pathway factors XII, XI, IX, VIII, X, V, prothrombin (II), fibrinogen (I)

Answer 35

partial prothrombin time PPT

Question 36

evaluates the extrinsic pathway factors VII, X, V, prothrombin(II), fibrinogen (I)

Answer 36

prothrombin time PT

Question 37

important for regulation of coagulation, plays key role in synthesis factors II, VII, IX, X

Answer 37

vitamin K

Question 38

helps synthesize protein C and S: important for negative feedback regulation of clotting cascade

Answer 38

vitamin K

Question 39

vitamin K deficiency does what

Answer 39

increased bruising and bleeding

Question 40

anticoagulant mediation, antagonist for vitamin K inhibits clotting

Answer 40

warfarin

Question 41

most important coagulation factor -converts fibrinogen into crosslinked fibrin -activates platelets -pro inflammatory effects -anticoagulation effects

Answer 41

thrombin

Question 42

4 factors limiting coagulation

Answer 42

* Dilution of blood past the site of injury * Negatively charged phospholipids required -activated platelets * Regulation by neighboring intact endothelium * Fibrinolytic cascade limits size of clot (Plasmin activation essential)

Question 43

1. Serves as barrier to platelets 2. Anticoagulant effects 3. Fibrinolytic effects

Answer 43

endothelium and coagulation limitation

Question 44

Endothelial injury * Coronary artery disease, MI * Chronic inflammation – physical injury, infectious agents, abnormal blood flow, inflammatory mediators, toxins

Answer 44

thrombosis

Question 45

1. abnormal blood flow * Promote endothelial procoagulant activity * Stasis allows platelets and leukocytes to associate with endothelial cells * Stasis slows removal of activated clotting factors, and impedes inflow of clotting factor inhibitors

Answer 45

thrombosis

Question 46

abnormally high tendency for blood to clot * Important risk factor for venous thrombosis * Primary (genetic) vs secondary (acquired) disorders

Answer 46

thrombosis

Question 47

Can develop anywhere in cardiovascular system Lines of Zahn: observed grossly and microscopically

Answer 47

thrombi

Question 48

4 fates of thrombi

Answer 48

1. propagation: clot enlarges 2. embolization: clot dislodged and moved by circulatory system 3. dissolution- activation of fibrinolytic factors 4. organization and recanalization- older thrombi are reorganized to facilitate some function

Question 49

most occur in veins in leg * Superficial veins: local congestion and swelling from impaired venous flow -Ex: varicose veins *Deep veins: deep venous thrombosis, larger veins -May be asymptomatic in 50% of patients -May embolize to lungs

Answer 49

venous thrombosis

Question 50

* Atherosclerosis is a major cause * Results in loss of endothelial integrity and abnormal blood flow * Leads to MI, ischemia to organs (especially brain, kidney, spleen)

Answer 50

arterial and cardiac thrombosis

Question 51

* Widespread thrombosis within microcirculation * Consumption of platelets and clotting factors * May occur from complications in obstetrics, injuries, cancer, and more * Net result: excessive clotting and bleeding

Answer 51

DIC- disseminated intravascular coagulation

Question 52

May be a solid, liquid or gaseous mass, carried by the blood from its point of origin to a distant site

Answer 52

embolism

Question 53

area of ischemic necrosis caused by occlusion of the vascular supply to the affected tissue involvement of heart and brain is common complication

Answer 53

infarction

Question 54

where are most infarctions

Answer 54

arterial thrombosis or embolism

Question 55

infarctions are classified according to

Answer 55

color

Question 56

Red infarct: (Venous occlusion, loose tissue (ie: lungs), tissue with dual circulation, previously congested tissue, reperfusion injury)

Answer 56

contain hemorrhage

Question 57

white infarct (heart, liver, spleen)

Answer 57

arterial occlusion in solid organs

Question 58

this shock leads to irreversible tissue injury

Answer 58

prolonged shock

Question 59

A state in which diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia

Answer 59

shock

Question 60

three types of shock

Answer 60

cardiac hypovolemic septic