Test 1: lecture 8 circulatory disturbances Flashcards
1
Q
function of circulatory system
A
Deliver nutrients to & remove waste products from cells
Circulate fluid & cells to maintain homeostasis & integrate function
2
Q
breakdown of water inside the body
A
3
Q
what is the outward pressure in blood vessels
A
hydrostatic
4
Q
what is the pull caused by proteins called
A
osmotic pressure
5
Q
fluid accumulation in tissues
A
edema
6
Q
fluid accumulation in body cavities
A
effusion
7
Q
Imbalance between intravascular & interstitial compartments cause ____
A
fluid accumulation in the interstitium
8
Q
what does edema look like microscopically
A
9
Q
4 causes of edema/effusion
A
increased vascular permeability
- increased intravascular hydrostatic pressure
- decrease plasma colloid osmotic pressure
- decrease lymphatic drainage
10
Q
an increase or decrease in osmotic pressure would cause edema
A
decrease (osmotic pressure pulls fluid back into the blood vessels)
11
Q
how does inflammation cause increased vascular permeability?
A
local release of inflammatory mediators such as histamine, bradykinin and leukotrienes
12
Q
increased hydrostatic pressure is due to ___
A
increased blood volume in microvasculature
(localized or generalized)
due to impaired venous outflow
13
Q
increased intravascular hydrostatic pressure is usually due to impaired ___
A
venous outflow (passive congestion)
14
Q
2 common ways to have low protein
A
protein loss through the kidneys or GI
or decreased protein synthesis due to liver failure or poor nutrient
15
Q
hypoproteinemia causes ___ plasma colloid osmotic pressure
A
decreased → leads to edema
16
Q
edema caused by low osmotic pressure is usually generalized or local?
A
generalized (all over decrease in protein, either from loss or from decreased synthesis)
17
Q
what are some causes of decreased lymphatic drainage
A
Compression or blockage due to trauma, fibrosis, invasive neoplasms, infectious agents, or congenital malformation (rare)
18
Q
lymphatic obstruction would increase or decrease lymphatic drainage
A
decrease (blockage in vessel prevents it from carrying away lymph)
19
Q
where are two places edema is bad
A
cerebral and pulmonary/thoracic
(have no place to swell)
20
Q
primary hemostasis is mediated by ___
A
platelets
21
Q
secondary hemostasis is mediated by ___
A
clotting factors
22
Q
what happens during primary hemostasis
A
vasoconstriction→ tries to reduce size of injury
collagen in wall of vessel exposed and triggers vWF to cause platelets to bind and clump
23
Q
what happens during secondary hemostasis
A
tissue factor cause coagulation cascade → thrombin formation which leads to fibrinogen into fibrin
24
Q
___ is blood loss from the
circulatory system
A
hemorrhage
25
3 causes of hemorrhage
blood vessel injury
decreased platelets
decreased clotting factor
26
decreased number of platelets can be caused by
**platelets not being made, not working right or being destroyed or used up**
decreased production of platelets
increased consumption/destruction
decreased function
27
what kind of cells make most clotting factors
hepatocyte in the liver
28
many clotting factors are vitamin ___ dependent
K
needs to be recycled
29
hemorrhage is bad where?
30
\_\_\_ is inappropriate clotting within the circulatory system
thrombosis
31
aggregate of platelets, fibrin, & other blood elements formed on
a vessel or heart wall
thrombus
32
If a thrombus (or fragment of a thrombus) breaks loose and enters the circulation, it becomes a \_\_\_\_
thromboembolus
33
when a piece of a blood clot breaks off and travels it is called a \_\_\_
thromboembolus
34
embolus
any mass (solid, liquid, or gas) carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or necrosis
35
\_\_\_ = any mass (solid, liquid, or gas) carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or necrosis
embolus
36
embolism
| (bone marrow in lung tissue)
37
what do thrombi look like
dull, rough, red/tan, friable
laminated
can be occlusive or non occlusive
38
difference between thrombi and postmortem blood clot
**thrombi:** dull, rough, red/tan, friable, laminated
**postmortem:** shiny, smooth, gelatinous
39
thrombi or post mortem clot?
**thrombi** → dull, rough, red/tan, friable
40
3 sides of virchow's triad
41
endothelial injury, abnormal blood flow and hypercoagulability are all part of \_\_\_
virchow's triad
| (cause a clot)
42
If thrombosis is widespread, it can lead to a ___ & subsequent \_\_\_
consumptive coagulopathy
hemorrhage
(DIC- too much clotting, use up all the factors, flips and leads to uncontrolled bleeding)
43
Systemic \_\_\_\_influences help maintain adequate blood flow to the tissues
neural & hormonal
44
\_\_\_\_= active engorgement of a vascular bed due to vasodilation & increased flow
hyperemia
45
passive engorgement of a vascular bed due to decrease outflow
congestion (blood not draining well)
46
hyperemia vs congestion
**hyperemia: active** increase of blood to an area→ vasodilation and increased blood flow
**congestion:** decrease in blood draining **(passive)** (CHF or obstruction)
47
CHF is an example of hyperemia or congestion
congestion (passive inability to move blood out)
blood pooling
48
grossly what does hyperemia look like
warm and bright red due to increased oxygenated blood to an area
(running get flushed)
49
grossly what does congestion look like?
cool and dark red/purple
pooling of deoxygenated blood
stagnation
50
Inadequate tissue perfusion
ischemia
51
ischemia
decreased blood flow caused by obstruction, congestion or decreased cardiac output
52
what three things happen during ischemia
decreased O2 delivery
decreased nutrient delivery
decreased waste removal
53
what organs are most susceptible to ischemia
brain and heart
high O2 need and poor collateral circulation
54
area of tissue necrosis due to ischemia
infract
cell death of tissues due to decreased blood flow
55
acute/subacute phase of infarct look \_\_\_
wedge shaped
swollen and dark red (hemorrhagic) or tan
56
chronic infracts grossly look \_\_\_
depressed, tan and firm
tissue has been replaced by fibrous material that shrinks during healing
57
a state of general circulatory failure that impairs tissue perfusion → cellular hypoxia ± cell injury & death
shock
58
cardiogenic shock
decreased cardiac output from heat failure
(pump doesn't work)
59
decreased cardiac output due to heart (pump) failure
cardiogenic shock
60
hypovolemic shock
decreased circulating blood volume due to massive fluid loss/hemorrhage
61
HYPOVOLEMIC SHOCK
heart/pump fine but not enough blood to pump through body due to fluid loss
(hemorrhage, diarrhea, vomiting, burns)
62
distributive shock
decreased peripheral vascular resistance with pooling of blood in peripheral tissue due to sepsis, anaphylaxis
vasodilation
63
decreased peripheral vascular resistance with pooling of blood in peripheral tissues due to sepsis, anaphylaxis, etc.
distributive shock
64
When that fluid accumulates in tissues
edema
65
mesocolonic edema
## Footnote
translucent yellow jelly- like appearance due to accumulation of fluid in the interstitial space.
66
"bottle jaw" refers to fluid build up \_\_\_
submandibular edema
67
"brisket edema"
pectoral edema
68
When excess fluid accumulates in a body cavity, we call it an \_\_\_
EFFUSION.
69
hydrothorax
70
hydropericardium
71
serous effusion in the peritoneal cavitity
hydroperitoneum
ascites
72
ascites
serous effusion in the peritoneal cavity
73
ASCITES
serous effusion in the peritoneal cavity
74
4 causes of edema
75
increased vascular permeability, which occurs during \_\_\_
inflammation
76
Inflammatory stimuli lead to local release of inflammatory mediators that cause ____ of the gaps between vascular \_\_\_\_cells.
vasodilation and widening
endothelial
77
exudate
fluid, proteins and cells that leave vessels due to increased vascular permeability, high specific gravity
leakage of plasma proteins and emigration of leukocytes
78
urticaria (hives)
dermal edema
79
blue → eosinophilic inflammation
green → edema
80
increased intravascular hydrostatic pressure can be due to an active increase in blood flow into the microvasculature called \_\_\_
hyperemia
81
hyperemia can be caused by acute inflammation or by \_\_\_
congestion - passive accumulation of blood due to impaired venous outflow
82
passive accumulation of blood due to impaired venous outflow.
(CONGESTION)
83
congestion causes increased blood volume that will increase ___ that will drive fluid from the intravascular compartment into the interstitium, resulting in \_\_\_
hydrostatic pressure
localized edema.
84
right sided heart failure
blood backs up into the body → SQ edema and ascites (cavitary effusions)
85
left sided heart failure
blood backs up into the lungs
pulmonary edema
86
**pulmonary edema**
heavy and exude frothy or watery (serous) fluid when incised
Fluid also expands the connective tissue septa of the lung, giving the septa a widened gelatinous appearance
87
pulmonary edema vs pleural effusion
pulmonary edema- fluid buildup **in the lungs**
pleural effusion- fluid buildup **around the lungs**
88
Low plasma protein concentration
hypoproteinemia
89
2 ways to have decreased osmotic pressure
protein loss through GI or kidneys
decreased protein synthesis (liver failure)
90
insufficient intravascular colloid osmotic pressure for fluid resorption from the interstitium, leading to \_\_\_
generalized edema.
91
what plasma protein is important for osmotic pressure
albumin
92
In cases of end-stage liver disease, there is decreased functional hepatic mass, which leads to decreased synthesis of plasma proteins by the liver. The resulting hypoproteinemia leads to decreased ___ and subsequent \_\_\_
plasma colloid osmotic pressure
edema/effusion
93
cirrhosis of the liver
94
cirrhosis will cause decreased ___ and increased \_\_\_
osmotic pressure → edema
hydrostatic pressure → fibrosis will impede normal hepatic blood flow and increase hydrostatic pressure which leads to ascites (edema in body cavity)
95
ascites
can be caused by increased hydrostatic pressure or decreased osmotic pressure from liver damage
96
Decreased lymphatic drainage can be the result of lymphatic vessel ___ and is usually localized to a particular region.
compression or blockage
97
congenital lymphedema.
lymph vessels do not grow all the way→ blunt end
leads to build up of lymph → edema
98
(mechanisms intended to seal an injured vessel and prevent blood loss
hemostasis
99
3 causes of hemorrhage
blood vessel injury
decreased platelets
decreased clotting factors
100
\_\_\_ is required for normal collagen cross-linking, which helps maintain the integrity of blood vessel walls
Vitamin C→ scurvy
101
periarticular
occur around a joint
102
scurvy in guinea pigs
low Vit C leads to misformed collagen → weak cell walls → hemorrhage near joints
periarticular hemorrhage
103
scurvy
low Vit C → can't make collagen correctly
vessels are weak and prone to periarticular hemorrhage
104
3 reasons to have low platelets
decreased platelet production
increased consumption or destruction of platelets
decreased platelet function
105
Without adequate platelets, primary hemostasis (formation of a platelet plug) cannot be achieved after blood vessel injury, resulting in \_\_\_
hemorrhage.
106
formation of a platelet plug
primary hemostasis
107
(low platelet count
thrombocytopenia
108
the cells responsible for production of platelets in the bone marrow
megakaryocytes
109
formation of a fibrin meshwork
secondary hemostasis
110
rodenticide poisoning leads to ___ why?
hemorrhage
messes up coagulation factor → Vit K can't be recycled
Anticoagulant rodenticides contain **vitamin K antagonists**, such as warfarin or brodifacoum, that inhibit **vitamin K epoxide reductase** in the liver, leading to decreased amounts of active reduced vitamin K. Without active vitamin K, there is decreased production of vitamin K-dependent coagulation factors (II, VII, IX, and X). This acquired clotting factor deficiency can result in **severe hemorrhage.**
111
HEMARTHROSIS
blood in a joint cavity (we see this a lot in horses with traumatic racing injuries
112
blood in a joint cavity (we see this a lot in horses with traumatic racing
injuries
HEMARTHROSIS =
113
cardiac tamponade
When fluid accumulates in the pericardial sac, it can put pressure on the heart and prevent the heart from filling normally with blood
114
Very small hemorrhages (up to ~ 1-2 mm diameter) on the skin, mucosal, or serosal surfaces are referred to as
petechiae (petechia singular)
115
larger hemorrhages (up to ~ 2-3 cm diameter) are referred to as
ecchymoses (ecchymosis)
116
petechia
ecchymoses
117
Leakage of blood from injured vessels beneath an intact surface (such as the skin) is known as \_\_\_
contusion or bruise
118
If blood accumulates in a tissue to the point that it forms a visible mass, it is called a \_\_\_
hematoma
119
Virchow's triad
120
another name for saddle thrombus
Feline Aortic Thromboembolism, or FATE
121
thrombus look \_\_\_
dull, rough, red/yellow and friable
122
thromboembolus in cats usually occur because of \_\_\_
hypertrophic cardiomyopathy (HCM)
## Footnote
the left ventricular myocardium hypertrophies and the left atrial chamber dilates. **Dilation of the left atrium** leads to alterations in blood flow (stasis or turbulence), which predispose to thrombus formation on the atrial wall (indicated by the green arrow in the image below). Thrombi are friable and can easily break apart, sending fragments (thromboemboli) into the circulation that can lodge at distant sites like the aortic bifurcation and block blood flow.
123
what two colors can be found in a post mortem clot
currant jelly
chicken fat
124
decreased tissue perfusion
ischemia
125
If perfusion is not rapidly restored, the tissue normally supplied by the affected vessel can undergo ___ due to insufficient blood supply.
coagulative necrosis
126
area of tissue necrosis caused by ischemia
infarct
127
\_\_\_ are usually sharply demarcated and angular or wedge-shaped.
Infarcts
128
renal infarct
129
**splenic infarcts** from a dog. The infarcts are the discrete swollen angular tan foci with dark red (hemorrhagic) rims (separated by the lighter red splenic parenchyma).
130
These are **cutaneous infarcts** from a pig. The infarcts are the discrete rhomboidal red foci. These lesions are caused by **Erysipelothrix rhusiopathiae infection**, and the condition is commonly referred to as "**diamond skin disease"** (you can guess why). This bacterial infection causes necrosis of dermal blood vessels, which leads to thrombosis and cutaneous infarcts.
131
Active engorgement of a vascular bed
hyperemia caused by inflammation or increased metabolic activity
132
HYPEREMIA usually occurs due to ____ or \_\_\_metabolic activity
inflammation
increased
133
Hyperemic tissues are usually \_\_\_due to increased delivery of \_\_\_
warm and bright red
oxygenated blood.
134
Passive engorgement of a vascular bed
congestion → passive
135
CONGESTION usually occurs due to decreased \_\_\_
venous outflow.
136
Congested tissues are usually ___ due to accumulation of \_\_\_blood.
cool and dark red to blue
deoxygenated
137
right sided heart failure
leads to build up in body
SQ edema and ascites
138
left sided heart failure
build up in the lungs
pulmonary edema
139
left-sided heart failure.
The patchy dark red coloration of the lungs is due to ____ (passive accumulation of blood in the pulmonary venous system). The excess blood causes ____ that drives fluid out of the vessels into the interstitium, resulting in pulmonary edema.
pulmonary congestion
increased hydrostatic pressure
140
right-sided heart failure.
The regular pattern of dark red coloration is due to ___ (passive accumulation of blood in the vasculature) in the centrilobular regions of the liver. This condition is often referred to as \_\_\_
hepatic congestion
nutmeg liver
141
nutmeg liver caused by right sided heart failure
