THROMBOTIC DISEASES AND EMBOLISM Flashcards
(42 cards)
DEFINE THROMBOSIS
THROMBOSIS:
THE FORMATION, DEVELOPMENT OR PRESENCE OF A THROMBI OR THROMBI
STATE 3 COMPONENTS OF VIRCHOW TRIAD.
- ENDOTHELIAL INJURY
- ABNORMAL BLOOD FLOW (STASIS OR TURBULENCE)
- HYPERCOAGULABILITY (PRIMARY OR SECONDARY)
WHAT IS THROMBUS?
THROMBUS:
A STATIONARY BLOOD CLOT ALONG THE WALL OF A BLOOD VESSEL, FREQUENTLY CAUSING VASCULAR OBSTRUCTION.
THROMBUS INVOLVED IN THE PATHOGENESIS OF: (CLUE: 5 DISEASE)
- MYOCARDIAL INFARCTION
- CEREBROVASCULAR DISEASE
- PERIPHERAL ARTERIAL DISEASE
- DEEP VEIN THROMBUS
- PULMONARY EMBOLISM
THE MOST COMMON SITES OF THROMBUS FORMATION WITHIN THE ARTERIAL SYSTEM ARE:
- LEFT ATRIUM
- LEFT VENTRICLE
- CAROTID ARTERIES
- ABDOMINAL AORTA
- LOWER LIMB VASCULATURE
WHEN DOES ARTERIAL THROMBOEMBOLISM OCCUR?
ARTERIAL THROMBOEMBOLISM OCCUR WHEN A PIECE OF THROMBUS TRAVELS FROM ITS SITE OF FORMATION TO A MORE DISTAL PART OF THE ARTERIAL CIRCULATION.
WHAT HAPPEN WHEN ARTERIAL THROMBOEMBOLISM OCCUR?
IT WILL CUTS OFF THE OXYGEN SUPPLY TO THE SUBTENDED TISSUE RESULTING IN ISCHEMIA AND IF THIS IS PROLONGED, TISSUE INFARCTION OCCUR.
EMBOLI FROM
1. THE HEART WILL TRAVEL TO THE ___
2. THE ARTERY WILL TRAVEL TO THE ___
- THE HEART WILL TRAVEL TO ANY ART OF THE ARTERIAL CIRCULATION
- THE ARTERY WILL TRAVEL TO THE DISTAL TO ITS SITE OF ORIGIN.
THE MOST COMMONLY AFFECTED ORGANS OR TISSUES IN ARTERIAL THROMBOEMBOLISM ARE:
1 BRAIN
2. UPPER OR LL
3. INTESTINE
WHERE DOES SUPERFICIAL VENOUS THROMBI OCCUR?
IN THE SAPHENOUS VEINS
WHERE DOES THE DEEP VEIN THROMBUS ALWAYS OCCUR?
IN THE DEEP LEG VEIN (EX: ILIAC VEIN, FEMORAL VEIN, POPLITEAL VEIN)
WHAT IS THE CM OF SUPERFICIAL VENOUS THROMBI?
- LOCAL CONGESTION
- SWELLING
- PAIN
- TENDERNESS
SUPERFICIAL VENOUS THROMBI CAN LEAD TO THE DEVELOPMENT OF
INFECTION
VARICOSE ULCERS
DEEP VEIN THROMBI IS (PRONE/RARELY) EMBOLIZE.
PRONE
MANY DVTS ARE (SYMPTOMATIC/ ASYMPTOMATIC)
SYMPTOMATIC
STATE 5 RF OF VENOUS THROMBOSIS
INHERITED RF
1. DEFICIENCY OF PROTEIN S
2. DEFICIENCY OF PROTEIN C
3. FACTOR V LAIDEN MUTATIONS
4. ANTITHROMBIN DEFICIENCY
MODIFIED RF
1. TRAUMA
2. SURGERIES ESP ORTHOPEDIC SURGERIES
3. BEDRIDDEN
4. OCP
5. PREGNANCY
STATE THE CM OF DVT
- DISTAL OEDEMA
- PAIN
- TENDERNESS
- REDNESS
- HEAT
- CYANOSIS
- SUPERFICIAL VEIN DILATATION
- SWELLING
DESC THE DEVELOPMENT OF THROMBUS
- THE FUNCTION OF THE VENOUS VALVE IS TO PREVENT THE BACKFLOW OF BLOOD AND CREATE A SLOW CIRCULATION IN THAT SPECIFIC AREA.
- FIBRIN, A FIBROUS CLOTTING PROTEIN, WILL ACCUMULATE IN THE SLOW MOVING VENOUS BLOOD TRAPPING THE BLOOD CELLS.
- FIBRIN TRAPPED BLOOD CELL COMBINE WITH PLATELET FORMING A PLATELET AGGREGATION.
- BY TIME, THE PLATELET AGGREGATION WILL INCREASES AND THIS WILL OCCLUDE THE BLOOD VESSEL CREATING A SLOWER CIRCULATION AS WELL AS LEADING TO SWELLING AND PAIN IN THE REGION.
WHAT IS POST THROMBOTIC SYNDROME?
POST THROMBOTIC SYNDROME OCCURS IN 1/3 OF PATIENT,
IT OCCUR AFTER MONTHS OR YEARS OF A LOWER LIMB DVT
VENOUS THROMBI THAT PERSIST CAN DESTROY VENOUS VALVES AND VENOUS RETURN IS IMPAIRED WHICH CAN LEAD TO VENOUS HPT
STATE THE SIGNS AND SYMPTOMS OF POST THROMBOTIC SYNDROME.
SYMPTOMS:
1. PAIN
2. CRAMPS
3. HEAVINESS
4. ITCHING
5. PARAESTHESIA
6. WORSE AT END OF THE DAY AND AFTER STANDING FOR LONG PERIODS
SIGNS
1. REDNESS
2. INDURATION
3. PATCHY HYPERPIGMENTATION
4. VENOUS ECTASIA
5. VENOUS ULCERATION
HOW TO PREVENT DVT?
- EARLY AMBULATION POST OPERATIVELY
- GRADUATED COMPRESSION STOCKING
- INTERMITTENT PNEUMATIC COMPRESSION DEVICES
- FOOT PUMPS
- ANTICOAGULANT THERAPY
- IVC FILTERS
DEFINE EMBOLUS.
EMBOLUS;
A DETACHED INTRAVASCULAR SOLID, LIQUID OR GASEOUS MASS THAT IS CARRIED BY THE BLOOD CIRCULATION TO THE DISTAL PART OF THE ORIGIN WHERE IT OFTEN LEAD TO TISSUE DYSFUNCTION OR INFARCTION.
STATE 3 DIFFERENT TYPES EMBOLISM.
- PULMONARY EMBOLISM
- FAT EMBOLISM
- AMNIOTIC FLUID EMBOLISM
PULMONARY EMBOLISM IS THE (MOST/LEAST) COMMON FORM OF THROMBOTIC EMBOLISM
MOST
