Unit 1.7 Ischemia, Infarction, Shock Flashcards

1
Q

a deprivation of adequate blood supply to a given tissue

A

ischemia

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2
Q

a localized area of necrosis produced by either blockage of the arterial blood supply or venous drainage of a part

A

infarction

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3
Q

Not sharply demarcated. Looks like severe peripheral passive hyperemia. Red to dark red to almost black. Swollen

A

Venous Infarct

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4
Q

What’s the biggest gross difference between a venous and arterial infarct?

A

arterial infarcts are sharply demarcated while venous infarcts are not

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5
Q

Why are old infarcts pale in color?

A

red infarcts gradually become pale due to lysis of RBCs

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6
Q

Why are healed infarcts pale and depressed?

A

because they are composed of fibrous CT (scar tissue)

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7
Q

Three main things that can cause an infarct:

A

thrombus, edema, external pressure/constriction

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8
Q

Effect and significance of infarction depends on (6):

A
  1. degree of collateral circulation provided
  2. gen. status of circulation
  3. vulnerability of tissue to ischemia
  4. invasion of saprophytes –> gangrene –> toxemia
  5. septic vs. bland
  6. extent of involvement
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9
Q

Why is it important to ischemia and infarction?

A

usually occur over a short period of time and cause severe debilitation or even sudden death

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10
Q

An arterial infarct will often be what shape?

A

wedge-shaped

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11
Q

A venous infarct will strongly resemble:

A

peripheral passive congestion

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12
Q

When infarcts heal, the dead tissue is replaced by:

A

fibrous connective tissue

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13
Q

What’s the name for wall-to-wall hemorrhage?

A

“transmural” hemorrhage

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14
Q

pulmonary infarct will always be:

A

red and hemorrhagic

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15
Q

Why is an infarct in the GI always bad?

A

b/c the dead tissue is immediately attacked by bacteria that readily break through the mucosal barrier

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16
Q

occurs when infarcted tissue is invaded by saprophytic bacteria

17
Q

compromises the supply not only of oxygen, but also metabolic substrates (glucose)

18
Q

Why are ischemic tissues injured more rapidly and severely than hypoxic tissues?

A

loss of supply of oxygen AND metabolic substrates

19
Q

List the 4 causes of ischemia:

A

pressure, vascular constriction, thrombi, thromboemboli

20
Q

Ischemia typically leads to:

A

infarction with coagulative necrosis

21
Q

What do most infarcts result from?

A

thrombotic or embolic events in arteries

22
Q

Although venous thrombosis may cause infarction, it usually results in:

A

venous obstruction and congestions

23
Q

When are infarcts caused by venous thrombosis more likely?

A

in organs with single venous outflow (i.e. testis, ovaries)

24
Q

Describe a typical infarct lesion:

A
  • Sharp line of demarcation between normal and necrotic tissue
  • Early on, the line of demarcation is surrounded by a zone of hyperemia
25
What colors are infarcts in tissues with dual circulation (i.e. liver, kidneys)?
red, dark purple
26
What colors are infarcts in solid organs? Why?
pale; frequently start out red due to back flow of blood and leakage of blood from injured vessels, but they rapidly become pale as RBC's and tissue proteins break down
27
Venous infarcts are caused by:
obstructed veins (starts as passive congestion)
28
Necrosis in a venous infarct occurs:
secondary to hypoxia
29
Why do the infarction of arteries have sharp lines of demarcation?
delineate the vascular field of that particular artery (often wedge shaped)
30
What is the earliest change in response to ischemia/necrosis?
cell swelling and disintegration of mitochondria