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7 PATH 1 > 3 SEQUELAE OF THROMBOSIS > Flashcards

3 SEQUELAE OF THROMBOSIS Flashcards

1
Q

What are the 6 types of Sequelae of Thrombosis?

A

1) Resolution
2) Organization
3) Racanalization
4) Propagation
5) Infarction
6) Embolism

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2
Q

What is Resolution?

A

Dissolving of a clot disappears on its own due to natural blood anticoagulation factor overcoming the thrombus formation factors

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3
Q

What is the LEAST dangerous sequela of thrombosis?

A

Resolution

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4
Q

What are 2 types of Resolution Thromboses?

A

In atherosclerosis and Transient Ischemic Attack TIA

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5
Q

What happens during Atherosclerosis in Resolution?

A

Thrombus disappears due to high fibrinolytic function

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6
Q

Resolution of Atherosclerosis thrombus leads to _____

A

A high chance of developing another thrombus

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7
Q

What happens in Transient Ischemic Attack (TIA) in Resolution of thrombus?

A

Decreased or blocked blood flow to the brain (ischemia) due to embolus - often clot that occludes a cerebral artery

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8
Q

After a short time in TIA, what happens?

A

Symptoms go away, TIA is a “mini stroke”

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9
Q

What is TIA a warning sign for?

A

A future stroke (neurological malfunction)

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10
Q

Define an Organization (sequelae of Thrombosis):

A

Thrombus doesn’t disappear, but it undergoes reorganization

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11
Q

What happens after Organization?

A

Replacement w/scar tissue (CT)

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12
Q

What happens during Organization?

A

Phagocytic digestion of the thrombus within 2-3 days after it forms

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13
Q

What does the replacement of CT mean in Organization?

A

Replacement with CT makes it non-contractile, this causes decreased blood flow, this causes recanalization

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14
Q

What is recanalization a result of?

A

Organization

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15
Q

What happens during Recanaliztion?

A

Endothelium is reformed, over the organized thrombus, fibrous tissue

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16
Q

What are Recanalizations?

A

Formations of canals w/in the thrombus (vessels within vessels)

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17
Q

What is Propagation?

A

Enlargement of thrombus size over time

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18
Q

Where does Propagation usually occur?

A

In veins

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19
Q

In areas of slow blood flow, what happens during Propagation?

A

In areas of slow blood flow, the thrombus serves as a site for further adherence and aggregation of platelets, propagating the thrombus

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20
Q

In arteries, what happens during Propagation?

A

Propagation is likely to happen in turbulent blood flow areas like bifurcations

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21
Q

Where else does propagation happen?

A

Valves, cardiac and venous

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22
Q

What is Infarction?

A

Process where an infarct is formed

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23
Q

What is the #1 cause of death in the US?

A

Infarction

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24
Q

What is an infarct?

A

Region of necrosis caused by O2 deficiency due to decrease in blood flow to that area

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25
Q

What are the 2 types of infarct?

A

white and red

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26
Q

What is White Infarct?

A

In tissues with only 1 blood vessels supply, artery, or vein

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27
Q

What is an example of White infarct?

A

Heart infarct: 1 blood supply (coronary artery)

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28
Q

What is a Red Infarct?

A

Red color in tissues with 2+ blood supplies

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29
Q

What is an example of Red infarct?

A

Lung Infarct: 2 blood supplies (pulmonary and bronchial art)

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30
Q

What is the most common form of Infarction?

A

Myocardial Infarction (infarct in the heart muscle)

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31
Q

What type of necrosis is associated with myocardial infarction?

A

Coagulative

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32
Q

What is Ischemic stroke associated with?

A

Infarction

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33
Q

What is ischemic stroke?

A

Brain infarct

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34
Q

What is the most common area for a stroke?

A

Brain

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35
Q

What type of necrosis is associated with Brain infarct?

A

Liquefactive Necrosis

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36
Q

What repairs lost brain tissue in Ischemic stroke?

A

Neuroglia repair lost brain tissue, no change in length (if CT repaired, it would decrease/shorten space)

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37
Q

What is Gliosis?

A

Replacement of damaged neurons without shrinking

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38
Q

What are the Factors leading to Infarction?

A

Thrombosis and Vasculitis (Aterial and Venous)

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39
Q

What is Thrombosis?

A

Obstruction of vessel lumen

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40
Q

What is the MC factor resulting in infarctions?

A

Thrombosis

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41
Q

If thrombosis occurs in Basilar Artery what happens?

A

Stroke

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42
Q

If thrombosis occurs in Coronary artery what happens?

A

Myocardial Infarction

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43
Q

What is the MC factor resulting in infarction?

A

Atherosclerosis (thrombosis)

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44
Q

What is Vasculitis?

A

Inflammation of vessel wall with decreased lumen

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45
Q

Where does Vasculitis predominantly occur?

A

In autoimmune diseases

46
Q

In Vasculitis, how many components of inflammation are present?

A

5 (ALL of them)

47
Q

What are the aka’s of Arterial Vasculitis?

A

Superficial Temporary artery/Temporal Arteritis/Giant Cell Arteritis/Actute Chronic Granulomatous Vasculitis/Horton’s Disease

48
Q

What is the most common autoimmune disease?

A

Giant Cell Arteritis

49
Q

What is Giant Cell Arteritis?

A

Inflammatory disease of the vessels to the head, especially the branches of the external carotid artery

50
Q

How is granuloma formed in Giant Cell Arteritis?

A

Dendritic cells recruit T cells and macrophages to form granuloma

51
Q

What age group is Giant Cell Arteritis?

A

> 50 year old and more in women 2:1

52
Q

What is the main symptom of Giant Cell Arteritis?

A

Headache

53
Q

What is visibly seen in Giant Cell Arteritis?

A

Inflamed arteries and tender upon palpation

54
Q

What are the symptoms of Giant Cell Arteritis?

A

Fever, Muscle Weakness, and Headache

55
Q

If ophthalmic artery is affected in Giant Cell Arteritis, what can happen?

A

Temporary loss of vision that may result in permanent loss if not treated

56
Q

What is the ONLY treatment for Giant Cell Arteritis?

A

Corticosteroids therapy because they inhibit the granuloma pathway (prednisone) 1 month

57
Q

What condition is Giant Cell Arteritis often accompanied by?

A

Polymyalgia Rheumatic

58
Q

What is Polymyalgia Rheumatic?

A

Seen in 50% of patients with Temporal Arteritis, it causes pain and stiffness in hip and shoulder muscles

59
Q

Para esophageal hernia is associated with what?

A

Venous Vasculitis

60
Q

Para esophageal hernia aka

A

Hiatal Hernia

61
Q

What happens during Para esophageal hernia?

A

Stomach protrudes from the abdomen through the hiatus into the thoracic cavity

62
Q

What happens with flexion/compression of the diaphragm? (para esophageal hernia)

A

VEINS of the stomach are occluded preventing outflow of venous blood

63
Q

What happens with Arteries during flexion/compression of the diaphragm?

A

The arteries are NOT occluded because the pressure in the arteries is higher than the pressure exerted by diaphragmatic compression

64
Q

What does Para Esophageal Hernia lead to?

A

Increased Hydrostatic pressure in the veins. As the pressure increases, it eventually becomes so high that it equals the pressure in the arteries, this causes stasis = no new blood tissue = infarction = gangrene

65
Q

What are the 2 syndromes associated with Venous Vasculitis?

A

Para esophageal hernia aka Hiatal Hernia and Sheehan’s Syndrome (aka postpartum syndrome)

66
Q

What is Sheehan’s Syndrome associated with?

A

Anterior Pituitary (adenohypophysis) doesn’t have an arterial blood supply and instead receives blood via a venous plexus only

67
Q

During normal pregnancy what happens?

A

The ant. pit. hypertrophies due to an increased demand in hormones

68
Q

What happens normally after delivery of pregnancy?

A

The ant pituitary undergoes physiological shrinkage due to a decreased need for hormones (normal)

69
Q

What happens during complications of Sheehan’s Syndrome?

A

Hemorrhaging from the uterus, the body responds with vasoconstriction as well as constriction of the venous plexus supplying the anterior pituitary

70
Q

What can Sheehan’s syndrome lead to?

A

Total Venous constriction and damage to the hypophysis = necrosis and loss of function of anterior pituitary

71
Q

What are the factors affecting infarction?

A

1) Tissues innate vulnerability to hypoxia
2) Pattern of Vascular supply
3) Oxygen delivering capacity of the blood
4) Rate of occlusion development

72
Q

What tissues have the highest vulnerability to Hypoxia from MOST to least?

A

1) BRAIN
2) Heart
3) Lungs
4) Kidney
5) Liver (least)

73
Q

What is under “Pattern of Vascular Supply?”

A

Anastomosis

74
Q

What is an Anastamosis?

A

The union of branches of 2+ arteries supplying the same region

75
Q

What is the purpose of Anastomosis?

A

Allows you to overcome infarction, and exercise increases anastomoses of the heart

76
Q

Who is likely to die from Infarction?

A

Young people die from infarction more than older b/c younger ppl haven’t developed Anastomoses yet

77
Q

What is under “Oxygen Delivering capacity of the bloods?”

A

Amount of RBC, hemoglobin in RBCs (Hb binds O2 in RBCs)

78
Q

What disease is associated with “Oxygen delivering capacity of the bloods?”

A

Anemia: Decreased amount of RBC, and/or Hb in RBC’s.

79
Q

With anemia the probability ______

A

Of infarction is increased

80
Q

If you have a slow rate of occlusion, what does this cause?

A

Possible development of anastomosis

81
Q

Fast rate of occlusion causes -

A

No anastomosis - infarction is very probable, death may occur

82
Q

What is involved with the coronary artery in “Rate of Occlusion”?

A

% of blockage determines if symptoms are experienced

83
Q

What normally happens in the coronary artery?

A

Usually develops slowly, patient doesn’t experience symptoms until blockage is > 75% (3/4 lumen blocked) = Atherosclerosis

84
Q

What is an Embolism?

A

Sudden occlusion of a blood vessel by an Embolus

85
Q

What is an Embolus?

A

Abnormal mass moving through bloodstream, liquid, solid, or gas. (anything other than serum, RBCs, WBCs, and platelets (blood clot, fat, foreign particle)

86
Q

What is a thromboembolism?

A

**MOST COMMON TYPE OF EMBOLISM; piece of thrombus BREAKS off

87
Q

What are the 2 types of Thromboembolism?

A

Venous and Arterial

88
Q

Where are the 2 places Venous Thromboembolism can occur?

A

LEGS and GI

89
Q

Where is the most common location of thrombi?

A

LEGS**

90
Q

What is significant about a thrombi in legs?

A

It can easily flow to the heart because vein lumen size increases as it approaches the heart

91
Q

When the thrombi coming from the legs reaches the lungs, what happens?

A

It STOPS and obstructs blood flow there - Infarction in lungs is (not dangerous, but painful)

92
Q

A venous thromboembolism will always end _____

A

In the LUNGS, and therefore, embolisms always end in the lungs (one exception)

93
Q

What is one exception to embolisms always ending in the lungs?

A

It reaches GI

94
Q

Any embolism that occurs in the GI will be seen in _____

A

The liver

95
Q

What is the route of embolism in the Liver?

A

It travels to the liver via hepatic portal vein (vena porta)

96
Q

Where will embolism stop in the liver?

A

Stops in the capillaries, liver infarction, PAINLESS and you will have detoxing problems

97
Q

Where does thrombus form in Arterial Thromboembolism?

A

Forms in the left atrium or Left ventricle

98
Q

What is the sequence in an arterial thromboembolism?

A

Left ventricle/atrium, then through aorta, then well supplied organs (heart, brain 20%, spleen, and kidneys), then likely to stop thrombus

99
Q

What is a thrombus in the heart?

A

Myocardial ischemia

100
Q

What is a thrombus in the brain?

A

Ischemic stroke

101
Q

What are the sources of thrombus in the heart?

A
  • mitral stenosis
  • subacute bacterial endocarditis
  • artificial valve
102
Q

What is subacute bacterial endocarditis?

A

Bacterial infection in the heart - valves full of bacterial colonies - colonies can travel throughout the body and to the brain

103
Q

What is most common cause of ischemic stroke?

A

Subacute bacterial endocarditis

104
Q

What is a fat embolism?

A

From long bone fracture

105
Q

What is the source of fat embolism?

A

Yellow Marrow, develops 1-2 days after fracture

106
Q

Where does fat embolism enter?

A

Enters venous circulation and goes to the lungs

107
Q

What happens when a fat embolism crosses the capillaries?

A

Travels in reverse direction to the brain, and this is called a purpuric brain hemorrhage

108
Q

Air Embolism aka

A

Air lock, Bends/Caisson disease, Diver’s disease/compression sickness

109
Q

What happens during an Air embolism?

A

Gas in vessels block fluid flow = air lock

Air embolism blocks blood flow

110
Q

What happens during Bend’s Disease?

A

Nitrogen bubbles in blood from coming up to the surface too quickly.

111
Q

How do you help Bend’s Disease?

A

Put pts right side up because this puts gas in pulmonary vein so you can breathe it out

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