8-6 Circulation Dz Flashcards
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Hyperemia vs. Congestion
A: [Active Hyperemia] = Sympathetic discharge or chemical mediators cause INC vasodilation of arterioles/arteries and INC intravascular blood volume (ex. acute inflammation of tissue). Skin appears red and warm and oxygenated.
B: [Congestion - passive hyperemia] = Impaired venous drainage causes nutmeg liver, lung problems and Hepatic necrosis. Congestion occurs because of R heart failure. Skin appears BLUE-RED and DeOxygenated.
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A: Edema (AKA 3rd Spacing)= accumulation of fluid around [interstitial spaces around the cell] or body cavities such as around heart / peritoneal cavity and pleura of lungs.
A2: Normally, interstitial fluid around cells that has accumulated is removed by lymphatic drainage.
B: There are different types of Edema
1. [Inflammatory Edema] = Tissue damage —> inflammation in the area which affects blood flow/hydrostatic pressures/vascular permeability—> INC fluid accumulation in [interstitial space around cells] . This fluid is referred to as EXUDATE.
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2. Non-Inflammatory Edema produces TRANSUDATE
2a) INC hydrostatic pressure
2b) DEC plasma oncotic pressure
2c) Lymphatic Obstruction
2D) Salt/Water Retention
2E) hypOproteinemia 2º to Kwashiorkor or hepatic failure
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Hemostasis = Process that normally prevents clotting and maintains blood in a liquid state; flowing fluidly! It also refers to clot regulation in ABNORMAL VESSELS THAT HAVE BEEN DAMAGED.
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A: Hemorrhage = Blood flow from a ruptured blood vessel into a body cavity, tissue or outside the body. Can be caused by trauma, neoplasm or inflammatory damage to a blood vessel.
B: Physiological hemorrhaging = female menses
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A: Thrombosis = Formation of a [thrombus blood clot] within an uninterrupted vascular system. Is associated with [Virchow’s Triad for thrombosis] which list 3 different causes that are related:
- Endothelial Injury (MOST IMPORTANT FACTOR) (ex. acute inflammation and atherosclerosis)
- Abnormal Blood Flow [stasis vs. turbulence] (ex. aFib or Prolonged immobilization)
- Hypercoagulable state (ex. [Protein C Deficiency] or [women on BCP but also uses tobacco]
Hypercoagulable [Abnormal blood flow] —->Hypercoagulable
Any of the factors alone can lead to Thrombosis
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A: Embolism = an intravascular substance (solid vs. liquid vs. gas) that develops in what part of the body and TRAVELS IN BLOOD to another part
- solid = example could be piece of a thrombus (thromboembolism) that travels OR microscopic fat molecule from long bone injury or soft tissue injury
- liquid= example could be amniotic fluid that breaks into placental membranes and/or uterine vein ruptures and allows fluid to leak out (uncommon but serious!)
- Gas = air bubble during medical procedure OR Decompression Sickness with scuba divers when nitrogen gas is compressed into air bubble
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A: Infarction = an AREA of [ischemic necrosis] in a tissue or organ typically caused by an arterial or venous occlusion from thromboembolisms
Types of Infarct!
1a: White Infarct = Arterial occlusion to a single-perfused organ leads to TOTAL ISCHEMIA [spleen/kidney/heart]
1B: RED INFARCT= VENOUS occlusion OR occlusion of Dual-perfused organs –> Hemorrhage [Lungs/ loose tissue organs]
B: 4 Factors influence the potential onset of Infarct
1) Vascular Supply
2) Levels of O2 in the blood
3) Rate of Formation of the occlusion
4) Vulnerability of the tissue to hypoxia
C: 2 Major things dictate if a pt can survive a thrombus
- Degree the occlusion is blocking the vessel
- Size and location of the occluded blood vessel
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SHOCK = final common pathway for many events. Consist of severe hypOperfusion of tissues typically due to DEC [effective circulating blood volume] or DEC [Cardiac Output]
3 types:
1) Cardiogenic Shock = [DEC Cardiac Output] due to myocardial pump failure
2) hypOvolemic Shock = [DEC Cardiac Output] due to loss of effective circulating blood volume
3) Sepsis = systemic immune response to pathogen causes global arteriolar vasodilation and venous pooling–> hypOperfusion of tissues
