Circulatory Flashcards
What is homeostasis?
ARREST BLEEDING by physiological properties of vasoconstriction and coagulation OR by surgery
Homeostasis is normally _________ and _________.
Antithrombotic & Profibrinolytic
What are the 2 things endothelium release?
- NO (vasodilator) - Endothelin (vasoconstrictor)
Define EDEMA
It is excess extracellular water (interstitial space/body cavities)
Name the 4 causes of edema:
- Increased blood hydrostatic pressure - Decreased plasma oncotic pressure - Lymphatic obstruction - Increased vascular permeability
______ and ______ are 2 ways you can increase blood hydrostatic pressure.
- generalized (CHF) - localized
How can there be decreased plasma oncotic pressure?
Proteins are not absorbed from diet Proteins may not be produced Or the may be protein loss
How can there be increased vascular permeability?
INLAMMATION
Inflammatory Edema:
EXUDATE -protein rich -high specific gravity
Non-Inflammatory Edema:
TRANSUDATE -protein poor -low specific gravity
On gross exam, tissue is wet, gelatinous/heavy, swollen organs, and may be yellow in color. This reprints…
EDEMA
What is the histological appearance of edema?
- Clear staining (non-inflam) - Pale eosinophilic (inflam) - Spaces distended - Blood vessels filled with RBC - Lymphatic are dilated - Collagen separated
Define: Pitting Edema
Pressure applied to an area of edema and a depression remains once you take pressure away from the area
Define: Hydrothorax
Fluid in the thoracic cavity
Define: Ascites/Hydroperitoneum
Fluid (transudate) in the peritoneal cavity
Define: Anascara
Generalized edema in SQ tissues
Define: Submandibular Edema
“Bottle Jaw” - related to parasites which cause hypoproteinemia
__________: is defined as transudate fluid in the pericardial sac
Hydropericardium
Describe Hydropericardium
NON INFLAMMATORY Fluid is clear/watery Transudate
__________: is defined as educate fluid in pericardial sac
Pericardial Effusion
Describe Pericardial Effusion
INFLAMMATORY Fluid is cloudy with strands of fibrin Educate **THINK MULBERRY DISEASE
Where is pulmonary edema located?
The lungs
If there is pulmonary edema cause by a circulatory failure (CHF), is it inflammatory OR non-inflammatory?
Non-Inflammatory
If there is pulmonary edema caused by pneumonia, is it inflammatory or non-inflammatory?
Inflammatory
ARDS stands for…
Acute Respiratory Distress Syndrome
What kind of edema will you see with ARDS?
Pulmonary Edema > Inflammatory > Pneumonia
Chronic pulmonary edema is associated with…
Left-sided heart failure
What does chronic pulmonary edema do?
Thickens alveolar walls -Congestion > accumulation of heart failure cells
What are Heart Failure Cells?
Macrophages in the alveoli
What type of stain will you use to see Heart Failure Cells?
Iron Perl Stain
Iron Perl Stain does what?
It stains hemosiderin, which are in the HFC that have been eating the backed up blood
What condition do you expect to see a lot of heart failure cells with?
LEFT SIDED HEART FAILURE
Define: Hyperemia
Increase of blood in the arterioles
Give examples of Physiological Hyperemia
Digestion, exercise, dissipate heat, neuromuscular (blushing)
Give examples of Pathological Hyperemia
Normally caused by inflammation and can be associated with edema
Define: Congestion
Increase of blood in the venules
What are the 2 types of congestion?
Localized and Generalized
Give an example of localized congestion:
Obstruction
Give an example of generalized congestion:
Systemic changes
Congestion color:
Blue - non-oxygenated
Hypermedia color:
Red - oxygenated
What is Hemorrhage?
Escape of blood from the blood vessels. Internal AND External.
Give examples of Internal and External hemorrhage:
Internal= Bleeding that we might not see External= We can see the blood leaving the body
-Trauma - Sepsis, viremia, bacteremia, toxins - Abdominal neoplasia > Hydroperitoneum - Coagulation abnormalities ALL CASUE:
Hemorrhage
Hemorrhage is determined by location and severity. T or F?
TRUE
Hemorrhage in the brain or heart is…
Fatal
Hemopericardium (blood in pericardial sac) results in…
Fatal cardiac tamponade
How is hemorrhage different from hyperemia/congestion?
Hemorrhage is OUTSIDE the vessel walls Hyperemia/Congestion is INSIDE the vessel walls
What is Hemorrhage by Rhexis?
A vessel bursts (b/c of a tear in the vascular wall)
Dissecting Aneurysm is a result of…
Copper Deficiency
Hemorrhage by Diapedesis>
Due to a small defect in the vessel wall. -congestion & inflammation
Hemorrhage by Diathesis>
Due to increased hemorrhages from INsignificant injuries -such as a clotting disorder
Blood in the thoracic cavity is called…
Hemothorax
Blood in the peritoneal cavity is called…
Hemoperitoneum
Blood in a joint space is called…
Hemarthrosis
Coughing up blood is called…
Hemoptysis
Bleeding from the nose is called…
Epitaxis
Petechia is a type of hemorrhage, what size is it?
1-2mm
Ecchymosis is a type of hemorrhage, what size is it?
1-2cm
Classify Suffusive Hemorrhage:
Larger and continuous
Describe Paint-Brush Hemorrhage:
Looks liked it was “painted” on tissue
What kind of hemorrhage is normal/usual to see in a cow that was slaughtered at a slaughter house?
Agonal Hemorrhage
Define Agonal Hemorrhage:
Petechiae & ecchymoses in the heart associated with terminal hypoxia. Usually seen in cows from slaughter houses.
What is the organization of a hematoma?
Fibrin + RBCs surrounded by vascular connective tissue. macrophages will phagocytize. Hemoglobin > Bilirubin > Hemosiderin
____________: Arrest of bleeding by physiological or surgical means. This is a normal response to prevent blood loss.
Hemostasis
What is the pathological form of Hemostasis?
THROMBOSIS
Define Thrombosis:
Inappropriate activation of the normal hemostatic process
What are the components of THROMBOSIS?
- Vascular Wall (endothelium) - Platelets - Coagulation
What happens in NORMAL hemostasis?
Immediately after injury, VASOCONSTRICTION occurs. This is done by secretion of endothelin. This does not last though, we nee something else or injury will continue to bleed
Tissue Injury > ____________ > ______________
Tissue Injury > Primary hemostasis Platelet Plug Formation > Secondary hemestasis Fibrin Plug Formation
What happens in Primary Hemostasis?
- Endothelial injury exposes collagen - Activation of platelets -Recruitment of additional platelets forms the hemostatic/platelet plug
Describe when a endothelial injury exposes collagen…
Platelets adhere to collagen. Gplb on platelet will bind to vWE > and becomes activated
Describe when platelets become activated…
Platelets are activated and undergo shape change. They flatten to increase their surface area. They also release secretory granules that further platelet aggregation
Secondary Hemostasis is composed of ________ & _________.
- Tissue Factor - Thrombin
Describe Tissue Factor:
- Exposed at the site of injury - Acts with factor VII to activate the coagulation cascade - Results in activating THROMBIN
What is the result of Tissue Factor?
ACTIVATION OF THROMBIN!
Describe Thrombin:
- Cleaves circulation fibrinogen to fibrin - Fibrin meshwork is formed secondary to the hemostatic plug - Polymierized fibrin + platelet aggregates = permanent plug
What makes the permanent plug in secondary hemostasis?
Polymerized fibrin and aggregation of platelets
For the coagulation cascade, know…
We need the tissue factor (thromboplastin) to get thrombin
What are 2 things that will help to ensure the hemostatic plug/clot won’t spread and is only at the site w/ injury?
- Tissue plasminogen factor - Thrombomodulin
_________ cells determine whether thrombus formation, propagation, or dissolution occurs.
Endothelial cells
Anticoagulants:
Prevent clots from forming
What are 4 examples of anticoagulants?
Prostacyclin, NO, Tissue Plasminogen Factor, Thrombomodulin
Procoagulants:
Promote clot formation
What are 3 examples of procoagulants?
Thromboplastin, Platelet Activating Factor, Von Willebrand Factor
What does THROMBIN do?
Converts fibrinogen to FIBRIN
Coagulation cascade factors are produced by the ________.
LIVER
If you have a p with liver disease, what do you expect to see?
You will see a decrease in these coagulation cascade factors, resulting in increased bleeding if p is cut or starts to bleed. There will be less factors to help out with forming a clot to stop the bleeding.
What is a thrombus?
Its an aggregation of platelets, fibrin, and blood cells.
Thrombus adhere to…
Vessel walls
Is thrombosis physiological OR pathological?
PATHOLOGICAL
What is the Virchow Triad?
Its combines the Endothelial injury, with abnormal blood flow AND Hypercoagulability
When do we see pulmonary thrombosis?
When we have glomelular disease. It can’t filter what’s going through. Antithrombin 3 is being lost so the p becomes more prone to having this.
What is Verminous Thrombosis?
A thrombus forming in the cranial mesenteric artery. Caused by STRONGYLUS VULGARIS
Where is saddle thrombus located?
Trifurcation of the abdominal aorta
What species do we see saddle thrombus in?
CATS, is associated with hypertrophic cardiomyopathy
The outcome of thrombi:
- Lysis - Propagation - Embolization - Organization / Recanalization
What is the most dangerous outcome of thrombi?
Embolism, it can occur in arteries OR veins. It can be liquid, solid, or gas.
Define embolism:
Piece of thrombus that breaks off from original mass and gets lodged at distant sites.
Bacterial Valvular Endocarditis occurs in…
CATTLE, Right AV valve Can result in septic embolism that lodges in pulmonary arteries
Thrombosis meningioencephalits
Histophilus somni infection Vasculitis and Thrombosis CIRCULAR LESIONS ON BRAIN
Disseminated Intravascular Coagulation (DIC) is…
The generalized activation of the blood coagulation system. MANY etiologies lead to DIC.
DIC results in:
Consumption of platelets, and fibrin, and coagulation factors.
Regarding DIC: During activation you may see increase in proteins, but afterwards you will see a decrease in proteins. T or F?
TRUE
What is an infarction?
Localized area of ischemic necrosis Occlusion of arterial supply or venous drainage
Define Venous Infarction:
Intense hemorrhagic / blood backing up Usually seen in intestinal volvulus
Define Arterial Infarction:
Initially hemorrhagic but becomes pale in color. It is coagulative necrosis. Usually seen in Kinsey Infarcts *blood can’t get to the organ
Shock can be characterized but a reduction in tissue perfusion and oxygen delivery. T or F?
TRUE
Cardiogenic Shock >
Failure to maintain Cardiac Output
Hypovolemic Shock >
Fluid Loss
Blood Maldistribution >
Decreased resistance, pooling of blood in peripheral tissues. Examples: anaphylactic, neurologuic (loss of vascular tone), and septic
Petechiae and ecchymoses associated with terminal
hypoxia. Commonly found in bovies at slaughter.
What kind of hemorrhage is this?
Agonal Hemorrhage
Can result in septic embolism
that lodges in pulmonary
arteries.
Right AV valve
Happens in bovine
Bacterial valvular endocarditis
Congestion or Hyperemia?
Congestion
What type of hemorrhage is this?
Eccymosis
Which one is inflammatory edema and which one is non infalmmatory edema?
Describe this tissue
- Wet
. Gelatinous/ heavy
. Swollen organs
. May be yellow
What is this called?
Nose bleed
aka
Epitaxis
What are the darkened areas on the lungs?
Heart Failure Cells
Caused by left-sided congestive heart failure
Leads to pulmonary edema and congetsion
What is this called?
Blood in joint
aka
hemarthrosis
What is this called?
Bleeding from the mouth
aka
hemoptysis
What kind of hemorrhage is this and what causes it?
Hemorrhage by rhexis
caused by copper deficiency
What is this classified as?
Hyperemia
What is this?
Intestinal volvulous
What kind of stain is this?
What is it showing?
Iron Perl Stain
Showing ups heart failure cells that have phagocytozed RBS. Hemosiderin is reacting with the stain causeing it to look light blue with in the heart failure cells
What is this?
Kindey infarct
What is this called?
What causes it?
Nutmeg Liver
Right sided heart failure causes this
Chronic hepatic congestion
What type of hemorrhage is this?
Paint brushed hemorrhage
What is this called?
Is it inflammatory or non-inflammatory?
Pericardial effusion
aka
Mulberry Heart Diease
Inflammatory — fluid looks to be exudate rather than transudate
What kind of hemorrhage is this?
Petechia
What kind of hemorrhage is this?
Petechia
This is pulmonary thrombosis.
When do we see this condition?
when there is a glomelular disease, it can’t filter/regulate whats going through. antithrombin 3 is being lost, so p is more prone . here in pulmonary artery
What is this called? What species do we see it in most frequently?
Saddle Thrombus
Cats
What is this?
Spinal cord infarct
What type of hemorrhage is this?
Suffisive hemorrhage
What is this?
What causes it?
Thrombotic meningioencephalits
Caused by Histophilus somni infection
What is this?
What parasite causes this in horses?
Verminous Thrombosis
Strongyloides vulgaris
