Circulatory Disorder: Hemorrhage & Homeostasis Flashcards

1
Q

Describe hemorrhage.

A

-escape of blood from blood vessels (extravasation)
>ext or int (tissue/body cavity)
>arterial, venous, capillary
*hyperemia & congestion = blood in vessel

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2
Q

Describe the 2 types of hemorrhage.

A
  1. Rhexis
    -tear in vascular wall due to:
    >trauma, necrosis of blood vessel wall, invasion of blood vessel by neoplasia
  2. Diapedesis
    -small defect in vessel wall or RBCs passing thru vessel wall in inflam or congestion due to:
    >inflam, congestion, hypoxia, toxins, coagulation disorder
    *wall is intact, but inc capillary permeability
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3
Q

Describe the causes of hemorrhage.

A
  1. Trauma
  2. Sepsis, viremia, bacteremia, toxic conditions -> necrosis & degen of endothelial cells
  3. Chemical agents
  4. Neoplasia
  5. Coagulation abnormalities
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4
Q

Describe hemorrhage classification based on size.

A
  1. Petechia = 1-2 mm
  2. Purpura = 3mm-1cm
  3. Ecchymosis = 1-2 cm
  4. Suffusive = larger than ecchymosis
  5. Paint brush
  6. Hematoma
  7. Linear
    *Diathesis = inc tendency to bleed/bruise easily from insig injuries (platelet & coagulation disorders)
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5
Q

Describe hemorrhage classification based on location.

A
  1. Perivascular
  2. Sub-serosal
  3. Sub-mucosal
  4. Sub-capsular
  5. Subdural
    -bleeding between arachnoid mater & dura
  6. Epidural
    -bleeding between dura mater & skull
  7. Hemothorax
    -blood in thoracic cavity
  8. Hemopericardium
    -blood within pericardial sac
    -can lead to fatal cardiac tamponade
  9. Hemoperitoneum
    -blood in peritoneal cavity
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6
Q

Describe other areas of hemorrhage.

A
  1. Hemarthrosis = blood in joint space
  2. Hemopytsis = coughing up blood or blood stained sputum from lungs or airways
  3. Hyphema = blood in anterior chamber of eye
  4. Epistaxis = bleeding from nose
  5. Hematemesis = vomit up blood
  6. Hematochezia = fresh blood in stool
  7. Melena = tarry blood in stool
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7
Q

Describe hemorrhage resolution.

A

-result of hemostasis
-sm amount can be reabsorbed
-lg amount require phagocytosis & degradation by macrophage
-organizing hematoma = central mass of fibrin & RBCs surrounded by supportive vascular CT (fibrous) -> macs phagocytose lesion

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8
Q

Describe hemorrhage clinical significance.

A
  1. General (vol & rate) hemorrhagic shock
    -profuse blood loss -> acute anemia -> hypovolemic shock -> death
    -anemia bc repeated small hemorrhage
  2. Location & severity compressive effects
    -mechanical compression of organs due to a hematoma
    -brain & heart = fatal
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9
Q

Describe hemostasis.

A

-keeps blood fluid clot free in blood vessel
-physiological response to vascular damage = rapid clot formation
-mechanisms to seal an injured vessel to prevent blood loss

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10
Q

Describe the mechanisms of hemostasis.

A
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11
Q

Describe the coagulation cascade.

A

-enzymatic conversions
>each step proteolytically cleaves inactive proenzyme into activated enzyme = thrombin formation
-conclusion of proteolytic cascade = thrombin coverts soluble plasma protein fibrinogen into fibrin
-coagulation factors are plasma proteins made by liver

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12
Q

Describe the end of the coagulation cascade.

A
  1. Stabilize clot by fibrin
  2. Contract fibrin platelet clot
  3. Reduce size of clot (restore flow)
  4. Draws damaged vessel edges closer (for healing)
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13
Q

Describe why coagulation would fail.

A
  1. Hepatic disease (cant make coagulation factors)
  2. Platelet defect
  3. Nutrition deficiency (vit K)
  4. Toxics (warfarin)
  5. Hemophilias (absence of coagulation factors)
  6. Bacterial invasion during clot formation
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