Circulatory Disorders Flashcards
Describe arteries VS veins.
Describe interstitial space.
-space between tissue compartments
-medium thru all metabolic prod pass between microcirculation & the cells
-CT
Describe fluid distribution & homeostasis.
- Homeostasis = state of steady internal conditions maintained by living things
- Total body water = 60% of total BW
-intracellular fluid 40%
-ECF 20%
>interstitial 15%
>plasma 5%
Describe hydrostatic pressure VS osmotic pressure.
water distribution between plasma & interstitum determined by osmotic & hydrostatic pressure differences between the 2 compartments
1. Hydrostatic
-fluid moves out of vasculature
2. Osmotic
-fluid into vasculature
-plasma proteins
[starling equation]
Describe edema & the different types.
*abnormal accumulation of excess ECF in the interstital spaces or in body cavities
*fluid is both outside the vascular & cellular fluid compartment
Describe inflammatory edema.
Inc vascular permeability
-immune reaction -> release inflam mediators -> vasodilation
-endothelium can be directly damaged by agents
Describe non inflammatory edema.
-inc hydrostatic pressure or dec plasma osmotic pressure causes extravascular fluid to accumulate
-tissue lymphatics remove excess volume & return it to the circ via thoracic duct but if the capacity for lymphatic drainage is exceeded = tissue edema
Describe the different types of non inflam edema.
- Inc hydrostatic pressure -> due to impaired venous blood flow (congestion)
-generalized (CHF)
-localized (tightly bandaged limb - vein occlusion) - Dec oncotic pressure -> hypoproteinemia
-generalized edema
-proteins not absorbed from diet/not produced/loss - Lymphatic obstruction
-localized edema
-damage/obstruction of lymphatics
Describe transudates VS exudate.
- Transudates
-non inflam
-inc blood hydrostatic pressure, dec osmotic pressure, lymphatic obstruction
-low protein, SG, nucleated cells - Exudate
-inc vascular permeability
-high protein, SG, nucleated cells
Describe the gross appearance of edema.
-wet, gelatinous & heavy, swollen, fluid weeps from cut surfaces, yellow
Describe generalized edema common locations.
-SQ edema
1. Ventrum of ab/thorax “brisket”
2. Ventral cervical/mandibular “bottle jaw”
-parasites
-hypoproteinemia
3. Limbs “stocking up”
-protein losing enteropathy
Describe different types of edema PM.
- Pitting edema in SQ = pressure applied, area of edema leaves a depression/dent due to excessive interstital fluid forced to adjacent areas
- Ascites/hydroperitoneum = fluid (transudates) in peritoneal cavity (CHF)
- Hydrothorax = fluid in thoracic cavity
- Pericardial effusion = ‘mulberry heart disease’
>inflam
>fibrin
>exudate - Anasarca = gen edema w profuse accumulation of fluid in SQ tissue
Describe the mechanism of development & common locations of generalized edema.
- Mech of development
-inc hydrostatic pressure
>heart failure
-dec colloidal osmotic pressure
>hypoproteinemia - Common locations
-ab cavity = hydro abdomen (ascites)
-thoracic cavity = hydrothorax
-pericardium = hydropericardium
Describe localized edema mechanisms of development.
-local impaired venous drainage
-local lymphatic blockage
-local inflam
Describe the histological appearance of edema.
-spaces distended
-blood vessels may be filled w RBCs
-lymphatics are dilated
-collagen bundles separated
-eosinophilic if inflam
Describe pulmonary edema & its gross appearance.
-accumulation of fluid in interstitum & alveoli of lungs
-common cause of death
GROSS:
-lungs swollen, heavy, wet
-interlobular septa distended w fluid
-froth in airways on cut surface
Describe pulmonary edema in left sided heart failure VS increased endothelial permeability.
- Left sided heart failure
-inc hydrostatic pressure in pulmonary circ -> non inflam edema
-flood alveolar space w transudates - Inc endothelial permeability
-damage to pulmonary capillary endothelium w acute inflam -> inflam edema or toxins (ex. Pneumonia)
-sudden, diffuse, direct inc in vascular permeability = massive inflam in distant organ/sepsis/toxins
-
Describe chronic pulmonary edema.
-associated w cardiac failure
-alveolar walls become thickened -> fibrosis
-congestion, microhemorrhages -> accumulation of heart failure cells
-chronicity -> fibrosis of pleura & alveolar septa
Describe cerebral edema causes & gross appearance VS histological appearance.
- Causes
-trauma to brain
-obstruction of venous outflow
-inflam - Gross appearance
-brain heavier
-sulci are narrow
-gyri are swollen & flattened - Histological appearance
-expansion of virchow robin spaces
Describe cerebellar coning VS herniation.
- Coning
-herniation of cerebellum thru foramen magnum - Herniation
-herniation of cd cerebral cortex beneath tentorium cerebelli
Describe the clinical significance of edema.
-depends on extent, location, duration
-tissue become firm & distorted due to inc in fibrous CT after prolonged edema
Describe hyperemia/congestion.
-local inc in blood vol & flow within vascular bed
-hyperemia = inc of arteriole mediated engorgement of vascular bed
>oxygenated blood (red)
-congestion indicates passive venous engorgement
>blood not oxygenated
Describe the 2 types of hyperemia.
- Physiological
-digestion: inc blood flow to GIT during digestion
-exercise: inc blood flow to muscles during exercise
-dissipate heat: inc blood flow to the skin to dissipate heat & cool down
-neurovascular (blushing): involuntary inc in blood flow to the face - Pathological
-caused by underlying pathological process (inflam)
-arteriolar dilation occurs 2ndary to inflam stim (mediators)
-5 cardinals signs of inflam
-associated w edema
Describe gross VS histological findings of hyperemia.
- Gross
-red color of tissue (eye, gums, etc)
-swelling, warmth
-localized - Histology
-capillaries (+/-) arterioles dilated & filled w blood
-accompanied by edema
-inflam
-hastens movement of metabolites into area & flushes catabolites from area
Describe congestion & its classification.
-engorgement of vascular beds caused by dec outflow of blood
-vascular bed engorged w poorly oxygenated blood
>tissues are dark red or blue depending on degree of stagnation
CLASSIFICATION:
1. According to duration = acute or chronic
2. According to extend = localized & generalized systemic change like in CHF
Describe gross VS histology findings of congestion.
- Gross
-red to blue/black -> depending on degree of stagnation of blood
-tissues might be cooler than normal
-cut surfaces ooze blood & wet bc edema
*EX: gastric volvulus - Histology
A) acute
-engorged capillaries, (-/+) edema
B) chronic
-hypoxia, atrophy, cell degen & necrosis
Describe pulmonary congestion.
-results of L side heart failure & associated w edema
>high hydrostatic pressure
Describe hepatic congestion.
-subacute to chronic congestion = result of R side congestive heart failure
Describe hyperemia VS congestion.
- Hyperemia
-active
-results in accumulation of oxygenated blood -> erythema - Congestion
-passive
-results in red cell stasis & accumulation of deoxygenated hemoglobin -> cyanosis
