Circulatory Disturbances Flashcards
Dynamics of blood flow
Hemodynamics
The manner of development of disease
Pathogenesis
The metabolism of organs and cells depends on an intact circulation for continuous delivery of
oxygen
nutrients
hormones
electrolytes
water
The metabolism of organs and cells depends on an intact circulation for the removal of
Metabolic waste and carbon dioxide
Delivery and elimination at the cellular level are controlled by exchanges between the
intravascular space
interstitial space
cellular space
lymphaticspace
“The well-being of tissues requires normal fluid balance. Abnormalities in ______________ can result in cellular injury even if the blood supply is intact.”
vascular permeability and hemostasis
Chambers by the heart are separated by
Interatrial septum
Interventricular septum
Capillary ends
Arterial ends
venous ens
Circulatory blood flow staring from the Aortae
Aortae → Major Arteries → Arterioles → Capillaries → Venules → Major Veins → VenaCavae → RA → RV → PulmonaryArteries → Lungs → PulmonaryVeins → LA → LV → Aortae
Chambers of the heart
Atria
Ventricles
The survival of cells and tissues is exquisitely dependent on the oxygen provided in a normal blood supply and therefore on
the delivery of sufficient blood through a patent circulatory system
The valve between the right atrium and right ventricle pushes blood from the RA to the RV during diastole and prevents regurgitation from the RV to the RA during systole.
Tricuspid Valve
Valves of the heart
Tricuspid valve
Mitral or Bicuspid valve
Pulmonary valve
Aortic valve
The amount of fluid that has been distributed should also be the substantial amount that would be brought back into circulation for its efficiency.
Starlings law
an animal which has four feet, especially an ungulate mammal
Quadruped
Two divisions of aorta
Abdominal and Thoracic Aorta
The velocity flow and the mean pressure is sustained by
Hydrostatic Pressure and Osmotic Pressure
The Continuous type of Capillary that is true for the
Brain (BBB)
Muscle
Lung
Bone
Three main types of Capillaries in microcirculation
Continuous Endothelium
Fenestrated Endothelium
Discontinuous Endothelium
It has fenestra or pores that allow filtration enabling some of the molecules to pass through
Fenestrated Endothelium
Fenestrated endothelium type of capillary is true for the
Renal glomeruli
Intestinal villi
Endocrine glands
Choroid Plexuses
Ciliary processes of the eye
Very open gap that allows the passage of large molecules
Discontinouos (sinusoidal) endothelium
Discontinouos (sinusoidal) endothelium type of capillary is true for the
Liver Sinusoids
Spleen Sinusoids
Bone Marrow
Lymph Nodes
In endocrinology, hormones are not secreted through the lumen of the epithelial gland. If this is true, then where are hormones being secreted?
Secretion happens via the Fenestrated endothelium type of capillary
Vascular disorder encompasses a range of conditions that affect blood vessels, leading to complications such as _______________________. These conditions are critical in veterinary pathology, as they can have severe consequences for animal health, including organ failure and death if not promptly address.
Ischemia
Necrosis
System organ dysfunction
A physical barrier between intravascular and extravascular spaces
Endothelium
Endothelium is an important mediator of
Fluid distribution
Hemostasis
Inflammation and healing
Meaning blood stoppage or control of bleeding. The natural reaction to an injury that plugs and repairs the wound.
Hemostasis
A process that dissolves fibrin clot that aims to prevent thrombosis and embolism.
Fibrinolysis
when red blood cells escape the blood vessels.
Hemorrhage
refers to a lesion where blood may be kept from reaching an area of tissue and the tissue becomes necrotic. a necrotized, vascular area blocked by embolic lesion.
Infarct
Hemorrhage may occur by:
Rhexis and Diapedesis
Hemorrhage that occur because of injured or destructed vessel
Rhexis
Hemorrhage of RBCs from intact vessel
Diapedesis
refers to a lesion in which excess blood may be drawn into an area. Usually on the arterial side of the circulation.
Hyperemia
lesion where blood passively accumulates in an area. Usually on the venous side.
Congestion
lesion where excess fluids accumulate in interstitial tissue spaces. may be a transudate or an exudate fluid.
Edema
an intravascular solid clot formed.
Thrombus
process of necrotizing an area blocked by a thrombus or other embolic lesion.
Infarction
refers to a process by which a blood may clot within blood vessels.
Thrombosis
a vascular space-occupying lesion. maybe a dislodged blood clot, a parasite, or an air bubble.
Embolus
process whereby a floating mass may occlude vascular channels.
Embolism
is the generalized failure of peripheral circulation.
Shock
occur when red blood cells are present outside the blood vessels. The vessel may be
physically damaged so that the cells simply flow out through, or the cells may pass
through an intact vascular wall.
Hemorrhage
Inflammatory fluid accumulation in interstitial tissue spaces
Exudate
a bluish, grayish, or purplish tinge of the skin, lips, or nails due to low blood oxygen.
Cyanosis
Non-inflammatory fluid accumulation in interstitial tissue spaces
Transudate
tiny pinpoint hemorrhage measuring 1 to 2 mm sized foci. visible along the kidney
capsule. of a pig suffering from of Hog cholera infection.
Petechial Hemorrhage
larger areas of hemorrhage measuring 2 to 3 cm in size. usually irregular and mottled in appearance.
Ecchymotic hemorrhage
type- refers to extensive streaking with hemorrhage.- (lesion as if someone literally splashed red paint on the tissue)
Paint-brush type
occurs when sufficient red blood cells come out of the area to form a lump
Hematoma (or more appropriately HEMATOCYST)
a medical condition characterized by the accumulation of blood in the pericardial sac, which surrounds the heart.
Hemopericardium
Hemorrhage that happened in the Thoracic cavity
Hemothorax
Hemorrhage that happened in the peritoneal cavity
Hemoperitoneum
a clinical term applied to an animal that has extensive petechial and ecchymotic hemorrhages on serous and mucous surfaces. more of a descriptive term and does not imply a specific disease.
Purpura
a skin-visible lesion and a result of hemorrhage.
Bruise
are indications of former
hemorrhage
Presence of hemosiderin-laden macrophages and erythrophagocytosis
Diseases that result in marked bleeding tendencies are named
Hemorrhagic diatheses
Plural term for Ecchymosis
Ecchymoses
Nasal bleeding
Epistaxis
passage of blood from the alimentary tract.
Entorrhagia
extensive hemorrhage within the tissue.
Extravasation
coughing out blood.
Hemoptysis
hemorrhage into the joint cavity.
Hemarthrosis
the accumulation of blood producing a lump. “black-eye” is a classical example.
Hematocyts (commonly termed as hematoma)
Decrease numbers of platelets
Thrombocytopenia
Causes of hemorrhages
- Trauma (subcutaneous or Intramuscular hemorrhage)
- Septicemia, viremia, or toxic condition (widespread petechiae and ecchymoses)
- Coagulation disorder
- Thrombocytopenia
the aftereffect of an infection
Septicemia
is when viruses enter the bloodstream and can infect various organs.
Viremia
2 critical sites of hemorrhage
CNS and Heart
Significance of hemorrhage depends on the
Site of location
Rate
Total Blood volume lost
An Intravascular excessive amount of blood in an organ, refers to both volume and flow.
Hyperemia
Three factors use in defining the type of pathological hyperemia
Duration
Extent
Mechanism
Implies abrupt onset with rapid development
acute
Duration factor of hyperemia is characterize as
Acute/chronic
Slowly developing and/or present for a long time
Chronic
Changes are confine to a discreet area
local
extent factor of Hyperemia is characterize as
local
Generalized
Indicate systemic changes within an organ
Generalized
Hyperemia due to arteriolar flow
Active
Hyperemia due to impaired venous drainage
Passive
Mechanism Factors of Hyperemia are characterized as
Active
Passive
An active engorgement of vascular beds with a normal or decreased outflow.
Active Hyperemia
A passive engorgement of the vascular bed generally caused by decreased outflow with a normal or increased inflow of blood.
Passive congestion
Acute passive congestion can occur in the
liver and lungs in response to acute heart failure
Left sided heart failure causes
Pulmonary congestion
happens because of the obstruction of venous outflow caused by a neoplastic or inflammatory mass, displacement of an organ, or fibrosis resulting from healing injury.
Localized chronic passive congestion
results in the dilation of the vasculature and vascular sinusoids such as in the spleen
relaxation of the muscle caused by barbiturate anesthesia or euthanasia
Occurs because of decreased passage of blood through either the heart or the lungs. This is most often cause by heart failure or condition that inhibit the flow of the blood to the lung.
Generalized passive congestion
right sided heart failure causes
Portal vein and hepatic congestion
There may be fibrosis caused by the hypoxia and cell injury that accompanies by a passive engorgement of the vascular bed
Chronic Congestion (e.g., chronic hepatic congestion)
Gross appearance: dark red, swollen (edema), and cooler than normal. The microvasculature is engorged with blood, and there is often surrounding edema and sometimes hemorrhage caused by diapedesis.
Chronic congestion
Occurs when the perfusion of the tissue in the affected area becomes inadequate to meet the metabolic needs of the tissue.
Ischemia
is most commonly result of incomplete laminar blockage of thrombus or embolus
Ischemia caused by arterial disease
blood in passive congestion is deoxygenated leading to
Cyanosis
The syndrome of right heart failure resulting from primary pulmonary disease
Cor Pulmonale
The dog liver is enlaarge and dark red
Acute passive congestion
Local obstruction to venous drainage
Acute local passive congestion
The dog’s lungs are moderately firm and yellow-brown because of alveolar macrophages containing hemosiderin. Inflammatory mediators of these macrophages also induce fibroplasia, thus there is the extensive formation of interstitial collagen in the long tern. This collagen is the reason the lung fail to collapse after loss of negative pressure in the pleura cavity whe the diaphragm is incised at necropsy.
Chronic Passive congestion in the lung of a dog
A slowly developing tumor or abscess, enlarges and eventually compresses adjacent veins
Chronic local passive congestion
the cut surface of a dog’s liver has a repeating pattern of red and tan mottling (an accentuated lobular pattern). The condition leads to consistent hypoxia in centrilobular areas and atrophy, degeneration, and/or eventually necrosis of centrilobular hepatocytes.
Chronic passive congestion (nutmeg liver), cut liver surface of a dog
A chronic inflammatory lesions that progress to fibrosis and lead to venous outflow obstruction e.g., Hepatic Cirrhosis
Chronic local passive congestion
The pressure that moves fluid out of the system
Hydrostatic pressure
Tissue pressure around blood vessels that contain the fluid within the vascular system.
Osmotic pressure of the plasma protein
all metabolic products pass to enter or leave cells, constant exchange both with plasma and with cellular fluids
Intermediary
Allows the free passage of H2O + ions and opposes the passage of plasma proteins.
Endothelium + underlying basement membrane
Passage of blood through the uterus
Metrorrhagia
Vomiting of blood
Hematemesis
defecation of blood
Hematochezia
increase Hydrostatic pressure is a result of
Increase venous pressure (e.g., cardiac failure, mechanical obstruction to venous drainage) e.g. in chronic congestion.
Twisted obstructed bowel
Volvulus
a mineral concretion or calculus formed anywhere in the gastrointestinal system
Enteroliths
linear or streak appearance of hemorrhage.
Paint-brush hemorrhage
Lesions with larger areas of hemorrhage
Purpura
Defined as an excessive visible accumulation of extracellular fluid in interstitial tissues and various body cavities.
Edema
In general, the etiology of edema relates to changes in
hydrostatic pressure of blood,
osmotic pressure of blood and tissue fluid,
permeability changes of capillaries,
lymphatic obstructions,
renal sodium retention
The two lymph ducts in the body
Right lymph duct and the thoracic duct
Presence of stones in the kidney due to a decrease in urine volume or excess of stone-forming substances in the urine. This causes back pain, abdominal pain, burning sensation during urination, blood in urine and fever.
Kidney stones, also known as renal calculus or nephrolithiasis
It may be transudate or exudate
Edema
a term used to describe calculi or stones that form the urinary tract. This condition involves the formation of calcifications in the urinary system, usually in the kidneys or ureters, but may also affect the bladder and/or urethra.
Uroliths
a neglected tropical disease. Infection occurs when filarial parasites are transmitted to humans through mosquitoes.
Lymphatic filariasis (LF), commonly known as elephantiasis
Alteration in the venous side (i.e., obstruction) results in the increase in the
Hydrostatic pressure along whole capillaries
Concretion in the gallbladder
Cholelithiasis
Reduction of albumin content in the blood
hypoalbuminemia
What could possibly block the venous ends
Parasite, thrombus or embolus, tumor, inflammation, concretion
prevents the drainage of tissue fluids leading to damming of fluids in the tissue. i.e. tumor that blocks lymphatics; elephantiasis, etc.
Lymphatic obstruction
Occurs in association with inflammation
Increase capillary permeability
holds excessive water in interstitial tissues.
Na+
an autosomal recessive disorder causing hypertension (high blood pressure), hypernatremia (increased blood sodium concentration) and hypokalemia (decreased blood potassium concentration)
Apparent mineralocorticoid excess syndrome
result from reduced
plasma protein levels blood and may occur from
decreased formation or excessive loss of plasma
from blood.
Osmotic (oncotic) pressure change
A series of vessels and nodes that collect and filter excess tissue fluids
lymph channels
results from low plasma proteins following starvation,
proteins excessive loss (e.g. renal diseases), or underproduction (e.g. liver disease).
i.e., in hypoalbuminemia, a protein-losing disorder
Decrease in blood osmotic pressure
A prefix that means under, below normal, slightly, in chemistry - containing an element with an unusually low valence. from Greek hupo means ‘under’
hypo
result from direct damage, as
in trauma or inflammation, and also from anoxia, as in heart failure.
Permeability changes
a filarial (arthropod-borne) nematode (roundworm) that is the major cause of lymphatic filariasis. It is one of the three parasitic worms, together with Brugia malayi and B. timori, that infect the lymphatic system to cause lymphatic filariasis. These filarial worms are spread by a variety of mosquito vector species.
Wuchereria bancrofti
nouns denoting that a substance is present in the blood. from modern Latin -aemia, from Greek -aimia, from haima ‘blood’
-emia
may occur when any lesion impedes normal lymphatic drainage by pressure or obstruction.
lymphatic obstruction
Increased osmotic pressure of extracellular fluids due to an excess of sodium ions in extracellular fluid following impaired excretion of sodium (e.g., excess mineralocorticoid (hyperadrenocortisolism), excess salt intake, kidney disease, or possibly increase in ADH).
Increase renal sodium
leading to feedback inhibition of aldosterone. Common symptoms include hypertension, hypokalemia, metabolic alkalosis, and low plasma renin activity.
hyperaldosteronism
Gross appearance: Subcutaneous tissues may show swelling. excess clear fluid and is most easily visualized beneath the skin or
between the layers of mucous membranes or in lobules of the lung, where there is space for accumulation to occur.
Edema
generalized edema. - extreme edema in the entire body, as occurs in some aborted fetuses.
Anasarca
caused by Escherichia coli in pigs
Gut Edema
a common lesion affecting lungs and is often the immediate cause of death in many different disease conditions (i.e. resultant of left congestive heart failure or LCHF)
Pulmonary edema
caused by Clostridium septicumin several species.
malignant edema
excess fluids in the thoracic or pleural cavity
Hydrothorax or pleurisy
lesion arises from leakage of surface pleural lymphatic vessels in very edematous lungs.
Hydrothorax
Gross appearance: Wet, gelatinous and heavy, organs are swollen, and fluid weeps from the cut surface (In several species [horse, and some cattle breeds], fluids are slightly yellow.
Edema
Histopathologic appearance: tissue is pale staining, tissue spaces are distended by lightly staining eosinophilic fluid. Blood vessels may be filled with erythrocytes (hyperemia). lymphatics are dilated. May be difficult to discern if the protein content is low. collagen bundles of interstitial stroma are separated by an increase in intercellular space.
Edema
In the usual H&E staining, his appears as pink staining homogenous material.
Edema fluid
A disease caused by virus infecting the respiratory tract.
Flu, also known as: influenza
Infectious canine hepatitis is an acute liver infection in dogs caused by
Canine mastadenovirus A, formerly called Canine adenovirus 1
Occurs when antigen-antibody complexes form in the bloodstream and get deposited in various tissues. This leads to an inflammatory response and tissue damage.
Type III hypersensitivity, also known as immune complex-mediated hypersensitivity
The viral agent is commonly found in specific species of fruit bats of the genus Pteropus (also called flying foxes), and close contact among horses and these bats is suspected to have caused transfer of the virus to horses. develops in horses that are infected by direct contact with the virus particles in urine, saliva, and respiratory secretions. Humans in very close contact with infected horses can become infected as well and develop flu-like symptoms. About 57% of human infections are fatal.
Infected horses develop severe and often fatal respiratory disease, characterized by labored breathing and fluid and swelling in the lungs. Damage to the heart and blood vessels may occur.
The disease, called equine morbillivirus pneumonia
a severe and often fatal viral disease caused by Most strains of FeCV are found in the gastrointestinal tract and usually don’t cause significant disease. However, in about 10% of infected cats, the virus mutates. The mutated virus triggers an intense inflammatory reaction in the tissues, particularly around blood vessels.
Feline Infectious Peritonitis (FIP)
a condition that primarily affects horses. It is a rare complication often associated with equine strangles (infection with Streptococcus equi subsp. equi) or after vaccination for strangles.
Symptoms
Swelling: Edema (swelling) in the limbs, head, and underbelly.
Skin Lesions: Red spots (petechiae) or larger bruises (ecchymoses) on the skin and mucous membranes.
Other Signs: Fever, anorexia, lameness, colic, weight loss, and in severe cases, skin sloughing
Purpura hemorrhagica
a severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen. It involves the whole body and can lead to serious complications if not treated immediately. It is a medical emergency, and prompt treatment is essential to prevent serious complications or death.
Anaphylaxis
a complication of diabetes mellitus that results from damage to the small blood vessels (capillaries) throughout the body due to prolonged high blood sugar levels. This condition can lead to various complications, particularly affecting the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy)
microangiopathy caused by diabetes mellitus
a serious condition that occurs when a blood clot gets lodged in an artery in your lung, blocking blood flow. This can cause damage to the lung tissue due to lack of oxygen and can put strain on your heart.
Pulmonary embolism
an allergic reaction that occurs almost immediately after exposure to an allergen. This reaction is mediated by IgE antibodies and involves mast cells and basophils
Type I hypersensitivity, also known as immediate hypersensitivity or allergy
a serious condition characterized by the widespread activation of clotting in small blood vessels throughout the body. This can lead to the formation of blood clots and, paradoxically, severe bleeding due to the consumption of clotting factors and platelets
Disseminated Intravascular Coagulation (DIC)
Gross appearance: clear to slightly yellow fluid (generally contains a small amount of protein [transudate]) which thickens and expands the affected submucosa.
Edema in the intestine submucosa of a horse
Gross appearance: Slightly yellow fluid is present in the peritoneal cavity. When edema occurs in tissue adjacent to body cavities, the increased interstitial tissue forces the edema fluid, which is usually clear to slightly yellow (transudate), into these cavities.
Ascites in the Peritoneal cavity of a dog, or hydroperitoneum
Gross appearance of a pig’s lung: The lung failed to collapse and is heavy and firm due to edema fluid in the alveoli and the interstitial fluid. There is a frothy edema fluid exuding from the bronchus. And a prominent interlobular septa.
Pulmonary edema, lung of a pig
histopathology appearance of a rat’s lung: There is a eosinophilic (pink staining) fluid distending the alveoli. An amorphous, pale eosinophilic fluid, and the depth of the eosinophilia is proportional to its protein content. The fluid in the specimen has a high protein content.
Pulmonary edema in the lung of a rat
2 types of edema
Inflammatory and non-inflammatory
often seen in areas of inflammation or venous/lymphatic obstruction .
Localized edema
Associated with systemic conditions like heart and renal failure
generalized edema (anasarca)
Accumulation of fluid in the abdominal cavity, often due to liver disease of heart failure.
Ascites
fluid in the lungs frequently due to heart failure that leads to respiratory distress.
Pulmonary edema
An Active Process (an inflammatory effusion or edema)
Characterized by:
1. high protein content
2. increased specific gravity
3. increased number of inflammatory cells
Exudate
A Passive Process edema (a non-inflammatory effusion or edema
Characterized by:
1. low protein content
2. low specific gravity
3. low or absence of inflammatory cells
Transudate
A localize anemia, a reduction of blood flow in an area
Ischemia
Possible causes of ischemia
a) Compression of blood vessels
b) Obstruction of blood vessels (Thrombosis, embolism)
c) Functional disturbance (in tissue anoxia)
Complete loss of oxygen supply
Anoxia
due to a reduction in the flow of oxygenated blood.
Atagnant anoxia
results from inadequate supply of oxygenated blood.
Anoxic anoxia
due to low hemoglobin content or reduced capacity of blood to carry oxygen.
Anemic anoxia
due to inability of cells to utilize oxygen.
histotoxic anoxia
if it lodges in organs with so called “end arteries” such as the kidneys, spleen and brain ischemia results to
Infarction, if partial or gradual, atrophy may result.
refers to a pathological formation of blood clots in the
living animal body, and denotes a defect in hemostasis.
Disseminated Intravascular Coagulation (DIC)
refers to acute ischemic coagulation necrosis of an area of tissue.
Infarction
the area of necrotized tissue is called an
Infarct
refers to an ante-mortem intravascular blood clot.
Thrombus
a solid structure formed in the blood stream from the normal
constituents of the blood.
Trombus
the process by which a thrombus is formed.
Thrombosis
formation of intravascular blood clots adherent within blood vessels. Its formation is influenced by three factors which is classically known as the Virchow’s Triad.
Thrombosis
Three principles required for hemostasis and thrombosis
Vascular wall - endothelial cells primarily
platelets
coagulation cascade
- Blood hypercoagulability
- Haemodynamic changes (such as slowing of flow, stasis, turbulence)
- Injury/dysfunction of the endothelium of the blood vessel wall
Virchow’s triad of thrombosis
One of the three components of Virchow’s triad: Damage or dysfunction of the endothelial lining of blood vessels, which can trigger the clotting cascade.
Endothelial injury
the natural reaction to an injury that plugs and repairs the wound.
Hemostasis
a pathological form of hemostasis where a clot is formed within the blood vessel even if it is not injured.
Thrombosis
One of the three components of Virchow’s triad:
An increased tendency of the blood to clot, often due to genetic conditions, medications, or diseases.
Type of thrombin: Form in veins, particularly deep veins (e.g., deep vein thrombosis, or DVT). Composed mostly of red blood cells and fibrin, with fewer platelets. Common in areas of slow or stagnant blood flow and can lead to conditions like pulmonary embolism if the clot travels to the lungs.
Venous thrombi
Type of thrombin: Completely block a blood vessel, preventing blood flow. Can form in both arteries and veins, leading to tissue ischemia (lack of oxygen) and damage.
Occlussive thrombi
Type of thrombin: Form in arteries. Composed mostly of platelets and fibrin. Often associated with atherosclerosis and can cause conditions like myocardial infarction (heart attack) or ischemic stroke.
Arterial throbi
Type of thrombin: Form on the walls of heart chambers or large blood vessels. Can occur after myocardial infarction (heart attack) or due to abnormal heart rhythms like atrial fibrillation. These clots can dislodge and cause embolism, especially to the brain (stroke).
Mural thrombi
One of the three components of Virchow’s triad: Sluggish or reduced blood flow, often caused by immobility or venous obstruction, which allows clotting factors to accumulate.
Abnormal blood flow
Type of thrombin: Associated with infection. Contain microorganisms and can form as a result of septicemia (blood infection). Can lead to the spread of infection if they embolize (break off and travel to another location).
Septic thrombi
Type of thrombin: Consist primarily of platelets and fibrin. Usually form in areas of high blood flow like arteries, where they develop slowly and remain adhered to the vessel wall.
White thrombi
Growth of thrombus is downstream resulting in a tail that does not attached to the vessel wall.
Mural thrombi
Thrombus formation often occur in areas of slow blood flow or statis. They are dark red and gelatinous as a result of large number of erythrocytes that are loosely incorporated into the thrombus because of the slow blood flow. Most of these are occlusive.
Venous thrombus
Type of thrombin: Composed predominantly of red blood cells, with fewer platelets and fibrin. Typically form in veins, where blood flow is slower, leading to a darker red appearance.
Red thrombi
A thrombus that are composed primarily of platelets and fibrin and because of rapid flow of blood which tends to exclude erythrocytes from the thrombus; thus they are usually tan to gray.
Arterial/mural thrombus
Thrombus resolution
Thrombolysis - small thrombi
phagocytosis - larger mor persistent thrombi
recanalization - large mural or occlusive thrombi
plural of thrombus
thrombi
thrombi may develop in
anywhere in the cardiovascular system;
cardiac chambers
valves
arteries (usually endothelial injury)
veins (often result of statis)
capillaries
and also lymphatic vessels
outcome of thrombi
Propagation
lysis
infarction
embolization
inflammation and fibrosis
recanalization
form while the patient is alive, etiology is endothelial injury, vessel wall adherent, dry, granular, rough, the endothelia of the vessel is also rough and damaged, partly organize and laminated.
Thrombus
Happens after death, etiology is blood stagnation as in a “downer animal”, not adherent, moist, smooth and glistering, endothelia is smooth and intact, not organized and homogenous.
Post-mortem clot
a compound produced by bacteria in the gut.
Trimethylamine-N-oxide (TMAO)
straddle the bifurcation of blood vessel kind of thrombi
saddle thrombi
in capillaries are called hyaline thrombi.
Fibrin thrombi
there are thrombi but still able to allows blood flow
canalized thrombi
predicts incident risk for thrombotic event in human subject
elevated Trimethylamine-N-oxide (TMAO) level
thrombi attached to heart valves
valvular thrombi
trailing thrombi with one end attached to vessel wall and the other end moving freely.
Obturating thrombi
CLASSIFICATION OF THROMBI
*Based on location on blood vascular system:
- Cardiac
- Arterial
- Venous
- Lymphatic
- Capillary
CLASSIFICATION OF THROMBI
*Based on location within heart or blood vessel:
- Mural thrombi
- Valvular thrombi
- Occluding thrombi
- Canalized thrombi
- Saddle thrombi
6.Obturating thrombi
refers to a process where a solid mass is transported from one part of the body to another through the circulatory system.
embolism
CLASSIFICATION OF THROMBI
*Based on color
1.Red thrombi–composed of all blood cell components
2.Pale or white thrombi–composed entirely of platelets
3. Laminated or mixed thrombi–composed of red and white thrombi
Apart from fragments of thrombi, emboli may be
parasites
bacteria
fungi
foreign bodies
and gas bubbles
CLASSIFICATION OF THROMBI
*Based on content of pathogenic agent
- Septic thrombi– contain bacteria
2.Aseptic thrombi– no pathogenic agent present
3.Parasitic thrombi– contains parasites.
a common cause of infarction.
embolism
If the vessel is a vein, the embolus will probably eventually lodge in the
Pulmonary circulation
may be groups of tumor cells, colonies of bacteria or foreign bodies injected into the blood or pieces of a thrombus that have broken off from a primary site.
emboli
often produces emboli of pieces of skin or hair.
Venipuncture
may cause air embolism and
occlusion of cerebral vessels and has been used in some species as a means of euthanasia.
Injection of air during venipuncture
a solid abnormal mass transported from one part of the body to another in the circulatory system
embolus
a significant cause of death in human after serious car accidents
Pulmonary and cerebral fat embolism from fractures
a generalized failure of peripheral circulation. A clinical term that means peripheral circulatory failure with pooling of the blood in the terminal circulatory bed in small vessels.
Shock
The causes of shock may be classified as:
- septic
- hypovolemic
- cardiogenic
- neurogenic
associated with hemorrhage, trauma, loss of fluid in burns and major surgery.
Hypovolemic shock
refers to failure of the central pump
Cardiogenic shock
usually results from pain or severe emotional upset.
Neurogenic shock
implies septicemia
or extreme localized infection, usually with gram-negative organisms (because of endotoxemia from G
endotoxins). The main problem is intravascular coagulation.
Septic shock
Lesions indicative of shock
Congestive atelectasis or shock lung
Visceral pooling
Acute renal and tubular necrosis
Sludging
Disseminated intravascular coagulation
Leads to consumptive coagulation or Thrombohemorrhagic or hemorrhagic diathesis
Disseminated intravascular coagulation
The one that supplies oxygenated blood to the lungs
bronchial artery
The one that supplies oxygenated blood to the heart
Coronary artery
the one that drains deoxygenated blood from the heart
cardiac veins
Dual blood supply of the lung
Pulmonary artery
Bronchial artery
Express clinically as sunken eyes and loss of elasticity in the skin. A loss of 5 percent of the body weight as fluid will cause death. This could lead to circulatory failure, hypovolemic shock, and renal failure.
Dehydration
A heart attack occurs when one or more coronary arteries get blocked. Over time, a coronary artery can narrow due to the build-up of various substances, including cholesterol (atherosclerosis).
Myocardial infarction
Death of a muscle tissue due to a lack of blood flow
Muscle infarction
Etiology of embolism
Parasite
Fibrocartilaginous emboli
Fat
Systemic infection
Other like air bubbles, hair, tumour cell clusters or amnionic fluid
50% of all human deaths results from
Myocardial or cerebral infarction due to cardiovascular diseases
Infarction that are common in domesticated animals
Pulmonary Infarction
Intestinal Infarction
Renal Infarction
Severe congestive lesion on lungs found at postmortem indicates shock due to pooling of blood in the respiratory bed
Congestive atelactasis
This happens in an animal that die with failing circulation whereby considerable fluid may be present in the intestine, and the fluid contains so many red cells that the fluid looks like blood. This blood may have seeped through by diapedesis.
Visceral pooling
Increase blood volume may be detrimental, as in the heart failure. the renal lesion associated with shock arise from excessive vasoconstriction in the initial stages of the sequence, to the point that acute ischemic degeneration and necrosis occurs randomly throughout the kidney.
Acute renal tubular necrosis
Refers to the widespread, or at times localized, formation of microthrombi in capillaries, arterioles and venules,. This can arise by a way of intrinsic or extrinsic system or by stasis of flow. Common in acute gram-negative septicemia in animals (such as hemorrhagic septicemia in cattle due to Pasteurella multocida). This may also be caused by antigen-antibody complexes, tissue damage, intravascular hemolysis, systemic hypersensitivity or by extensive diffuse endothelial damage.
Disseminated intravascular coagulation (DIC)
this refers to the slowing down of the circulation, settling out of red cells from plasma and increase stickiness of blood. This is very common in shock.
Sludging
Ventricular contraction strength related to amount of ventricular myocardial stretch. Maximum contraction force is achieved when myocardial actin, and myosin fibers are stretched about 2–2.5 times the normal resting length
Frank–Starling Mechanism
