Circulatory Disturbances I & II Flashcards
The intestitium composed of what two things?
ECM and supporting cells
What is ECM composed of?
Structural molecules and ground substance
Water distribution between plasma &; interstitium is primarily determined by what two pressure differences?
Hydrostatic and osmotic pressure differences between two compartments
What does the starling equation illustrate?
Role of hydrostatic and osmotic forces in movement of fluid across capillary membranes.
Hydrostatic moves fluid out and osmotic pressure moves fluid in
What results in tissue edema?
When capacity for lymphatic drainage is exceeded
Edema is the abnormal accumulation of what?
Excess extracellular water in interstitial spaces or body cavities
Where is the fluid located during Edema?
Fluid is outside both vascular fluid compartment and cellular fluid compartment (w/in interstitium)
What are the 4 pathomechanisms of edema?
- Increased blood hydrostatic pressure
- Decreased plasma colloidal osmotic pressure
- Lymphatic obstruction
- Increased vascular permeability
What two categories can edema be classified under?
Inflammatory and non-inflammatory
Inflammatory edema is increased vascular permeability and refers to a what?
Exudate
Non-inflammatory edema refers to what?
Transudate
T/F: Inflammatory edema has protein rich fluid and non-inflammatory edema has protein poor fluid
True
What is the typical gross appearance of Edema?
- Wet
- Gelatinous and heavy
- Swollen organs
- Fluid seeps
- May be yellow
In pitting edema, what happens when pressure is applied to an area of edema?
Depression or dent results bc of the forced excessive interstitial fluid to adjacent areas
Hydrothorax is fluid in what cavity?
Thoracic cavity
Pericardial effusion is also called what disease?
Mulberry heart disease
What two characteristics are noted in pericardial effusion?
Fibrin strands and cloudy appearance
Ascites or hydroperitoneum is what type of fluid within what cavity?
Transudate in peritoneal cavity
Anasarca is what type of edema?
Generalized edema
Anasarca results in fluid accumulation in what type of tissue?
Subcutaneous tissue
Submandibular edema is commonly called what and is associated with what two types of things in sheep?
- Bottle jaw
2. Severe GI parasitism and hypoproteinemia
Edema is dependent on what three things?
- Extent
- Location
- Duration
Non-inflammatory pulmonary edema is associated with what?
Left sided congestive heart failure (CHF)
Inflammatory pulmonary edema is associated with what type of syndrome?
Acute respiratory distress syndrome (ARDS)
Inflammatory pulmonary edema happens after damage to what type of endothelium? Give Example
Damage to pulmonary capillary endothelium
Ex: Pneumonia
What type of fluid is indicative of pulmonary edema?
Frothy fluid
Pulmonary hypertension results when blood gets into what organ?
Lungs
Chronic pulmonary edema is most commonly associated with what type of failure?
Cardiac failure
What happens to the alveolar walls during chronic pulmonary edema? What may this lead to?
Alveolar walls become thickened; may lead to fibrosis
What other characteristics may be present in chronic pulmonary edema?
Congestion, micro-hemorrhages, and accumulation of heart failure cells
Heart failure cells are macrophages containing what?
Hemosiderin
Hyperemia is indicated by an increase is what type of engorgement of the vascular bed? Is blood oxygenated?
Increase in arteriole-mediated engorgement
Blood is oxygenated
Congestion is indicated by what type of engorgement? Is blood oxygenated?
Passive venous engorgement
Blood is not oxygenated
During physiological hyperemia, does blood flow increase or decrease?
Increase
Pathological hyperemia is caused by what?
Underlying pathological process-usually inflammation
During pathological hyperemia, does arteriolar dilation occur primary or secondary to inflammatory stimuli?
Secondary
T/F: Pathological hyperemia is often associated with edema
True
T/F: Gastric volvulus (torsion) in dog is an example of congestion
True
Pulmonary congestion is usually the result of what is associated with what?
- Heart failure
2. Edema
T/F: Subacute to Chronic hepatic congestion is usually the result of Left sided CHF
False; Right side CHF
What is a characteristic identifier of chronic hepatic congestion and subacute hepatic congestion?
Nutmeg liver
Hemorrhage is defined as the escape of what form blood vessels?
Blood (Extravasation)
What are some causes of hemorrhage?
- Trauma
- Sepsis, viremia, bacteremia, or toxic conditions
- Abdominal neoplasia
- Coagulation abnormalities
Hemorrhage is blood (outside or inside?) the vessel wall and hyperemia/congestion is blood (outside or inside?) the blood vessels?
- Outside
2. Inside
Hemorrhage is determined by what to things?
Location and severity
T/F: Severity plays a role in the clinical manifestation of a hemorrhage
True
What does hemopericardium lead to?
Fatal cardiac tamponade
Hemorrhage by rhexis is caused by what kind of damage in the vascular wall (or heart)?
Substantial rent or tear
Dissecting aneurysms are reported in horses and in the coronary and renal arteries of what type of animal?
Young male racing greyhounds
Dissecting aneurysms can lead to what two things?
- Arterial rupture
2. Fatal hemorrhage
Hemorrhages by diapedesis is due to what two things?
- Small defect in vessel wall
2. RBCs passing through vessel wall
T/F: Hemorrhagic diathesis is seen usually from insignificant injuries?
True
Hemoperitoneum is blood is what cavity?
Peritoneal cavity
Hemarthrosis is blood between which space?
Joint space
What is hemoptysis?
Coughing of blood or blood stained sputum form lungs or airways
Epistaxis is bleed from what?
Nose
A small Fock of hemorrhage is know as?
Petechia
Ecchymosis is larger than a petechia and is seen in what type of injury?
Bruise or small hematoma
Agonal hemorrhages are petechiae and ecchymoses associated with what?
Terminal hypoxia
What type of hemorrhage is larger than ecchymosis and is contiguous?
Suffusive hemorrhage
T/F: Paint brush hemorrhage is most common on mucosal and serosal surfaces
True
In an area of hemorrhage, small amounts can be reabsorbed while larger amounts require what two things?
- Phagocytosis
2. Degradation by macrophages
A hematoma is organized by a central mass of what two things surrounded by supportive vascular CT?
Fibrin and RBCs
What are the 3 resolutions of a hematoma?
- Hemoglobin
- Bilirubin
- Hemosiderin
What is the pathological form of hemostasis?
Thrombosis
What are the 3 general components for a normal hemostasis or thrombosis to occur?
- Vascular wall
- Platelets
- Coagulation cascade
What is the process of primary hemostasis?
- Adhesion and activation of platelets
- Shape change
- Release of secretory granules
- Recruitment
- Hemostasis plug forms
What is the process of secondary hemostasis?
- Tissue factor
- Phospholipid complex expression
- Thrombin activation
- Fibrin polymerization
What is the process of normal hemostasis?
- Vasoconstriction
- Primary hemostasis
- Secondary hemostasis
- Thrombus and antithrombotic effects
What type of cells are key players in the regulation of hemostasis?
Endothelial cells
Thrombosis is the formation of what within the CV system?
Solid mass (Thrombus)
What is a thrombus composed of?
Platelets, fibrin, entrapped blood cells
Is a thrombus adhered or detached from the vascular wall?
Adhered
T/F: Thrombus has a more opaque, dull, granular appearance
True
What three things play a role in the formation of a thrombus?
- Endothelial injury
- Alterations in blood flow
- Hypercoagulability
What is a major inhibitor of thrombin?
Antithrombin III
T/F: A dog with renal failure can develop pulmonary thrombosis
True
Verminous thrombosis is formed in what artery of horses with Strongyles vulgarisms infections?
Cranial mesenteric artery
What kind of thrombus is formed in the trifurcation of abdominal aorta?
Saddle thrombus
What are some outcomes of a thrombi?
- Lysis
- Propagation
- Embolization
- Organization/recanalization
If pieces of a thrombus break off of original mass and go down to lodge at a distant site, the process is called what? And the mass that breaks off is called what?
- Embolism
2. Embolus
What kind of embolism can be occur due to a complication of long bone fractures?
Fat embolism
T/F: Bacterial valvular endocarditis can be a cause of thrombosis/thromboembolism
True
T/F: Thrombotic meningoencephalitis (TME) is an example of thrombosis
True
What three things can be seen with disseminated intravascular coagulation (DIC)?
- Tissue hypoxia
- Infarction
- Hemorrhage
Infarction is a localized area of what necrosis in a tissue or organ caused by occlusion of either what two things?
- Ischemic necrosis
2. Atrial supply or venous drainage
T/F: Arterial infarcts are initially pale but become hemorrhagic
False, initially hemorrhagic and become pale
Microscopically, an infarction is a focal of what type of necrosis?
Coagulation necrosis
Shock gives rise to what?
System hypoperfusion
Shock may lead to what two things?
DIC and multi-organ system failure
What are 3 types of shock?
- Cardiogenic shock
- Hypovolemic shock
- Blood maldistribution
What kind of bacteria causes septic shock?
Endotoxin producing gram negative bacilli