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MHD Block 1 > Disorders of Circulation > Flashcards

Disorders of Circulation Flashcards

1
Q

Define hyperemia and congestion?

A

both refer to increased intravascular volume in a tissue, an organ, or body part

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2
Q

What kind of process is hyperemia, and how does it occur?

A

Hyperemia is an active process, and is caused by arteriolar dilation and increased blood flow. This is caused by sympathetic neurogenic discharge or chemical mediators

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3
Q

What will be the appearance of tissues with hyperemia?

A

rubor (red) color

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4
Q

What are two exmaples of hyperemia?

A

sites of inflammation

exercising skeletal muscle

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5
Q

What kind of process is congestion, and how does it occur?

A

Congestion is a passive process, caused by impaired outflow of venous blood from a tissue. Can be systemic or local, acute or chronic

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6
Q

What will be the appearance of tissues with congestion?

A

red-blue color

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7
Q

What is a clinical example of congestion?

A

congestive heart failure resulting in hepatic congestion

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8
Q

What are the characteristics of a necrotic cell in chronic hepatocyte congestion?

A

loss of nuclei
cytoplasm is ragged (no distinct outline of cells)
coagulative necrosis
pyknosis

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9
Q

define hemostasis

A

a series of regulated processes that maintain blood in a fluid cot-free state in normal vessels, and rapidly forms a localized hemostatic plug at the site of vascular injury

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10
Q

Define hemorrhage

A

flow of blood from a ruptured blood vessel - blood may flow into tissue, body cavity, or outside the body

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11
Q

What can lead to hemorrhage?

A

trauma

pathological process (congestion, inflammation, neoplastic erosion of vessel)

abnormal hemostasis

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12
Q

Define edema

A

result of movement of fluid from vasculature into interstitial spaces or body cavities

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13
Q

What pathological processes can lead to edema?

A

increased hydrostatic pressure

decreased colloid osmotic pressure due to reduced albumin

lymphatic obstruction

increased vascular permeability

sodium retention

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14
Q

What can result from edema due to increased hydrostatic pressure?

A

systemic: heart failure

Local: impaired venous return post deep venous thrombosis

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15
Q

How can reduced colloid osmotic pressure occur?

A

decreased synthesis of albumin (liver disease, malnutrition)

increased loss of albumin (nephrotic syndrome)

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16
Q

What can a lymphatic obstruction be caused by?

A

neoplasm

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17
Q

what can cause increased vascular permeability?

A

inflammation

18
Q

What can cause sodium retention?

A

renal failure

19
Q

What are the three main pathways leading to edema?

A

heart failure leading to increased capillary hydrostatic pressure and edema

decreased renal blood flow which activates the renin-angiotensis-aldosterone system resulting in retention of Na and H20 which will increase blood volume and lead to edema

malnutrition, decreased hepatic synthesis, or nephrotic syndrome can result in decreased plasma albumin which will lead to edema

20
Q

what is transudate normally due to?

A

increased hydrostatic pressure and/or decreased colloid osmotic pressure

21
Q

What is exudate normally do to?

A

inflammation

22
Q

Define Thrombosis

A

formation of a blood clot within an intact vessel

23
Q

Is a thrombosis normal or pathological?

A

thrombosis is pathological

24
Q

What are three key elements to maintain normal hemostasis?

A

vascular wall (esp endothelium) must be intact

platelets

coagulation cascade

25
Q

What are three mechanisms that will lead to thrombosis (Virchow’s triad)?

A

endothelial injury (inflammation, atherosclerosis)

altered blood flow (turbulence, stasis)

hypercoagulable state (predisposed - inherited protein C deficiency, smoking/oral contraceptives, cancer, obesity)

26
Q

What is the most important factor in Virchow’s triad of thrombosis?

A

endothelial integrity

27
Q

Define embolism

A

intravscular substance (solid, liquid, gas) which is carried by blood from the point of origin to a distant site

28
Q

What are some different types of emboli?

A

fragments of thrombi (thromboembolism)

atherosclerotic

amniotic fluid

air (gas)

fat (from bone marrow)

29
Q

When will a bone marrow/fat embolus develop?

A

in patients with severe skeletal injuries

fat embolism syndrome is systemic and presents with pulmonary insufficiency, neuro symptoms, anemia, thrombocytopenia, petechial rash

30
Q

When will an amniotic fluid emboli develop?

A

uncommon complication of labor, mortality rate 80%

presents with nuro deficits, dyspnea, cyanosis, shock

31
Q

Define infarct

A

area of ischemic necrosis (coagulative) caused by occlusion of vascular supply to the affected tissue

32
Q

What are the majority of infarcts associated with?

A

thromboembolism and involve arterial occlusions

33
Q

What are the two types of infarcts?

A

White (pale) and Red

34
Q

Describe white infarcts

A

due to arterial occlusions of solid organs with end-arterial circulation (eg heart, liver, spleen, kidney)

35
Q

What are red infarcts due to

A

venous occlusions

tissues with dual circulations

loose tissues

flow re-established after infacrction

36
Q

What are some factors that influence infarct development?

A

Nature of vascular supply
Rate of development of occlusion
Vulnerability of tissue to hypoxia
Oxygen content of blood

37
Q

What is the clinical outcome of thrombosis?

A

Survival of patient determined by size and location of infarct as well as collateral circulation

38
Q

define shock

A

characterized by profound systemic hypoperfusion of tissues with resultant impaired tissue perfusion and cellular hypoxia

39
Q

What are the three major types of shock?

A

cardiogenic

hypovolemic

septic

40
Q

Describe cardiogenic shock

A

low cardiac output due to myocardial pump failure

  • MI
  • ventricular rupture
  • arrhytmia
  • cardiac tamponade
41
Q

describe hypovolemic shock

A

low cardiac output due to loss of blood or plasma volume

  • hemorrhage
  • fluid loss (vomiting, diarrhea, burns, trauma)
42
Q

describe septic shock

A

arteriolar vasodilation and venous blood pooling that stems from systemic immune response to microbial infection

MHD Block 1 (7 decks)

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