Disorders of Circulation Flashcards

1
Q

Definition of hyperemia and congestion

A

Increased intravascular blood volume in tissue, an organ, or part of the body

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2
Q

What is hyperemia more specifically?

A

Dilatation of an artery or arteriole and increased blood flow into the capillaries

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3
Q

What causes active hyperemia?

A

Sympathetic neurogenic discharge or chemical mediators

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4
Q

Clinical examples of hyperemia

A

Acute inflammation of tissue, blushing, body’s need to disippate heat

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5
Q

How does hyperemic skin appear?

A

Red

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6
Q

What causes passive hyperemia?

A

(Congestion)

Impaired venous drainage due to active influence of sympathetic discharge or chemical mediator

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7
Q

What is the most common cause of congestion?

A

Right-sided heart failure

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8
Q

Definition of edema

A

Accumulation of abnormal amounts of fluid in interstitial spaces or body cavities

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9
Q

Forces that influence movement of fluid across the capillary wall

A

Capillary hydrostatic pressure
interstitial hydrostatic pressure
Plasma colloid osmotic pressure
Interstitial colloid osmotic pressure

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10
Q

What is the normal physiology of fluid distribution?

A

All the osmotic forces are near equilibrium and allows for most of the fluid to remain in the vascular compartment and what isn’t is cleared by lymphatics

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11
Q

Non-inflammatory edema

A

Fluid accumulates in the interstitium as a consequence of changes in hydrostatic pressure and colloid osmotic pressure

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12
Q

Transudate

A

Non-inflammatory edema

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13
Q

Inflammatory fluid accumulation

A

Tissue injury alters blood flow and vascular permeability as a result of increased interendothelial space, which is modulated by chemical mediators

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14
Q

Exudate

A

Inflammatory edema

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15
Q

Definition of hemorrhage

A

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

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16
Q

Mechanism of hemorrhage

A

Occurs when a large or small blood vessel is disrupted by a mechanical force (trauma) or a pathological process (inflammation, neoplasm)

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17
Q

Bleeding diathesis

A

Abnormal hemostasis that causes a predisposition to bleeding

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18
Q

What is the only normal hemorrhage?

A

Menstruation

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19
Q

Hematoma

A

Solid swelling of clotted blood under the skin

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20
Q

Hemothorax

A

Accumulation of blood in the pleural cavity

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21
Q

Hemopericardium

A

Blood in the pericardial sac of the heart

22
Q

Hemoperitoneum

A

Blood in the abdominal cavity

23
Q

Hemarthrosis

A

Blood in the joint cavity

24
Q

Petechiae

A

Small red or purple spots on the skin caused by ruptured capillaries

25
Q

Purpura

A

Slightly larger red or purple spots on the skin caused by ruptured vessels

26
Q

Ecchymosis

A

Discoloration under the skin caused by bleeding into tissues

27
Q

Definition of thrombosis

A

Blood clot within an uninterrupted vascular system

28
Q

Three mechanisms of thrombosis

A

Endothelial injury, altered blood flow, hypercoagulable state

29
Q

Examples of endothelial injury as a mechanism of thrombosis

A

Inflammation, advanced atherosclerosis

30
Q

Examples of altered blood flow as a mechanism of thrombosis

A

Turbulence vs. stasis: a-fib, bed rest

31
Q

Examples of hypercoagulable state as a mechanism of thrombosis

A

Predisposition to easy clot formation: protein C deficiency, increased risk by OCPs and smoking

32
Q

Four fates of a thrombus

A

Propagation
Dissolution
Embolization
Organization & recanalization

33
Q

Define propagation. What are its consequences?

A

Thrombus enlarges, resulting in increased odd of vascular occlusion or embolization

34
Q

Define dissolution

A

Activation of the body’s fibrinolytic system may lead to rapid shrinkage and even complete dissolution of a newly formed thrombus

35
Q

What occurs over time as the thrombus is being dissolved?

A

Extensive fibrin polymerization renders the thrombus increasingly resistant to lysis/dissolution.

36
Q

Define embolization (process of thrombosis)

A

Part or all of the thrombus is dislodged and travels elsewhere in the vasculature

37
Q

Define organization and recanalization

A

Older thrombi become “organized” with the ingrowth of endothelial cells, smooth muscle cells, and fibroblasts into the thrombus. With time, small vascular channels are formed, reestablishing some flow in the lumen.

38
Q

Definition of an embolism (separate definition)

A

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

39
Q

Four types of emboli

A

Thromboembolism
Amniotic fluid
Gas
Fat and marrow embolism

40
Q

Describe amniotic fluid as an embolism process.

A

Uncommon, serious complication of labor; amniotic fluid enters placental membranes and/or uterine vein rupture

41
Q

Describe gas as an embolism process.

A

Gas bubbles within circulation obstruct vascular flow, which can develop during medical procedures or from decompression sickness

42
Q

Describe fat and marrow embolisms

A

Happens s/p soft tissue crush injury or long bone injury where marrow vascular sinusoids release microscopic fat globules into circulation

43
Q

Describe mortality of fat embolism syndrome

A

Systemic; fatal in 10+% of patients

44
Q

Define infarction

A

Area of ischemic necrosis within tissue or an organ, produced by occlusion of either its arterial supply or venous drainage.

45
Q

Majority of infarcts are associated with what?

A

Arterial occlusion by thromboembolism

46
Q

Types of infarct

A

White (ischemic, arterial) and red (hemorrhagic, venous or arterial)

47
Q

Four factors influencing development of an infarct

A
  • Nature of vascular supply
  • Rate of development of the occlusion
  • Vulnerability of tissue to hypoxia
  • Oxygen content of the blood
48
Q

Clinical outcome of a thrombosis depends on which two factors?

A

Degree of occlusion and size/location of the blood vessel

49
Q

Definition of shock

A

Final common pathway for a number of possible events which result in systemic hypoperfusion of tissues

50
Q

What can cause shock?

A

Diminished cardiac output or reduced effective circulating blood volume

51
Q

Three types of shock

A

Cardiogenic, hypovolemic, and septic

52
Q

What causes septic shock?

A

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