Edema/Congestion/Hemostasis Flashcards
What is edema?
increased fluid within interstitial tissues
True or False: Increased fluid (edema) can results from decreased hydrostatic pressure and increased venous return.
False: Edema = increased hydrostatic pressure with decreased venous return
Edema can result from ______ plasma osmotic pressure.
Reduced (decreased proteins allows fluid to penetrate more easily)
Edema can result from ______ obstruction.
lymphatic
Edema can result from ______ and water retention.
sodium
True or False: Edema can result from inflammation.
true
Decrease in protein = _______ in osmotic pressure
decrease
In the case of “transudate,” which is higher: Osmotic Pressure or Hydrostatic Pressure?
Hydrostatic pressure (transudate = low protein = leakiness)
What is “effusion?”
collection of fluid in the body cavity or space
What are four typical types of effusion?
Pleural (lung)
Pericardial (heart)
Peritoneal (abdomen)
Joint Space
________ is the increase in tissue blood volume secondary to neurogenic mechanisms or inflammation
Hyperemia
________ is the increase in tissue blood volume secondary to impaired venous return
Congestion
True or False: Hyperemia is an active process.
True (things are moving quickly)
True or False: Congestion is an active process.
False. It is PASSIVE (outflow is restricted)
Hyperemia is characterized by _________ inflow such as in exercise or inflammatory processes.
increased
Congestion is characterized by ________ outflow such as in congestive heart failure.
decreased
What is a hemorrhage?
Loss of blood secondary to vessel injury or physical disruption (total or partial)
Hemorrhage can be of what two varieties?
Internal (not to a surface)
External (bleeding out)
What are four signs of “internal hemorrhage” that appear on the skin?
Hematoma
Ecchymosis
Purpura
Petecchia
A _______ is a large mass (tumor) of blood.
hematoma
_________ is a sign of internal hemorrhage that is 1 cm or larger.
Ecchymosis
A ______ is between 0.3 and 0.9 cm (3-9 mm).
Purpura
How large are petechia?
1 to 2 mm (pinpoints)
“Shock” is the loss of more than ____ % blood volume and is also called _____ hemorrhage.
20
acute
Anemia is an example of ______ hemorrhage.
chronic
True or False: Hemorrhage can flow into body spaces.
True
ex. hemothorax, hemopericardium, hemarthrosis, hemoperitoneum
With which disease is petechial hemorrhage commonly seen?
mononucleosis
What is hemostasis?
Rapid arrest of blood loss at site of injury
What are the three major components of hemostasis?
- Endothelium
- Platelets
- Coagulation Cascade
Endothelial cells line the vascular surfaces and control the clotting system by regulating the expression of binding sites for ________ and ______ factors on the cell
anticoagulant
procoagulant
Platelets function mostly as a ______.
procoagulant
The _______ cascade is a series of proteolytic events.
coagulation
vWF and the extrinsic pathway (tissue factor) are involved in ________.
thrombosis
Exposure of membrane-bound _______ will initiate the extrinsic coagulation sequence.
tissue factor
Von Willebrand Factor binds to _______ when it is exposed in endothelial cells due to damage occurring to the blood vessel.
collagen
Factor _____ is bound to vWF (preventing its destruction) while it is inactive in circulation and is released from vWF by the action of thrombin.
VIII
What are some of the molecules involved in INHIBITION of thrombosis?
Antithrombin III = inactivates thrombin
Thrombomodulin = binds thrombin to activate Protein C
Prostacyclin/NO = inhibit platelet aggregation
t-Pa = activates fibrinolysis
von Wildebrand Factor binds to ______ on platelets.
GP I b
The extrinsic system of the coagulation cascade is dependent on ________.
tissue factor
The intrinsic system of the coagulation cascade involves factor ______.
twelve (XII)
The coagulation cascade involves what four basic elements? 1. active enzyme 2. substrate 3. 4.
- Cofactor
4. Calcium
What would a calcium-chelator due to the coagulation cascade?
it would prevent clotting because you need calcium to form the clot
What are the two final products of coagulation?
thrombin
fibrin
In coagulation, what occurs prior to Primary and Secondary Hemostasis?
Vasoconstriction
Why is vasoconstriction important in coagulation?
minimizes the surface area that must be filled in by platelets
What occurs during Primary Hemostasis?
Platelets adhere Platelets flatten out on top of the vWF and collagen Granules (ADP, TXA2) are released Recruitment of more platelets Hemostatic Plug
What occurs during Secondary Hemostasis?
Tissue Factor is released Complex expression of phospholipid Thrombin is activated Fibrin polymerization (meshwork) = more stable clot than "hemostatic plug" of primary hemostasis
Why is fibrinolysis important in the coagulation cascade?
you do NOT want to completely close off blood supply…the clot is trimmed to fit the area of injury
______ trims the clot after it is activated by ______
Plasmin
tPA (tissue plasminogen activator)
What does thrombomodulin do?
blocks the coagulation cascade by acting as a cofactor in the activation of Protein C (antigoagulation path)
True or False: Fibrin degradation products are able to activate monocytes and cause inflammation.
True (this causes issues in areas away from the injury)
_______ is involved in neutrophil adhesion, monocyte activation, and platelet activation.
Thrombin
