Exam 1: Circulatory Disorders Parts 1&2 Flashcards
What are the 3 functions of the Vascular endothelium?
- role in hemostasis
- Modulates Perfusion
- Role in inflammation
arrest bleeding by the physiological properties of vasoconstriction and coagulation or by surgical means
Hemostasis
The space between tissue comaprtments
interstitium
Water distribution b/t plasma and theinterstitium is primarily determined by the ____ and ____ pressure differences b/t the 2 compartments
hydrostatic , oncotic
What equation is used to measure pressure differences between two compartments?
starling equation
T/F Capillary hydrostatic and oncotic pressures are normally equal
T
T/F. an inc. in hydrostatic pressure or diminished plasma osmotic pressure will cause extravascular fluid to accumulate.
T
List the 7 circulatory disturbances
- edema
- hyperemia & congestion
- Hemostasis
- Helmorrhage
- Thrombosis, embolism, DIC
- infarction
- Shock
Abnormal accumulation of excess extracellular water in interstitial spaces or body cavities
Edema
What are the 4 pathomechanisms of Edema?
- inc. blood hydrostatic pressure
- dec. plasma colloidal osmotic pressure
- lympahtic obstruction
- inc. vascular permeability
What are the 2 categories of edema?
- inflammatory
2. non-inflammatory
Type of edema that is characterized by an inc vascular permeability
Inflammatory
What is inflammatory edema referred as?
exudate
What is non-inflammatory edema referred to as?
Transudate
liver failure causes which type of edema?
non-inflammatory
What does edema look like in cadaver?
- Wet
- gelatinous/ heavy
- swollen organs
- fluid weeps when cut
- yellow
When pressure is applied to an area of edema a depression results as excessive interstitial fluid is forced to adjacent areas
Pitting edema
Fluid in the thoracic cavity
hydrothorax
fluid within the peritoneal cavity
Ascites/hydroperitoneum
Generalized edema with profuse accumulation of fluid within the subcutaneous tissue
Anasarca
What are the 3 factors that determine the clinical significance of edema?
- extent
- location
- duration
Which type of edema is associated with damage to pulmonary capillary endothelium
inflammatory
Which type of edema is associated with left sided CHF?
non-inflammatory
What does ARDS stand for?
Acute respiratory distress syndrome
What is chronic pulmonary edema most commonly associated with?
cardiac failure
inc. of arteriole-mediated engorgement of the vascular bed
Hyperemia
passive, venous engorgement
congestion
Hyperemia or congestion?
Blood is not oxygenated?
congestion
Hyperemia or congestion?
blood is oxygenated
hyperemia
What are the 2 types of hyperemia?
- physiological
2. pathological
what are 4 examples of physiological hyperemia?
- digestion= inc blood to GIT
- Exercise= inc blood to m.
- Dissipate heat
- neurovascular= blushing
What causes pathological hyperemia?
underlying pathological processes, usually inflammation
List 2 examples of pathological hyperemia
- gingivitis
2. conjunctivitis
passive engorgement of vascular beds caused by a dec. outflow of blood
congestion
Usually the result of heart failure and associated with edema.
pulmonary congestion
subacute to chronic ______ is usually the result of right sided CHF.
hepatic congestion
the escape of blood from the blood vessels
hemorrhage
what are the two types of hemorrhage
internal or external
What are some of the primary causes of hemorrhage?
- Trauma
- Sepsis
- viremia/bacteremia/toxins
- abdominal neoplasia
- Coagulation abnormalities
What is the diff. between hemorrhage and hyperemia/congestion?
hemorrage means blood is outside the vessel wall, hyperemia means blood is within the vessels
How is the clinical significance of hemorrhage determined?
Location and severity
Hemorrhage due to a substantial tear in the vascular wall
Hemorrhage by rhexis
Hemorrhage due to a small defect in the vessel wall or rbcs passing through the vessel wall in cases of inflammation or congestion
Hemorrhage by diapedesis
inc. tendency to hemorrhage from usually insignificant injuries
hemorrhagic diathesis
blood in the thoracic cavity
hemothorax
blood in the peritoneal cavity
hemoperitoneum
blood within a joint space
Hemoarthrosis
coughing up of blood or blood-stained sputum from the lungs or airways
hemoptysis
Bleeding from the nose
epistaxis
hemorrhage that is up to 1-2mm in size
petechia
Where is petechia commonly found?
skin, mucosal and serosal surfaces
hemorrhage that is larger than petechia, up to 2cm in size
ecchymosis
hemorrhage that is larger than ecchymosis
suffusive hemorrhage
petechiae and ecchymoses associated with terminal hypoxia
agonal hemorrhages
hemorrhage that looks like if red paint was hastily applied with a paint brush
paint-brush hemorrhage
where is paint brush hemorrhage most commonly found?
mucosal and serosal surfaces
Central mass of fibrin and RBCs surrounded by supportive vascular CT
Organizing hematoma
arrest bleeding by physiological or surgical means
hemostasis
The pathological form of hemostasis
thrombosis
What is thrombosis?
A clot that forms within a vessel which is not injured or only mildly injured.
What are the 3 general components necessary for normal hemostasis to occur?
- vascular wall
- platelets
- coagulation cascade
Aggregate of platelets, fibrin, and entrapped blood cells
thrombus
What are the 3 components of the virchow triad?
- endothelial injury
- Alterations in blood flow
- hypercoagulability
What are the 3 ways you can get hypercoagulability?
- inc. in coagulation factors
- inc. in sensitivity to coagulation factors
- dec. in coagulation inhibitors
Thrombus formation in the cranial mesenteric artery of horses with strogylus vulgaris infection
verminous thrombosis
what are the 4 possible outcomes of thrombi
- lysis
- propagation
- embolism
- organization
What is embolism?
when pieces of a thrombus break off from the original mass and sail downstrem to lodge at a distant site
The mass that breaks off a thrombus
embolus
A physiological response to vascular damage to seal an injured vessel to prevent blood loss
hemostasis
What does DIC stand for and what is it?
Disseminated Intravascular Coagulation
systemic reaction in which there is generalized activation of the blood coagulation system
Localized area of ischemic necrosis in a tissue or organ caused by occlusion of either the arterial supply or the venous drainage
infarction
What are the 3 types of shock?
- cardiogenic shock
- hypovolemic shock
- blood maldistribution
What is cardiogenic shock?
failure of the heart to maintain normal cardiac output
What is hypovolemic shock?
fluid loss due to hemorrhage, vomiting, or diarrhea
What are the 3 types of blood maldistribution?
- anaphylactic
- neurogenic
- septic
What causes anaphylactic blood maldistribution shock
type 1 hypersensitivity
What causes neurogenic blood maldistribution shock?
neurological injury leading to loss of vascular tone and peripheral pooling of blood
what causes septic blood maldistribution shock?
host innate IS response to infectious organisms that may be blood borne or localized to a particular site
what is the most common cause of septic shock/
endothoxin-producing gram-negative bacilli
