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Disease processes > Haemodynamic disorders > Flashcards

Haemodynamic disorders Flashcards

Week 1

1
Q

Haemodynamics

A

the movement of blood, the study of blood circulation

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2
Q

What does homeostasis require?

A

vessel wall integrity
osmolarity
maintenance of intravascular pressure

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3
Q

Hydrostatic pressure

A

pressure exerted by a fluid at equilibrium at a given point within the fluid

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4
Q

What does a high hydrostatic pressure do to fluid

A

drives it out of the vessel and into the tissues

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5
Q

What is colloid osmotic pressure

A

a form of osmotic pressure exerted by proteins (albumin)

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6
Q

What does high colloid osmotic pressure do to fluid

A

drives fluid into the vessel from the interstitial space

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7
Q

Hydrothorax

A

oedema in the thoracic cavity

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8
Q

Hydropericardium

A

oedema in the pericardial cavity

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9
Q

General causes of oedema

A 
increased hydrostatic pressure
decreased colloid osmotic pressure
lymphatic obstruction 
sodium retention 
inflammation
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10
Q

example of oedema due to increased hydrostatic pressure

A

generalised heart failure

localised in limbs in DVT

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11
Q

example of oedema due to decreased colloid osmotic pressure

A

reduction in general plasma proteins (e.g. liver cirrhosis and malnutrition).

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12
Q

Anasarca

A

widespread swelling of the skin due to effusion of fluid into extracellular space

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13
Q

what conditions can cause anasarca

A

cirrhosis, renal failure, right-sided heart failure, severe malnutrition

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14
Q

example of oedema due to lymphatic obstruction

A

elephantiasis (lymph nodes blocked by parasitic worm)
malignancy
following surgery and radiation therapy

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15
Q

example of oedema due to sodium retention

A

excessive salt intake in renal insufficiency

increased renin-angiotensin-aldosterone system –> these increase hydrostatic pressure

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16
Q

3 phases of the circulatory haemostats process

A

1- haemorrhage (process of bleeding)
2- thrombosis (process of clotting)
3- fibrinolysis (process of close dissolution)

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17
Q

what is a haemorrhage?

A

the extravasation of blood due to rupture of blood vessel. can be internal or external.

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18
Q

what happens if you have above 20% blood loss

A

hypovolemic shock (severe fluid loss makes it impossible for heart to pump sufficient blood around the body, can lead to organ failure)

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19
Q

name 4 causes of haemorrhage

A

trauma
atherosclerosis
inflammation
erosion by tumour

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20
Q

name 3 types of bleeding into skin in size order

A

petechiae
purpura
ecchymosis

21
Q

petechiae

A 
minute haemorrhage (1-2 mm) of skin and mucosa
occurs during thrombocytopenia, clotting factor deficiency or increased pressure in capillaries
22
Q

purpura

A 
small haemorrhage (3-5 mm) 
Usually due to trauma or vasculitis
23
Q

ecchymosis

A

subcutaneous hepatoma. changes in colour from red –> blue-green –> yellow —> brown

24
Q

what is a blood clot made up of

A

platelets, red blood cells, neutrophils, lymphocytes held together by fibrin

25
Q

what 3 main factors can form a thrombus

A

endothelial injury, abnormal blood flow, hyper-coagulability

26
Q

what are arterial thrombi usually made up of

A

platelets

27
Q

why are arterial thrombi made up of platelets

A

blood is flowing under higher pressure. form around ruptured atherosclerotic plaques or damaged endothelium.

28
Q

what is the name of the arterial thrombi that don’t occlude vessel

A

mural thrombi

29
Q

occlusive thrombi

A

occludes vessel

30
Q

what are venous thrombi rich in

A

fibrin

31
Q

how is a venous thrombi formed

A

changes in blood flow (stasis due to immobility) –> activates coagulation system –> hyper coagulation –> fibrin driven response

32
Q

what is an embolism?

A

solid, liquid or gaseous mass carried in the blood to a site distant from the point of origin, clinical significance is related to where they lodge rather than origin

33
Q

what are nearly all emboli the result of

A

a dislodged thrombus (a thromboembolism)

34
Q

what is are hyperaemia and congestion characterised by

A

a local increase of blood volume in a particular tissue

35
Q

hyperaemia

A

increased blood flow in to a tissue in response to a change in the environment

36
Q

2 types of hyperaemia

A

reactive –> local vasodilation in response to oxygen debt or accumulation of metabolic waste
active –> increased blood flow/vasodilation is response to a period of activation (e.g exercise)

37
Q

congestion

A

reduced blood flow out caused by impaired venous return from the affected area (passive process)

38
Q

what can cause congestion

A

physical obstruction of veins or failure of heart to pump blood away from affected area

39
Q

what is circulatory shock

A

life-threatening medical condition that occurs due to the provision of inadequate substrates for cellular respiration

40
Q

typical symptoms of shock

A 
weak heart rate
low blood pressure
poor organ function
confusion
low urine output
loss of consciousness
41
Q

causes of shock

A

reduced cardiac output or ineffective circulation

42
Q

types of shock

A 
cariogenic shock 
hypovolemic shock 
septic shock 
neurogenic shock
anaphylactic shock
43
Q

cardiogenic shock

A

failure of the heart to pump sufficient blood due to myocardial damage (e.g. myocardial infarction, arrhythmia, pulmonary embolism with outflow obstruction)

44
Q

hypovolemic shock

A

loss of blood plasma (e.g. haemorrhage or severe burns

45
Q

septic shock

A

systemic infection, primary cause is bacteria (bacteria in the bloodstream).

46
Q

sepsis vs septic shock

A

sepsis –> uncontrolled systemic reaction to the infection leading to life threatening organ dysfunction
septic shock –> subset of patients with sepsis in which particularly profound circulatory, cellular and metabolic abnormalities substantially increase mortality

infection –> bacteremia –> sepsis –> septic shock

47
Q

neurogenic shock

A

caused by severe damage to the CNS. loss of systemic stimulation of blood vessels (via sympathetic adrenergic stimulation). leads to widespread vasodilation, pooling of blood in extremities and hypotension

48
Q

anaphylactic shock

A

severe allergic reaction causes release of inflammatory mediators cytokines (triggers widespread vasodilation and hypo perfusion).

Disease processes (21 decks)

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