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D&D Unit 2 > Hemodynamic Basis of Disease (complete) > Flashcards

Hemodynamic Basis of Disease (complete) Flashcards

1
Q

What is the role of hydrostatic pressure in maintaining body fluid balance?

A

Pushes fluid from arterial end of capillary to interstitial space

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2
Q

What is the role of oncotic pressure in maintaining body fluid balance?

A

Essentially plasma protein concentration

When hydrostatic pressure pulls fluid out of arterial end, oncotic pressure increases —» causes fluid to be pulled back into venous end of capillary to balance the [plasma protein]

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3
Q

Define edema

A

fluid movement from capillaries to adjacent tissue

transudate or exudate

CAUSE: Increased hydrostatic pressure and decreased oncotic pressure

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4
Q

Define effusion

A

fluid movement from capillaries to body cavity

transudate or exudate

CAUSE: Increased hydrostatic pressure and decreased oncotic pressure

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5
Q

Define hypermia

A

An active increase in blood flow due to arteriolar dilation

  • Brings inflammatory/repair mediators to areas of tissue damage/infection
  • Provides ^O2 to exercising skeletal muscle
  • Causes a red coloration (erythema) to tissue b/c of ^ mass of oxygenated RBCs
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6
Q

Define congestion

A

Pathologic accumulation of blood due to impaired outflow of venous blood

  • Has red/blue color due to deoxy blood accumulation
  • May have increased hydrostatic pressure
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7
Q

What is the underlying etiology of exudate?

A

Increased vessel permeability due to inflammation — damaged blood vessels

A type of edema/effusion

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8
Q

Is the protein fluid/serum ratio higher in exudate or transudate?

A

Exudate

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9
Q

Is the LDH fluid/serum ratio higher in exudate or transudate?

A

Exudate

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10
Q

Is the glucose fluid/serum ratio higher in exudate or transudate?

A

Transudate

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11
Q

Describe the cells in exudate

A

Many WBCs

> 1000/microL

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12
Q

What is the underlying etiology of transudate?

A

Ultrafiltrate of plasma

Increased hydrostatic pressure and/or reduced oncotic pressure

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13
Q

Describe the cells found in transudate

A

None or few WBCs

<1000/microL

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14
Q

What are the defects that lead to hemorrhage?

A

1) Damaged blood vessel walls
2) impaired function/low levels of platelets or coag factors

Essentially:

  • Because damage exceeds body’s normal hemostatic mechanisms
  • hemostatic mechs cannot manage/repair normal levels of damage
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15
Q

Name the key factors (Virchow’s Triad) that are involved in thrombosis

A

1) endothelial injury
2) abnormal blood flow (stasis or turbulence)
3) hypercoagulability (inherited or acquired)

Thrombosis can occur b/c of 1 or more factors

THINK: out of control clotting

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16
Q

What is the difference between a thrombus and an embolus?

A

Thrombi are attached to the vessel wall

Emboli are detached/fragmented thrombi (free floating)

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17
Q

Describe disseminated intravascular coagulation (DIC)

A
  • Thrombosis and hemorrhage occur simultaneously

T dominates chronic DIC
H dominates acute DIC

Often presents w/

1) anemia
2) respiratory insufficiency (b/c of small clots in lungs)
3) convulsions (b/c of small clots in brain)
4) acute renal failure (thrombi in glomeruli)
5) shock

18
Q

Describe white infarcts

A
  • Arterial blockage
  • single blood supply
  • dense tissue
  • organs: kidney, heart, spleen

No reperfusion
No opportunity for hemorrhage

bottomline — NECROSIS!

19
Q

Describe red infarcts

A
  • Venous blockage
  • dual blood supply
  • loose tissue
  • reperfusion
  • organs: lung, liver, intestine

Was an opportunity for hemorrhage

bottomline — NECROSIS!

20
Q

What is shock? Which types exist?

A

Occurs when circulating blood volume or pressure is not adequate to perfuse body tissues —»> widespread cell hypoxia

1) Cardiogenic shock
2) Hypovolemic shock
3) Septic shock

21
Q

Describe cardiogenic shock

A

Results from failure of heart to pump adequate blood and/or generate adequate blood pressure to perfuse distal tissues

22
Q

Describe hypovolemic shock

A

Happens when there’s not enough blood volume to perfuse all tissues

Cardiac output decreases b/c of low blood return to heart

Vasoconstriction, ^HR, renal conservation of fluid

23
Q

Describe septic shock

A

B/c of systemic inflammation (SIRS)

Micro infections —» high levels of inflammatory mediators —» arterial vasodilation, vascular leakage, venous pooling

Hypotension, decreased tissue perfusion

24
Q

What are the sources/causes of thromboemboli of the venous style?

A

Deep leg veins

also, arm veins (but less come than legs)

Most common emboli of right side/venous circulation

25
Q

Which organs are affected by thromboemboli of the venous style?

A

Lungs

26
Q

What are the clinical outcomes of thromboemboli of the venous style?

A

Respiratory insufficiency

Chest pain

27
Q

What are the sources/causes of fat/BM emboli?

A

Long bone fractures (think leakage!)

These cause vein damage

28
Q

Which organs are affected by fat/BM emboli?

A

Lungs

29
Q

What are the clinical outcomes of fat/BM emboli?

A

Respiratory insufficiency 1-3 days post-trauma (bone breaking)

mental status changes!

30
Q

What are the sources/causes of amniotic fluid emboli?

A

Torn placental membranes

Uterine vein rupture

31
Q

Which organs are affected by amniotic fluid emboli?

A

Lungs

Brain

Vasculature

32
Q

What are the clinical outcomes of amniotic fluid emboli?

A

Respiratory insufficiency, shock, seizures — all during labor or immediately post-partum

Causes 10% of maternal deaths

33
Q

What are the sources/causes of thromboemboli of the arteriole style?

A

Heart (vegetations/mural thrombi)

Aorta, carotid artery

34
Q

Which organs are affected by thromboemboli of the arteriole style?

A

Legs (75%)

Brain (10%)

No idea what happened to the other 15%

35
Q

What are the clinical outcomes of thromboemboli of the arteriole style?

A

Stroke

Tissue necrosis in the leg

36
Q

What are the sources/causes of atheroemboli?

A

atherosclerotic plaque of the aorta, iliac, carotid arteries

37
Q

Which organs are affected by atheroemboli?

A
  • Legs
  • Brain
  • GI tract
  • Kidney
38
Q

What are the clinical outcomes of atheroemboli?

A
  • Stroke
  • Tissue necrosis in the leg
  • GI pain/bleeding
  • Acute kidney injury

Most common emboli of left side/arteriole circulation

39
Q

Which organs are generally affected by emboli in the right side/venous circulation?

A

Da lungs!

40
Q

Which organs are generally affected by emboli in the left side/arteriole circulation?

A

Pretty much any organ

More commonly, legs or brain

D&D Unit 2 (10 decks)

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