Hemodynamic Disorders Flashcards
____ delivers oxygen and nutrients to tissues and removes wastes
blood circulation
The functions of circulation include:
- Delivers oxygen & nutrients
- Wastes are removed
Blood clotting that prevents excess bleeding after blood vessel damage:
hemostasis
Inappropriate clotting:
thrombosis
migration of clots:
embolism
active process, arteriolar dilation and increased blood inflow:
hyperemia
Describe the color of blood associated with hyperemia:
Red color- due to oxygenated hemoglobin
Passive process, impaired outflow of venous blood from a tissue:
congestion
Describe the color of blood associated with congestion:
blue/red color (cyanosis)- deoxygenated hemoglobin
Hyperemia is a ____ process
Congestion is a ____ process
Hyperemia- active
Congestion- passive
What is seen in this image? Is the specimen from a living or dead individual?
Liver with chronic passive congestion and hemorrhagic necrosis- they dead
_____% of body weight is water, ___ intracellular
60%; 2/3
2/3 of the 60% water comprising our body weight is:
intracellular
The remaining fluid of the body (not including the water) is comprised by mostly:
interstitial fluid
around ___% blood plasma is found in the body
5%
accumulation of interstitial fluid in tissues
edema
Edema is the accumulation of ___ in tissues
interstitial fluid
extravascular fluid that collects in body cavities:
effusions
Effusions are ___ that collects in body cavities
extravascular fluid
Effusion in the pleural cavity:
hydrothorax
Effusion in the pericardial cavity:
hydropericardium
Effusion in the peritoneal cavity:
hydroperitoneum or ascites
Severe generalized edema due to fluid retention in tissues and cavities:
Anasarca
Causes of edema include: (5)
- increased hydrostatic pressure
- reduced plasma osmotic pressure (hypoproteinemia)
- lymphatic obstruction
- sodium retention
- inflammation
What may cause increased hydrostatic pressure that leads to edema? (2)
- impaired venous return
- arteriolar dilation
- CHF
- Constrictive pericarditis
- Ascites (liver cirrhosis)
- Venous obstruction or compression
- Thrombosis
- External pressure (e.g. mass)
- Lower extremity inactivity with prolonged dependency
These are all examples of:
impaired venous return (leading to increased hydrostatic pressure which is a cause of edema)
- Heat
- Neurohumoral dysregulation
These are examples of:
components leading to arteriolar dilation (which leads to increased hydrostatic pressure which is a cause of edema)
- Protein-losing glomerulopathies (nephrotic syndrome)
- Liver cirrhosis (ascites)
- Malnutrition
- Protein-losing gastroenteropathy
These are all conditions leading to:
reduced plasma osmotic pressure (hypoproteinemia)
(which is a cause of edema)
-Inflammatory
- Neoplastic
- Postsurgical
- Postirradiation
These are all conditions leading to:
lymphatic obstruction (which is a cause of edema)
- Excessive salt intake with renal insufficiency
- Increased tubular reabsorption of sodium
- Renal hypperfusion
- Increase renin-angiotensin-aldosterone secretion
These are all conditions leading to:
sodium retention (which is a cause of edema)
- Acute inflammation
- Chronic inflammation
- Angiogenesis
These are all conditions leading to:
inflammation (which is a cause of edema)
What is responsible for dictating fluid movement between vascular and interstitial spaces?
- vascular hydrostatic pressure
- colloid osmotic pressure (plasma proteins)
What causes colloid osmotic pressure?
plasma proteins
vascular hydrostatic pressure and colloid osmotic pressure (plasma proteins) dictate fluid movement between:
vascular and interstitial spaces
Arterial outflow is normally balanced by:
inflow at the venous end
____ is normally balanced by inflow at the venous end
arterial outflow
Arterial outflow is normally balanced by inflow at the venous end: Results in small net ____ –> drained by ___
outflow of fluid in interstitial space; lymphatics
Capillary hydrostatic and osmotic forces are normally balanced so their is little net movement of fluid into the:
interstitium
Capillary hydrostatic and osmotic forces are normally balanced so their is little net movement of fluid into the interstitium. However, increased hydrostatic pressure or diminished plasma osmotic pressure leads to:
extravascular fluid accumulation (edema)
Increased _____ or diminished ____ leads to extravascular fluid accumulation (edema)
hydrostatic pressure; plasma osmotic pressure
When extravascular fluid accumulates, tissue lymphatics drain much of the excess fluid back to the circulation by way of the ___. However, if the capacity for lymphatic drainage is exceeded, ____ results
thoracic duct; tissue edema
Usually caused by disorders that impair venous return:
increased hydrostatic pressure
Disorders that can cause impaired venous return: (2)
- Deep venous thrombosis
- Congestive heart failure
Increased hydrostatic pressure is usually caused by disorders that:
impair venous return
Reduced plasma albumin concentration will lead to:
reduced plasma osmotic pressure
Reduced plasma albumin concentration may result from:
loss in circulation or reduced synthesis
Nephrotic syndrome and severe liver disease are both causes for:
reduced plasma albumin concentration (which reduces plasma osmotic pressure)
Fill in the highlighted portions:
A: heart failure
B: malnutrition
C: decreased hepatic synthesis
D: nephrotic syndrome
E: renal failure
F: edema
Fill in the highlighted portions:
Green: DECREASED plasma albumin
Blue: DECREASED plasma osmotic pressure
Fill in the highlighted portions:
Green: INCREASED capillary hydrostatic pressure
Blue: INCREASED renal blood flow
Orange: activation of RNENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
Pink: retention of Na+ & H2O
Purple: INCREASED blood volume
Pathways leading to _____ can result form heart failure, renal failure, or reduced plasma osmotic pressure
systemic edema
Compromises resorption of fluid from interstitial spaces –> edema:
lymphatic obstruction
What conditions can lead to lymphatic obstruction? (3)
- inflammatory conditions
- neoplastic conditions
- congenital lymphedema
What does lymphatic obstruction compromise?
resorption of fluid from interstitial spaces (ultimately leading to edema)
Stage of lymphedema in which the lymphatic system experiences abnormal flow but no fluid build-up; (asymptomatic):
stage 1
Stage of lymphedema which is due to an accumulation of lymph fluid that may subside when elevated; (swelling):
stage 2
Stage of lymphedema categorized by permanent swelling that cannot be relived through elevation, accompanied by changes in the skin (fibrosis):
stage 3
Stage of lymphedema characterized by lymphostatic elephantiasis, or the deformation of a limb due to extensive swelling, skin thickening and scarring:
Stage 4
extravasation of blood from vessels:
hemorrhage
Defective clot formation, trauma, atherosclerosis, inflammatory, neoplastic condition, inherited/aquired defects are all causes of:
hemorrhage
Hemorrhage manifestations include: (4)
- hematoma
- ecchymoses
- purpura
- petechiae
Large collection of hemorrhage in a tissue:
hematoma
1-2cm subcutaneous hemorrhage (bruises):
ecchymoses
3-5mm hemorrhages:
purpura
1-2 mm minute hemorrhage:
petechiae
Often a consequence of thrombocytopenia or vitamin C deficiency:
petechiae
What can be seen in this image?
petechiae
Clot formation steps include: (4)
- vasoconstriction
- platelet plug formation
- fibrin deposition
- clot stabilization & resorption
____ are the primary regulations of hemostasis though changes in expression of procoagulaant or anticoagulation factors
endothelial cells
Endothelial cells are the primary regulators of hemostasis through changes in expression of ___ or ___ factors
procoagulant; anticoagulant
Disk-shaped, enucleate fragments of megakaryocytes:
platelets
Platelet adhesion is mediated by:
von willebrand factor