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FM 1 > Hemodynamic disorders > Flashcards

Hemodynamic disorders Flashcards

1
Q

fluid homeostasis requires:

A
  • vascular wall integrity
  • control of intravascular volume, pressure, protein
  • normal clotting mechanisms
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2
Q

Edema

A

increased fluid in tissue interstitial spaces

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3
Q

Pleural effusion/hydrothorax

A

-fluid accumulation in pleural space

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4
Q

ascites

A
  • fluid accumulation in the abdominal cavity

- aka hydroperitoneum

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5
Q

pericardial effusion

A
  • hydropericardium

- edema fluid accumulation in pericardial sac

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6
Q

anasarca

A

serve and generalized edema w/ diffuse involvement of all interstitial tissues and grossly evident subQ swelling

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7
Q

Categories of edema

A
  • increased hydrostatic pressure/impaired venous return
  • decreased plasma oncotic pressure (hypoproteinemia)
  • lymphatic obstruction
  • sodium retention
  • inflammation
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8
Q

hyperemia

A
  • active process
  • arterioles dilate and let blood into tissue
  • erythema
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9
Q

congestion

A
  • passive process
  • decreased outflow of blood
  • cyanotic (blue-ish red) color
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10
Q

Hemorrhage

A
  • extravasation of blood due to vessel rupture
  • vascular injury
  • vascular disease +/- minor trauma
  • defects in clotting mechanism + minor trauma
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11
Q

hematoma

A

-blood accumulation in a space or tissue (coagulates)

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12
Q

petechiae

A
  • small (1-2mm) punctate hemorrhages
  • seen on skin or mucosal/serosal surfaces
  • low platelets (thrombocytopenia)
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13
Q

Purpura

A
  • slightly larger (>3mm) hemorrhages
  • low platelets
  • small vessel vasculitis
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14
Q

hemostasis

A
  • rapid formation of localized plug at site of vascular disruption
  • requires: vascular wall, platelets, and coagulation proteins
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15
Q

events leading to hemostasis

A
  • arteriolar vasoconstriction
  • platelet adherence, activation, and aggregation (von wilebrand factor) (primary hemostasis)
  • generation of thrombin and fibrin, w/ polymerization of fibrin and platelet aggregates (secondary hemostasis)
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16
Q

thrombosis

A

-pathologic activation of hemostatic mechanism (clot occurs inside blood vessel)

17
Q

Virchow triad

A
  • predispose to thrombosis
  • endothelial injury
  • hypercoagulability (genetic or acquired)
  • abnormal blood flow (stasis or turbulence)
18
Q

potential fates of thrombus

A
  • keep growing-propagate towards heart
  • resolution-gets broken down
  • pushed to one side
  • recanalization
  • pieces can break off-embolus
19
Q

embolus

A

-an intravascular solid, liquid, or gaseous mass that is detached from the vascular wall and is carried by the blood to a site distant from point of origin

20
Q

thromboembolus

A

-an embolus made up thrombosed blood (vast majority)

21
Q

pulmonary thromboembolism

A
  • most common type of embolism

- over 95% of these originate in deep venous system of lower limbs (DVT)

22
Q

saddle embolus

A

obstruct entire pulmonary inflow-block both arteries-rapidly fatal

23
Q

air embolism

A
  • causes: trauma, obstetrics

- generally at least 100ml necessary for clinical manifestations

24
Q

paradoxical embolism

A

-venous thromboembolism passing through an atrial or ventricular heart defect to lodge in the systemic arterial system

25
Q

infarct

A

an area of ischemic necrosis caused by occlusion of arterial supply or venous drainage
-nearly all result from arterial thrombosis or thromboembolism

26
Q

hemorrhagic infarct

A

blood leaks back into tissue (dual blood supply)

27
Q

anemic infarct

A

infarcted tissue never regains blood flow (end arterial)

28
Q

factors that influence development of infarct

A
  • nature of vascular supply
  • rate of occlusion of vascular supply
  • O2 content of blood
  • susceptibility of tissue to infarction
29
Q

shock

A

cardiovascular collapse resulting in systemic hypoperfusion

30
Q

hypovolemic shock

A
  • substantial loss of intravascular volume
  • hemorrhage
  • plasma loss (burns, diarrhea, vomiting, dehydration
31
Q

cardiogenic shock

A
  • failure of pump

- MI, cardiac tamponade, saddle embolus

32
Q

sepsis

A
  • presence of various pus-forming or other pathogenic organisms, or their toxins, in blood or tissues
  • widespread infection w/ systemic inflammatory response
33
Q

disseminated intravascular coagulation

A
  • widespread activation of coagulation w/in blood vessels
  • consumption of coagulation factors as well as widespread activation of fibrinolytic system leads to excessive bleeding
  • hemorrhage and thrombosis at same time
34
Q

acute respiratory distress syndrome (ARDS)

A
  • shock lung
  • pulmonary dysfunction caused by diffuse alveolar capillary damage
  • endothelial damage in lungs leads to protein leakage across walls -> creates a hyaline membrane that blocks gas exchange
  • histologic change = diffuse alveolar damage (DAD)
35
Q

multisystem organ failure

A
  • terminal complication in fatal cases of septic shock

- hypoxemia/acidosis, oliguria/anuria, and confusion, ischemic complications

FM 1 (9 decks)

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