Hemodynamics, DIC and shock Flashcards
The starling hypothesis
The flow of fluids across capillary walls depends on the balance between the force of blood pressure on the walls
Describe the pathophysiology of edema
Inc hydrostatic pressure Reduced oncotic pressure Sodium retention Lymphatic obstruction Inflammation
What would you see in a sample of transudate?
Dec protein concentration, clear color, not WBCs
What would you see in a sample of exudate?
Inc protein content and inc WBCs (neutrophils)
What is a subfalcine herniation?
First herniation in hydrocephalous
where does an uncinate hernia enter into?
Foramen magnum
What is the most dangerous hernia which moves into the spinal cord?
Tonsiliar herniation
Lymphedema
Blockage in the lymphatic system leading to swelling
Hyperemia
Active process resulting from augmented tissue inflow because of arteriolar dilation causing a red color
Congestion
Passive process resulting from impaired tissue outflow causing a blue-red color (cyanosis)
Hemorrhage
Extravasation of blood due to vessel rupture (internal or external to tissue)
Hematoma
Accumulation of blood within tissues
Petechiae
Minute hemorrhages into skin, mucous membranes or serosal surfaces
Larger endothelial hemorrhages similar to petechiae are called;
Purapura
What are the steps in hemostatsis?
- Vasoconstriction
- Primary hemostatis
- Secondary hemostatis
- Thrombic events
What are the factors of the intrinsic pathway?
8, 9, 11, 12, prekallikrein, HMWK
What are the factors in the extrinsic pathway?
7, TNF (tissue factor; 3)
What are the factors in the common pathway?
1 (fibrinogen), 2, 5, 10
Which pathway is slow and which is fast?
Intrinsic is slow
Extrinsic is fast
What occurs when to cogaulation cascade enters the common pathway?
Thrombin is released altering fibrinogen to fibrin
How is the intrinsic pathway activated? What happens after it is active?
Activated when factor 12 binds to a neg charged foreign surface
Activates 11, 9, 8, 10, 2 I in the order) and fibrinogen is converted to fibrin
Which intrinsic factors are related to bleeding disorders?
8, 9, 11
How is the extrinsic pathway activated what what occurs once active?
TF at the site of injury activates it
TF complexes with 7 to form TF/7 (7a) which activates 10 and 9
9 activates more than 10 which activates 2 to form thrombin
What is the extrinsic pathway shut down by?
TFPI
