Hemodynamics disorders Flashcards
What is meant by hyperemia and congestion?
Increase in blood volume
Describe this increase
Local
Where does this local increase in blood volume occur in?
Particular tissue
Describe the process of Hyperemia
Active
What is affected in the organs, in Hyperemia?
Arterial blood inflow
How is this arterial blood inflow affected?
Increased
What causes this increase in the arterial blood inflow?
Active arteriolar dilatation
What is changed in the these arterioles?
Muscle tone
Describe the color of the affected tissue
Reddened
What happens to these tissues so that they become reddened?
Engorgement
What are the affected tissues engorged with so that they become reddened?
Oxygenated blood
What are the 2 types of Hyperemia?
Physiological
Pathological
What are the 2 sites in which physiological Hyperemia occur in?
Skeletal muscles
Gut
When does the Hyperemia occur in skeletal muscles?
During exercise
What does the Hyperemia that occur in the gut follow?
Meal
When does the pathological Hyperemia occur?
Acute inflammation
Describe the process of congestion
Passive
What is the Congestion known as? (2 points)
Venous congestion
Passive hyperemia
What is affected in the organs, in congestion?
Venous blood
Describe the venous blood in the tissues of these organs (2 points)
Increased
Excess
What causes this increased/excess venous blood in the tissues of these organs?
Obstruction
What is obstructed causing this increased/excess venous blood in the tissues of these organs?
Venous outflow
How is this venous blood outflow also affected?
3 points
Impaired
Slow
Reduced
What are the 3 sites in an organ where the increased/excess the venous blood resulted from the obstruction of the venous outflow occur in?
Veins
Venules
Capillaries
What do these 3 sites become due to the increased/excess the venous blood resulted from the obstruction of the venous outflow?
Passively dilated
Describe the color of the tissues where the congestion occur in
Red-blue
What are these tissues accumulated with so that they become reddened?
Deoxygenated blood
What are the 2 types of Congestion?
Localized
Generalized
What are the 2 subtypes of localized and generalized congestion?
Acute
Chronic
Describe the venous obstruction in acute localized congestion (2 points)
Sudden
Complete
What causes this sudden complete venous obstruction in acute localized congestion?
(4 points)
Thrombosis
Ligature
Strangulation
Twisting
What is twisted and strangulated in an organ causing this sudden complete venous obstruction?
Pedicle
Describe the organ which its pedicle is twisted and strangulated causing this sudden complete venous obstruction
Movable
What are the effects of acute localized congestion? (4 points)
Severe distention
Edema
Infarction
Gangrene
Describe the severe distention and the edema
Rapid
What are the 2 sites where the rapid severe distention occur in?
Veins
Capillaries
What may happen to these veins and capillaries?
Rupture
What does the rapture of these veins and capillaries cause?
Hemorrhage
Where does the rapid Edema occur in?
Tissues
Where do the infraction and the gangrene occur in?
Intestine
Describe the venous obstruction in chronic localized congestion (2 points)
Gradual
Incomplete
What causes this gradual incomplete venous obstruction?
3 points
Venous compression
Liver cirrhosis or Fibrosis
Left ventricular failure
What is venous compression done by?
3 points
Tumor
Enlarged lymph node
Pregnant uterus
Where does the congestion caused by liver cirrhosis or fibrosis occur in?
Veins
Which veins does the congestion caused by liver cirrhosis or fibrosis occur in? (2 points)
Mesenteric
Splenic
Where does the congestion caused by the left ventricular failure occur in?
Pulmonary veins
What are the 2 effects of chronic localized congestion?
Edema
Stasis
What does the statis predispose?
Thrombosis
What is gradually opened as an effect of chronic localized congestion?
Collateral veins
What is developed as an effect of chronic localized congestion?
Varicoses
What is an example of this varicoses?
Oesophageal varices
What are the 6 causes of chronic congestion in lung?
Left sided heart failure Mitral stenosis Phagocytosis Degradation Fibrosis Hemosiderin deposition
Where does chronic congestion in lung occurs in?
Alveolar capillaries
What also happens to these alveolar capillaries?
Distention
What do the congestion and the distention lead to?
Transudation
What is transded as a result of the congestion and the distention of the alveolar capillaries?
Fluid
Where is this fluid transuded?
Alveolar spaces
What then happens to the alveolar capillaries when the fluid is transuded into the alveolar spaces?
Rupture
What will then pass when the alveolar capillaries rupture?
RBCs
What will the RBCs pass to when the alveolar capillaries rupture?
Alveoli
Describe the lung in this stage of chronic congestion
2 points
Enlarged
Heavy
Describe the color of the lung in this stage of chronic congestion
Bluish-red
What is seen in the cut section of the lung at this stage?
Bloody froth
What will then happen to these RBCs?
2 points
Phagocytosis
Degradation
Which cells are resulted when phagocytosis
degradation occur in the RBCs?
Intra-alveolar hemosiderin-laden macrophages
What are these cells known as?
Heart failure cells
Which case of congestion does the fibrosis and hemosiderin deposition occur in?
Long-standing
Where does this fibrosis occur in?
Interstitium
What is resulted in the lung due to the Interstitium fibrosis and the hemosiderin deposition?
Brown Induration
Describe the color of the lung in this stage
Dark brown
Describe the consistency of the lung in this stage (2 points)
Firm
Indurated
What causes the lung’s consistency to be firm and indurated?
Fibrosis
Which conditions does Acute generalized congestion occur in?
Terminal
What causes terminal conditions to lead to acute generalized congestion?
Acute heart failure
Where does the acute generalized congestion occur in?
All viscera
Describe the acute generalized congestion occur in all viscera
Rapid
Describe the chronic generalized congestion
Gradual
What does the chronic generalized congestion occur in?
Whole venous system
What are the 2 causes of chronic generalized congestion?
Right sided heart failure
Pulmonary hypertension
What does the chronic generalized congestion cause? (4 points)
Hypoxia
Cyanosis
Dyspnea
Generalized edema
What is defected causing Hypoxia?
Blood oxygenation
Where does the defective blood oxygenation occurs in?
Congested lungs
What increases in amount causing Cyanosis?
Reduced Hemoglobin
What reduces the Hemoglobin?
Stasis
What causes Dyspnea?
Pulmonary congestion
What causes Chronic congestion of the liver?
Right heart failure
What is occluded which sometimes cause chronic congestion in liver? (2 points)
Inferior vena cava
Hepatic vein
Describe the liver when chronic congestion occurs in it (2 points)
Enlarged
Tender
Describe the capsule of the liver when chronic congestion occurs in it
Tense
What does the liver look like when in the cut section when chronic congestion occurs in it?
Nutmeg
Describe the appearance of the liver that causes it to look like nutmeg when chronic congestion occurs in it
Mottled
What are the 2 colors of the mottled liver?
Red
Yellow
What are congested causing this red and yellow mottled appearance? (2 points)
Center of lobules
Fatty peripheral zone
What causes the change of chronic congestion that occurs in the liver, under the microscope?
Sever Hypoxia
Which zone is the severe Hypoxia of chronic congestion in liver more marked in, under the microscope?
Centrilobular
What are the 2 changes that occur in chronic congestion in liver due to severe hypoxia, under the microscope?
Distention
Filling with blood
What are distended and filled with blood in the chronic congestion of the liver, under the microscope? (2 points)
Central veins
Adjacent sinusoids
What undergo changes in the chronic congestion of the liver, under the microscope?
Centrilobular hepatocytes
Describe these changes
Degenerative
What will eventually be seen in these centrilobular hepatocytes?
Centrilobular hemorrhagic necrosis
What is seen in the chronic congestion of the liver in the long-standing cases under the microscope? (2 points)
Fine centrilobular fibrosis
Hepatocytes regeneration
What do the fine centrilobular fibrosis and hepatocytes regeneration cause?
Hepatic cirrhosis
Which zone of lobule is the severe Hypoxia of chronic congestion in liver less marked in, under the microscope?
Peripheral
What is also seen in the peripheral zone of the lobules?
Fatty change
Where is the fatty change seen in?
Hepatocytes
What are the 2 causes of chronic congestion of the spleen?
Right heart failure
Portal hypertension
What causes right heart failure and
portal hypertension that lead to chronic congestion of the spleen?
Hepatic cirrhosis
Describe the size of the spleen in the early stages of chronic congestion
Slightly to moderately enlarged
What is the size of the spleen in chronic congestion?
Up to 250g
What is the normal size of the spleen?
150g
Describe the enlargement in long-standing cases
Progressive
What is the rage of size of spleen in chronic congestion in long-standing cases?
Up to 500g-1000g
Describe the spleen in the long-standing cases of chronic congestion (3 points)
Congested
Tense
Cyanotic
What is seen in the spleen in chronic congestion ,under the microscope?
(3 points)
Red pulp
Hyperplasia
Deposits
What is the red pulp congested with?
Marked sinusoidal dilatation
What occurs in the red pulp?
Hyperplasia
Which cells does the hyperplasia occur in?
Reticuloendothelial cells
What get deposits?
Hemorrhages
What do these hemorrhages which get deposits overlay?
Fibrous tissue
What are these 2 deposits which some of the hemorrhages that overlay the fibrous tissue get?
Hemosiderin pigment
Calcium salts
What are these organized structures known as? (2 points)
Gamna-Gandy bodies
Siderofibrotic nodules