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Pathology > Hyperemia and Congestion > Flashcards

Hyperemia and Congestion Flashcards

1
Q

What do Hyperemia and Congestion Indicate?

A

Local Increase in blood volume and flow within the vascular bed

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2
Q

What does Hyperemia indicate?

A

Increase of arteriole-mediated engorgement of vascular bed - - blood is RED - OXYGENATED

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3
Q

What does Congestion indicate? What is an example of Congestion?

A

PASSIVE, venous engorgement
Blood is BLUE - - NOT OXYGENATED

Ex: Right-Sided CHF - - backing up of De-oxygenated blood in the veins bc the heart is unable to obtain normal Cardia Output

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4
Q

What changes occur (Digestion, Exercise, Heat Dissipation and Neurovascular) during Physiological Hyperemia?

A

BLOOD FLOW INCREASES IN ALL ASPECTS.

 Digestion: ↑ blood flow to the GI tract during digestion.
 Exercise: ↑ blood flow to muscles during exercise
 To dissipate heat: ↑blood flow to the skin to dissipate heat and cool down.
 Neurovascular: Involuntary ↑in blood flow to the face (facial hyperemia) as a result of embarrassment or emotional distress common in people with social anxiety.

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5
Q

What changes occur during Pathological Hyperemia? What are 2 examples given in lecture?

A

 Caused by an underlying pathological process – usually
INFLAMMATION!!!
 Arteriolar dilatation occurs secondary to inflammatory stimuli (inflammatory mediators).
 REDDENING (“rubor”) is one of the cardinal signs of inflammation (tumor, calor, rubor, pain, loss of function).
 Often associated with EDEMA

Ex: Gingivitis, Bulbar and Palpebral Conjunctivitis

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6
Q

Describe the pathogenesis of Gastric volvulus (torsion) in a dog…

A

twisting of vessels obstructs gastric veins → severe venous congestion (acute, local, congestion) →
ischemia (necrosis) →loss of endothelial integrity →hemorrhage →shock →death

See Image from Lecture - Slide 43

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7
Q

What type of Congestion is Gastric volvulus?

Hint: think of how you would CLASSIFY it

A

Localized Congestion

Colonic Torsion in Equine is another Example of Both Localized Congestion and Localized Edema

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8
Q

In intestinal volvulus of the equine, the tissue turns blue. Why is this?

A

The blood within the organs cannot move and becomes de-oxygenated - resulting in the BLUE color!
See image from Lecture - Slide 44

This is Venous Infarction of the Intestine!

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9
Q

What is the USUAL result of Right-Sided Congestive Heart Failure?

What is another name/”nickname” for the appearance of a Liver like this?

A

Subacute to Chronic HEPATIC CONGESTION
See Slide 49 - Horse Liver - enlarged livers that exhibit rounded edges

“NUTMEG LIVER”

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10
Q

Zone 1 is closest/in the middle/farthest from the Terminal Hepatic Vein?
What is the name of Zone 1 in Parenchyma?

A

Farthest.

Periportal.

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11
Q

Zone 2 is closest/in the middle/farthest from the Terminal Hepatic Vein?
What is the name of Zone 2 in Parenchyma?

A

In the middle.

Midzonal.

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12
Q

Zone 3 is closest/in the middle/farthest from the Terminal Hepatic Vein?
What is the name of Zone 3 in Parenchyma?

A

Closest.

Centrilobular.

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13
Q

Describe the Pathogenesis of Chronic Hepatic Congestion…

A

Chronically there is low-grade Hypoxia & ↑ pressure of centrolobular hepatocytes leading to atrophy and necrosis.

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14
Q

Define Hemorrhage…

A

Is defined as the escape of blood from the blood vessels (extravasation)

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15
Q

T/F: Hemorrhage can be external OR internal…within tissues or body cavities.

A

True

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16
Q

What are the causes of Hemorrhage (4)?

A
  1. Trauma
  2. Sepsis, viremia, bacteremia or toxic conditions
  3. Abdominal neoplasia may lead to hemoperitoneum
  4. Coagulation abnormalities (platelet and coagulation factor defects or deficiencies)
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17
Q

What is the difference between hyperemia, hemorrhage, and congestion?

A
  1. Hemorrhage- blood is outside the vessel wall

2. Hyperemia & congestion blood is within the blood vessels

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18
Q

What is the Clinical Significance of Hemorrhage?

A

Determined by the location and the severity

e.g.: Profuse blood loss is the most common cause of hypovolemic shock; Hemorrhage in the brain or heart can be fatal.

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19
Q

What does Hemopericardium lead to?

A

Fatal Cardiac Tamponade

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20
Q

What is Hemorrhage by Rhexis due to?

A

Due to a substantial rent or tear in the vascular wall (or heart).

21
Q

What is Hemorrhage by Diapedesis due to?

A

Hemorrhage due to a small defect in the vessel wall or rbc‟s passing through the vessel wall in cases of inflammation or congestion (like in the lungs of animals with left-sided CHF…)

22
Q

In racing horses or racing greyhounds, what are reasons for arterial rupture and fatal hemorrhage?>

A

Dissecting Aneurysms reported in the coronary and renal arteries of young, male racing greyhounds.
The aorta is primarily affected in horses.

23
Q

Define Hemorrhagic Diathesis…

A

Increased tendency to hemorrhage from usually insignificant injuries (seen in a wide variety of clotting disorders).

24
Q

Define hemothorax…

A

blood in the thoracic cavity

25
Q

Define Hemoperitoneum…

A

Hemoperitoneum – blood in the peritoneal cavity

26
Q

Define Hemarthrosis…

A

Hemarthrosis –blood within a joint space

27
Q

Define epistaxis…

A

Epistaxis is bleeding from the nose

28
Q

What is petechia?

A

Hemorrhage up to 1-2 mm in size. Especially found on skin, mucosal and serosal surfaces

29
Q

What is Ecchymosis?

A

Hemorrhage that is larger than petechia (up to 1-2cm in size) as seen in bruise (contusion) or small hematoma.

30
Q

What is Hemoptysis?

A

Hemoptysis:Coughing up of blood or blood- stained sputum from the lungs or airways.

31
Q

Agonal Hemorrhage is….

A

petechiae and ecchymoses associated with terminal hypoxia

32
Q

Small amounts of hemorrhage can be…

A

reabsorbed.

33
Q

Large amounts of hemorrhage requires…

A

Phagocytosis and Degradation by Macrophages

34
Q

What is Suffusive Hemorrhage?

A

Suffusive hemorrhage: larger than ecchymosis and contiguous. Serosal surface of the stomach, dog.

35
Q

What is Paint-Brush Hemorrhage?

A

Paint-brush hemorrhage: Looks like if red paint was hastily applied with a paint brush. Most common on mucosal and serosal surfaces.

36
Q

What is Organizing Hemotoma?

A

Organizing hematoma: Central mass of fibrin & red blood cells surrounded by supportive vascular connective tissue macrophages will eventually phagocytize this lesion.

37
Q

What are the phases of Hemorrhage Resolution (3)?

Hint: Think Pigments and what causes them!

A
  1. Hemoglobin
  2. Bilirubin
  3. Hemosiderin

Hemoglobin (dark red blue color) - - enzymatically converted to bilirubin (blue-green color) and eventually into hemosiderin (gold-brown color).

See Slide 20 from Lecture

38
Q

What is torsion?

A

When a piece of gut twists along its OWN axis

39
Q

Colonic Torsion is an example of….(2)

A

Localized Congestion and Localized Edema

40
Q

Left sided congestive heart failure leads to…

A

Pulmonary Congestion and Pulmonary Edema

41
Q

Pulmonary Hemosiderosis is…

A

the presence of “heart failure cells”

42
Q

“Heart Failure Cells” are AKA

A

Siderophages

43
Q

Right Sided Congestive Heart Failure usually results in…

A

Subacute to Chronic Hepatic Congestion

44
Q

Chronic Hepatic Congestion can is due to…

A

an increase in venous blood in the Liver

45
Q

What does a Liver with Chronic Hepatic Congestion look like?

A

enlarged with rounded edges that leads to hypoxic injury

46
Q

What is the common name for a liver with chronic hepatic congestion?

A

Nutmeg Liver

47
Q

What makes up the portal triad?

A
  1. portal vein
  2. bile duct
  3. hepatic artery
48
Q

True/False: Zone 3 is more susceptible to ischemic injury.

A

True - bc they are farther away from the portal triads

49
Q

True/False: Zone 1 receives less oxygen than Zone 2.

A

False…Zone 1 received the more oxygen than Zone 2. Zone 3 receives the least amount of oxygen because it is furthest away from the Hepatic Artery.

Pathology (14 decks)

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