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Cardiovascular System > Ischaemia And Infarction > Flashcards

Ischaemia And Infarction Flashcards

1
Q

Hypoxic hypoxia

A

Low inspired O2

Or normal inspired O2 but low PaO2

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2
Q

Anaemic hypoxia

A

Normal inspired O2 but blood is abnormal

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3
Q

Stangnant hypoxia

A

Normal inspired O2 but abnormal delivery from local occlusion of vessel or systemic effects eg shock

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4
Q

Cytotoxic hypoxia

A

Normal inspired O2 but abnormal at tissue level

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5
Q

Factors affecting oxygen supply

A 
Inspired O2
Pulmonary function
Blood constituents
Blood flow
Integrity of vasculature
Tissue mechanisms
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6
Q

Factors affecting oxygen demand

A

Different types of tissue

Activity of tissues above baseline value

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7
Q

Causes of supply issues in is ischaemic heart disease

A

Coronary artery atheroma, cardiac failure, pulmonary disease or oedema (LVF), anaemia, previous MI

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8
Q

Cause of demand issues in is ischaemic heart disease

A

Heart has high Intrinsic demand, exertion/stress

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9
Q

Atheroma types in coronary artery

A

Established - stable angina(on exertion)

Complicated - unstable angina (at rest)

Ulcerated/fissured - thrombosis then ischaemia/infarction

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10
Q

Clinical consequences of ischemia

A 
MI
TIA
Cerebral infarction
Abdominal aortic aneurysm
Peripheral vascular disease
CF
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11
Q

blood flow formula

A

Q= difference in Pressure over resistance

Resistance is worked out with radius and constants and length and viscosity

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12
Q

Biochemical effects of ischemia

A

Only anaerobic respiration so less ATP

Lactate produces and the acid damages tissue

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13
Q

Clinical effects/symptoms of ischemia

A

Dysfunction
Pain
Physical damage

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14
Q

Outcomes of ischemia

A

No clinical effects
Resolution with or without therapeutic intervention
Infarction

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15
Q

Causes of infarction

A

Thrombosis
Embolism
Strangulation eg gut
trauma

Occlusion of either arterial supply or venous drainage

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16
Q

what is coagulative necrosis and where does it happen

A

Goes hard eg heart, lung

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17
Q

Colliquitive necrosis

A

Eg brain, draws fluid

18
Q

Onset time of anaerobic metabolism and ATP depletion in MI

A

Seconds

19
Q

Onset of loss of myocardial contractility (heart failure) in MI

A

Less than 2 minutes

19
Q

Onset of loss of myocardial contractility (heart failure) in MI

A

Less than 2 minutes

20
Q

Onset of ultrastructural changes in MI eg myofibrillar relaxation, glycogen depletion, cell and mitochondrial swelling

A

A few minutes

21
Q

When does severe ischaemia become irreversible in MI

A

20-30 minutes

22
Q

Onset of myocyte necrosis (disruption of sarcolemmal membrane and leakage of cell contents) in MI

A

20-40 minutes

23
Q

Onset of injury to microvasculature in MI

A

Over an hour

24
Q

Changes of appearance of infarcts at under 24 hours

A

No visual but under EM swollen mitochondria at under 12 hours

25
Q

Changes of appearance of infarcts at 24-48 hours

A

Pale infarct eg myocardium, spleen , kidney (solid tissues)

Or

Red infarct eg lung, liver (loose tissues, previously congested tissue, second/continuing blood supply, venous occlusion

Microscopically, acute inflammation initially at edges, loss of specialised cell features

26
Q

Changes in appearance of infarcts at 72hours

A

Pale infarct with red periphery
Red little change

Chronic inflammation, MQ to remove debris, granulation tissue, fibrosis

27
Q

End result appearance of infarcts

A

Scar replaces tissue damage

28
Q

Reparative processes in myocardial infarction

A 
Cell death
Acute inflammation
Macrophages phagocytosing dead cells
Granulation tissue
Collagen deposition (fibrosis)
Scar formation
29
Q

4-12 hours of myocardial infarction

A

Early coagulation necrosis, odema and haemorrhage

30
Q

12-24 hours of myocardial infarction

A

Ongoing coagulation necrosis, myocyte changes, early neutrophilic infiltrate

31
Q

1-3 days of myocardial infarction

A

Coagulation necrosis again, loss of nuclei and striations, brisk neutrophilic infiltrate

32
Q

3-7 days of myocardial infarction

A

Disintegration of dead myofibres, dying neutrophils, early phagocytosis

33
Q

7-10 days of myocardial infarction

A

Well developed phagocytosis, granulation tissue at margins

34
Q

10-14 days of myocardial infarction

A

Well established granulation tissue with new blood vessels and collagen deposition

35
Q

2-8 weeks of myocardial infarction

A

Increased collagen deposition, decreased cellularity

36
Q

> 2 months of myocardial infarction

A

Dense collagenous scar

37
Q

Transmural infarction

A

Ischemic necrosis affects full thickness of myocardium

38
Q

Subendocardial infarction

A

Ischemic necrosis mostly limited to a zone of myocardium under the endocardial lining of the heart

39
Q

What type of infarct correlates with Non-stemi

A

Subendocardial

Cardiovascular System (33 decks)

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