L12-13 Haemodynamic disorders

Question 1

What are the 3 causes of localised edema?

Answer 1

1. Impaired venous drainage
2. Increased vascular permeability
3. Obstruction of the lymphatics

Question 2

Identify the 3 causes of generalised oedema

Answer 2

1. Cardiac
   - Increased peripheral resistance –> increased hydrostatic pressure –> oedema
   - Decreased cardiac output –> decreased renal BF –> increase RAAS –> increased ADH –> increased in plasma volume and pressure –> increased hydrostatic pressure –> oedema
2. Renal
   - glomerular problem: lose protein in urine –> decreased oncotic pressure –> oedema
3. Hepatic

Question 3

5 predisposing factors of thrombogenesis

Answer 3

1. Alteration to BF (stasis, tubulence)
2. Injury to the endothelium –> exposure of collagen
3. Alteration in blood coagulability
4. Depletion of PGI-2 and plasminogen activator
5. Release of tissue thromboplastin

Question 4

5 fate of a thrombus

Answer 4

1. Complete resolution via fibrinolytic activity
2. Recanalization (formation of a new blood vessel through the thrombus)
3. Propagation (increase in size and occlude blood vessel completely)
4. Infection –> septic thrombosis
5. Embolize –> travel to distant organs

Question 5

What are the effects of pulmonary embolism? (3)

Answer 5

1. Sudden death
2. Pulmonary infarction
3. Pulmonary hypertension

Question 6

How does prolonged bedrest lead to thrombogenesis?

Answer 6

[1] blood stasis –> disruption of laminar flow –> [2] exposure of platelets with basement membrane –> [3] prevent the dilution of activated coagulative factor by fresh blood –> no incoming anti-coagulative factors by fresh blood

Question 7

Journey of DVE to pulmonary embolism

Answer 7

1. Right side of the heart
2. Main pulmonary artery
3. Bifurcation
4. Branching arterioles