Lecture 5 - Thrombosis/ Embolism/ Infarction/ Shock Flashcards
what is thrombosis in terms of an endothelial injury?
- loss of endothelial barrier
- increased prothrombotic activity caused by hemodynamic stress; hypertension, homocystinuria, hypercholestolemia, radiation, cytokines, endotoxin
turbulence induces endothelial ____ and ______
dysfunction and activation
stasis disrupts what?
disrupts laminar flow (platelets move to periphery of the vessel)
stasis allows concentration of what?
clotting factors
stasis activates what?
endothelial cells, major factor in venous thrombi and some intra-cardiac thrombi
alterations in blood flow can lead to aneurysms ot
atherosclerotic plaques
what are inherited conditions of hypercoagulability? (3 of them)
- factor V Leiden mutation associated with a factor V that cannot be degraded by protein C
- Prothrombin mutation
- Deficiencies of anticoagulant proteins such as AT III
what are acquired conditions of hypercoagulability (5 of them)
- prolonged bed rest
- extensive tissue damage for example burns and surgery
- cancer
- antiphospholipid antibody syndrome also called lupus anticoagulant
- pregnancy
where do arterial thrombi tend to occur?
at sites of turbulence or endothelial injury and loss
what appearance do arterial thrombi have?
pale (“white”) appearance (kind of like me in the winter) with distinct lines of Zahn and may be occlusive or mural
where do emboli usually lodge?
in smaller arteries, often causing infarction
what are sterile (non-infectious) thrombi on hear valves called?
nonbacterial thrombotic endocarditis (NBTE)
what appearance do venous thrombi typically have
dark maroon color (“red”) (cabernet, blood, merlot, pino noir - could be any of these, have to be ready for all possibilties) and indistinct lines of Zahn
where do venous thrombi often form?
deep veins of the legs
fate of thrombi:
definition of propagation
enlarge by additional fibrin/ platelet deposition
