local circulatory disorders Flashcards
thrombosis
intravital/intravascualar blood caugualtion
why does thormbosis happen
disbalance btw coagulative and thrombotic factors
types of thrombus
parietal: attached to eall os vv, but vv is still permable
obturative: whole vv and blood stopped
red thrombus
- mainly eryhtocytes
- venous sys, when BF is slow bc of sedimentaiton +fibrin
-deep vein thrombosis
white thrombus
- thromocytes
-pale color, yellow white - rapid blood steraem–>ARTERIAL BF and cardiac cavities
- active coagulaiton
mixed thrombus
- bead thrombus: rapid, arterial wall
- white head and red are behind - layered: aneurysms, quit blood flow /blood stasis
hyaline thombus
-microscopically visible thrombi form thrombocytes and fibrin (shock, DIC)
- cappilaries
-thromobo and fibrin
- sever disturbance of capp BF
-stagnation
virchow triad
- Hypercoaguability
- stasis
- vessle wall injury
disturbance of blood floq
- slow blood flow-stenosis and strictures of vv, stagnation of blood by global circulatory disorders
-venous sytsem - tuburlent BF-by intraluminal blockage of BF=endothelial damage
-arterial and cardiac chmaber
- alteration of vv wall
- internal injury of endothelium-atherscleoris
- alteration of vv form ext enviroment
- inflamamiton, tumorus infiltarte, trauma
- chnages in blood composition
- thickening of blood (polycythemia)
- less fluid more proteins or cells
-dehydration - disbalance btw hemocoagualtive and thromobolytic factros=thrombofil conditions
- inbron: rare, aquired: more comon
INBORN:
- APC-act protein c-resistnace (f.leiden): point mutation of prothrombin 2, lack of antithrombin 3, protien c and protien s.
4p rule
pulmo, pancreas, prostate, placenta
lysis of thrombus-small pariental thrombi in circulating blood
-fibrinolysis act to dissolve or lyse thombus
-most common and most favorable
organiszation of thrombus
- organization in fibrotic tissue-small thrombi in tissues wiht abundant collateral
- parielta –>resorbed by macrophages–>non specific grnaukltion tissue–<fibrotic tissue and sacr
recanalization of thrombus-large, obturative¨
- non specific granulation tissue will penetrate thrombus–>vv fuse and dilate–>penetrattin by multiple vv and reneaval partially of blood flow
- dont chnage into scar
purified thrombus
- internal dissolution of large thrombi with limited adherence to vv wall (intracardial thrombi)
- dissolved or chnaged into fluid material with proteins and greu color-pus
embolsim
plugging of vv lumen by insoluble material
thrmobit embolization
- sudden, massice–>acute right heart failure
- succesive->chronic right heart failure
- smaller and plug vv subsequently
-silent
-intermittent cough, expectoration of blood formlung or small fine pain in chest
both lead to detah but succesive takes time
fat embolization
-release of fat droplets form subcutaneous adipose tissue by trauma of from boone marrow by bone fractures
air embolization
- spreafing of air into veins by operations or traumas
-during TG operaiton
caissons disease/diver disease:
- perosn is exposed to rapid decrease in pressure typically in divers ascending to quickly
-brain embolism
subcellular embolization
-plugging of vv by cellular debris form atherosclerotic plates, tumors
- material from necrotic dead tissue, infarction, malignant tumor or atherosclarotic plaques
porogenous metastasis
spreading of pathologic proces in hollowed organs by implatation, intramural spreading or direct contact of walls
-sprading thorugh body cavities
phlebitis
- happens in veins
- thrombophlebitis: inflammation of superficial veins
- venus varices - phlebothrombosis: deep venous
steal syndorme
-outflow of blood to better permeable vv according pressure difference in vv
like arteriovenous aneursm-pathological connection btw arterial and venous vv
- peripheral artery will lack of blood
manifestation of local circualtory disorders
- hyperemia
- ischemia
- bleeding
hyperemia
-increased BF thorugh tissue
- arterial-dilatttion of arterial sphincter and opening of reverse vessles
- physiological
- tissue gets mire blood by dialtion of arterioles
- muscles in physical act or HIT after food intake - peristaltic hypermia
- reflec and by local mediators induced hyperemia of tissue caused by tissue injury (inflammaton)
-increased permeability of vv–>spreading of fluid and plasma proteins to interstitium, later spreading of blood cells
-apthological: stasis in capp netowk - venous hyperemia
-obturation (thromotic, compressice) of veins draining the tissue
- blocage of venous outflow
- when v blood cant get outside circulatory bed–>acc and become hypermeia
-hemorrhagic infarction
ischemia
-regressive tissue change caused by insufficient by blood supply
-atrophy, dyrstrohy and necrosis
factors influencing ischmie
- type of tissue(oxy need)
- soft tissue, skin, CT and bone=RESISTANT OT ISCHEMIA - functional act of tissue
- anatomy of vascualr netowk
-heart and brain->NO ANASTOMOSIS
infarction
most severe form of ischemia
1,arterial induced tissue ischemia causing necrosis
- lack of arterial blood
- plugging of vv by thrmobus of embolus
- distinct stenosis of artery+increased tissue need for blood and ocy
- serous hypotension of systemic circulation (shock inafrction- watershed areas-brain, LI, cardiac muscle)
white infarction
- coagulative necrosis with mninmal reflux of blood form surronding vital tissue (anemic infarction)
-arterial induced
red infaction
-spleen, lungs
bleeding
-spreding of blood fomr vv into tissues /body cavities
bleeding per rhexim
-local disruption of vv continutiy(ruptur/trauma to vv)
-rupture of aneurysm of atherosclerotic plate
-acute local inhur of vv integrity
- focal blleding, extensive or lethal
-easly stopped bc local
bleeding per diabrosim
-diffuse injudry of vv wall infiltartive process(tumor, inflamamiton)
- like inflamamiton or tumor
bleeding per diapedeism
-spreasifin of blood cells outside the vessle without disruption of vv wall continuity(seroious hyperemia, shock, toxemia)
petechiae bleeding
small, spotty, local
-very small dots on organs or tissues
purpura
-numeroys and more extensive spotty bleeding
-larger but not fused together
-if fused.>ecchymoses–>suffisiones
site of bledding
epistaxis: form nose,
hematemesis: vomiting fresh blood
hemoptoe: expectoraiton of food
hemoptysiss: expectoration of sputum which contian blood
gastro/enterorrhagia/melaena:
heamturia: blood in urine
uterine bleeding
- hypermenorrhea: voluminor mentrual bleeding, time is normal
- mennorhagia: extended time, amount is normal
- emtorrhagia: uterine bleedding wihtout connection wiht menstrual cycle
accoridng to presence-where oyu find blood
hemothroax-pleural caity
hemopericardium-pericardium
hemoperitoneum-abdominal cavity
hemarhos-bleeding into joints
apolexia- destructuive arterial bleeding-kidney and brian
hemeocephalus-brian chambers
bleeding conditions
- thrombocytopenia
- coagukaopathies
- vasculopathoes
thrombocytopenia-decreased nr of thromobocytes
-infection, drug, tumors
- not massice bleeding
-HYPERSPLENISM
IDIOPATHIC THROMBOCYTOPENIA PURUPURA(ITP)
-antibodies again thrmobocytes, unknow
IMMUNO-THROMBOCYTOPENIA
- generalized infla (SLE), lymphomas, HIV, durg injury, heparin induced
coagulotpathies
INBORN-hemophilias
- A: deficiency of 8: C
- B: 9
-defiecnit of von willebranf factor
ACQUIRED:
-disorder of formaiton of coaguaktion facotrs in liver
-lack of vit K: malabsroption syndorme, ATB tehrapy
DISSEMINATED INTRAVASCULAR COAGULOPATHY (DIC)-masisve act of coagualtion cascade with formaiton of microthrombi–>consumption of coagulative factors–>hemorrhagic diathesis+injury of microcirculation–>injury of organs (kidney, lung)
vascullopathies (purpuras)
-disturbance of vv wall structure causing bleeding
INBIRN: herediatry telangiectasias
AQUIRED: lack of vit c (moller -barlowova disease) (SCURVY)
- INADEQUATE COLLAGEN SYNTHESIS
- ADULT-SCRUVY
- CHILDREN-GROWTH RETADETION
SENILE PURPURA.IMMUNE REACITON
-eldrelry
- insufficnet coll prod or not good quality
- wrinkles, vv are very fine, easy bleeding bc of alteraiotn to ewall
HENOCH -SCHONLEIN PURPURA
-immune reaction 3 type-very sevre
-deposition of antigen-antibody complexes in subendothelial space–>act of comlement
- in children after viral infectio of upper resp tract-meningococcal infection
