pathology exam 3 Flashcards
causes of edema
increase intravascular hydrostatic pressure, decreased intravascular pressure, increased microvascular permiability, decreased lymphatic drainage
hyperemia vs congestion
hyperemia is an increase due to inflammation congestion is an increase due to a blockage not flowing
what causes decreased intravascular osmotic pressure and what causes that protein to do that
decrease in albumin. this is caused by PLE, PLN, liver failure
increased microvascular permeability is due to what
acute inflammatory vascular changes
two main causes of hyperemia
physiologic (increased demand. blood to stomach)
pathologic inflammation.
R cardiac infufficiency is usually due to what? what does this cause? what is the general term for it
Right heart cardiac insufficiency. vena cava gets backed up causes blood to accumulate in the central lobular areas of the liver. congestion and degeneration occur. nutmeg liver
Left cardiac insufficiency is due to what. what occurs?
accumulation of blood and inc hydrostatic pressure in lung. macrophages in the lungs.
ecchymosis
3mm-2cm. increased vascular fragility, secondary to trauma or petechiae. dark red centers
hematoma
hemorrhage in a focal confined space.
virchows triad that is needed for a thrombi
endothelial injury, abnormal blood flow, hypercoagulability.
three requirements for a thrombosis
blood must flow, decreased flow rate that allows for contact with the epithelium, eddies are formed
the _____ alteration of blood flow is a major contributor to formation of venous thrombus
local formation of stasis
which direction do thrombi form
away from the heart. venous grow in direction of flow arterial grow against flow
four things a thrombi can do
propagate, embolize ( travel), dissolute (remove it), organize and recanalize (incorporate into vascular wall)
thrombus vs blood clot
thrombus: dry, attached to the wall, composed of platelets, opaque, rough, from circulating blood
blood clot: moist, smooth, shiny, not attached to the wall, from fibrin, forms in stagnant blood
DIC
pathological activation of the clotting cascade. throw clots everywhere in microcirculation. consequence not a disease
what is the major cause of embolism
thrombus
infarct? what are these usually the result of
area of ischemic necrosis bc blood supply or drainage was occluded. main result of a thrombotic or embolic event.
explain the difference betwen acute, subacute, and chronic infarcts grossly
acute: red, raised
subacute: level, with with red periphery
chronic: sunken in. fibrous replacement
hypovolemic shock is caused by what? what does it do?
loss of blood or plasma volume. bp falls and b/v decreases. compensation is bp increases and b/v increases
cardiogenic shock. cause, signs
heart pump failure. decrease in b/v and cardiac output. anaerobic glycolysis so metabolic acidosis occurs
neurogenic shock. cause, consequence
injury or pain. loss of sympathetic tone. PNS takeover. vasodilation
anaphylactic shock cause, consequence
IgE allergic rxn. vasodilation, inc permiability, edema
Septic shock. cause and consequence
LPS generally from G- infection. TLR4 pathway. increase thrombi, organ failure, DIC, vasodilation.
three stages of shock: compensation, progressive, irreversible. defining factor of compensation
inc cardiac rate, slight inc in anaerobic met and decrease in nonvital circulation
progressive stage of shock. symptoms
cardiac rate increases while cardiac output greatly decreases,
aerobic metabolism decreases, vital and nonvital circulation decrease
irreversible shock symptoms
cardiac rate and output low
all metabolism low
circulation all low, lactic acid is high
what is the first area of the body to suffer from hypoxia
central portal area in hepatic lobule. very active
if tissue framework is damaged what occurs
fibrosis and scarring
five components of fibrosis
inflammation, angiogenesis, fibroblast , scar formation, connective tissue remodel
angiogenesis is important for what two things
formation of blood vessels. important for fibrosis and tumor growth.
granulation tissue appearance. why
pink/tan shiny. new bloodvessels are leaky
angiogenic factor. what does it do (3 things)
vascular endothelial growth factor (VEGF). proliferation, mobilization and survival of endothelial cells
main differences between first intention and second intention healing.
1st: clean, small, epidermis returns to normal thickness, no real surface scar seen.
2nd: large, infected, wound is closed by contraction from myofibroblasts. epidermis is thinner, divot on surface is seen.
number one thing that impairs wound healing
infection. (also nutrition)
contracture what does it look like? why does it happen?
loss of mobility due to excessive contraction of myofibroblasts. common after severe burns
3 forms of amyloid (pathologic deposition in tissues)
AL, AA, AB
which form of amyloid is associated with primary amyloidosis
AL, from plasma cells. neoplasia
which form of amyloid is associated with secondard amyoidosis
AA. serum, from the liver. persistent inflammation
what is the overall pathogenesis of amyloidosis
abnormal folding of proteins that are deposited in tissues and organs and interfere with normal cellular function
chronic inflammation involves what amyloid
AA. from liver
unknown stimuli and carcinogens involve what amyloid
AL. from plasma cells
