Pathology Unit 4 - Edema

Question 1

What is Edema?

Answer 1

Edema is an excess accumulation of fluid in the interstitial tissue spaces.

Question 2

What causes Edema?

Answer 2

Edema results from escape of excess amounts of fluid or from its inability to return to the blood.

Question 3

What are 4 examples of Edema?

Answer 3

4 Examples of Edema are:

1. Anasarca / Dropsy – Severe generalized massive edema.
2. Ascites – Excess fluid in the peritoneal (abdominal) cavity.
3. Hydrothorax or Pleural effusion – Excess fluid in the pleural (lung) cavity.
4. Hydropericardium or pericardial effusion – Excess fluid in the pericardial cavity

Question 4

What is Hyperemia / Congestion

Answer 4

Hyperemia or Congestion is an excess amount of blood in a body part or area due to an increased arterial supply to the part or to a decrease in venous return.

Question 5

What are two types of hyperemia / congestion?

Answer 5

The two types of hyperemia / congestion are:
1. Active or arterial hyperemia – Hyperemia as a result of an increase in the arterial flow to a body part.

2. Passive or Venous Hyperemia / Congestion – Hyperemia as the result of a decrease in the venous drainage from a body part.

Question 6

What are 2 types of Active / arterial hyperemia ?

Answer 6

2 types of Active / arterial hyperemia are:
1. - Active / Arterial Physiological Hyperemia / Congestion – Results from increased arterial flow for natural reasons, such as in blushing, where no lesion exists. Presence of extra blood in the muscles of the body during exercise.

2. • Active / Arterial Pathological Hyperemia / Congestion – Results from increased arterial flow as a bodily reaction to injury, such as in inflammation.

Question 7

What are 2 types of Passive or Venous Hyperemia / Congestion

Answer 7

2 types of Passive or Venous Hyperemia / Congestion are

1. Local passive hyperemia – Caused by an obstruction of a vein due to a thrombus, embolus, thickening of the vessel walls or external pressure. The affected area will appear swollen, cool to the touch, and will be dark reddish-blue in color.
2. Generalized – Caused by an obstruction of blood flow through the heart, leading to inadequate circulation. The results of this are known as hypostatic congestion (the settling of the blood to dependent regions).

Question 8

What is Ischemia?

Answer 8

Ischemia is a decrease in the arterial blood flow or supply to a given part of the body.

Question 9

What are the 2 Causes of Ischemia?

Answer 9

The 2 Causes of Ischemia are:
1. - Blood Clot (thrombus, embolus). Hypotension (decreased blood pressure).

2. • Changes in blood vessels (atherosclerosis-a thickening in the vascular walls)

Question 10

What is Thrombosis?

Answer 10

Thrombosis
Refers to the formation of a solid mass, or blood clot within the heart or vessels of the body. The mass itself is called the thrombus.

Question 11

What are the 4 causes of Thrombosis?

Answer 11

The 4 Causes of Thrombosis are:
1. Injury to a blood vessels – the inner lining (tunica intima) of a vessel is normally a very smooth, slick lining of endothelium. Rough spots on this lining will give rise to the formation of clots.

2. Reduced rate of blood flow -blood does not normally remain stagnant for any length of time, as it is always on the move. Slowing of blood will predispose blood to clotting.
3. Alterations in blood composition – the blood may become thicker thereby predisposing to clots.
4. Blood diseases – some blood diseases will have an increase in the number of red blood cells or platelets increasing its viscosity and clotting ability.

Question 12

What are the 4 common locations of Thrombi?

Answer 12

The 4 common locations of Thrombi are:
1. Arteries

2. Veins – especially legs
3. Heart
4. Aorta

Question 13

What is obstructive thrombus?

Answer 13

Obstructive thrombus is when the entire lumen is occluded (blocked).

Question 14

What is parietal thrombus?

Answer 14

Parietal thrombus when part of the lumen is occluded (blocked).

Question 15

What does embolize mean?

Answer 15

Embolize mean the thrombus breaks off or dislodges and travels to different sites in the blood vascular system.

Question 16

What does propagate mean?(as it relates to Thrombus)

Answer 16

Propagate is a small thrombi can extend down the long axis of the vessel, increasing in thickness until the vessel is totally occluded.

Question 17

What does dissolution mean?(as it relates to Thrombus)

Answer 17

Dissolution means enzymes specific for this purpose (fibrinolytic proteins) engulf and dissolve the clot.

Question 18

What does Organization mean? (as it relates to Thrombus)

Answer 18

Organization is a conversion of the thrombus into a fibrous plug.

Question 19

What is recanalization? (as it relates to Thrombus)

Answer 19

Recanalization is when channels start to develop within the fibrous plug restoring partial blood flow.

Question 20

What are the 5 consequences of Thrombi?

Answer 20

5 Consequences of Thrombi are:

1. Ischemia – is a decrease in blood flow to an area resulting from the blockage (obstruction) in the vascular system.
2. Passive hyperemia (congestion) – if the thrombus is in a vein, blood will back up causing congestion (hyperemia).
3. Gangrene
4. Infarction – necrosis (death) of tissue due to decrease in blood supply.
5. Emboli /embolus – it is when a piece of thrombi breaks off and circulates in the blood stream (thromboembolus).

Question 21

Name 7 types of Emboli

Answer 21

7 Types of Emboli / embolus

1. Fragments of thrombi – most common type.
2. Septic emboli – occurs in bacterial endocarditis and when bacterial colonies either are growing in veins or gain access to the circulation.
3. Tumor cells – malignant tumors; tumor cells may become detached and enter circulation and then carried to the lungs or other organs. It is by this means that cancer is spread throughout the body.
4. Animal parasites – numerous parasitic worms find their way into the blood stream.
5. Fat embolism – results from severe trauma or crushing injuries to bone which allows the fat in the bone marrow to enter the veins in form of fat globules.
6. Air or gas – due to the entrance of air into the veins either during surgical procedure or through hypodermic injections.
7. Foreign bodies – such as dirt or even pellets from a shotgun blast can enter the vessels and become an emboli.

Question 22

What are the 6 Consequences of Embolus?

Answer 22

The 6 Consequences of Embolus are:

1. Ischemia – reduction of blood flow resulting in lack of oxygen and nutrients to the tissue.
2. Infarction or ischemic necrosis – as a result of ischemia, the area of tissue which was deprived of its blood supply dies. The area of tissue that has died is called an infarct.
3. Spread of infection – infectious emboli may result in system infection.
4. Spread of tumor cells – tumor cells may travel to distant sites and cause metastatic tumor growth.
5. Necrosis – death of the tissue.
6. Tumor Embolus

Question 23

What is Hemorrhage?

Answer 23

Hemorrhage is the escape of blood from the blood vascular system. Anytime that blood leaves a vessel, it can be described as hemorrhage.

Question 24

What are the 4 causes of Hemorrhage?

Answer 24

The 4 causes of Hemorrhages are:

1. Trauma – injury to blood vessels or soft tissue resulting in bleeding.
2. Vascular disease – increased vascular fragility i.e. infections, drug reactions, poor vascular support.
3. Blood disorder that increases the tendency to bleed – disorders of platelets (thrombocytopenia) or defects in clotting factors (coagulation) hemophilia.
4. Hypertension – elevated blood pressure resulting in disruption of the blood vessel wall – i.e. hemorrhagic stroke

Question 25

What is Petechiae?

Answer 25

Petechiae are small pinpoint hemorrhages found in the skin, mucous membranes or eye sclera (white portion) (small purpura).

Question 26

What is Purpura?

Answer 26

Purpura are purple colored spots and patches that occur on the skin, on organs, and membranes including the lining of the mouth.

Question 27

What is Ecchymosis (Bruise)

Answer 27

Ecchymosis (Bruise)A purple or bluish area on the skin or mucous membrane caused by extra-vasation of blood into the subcutaneous tissue, often due to trauma to the blood vessel or fragility of the blood vessel, A large purpura.

Question 28

What is Hematoma?

Answer 28

Hematoma is a localized collection of extravascular blood; a circumscribed tumor-like swelling filled with blood. A space occupying a collection of blood. On a small scale, when you hit yourself with a hammer, you get a hematoma or a blood blister.

Question 29

Epistaxis

Answer 29

Epistaxis is a Nose Bleed; Hemorrhage from the nose.

Question 30

Hemoptysis

Answer 30

Hemoptysis is the presence of blood in the sputum; coughing up blood caused by a hemorrhage in the lungs; or TB

Question 31

Hematemesis

Answer 31

Hematuria is blood in urine caused by: infection; tumor; trauma and kidney stones.

Question 32

Hemothorax

Answer 32

Hemothorax is the accumulation of blood in the thoracic cavity.

Question 33

Exsanguination

Answer 33

Exsanguination is the excessive loss of blood due to internal or external hemorrhage

Question 34

What are 4 Post-Mortem Conditions associated with Circulatory Disorders

Answer 34

4 Post-Mortem Conditions associated with Circulatory Disorders:
1. Diminished circulation – is a prime concern to the embalmer. Thrombosis, embolisms, tumors and various other arterial disorders can result in decreased flow of embalming fluids. Diminished circulation may even have the effect of causing emaciation and dehydration of various body areas if the blood supply had been lessened for an extended period of time.

2. Rapid decomposition – edema in the tissues predisposes to rapid decomposition in a dead body.
3. Discoloration – in areas visible during viewing.
4. Hemorrhage – can actually short circuit the flow of embalming fluid through out the body.
5. Abscess – can put pressure on vessels also leading to a decrease in the flow of embalming fluids.