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Year 1-Cardiovascular System > Pathophysiology of Thrombosis and Embolism > Flashcards

Pathophysiology of Thrombosis and Embolism Flashcards

1
Q

What is blood flow?

A

The amount of blood moved per unit of time

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2
Q

What is normal blood flow described as being?

A

Laminar

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3
Q

What can affect blood flow?

A

Pressure gradient, resistance, viscosity of blood, velocity, compliance

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4
Q

RECAP- what affects resistace?

A

Diameter of a blood vessel

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5
Q

Name the two types of abnormal blood flow.

A

Stasis
Turbulence

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6
Q

What is meant by a stasis blood flow?

A

Stagnation of the blood flow

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7
Q

What is meant by a turbulent blood flow?

A

Forceful, unpredictable flow

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8
Q

What can cause defects in blood flow?

A

Thromboembolism- most common
Atheroma
Hyperviscosity
Spasm
External compression
Vasculitis
Vascular steal

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9
Q

What is meant by hyperviscocity?

A

Blood is too thick

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10
Q

What is vasculitis?

A

Inflammation of the vessel wall

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11
Q

What is meant by vascular steal?

A

When a vascular system steals blood from another system

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12
Q

RECAP- what is Virchow’s Triad?

A

Changes in the blood vessel wall

Changes in the blood constituents

Changes in the pattern of blood flow

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13
Q

What can Virchow’s triad cause?

A

Thrombosis

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14
Q

What is meant by thrombosis?

A

Formation of a solid mass from the constituents of blood within the vascular system during life

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15
Q

What is the difference between a clot and a thrombus?

A

A clot is solidified blood
A thrombus is a mass within the system

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16
Q

Give an example of a condition when there is a change in the blood vessel wall.

A

Atheromatous coronary artery

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17
Q

Describe how you can develop a thrombosis regarding Virchow’s triad.

A

Endothelial injury

Stasis or turbulent blood flow

Hypercoagulability of the blood

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18
Q

Describe how a thrombin can be formed.

A

-Cell has atheromatous plaque where the endothelial surface is still in tact
-Turbulent blood flow damages endothelial surface
–Exposes collagen of plaque to the blood
-Elements, like platelets, fibrin and RBC’s get stuck to the collagen, hence forming an thrombus

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19
Q

Give an example of a condition where there is a change in the blood’s constituents.

A

Hyperviscosity
Post-traumatic hypercoagulability

20
Q

Give two examples of changes of blood flow which would cause stasis.

A

Long haul flights
Post-surgery patients who are lying in bed

21
Q

Give two examples of changes of blood flow which could cause turbulence.

A

Atheromatous plaque
Aortic aneurysm

22
Q

What do the consequences of thrombosis depends on?

A

Site
Extent- partial or complete occlusion?
Collateral circulation

23
Q

List some common clinical conditions involving thrombosis.

A

DVT (deep vein thrombosis)
Ischaemic limb
MI

24
Q

What are the outcomes of thrombosis?

A

Resolution
Organisation/recanalisation
Death
Propagation leading to embolism

25
Q

What is embolism?

A

Movement of abnormal material in the bloodstream and its impaction in a vessel, blocking its lumen

26
Q

What is an embolus?

A

Detached intravascular solid, liquid or gaseous mass

27
Q

What are most emboli formed from?

A

Dislodged thrombi aka thromboembolism

28
Q

What are some possible sources for Systemic/Arterial Thromboembolus?

A

Mural thrombus (associated with MI or left atrial dilatation + AF)
Aortic aneurysms
Atheromatous plaques
Valvular vegetations

29
Q

Where may a systemic thrombus travel to?

A

Travel to wide variety of sites-
lower limbs most common, brain, other organs

30
Q

What does the consequence of systemic thrombus depend on?

A

Vulnerability of affected tissues to ischaemia
Calibre of occluded vessel
Collateral circulation

… but usually infarction occurs

31
Q

Where does venous thromboembolus originate from?

A

Deep venous thromboses

32
Q

What is the most common thromboembolic disease?

A

Deep venous thrombus

33
Q

Where do venous thromboembolus’ travel to?

A

Pulmonary arterial circulation

34
Q

Where can venous thromboembolus’ occlude?

A

Depending on size, may occlude main pulmonary artery, bifurcation (saddle embolus), smaller arteries

35
Q

What are the potential outcomes of pulmonary thromboembolism?

A

Pulmonary haemorrhage/infarction
Right heart failure
Sudden death

36
Q

What can several pulmonary thromboembolisms over time lead to?

A

Pulmonary hypertension and right ventricular failure

37
Q

What are some of the risk factors for DVT and pulmonary thromboembolism?

A

Cardiac failure
Severe trauma/burns
Post-op/post-partum
Nephrotic syndrome
Disseminated malignancy
Oral contraceptive
Increased age
Bed rest/immobilisation
Obesity
Past medical history of DVT

38
Q

What can you do to patients at a higher risk of DVT/PT?

A

Give prophylaxis before any surgery
Thromboembolic disease stockings
Anticoagulants

39
Q

When may a fat embolus occur?

A

After major fractures- little bits of fat get in the circulation

40
Q

When might you get gas embolus?

A

Decompression sickness

41
Q

What happens in air embolus?

A

Nitrogen forms as bubbles which lodge in capillaries

42
Q

When might you get an air embolus?

A

Head and neck wounds
Surgery
CV lines (central venous catheter)

43
Q

Who might be affected by a trophoblast embolus?

A

Pregnant women

44
Q

Where in the body will a trophoblast embolus affect a pregnant woman?

A

Lungs

45
Q

What can amniotic fluid embolus cause?

A

Cause of collapse and sometimes death in childbirth

46
Q

Bone marrow can embolise as a result of what?

A

Fractures

47
Q

Give some examples of foreign bodies which could end up embolising.

A

Intravascular cannulae tips, sutures, etc

Year 1-Cardiovascular System (41 decks)

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