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Systems: Cardiovascualar AB > Pathophysiology of Thrombosis and Embolism > Flashcards

Pathophysiology of Thrombosis and Embolism Flashcards

1
Q

What is the characteristic of normal blood flow?

A

Laminar

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2
Q

What contributes to bloods laminar flow?

A
  • Pressure gradient
  • Resistance
  • Viscosity of blood
  • Velocity
  • Compliance
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3
Q

Stasis

A

Stagnation of flow

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4
Q

Turbulence

A

Forceful, unpredictable flow

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5
Q

Defects in blood flow

A
  • Thromboembolism
  • Atheroma
  • Hyperviscocity
  • Spasm
  • External compression
  • Vasculitis
  • Vascular steal
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6
Q

What are the 3 components of 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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7
Q

What is Virchow’s triad?

A

Factors causing thrombosis

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8
Q

Thrombus

A
  • Formation of a solid mass from the constituents of blood within the vascular system during life
  • Caused by Virchow’s triad
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9
Q

Give an example of a change in a vessel wall.

A

Atheromatous coronary artery

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10
Q

How does Virchow’s triad influence the pathogenesis of thrombosis?

A
  • Endothelial injury
  • Stasi or turbulent blood flow
  • Hypercoagulability of the blood
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11
Q

Pathogenesis of thrombosis

A
  • Atheromatous coronary artery
  • Turbulent blood flow
  • Loss of intimal cells, denuded plaque
  • Collagen exposed, platelets adhere
  • Fibrin meshwork, RBCs trapped
  • Alternating bands: lines of Zahn
  • Further turbulence an platelet deposition
  • Propagation
  • Consequences
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12
Q

What is the relationship between atheroma and thrombosis?

A

Arterial thrombosis most commonly superimposed on atheroma

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13
Q

How is hypercholesterolemia related to Virchow’s triad?

A

Change in blood constituents

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14
Q

How does flow vary across the thrombus?

A

Turbulent flow is greatest at the end of the thrombus

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15
Q

Give 2 examples of changes to blood constituents.

A
  • Hyperviscosity

- Post traumatic hypercoagulability

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16
Q

What can cause stasis?

A
  • Post-op

- Economy class syndrome

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17
Q

What can cause turbulence?

A
  • Atheromatous plaque

- Aortic aneurysm

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18
Q

What do consequences of thrombosis depends on?

A
  • Site
  • Extent
  • Collateral circulation
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19
Q

What are common clinical scenarios related to thrombosis?

A
  • DVT
  • Ischaemic limb
  • MI
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20
Q

What are the possible outcomes of thrombosis?

A
  • Resolution
  • Organisation/ recanalization
  • Death
  • Propagation leading to embolism
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21
Q

Embolism

A

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

22
Q

Embolus

A

Detached intravascular solid, liquid or gaseous mass

23
Q

What are most emboli?

A

Dislodged thrombi

24
Q

What do factors causing embolism depend on?

A

Type of embolus

25
Q

What are the possible sources of a systemic/arterial thromboembolus?

A
  • Mural thrombus
  • Aortic aneurysms
  • Atheromatous plaques
  • Valvular vegetations
26
Q

What are mural thrombi associated with?

A
  • MI

- Left atrial dilatation and AF

27
Q

Where do thromboembolism travel to?

A

Travel to wide variety of sites:

  • Lower limbs most common
  • Brain
  • Other organs
28
Q

What do consequences to systemic thromboembolism depend on?

A
  • Vulnerability of affected tissues
  • Ischaemia calibre of occluded vessels
  • Collateral circulation
  • Usually infarction occurs
29
Q

Where do venous thromboembolus originate from?

A

Deep venous thrombosis (lower limbs)

30
Q

What is the most common form of thromboembolic disease?

A

DVT

31
Q

Where does DVT travel to?

A

Pulmonary arterial cicrulation

32
Q

What may DVT occlude?

A

Dependent on size:

  • Main pulmonary artery
  • Bifurcation
  • Smaller arteries
33
Q

What are the possible consequences of DVT?

A
  • Silent
  • Pulmonary haemorrhage/infarction
  • Right heart failure
  • Sudden death
34
Q

What do multiple PEs over time lead to?

A
  • Pulmonary hypertension

- Right ventricular failure

35
Q

What are consequences of thromboembolism dependent on/

A

Size of embolus

36
Q

What are 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
  • PMH of DVT
37
Q

What is the prophylaxis for surgical patients at risk?

A
  • TEDS

- s/c heparin

38
Q

When do fat embolus occur?

A

After major fractures

39
Q

What is affected by fat embolisms?

A
  • Brain
  • Kidneys
  • Skin
40
Q

What can gas embolisms cause?

A

Decompression sickness

41
Q

How do gas embolisms occur?

A

N2 forms as bubbles which lodge in capillaries

42
Q

How can air embolisms enter the body?

A
  • Head and neck wounds
  • Surgery
  • CV lines
43
Q

How can tumours cause embolisms?

A

Spread of the tumour

44
Q

Who do trophoblast tumours affect?

A

Pregnant women

45
Q

What is affected by trophoblast embolisms?

A

Lungs

46
Q

Give an example of a condition which can result in septic material forming an embolism?

A

Infective endocarditis

47
Q

What are amniotic fluid embolism the cause of?

A

Collapse +/- death in childbirth

48
Q

How are bone marrow embolisms formed?

A
  • Fractures

- CPR

49
Q

How are foreign body embolisms formed?

A
  • Intravascualr cannulae tips

- Sutures

50
Q

Types of embolisms

A
  • Amniotic fluid
  • Bone marrow
  • Foreign bodies
  • Tumour
  • Trophoblast
  • Septic material
  • Gas
  • Air embolus
  • Fat
  • Venous thromboembolism
  • Systemic/ arterial thromboembolism

Systems: Cardiovascualar AB (42 decks)

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