Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular System > Pathophysiology of Thrombosis and Embolism > Flashcards

Pathophysiology of Thrombosis and Embolism Flashcards

1
Q

What are the two types of abnormal blood flow?

A

stasis

turbulent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is static blood flow?

A

stagnation of flow e.g. haemostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would you describe turbulent blood flow?

2

A

unpredictable and forceful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are causes of abnormal blood flow?

7

A 
thromboembolism
atheroma
hyperviscosity
spasm
external compression
vasculitis
vacsular steal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause external compression of blood vessels causing abnormal flow?

(2)

A
  • tumour

- pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is vascular steal?

A

Dilation of one vascular network (e.g., during exercise or vasodilator therapy) “steals” blood flow from another region within the organ that is already maximally dilated because of the presence of proximal lesions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Virchow’s triad of factors causing thrombosis?

A
  • changes in the blood vessel wall
  • changes in the blood constituents
  • changes in the pattern of blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference between a thrombus and a clot?

A

Clot forms in stagnated blood (RBC + fibrin)

Thrombus forms within blood vessels during life (when blood is moving).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give an example of a change in vessel wall that can increase the risk of thrombosis?

A

atheromatous coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give an example of three typical changes which lead to thrombosis?

A
  • endothelial injury (clotting cascade = fibrin)
  • stasis or turbulent blood flow (atheroma)
  • hypercoagulability of blood (increased viscosity in smokers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Outline the pathogenesis of thrombosis.

6

A
  1. atheromatous plaque
  2. turbulent blood flow
  3. loss of intimal cells, collagen exposed
  4. fibrin meshwork and RBC stagnate, platelet aggregation
  5. Lines of Zahn
  6. propagation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are line’s of Zahn?

A

Alternating bands of fibrin and platelet thrombi and RBC clots.

They appear in bands of cream and dark red.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Arterial thrombosis is most commonly superposed on what?

What increases the likelihood of this?

A

atheroma

hypercholesterolaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can cause changes in vessel wall that leads to thrombosis?

(5)

A
  • MI - can lead to mural thrombosis in the heart.
  • trauma
  • smoking
  • hypertension
  • atheroma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a mural thrombosis?

A

Mural thrombi are thrombi that adhere to the wall of a blood vessel. They occur in large vessels such as the heart and aorta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What factors can lead to changes in blood constituents, leading to increased risk of thrombosis?

(3)

A
  • polycythaemia
  • hyperviscosity (e.g. smoking)
  • post-traumatic hypercoagubility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is meant by changes to blood flow which can lead to thrombosis?

(2)

A
  • stasis

- turbulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can lead to stasis of blood flow and then thrombosis?

2

A
  • long flights sitting down (“economy class syndrome”, DVT)

- post operation (bed-bound)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause turbulence of flow which can lead to thrombosis?

(2)

A

atheromatous plaque

aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What three things do the consequences of a thrombosis depend on?

A
  • site
  • extent
  • collateral circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the common consequences/outcomes of thrombosis?

A
  • myocardial infarction
  • DVT (PE)
  • critical limb ischaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the hopeful outcomes from thrombosis?

2

A
  • resolution

- organisation/recanalisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does propagation of thrombosis lead to?

A

embolism (thromboembolism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an embolism?

Give examples.

A

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

It could be anything: blood, brick dust, air.

25
Q

What are most emboli?

A

Dislodged thrombi i.e. thromboembolism

26
Q

What are some of the sources of thrombi in the systemic/arterial system?

(4)

A
  • mural thrombus
  • aortic aneurysm
  • atheromatous plaques
  • valvular vegetations
27
Q

What is a paradoxical emboli?

A

A paradoxical embolism refers to an embolus which is carried from the venous side of circulation to the arterial side, or vice versa.

28
Q

What is the most common site where thromboembolisms travel to?

A

lower limbs

29
Q

What do the consequences of a thromboembolism depend on? (3)

What do they usually end up in?

A
  • vulnerability of affected tissues to ischaemia
  • calibre of occluded vessel
  • collateral circulation

Infarction

30
Q

Where do venous thrombi embolise to?

What is the name of the clinical emergency associated with severe cases of this?

A

pulmonary circulation

pulmonary embolism

31
Q

What do the consequences of a pulmonary embolus depend on?

2

A
  • the size of the embolus.

- this determines the size of the artery it gets lodged in.

32
Q

What are the consequences of severe pulmonary thromboembolism?

(4)

A
  • pulmonary haemorrhage
  • infarction
  • right heart failure
  • sudden death
33
Q

What can multiple pulmonary emboli over time lead to?

A
  • pulmonary hypertension

- right ventricular failure

34
Q

What is a silent pulmonary embolus?

A

a pulmonary embolism with no clinical symptoms

35
Q

What are the risk factors for deep venous thrombosis?

10

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
36
Q

What prophylaxis measures are taken for surgical patients at risk of thrombosis/thromboembolism?

A
  • s/c heparin

- TEDs

37
Q

What is heparin?

A

anticoagulant

38
Q

When are patients at risk if fat embolism?

A

after major fractures

39
Q

Which parts of the body are usually affected by fat embolism?

(3)

A

brain, kidneys, skin

affected

40
Q

When can gas embolus (of nitrogen) occur?

Give an example.

A

in decompressoin sickness (divers come up to the surface too quickley)

41
Q

When can an air embolus occur?

3

A
  • head and neck wounds
  • surgery
  • CV lines
42
Q

What is a trophoblast embolism?

A

material from the placenta dislodges and enters the maternal blood stream

43
Q

When can a tumour cause an embolism?

A

part of the tumour detaches and spreads to another part of the body (metastasises)

44
Q

Give an example of when septic material can cause an embolism?

A

Infective endocarditis

45
Q

What sort of embolism can occur in childbirth?

What can this cause?

A

amniotic fluid embolism

collapse +/- death

46
Q

What sort of embolism can occur as a result of fractures (and CPR)?

A

bone marrow

47
Q

When can embolisms occur from foreign bodies?

A

from medical intervention. eg. cannulae tips and sutures

48
Q

What is rheumatic fever?

A

a disease of disordered immunity

49
Q

When might rheumatic fever develop?

A

following the infection of a group A beta haemolytic streptococcus e.g. throat infection.

50
Q

How does rheumatic fever present?

4

A
  • “flitting” (painful) polyarthritis of large joints (wrists, elbows, knees, ankles)
  • skin rashes
  • fever
  • recent throat infection
51
Q

How does rheumatic fever affect the heart?

How?

A
  • pancarditis
  • heart murmurs common

Damage to heart tissue may be caused by combination of antibody-mediated and T cell-mediated reactions.

52
Q

What inflammatory bodies form in the heart in rheumatic fever?

A

aschoff body

53
Q

How does rheumatic fever affect the valves of the heart?

3

A
  • valvular stenosis
  • valvular regurgitation
  • vegetations- impair mobility, may embolise
54
Q

When does pancarditis present in rheumatic fever?

What can it progress to?

A

acute phase

progresses to chronic, manifesting as valvular abnormalities.

55
Q

Which valves are affected by rheumatic heart disease?

A

L side

mitral mainly

56
Q

What is the pathogenesis of fibrotic valvular disease?

3

A
  • leaflet thickening
  • commissural fusion
  • shortening/thickening and fusion of chordae tendineae
57
Q

What is the most common cause of aortic stenosis?

A

calcific aortic valve disease

58
Q

What is the most common cause mitral regurgitation?

A

ischaemic heart disease

59
Q

What is virtually the only cause of mitral stenosis?

A

rheumatic heart disease

Cardiovascular System (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions