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Pathology > Pulmonary Vascular Disease ( Edema, Embolus, Hypertension)🦋 > Flashcards

Pulmonary Vascular Disease ( Edema, Embolus, Hypertension)🦋 Flashcards

1
Q

The dual supply the pulmonary circulation receives is from

A

Pulmonary arteries and bronchial arteries

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2
Q

The pulmonary system has what type of pressure system

A

Low pressure

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3
Q

What makes up the low pressure system of the pulmonary circulation

A
  • thin walled vessels

- low incidence of atherosclerosis

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4
Q

What is pulmonary edema

A

It’s the accumulation of fluid in the lungs interstitium and alveolar spaces

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5
Q

Describe the development of pulmonary edema

A
  • fluid builds up first in interstitial space (causing a stiff lung)
  • the fluid eventually gets into alveolar space
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6
Q

What does pulmonary edema cause

A
  • dyspnea
  • if chronic can cause pulmonary hypertension
  • hypoxia(blood isn’t fully oxygenated)
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7
Q

What can complicate pulmonary edema

A

An infection

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8
Q

What things can cause an increase in hydrostatic pressure

A
  • heart failure
  • mitral stenosis
  • mitral competence
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9
Q

What causes a decrease in oncotic pressure

A
  • malnutrition
  • nephrotic syndrome
  • liver disease
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10
Q

What causes microvascular injury (capillary permeability)

A
  • infections
  • aspiration
  • drugs
  • radiation
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11
Q

What are signs of pulmonary edema

A
  • Dyspnea
  • Tachypnea
  • cyanosis
  • pink or blood tinged frothy sputum
  • restlessness
  • agitation
  • wheezing
  • crackles
  • sudden weight gain
  • decreased urinary output
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12
Q

Pulmonary embolus can cause what effects

A
  • Sudden death
  • pulmonary hypertension
  • pulmonary infarction
  • severe chest pain/ dyspnea/haemoptysis
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13
Q

Most emboli are what

A

Thromboemboli

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14
Q

What’s an embolus

A

A detached intravascular mass carried by the blood to a site in the body distant from its point of origin

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15
Q

What is the source of most pulmonary emboli

A

Deep vein thrombosis of lower limbs

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16
Q

What are the risk factors for pulmonary embolus

A
  • abnormal blood flow (venous stasis-which is where the blood moves slowly)
  • hypercoaguable blood (cancer patients, post-MI, birth control pill)
  • factors in vessel wall (endothelial hypoxia)
17
Q

Effects of pulmonary embolus depend on what

A
  • size of embolus/ location of embolus/ number of emboli
  • cardiac function
  • respiratory function
18
Q

What are the effects of embolus size

A

Large emboli can cause- death,infarction, severe symptoms

Small emboli can cause- recurrent pulmonary hypertension and is clinically silent

19
Q

What are the types of pulmonary hypertension

A
  • primary (rare, young women)

- secondary

20
Q

What causes pulmonary hypertension

A
  1. Left heart failure (which causes increased back pressure in the pulmonary vessels)
    - left ventricular pump failure (heart attack,cardiomyopathy)
    - left ventricular stiffness (hypertension,diabetes,metabolic syndrome)
    - valve disease (mitral or aortic stenosis/regurgitation)
  2. Disease affecting the whole lung (lung diseases obliterate blood vessels)
    - chronic bronchitis and emphysema (results in loss of lung and hypoxia)
    - interstitial lung diseases (pulmonary fibrosis, sarcoidosis)
  3. Congenital heart disease
    - left to right shunts ASD and VSD
  4. Hypoxia which causes hypoxia induced vascular vasoconstriction
    - high altitude dwelling
    - sleep apnea and hypoventilation syndromes
    - hypoxia of COPD
  5. Pulmonary arterial hypertension (which results in changes in the structure and function of the pulmonary arteries)
    - idiopathic
    - heritable
    - drug and toxin induces
    - connective tissue diseases (scleroderma)
    - hiv infection
21
Q

What is the morphology of pulmonary hypertension

A
  • there is medial hypertrophy of the arteries
  • intimal thickening of artery (fibrosis)
  • atheroma
  • right ventricular hypertrophy

NB: narrowing of the pulmonary arterioles causes hypertension and hypertension causes more narrowing

22
Q

What is Cor Pulmonale

A
  • it results from pulmonary hypertension
  • it involves right ventricular hypertrophy
  • it involves right ventricular dilation
  • it is right heart failure ( which can cause swollen legs,congested liver,pulmonary edema, pleural effusion,tiredness)

Pathology (13 decks)

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