Brainscape's Knowledge GenomeTM

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


See full index

SA pathological processes > S5) Thrombosis and Embolism > Flashcards

S5) Thrombosis and Embolism Flashcards

1
Q

What is a thrombosis?

A

A thrombosis is the formation of a solid mass from the constituents of the blood, within the circulatory system

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

There are three fundamental predisposing factors to thrombosis.

What is this called?

A

Virchow’s triad

  1. Changes in the vascuar wall
  2. changes in blood flow
  3. Changes in Blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Identify the three predisposing factors to thrombosis as outlined in Virchow’s triad

A
  • Abnormalities of the flow of blood
  • Abnormalities of the blood vessel wall
  • Abnormalities of the constituents of the blood

2/3 are enough to create a thrombus

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

State two possible abnormalities in the flow of blood

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

State three causes for abnormalities in the blood vessel wall

A
  • Atheroma
  • Direct injury
  • Inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

State three causes for abnormalities in the constituents of the blood

A
  • Smoking
  • Post-partum
  • Post-operation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the appearance of arterial thrombi

A
  • Pale
  • Granular
  • Lines of Zahn
  • Lower cell content
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the appearance of venous thrombi

A

(normally found where there is stasis - slowinf/stopping of blood flow)

  • Soft
  • Gelatinous
  • Deep red
  • Higher cell content
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 5 possible outcomes of a thrombosis?

A
  • Lysis - thromus dissolves
  • Propagation - thrombus grows
  • Organisation - undergoes fibrous repair and forms a scar
  • Re-canalisation - new channels grow and restore blood flow
  • Embolism - part breaks off and embolises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In three steps, describe the following outcome of a thrombosis: lysis

A

⇒ Complete dissolution of thrombus (small)

⇒ Fibrinolytic system active

⇒ Blood flow re-established

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In three steps, describe the following outcome of a thrombosis: propagation

A

⇒ Progressive spread of thrombosis

⇒ Spreads distally in arteries

⇒ Spreads proximally in veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In two steps, describe the following outcome of a thrombosis: organisation

A

⇒ Ingrowth of fibroblasts and capillaries (similar to granulation tissue)

⇒ Lumen remains obstructed

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

In two steps, describe the following outcome of a thrombosis: re-canalisation

A

⇒ Blood flow re-established but usually incompletely

⇒ 1/more channels formed through organising thrombus

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

In three steps, describe the following outcome of a thrombosis: embolism

A

⇒ Part of thrombus breaks off

⇒ Travels through bloodstream

⇒ Lodges at distant site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the arterial effects of thrombosis?

A

Depends on site and collateral circulation:

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

What are the venous effects of thrombosis?

A
  • Congestion
  • Oedema
  • Ischaemia
  • Infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is an embolism?

A

An embolism is the sudden blockage of a blood vessel by thrombus or foreign material which has been brough back to its site of lodgement by blood current

(part of a thrombus thats come off)

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

What is the most common type of embolism?

A

Over 90% of emboli are thrombo-emboli

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

What are other types of embolism?

A
  • Air
  • Amniotic fluid
  • Nitrogen
  • Medical equipment
  • Tumour cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Outline the four different pathways for thromboemboli

A
  • From systemic veins → lungs (pulmonary emboli)
  • From the heart (via aorta) → renal, mesenteric and other arteries
  • From atheromatous carotid arteries → brain
  • From atheromatous abdominal aorta → leg arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Identify common areas where emboli can occur

A
  • Pulmonary embolism
  • Coronary embolism
  • Cerebral embolism
22
Q

What is a deep vein thrombosis?

A
  • A deep vein thrombosis is the formation of a thrombus within a deep vein, most commonly the deep calf veins
  • It produces an inflammatory response (calor, dolor, rubor, tumor, functio laesa)
23
Q

Identify 5 predisposing factors to deep vein thrombosis

A
  • Immobility
  • Post-operative
  • Pregnancy and postpartum
  • Oral contraceptives
  • Severe burns
24
Q

How does one prevent DVT?

A
  • Prophylaxis for high-risk patients
  • Heparin sub-cutaneously
  • Leg compression during surgery

I. TED stockings

II. ‘Flowtron’ boots

25
Q

What is the treatment for DVT?

A
  • aspirin
  • Intravenous heparin
  • Oral warfarin
26
Q

What is a pulmonary embolism?

A
  • A pulmonary embolism is a sudden blockage of a pulmonary artery in the lung, usually due to a deep vein thrombosis
  • It presents with chest pain, shortness of breath, coughing and blood stained sputum
27
Q

Identify and describe the three forms of pulmonary embolism

A
  • Massive PE – >60% reduction in blood flow (rapidly fatal)
  • Major PE – medium-sized pulmonary vessels blocked (SOB ± cough, blood stained sputum)
  • Minor PE – small peripheral pulmonary arteries blocked (asymptomatic/SOB)
28
Q

What is the effect of recurrent minor pulmonary emboli?

A

Recurrent minor PEs lead to pulmonary hypertension

29
Q

arterial and cardiac thrombi

A

occur at site of endothelial injury or turbulence

30
Q

endothelial damage

A
  • after MI secondary to haemodynamic stress of hypertension, scarred heart valves, after trauma or surgery
  • stasis thrombus will form (as platelets, clotting factors and chemical mediators) arent being washed away
31
Q

Slow/Turbulent flow

A

abnormal flow increases chance of clot forming

==> Veins have higher chance as their flow is slow

==> Patients on bed rest are at risk

==> occurs in ulcerated atheroscletoric plaques, with aneurysms

turbulent flow can also additionally cause damage to endothelial wall

turbulent flow (calcification/plaque)

32
Q

formation of a thrombus

A
  • platlets concentrated in th endothelium
  • catch onto a valve
  • form and aggrevate into a clump
  • more platelets join

haemostasis fibrinogen

  • Platelets combine
  • fibrin gows out
  • fibrin traps red blood cells
  • then a second layer of white platelets join (lines of zahn)
33
Q

hypercoagulability

A

pregnancy/after surgery = increased levels of fibrinogen and factor VIII = blood is hypercoagulability

=->the pill causes this

==> DIC

34
Q

difference btetween post/pre mortem

A

post = more rubbery and shiny

35
Q

thrombophlebitis

A

painful/superficial thrombi where the vein is inflammed

36
Q

parietal

A

thrombi attached to the vessel wall and restrict the the lumen

eg. arterial thrombi

37
Q

clinical effects of thrombosis

A

==> occulusion of an artery at site of thrombus

==> embolisation thrombus = occlusion of artery

==> congestion and odema in venous bed

==> repeated miscarriages due to thrombosis of uteroplacental vasculature

38
Q

thromboemboli

A

emboli that arise from thrombi

39
Q

why cant embolization occur in veins

A

vein blood flows from small -> Large vessels

objects carried by blood in veins goes through right side of heart and embolise in pulmonary arteries

40
Q

embolization in arteries

A

blood flows from large - small

objects in the large arteries impact small ones

  • arise in the left heart, aneurysms and thrombi and embolise to lower extremities, brain, intestines
41
Q

paradoxial emboli

A

RARE!

form in systemic veins but embolise to systemic arteries and bypass lungs

42
Q

thrombi seen in left heart as

A

1) infarcts
2) Atrial fibrillation => decreased atrial contraction => dialation of left atrium
3) vegetations

43
Q

Emboli from Atheroma

A
  • build up of materials that adhere to arteries

occurs spontaneously / surgery / catherisation

44
Q

TIAs

A

Transient ischameic attacks

  • episodes of neurological dysfunction
  • result of microscopic emboli
45
Q

fat and bone marrow

A
  • complication of bone fractures
  • damaged bone marrow fat cells release oil droplets
  • sucked up into venules

RESPIRATORY SYMPTOMS

  • emboli lodge into lungs
  • some droplets pass through into brain, kidney, skin ===> coma, agitation, rash
46
Q

Gas emboli

A

negative pressure in veins

air transports into right heart

bubbles gather = frothy mass that stops circulation

fatal = 100mls of air

47
Q

The bends

A
  • diver resurfaces too quickly then sudden depressurisation => dissolved gases being released as bubbles

bubbles distort tissue and acts as an emboli

  • Nitrogen is very bad => fat soluble and creates problems in lipid - rich tissues

treatment

slow decompression

48
Q

amniotic fluid embolism

A

complication of labour and C section

amniotic fkuid enters maternal circulation

respiratory distress/hypotension/seizures

49
Q

Talcum Emboli

A

microscopic foreign bodies

50
Q
A

SA pathological processes (15 decks)

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