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22 fall: path > Test 1: lecture 8 circulatory disturbances > Flashcards

Test 1: lecture 8 circulatory disturbances Flashcards

1
Q

function of circulatory system

A

Deliver nutrients to & remove waste products from cells

Circulate fluid & cells to maintain homeostasis & integrate function

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2
Q

breakdown of water inside the body

A
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3
Q

what is the outward pressure in blood vessels

A

hydrostatic

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4
Q

what is the pull caused by proteins called

A

osmotic pressure

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5
Q

fluid accumulation in tissues

A

edema

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6
Q

fluid accumulation in body cavities

A

effusion

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7
Q

Imbalance between intravascular & interstitial compartments cause ____

A

fluid accumulation in the interstitium

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8
Q

what does edema look like microscopically

A
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9
Q

4 causes of edema/effusion

A

increased­ vascular permeability

  1. ­ increased intravascular hydrostatic pressure
  2. decrease plasma colloid osmotic pressure
  3. decrease lymphatic drainage
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10
Q

an increase or decrease in osmotic pressure would cause edema

A

decrease (osmotic pressure pulls fluid back into the blood vessels)

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11
Q

how does inflammation cause increased vascular permeability?

A

local release of inflammatory mediators such as histamine, bradykinin and leukotrienes

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12
Q

increased hydrostatic pressure is due to ___

A

increased blood volume in microvasculature

(localized or generalized)

due to impaired venous outflow

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13
Q

increased intravascular hydrostatic pressure is usually due to impaired ___

A

venous outflow (passive congestion)

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14
Q

2 common ways to have low protein

A

protein loss through the kidneys or GI

or decreased protein synthesis due to liver failure or poor nutrient

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15
Q

hypoproteinemia causes ___ plasma colloid osmotic pressure

A

decreased → leads to edema

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16
Q

edema caused by low osmotic pressure is usually generalized or local?

A

generalized (all over decrease in protein, either from loss or from decreased synthesis)

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17
Q

what are some causes of decreased lymphatic drainage

A

Compression or blockage due to trauma, fibrosis, invasive neoplasms, infectious agents, or congenital malformation (rare)

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18
Q

lymphatic obstruction would increase or decrease lymphatic drainage

A

decrease (blockage in vessel prevents it from carrying away lymph)

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19
Q

where are two places edema is bad

A

cerebral and pulmonary/thoracic

(have no place to swell)

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20
Q

primary hemostasis is mediated by ___

A

platelets

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21
Q

secondary hemostasis is mediated by ___

A

clotting factors

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22
Q

what happens during primary hemostasis

A

vasoconstriction→ tries to reduce size of injury

collagen in wall of vessel exposed and triggers vWF to cause platelets to bind and clump

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23
Q

what happens during secondary hemostasis

A

tissue factor cause coagulation cascade → thrombin formation which leads to fibrinogen into fibrin

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24
Q

___ is blood loss from the
circulatory system

A

hemorrhage

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25
Q

3 causes of hemorrhage

A

blood vessel injury

decreased platelets

decreased clotting factor

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26
Q

decreased number of platelets can be caused by

A

platelets not being made, not working right or being destroyed or used up

decreased production of platelets

increased consumption/destruction

decreased function

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27
Q

what kind of cells make most clotting factors

A

hepatocyte in the liver

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28
Q

many clotting factors are vitamin ___ dependent

A

K

needs to be recycled

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29
Q

hemorrhage is bad where?

A
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30
Q

___ is inappropriate clotting within the circulatory system

A

thrombosis

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31
Q

aggregate of platelets, fibrin, & other blood elements formed on
a vessel or heart wall

A

thrombus

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32
Q

If a thrombus (or fragment of a thrombus) breaks loose and enters the circulation, it becomes a ____

A

thromboembolus

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33
Q

when a piece of a blood clot breaks off and travels it is called a ___

A

thromboembolus

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34
Q

embolus

A

any mass (solid, liquid, or gas) carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or necrosis

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35
Q

___ = any mass (solid, liquid, or gas) carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or necrosis

A

embolus

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36
Q
A

embolism

(bone marrow in lung tissue)

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37
Q

what do thrombi look like

A

dull, rough, red/tan, friable

laminated

can be occlusive or non occlusive

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38
Q

difference between thrombi and postmortem blood clot

A

thrombi: dull, rough, red/tan, friable, laminated

postmortem: shiny, smooth, gelatinous

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39
Q

thrombi or post mortem clot?

A

thrombi → dull, rough, red/tan, friable

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40
Q

3 sides of virchow’s triad

A
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41
Q

endothelial injury, abnormal blood flow and hypercoagulability are all part of ___

A

virchow’s triad

(cause a clot)

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42
Q

If thrombosis is widespread, it can lead to a ___ & subsequent ___

A

consumptive coagulopathy

hemorrhage

(DIC- too much clotting, use up all the factors, flips and leads to uncontrolled bleeding)

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43
Q

Systemic ____influences help maintain adequate blood flow to the tissues

A

neural & hormonal

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44
Q

____= active engorgement of a vascular bed due to vasodilation & increased flow

A

hyperemia

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45
Q

passive engorgement of a vascular bed due to decrease outflow

A

congestion (blood not draining well)

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46
Q

hyperemia vs congestion

A

hyperemia: active increase of blood to an area→ vasodilation and increased blood flow

congestion: decrease in blood draining (passive) (CHF or obstruction)

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47
Q

CHF is an example of hyperemia or congestion

A

congestion (passive inability to move blood out)

blood pooling

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48
Q

grossly what does hyperemia look like

A

warm and bright red due to increased oxygenated blood to an area

(running get flushed)

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49
Q

grossly what does congestion look like?

A

cool and dark red/purple

pooling of deoxygenated blood

stagnation

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50
Q

Inadequate tissue perfusion

A

ischemia

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51
Q

ischemia

A

decreased blood flow caused by obstruction, congestion or decreased cardiac output

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52
Q

what three things happen during ischemia

A

decreased O2 delivery

decreased nutrient delivery

decreased waste removal

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53
Q

what organs are most susceptible to ischemia

A

brain and heart

high O2 need and poor collateral circulation

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54
Q

area of tissue necrosis due to ischemia

A

infract

cell death of tissues due to decreased blood flow

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55
Q

acute/subacute phase of infarct look ___

A

wedge shaped

swollen and dark red (hemorrhagic) or tan

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56
Q

chronic infracts grossly look ___

A

depressed, tan and firm

tissue has been replaced by fibrous material that shrinks during healing

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57
Q

a state of general circulatory failure that impairs tissue perfusion → cellular hypoxia ± cell injury & death

A

shock

58
Q

cardiogenic shock

A

decreased cardiac output from heat failure

(pump doesn’t work)

59
Q

decreased cardiac output due to heart (pump) failure

A

cardiogenic shock

60
Q

hypovolemic shock

A

decreased circulating blood volume due to massive fluid loss/hemorrhage

61
Q

HYPOVOLEMIC SHOCK

A

heart/pump fine but not enough blood to pump through body due to fluid loss

(hemorrhage, diarrhea, vomiting, burns)

62
Q

distributive shock

A

decreased peripheral vascular resistance with pooling of blood in peripheral tissue due to sepsis, anaphylaxis

vasodilation

63
Q

decreased peripheral vascular resistance with pooling of blood in peripheral tissues due to sepsis, anaphylaxis, etc.

A

distributive shock

64
Q

When that fluid accumulates in tissues

A

edema

65
Q
A

mesocolonic edema

translucent yellow jelly- like appearance due to accumulation of fluid in the interstitial space.

66
Q

“bottle jaw” refers to fluid build up ___

A

submandibular edema

67
Q

“brisket edema”

A

pectoral edema

68
Q

When excess fluid accumulates in a body cavity, we call it an ___

A

EFFUSION.

69
Q
A

hydrothorax

70
Q
A

hydropericardium

71
Q

serous effusion in the peritoneal cavitity

A

hydroperitoneum

ascites

72
Q

ascites

A

serous effusion in the peritoneal cavity

73
Q
A

ASCITES

serous effusion in the peritoneal cavity

74
Q

4 causes of edema

A
75
Q

increased vascular permeability, which occurs during ___

A

inflammation

76
Q

Inflammatory stimuli lead to local release of inflammatory mediators that cause ____ of the gaps between vascular ____cells.

A

vasodilation and widening

endothelial

77
Q

exudate

A

fluid, proteins and cells that leave vessels due to increased vascular permeability, high specific gravity

leakage of plasma proteins and emigration of leukocytes

78
Q
A

urticaria (hives)

dermal edema

79
Q
A

blue → eosinophilic inflammation

green → edema

80
Q

increased intravascular hydrostatic pressure can be due to an active increase in blood flow into the microvasculature called ___

A

hyperemia

81
Q

hyperemia can be caused by acute inflammation or by ___

A

congestion - passive accumulation of blood due to impaired venous outflow

82
Q

passive accumulation of blood due to impaired venous outflow.

A

(CONGESTION)

83
Q

congestion causes increased blood volume that will increase ___ that will drive fluid from the intravascular compartment into the interstitium, resulting in ___

A

hydrostatic pressure

localized edema.

84
Q

right sided heart failure

A

blood backs up into the body → SQ edema and ascites (cavitary effusions)

85
Q

left sided heart failure

A

blood backs up into the lungs

pulmonary edema

86
Q
A

pulmonary edema

heavy and exude frothy or watery (serous) fluid when incised

Fluid also expands the connective tissue septa of the lung, giving the septa a widened gelatinous appearance

87
Q

pulmonary edema vs pleural effusion

A

pulmonary edema- fluid buildup in the lungs

pleural effusion- fluid buildup around the lungs

88
Q

Low plasma protein concentration

A

hypoproteinemia

89
Q

2 ways to have decreased osmotic pressure

A

protein loss through GI or kidneys

decreased protein synthesis (liver failure)

90
Q

insufficient intravascular colloid osmotic pressure for fluid resorption from the interstitium, leading to ___

A

generalized edema.

91
Q

what plasma protein is important for osmotic pressure

A

albumin

92
Q

In cases of end-stage liver disease, there is decreased functional hepatic mass, which leads to decreased synthesis of plasma proteins by the liver. The resulting hypoproteinemia leads to decreased ___ and subsequent ___

A

plasma colloid osmotic pressure

edema/effusion

93
Q
A

cirrhosis of the liver

94
Q

cirrhosis will cause decreased ___ and increased ___

A

osmotic pressure → edema

hydrostatic pressure → fibrosis will impede normal hepatic blood flow and increase hydrostatic pressure which leads to ascites (edema in body cavity)

95
Q
A

ascites

can be caused by increased hydrostatic pressure or decreased osmotic pressure from liver damage

96
Q

Decreased lymphatic drainage can be the result of lymphatic vessel ___ and is usually localized to a particular region.

A

compression or blockage

97
Q

congenital lymphedema.

A

lymph vessels do not grow all the way→ blunt end

leads to build up of lymph → edema

98
Q

(mechanisms intended to seal an injured vessel and prevent blood loss

A

hemostasis

99
Q

3 causes of hemorrhage

A

blood vessel injury

decreased platelets

decreased clotting factors

100
Q

___ is required for normal collagen cross-linking, which helps maintain the integrity of blood vessel walls

A

Vitamin C→ scurvy

101
Q

periarticular

A

occur around a joint

102
Q

scurvy in guinea pigs

A

low Vit C leads to misformed collagen → weak cell walls → hemorrhage near joints

periarticular hemorrhage

103
Q
A

scurvy

low Vit C → can’t make collagen correctly

vessels are weak and prone to periarticular hemorrhage

104
Q

3 reasons to have low platelets

A

decreased platelet production

increased consumption or destruction of platelets

decreased platelet function

105
Q

Without adequate platelets, primary hemostasis (formation of a platelet plug) cannot be achieved after blood vessel injury, resulting in ___

A

hemorrhage.

106
Q

formation of a platelet plug

A

primary hemostasis

107
Q

(low platelet count

A

thrombocytopenia

108
Q

the cells responsible for production of platelets in the bone marrow

A

megakaryocytes

109
Q

formation of a fibrin meshwork

A

secondary hemostasis

110
Q

rodenticide poisoning leads to ___ why?

A

hemorrhage

messes up coagulation factor → Vit K can’t be recycled

Anticoagulant rodenticides contain vitamin K antagonists, such as warfarin or brodifacoum, that inhibit vitamin K epoxide reductase in the liver, leading to decreased amounts of active reduced vitamin K. Without active vitamin K, there is decreased production of vitamin K-dependent coagulation factors (II, VII, IX, and X). This acquired clotting factor deficiency can result in severe hemorrhage.

111
Q

HEMARTHROSIS

A

blood in a joint cavity (we see this a lot in horses with traumatic racing injuries

112
Q

blood in a joint cavity (we see this a lot in horses with traumatic racing
injuries

A

HEMARTHROSIS =

113
Q

cardiac tamponade

A

When fluid accumulates in the pericardial sac, it can put pressure on the heart and prevent the heart from filling normally with blood

114
Q

Very small hemorrhages (up to ~ 1-2 mm diameter) on the skin, mucosal, or serosal surfaces are referred to as

A

petechiae (petechia singular)

115
Q

larger hemorrhages (up to ~ 2-3 cm diameter) are referred to as

A

ecchymoses (ecchymosis)

116
Q
A

petechia

ecchymoses

117
Q

Leakage of blood from injured vessels beneath an intact surface (such as the skin) is known as ___

A

contusion or bruise

118
Q

If blood accumulates in a tissue to the point that it forms a visible mass, it is called a ___

A

hematoma

119
Q

Virchow’s triad

A
120
Q

another name for saddle thrombus

A

Feline Aortic Thromboembolism, or FATE

121
Q

thrombus look ___

A

dull, rough, red/yellow and friable

122
Q

thromboembolus in cats usually occur because of ___

A

hypertrophic cardiomyopathy (HCM)

the left ventricular myocardium hypertrophies and the left atrial chamber dilates. Dilation of the left atrium leads to alterations in blood flow (stasis or turbulence), which predispose to thrombus formation on the atrial wall (indicated by the green arrow in the image below). Thrombi are friable and can easily break apart, sending fragments (thromboemboli) into the circulation that can lodge at distant sites like the aortic bifurcation and block blood flow.

123
Q

what two colors can be found in a post mortem clot

A

currant jelly

chicken fat

124
Q

decreased tissue perfusion

A

ischemia

125
Q

If perfusion is not rapidly restored, the tissue normally supplied by the affected vessel can undergo ___ due to insufficient blood supply.

A

coagulative necrosis

126
Q

area of tissue necrosis caused by ischemia

A

infarct

127
Q

___ are usually sharply demarcated and angular or wedge-shaped.

A

Infarcts

128
Q
A

renal infarct

129
Q
A

splenic infarcts from a dog. The infarcts are the discrete swollen angular tan foci with dark red (hemorrhagic) rims (separated by the lighter red splenic parenchyma).

130
Q
A

These are cutaneous infarcts from a pig. The infarcts are the discrete rhomboidal red foci. These lesions are caused by Erysipelothrix rhusiopathiae infection, and the condition is commonly referred to as “diamond skin disease” (you can guess why). This bacterial infection causes necrosis of dermal blood vessels, which leads to thrombosis and cutaneous infarcts.

131
Q

Active engorgement of a vascular bed

A

hyperemia caused by inflammation or increased metabolic activity

132
Q

HYPEREMIA usually occurs due to ____ or ___metabolic activity

A

inflammation

increased

133
Q

Hyperemic tissues are usually ___due to increased delivery of ___

A

warm and bright red

oxygenated blood.

134
Q

Passive engorgement of a vascular bed

A

congestion → passive

135
Q

CONGESTION usually occurs due to decreased ___

A

venous outflow.

136
Q

Congested tissues are usually ___ due to accumulation of ___blood.

A

cool and dark red to blue

deoxygenated

137
Q

right sided heart failure

A

leads to build up in body

SQ edema and ascites

138
Q

left sided heart failure

A

build up in the lungs

pulmonary edema

139
Q

left-sided heart failure.

The patchy dark red coloration of the lungs is due to ____ (passive accumulation of blood in the pulmonary venous system). The excess blood causes ____ that drives fluid out of the vessels into the interstitium, resulting in pulmonary edema.

A

pulmonary congestion

increased hydrostatic pressure

140
Q

right-sided heart failure.

The regular pattern of dark red coloration is due to ___ (passive accumulation of blood in the vasculature) in the centrilobular regions of the liver. This condition is often referred to as ___

A

hepatic congestion

nutmeg liver

141
Q
A

nutmeg liver caused by right sided heart failure

22 fall: path (46 decks)

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