thrombi

Question 1

Morphology of Thrombi

1) arterial or cardiac at sites of
2) venous at sites of

Answer 1

1) Arterial or cardiac at sites of endothelial injury or turbulence
2) Venous at sites of stasis

Question 2

Thrombi are focally attached to?

Answer 2

underyling vasculature

Question 3

Thrombi propagate toward the heart in what direction?

Answer 3

1) arterial grow in a retrograde direction

2) venous grow in the direction of blood flow

Question 4

what causes the risk of embolus formation?

Answer 4

The propagating portion of a thrombi is poorly attached to the underlying vasculature

Question 5

Lines of Zahn

Answer 5

■ Concentric layers of platelets and fibrin alternating with RBCs.
■ Only noted in thrombi that form in flowing blood.

Question 6

Mural thrombus occurs in the?

Answer 6

heart chamber or aortic lumen

Question 7

Cardiac mural thrombus etiologies include?

Answer 7

abnormal cardiac contraction (MI, dilated cardiomyopathy) and endomyocardial injury (catheter trauma)

Question 8

Aortic thrombi may result from ulcerated?

Answer 8

atherosclerotic plaques and aneurysms

Question 9

Arterial thrombi are relatively rich in?

Answer 9

platelets

Question 10

Arterial thrombi are often superimposed on?

Answer 10

ruptured atheroscelerotic plaques

Question 11

Arterial thrombi may lead to?

Answer 11

cardiac or cerebral infarction

Question 12

Venous thrombi may result in the formation of?

Answer 12

emboli

Question 13

Venous thrombi often result from increased activation of?

Answer 13

coagulation factors

Question 14

Venous thrombi mostly occur in?

Answer 14

veins of the lower extremities

Question 15

what are the 4 steps to the cycle “fate” of thrombus?

Answer 15

1) propagation
2) Embolization
3) Dissolution
4) Organization and recanalization

Question 16

define thrombus propagation

Answer 16

Enlargement by the addition of platelets and fibrin

Question 17

define thrombus Embolization

Answer 17

Part or all is dislodged and transported to a distant site in the vasculature

Question 18

define thrombus Dissolution

Answer 18

A new thrombus may be dissolved via fibrinolytic factors

Question 19

define thrombus Organization and recanalization?

Answer 19

Older thrombi organized via the ingrowth of endothelial cells, smooth muscle cells, and fibroblasts. Later, formation of capillary channels within the thrombus. May incorporate into the wall of the remodeled vessel

Question 20

what is often associated with varicose veins?

Answer 20

Superficial (saphenous veins) or
deep veins of the leg
**Rarely embolize, may be painful.

Question 21

Superficial (saphenous veins) or Deep venous thromboses (DVTs) more at risk to embolism?

Answer 21

Deep venous thromboses (DVTs)

Question 22

Deep venous thromboses (DVTs) occur in?

Answer 22

the larger leg veins at or above the knee. **Higher risk to embolize. May cause local pain and edema.

Question 23

Lower Extremity DVTs are associated with?

Answer 23

stasis and hypercoagulable states

Question 24

Lower Extremity DVTs predisposing factors

Answer 24

CHF, bed rest, immobilization, age

Question 25

Lower Extremity DVTs do what with trauma, surgury and burns?

Answer 25

Immobilize, vascular injury, procoagulant release, increase hepatic synthesis of coagulation factors, decrease t-PA production

Question 26

Pregnancy, tumor-associated procoagulant release is associated with what type of thrombi

Answer 26

Lower Extremity DVTs