Thrombi and Emboli Flashcards
What is the most common cause of death in the U.S.?
Arterial thrombi
What are the three most common sites of arterial thrombi?
- Coronary
- Cerebral
- Femoral arteries
Arterial thrombi will result in…
ischemic infarction
Myocardial infarction involves what type of necrosis?
Coagulative
Cerebral infarction/stroke involves what type of necrosis?
Liquefactive
Renal infarction involves what type of necrosis?
Coagulative
What is phlebothrombosis?
Venous thrombosis
Where do red thrombi occur?
Within veins
What is the most common site of phlebothrombosis?
Superficial leg veins (varicose veins)
What is the most common clinical manifestation (and most clinically significant) of phlebothrombosis?
Deep vein thrombosis
If the tissue is pale, not swollen, and has gangrenous necrosis, what is the most likely type of thrombus?
Arterial thrombus
If the tissue is swollen and has changed color, what is the most likely type of thrombus?
Venous thrombus
What are lines of Zahn?
Morphological attribute of thrombi: alternating dark and light lines indicating start/stop growth pattern of clot
What is mural thrombi?
Thrombi attaching to wall of blood vessel and cardiac chamber
What are vegetations (infective endocarditis)?
Thrombi occurring at tip of valve due to strep and staph
What is verrucous (Libman sacks) endocarditis?
Autoimmune (lupus)
Thrombi occur on top of heart valves
What are some clinical manifestations of deep vein thrombosis?
- Edema of foot and ankle
- Pain of foot and ankle (Homan’s sign)
- Local ischemia - bacterial skin infections
- Pulmonary embolization
What is Homan’s sign?
Apprehension with contact of back of knee, pain of foot and ankle, a clinical manifestation of deep vein thrombosis
What is pulmonary embolization?
Detached venous thrombosis travels to lung
What are the potential fates of a thrombus in order of least to most severe?
- Dissolution
- Propagation
- Organization
- Recanalization
- Embolization
What is dissolution of a thrombus?
Blood clot dissolves by plasmin
What is propagation of a thrombus?
Continued growth
What is embolism?
A detached intravascular mass (any) that is carried by the blood to a site distant from its point of origin
What is the most common type of embolism?
Thromboembolism
Thromboembolism results in…
partial or complete occlusion of vessel lumina
Thromboembolus may lodge in ___ or ___
pulmonary (venous) or systemic (arterial) circulation
Fat embolism usually occurs with…
long bone fracture
If a substance turns red with acid-fast staining, it is…
fat
What type of embolism is involved in “the Bends”?
Air embolism in venous system
What is an amniotic embolism?
Birth complication: placental tear/abruption, fetus sheds epithelial cells that are expressed in mother’s blood
What is the most common preventable death in hospitalized patients?
Pulmonary emboli (role of ambulation and anticoagulants)
Deep leg vein thrombi can lead to…
pulmonary emboli
What is a saddle embolus?
Large emboli at bifurcation of pulmonary trunk
Systemic emboli have what origin?
Arterial (left ventricle, atherosclerotic plaques)
What is the most common site of lodgment for systemic emboli?
Lower extremities (75%)
What are three sites of lodgment for systemic emboli?
- Lower extremities
- Brain
- VIscera
