Thromboembolism Flashcards
Tunica intima
endothelial layer, internal elastic lamina (stretch)
Tunica media
vascular smooth muscle, external elastic lamina (stretch)
Tunica adventitia
nerves, capillaries
Local factors that maintain localized formation of clot (prevents spreading)
Antithrombin, Protein C, Tissue factor pathway inhibitor, Plasmin, Prostacyclin
What does prostacyclin do?
Decrease free calcium levels available for pathway cascades - prevent spreading of clot
What does protein C do?
It is a vitamin K dependent anticoagulant that degrades factor Va and VIIIa
What does antithrombin do?
Degrades serine proteins in coagulation cascade IXa, Xa, XIa
What does plasmin do?
Cleaves fibrin into degraded products unable to clot
What are the three pillars in Virchow’s triad?
Vessel quality, blood flow, blood composition
Primary hypercoagulation
Genetic - V and prothrombin genes are mutated
What is homan’s test?
A symptom of DVT characterized by pain on dorsoflexion of blood
What accounts for one point in the Well’s criteria for diagnosis?
- tenderness along vein system
- swelling of entire leg/limb
- > 3cm difference in calf circumference
- pitting edema
- swollen/visible superficial veins
- risk factors: cancer, immobility, paralysis, surgery, illness
What score from Well’s criteria is considered high DVT risk?
> 3
What are the 3 classic symptoms of pulmonary embolism?
sputum production, difficulty/rapid breathing, chest pain on inspiration
