thrombosis and embolism Flashcards
what is stasis blood flow
stagnation of blood flow
what is turbulence in relation to blood flow
forceful, unpredictable blood flow
what defects occur in blood flow
thromboembolism
atheroma
hyperviscosity
spasm
external compression
vasculitits
vascular steal
what is vascular steal
when the effects of stenosis are exhazarrbated because of excersise and redirection of blood
what are the 3 parts of virchows triad
changes in the blood vessel wall
changes in the bloos constituents (platlets, RBCs, WBCs)
changes in the pattern of blood flow
what do virchows triad do
the factors causing thrombosis
what is the definition of a thrombus
formation of a solif mass from the constituents of blood WITHIN the vascular system DURING LIFE
what is the definition of a clot
formation of mass from the constitiuents of blood
either OUTSIDE the vascular system
or inside the vascular system AFTER DEATH
what is the factor that causes thrombus formation (thrombosis)
changes in the vessel wall
what are 3 main parts of pathogenesis of thrombosis
VIRCHOWS TRIAD
endothelial injury
stasis or turbulent blood flow
hypercoaguablitity of the blood
what happens to a atheromatous coronary artery to form a thrombus
turbulent blood flow, loss of intimal cells,
collagen exposed - platelets adhere, fibrin meshwork RBCs trapped
what are examples of the virkos triad relating to change in constituents
hyperlipdeamia
hyper viscosity
post- traumatic hypercoagulablity
what are some examples of changes in blood flow (virkows triad)
stasis - economy class syndrome
turbulence - atheromatous plaque, aortic aneurysm
what do the consequences of a thrombus depend on
site
extent
collateral circulation
what are the outcomes of a thrombus
resolution (small thrombus)
organasation/recanulisation
propagation (forming an embolism)
death
what is the definition of embolism
movment of abnormal material in the blood stream that then gets lodged (inpactation) in a vessel blocking its lumen
what is an embolus
detached intravascular solid, liquid or gaseous mass
what are the types of embolus
systemic/arterial thromboembolus
venous thromboembolus
fat embolus
gas embolus
air embolus
tumour
trophoblast
amniotic fluid
bone marrow
septic material
foreing bodies
what is an example of a embolus caused by a foreing body
intravascular cannulae tip, sutures
how could a embolism be caused by bone marrow
rib fractures
caused by CPR?
what whould an amniotic fluid embolus cause
mother collapses
can die during child birth
what embolus can a pregnant woman get (other than an amniotic fluid embolism)
trophoblast embolism
in pregnant women
often in the lungs
how world someone get a septic material embolism
by infective endocatditits - microorganism vegitations break off and form emboli
how would you get a air embolus
head and neck wounds
surgery
central venous lines
how would you get a gas embolus
decompression sickness
N2 forms as bubbles wich lodge in cappilaries
how would you get a fat embolus
after a major fracture
24-72hrs after fat embolism syndrome - brain, kidneys, skin all affected
how wohow would you get a systemic/arteriral thromboembolus
mural thrombus (because of MI or left atrial dilatation with atrial fibrillation )
aortic aneyrysms, atheromatous, plaques, valvular vegitations
what is a mural thrombus
a thrombus that occurs in large arteries like the aorta
where do systemic thromboembolus travel to
wide variety of sites
lower limbs are most common, brain is common too
where would a venous thromboembolus orginitate
deep venous thromoboses (lowe limbs)
most common form of thromboemboli disease
where do venous thromboembolus thravel to
the pulmonary arterial circulation
what is a saddle embolus
one that lodges at a bifurcation
what would happen if tyou have multiple pulmonary embolisms over time
pulmonary ypertension and right ventricular failure
consequences of a pulmonary thromboembolus depend on what
size
what are the risk factors for DVT and pulmonary thromboembolism
cardiac failure
severe trauma/ burns
oral contraceptive
old age
immobalisation ( bed rest)
obesity
post- operative/ post-partum (giving birth)
what are the prophalaxys given for surgical pateints
heprin
what is rheumatic fever
a immunity disorder
inflammatory changes in the heart and joints
common in india, middle east, central Africa
children aged 5-15 years
what can rheumatic fever lead to
pancarditis (inflammation affecting endocardium myocardium and pericardium)
heart murmours are common
what cells are seen in heart in acute rheumatic fever
aschoff body
what are the pathological problems that result from valvular heart disease
valvular stenoisis
valvular incompetence
vegitations - often mitral valve
what can Pancarditis in acute rheumatic fever lead to
chronic rheumatic heart disease whci presents as valvular abnormalities
what is virtulally the only cause of mitral stenosis
rheumatic heart disease
