Thrombosis, Embolism & Shock Flashcards
What is a thrombosis
It’s a clot:
Formation of a solid/semi solid mass from the constituents of the blood while moving within the vascular system during life
Where can a thrombi form?
Many places, such as:
- Lumen of the heart
- Arteries
- Veins (DVT)
- Capillaries
What 3 factors promote thrombosis?
- Abnormalities to the vessle wall
- Abnormalities of blood flow
- Abnormalities of the blood constituents
Give some possible abnormalities to vessel walls and which type of vessel they may form in…
ARTERIES- atheroma, inflammation
HEART- MI, rheumatic endocarditis (inflammatory heard disease with scar tissue from previous infarction causing autoimmune response)
VEINS- trauma, inflammation, chemicals (Sclerosants which get rid of varacous veins, glucose)
CAPILLARIES - Inflammation
What things can cause abnormalities of blood flow in the arteries?
Turbulance from:
- Aneirysms
- Plaques
- Spasms
What sort of things can cause abnormalities of blood flow in the heart?
- Atrial Fibrillation
- Aneurysms
What factors can cause abnormalities of blood flow in Veins?
Local Problems: -Compression inactivity (from bed rest/ economy class syndrome) General Problems -Heart Failure -Circulatory Shock
Having abnormality of blood constituents can promote thrombosis. Name some of the causes of blood abnormality constituents.
Increased thickness (Viscosity)
- Polycythaemia
- Dehidration
- Chronic Hypoxia
- Polychthaemia rubra vera (bone marrow disorder producing too many RBC)
- Hyperproteinaemia
- Multiple Myeloma (Tumour of plasma cells in bone marrow with accumulation of immunoglobulins in plasma)
- Following Trauma (liver produces more clotting factoes)
Why are you more at risk of getting a thrombosis following a trauma?
(hint: blood constituents)
Because the liver produces more clotting factors so the blood if more viscous (thicker) making it at higher risk of clotting.
What is Thrombocythaemia?
It’s a rare disorder where the bone marrow overproduces platelets causing the blood to be thicker (viscous) and making the person more at risk of thrombosis
What is the definition of Embolism?
It’s the transport of abnormal material (solid, liquid, gas) by the blood stream and its impacting on a blood vessel.
Name some possible types of Emboli?
- Pulmonay thromboembolus
- Arterial Thromboembolism (can cause ischemia especially if in legs)
- Fat embolism
- Gas embolism (infusions, vascular surgery, caisson disease)
- Tumour materia
- Infective agents
- Atheroma
- Amniotic Fluid
- Foreign bodies (IV drug abusers)
How does a tumour cause embolism?
Can happen when tumours penetrate blood vessels and parts may break away to form metastases.
How can pregnancy increase the risk of embolism?
The uterus may force amniotic fluid and squames from infant into uterine veins of mother.
What is the definition of the physiological state of SHOCK?
Shock is characterised by the significant, systemic reduction in blood beind delivered to capillaries (perfusion), resulting in decreased tissue oxygen delivery insufficient removal of cellular metabolic products, causing tissue injury.
Is shock the same as emotional shock?
NO
What’s Hypovolaemic Shock?
It’s an emergency condition where there has been significant blood and fluid loss causing the heart to not be able to pump efficiently.
- Severe burns
- Haemorrhage
What is Cardiogenic shock?
Cardiogenic shock is a state where the heart has been damaged to the point where it is unable to supply the body with enough blood and therefore nutrience. Causing organ failure.
- Large MI
- Other acute heart diseases
What’s septic Shock?
When the body is infected with bacteria (endotoxins Gram -ve and exotoxins from gram +ve) and the vessles dilate so much that bp drops and is life-threatening.
What is Anaphylactic shock?
It’s a sever form of allergic reaction from food, antibiotics and insect stings. dilates blood vessels and lowers BP. Life threatening
What type of shock is associated with spinal cord trauma
Neurogenic Shock
Can be caused by damage to the CNS such as spinal cord injury. Characterised by low BP and slower HR.
Cardiac tamponade (compression of heart by fluid in pericadial sac), tension pneumothorax and massive pulmonary embolism are causes to what type of shock?
Obstructive shock
What are some clinical features of shock?
- Low BP (less than 110)
- Tachy (over 90bpm)
- RR below 7/above 29
- low urine output
- metabolic acidosis
- Hypoxia
- cutaeous vasoconstriction/ vasodilation
- anxiety, agitation, indifference, lethargy, obtunded
