Vascular Disorders and Thrombosis I Flashcards
what is the interstitium and what is it composed of?
space outside cells
fluid and extracellular matrix
what is effusion?
accumulation of fluid in a body cavity
what is the difference between edema and effusion?
edema is excess fluid in interstitium
effusion is accumulation of fluid in body cavity
what is different about pulmonary edema?
lungs will not collapse/deflate as expected
foam results from fluid mixing with surfactant as spills out
what is ascites?
clinical term for abdominal effusion
what is required for Starling’s equilibrium?
intact, functioning blood vessels
intact, functioning lymphatic vessels
adequate intravascular concentrations of serum protein- albumin
what are the mechanisms of edema or effusion?
increased vascular permeability due to inflammation or direct vessel injury
decreased lymphatic drainage
decreased plasma oncotic pressure
increased intravascular hydrostatic pressure
is lymphatic blockage/decreased lymphatic drainage usually localized to a particular location?
yes
what can cause decreased albumin production?
liver disease
malnutrition
intestinal malabsorption
how can you lose albumin leading to hypoalbuminemia?
glomerular disease
gastrointestinal disease
severe burns
what can lead to increased intravascular hydrostatic pressure (three things)?
heart failure
venous compression/obstruction
portal hypertension
what do you generally get from left-sided heart failure?
pulmonary edema
is pleural effusion the same as pulmonary edema?
no!!!
where is pleural effusion?
pleural cavity
what is the prefix for an effusion that is composed of high triglycerides?
lymph so chylo- (chylothorax)
what are exudates typically caused by?
inflammation
what causes transudates?
increased hydrostatic pressure
low oncotic pressure
what are the causes of chylous effusions?
leakage of lymph
left-sided heart failure in some cats
idiopathic
what are the primary cells in chylous effusions?
lymphocytes at least at first
what are the causes of hemorrhagic effusions?
trauma
ruptured tumors
altered hemostasis
if a cat has opaque white effusion in the pleural space, what are the predominate cells?
lymphocytes
is hyperemia an active or passive process?
active
is congestion an active or passive process?
passive
what colors distinguish hyperemia from congestion?
hyperemia is bright red
congestion is purple to nearly black
can congestion and hyperemia occur at the same time?
yes
what causes focal or regional hemorrhage?
trauma
rupture of tumor
vessel injury associated with inflammation
what are the terminologies for hemorrhage into a cavity?
hemothorax
hemoadbomen
hemopericardium
what is hemorrhage into a synovial joint space?
hemarthrosis
why does loss of blood cause problems?
hypoxia
hypovolemic shock
are higher metabolic rate organs more susceptible to hypoxic injury?
yes
what is the acute response in compensation to hemorrhage?
vasoconstriction
platelet plug and clotting cascade
what is the chronic response in compensation to hemorrhage?
formation new red blood cells, white blood cells, blood vessels, etc
what is primary hemostasis?
initial vascular and platelet response:
contraction of injured blood vessel
formation platelet plug
what is secondary hemostasis?
clot formation: firmer platelet plug with fibrin clot
what is important in the platelets binding to the subendothelial matrix?
collagen, fibronectin, laminin, glycoproteins, proteoglycans
von Willebrand factor
what is the major initiator of secondary hemostasis?
exposure of tissue factor (III)
what is the end goal of secondary hemostasis?
cleavage of fibrinogen to fibrin by thrombin (active form of prothrombin)
fibrin self-polymerizes to form major structural protein of thrombus
what factors in the coagulation cascade are dependent upon vitamin K?
II
VII
IX
X
what crosslinks the fibrin polymers to make them insoluble?
factor XIIIa
what is thrombolysis?
enzymatic breakdown of thrombus
what is fibrinolysis?
breakdown of fibrin specifically
what is the major enzyme involved in thrombus removal/thrombolysis?
plasmin (active form plasminogen)
what is the main trigger of the coagulation cascade in vivo?
exposure of subendothelial collagen
what is pulmonary edema and what causes it?
lung tissue edema
left-sided heart failure
what is pleural effusion and what causes it?
pleural cavity effusion
right-sided heart failure (except cats- can be left)
