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Pathology 2220 > Week 5: Tissue Damage and Trauma > Flashcards

Week 5: Tissue Damage and Trauma Flashcards

1
Q

What are the causes of tissue damages?

A

Physical and Chemical Trauma

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2
Q

What are the 3 mechanisms of damage?

A

Disruption
Metabolic Interference
Free Radicals

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3
Q

What are some causative agents?

A 
Trauma
Thermal Injury (Hot or Cold)
Poisons
Drugs
Infectious Organisms
Ionising Radiation
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4
Q

Ischaemia is caused by __________ and results in _________________________. The damage caused is _________________________________.

A

Reduced Blood flow
Accumulation of Metabolites
Repairable until a point of no return

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5
Q

Shock is a pathological process characterised by ____________________ resulting in life threatening ___________ of the bodies vital organs. Compensatory mechanisms maintain blood pressure until ________________________.

A

Profound circulatory failure
Hypo-perfusion
They fail leading to hypotension

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6
Q

What is Cardiogenic Shock?

A

Shock commonly due to myocardial infarction - it is the failure of the heart’s pumping mechanism

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7
Q

What is Hypovolemic Shock?

A

Shock due to reduction in the effective circulation blood volume - loss of blood, loss of fluid, shift of fluid into the cellular component and body cavities and away from the circulation

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8
Q

What are the consequences of shock?

A

Irreversible neural damage
Renal failure
Cerebral infarction
Infarction in any area/organ

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9
Q

What is inflammation?

A

Initial reaction of tissue to injury
Vascular phase - dilation and increased permeability
Exudative phase - fluid and cells escape from the permeable venules

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10
Q

What happens if the nucleus or nucleolus is damaged?

A
  • Damages both transcription and translation
  • If the cell goes into mitosis before the damage is repaired it leads to cell death
  • Damaged DNA can lead to mutations
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11
Q

What happens if the mitochondria is damaged?

A
  • Damage to mitochondria leads to impairment of the metabolic pathways
  • This results in energy deficiency, particularly of ATP within the cell
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12
Q

What is hypertrophy?

A

Increase in the size of individual cells resulting in overall increase in organ size

Example - increased workload on a muscle

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13
Q

What is hyperplasia?

A

Increase in the number of cells in an organ, also resulting in an increase in organ size

Example - Thickened keratinising squamous epithelium of skin in area of rubbing or chronic irritation

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14
Q

What is Atrophy?

A

Decrease in cell size and number of cells

Example - Disuse limb immobilised following fracture or loss of innervation

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15
Q

What is Metaplasia?

A

Reversible change from one differentiated cell type to another

Example - Intestinal metaplasia in the oesophagus in the setting of reflux disease

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16
Q

The effect of injury is dependent on:

A

Duration of the injury
Type of injurious agent
Type and number of cells involved
Ability of the tissue to resolve and regenerate

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17
Q

What are the possible outcomes after trauma?

A 
Necrosis
Apoptosis
Inflammation
Cell Renewal
Organisation/Fibrosis
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18
Q

What is/are Bruising/Contusions?

A

Blunt impact tears the capillaries and larger blood vessels deep to the skin surface, leading to bleeding into the extravascular space

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19
Q

What are Lacerations?

A

When the blunt object injury exceeds the elastic capacity of the skin and underlying tissues forceful tearing of the skin occurs

20
Q

What is Avulsion?

A

Tearing away of tissue from its attachments for instance skin torn from thigh after fall from height

21
Q

What is the difference between a stab and an incision?

A

A stab is deeper than it is long

An incision is longer than it is deep

22
Q

What is Myocardial Infarction?

A

Irreversible necrosis of myocardium due to inadequate blood supply

23
Q

The site and degree of damage of myocardial ischaemia or infarction is dependent on:

A
  • Which vessel is affected and how far along
  • How narrow the stenosis
  • How great the demands
  • How long the imbalance (30 minutes)
  • How soon intervention
  • Other medical conditions i.e. lung disease
24
Q

What are the risk factors for atherosclerosis?

A 
Family History
Cigarette smoke
Diabetes
Hyperlipidaemia 
Infections
Haemodynamic forces (Hypertension)
Immune mechanisms
25
Q

What are some complications of atherosclerosis?

A

Ulceration, Rupture, Haemorrhage, Thrombosis

26
Q

What are the signs and symptoms of myocardial infarction?

A

Angina - Radiating chest pain
Nausea and vomiting
Shortness of Breath

27
Q

What sign on an ECG tell you a heart attack has occurred?

A

The ST segment is markedly raised above the baseline

28
Q

What signs in a blood test tell you if a heart attack has occurred?

A

1 - 4 Hours after symptoms = Myoglobin
3 Hours - Days = Creatine Kinase
3 Hours - Days = Troponin

29
Q

What are the general treatment options for heart attacks?

A

Rest, lying f lat, O2
Glyceryl trinitrate GTN (dilates arteries)
Beta blockers (slows heart rate)

30
Q

What are the acute treatments for heart attacks?

A

Thrombolysis (dissolves the clot)

Stenting (opens up the stenosis)

31
Q

What are the chronic treatments for heart attacks?

A

Aspirin (decreases platelet stickiness)
Stenting
Bypass

32
Q

What are the Acute consequences of heart attacks?

A 
- Sudden death (40%)
 > from acute left ventricular failure
 > from an arrythmia
- Other arrythmias 
- Mural thrombus and thromboembolism
- Rupture (free wall or septum or papillary muscle)
33
Q

What are the Acute consequences of heart attacks?

A
  • Heart failure
  • Left ventricular or bi-ventricular
  • Arrythmias
  • Ventricular aneurysm
    > Mural thrombus
    > Thromboembolism
34
Q

What is a stroke/Cerebro-Vascular Accident?

A

A focal neurological deficit that persists for >24hr

and is due to a vascular cause

35
Q

What are the causes of CVA/stroke

A
  1. Narrowing or blockage of blood vessels supplying the
    brain
    - Thrombus (50%)
    - Embolus (30%)
  2. Rupture of a vessel (hypertension or aneurysm) with
    haemorrhage (20%)
36
Q

The brain is highly dependent on ___________ and therefore is very sensitive to ________.

A

Aerobic Respiration

Hypoxia

37
Q

Critical ischaemia occurs when the neuron receives ___% of it’s normal blood supply, then it will __________.

A

30%

Shut-Down

38
Q

The site and degree of damage due to a CVA depends on:

A

Which vessel is affected and where
How complete the block
How long the ischaemia (30 minutes)
How soon intervention

39
Q

What are the macroscopic features of CVA?

A
  • Soften, loss of definition, pale or haemorrhagic

- Shrunken, yellow, cystic

40
Q

What are the microscopic features of CVA?

A
  • Neuronal necrosis, pallor of myelin, oedema, haemorrhage
  • Macrophages, gliosis but no fibrosis, cystic
    change instead of scarring
  • Haemosiderin
41
Q

What are the symptoms of CVA?

A
  • Pain
  • A decrease or loss of consciousness, ie coma.
  • Symptoms and signs are variable and depend on the site of damage and the function of that area
42
Q

Why might a patient die from a CVA?

A
  • Critical areas are affected (brain stem)
  • The damage is too massive
  • Increased intracranial pressure can cause coning,
    i. e. trying to squeeze the brain out of the skull through the foramen magnum
43
Q

What are the acute treatments for CVA?

A
  • Support
  • Thrombolysis
  • Clipping of an aneurysm
  • Evacuation of blood clot
44
Q

What are the chronic treatments for CVA?

A

Aspirin

45
Q

How do we prevent CVA?

A

Prevention of risk factors:
- Atherosclerosis
> HT, smoking, hypercholesterolaemia, DM
- Stent, bypass, surgery of atherosclerotic stenoses
- Aneurysm repair
- Anti-platelet agents

Pathology 2220 (10 decks)

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