Hemodynamic Disorders

Name
the types of hemodynamic disorders?? edema hyperemia and congestion hemorrhage hemostasis thrombosis embolization infarction shock
Edema:
increased fluid in interstitial extravascular spaces. Normally 1/3 body water extracellular Name the types of fluid in body cavities?? hydrothorax (pleural eff) hydropericardium ( pericardial eff) hydroperitoneum (ascites) anasarca (hydrops: severe, generalized edema with subcutaneous swelling
Name
the categories of edema??? 1. increased hydrostatic pressure forces fluid OUT of vessels 2. Decreased plasma colloid osmotic pressure movement of fluid INTO vessels 3. Lymphatic obstruction blocks removal of interstitial fluid 4. Sodium and water retention 5. Inflammation causes increased permeability with hyperemia and endothelial "leakiness"
Describe
increased hydrostatic pressure?? Occurs with reduced venous return Localized: impaired venous return; DVT Generalized
What is hyperemia and congestion? Localized increased in blood volume in a tissue. Congestion of capillary beds and edema commonly occur together Hyperemia: Active augmented blood flow due to arteriolar dilatation e.g. inflammation or exercise. Tissue is wet, red and erythematous due to engorgement by oxygenated blood congestion: Passive due to impaired outflow from a tissue. Occurs systemically in cardiac failure or locally due to isolated venous obstruction. Tissue is blue-red due to deoxygenated blood
Describe
acute congestion?? lung: engorged capillaries, septal edema, and trasudate in airspaces. liver: central vein and sinusoids distend, central hepatocytes degenerate; periportal hepatocytes are better oxygenated because of their proximity to hepatic arterioles.
Transudate: ultrafiltrate of blood extravascular fluid with low protein content, specific gravity <1.012
Define chronic passive congestion?? Long standing congestion with stasis of poorly oxygenated blood, as occurs in heart failure, leads to chronic hypoxia and cell degeneration or death w/ scarring.
Describe chronic passive congestion in the lung? Hemosiderin-laden macrophages (heart failure cells) are in alveoli and septae are edematous and fibrotic. Vessels are engorged. Capillary rupture causes small foci of hemorrhage. Macrophages phagocytose an degrade RBC and accumulate hemosiderin.
Describe chronic passive congestion in chronic liver congestion?
the central regions of the hepatic lobules are grossly red-brown and slightly depressed (because of a loss of cells) and are accentuated against the surrounding zones of uncongested tan, "nutmeg liver
sinusoids are dilated and filled with blood
Microscopically, there is centrilobular necrosis with hepatocyte drop-out, hemorrhage, and hemosiderinladen macrophages
In long-standing, severe hepatic congestion (most commonly associated with heart failure), hepatic fibrosis ("cardiac cirrhosis") can develop
.
Describe
hemorrhage and what are its two
factors? Extravasation of blood into the extracellular space due to vessel rupture. Hemorrhage enclosed in a tissue is a hematoma size, location hemorrhage rate and location of blood loss can determine outcome
Name
the types of hemorrhage? petechiae purpura ecchymoses blood can accumulate in body cavities
Petechiae: 1-2mm in skin, mucous membrance or serosa Associations: 1. local increased intravascular pressure 2. thrombocytopenia or defective platelet funciton 3. clotting factor deficiency
purpura: 3-4mm Similar assocations as petechiae Trauma Vasculitis Increased vascular fragility as occurs in amyloidosis
Ecchymoses:
>1-2cm subcutaneous hematoma "bruise" trauma Any of above associations As erythrocytes degrade and are phagocytosed by macrophages, lesions changes from red-blue (Hg) to blue-green (bilirubin) and then to golden-brown (hemosiderin)
Name
the places blood can accumulate in body cavities.?? hemothorax hemopercardium hemoperitoneum hemathrosis
Describe how rate and location of blood loss can determine outcome.??
Rapid removal of as much as 20% of the blood volume or slow losses of even larger amounts may have little impact in healthy adults - Greater losses, can cause hemorrhagic
(hypovolemic) shock
Small hemorrhage in brain stem can be life threatening
Chronic or recurrent external blood loss (a peptic ulcer or menstrual bleeding) causes a net loss of iron (an iron deficiency anemia)
Hemostasis:
With vascular injury, rapid formation of a localized hemostatic plug occurs.
What is the sequence of events in hemostasis? Vasocontriction Primary hemostasis Secondary hemostasis Counterregulatory mechanisms

Hemodynamic Disorders

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Hemodynamic Disorders

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Name

Describe chronic passive congestion in chronic liver congestion?

hemorrhage and what are its two

Small hemorrhage in brain stem can be life threatening

With vascular injury, rapid formation of a localized hemostatic plug occurs.

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