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41 Cards in this Set
- Front
- Back
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what are the stages of normal hemostasis?
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vasoconstriction
primary hemostasis secondary hemostasis thrombus and antithrombus |
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what are 3 components that make up the virchow triad in thrombosis?
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endothelial injury
abnormal blood flow hypercoagubility |
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in abnormal blood flow, what are 2 alterations?
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turbulence (factor in arterial thrombosis)
stasis (more important in venous thrombosis) |
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what kind of flow is normal blood in thrombosis mechanisms of abnormal blood flow?
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laminar
(plasma layer between endothelium and platelets-prevents contact/activation of endothelium, dilutes clotting factors, contains antithrombotic factors) |
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in the virchow triad, what is hypercoagubility?
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cancer increases coaguability
increase in procoagulant molecules decrease in anticoagulant molecules alterations in the fibrinolytic system release of cytokines interactions w/ other blood cells (endothelial cells) and monocytes/macrophages (platelets) |
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where are thrombi of the arterial or cardiac wall located?
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at site of plaques
at vessel bifurcations -grow retrograde to direction of flow |
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where are venous thrombi located?
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at site of stasis
-grow in direction of blood flow (may have a long detached "tail) |
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what are post-mortem thrombi?
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not attached to endothelium. they are:
gelatinous rubbery dark red at the ends yellowish elsewhere ("chicken fat") |
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what are ante-mortem arterial thrombi?
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attached to endothelium
traversed by pale grey fibrin strands more firm but fragile |
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what are the alternating layers of lines of zahn?
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pale platelets and fibrin
darker laminations containing red blood cells |
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what do lines of zahn imply?
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thrombosis at sigte of blood flow
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how is the fibrinolytic system regulated?
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restricting factor activation to sites of exposed phospholipids
3 types of natural coagulants (antithrombins, proteins C & S, and tissue factor pathway inhibitor) |
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what is the etiology of an embolism?
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99% arise from thrombi
15 are amniotic fluid, air, or fat |
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what are the 2 mechanisms of an embolism?
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pulmonary emboli (from deep leg veins)
systemic emboli (from heart, aorta, carotids) |
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what are the clinical indications of an emboli?
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systemic (may lodge in extremities, brain, or viscera)
amniotic fluid air (bubbles act as physical masses) fat (from fracture of long bones |
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what are complications of an emboli?
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stroke/gangrene
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what are 6 disturbances in fluid homeostasis?
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hyperemia
congestion plethora florid infarction ischemia |
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what is hyperemia?
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active;
due to increased arterial flow causes erythema may lead to edema physiologic pathologic |
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what is congestion?
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due to diminished venous outflow
causes cyanosis as deoxygenation process |
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what are 2 types of congestion?
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local (obstructed venous return from an extremity/portal vein, etiology is thrombus, tumor, tourniquet, variscosities)
systemic (CHF) |
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what is plethora?
what is florid? |
an excessive increase in blood volume which may be local or generalized (i.e. cushing dz, alcoholism, polycythemia vera)
adjective synonymous with plethoric referring to skin, especially face |
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what is ischemia?
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deficiency of blood supply to a part of the body due to obstruction of a blood vessel (leads to hypoxia, brain and heart especially susceptible)
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what is the etiology of ischemia?
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atherosclerosis
thrombus embolus edema arteritis vasospasm external compression (tourniquet, tumor, scar, abscess) |
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what are clinical implications of ischemia?
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acute (angina, claudication, TIA, ischemic colitis)
chronic (atrophy) |
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what is an infarction?
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localized area of necrosis resulting from circulatory insufficiency within an organ or tissue
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what is the etiology of infarction?
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arterial or venous occlusion
nearly all are due to thrombi or emboli may also be: hemorrhage w/in a plaque torsion of blood vessels (ovary, testes, bowel) |
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what is the typical morphology of infarcts?
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coagulation necrosis
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what factors determine if an infarct will occur with occlusion?
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collateral circulation
rate of development of occlusion tissue susceptibility to hypoxia |
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what are two types of edema?
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inflammatory and non inflammatory
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what is inflammatory edema?
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due to increased vascular permeability
leads to escape of protein-rich fluid (exudate) |
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what is edema?
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accumulation of abnormal amounts of fluid in the intercellular tissue space or body cavities
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what is non-inflammatory edema?
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due to alterations in hemodynamic forces across the capillary wall
fluid is low in protein (transudate) crossing an intact capillary wall |
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what is the etiology of non-inflammatory edema?
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increased hydrostatic pressure (impaired venous outflow)
local-venous thrombosis systemic-CHF, cirrhosis decreased plasma osmotic pressure (loss of albumin and decreased synthesis of albumin) |
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what can cause edema?
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lymphatic obstruction
sodium and water retention most offen seen in subcutaneous, lungs, brain |
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what is pitting edema?
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when you push your finger and take it away, see indentation
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what is anasarca
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extreme generalized edema
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what is dependent edema?
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gravity driven, ambulatory, bed ridden
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what is dehydration?
etiology? |
decrease in total body fluid
fluid losses decreased intake of fluid |
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what are clinical signs of dehydration?
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dry skin and mucous membranes
loss of skin turgor oliguria decreased BP and pulse brain dysfunction |
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what are the three shock stages?
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non-progressive
progressive irreversible |
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what are the 3 types of shock?
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cardiogenic
hypovolemic septic shock |
