Pathology of Cardiovascular and Vascular System

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  1. Abnormal accumulation of fluid within the interstitial spaces  body cavities
  2. Type of edema that involves the whole body and is usually caused by decrease in albumin, heart failure, and malnutrition.
    Systemic Edema
  3. Type of edema that involves a part of the body or one extremity only. It is usually caused by obstruction in whatever structure.
    Localized Edema
  4. Causes of Edema
    • Inflammatory (increase in capillary permeability)
    • Hemodynamic (increase in HP, decrease in OP)
    • Lymphedema (blockage of lymphatic system)
    • Sodium Retention
  5. Specific causes of Systemic Edema
    • (HMRPS)
    • Heart Failure
    • Malnutrition
    • Renal Disease
    • Protein Deficiency
    • Steroid Use
  6. Specific Causes of Localized Edema
    • (VPV)
    • Venous Obstruction (femoral/iliac v. thrombosis)
    • Pregnancy
    • Varicose Veins
  7. Hyperemia and Congestion occur because of ___________________________________
    Local increase in blood in particular tissue
  8. Active process through arteriolar dilatation causing increased blood flow
  9. Passive distension of veins and capillaries because of poor drainage
  10. Congestion characterized by sudden on set and caused by shock, acute inflammation, and active infection
    Acute Passive Congestion
  11. Congestion caused by left sided heart failure or mitral stenosis
    Chronic Passive Congestion
  12. Extravasation of blood due to vessel rupture
    Internal/External Hemorrhage
  13. Hemorrhage is most often caused by _______
  14. Localized hemorrhage within a tissue or organ
  15. - Small, red macule usually found in dengue patients
    - small punctuate hemorrhage in skin, mucous membrane or serosal surfaces
  16. Diffuse hemorrhage usually found in the skin and subcutaneous tissue
  17. Hemorrhage located in joints
  18. Steps of Hemostasis
    • 1. Reflex vasoconstriction upon injury
    • 2. Primary Hemostasis (platelet and coagulation factor releases to bride the gap)
    • 3. Secondary Hemostasis (clot/fibrin formation)
    • 4. Thrombus
  19. Intravascular coagulation of blood often resulting in significant interruption in blood flow
  20. Thrombosis is pathologically predisposed by many conditions like
    • (VIPSM)
    • Venous stasis
    • Immobilization
    • Polycythemia
    • Sickle Cell Disease
    • Malignancies
  21. Virchow's Triad
    • Endothelial Damage
    • Venous Stasis
    • Hypercoagulability
  22. Passage and eventual trapping within the vasculature by any of a wide variety of mass objects
  23. Embolism of the thrombi, most common form of embolism
  24. Important cause of sudden death in patients with immobilized patients, post operative patients, and those with heart disease.
  25. Severity of symptoms of emobolism depends on
    • 1. size of embolus
    • 2. extent of pulmonary artery occlusion
  26. Obstructs the bifurcation of the pulmonary artery causes sudden death
    Saddle emboli
  27. Obstruct smaller arteries and may cause pulmonary hypertension and right ventricular failure
    Intermediate size emboli
  28. Usually arise from mural thrombus or a thrombus that adheres to the heart or a major artery
    Arterial Embolism
  29. Sites of origin of arterial embolism
    • Heart
    • Carotid Arteries
  30. Sites of arrest of arterial embolism
    • branches of carotid (MCA - middle cerebral artery)
    • renal and mesenteric arteries
  31. Left-sided emboli from venous system which gain access to the arterial circulation from a patent septal defect
    Paradoxical emboli
  32. Emboli from fractures
    Fat Embolism
  33. Embolism caused by decompression sickness and penetrating chest injury
    Air Embolism
  34. Results from escape of amniotic fluid in maternal circulation
    Amniotic Fluid Embolism
  35. Necrosis from ischemia caused by obstruction of blood supply
  36. Pale and are caused by arterial occlusion (heart, spleen, and kidney)
    White Infarcts (Anemic Infarcts)
  37. Occur when red cells ooze into the necrotic area, this occurs in areas with redundant blood supply (GIT and lungs)
    Red Infarcts (Hemorrhagic Infarcts)
  38. Acute dramatic syndrome due to inadequate circulatory provision of oxygen so that the metabolic demands of vital organs and tissues are not met
  39. Responses of the body to shock
    • Increased heart rate, stroke volume, vascular smooth muscle tone
    • Increased respiratory rate to promote the excretion of CO2
    • Increased renal excretion of hydrogen ions and retention of bicarbonate to maintain normal pH
    • Maintenance of vascular volume through the renin-angiotensin and the atrial natriuretic factor axes, steroid hormone and catecholamine synthesis and release, and secretion of antidiuretic hormone.
  40. General term for 3 types of vascular diseases characterized by rigidity (sclerosis) and thickening of blood vessels
  41. Type of arteriosclerosis involving the media of medium-sized arteries. It does not obstruct blood flow and results in ring-like calcifications or "pipestem" arteries.
    Monckenberg Arteriosclerosis (Medial Calcific Sclerosis)
  42. Characterized by hyaline thickening or proliferative changes in small arteries and arterioles, most prominent in kidneys.
  43. Caused by formation of fibrous plaques or atheroma in the intima of arteries.
  44. - It has a central core containing cholesterol, lipid laden macrophages, foam cells calcium, and necrotic debris.
    - Covered by fibrous cap with smooth muscles, foam cells, fibrin, collagen, and elastins.
  45. Develop from a fatty streak, or the focal accumulation of lipid laded foam cells.
  46. Plaques cause morbidity due to:
    • Hemorrhage and ulceration into the plaque - aneurysm
    • Thrombus formation causing obstruction - IHD, MI, claudication
    • Embolization of the thrombus of plaque - stroke, ischemic bowel
  47. Risk factors of Atherosclerosis
    • Age
    • Gender
    • Hypercholesterolemia
    • Hypertension
    • DM
    • Cigarette smoking
    • *Obesity
    • *Physical Inactivity
    • *Type 'A' Personality
    • *Hyperuricemia
    • *OCP (oral contraceptive pills)
    • *Chlamydia

    * - less established risk factors
  48. Localized abnormal dilatations of either artery of veins which can erode adjacent structures or rupture.
  49. Aneurysm in the descending aorta.
    Atherosclerotic Aneurysm
  50. Aneurysm at the aortic root
    Aneurysm secondary cystic medial necrosis
  51. - small saccular Aneurysm usually seen in the brain.
    - common cause of non-traumatic sub arachnoid hemorrhage
    Berry Aneurysm
  52. Aneurysm in thoracic aorta
    Syphilitic Aneurysm
  53. Longitudinal, intraluminal tear associated with hypertension or cystic medial necrosis which may cause aortic rupture.
    Dissecting Aneurysm
  54. Abnormal connection between an artery and vein
    Arteriovenous fistula
  55. - Obstruction of the veins
    - Most commonly occur in deep veins of lower extremities
    - Often associated with inflammation (thrombophlebitis)
    Venous thrombosis (phlebothrombosis)
  56. Risk factors of Venous Thrombosis:
    • Venous circulatory stasis
    • Partial venous return obstruction in pregnancy
    • Bed rest
    • Heart failure
    • Varicose veins
  57. A venous disorder that lead to complications of pulmonary infarction and paradoxical embolism
    Venous thrombosis
  58. Abnormally dilated and torturous veins, usually superficial
    Varicose Veins
  59. Risk factors of varicose veins
    • Increased venous pressure (obesity, pregnancy, thrombophlebitis)
    • Prolonged standing
  60. Inflammatory and often necrotizing immune complex inflammation
    Vasculitis syndrome
  61. Examples of Vasculitis Syndromes (7)
    • Polyarteritis nodosa
    • Churg-Strauss syndrome
    • Hypersensitivity vasculitis
    • Wegener granulomatosis
    • Giant cell arteritis
    • Kawasaki disease
    • Thromboangitis obliterans (Buerger disease)
  62. Manifested by recurrent vasospams of small arteries and arterioles with pallor and cyanosis of fingers and toes. Usually due to cold
    Raynaud disease
  63. Occurs when Raynaud's Disease is secondary tp an underlying disorder (SLE or schleroderma)
    Raynaud Phenomenon
  64. Hypertension of unknown etiology
    Caused by genetic and environmental factors (Na, stress, obesity, inactivity)
    Essential Hypertension
  65. Due to
    - renal diseases (renal artery stenosis, renal parenchymal disease)
    - endocrine diseases (Conn Syndrome, pheochromocytoma, DM)
    - coarcatation of the aorta, pre eclampsia, CNS disorders, drugs and chemicals
    Secondary Hypertension
  66. - Can be a complication pf essential or secondary hypertension
    - Follows an accelerated clinical course with end organ damage
    Malignant Hypertension
  67. Symptoms of Malignant Hypertension
    • Focal retinal hemorrhage, papilledema
    • LVH and LV failure
    • Malignant nephrosclerosis - "flea bitten kidneys"
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Pathology of Cardiovascular and Vascular System
2014-09-06 01:29:23

Pathology of Cardiovascular and Vascular System
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