-
ascites
fluid in digestive area
-
causes/pathogenesis of edema (4)
- increased venous pressure (RAAS)
- increased permeability of vessel wall
- decreased oncotic pressure of plasma due to low albumin concentration
- obstruction of lymphatics
-
hydrostatic pressure
pressure brought by arterial pressure pushing against vessels
-
plasma colloid oncotic pressure
pressure from interstitial fluids pushing against veins
-
lymphatics end point
subclavian vein of thoracic duct
-
exudate
proteins in transudate and inflammation cells
-
transudate
ultrafiltrate of plasma
-
form of edema
- inflammatory
- hydrostatic
- oncotic
- lymphedema
- hypervolemic
-
hydrostatic edema caused by
- hypertension
- venous stagnation
- congestive heart failure
-
lymphedema
- obstruction of lymphatics resulting in decreased drainage of interstitial fluids
- can be caused by worms
- massive swelling of legs - elephantiasis
-
oncotic edema caused by
- reduction in colloid osmotic pressure of plasma
- nephrotic syndrome
- cirrhosis
- hypoalbuminemia
-
hypervolemic edema caused by
- caused by retention of Na in kidney
- Renin increase
- aldosterone increase
-
Edema of lower extreminities indiates
right sided heart failure.
-
cardiac edema indicates
left ventricular failure
-
pulmonary edema
- accumulation of exudate in lungs
- usually left sided heart failure
- shortness of breathe - edema
-
Active hyperemia
- dilation of arterioles
- caused by blushing, exercise, inflammation
-
passive hyperemia (congestion)
- result from heart failure
- typically chronic
- cyanosis - bluish coloration of tissue
- associated with hydrostatic edema
-
what happens to the lungs during chronic passive congestion
- edema
- presence of hemosiderin (degraded RBC) - heart failure cells - macrophages that contain hemosiderin
-
types of hemorrhage
- cardiac
- aortic
- arterial
- capillary
- venous
-
hemoptysis
respiratory tract bleeding
-
hematemesis
vomiting of blood
-
hematochezia
anorectal bleeding
-
melena
passage of black discolored blood in stool. usually represents upper gastrointestinal tract bleeding
-
metrorrhagia
uterovaginal bleeding
-
what happens when 1000 mL blood loss
shock
-
what happens when 1500 mL blood loss
death
-
chronic hemorrhage
iron deficiency
-
intracerebral hemorrhage
stroke, death
-
hematoma
blood filled swelling or tumor, causes compression of tissues
-
formation of thrombus (3)
- damage to endothelial layer
- fibrin forms meshwork, collecting RBCs with it
- fully formed thrombus consists of fibrin and RBC
- forms only in living organisms
-
Three factors of intravascular coagulation
- coagulation factors
- platelets
- endothelial cells
-
how are coagulation proteins involved with thrombus formation
coagulation proteins act on a cascade. thrombin catalyzes fibrin formation providing meshwork for clot
-
how are endothelial cells involved with thrombus formation
- damaged endothelial cells can't secrete anticoagulants thus thrombus can form.
- IL-1 and TNF initiates thrombus formation making endothelial cells lose its negative charge
-
how are platelets involved with thrombus formation
- able to neutralize heparin and other anticoagulant factors
- secretes thromboxane
-
what happens to small thrombi
usually washed away
-
how can the rate of blood flow affect thrombus formation
- disturbances in normal blood flow: platelets become exposed to vessel wall and discharge their neutralizing coagulants
- slow blood flow: promotes sedimentation of RBC
-
hypercoagulabilty
burn patients typically have hypercoagulative blood because of fluid loss and hemoconcentration
-
what are the common sites of thrombus formation
- coronary arteries
- varicose veins
- myocardial infarcts
- carotid and cerebral arteries
-
fate of thrombi
- occlusion of lumen: leading to infarct or ischemia
- narrow lumen of vessel:hypoxia
- organization of thrombus
- recanalization: reestablishing blood flow through a broken thrombus
- embolization: broken pieces of thrombu are carried out
-
characteristics and symptoms of venous emboli
- eventually end affecting the lungs
- saddle embolus
- lung infarct
- shortness of breath
- sudden death
-
symptoms of arterial embolism
- brain infarct
- ventricular thrombus
- splenic infarct
- kidney infarct
- intestinal infarct
- infarct of extremities
-
infarct
insufficient blood supply leading to ischemic necrosis
-
what are the causes of shock
- hypovolemia- hemorrhage, fluid loss
- heart failure
- vasodilation - anaphylaxis
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