Hemodynamic9 Disorders Lecture Quiz

Hemodynamic Disorders

• Include hyperemia, congestion, hemorrhage, edema, thrombosis, embolism, and infarction.

Hyperemia and Congestion

• Hyperemia: Active process with increased blood flow due to arterial dilatation; example: skeletal muscle post-exercise, blushing.
• Congestion: Passive process from impaired venous outflow; acute congestion leads to blue-red coloration (cyanosis).
• Causes of congestion: portal vein obstruction in liver cirrhosis, external vessel pressure, or thrombosis.

Morphology of Congestive Venous Congestion (CVC)

• Lung: Heavy, dark brown (“Brown induration”), capillary rupture, and intra-alveolar hemorrhages lead to heart failure cells.
• Liver: Enlarged with a nutmeg appearance due to alternating red and yellow mottling from congestion and fatty changes.
• Spleen: Congested with a tense capsule, gray-tan cut surface seen on microscopy with Gamna Gandy bodies.

Edema

• Defined as abnormal fluid accumulation in interstitial spaces; types include ascites, hydrothorax, and hydropericardium.
• Pathogenesis involves increased hydrostatic pressure, decreased plasma oncotic pressure, lymphatic obstruction, sodium retention, increased capillary permeability, and tissue factors.
• Common sites: subcutaneous tissues, lungs, and brain; categorized into pitting (e.g., subcutaneous edema) and non-pitting (e.g., myxedema).

Hemostasis, Thrombosis, and Embolism

• Normal hemostasis requires integrity of blood vessels, adequate platelets, and coagulation factors/inhibitors.
• Thrombosis: Formation of a blood clot (thrombus); Virchow’s triad includes endothelial injury, abnormal blood flow, and hypercoagulability.
• Thrombi can form in various sites: heart, arteries, and veins with varied morphology and attachment patterns.

Fates of Venous Thrombi

• Can propagate, resolve, embolize, or undergo organization and recanalization.
• Thrombi obstruct vessels and may lead to thromboemboli.

Embolism

• Defined as obstruction caused by a mass in circulation; most are thromboemboli.
• Types include solid, liquid, and gas emboli; also classified by source (cardiac, arterial, venous).
• Pulmonary Thromboembolism: Most common and fatal; originates from deep veins and can cause “saddle embolus”.

Consequences of Pulmonary Thromboembolism

• Varies based on vessel size, number of emboli, and patient cardiovascular status.
• Potential outcomes include sudden death, acute right heart failure, pulmonary infarction, and hemorrhage.

Systemic Thromboembolism

• Emboli that travel within arterial circulation, originating from diseased heart conditions.
• Can cause infarction in various organs, including the brain, kidneys, and limbs.

Infarction

• Ischemic necrosis due to arterial or venous blockage; results in localized area of necrosis (infarct).
• Most infarcts are due to thrombotic or embolic occlusion; etiologies include cardiac insufficiency, arterial obstruction, and microcirculation issues.
• Types of infarcts based on color (red or white), infection status (septic or bland), and age (fresh or old).

Types of Infarcts

• Red (Hemorrhagic): Occurs in tissues with dual blood supply or venous occlusion.
• White (Anemic): Seen in solid organs with end-artery supply; wedge-shaped appearance in heart, spleen, kidney.

Test your knowledge on hemodynamic disorders with this quiz. You'll explore concepts like congestion, hyperemia, edema, thrombosis, and embolism, as well as their mechanisms and effects on the body. Perfect for students looking to solidify their understanding of these important topics.