Pathology of Chronic Congestion

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Questions and Answers

What is the main cause of chronic hypoxia in long-standing chronic passive congestion?

Increased blood flow

Increased oxygen supply

Lack of blood flow (correct)

Decreased red blood cell count

What is the result of catabolism of extravasated red cells in capillary rupture?

Increased blood flow

Residual clusters of hemosiderin-laden macrophages (correct)

Formation of blood clots

Reduced oxygen supply

What is the characteristic appearance of the liver in chronic venous congestion?

Swollen and inflamed

Mottled appearance similar to the nutmeg (correct)

Bright red

Uniformly pale

What is the clinical manifestation of generalized systemic congestion?

Dilated veins and edema Signup and view all the answers

What is the cause of cough with blood-stained sputum in left ventricular failure?

Pulmonary venous congestion Signup and view all the answers

What is the term for a small, localized collection of blood outside of blood vessels?

Hematoma Signup and view all the answers

What is the term for a small hemorrhage in the skin, mucous membranes, or serosal surfaces?

Petechia Signup and view all the answers

What is the term for a subcutaneous hematoma that is 1-2 cm in size?

Ecchymosis Signup and view all the answers

What is the result of increased blood volumes in hyperemia?

Increased blood flow Signup and view all the answers

What is the common outcome of congestion?

Edema Signup and view all the answers

What is the cause of cyanosis in congested tissues?

Red cell stasis and the accumulation of deoxygenated hemoglobin Signup and view all the answers

What is the type of hyperemia that occurs at sites of inflammation?

Pathological hyperemia Signup and view all the answers

What is the effect of brain edema on vital centers?

Compression Signup and view all the answers

What is the consequence of pulmonary edema?

Impaired oxygen diffusion Signup and view all the answers

What is the result of venous obstruction?

Impaired outflow Signup and view all the answers

What is the characteristic of edema?

Swollen with narrowed sulci Signup and view all the answers

What is a common cause of aneurysmal dilatation and rupture of arteries?

Inflammatory lesions Signup and view all the answers

What is the effect of blood loss if less than 20% of blood volume is lost?

The effect is slight Signup and view all the answers

What is the consequence of chronic blood loss?

Iron-deficiency anemia Signup and view all the answers

What is the result of constriction of veins and venules?

Increased venous return to the heart Signup and view all the answers

What is the characteristic of systemic hypotension in shock?

Low cardiac output Signup and view all the answers

What is a cause of hypovolemic shock?

Hemorrhage Signup and view all the answers

What is the mechanism of development of hypovolemic shock?

Inadequate blood or plasma volume with resultant low cardiac output Signup and view all the answers

What is the effect of high pressure within blood vessels?

Hemorrhage at sites of arterial weakness Signup and view all the answers

Study Notes

Chronic Passive Congestion

Caused by long-standing lack of blood flow, leading to chronic hypoxia
Capillary rupture can cause small hemorrhagic foci, leading to hemosiderin-laden macrophages

Generalized Systemic Congestion

Occurs in right ventricular failure, leading to decreased venous return and blood accumulation in the venous side
Clinically characterized by:
- Dilated veins (e.g., increased JVP)
- Edema (in limbs, ascites, hepatospleenomegaly)
Morphology:
- Liver: chronic venous congestion causing a grossly mottled appearance (Nut meg liver)
- Mic.: congestion of central venule, necrosis of surrounding hepatocytes, and normal or fatty changed peripheral liver cells

Pulmonary Venous Congestion

Occurs in left ventricular failure, leading to blood accumulation in surrounding capillaries
RBCs escape to the alveolar space and are engulfed by macrophages (heart failure cells), causing cough with blood-stained sputum

Localized Venous Congestion

Occurs in DVT of leg, leading to edema, cold, and cyanosis

Hemorrhage

Extravasation of blood into the extravascular space
Can be external or internal (encased within tissue, hematoma)
Types of hemorrhage:
- Petechiae: minute hemorrhage in skin, mucous membranes, and serosal surfaces (1-2 mm)
- Purpura: slightly larger hemorrhages (≥3 mm)
- Ecchymosis: 1-2 cm subcutaneous hematoma

Causes of Hemorrhage

Trauma: e.g., penetrating wounds to the heart and large vessels
Abnormalities of blood vessel wall: e.g., inflammatory lesions, neoplastic invasion, and vascular diseases
High pressure within blood vessel: e.g., systemic hypertension, varicose veins

Effects of Acute Hemorrhage

Depend on volume and rate of blood loss
Sudden loss of 33% of blood volume can lead to death, while gradual loss of more than 50% blood volume can be serious but not fatal

Shock

State in which the supply of blood to the tissues is inadequate to meet metabolic demands
Characterized by systemic hypotension due to reduced cardiac output or reduced effective circulating blood volume

Classification of Shock

1. Hypovolemic shock: real decrease in blood volume due to hemorrhage, fluid loss, or severe burns
1. Cardiogenic shock: relative decrease in blood volume due to myocardial infarction, rupture of the heart, pulmonary embolism, arrhythmias, or cardiac tamponade

Hyperemia and Congestion

Hyperemia: active process of arteriolar dilation, leading to increased blood flow and erythema
Congestion: passive process of impaired outflow from tissue, leading to cyanosis and edema

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Description

This quiz covers the effects of chronic congestion on the body, including hypoxia, capillary rupture, and residual hemosiderin-laden macrophages. It also touches on systemic congestion and its clinical manifestations