Term
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Definition
| confinement of blood to cardiovascular system CLSOED SYSTEM. |
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Term
| 3 imp components of blood homeostasis |
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Definition
clotting system(and platelets), intact heart and blood vessel.
- needs to be balanced by fibrinolytic system. |
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Term
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Definition
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Term
| 2 basic functions of normal homeostasis. |
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Definition
ability to rapidly form localized hemostatic plug (clot) at the site of vascular injury
ability to maintain fluidity of blood within clot-free intact vessels |
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Term
if homeostasis is of, hypercoagulability leads to thrombosis and embolism, while hypocagulability leads to hemorrhage
t/f |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
Vascular or heart wall defect
- Inability to clot after vascular injury |
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Term
consequences of hemorrage
local vs extensive |
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Definition
LOCAL BLEEDING:
- may compromise local tissue perfusion
EXTENSIVE HEMORRHAGE:
- Leads to hypovolemic shock, multisystem organ failure and death |
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Term
| how hemostasis get off via clotting causes: |
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Definition
CLOTTING AT INAPPROPRIATE SITES OR OF INAPPROPRIATE EXTEND
- LEADS TO INTRAVASCULAR CLOT
FORMATION = THROMBOSIS |
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Term
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Definition
LEADS TO EMBOLIZATION,
LOCALIZED OBSTRUCTION OF
BLOOD FLOW TO TISSUES
- EFFECT: CELL DEATH BY INFARCTION |
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Term
| 3 common causes of morbidity and mortality |
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Definition
MYOCARDIAL INFARCTION
PULMONARY EMBOLISM
CARDIOVASCULAR ACCIDENTS (CVA) |
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Term
| 4 essentials of hemostatic mechanisms |
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Definition
Intact vasculature
Adequate number of healthy platelets
Intact coagulation system
Intact fibrinolytic system |
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Term
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Definition
Triggering event which activates hemostatic mechanisms
-normally:Intact endothelium has antiplatelet, anticoagulant and fibrinolytic properties
when injured:Injured endothelium exhibits procoagulant activity |
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Term
| what are the procoagulants: |
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Definition
Tissue Factor
vWF
Platelets
Clotting factors |
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Term
| what are the anticoagulants |
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Definition
Endothelial cells (intact)
Anticoagulant proteins (AT3, Proteins C & S) |
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Term
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Definition
what happens first is:Platelets and vWF
Formation of platelet plug |
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Term
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Definition
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Term
| primary hemostatsis: activity of platelets |
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Definition
platelet: adhesion, aggregation, secretion (release of granule content w/ its porcagualtn effect --< plately plug.
von woven facts (what becomes sticky |
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Term
| Problems with Platelets 2 considerations |
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Definition
is there enough
or are they just not functioning |
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Term
| why people have adequate number,but just dysfunctional? |
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Definition
| medications most common cause. aspirin, plavis. |
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Term
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Definition
Rare: congenital diseases (Glanzmann, Bernard-Soulier)
Rare: acquired functional platelet disorders (myelodysplasia) |
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Term
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Definition
intrinsic path: uses 7
extrinsince: factor 12
common pathway: fibrin to make fibrin clot |
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Term
| important components of blood clot |
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Definition
| plate aggregation + activation of humoral coagulation system. (ie clotting facotrs) |
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Term
| most common cause of secondary hemostatic disorderse |
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Definition
Coagulation factor deficiencies (hemophilias)
- Liver disease
- Vit. K deficiency
- Warfarin therapy
- Fibrinogen deficiency |
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Term
| congenital hemophilia diseases effect which factors |
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Definition
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Term
| acquired diseases causes problems with secondary hemostatsis |
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Definition
Liver disease
- Vit. K deficiency
- Warfarin therapy
- Fibrinogen deficiency |
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Term
| PT/PTT screening indicates that? |
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Definition
Both: deficiency in common pathway
Pt only: factor 7 (intrinsicic)
Ptt only: factor 12 11 or 9 or 8 (alternate) |
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Term
| clinical evaluation for coagulation problems |
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Definition
| cbc, pt/ptt, metabolic profile including liver function tests |
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Term
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Definition
| formation of a blood clot (thrombus) inside a blood vessel obstructing flow of blood through anatomically dependent segment of circulatory system |
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Term
| abnormalities resulting in thrombogenesis (3) |
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Definition
injury to vascular endothelium
atelration in norma blood flow (stasis turbulence)
-hypercoagulable state (inherited (primary) or acquired (secondary) |
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Term
| venous thrombosis is associated with |
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Definition
OCP:oral contraceptive
Smoking
Other risk factors of hypercoagulability (nephrotic syndrome/obesity) |
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Term
| Factors allowing for hypercoagulable state |
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Definition
Factor V Leiden: inherited prothrombin mutation
Prothrombin gene mutation
Elevated homocysteine levels
Antiphospholipid antibody syndrome
CANCER |
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Term
T/F
there is not an association between cancer and thrombosis |
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Definition
| False there is an association |
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Term
trousseau syndrome
what is this syndrome associated w/? |
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Definition
Recurrent migratory thrombophlebitis
-associated w/ mucinous adenocarcinoma |
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Term
| arterial thrombosis main associations (5) |
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Definition
Atherosclerosis with intimal injury
Antiphospholipid antibodies
Homocysteine (elevated)
Malignancy – Myeloproliferative disorders
Dysfibrinogenemia |
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Term
| T/F : a fresh thrombus will be attached to the damaged endothelium |
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Definition
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Term
| HIT syndrome: heparin induced thrombocytopenia disorder |
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Definition
Make complex btwn plate fact 4 with heparin. Make antibody, then activates platelet makes clot.
High morbidity and mortality. Arterial and venous thrombosis. |
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Term
| T/F: occurs 3-6 days on heparin |
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Definition
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Term
| IgA or IgE form a complex with the heaprin and PF-4 T/F |
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Definition
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Term
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Definition
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Term
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Definition
| – detached intravascular solid or liquid mass or gas bubble – carried by the blood from its point of origin to a distant site, disturbing normal blood flow |
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Term
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Definition
pulmonary or systemic:
Pulmonary thromboembolism: into pulomonary ciruclation, vessel narrows, and blocks
Systemic thromboembolism: block in general circulation |
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Term
| systemic thromboembolism;: |
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Definition
| Dislodegment within sytem circulation. Will originate in atrium. People with atrial fibrillation and endocarditis are more prone to develop this |
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Term
| type of non-thrombogenic emboli: |
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Definition
Fat embolism (fat droplets)
Air embolism (air, nitrogen)
Amniotic fluid embolism
Atherosclerotic debris (cholesterol emboli) – atheromatous embolization
Tumor emboli
Marrow emboli
Foreign bodies (bullet)
Septic emboli |
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Term
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Definition
| straddles a vascular bifurcation |
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Term
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Definition
| contains an infectious agent |
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Term
| what are the consequences of thombosis and embolism? |
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Definition
| congestion and infarction |
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Term
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Definition
| caused by resistance or obstruction to the outflow of venous blood |
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Term
| t/f congestion involves resistane or obstruction to the outflow of arterial blood? |
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Definition
| F, venous blood not arterial. |
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Term
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Definition
| Local ischemic necrosis caused by occlusion of arterial supply or venous drainage of particular area of tissue |
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Term
| T/F almost all infarctions are caused by venous occulsion |
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Definition
| false. arterial occlusion |
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Term
| non-thromboemoblic mechanisms that can cause blood flow disruption -> infarction |
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Definition
Severe vasospasm
Expansion of atheroma
Extrinsic compression (ex. by tumor)
Twisting of the vessel
Compression of blood vessel by edema or by entrapment (incarcerated hernia)
Traumatic rupture of the blood vessel |
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Term
| infaracts are classified as |
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Definition
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Term
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Definition
| defined area of myocardial necrosis caused by local ischemia |
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Term
| most common cause of myocardial infarction |
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Definition
| cornoary thrombosis due to athersclerotic plaque. --> plug ruptures |
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Term
T/F
myocardium is not vulnerable so can within stand disruption of flow for very long |
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Definition
| F. it is very vulnerable. cant within disrupted flow |
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Term
gross determination time frame for MI
1-2 days? |
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Definition
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Term
gross determination of MI
3-4 days |
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Definition
| necrotic zone, surrouned by hyperemic zone |
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Term
| pale area in MI represents |
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Definition
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Term
| T/F ill-define pale area represents coagulative necrosis |
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Definition
F. WELL defined represente.s
ill -defined = fibrous scar of old MI |
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Term
| T/F Ill define plae are represents fibrous scar from old MI |
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Definition
| T. well define = acute myocardial |
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Term
MI gross determiantion
1 week |
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Definition
| gelatinous granulation. white fibrous scar. |
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Term
| 4 steps in MI progression. |
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Definition
1. coagulative necrosis/inflammation
2. granulation tissue
3. resoprtion of necrotic debri
4. organization and scar |
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Term
histologic presentation of mi:
0-1/2 hours |
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Definition
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Term
| 4-12 hrs. histologoic progression of MI |
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Definition
| Eosinophilic myocytes, few PMNs; edema, hemorrhage |
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Term
| t/f: within 1/2-4 hours you would see Eosinophilic myocytes, few PMNs; edema, hemorrhage |
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Definition
| F. not until 4-12 hours. see wavy fibers at 1/2-4 |
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Term
| 1-3 d histologic MI infarction |
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Definition
| complete necrosis, heavy PMNS |
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Term
cerebral infarction
hemorrhaic liuefactive necrosis |
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Definition
| Well-defined hemorrhagic area in the acute cerebral infarct represents hemorrhagic |
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Term
| cavitary area represents ____in cerebral infarct |
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Definition
| represents remote infarct and is the end result of liquefactive necrosis |
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Term
| significant of infarct depends on (3) |
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Definition
1. nature of vascular supply of organ effected (more than one blood supply to it)
2. rate of development of the occulsion (slow development may allow for alternative perfusion pathway to be created)
3. vulnerabliyt of tissue to hypoxia. (ex: neurons need a lot of blood, so damage fast) |
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Term
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Definition
| Segmental pulmonary anoxia is most commonly due to a detached venous thrombus that is carried from the leg veins to the right side of the heart and occludes pulmonary arterial branch (pulmonary thromboembolism) |
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