logy course 8

8/14/2019 logy Course 8

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.IRCLL'\TORY D]STURBANC]ES

I H.reFdia & congesti.n

Edema

Edema is an excessve accumulation oflluid in

r ssues and body cavlies

unirf lamhatory (rransudale):

ec@sd p c o p,och os 1sN). Lw pr& n vihes s (cHl

- nfiammalory {exudatel

Uninflammatory edema

va o!.op7 rqq.e rrer nq&drr- Mrcrosooov 6 qht@l!u ar sre In

e,t6.eru;r mak \ (MEC) componenrs

Loca isation of the edemal

- edema is mor€ iiequent Y encou

TvDes oi edema based on ihe slte oi nu d accumulaiion

{iiiiersulium aid body caviues):htaiqsular: subculanmus. ma zedordftuse

qene.a zed anasarca 4h.hisa*!ere andgeiera Idadema wih rssue and.:vrary M!on



Subcutaneous edema

: "-sa cafd ac edema

:c.urs n congestive heartiailure wiih high pH

-subc!taneous edema depending on gravlly

n areas wth increased pH)

generalized rcnal edema

- occurs in renal dysiunction wrui low p c o.

subculaneous d ff!se edema fiiiallydeveloped perlorbllary

Pulmonary edemaudeiaiu,e(miia sienosb +atd

ste. w h trcshr d2.3 umes

Gr€o a, tansldd6 donreii)

rdhy/loamt nuid (:n coded),p4e pin' in.dor{bv he F*en.e

bois6lon 3nd sePlar,:ite6rta

[email protected]|'



Cerebral edema n'""""

ar€s (bd i absces eai

cenera zed edema (6n€Pharts,

pg€pi|ary.9a6and.oose

2. HYPERAEMIA AND CONGESTION

Hyperaemia = increase ofthe bood volume in a

tissue or organ terrltory byvascular dllatation

(distended wiih blood)Types of hyperaemia:

-ac ve(hype'aenra o 3c1ve corsesliol) = i.c'easeooiblood volume in a lissue oroean by arte olardilaialion (es inflammatory rocus, etc.).

- passive (stasis or passive coigesiion) = incrssed oiblood volume in a tssue of organ by venoLs beddilatation (e.9. systemic cause n RCF orlo€lcauseir venous obslruclion)

E.

V,:;.4



PaSSiVe

the lncrcase in blood volume in a tissue or

organ territory by dilatation of capillary

network.

Causes:(a) loca jzed stasis

) venous obsiruciion(b) generallzed or systemic stasis

t left or right cardiacfailure (URCF)

congestion (stasis)



Pulmonary passive congestion(Lung stasis )

Pulmonary stasisdLre to rekograde

n the ung.

occurs in chronic LCFvenous blood stagnation

The most freqL]ent causes of LCF are

HTA, Cland SA.

Macroscopy

luno4senaled b ood), and

ar.oh c had rf brosis) and

henosydeine) = appe6nce



Microscopy

{n rohemo'lhase) and aid



l\/li.r^c.nn\,/

3. HEMORRHAGE

Beed nq sthe escape ofblood from heart and vesses

d!riio lile+vaious cond tionsBleeding rnay occLr invanous circumstancesl

.ap ary ruplures + oeu.ln caplLary congeslron

a/rer a and vedouB ruplures + occur ofien in ader ai and venouq

card e ruplure ptuduced in ohesl lraumaormmp caled reat

Types ofbLeeding o. hemorrhage l

(a) exlenal bleed ns - the escaped b md

- (bj nremar bleedinq - lh€ esaped blood

. intaevharybrd ns (*rcus€v1*)

. mrereir d bei 19lfrsslet



Types of external haemorrhages

Types of internal haemorrhages

' Lntracaviiary haemoilhages:

- haemorhoa cDn€dbn olblood nlh6 pleu€L€vllv

'o.1o.o,ooodr.Eoe''dd".a''lJ

- hemop€itoneumcolleciion of blood n th€ perilonea @'q

- h emarlhrosis @llection of blood in the joint cavlv

. Interslifal bleeding in €lation with the volume of the

Pel*hiae-poinrlke bl€eding ol€pillary ongin

- 1na-u,a'raflo'aqe- dfiuse b'"d'1S {rho r d +or'o' o

ihe aff*led ussuesi e g bruse

I o' oaq a eo DLood tridi*.nion ihe affected i ssue



nierctitial haemorrhages

s ohrv b'ood haPmorhdres = pfpuc lo,er I r -.:";,""..""."

: o i.- "o qq"

J-e!Nmruiurql.anbefala!- Eo ;rebia h*mdoma6.ureit

mEroaieurysms n NrA

Cerebral Haemorrhage



The clinical picture

. The clin calsgn ficance of haenrorrhage

depends on vo ume and raie of bleeding. Rapid bleeding, in larse amount morc than 20%

of blood volume produce dealh by lripovolem c

. Chronic haemorfiage, in smallamount,

depend ng on b eeding location, may occur:

(a) death i nleresl v ta orSans{brain sleh)i

(b)ferp ve anemla li interesl dfrereni otlier organs

(chron c Peoiic ulcer)

4. THROMBOSIS

.oD



Path

There are 3 main iactorsthal pred sposelo tne

fornal on of a thromb!s NnchofirLad):

, le€l on ii lh. r..:r lor lstas s 0r tutu encel

. (prnary d sotue's

r.enel rl and se3dndary (3cqu red) d sodeisl''d.tsoihFdcoaauabjlltLod$s

ogenesls

Microscopy. Thelhrombrs scomposeo0r

Fodre ibli (pormsz' on

. re h sto osda seciod (HE

o e6 iophi. rb h.onLadnq



to thrombosis

Thrombus -

macr0scopy

isposition



Thrombi classification

Thrombi evolution

Resoluloi hrcmbus lysis by r fi no !r d svst€m

P,ooao.ton tbombus mav nneale n eze bv add ng neo aveB

- rhe retad o; ofhe thombus io rhe

'dbjle€lwlhrcmbusisrag|aodby

Embo sm / Ihrombemhrsm: part o he lhrombus can bederadhed and 6ried alonq oflhe brod stEan b mp.d n a

ca cf.ddn ofthethrcmbus bv imprcgnalion sith €lc um *li

6i dd,N'd dery (osrrudrye srcmblt



Connective organized thrombi

Ma a(e,y rumei s odlealed aid

5, EMBOLISM

Ernbolism (E)'s

a pathological process

characierized by caring of emboli in the

blood stream, at djstance from point oforigin, and obliteration of smaller blood

vessels through an embolus-

Embolus (e) is a solid, liquid or gas

material, circulating in the blood, away

from his point of origin.



Types of enrboli

i$!eFrer€nboal

ErnboLLsm wilh amr olcil!id

Thrombembolism

-:,, , -* d- c*"ea.brp'--r.-"-

, o!res naedtus6.nqcvd4*

, -";. ,- ,."""



Fluid embolism

Fat embo lsm )lipidic embol

- .onsequE^.es lal q obu es rroms-c dp _o-ary 2ruF

Amnioiiciuld embolism t amniotici!id emboi'o-o.da1 bn d o.i a..o-ared ^rosipanufr delvratons/p.duf rion; is a malof €lse of maiem:l

o.q n rupru,eol uler ne veiisal b drr

sauamouire s.4n es63a. p'd m

Gas embolism

s a rare fom ofembolism

- Armaventer n the b@d n case ol a vein nc s oni as a €sula€ lotn nq a r pulmod.ry mbd (obsi@tidn)

NLtrooen mav enle. n lhe dcu aion as bubbre, or qas (ihis.ondil on oauE oft€n ro peBonEmtl nq al q€al depihs -

' o /d4 f q* lbroodnfq"n) xforcdud on ofors bubbLes

'nLhebloodc@dioi (!*se

6birud od=d@mp'essoi ds€ase

- oL mon"to '"a- bra'' eabosedoMai ehemicneDross (adre ischem:)



Emoo sm uonseouences

. Obstruction of the aderies withsuppfession of blood circulation in thelarrit^n,

^fr ticc,'a

^r ^rdrn.)(ischemlc necrosis)

. l\,4ay be a cause of death in cases of

-rnassve embolism of main pulmonary adery

cerebral embolism

6, ISCHEIVIIA

chrcn. s.lr€ma: pa'13land grad!a reduclon of lhe arler a fow, causes aderardamages ass@iaied wilhwitb lumenal

stenosis 1e g uncompicated arh€rcma.ATs)

(pros€ssve rep acement or the drdph ed tssre by r bos t- A.ule schem a sudden and toialsuppresson ol the eneia flDw

narobtruction 1oqcomdcaled arhercfra Ars by thbmbG 3)

. donsequ€nc*: ischemlc necrcsis 0nfdd)in the te.dlory oldistr burion ofa rssueor organ



'.doryora1$ue9iolgan t

rar:: tmphy=ceradaPrve

rc. a. no of lio tuohrc dairL

. comEleres samp es or acde

. Micb.coplc.rry a@le schemia

INFARCTION

C assif €l on or lhe inracbonslintarcls aE c a$ifed basd

the amouni 01 losr b e€din9)



Myocardial infarction

[,4yocardial infarction microscopy



[,4yocafdial nlarcton nr rroscopy

(presef/ed er imb fremeeos nophr..n0pasm rhe

Renal Infarct

,-.- :--':.

.1,:',.:

<1-

^er.ss (dtaoperai.a or lhe



Splenic Infarct

Cerebral I nfarct

tr-



Pulmonary Infarct

. I nre stinal i nf&.lion i causcd by

ob{ructi\elesions.frheupFerneTenrenodirea duel.(a) llnonbenrboli occludine a distll anery brdch;(b) obslructile thJonbosh deleloped or an ATS plaque ar $e level ofproxnml anerlseemenr, resuhing & c\tensile latal inlacti

venous iniifction by $nngularion (snh rhepresence oJ Lhe heniarbagl.orlosion (inlhe case ofsienoidian lohalut

Necrotic ul4rinal scgme.li.rea da'k in color- *jlhlhick {all dnd

baemonhaeic inihmtiorTnerc is a ncl lihil6eNleen inteni.al ne.r.ri. s.gnc.land adjacent

nomral irteslinum

- Ilar beasso.iared*ith suppurallon.Il conplicates $i1h pefomlion d.dpenlonnis (!c!le abd..r.i]

logy course 8

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