Hemorrhage, Emboli, and Shock

ADD PICTURE AFTER WATCHING LECTURE***

failure of hemostasis results in

hemorrhage or thromboses, or combo of both

what factors that influence hemostasis will result in hemorrhage is there is damage or loss of function

endothelium

blood vessel

platelets

coagulation factors

what are some causes of hemorrhage

trauma

infectious agents

collagen disorders

DIC

severe liver disease

decreases platelet function

what is hemarthrosis

articular hemorrhage in guinea pigs

what causes hemoarthosis

vitamin C deficiency

what is vitamin C required for

collagen synthesis

what are some causes of thrombocytopenia

can't produce enough platelets

increased platelet destruction

increased use of platelets

decreased platelet function can be from

inherited

Von Willebrand's disease

uremia

NSAIDS

what occurs in Von Willebrand's disease

autoantibodies against vWF leads to decreases platelet aggregation

what is thrombosis

formation of an excessive or inappropriate blood clot

what are the major determinants of thrombosis

abnormal blood flow

hypercoagulability

endothelial injury

what is the most important factor of Virchow's triad

endothelial injury! it is a potent stimulus for platelet aggregation and coagulation

what causes hypercoagulability

increase of decrease in the concentration of activated hemostatic proteins from enhanced activation or decreased degradation

what is the most common cause of hypercoagulability

inflammation

what will happen if there is reduced blood flow

activated coagulation factors can accumulate and increase contact with platelets and endothelium

what are some characteristics of arterial thrombi

tapering tale

pale red, dull

do not have a lot of red blood cells embedded, formed under high pressure high flow state

what are some characteristics of venous thrombi

molded to vessel wall, formed under low pressure with increased blood stasis

dull, mottled dark red, no tail!

what are the types of postmortem clots

current jelly clots

chicken fat clots

what are emboli

piece of free floating material within a vessel

what are some examples of emboli

bacterial

parasitic

fat

neoplastic

air

shock will cause

hypertension, which results in impaired tissue perfusion, cellular hypoxia, and shift to anerobic metabolism

what are the three types of shock

cardiogenic

hypovolemic

blood maldistribution

what is cardiogenic shock

failure of heart to adequately pump blood (decreased stroke volume and cardiac output)

what is hypovolemic shock

reduced circulating blood volume that leads to tissue hypoperfusion, peripheral vasoconstriction, and increased blood flow to vital organs

what is blood maldistribution

decreased peripheral vascular resistance resulting in pooling of blood in peripheral tissues

what is the most common cause of blood maldistribution

septic

peripheral vasodilation caused by infectious agent to induce excessive inflammatory mediators

what are some clinical and morphological features of shock

hypotension

weak pulse

tachycardia

reduced urine output

hypothermia