Hemo Extracted
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ShumaqMAHEMODYNÁMICS 199
HEMODYNAMICS QUICK HINTS
Thrombosis
virshow t r a d
.1 Endothelial injury
2. Blood Stasis
3. Rupercoagulability
• In women Post surgery DVT occur due to - Blood stasis +Hypercoagulability > Endothelial injury +
Hypercoagulability
pose of thrombi
interial (White)
• D e v e l o p in arteries or heart
O n Transection Dark gray lines ofAggregated platelets interpersed between paler layer ofCoagulated
Fibrin these lamellae called Lines of Zahn
Com Snake like structure away from heart
reses (Red)
R i c h in RBC so are red
0 n Transection Fibrin seen
Formsnake like structure towards Heart
Renous Thrombi vs Postmortem Clot
Ve n o u s thrombiare firm and Postmortem clot rubbery
Venous thrombi rich ni RBC and Post mortem clot dependent port rich ni RBC appear as Red
Currant Jelly and Superant Portion free of RBC appear as Chicken Fat
Venous thrombi attach to vessel and Postmortem clot not
Use o f Zahn seen in
/ Cora line Thrombus
/ Pre mortem Thrombus
Arterial Thrombus
(icke n Fat Appe aranc e seen in
7 Post Mortem Thrombus
Embolism
Occlusion of some part ofcardiovascular system by some mass impaction(Embolus)
hipes
lir Embolism
History of Passing CVP then SOB
* In Ascending divers (caisson discase/decompression sickness)
B e n d - Pain ni joint limb and abdomen due ot gas bubble
~ Chock - Sudden respiratory distress due ot gas emboli
leniotic Fluid Embolism
Pregnant lady +Long bone fracture Died on way to hospital within 24h or during labour
/ Lead to DIC
Most Fatal type of Pulmonary Embolism that causeextensive Pulmonary necrosis Shock and Death
kImbolism
" Symptoms start ot appear after 21 h
Long bone fracture
* Death after 3-5 days
P r e s e n t with Hypoxemia and Cerebral Petechiae is due to Low platelets
Edema
" Perimheral edema ni CLD
. due to -loss of albumin (Low oncotic pressure)
' Ascities in CLDdue to - Portal HTN
" Kenal origin edema due ot - Loss of albumin (low oncotic pressure) +can be salt and waterretention.
' Netroticsyndrome edema due ot -Hypoalbuminemia
' Nephriticsyndrome edema due ot - Salt and water retention.
" Pedal edema in CHF and HTNdue to - Increase hydrostatic pressure.
AA-HEMODYNAMICS 204
In CHF edema woarsen by - Sodium and water retention.
Infraction
~ Area of ischemic necrosis within tissue or organ by occlusion of either arterial or venous drainage
liacaorehagic (Red Infarct)
Due to venuous occlusion seen in
/ Liver
v Lune
~ Intestine
/ Tes tis
Pale infarct(White)
Due to Arterial occlusion seen in
Heart
Kidney
Shock
Inadequate organ perfusion and delivery of nutrients necessary for normal tissue and cellular function
Types
Hypovolemic Shock
~ Causes- Hemorrhage , Dehydration and burn
Increase TPR + Decrease Cardiac output +Decrease CVP +Increase Lactate +Cold Skin
Cardiogenic Shock
V Causes - MI, Heart failure and Arrhythmia
Increase TPR + Decrease Cardiac output +Cold Skin
Distributive Shock
1. Septic Shock - Due to Sepsis + Decrease TPR +Increase Cardiac output +Increase Lactate +Warm
Skin
2. Anaphylactic Shock - Decrease TPR +Increase Cardiac output +Warm Skin
.3 Neurogenic Shock - Loss of vascular tone +Decrease TPR and Cardiac output*
4. Cardiac Shock -Raised JVP
Random
Factor V mutation(Laden) leads to -- Thrombosis
Factor V deficiency leads -- Bleeding
V. Factor 12 deficiency leads - Thrombosis.
Most common acquired thrombotic disorder si - Anti-phospholipid syndrome
Most common Inherited coagulopathy -- VWBD
V Most common inherited Thrombotic disorder is - Factor V Mutation (Laden)