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MindMap Gallery Local blood circulation disorder-thrombosis

Local blood circulation disorder-thrombosis

Pathology, local blood circulation disorder - Thrombosis is a disease manifestation in which the blood content in the blood vessels of local tissues increases, causing the blood to escape from the blood vessels or the heart.

Edited at 2024-03-31 16:23:05

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Local blood circulation disorder-thrombosis

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Outline

local blood circulation disorder

local congestion

ischemia

Definition: Reduced blood input from arteries in an organ or local tissue is called ischemia or ischemia

reason

Arterial pressure

such as tumor pressure

Arterial lumen narrowing or obstruction

Such as atherosclerosis, arterial intimal hyperplasia or thrombosis, embolism

arterial spasm

Cold, mental stimulation, certain chemicals (ergot alkaloids), etc. can cause arterial spasm

Pathological changes

Small size, pale color, soft texture, low heat production, low temperature and pain

Impact and outcome

During ischemia, tissue ischemia and hypoxia lead to metabolic disorders, tissue atrophy, degeneration, and necrosis. Decreased organ and tissue function, ischemic pain, etc.

severity depends on

The extent and speed of blood vessel obstruction

The establishment of collateral circulation

Tolerance of local tissues to hypoxia

Bleeding

Definition: The escape of blood from the heart chambers or blood vessels is called hemorrhage

Classification

According to the presence or absence of disease

Physiological bleeding

pathological bleeding

According to blood escape mechanism

rupture hemorrhage

Concept: Bleeding caused by rupture of the heart or blood vessel wall

reason

trauma

Erosive lesions destroy blood vessel walls

such as ulcers and inflammation

Diseases of the cardiovascular wall itself

Such as myocardial infarction

leakage bleeding

Concept: Bleeding caused by increased permeability of blood vessel walls

reason

damage to blood vessel walls

Thrombocytopenia or dysfunction

coagulation factor deficiency

Press the bleeding site

internal bleeding

Hemorrhage: accumulation in a body cavity

Hematoma: a collection of blood in tissue

external bleeding

1. Hemoptysis - respiratory tract bleeding and vomiting through the mouth 2. Hematemesis - gastrointestinal bleeding and vomiting through the mouth 3. Hematuria - urinary tract bleeding 4. Hematochezia - blood discharged from the anus 5. Melena - upper gastrointestinal bleeding 6. Petechiae - Small bleeding spots on the skin and mucous membranes 7. Purpura - dense spot bleeding all over the body 8. Petechiae - larger bleeding spots with a diameter of more than 1-2cm

Pathological changes

Fresh bleeding is red, with a brownish-yellow color as red blood cells degrade to form hemosiderin; under the microscope, red blood cells can be seen escaping from the tissue, and hemosiderin or orange blood is present.

as a result of

thrombosis

concept

In the heart or blood vessels of a living body, the process in which formed components of blood agglomerate to form a solid mass is called thrombosis.

The solid mass formed is called a thrombus

Conditions and mechanisms of thrombosis

conditions for thrombosis

Cardiovascular endothelial cell damage

The most important and common reason

disease type

1) Atherosclerosis 2) Rheumatic or infectious endocarditis 3) Myocardial infarction 4) Endophlebitis or multiple injections in the same vein 5) Disseminated intravascular coagulation (DIC) caused by hypoxia, shock, sepsis, etc. )

changes in blood status

reason

slow blood flow

vortex

mechanism

Increase the chance of contact and adhesion between platelets and intima

When blood flow is slow, endothelial cells are damaged and the endogenous coagulation pathway is activated.

Vortex - generates centrifugal force, and platelets enter the side flow, increasing the chance of contact with the vascular intima.

Venous thrombosis is 4 times more common than arterial thrombosis

Veins do not dilate and contract with the heart beat like arteries, and their blood flow may even temporarily stagnate.

Vein walls are thin and susceptible to compression

The viscosity of blood increases as it passes through capillaries and reaches veins

The blood flow in the venous valves appears vortex-like

Increased blood coagulation type

Reasons: Increased platelets or coagulation factors, increased platelet viscosity, decreased fibrinolytic system activity, etc.

Classification

Acquired hypercoagulable state (most common)

(1) Massive blood loss (increased immature platelets, increased viscosity, and increased synthesis of coagulation factors) (2) Severe burns (blood concentration, platelets also increase accordingly) (3) Abnormal blood transfusion (platelets and red blood cells are massively destroyed, and coagulation factors are released) ( 4) Late pregnancy or the use of hormones (the body's fibrinolytic function is reduced) (5) Malignant tumors, placental abruption, etc. (intracellular tissue factor is released and the exogenous coagulation system is activated)

hereditary hypercoagulable state

Factor V gene mutation—Protein C loses anticoagulant activity and congenital deficiency of anticoagulant factors

subtopic

Any of three conditions, under certain circumstances, can lead to thrombosis

The process and types of thrombosis

White thrombus

The head of a persistent venous thrombosis

Site: Sites with faster blood flow (such as arteries, ventricles, heart valves) or the origin of venous thrombosis

Naked eye: off-white, solid, rough surface, adherent to blood vessel wall

Light microscopy: platelets, small amounts of fibrin (cellulose)

mixed thrombus

body that constitutes venous continuation of thrombosis

Location: Often occurs in places where vortices form in the blood flow, or when the blood flow speed changes. Aneurysm, ventricular aneurysm, left atrium or venous continuation of thrombus body

Naked eye: gray-white and red-brown alternately arranged, adhering to the blood vessel wall

Light microscope: Platelet trabeculae are coral-shaped and composed of platelets, fibrin, red blood cells, and white blood cells (mostly neutrophils)

red blood clot

form the tail of a persistent venous thrombus

Occurs after blood flow extremely slows down or even stops

Site: lower extremity veins (90%), upper extremity veins, tail of venous continuation thrombosis

naked eye

Fresh: dark red, moist, elastic

Old: dark red, dry and brittle, inelastic, easy to fall off

Under the microscope: a large number of red blood cells, white blood cells, platelets, and cellulose

Easy to fall off and cause embolism

hyaline thrombus

Also known as microthrombus or fibrin thrombus

Location: capillaries and venules of microcirculation

Light microscopy: cellulose (fibrin)

Seen in disseminated intravascular coagulation (DIC)

outcome of thrombosis

Dissolve and fall off

mechanization and recanalization

Thrombus organization: When the thrombus cannot fall off or be softened and absorbed, the intima of the blood vessel where it attaches will grow granulation tissue and gradually replace the thrombus. This process is called thrombus organization.

Recanalization: During the process of thrombus organization, due to the absorption of water, the thrombus dries, shrinks or partially dissolves, causing cracks. New endothelial cells cover the surface to form new blood vessels, and anastomose and communicate with each other, so that the blocked blood vessels are partially recanalized. The process of reestablishing blood flow is called recanalization

Calcification

Old blood clots, forming venous or arterial stones in blood vessels

The impact of blood clots on the body

favorable

seal the wound to stop bleeding

Prevent local infection from spreading

unfavorable

block blood vessels

embolism

Heart valve deformation

Extensive bleeding or shock

Microthrombosis consumes a large amount of coagulation factors, causing widespread bleeding throughout the body

embolism

infarction