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MindMap Gallery local blood circulation disorder
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local blood circulation disorder
Mind map of local blood circulation disorders, where congestion is an increase in local blood content in an organ or local tissue due to increased arterial input. Also known as arterial congestion, active congestion.
Edited at 2023-10-13 21:26:23
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local blood circulation disorder
congestion and bruising
congestion
definition
An increase in local blood content in an organ or local tissue due to increased arterial input. Also known as arterial congestion, active congestion
Classification
Physiological congestion
Gastrointestinal mucosa after eating
skeletal muscles during exercise
uterus during pregnancy
Facial congestion and cerebral blood vessel congestion during emotional agitation
Pathological congestion
inflammatory hyperemia
Hyperemia after decompression
For example, a bandage is used to wrap a limb, and a large amount of ascites compresses the abdominal organs.
Pathological changes
Increased volume: increased blood perfusion in the microcirculation,
Bright red: During congestion, oxygenated hemoglobin increases in local microcirculation.
Increased body temperature: increased local metabolism
Under the microscope: capillaries and local arterioles dilate, and a large number of red blood cells accumulate
as a result of
After the cause is removed, local blood flow can return to normal.
Blood stasis
definition
The obstruction of venous return in organs or local tissues causes blood to accumulate in small veins and capillaries. Also known as venous congestion and passive congestion.
Cause
venous compression
Tumor compresses local veins
Compression of the common iliac vein by the enlarged uterus
Intestinal hernia incarceration, intussusception, mesenteric vein compression during intestinal volvulus
venous obstruction
Venous thrombosis, failure to establish effective collateral circulation
heart failure
Left heart failure leading to pulmonary congestion
Right heart failure leads to blood stasis in systemic circulation organs
Total heart failure causing blood stasis throughout the body
Pathological changes
Increased size
Purple-blue: Oxygenated hemoglobin in the blood decreases, reduced hemoglobin increases, and the skin becomes cyanotic.
Drop in body temperature: local capillaries dilate, heat dissipation increases, and body surface temperature drops
Under the microscope: small veins and capillaries are dilated and congested, tissue edema and hemorrhage, red blood cell fragments in the bleeding focus are engulfed, hemoglobin is decomposed by lysosomes, and hemosiderin is precipitated and accumulated in macrophages.
as a result of
Increased capillary permeability and stasis edema
Increased intravascular hydrostatic pressure, leakage bleeding
Lack of water and oxygen, parenchymal cell atrophy, degeneration, and necrosis
Interstitial fibrous tissue hyperplasia, organ fibrosis, and hemorrhagic sclerosis
Collateral circulation is established, the endothelium of new capillaries is weak, and ruptures and bleeds.
Blood stasis in important organs
Pulmonary stasis
reason
Mainly left heart failure, followed by venous compression and venous obstruction
naked eye
The volume increases, dark red, and foamy liquid flows out on the cut surface. In the late stage, the lung texture becomes hard and brown, which is called brown sclerosis of the lung.
under the mirror
acute pulmonary congestion
The capillaries and pulmonary veins in the alveolar walls are obviously dilated, and foamy red bloody fluid (mixed red blood cells and edema fluid) can be seen in the alveolar cavity.
chronic pulmonary congestion
The alveolar walls are thickened, and there are edema fluid, red blood cells, and heart failure cells in the alveolar spaces.
Long term pulmonary stasis
There is a large amount of hemosiderin deposition in the alveolar space and interstitium of the lungs.
clinical manifestations
Shortness of breath, hypoxia, cyanosis, and coughing up pink frothy sputum
Liver stasis
reason
Mainly right heart failure, followed by venous compression and venous obstruction
naked eye
acute liver stasis
Increased volume, dark red
chronic liver congestion
The central part of the lobule is highly stagnant and dark red, and the liver cells in the peripheral part of the lobule are fatty and yellow-----i betel nut liver
Long term liver stasis
Central lobular hepatocytes atrophy and disappear, the mesh scaffold collapses, and interstitial fibrous tissue proliferates significantly, which can form stasis cirrhosis.
under the mirror
The central veins of the liver lobules and liver sinusoids were dilated and stagnated, the liver cells in the central area were atrophic, degenerated and necrotic, and the peripheral areas were fatty.
thrombosis
definition
In the cardiovascular system of a living body, the process of blood coagulation or the aggregation of certain formed components in the blood to form a solid mass is called thrombosis, and the solid mass formed is called a thrombus.
condition
Cardiovascular endothelial cell damage (most important)
changes in blood status
Phenomenon
Blood flow slows down, creating whirlpools
parts
Vein (often occurs)
There are venous valves in the veins, and the blood flow in the valve sac is slow and vortex appears, which is conducive to the precipitation of platelets. Venous thrombosis often begins in the valve sac
Venous blood flow may be temporarily stagnant
Vein walls are thin and prone to compression
After blood flows through capillaries into veins, blood viscosity increases
arteries and atria
Local blood flow is slow and vortex appears in the left atrium with mitral valve stenosis, in aneurysms, vascular branches or ulcers formed by atherosclerosis.
Commonly found in coronary arteries, cerebral arteries, renal arteries, and lower extremity arteries
increased blood coagulability
hereditary hypercoagulable state
acquired hypercoagulable state
Increased synthesis of coagulation factors, decreased antithrombin, or increased neonatal immature platelets
The process of thrombosis and the morphology of thrombus
process
Thrombus type and morphology
White thrombus
It mostly occurs in the heart valves with fast blood flow, in the heart chambers and at the beginning of intra-arterial or venous thrombi, forming the head that continues the thrombus.
To the naked eye, small gray-white nodules have a rough surface and are closely adhered to the site of occurrence.
Under the mirror, light red without structure
Composition: Platelets and a small amount of cellulose
mixed thrombus
More common in veins with slow blood flow, forming persistent thrombosis in the body
To the naked eye, the layered structure alternates between gray-white platelets and red-brown red blood cells.
Under the microscope, platelet trabeculae appear light red and have no structural irregularity. The edges of the trabeculae are neutrophils, and the middle of the trabeculae is a fibrous network filled with red blood cells.
For example
Mural thrombus: Mixed thrombus in the heart and arteries, such as ventricular aneurysm and aneurysm. Often because the bottom of the thrombus is connected to the heart wall or blood vessel wall, it is called mural thrombus.
Globular thrombus: A mixed thrombus formed in the dilated left atrium that is spherical in shape
red blood clot
Mainly seen in veins, forming the tail of persistent thrombi
Naked eyes, dark red, moist, elastic,
hyaline thrombus
Mainly occurs in the blood vessels of microcirculation, also known as microthrombus, fibrinous thrombus
Mainly composed of eosinophilic homogeneous cellulose, most commonly associated with DIC
persistent thrombosis
In the vein, white thrombus, mixed thrombus, and red thrombus are often formed in sequence. This complete thrombus with three parts: head, body, and tail is called continuous thrombus.
outcome of thrombosis
soften, dissolve, absorb
The dissolution process depends on the size and age of the clot
Newly formed thrombus can be completely dissolved
Larger thrombi are not completely dissolved and are broken into fragments by the blood, causing thromboembolism.
Old thrombi contain more fibrin polymers, which are difficult to dissolve and absorb.
plasmin, lysin
mechanization, recanalization
Thrombus organization: the process of gradual replacement of thrombus by granulation tissue
Calcification
Calcium salts deposited within the thrombus are called thrombotic calcification (phleboliths, arterial stones)
fall off
Thrombus breaks off or softens and breaks off to form an embolus, which can cause embolism.
The impact of blood clots on the body
favorable
Hemostatic effect
harmful
block blood vessels
embolism
Valvular heart disease: During endocarditis, repeated thrombosis and organization on the heart valves can make the valves sticky, thickened, and hardened, and the chordae tendineae thickened and shortened, causing valve orifice stenosis or insufficiency, leading to valvular heart disease
Bleeding: thrombosis, which consumes a large amount of coagulation substances and subsequently causes widespread bleeding and shock throughout the body.
embolism
definition
The phenomenon of abnormal substances insoluble in blood that appear in circulating blood and block the lumen of blood vessels as the blood travels is called embolism. Material that blocks a blood vessel is called an emboli.
form
Solid, liquid, gas. Such as shed thrombus, fat droplets, air, amniotic fluid, tumor cell clusters.
embolus travel path
Venous system and right heart: embolism in the pulmonary artery and its trunk
Left heart or systemic circulatory system: embolism in the small arteries of various organs.
Portal venous system: emboli originate from the mesenteric vein and embolize branches of the hepatic portal vein.
Cross emboli: seen in atrial septum, ventricular septal defect or arteriovenous fistula
Retrograde embolism: Increased chest and abdominal pressure, inferior vena cava thrombus enters the liver, kidneys, and iliac vein branches in the opposite direction of blood flow.
Embolism type
Thromboembolism
pulmonary embolism
90% come from the deep veins above the knee in the lower limbs, such as the popliteal vein, femoral vein, and iliac vein, and a few come from the pelvic veins or right heart mural thrombus.
as a result of
The embolism caused by medium and small emboli can embolize small branches of the pulmonary artery. Under normal circumstances, there may be a compensatory effect. When there is severe blood stasis in the lung tissue, it can cause pulmonary hemorrhagic infarction.
Embolism caused by large thrombi can embolize the main trunk or large branches of the pulmonary artery, forming straddling embolism, and death due to acute respiratory failure, that is, sudden death.
The embolism formed by a large number of small emboli extensively embolizes the small branches of the pulmonary artery, resulting in sudden death due to increased pulmonary artery pressure and right heart failure.
systemic arterial embolism
80% come from the left heart, such as valvular vegetations in subacute bacterial endocarditis, left atrial mural thrombus in mitral stenosis, and mural thrombus in myocardial infarction; a few come from atherosclerotic ulcers or Thrombus on the surface of aortic aneurysm. Rarely from the vena cava.
as a result of
Involves lower limbs and brain
fat thrombus
definition
Lipid droplets appear in the circulating blood and block small blood vessels.
source
traumatic
Long bone fractures, fatty tissue contusions, fatty liver crush injuries
non-traumatic
Diabetes etc.
as a result of
Commonly found in lungs, brain
Lipid droplets with a diameter >20 microns can cause pulmonary artery branches or capillary embolism
The diameter of lipid droplets is less than 20 microns, and lipid droplet emboli pass through the capillaries of the alveolar wall, through the pulmonary veins to the left heart, and reach the branches of the systemic circulation, causing multi-organ embolism throughout the body.
gas embolism
air embolism
It is common in venous injury rupture, such as head and neck, chest wall, cardiopulmonary surgery or pulmonary trauma injury to the veins, the use of positive pressure intravenous infusion or pneumothorax, accidental injury to the veins.
Decompression sickness (caisson disease, diver's disease)
reason
The human body quickly enters a low pressure or normal pressure environment from a high pressure environment, and nitrogen dissolves slowly in body fluids.
Commonly seen in divers, aviation
amniotic fluid embolism
Refers to embolism caused by amniotic fluid containing fetal cells and other components entering the maternal blood circulation.
reason
The amniotic membrane ruptures, the fetus blocks the birth canal, the uterus undergoes strong contractions, and the amniotic fluid presses into the venous sinus of the uterine wall.
infarction
definition
Necrosis of local tissues or organs due to blood vessel obstruction and interruption of blood flow leading to ischemia and hypoxia is called infarction.
reason
blood vessel obstruction
blood vessel compression and occlusion
arterial spasm
Effective collateral circulation is not established
Local tissue tolerance to ischemia and systemic blood circulation status
Morphological features of infarction
Lesion type of infarction
anemic infarction
Hemorrhagic infarct (red infarct)
Occurrence conditions
Dual blood circulation
loose tissue
Vein obstruction, severe blood stasis
site of occurrence
enterohemorrhagic infarction
pulmonary hemorrhagic infarction
septic infarction
Caused by emboli containing bacteria blocking blood vessels.
Effects of infarction on the body
outcome of infarction