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Thrombo embolc vascular occlusion
Thrombo embolc vascular occlusion
37
Medical
Undergraduate 2
01/17/2017

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Term
Thrombus
Definition
Solid mass (blood clot) made up of blood constituents which develops in a vessel during life .
Term
Constituents of a thrombus (4)
Definition
Red blood cells , platelets . white blood cells and fibrin
Term
Haemostasis
Definition
ochestrated process by which blood clot forms at sites of vascular injury which involves platelets and clotting factors
Term
Virchow's Triad ( Predisposing factors of thrombosis)
Definition
Endothelial Injury
Hypercoagulability
Stasis or Turbulance( abnormal blood flow)
Term
Abnormalities in blood flow .(2)
Definition
Turbulance . ( caused by ulcerated atherosclerotic plaques)
Stasis (aneurysms,myocardial infarct, mitral stenosis and atrial fibrilation and sickle cell anemia (luminal occlusion)
Hyperviscosity syndromes.
Term
Stasis and Turbulance . Further endothelial injury . (3 Steps)
Definition
1. Disrupt laminar flow (platelets touch endothelium)
2.Retard inflow of clotting facts
3.Endothelial cell activation
Term
Primary Hypercoagulable states (7)
Definition
protein C &S deficiency . antithrombin 3 deficiency . factor 5 gene and prothrombin mutuations. Fibrinolysis defects . Increased levels of factor coagulative factors .
Term
Secondary Hypercoagulable states
Definition
High Risk . Cancer ,prolonged bed rest, myocardial infarcts
Low risk . Cardio myopathy ,nephrotic syndrome,pregnancy,oral contraceptives,smoking and sickle cell.
Term
Heriditry Thrombophilia
Definition
prothrombic,recurrent venous thrombosis +thromboembolism. deficiencies of anthrombic proteins . Primary hyperCoag States.
Term
Antiphospholip Antibody Syndrome
Definition
prothrombic.
auto antibodies directed against a number of protein antigens that form complexes with phospholipids.
Ass with Systemic Lupus Erythematosus
Term
Disseminated Intravascular Coagulation
Definition
Prothrombic plus antithrombic
Widespread thrombosis and heamorhage resulting from consumption of platelets plus coag factors.
Term
Endothelial Injury Causes (6)
Definition
ulcerated atheromatous plaques ,physical injury,infectious agents, inflammatory vascular injury, cholesterol , cigarette smoke
Term
Arterial Thrombosis
Definition
grey /white appearance (fibrin deposition plus platelet clumping )
Layered laminated line (lines of Zahn)
Term
components of heamostatic process (3)
Definition
Platelets, endothelial cells and coagulation cascade
Term
Components of Thrombus
Definition
Platelets .fibrin plus red blood cells .
Term
Venous thrombosis
Definition
phlebothrombosis. invaribly occlusive
stasis thrombi (red) present predominently in lower extremeties.
Term
Postmortem Clots .
Definition
Not attatched to vessel wall . gelatinous .with layers . firmer with a pt of attatchment
Term
Mural thrombosis
Definition
Cardiac chambers.adhere to the heart wall .
causes. myocardial infarcts .arrythmia .dialated cardiomyopathy. aneurysms.
Term
Vegetations
Definition
Thrombi that occur on heart valves .
Infective (blood borne ,infective endocarditis)
NonInfective (hypercoagulable states, non bacterial thrombotic endocarditis . eg Systemic Lupus Erthematosis
Term
Fate of thrombi
Definition
Dissolution
Embolism
Propagation
Organization and Recanalisation
Term
Embolus
Definition
detached intravascular solid ,liquid or gaseous mix that is carried by blood to a site distant from its pt of origin
Term
Types of emboli (6)
Definition
thrombo emboli
atheromatous plaque
vegetations on heart valves
tumour emboli
amniotic ,plus fat
Term
Clinical effects depend on ? 3 factors
Definition
1 caliber of vessel affected
2 territory supplied by that vessel
3 presence/absence of an alternative circulation
Term
Pulmonary thromboembolism
Definition
Origin. leg veins(95%) ,pelvic veins intercranial venous sinuses
Term
Saddle embolus
Definition
embolus present at the bifurcation of the pulmonary arteries
Term
Systemic Embolism
Definition
Arise in the arterial system and embolises peripherally. Caused by (myocardial infarction,atrial fibrilation ,vegetation ,anuerysm
Term
Systemic Emboli Effects
Definition
brain (transient ischaemic attacks,strokes)
other organs eg limbs( gangrene)
Ischeamia
Infarction
Term
Embolic Atheroma
Definition
embolised fragments of the atheromatous plaques ususally in lower limbs of arteriopathic patients
Term
Platelet Emboli
Definition
Early lesions of atheroma may contain platelets only . no severe clinical sign except brain .
Term
Infective Emboli
Definition
emboli break off from infected vegetations and lodge in small vessels
Term
Fat Embolism
Definition
due to long bone fracture due to severe trauma .rapture of marrow vascular sinusoids,soft tissue injury
Term
Clinical effects of fat embolism
Definition
pul insufficiency ,neurologic ,renal impairment .thrombocytopenia
Term
Gas Embolism Causes
Definition
Caisson /decompression disease
Surgical intervention
suicide
Trauma .
Term
Gas Embolism effects
Definition
more than 100mls required for clinical effect
visible bubbles in the vessels
frothy ball of fibrin and air in the right of the heart
Term
amniotic embolus
Definition
amniotic fluid escaped into maternal uterine veins may lodge in the lungs causing resp distress , dyspnoea,cyanosis and cardiovascular shock leading to seizures and coma
Term
Tumour embolism
Definition
source of tumour metastasis spread . usually small and dont cause immediate physical problems .
Term
Foreign Matter embolism
Definition
eg. Contaminated IV fluid .
granulomatous may occur secondary to the foreign material
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