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Fluid & haemodynamic disorders

Fluid & haemodynamic disorders. Hyperaemia & Hemorrhage. DR SHASHIDHAR. HYPERAEMIA. Increased blood volume within dilated vessels of an organ/ tissue Active (arterial) Passive (venous) Acute Chronic. Active hyperaemia. Inflammation Blushing

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Fluid & haemodynamic disorders

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  1. Fluid & haemodynamic disorders Hyperaemia & Hemorrhage DR SHASHIDHAR

  2. HYPERAEMIA • Increased blood volume within dilated vessels of an organ/ tissue Active (arterial) Passive (venous) • Acute • Chronic

  3. Active hyperaemia • Inflammation • Blushing • Menopausal flush • Muscular exercise • Fever

  4. Passive hyperaemia • Also called chronic venous congestion • Local --- portal venpous obstruction, thrombosis • Systemic Lt and Rt heart failure, pulmonary fibrosis, emphysema

  5. Chronic venous congestion (cvc) Heart failure Right sided Left side Back pressure IVC,HV obstrn Back pressure Systemic VC PVP Liver CVC CVC spleen, kidneys, leg veins CVC Lungs

  6. Morphology CVC Lung • Gross : Heavy, firm in consistency( brown induration) • Micro : Alveolar septa widened- interstitial edema dilated, congested capillaries, intra alveolar hemorrhage---- hemosiderin engulfed by macrophages--- heart failure cells in lumina

  7. Morphology CVC Liver • Gross: Enlarged, tender. C/S “Nutmeg liver” ---- red and yellow mottled appearance • Micro: Central veins and adjacent sinusoids congested, distended. Centrilobular hepatocytic necrosis---fibrosis---Cardiac cirrhosis peripheral zone--- fatty change

  8. NUTMEG LIVER CENRILOBULAR NECROSIS

  9. Morphology CVC Spleen • Gross: mild to moderately enlarged,congested,tense,cyanotic. • Micro: Red pulp congestion, sinusoidal dilation, recent and old hemorrhage---- GAMNA GANDY BODIES (siderofibrotic nodules) In advanced stage --- fibrosis & hyperplasia of red pulp---- congestive splenomegaly --- Hypersplenism

  10. Morphology CVC Kidney • Gross: Slightly enlarged, medulla congested • Micro: Degenerative tubules, fatty change,mesangial proliferation in glomeruli.

  11. HAEMORRHAGE • The escape of blood from the blood vessel • Extrenal • Internal – serous cavities Extravasation of blood into tissue with resultant swelling is haematoma

  12. Slightly larger (≥3 mm) hemorrhages are called purpura • Larger (>1 to 2 cm) subcutaneous hematomas (i.e., bruises) are called ecchymoses • Depending on the location, a large accumulation of blood in a body cavity is denoted as a hemothorax, hemopericardium, hemoperitoneum, or hemarthrosis(in joints).

  13. INTRACEREBRAL BLEED PETECHIAL HMG COLON

  14. Etiology • Vessel wall trauma,inflammation • Spontaneous rupture aneurysm • Bleeding disorders, scurvy, acute leukemias • Neoplastic vascular invasion • Atherosclerosis • Elavated pressure- end artery rupture

  15. Loss depends on • Amount (>33%) • Speed • Site • Acute blood loss--- (>33%) --- hypovoluemic shock--- death • Chronic blood loss --- iron defeiciency anaemia • (Upto 20% loss can be compensated)

  16. THANK YOU…

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