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Explore the fundamentals of haemodynamic disorders, including edema, hyperemia, congestion, and hemorrhage. Learn about the pathophysiological classifications, factors affecting fluid balance, and different types of hemorrhage. Gain insights into maintaining normal fluid homeostasis and the impact of abnormalities in the haemodynamic system. Enhance your knowledge for a better understanding of cellular and organ health.
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HAEMODYNAMICDISORDERS Dr. Afsar Saeed Shaikh M.B.B.S, M.Phil. Assistant Professor of Chemical Pathology Pathology Department, KEMU, Lahore.
INTRODUCTION Health of Cells & Organs: • Uninterrupted Circulation (O2 & Nutrients, Wastes) • Normal Fluid & Electrolyte Balance
INTRODUCTION (contin……) Normal Fluid Homeostasis • Vessel Wall Integrity • Intravascular Pressure • Intravascular Osmolarity (CONTIN…….)
INTRODUCTION(contin……) Normal Fluid Homeostasis • Maintenance of blood as fluid • Formation of clot in case of injury
INTRODUCTION(contin……) Abnormalities of Haemodynamic System • Primary (e.g. Pathology in discrete blood vessels like Hemorrhage, Thrombosis or Infarction) • Secondary (e.g. Pulmonary Edema, Shock etc.)
EDEMA Definition: “Increased Fluid in the Interstitial Tissue Spaces” Also Includes: Hydrothorax, Hydropericardium Hydroperitonium or Ascites and Anasarca.
Pathophysiological Classification • Inflammatory Edema • Non-Inflammatory Edema • Increased Hydrostatic Pressure • Reduced Plasma Osmotic Pressure • Lymphatic Obstruction • Sodium Retention
Pathophysiological Classification(Continued….) • Increased Hydrostatic Pressure: • Impaired Venous Return: (e.g. CCF, Constrictive Pericarditis, Liver Cirrhosis, Venous Obstruction) • Arteriolar dilatation: (e.g. Exposure to Heat, Neurohormonal dysregulation)
Pathophysiological Classification(Continued….) • Reduced Plasma Osmotic Pressure • Protein-Loosing Glomerulopathies (Nephrotic Syndrome) • Liver Cirrhosis (Ascites) • Malnutrition • Protein-Loosing gastroenteropathies
Pathophysiological Classification(Continued….) • Lymphatic Obstruction • Inflammatory • Neoplastic • Postsurgical • Postirradiation
Pathophysiological Classification(Continued….) • Sodium Retention • Excessive salt Intake with Renal Insufficiency • Increased Tubular Reabsorption of Na+ • Renal Hypoperfusion • Incresed Renin-Angiotension-Aldosterone Secretion
HYPERMIA AND CONGESTION Definitions: “Both indicates a local increased volume of blood in a particular tissue. ”
HYPERMIA AND CONGESTION Differences:
Hemorrhage Definition: “Extravasation of blood due to vessel rupture” Types: (depending on the site, extent and location) External Internal Hematoma: ‘Blood within the tissue’ (small; like a Bruise, or sufficiently large as to be fatal)
Hemorrhage Petechiae: • Minute 1-2 mm • Into skin, mucous membrane, or serosal surfaces • Causes: Locally increased intravascular pressure, low platelet count, defect in platelet function, and deficiency of clotting factors.
Petechial hemorrhages of colonic mucosa as a consequence of thrombocytopenia
Hemorrhage Purpura: • Slightly larger ≥ 3mm • All causes of Petechiae, plus • Secondary to trauma, vascular inflammation, and increased vascular fragility
Hemorrhage Ecchymoses: (Subcutaneous hematoma; Bruises) • Larger > 1-2 cm • Characteristically seen after trauma • Exacerbation of any of the aforementioned conditions
Hemorrhage Ecchymoses: (Colours changes in hematoma) • Hemoglobin (Red-blue) • Bilirubin (Blue-green) • Hemosiderin (Gold-brown)
