HEMODYNAMIC DISORDERS yein(刘晔) Dept Pathology, SMC
Hemodynamic Disorders Ye Liu （刘 晔） Dept. Pathology, SMC
High ow Containing Pressure Pulmonary Arteries Pressure Heart, artery, Vein · Genera|crcu|aton Pulmonary circulation Lowest Highest Pressure Atum Pressure Functions Deliver oxygen and entec nutrients Carry away metabolic vastes A Healthy circulatory system ◆Noma/ blood volumn ◆ Homeostasis
Containing • Heart, artery, Vein • General circulation Pulmonary circulation Functions • Deliver oxygen and nutrients • Carry away metabolic wastes A Healthy circulatory system ♠ Normal blood volumn ♠ Homeostasis
Normal homeostasis vesse/Wa∥ integrit Edema intravascular pressure Hyperemia congestion osmolar · Thrombosis& Embolism normal hemostasis Infarction Hemorrhage Shock Three Major Causes of morbidity and mortality o Myocardial infarction ◆ Pulmonary embolism Cerebral vascular accident
Normal homeostasis vessel wall integrity intravascular pressure osmolarity normal hemostasis • Edema • Hyperemia & congestion • Thrombosis & Embolism • Infarction • Hemorrhage • Shock Three Major Causes of morbidity and mortality ♦ Myocardial infarction ♦ Pulmonary embolism ♦ Cerebral vascular accident
EDEMA(水肿) ncreased fluid in the interstitial tissue spaces To thoracito deft sand evant vell general local Pathogenesis 气 ncreased interstitial Hydrostatic pressure fluid pressure Vascular hydrostatic pressure Plasma colloid osmotic Plasma colloid pressure osmotic pressure Lymphatic drainage Arterial end CAPILLARY BED Venous end
EDEMA (水肿) • Increased fluid in the interstitial tissue spaces • General & local • Pathogenesis – Vascular hydrostatic pressure – Plasma colloid osmotic pressure – Lymphatic drainage
EDEMA Increased hydrostatic pressure C cardiac edema, etc Reduced plasma osmotic pressure (nephrotic, hepatic, malnutrient edema etc.) Lymphatic obstruction (filariasis infection-elephantiasis, breast surgery, etc) Sodium and water retention(ARf etc) elephantiasis Minimal change disease Pitting edema
EDEMA • Increased hydrostatic pressure ( cardiac edema, etc.) • Reduced plasma osmotic pressure (nephrotic, hepatic, malnutrient edema, etc. ) • Lymphatic obstruction (filariasis infection — elephantiasis，breast surgery, etc ) • Sodium and water retention (ARF, etc) elephantiasis Minimal Change Disease Pitting edema
EDEMA Morphology Clearing and separation of the extracellular matrix elements Cell swelling Subcutaneous edema Pulmonary edema Edema of the brain
EDEMA LM: Clearing and separation of the extracellular matrix elements Cell swelling Subcutaneous edema Pulmonary edema Edema of the brain • Morphology
EDEMA Hydrothorax yaropericardlum hydroperitoneum(ascites) anasarca · Cinica/ correlation from annoying to fatal indicate subtle disease benefit or harmful
• Hydrothorax • hydropericardium • hydroperitoneum (ascites) • anasarca • Clinical correlation from annoying to fatal indicate subtle disease benefit or harmful EDEMA
HYPEREMIA CONGESTION A local increased volume of blood in a particular tissue Arterial hyperemia( hyperemia,充血) An augmented blood flow inducing arteriolar and capillary dilation Venous hyperemia( congestion,淤血) Accumulation of blood in Small Veins and capillaries result from drainage difficulty of veins
HYPEREMIA & CONGESTION A local increased volume of blood in a particular tissue Arterial hyperemia (hyperemia，充血) An augmented blood flow inducing arteriolar and capillary dilation Venous hyperemia (congestion，淤血) Accumulation of Blood in Small Veins and capillaries result from drainage difficulty of veins
HYPEREMIA CONGESTION hyperemia Active process Red, raised tempreture Arteriole increased volume Enhanced function HYPEREMIA erythema Increased Congestion inflow passive process, (e,g, exercise, inflammation) general of local CONGESTION Reddish blue color(cyanosis low temperature increased volume, edema (e. g, local Decreased function
HYPEREMIA & CONGESTION Hyperemia: Active process; Red, raised tempreture, increased volume ; Enhanced function; Congestion: passive process; general of local; Reddish blue color (cyanosis), low temperature, increased volume, edema; Decreased function
HYPEREMIA Types Physiological: Shy, exercise, taking Meal Pathological: Inflammatory, post-decompressed Significance Benefits Plenty supply of o2, functional enhancement, nutrition substance Hazards Headache. hemorrhage, stroke
• Types Physiological: Shy, exercise, taking Meal Pathological: Inflammatory, post-decompressed • Significance －Benefits Plenty supply of O2, functional enhancement, nutrition substance － Hazards Headache , hemorrhage, stroke HYPEREMIA