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Disordersofvascularflow

Hyperemia(充血）

Hemorrhage

（出血）

Thrombosis

（血栓形成）

Embolism

（栓塞）

infarction

（梗死）Localincreasedvolumeofbloodinanaffectedtissueororgan.Arterial~(active~)hyperemia

(充血)Venous~(passive~)congestion

(淤血)Hyperemia(充血)ArterialhyperemiaActiveprocessresultingfromaugmentedbloodflowduetoarteriolardilation.Types:

1.

Physiological:muscleexercise2.Inflammatory:3.decompressing:Morphology:redderhottermildturgidcongestionPassiveprocessresultingfromblock(obstruction)ofvenousdrainage(outflow).Causes:

1.

Compressionofveins2.Obstructionofvenouslumen:thrombi3.HeartfailureMorphologyMicro:

engorgementofcapillariesandvenules,minutehemorrhage.Cutsurface:excessivelybloody

Bodysurface:cyanosis(nail,lip)lowertemperatureGross:

swollenheavierblue-red

hyperemiasequels1.Congestiveadema2.Congestivehemorrhage3.Parenchymadegenerationornecrosis4.CongestivesclerosisCongestionofimportantorganslungliverPulmonarycongestion

1.leftheartfailure

2.acute~:congestionofalveolarcap.minutehemorrhage,edema,heartfailurecells

3.Chronic~:fibrosisandhemosiderindeposition,pulmonaryhypertension.edemaHeartfailurecellSymptoms:

dyspenea(呼吸困難）

hypoxia（缺氧）

Cyanosis（紫紺）

Bloodyortingedrustysputum（鐵銹痰）Congestionofliverrightheartfailure

Morphology:1.central(red-bluecolorgrossly):Dilatationofcentralveinsandbloodsinusoids,Minutehemorrhage,atrophyandnecrosisoflocallivercells2.peripheral(yellow-brown)Slightcongestion,fattydegenerationoflivercells,Nutmegliver3.HeartcirrhosisNetmegliverHemorrhage(出血)Extravasationofbloodduetoruptureofbloodvessel.hematomapetechiaechymosis血腫淤點(diǎn)淤斑

RupturingHemorrhage(破裂性出血）

TransudatoryHemorrhage

(漏出性出血）出血灶破裂性出血小腿皮下出血

thrombsis(血栓形成)Theprocessofformationofasolidmassfromconstituentsofthebloodwithinvesselsortheheartinalivingbody.thrombus血栓PredisposingfactorsofthrombosisthrombosisEndothelialinjuryAbnormalbloodflowhypercoagulabilityVascularandcardiacendothelialinjuryphlebitisRheumaticendocarditisBacterialendocarditisAtheroscleroticplaqueCardiacinfarction

exposureofsubendothelialcollagensandPLaggregationInitiates

thrombosis1

SlowingandturbulenceofbloodflowLeftatriaofmiral

stenosisofrheumaticendocarditisAneurysm(動脈瘤)PatientsprolongedbedrestBringPLintocontactwithendotheliumCausesmildinjutyofendotheliumandcollagenexposurePreventsdilutionandclearanceofbloodclottingfactorsinloction2

HypercoagulabilityofbloodpostpartumpastoperationPost-traumaAtherosclerosisDICIncreaseinamountofandviscosityofplateletsandbloodclottingfactors3Processofthrombosis

Typesofthrombi

Pale

thrombusMixedthrombusRedthrombus

microthrombuspalethrombus1.formdunderhighspeedofbloodflowinarteriesorheart.2.composedofPL.trabecula,lessfibrinnetworkandwhite,redcellstrapped.3.gross:dry,friable,graypolyp-likemass.4.tightlyattachedtotheendotheliuminjured.Palethrombusmixedthrombus1.formdunderslower-movingbloodinA,Vorheart.2.Head

tailPL.trabecula+fibrinnetwork+WBC+RBC.

body3.Gross:graylayers+redlayersMixedthrombusredthrombus1.Closelyresemblestobloodclot:RBC+fibrinnetwork.2.Tailpartofmixedthrombus.3.Thrombiinsystemicveins,portalveins,heartandaorta.microthrombus1.seenundermicroscopy2.Occureinmicrocirculation3.mainlycomposedoffibrin透明血栓ThefateofthrombiSoftening,dissolvingOrganization：replacedbygranulationtissueCalcification:phlebolith

(靜脈石)

機(jī)化organization

再通recanalizationRecanalization(再通）Theeffectsofthrombi

tothebody

1.occlusionofvessels

2.thrombi-embolism3.distortedcardiacvalves

4.DIC

embolism(栓塞)Theprocessofadetachedintravascularsolid,liquid,gaseousmassthatiscarriedbythebloodtoasitedistantfromitspointoforigin.embolus栓子99%:thrombus1%:air,amnioticfluid,fat,tumorTypesofembolismThromboembolism

(血栓栓塞)Gasembolism

(氣體栓塞)Amnioticfluidembolism(羊水栓塞)Fatembolism

(脂肪栓塞)Other:tumor,bacteria……1.Thromboembolism

PulmonarythromboembolismSystemicthromboembolismPulmonarythromboembolismThromboembolioriginatefromdeeplegveins.Smallemboli:clinicallysilent.Leftfailure+lungcongestion+emboliinfarction3)largeormoreemboli:suddendeath,rightfailure.肺動脈內(nèi)血栓肺動脈內(nèi)血栓左心(SBE)房缺、室缺右心、Ｖ下肢、腦、腎脾梗死Systemicthromboembolism2.gasembolism

Airembolismdecompressionsickness3.Amnioticfluidembolism

Infusionofamnioticfluidintothematernalcirculationviaatearintheplacentalmembranesandruptureofuterineveins.角化上皮4.Fatembolism

Afterfracturesoflongbones.Inthesettingofsofttissuetraumaandbums.肺血管內(nèi)的脂肪（蘇丹Ⅲ染色紅色）5.Otherembolism

1)tumor2)parasitism3)becteria

infactionTissuenecrosisresultingfromextremereductionorlossofbloodsupply(vascularocclusion).ischemia缺血ThrombosisEmbolismofarteriesCompressionandobliterationArterialspasmcauses

Factorsthatinfluencedevelopmentofaninfaction1.natureofthevascularsupply2.rateofdevelopmentofocclusion3.vulnerabilitytohypoxia4.oxygencontentofbloodMorphologyTypesofnecrosis:

Coagulative~:Solidorgan,heart,kidney,spleen,lungsandintestine

Liquefective~:cerebralmalaciashapes:

1.dependonvasculardistributionoftheorgan.2.Kidneys,lung,spleen:pyramidshaped3.Heart,brain:irregular,mapshaped梗死區(qū)TypesofinfarctionIschemic(white)infarctHemorrhagi