1. Hemodynamic Disorders
Hemodynamic Disorders
 Edema
 Edema
 Hyperemia and Congestion
 Hyperemia and Congestion
 Hemorrhage
 Hemorrhage
 Hemostasis and Thrombosis
 Hemostasis and Thrombosis
 Embolism
 Embolism
 Infarction
 Infarction
 Shock
 Shock
1
Dr. Krishna Tadepalli, MD, www.mletips.com

2. Definitions
Definitions
 Homeostasis  maintaining blood as a liquid
 Homeostasis  maintaining blood as a liquid
 Thrombosis Clotting at inappropriate sites
 Thrombosis Clotting at inappropriate sites
 Hemostasis  Clotting at appropriate site (site of
 Hemostasis  Clotting at appropriate site (site of
injury)
injury)
 Embolism migration of clots
 Embolism migration of clots
 Infarction obstruction of blood flow to tissues
 Infarction obstruction of blood flow to tissues
and leads to cell death
and leads to cell death
 Hemorrhage inability to clot after vascular
 Hemorrhage inability to clot after vascular
injury
injury
 Shock extensive hemorrhage can result in
 Shock extensive hemorrhage can result in
hypotension and death
hypotension and death
2
Dr. Krishna Tadepalli, MD, www.mletips.com

3. Hyperemia and Congestion
local increased volume of blood in a particular tissue
(common in both)
Hyperemia
Congestion
Active process
passive process
skeletal muscle during
exercise or at sites of
inflammation
Generalized in cardiac
failure
arteriolar dilation
Local- isolated venous out
flow obstruction
tissue is red
blue-red color (cyanosis)
due to increased tissue inflow
resulting from impaired
venous outflow
3
Dr. Krishna Tadepalli, MD, www.mletips.com

4. •• Hyperemia
Hyperemia
–– Usually physiologic rather than in pathologic (inflammatory)
Usually physiologic rather than in pathologic (inflammatory)
conditions
conditions
•• Congestion
Congestion
••
••
Causes
Causes
Consequences
Consequences
•• Tissue Hypoxia Degeneration  Scarring/Fibrosis ((Cardiac
Tissue Hypoxia Degeneration  Scarring/Fibrosis Cardiac
Cirrhosis in Liver)
Cirrhosis in Liver)
•• Capillary rupture  Focal small hemorrhages Hemosiderin
Capillary rupture  Focal small hemorrhages Hemosiderin
laden macrophages (Heart Failure Cells in Lung)
laden macrophages (Heart Failure Cells in Lung)
•• Organ systems involved = Lung, Liver
Organ systems involved = Lung, Liver
•• Lungs  Acute ((Engorged Pulmonary capillaries, alveolar
Lungs  Acute Engorged Pulmonary capillaries, alveolar
hemorrhages,) Chronic (thickened fibrous septa, Heart failure cells)
hemorrhages,) Chronic (thickened fibrous septa, Heart failure cells)
•• Liver  Acute (distended central hepatic veins, centrilobular
Liver  Acute (distended central hepatic veins, centrilobular
hepatocyte degeneration), Chronic ((Nut Meg liver, fibrosis – Cardiac
hepatocyte degeneration), Chronic Nut Meg liver, fibrosis – Cardiac
cirrhosis, centrilobular necrosis)
cirrhosis, centrilobular necrosis)
4
Dr. Krishna Tadepalli, MD, www.mletips.com

5. Hyperemia and Congestion
Hyperemia and Congestion
5
Dr. Krishna Tadepalli, MD, www.mletips.com

6. Liver - congestion
Nutmeg
centrilobular necrosis
EQ
Central vein
6
Dr. Krishna Tadepalli, MD, www.mletips.com

7. Liver - congestion
Nutmeg
centrilobular necrosis
EQ
Central vein
6
Dr. Krishna Tadepalli, MD, www.mletips.com