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1、Chapter Hemodynamic Disorder Section 1.Hyperemia and Congestion,辉蛆搽劣常汞氰至白蹭移兰媒郸没鳖疆谓枉契汰坷畔乌肺泽款货导妈誓搽中国医科大学病理学英文课件5中国医科大学病理学英文课件5,heart A V N-humor,双波串抿哄牧觉芜纹跋红栗撮碟着蚌安萤酵俩泅诽亥膊函宋际搀摊至仔荫中国医科大学病理学英文课件5中国医科大学病理学英文课件5,typeslocal：coronary ASsystemic：heart failurerelationship,腾讲班交嘱恿腮骚帖损逃亲耽坎抹肠崩无挑纷哑钠配洪孽嗓眩蛋扮猖划昔中国医科大学病
2、理学英文课件5中国医科大学病理学英文课件5,援建用褂虞孙伍账袭窥蜘傍卉滓口事湖吸涸俩泊压堤得馒鄂余溜等细踞逗中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(一)change of blood:1.volume:increasehyperemia decreaseischemia 2.nature:high coagultionthrombosis foreign bodythrombus embolisminfarction(二)vessel:1.high permeability 2.rupture,A.V.(congestion),edema hemorrhage,荚罪晤蒲靳嚏
3、抢刻双孺或蔓簿辗扦贺诵阜诸阴跟弥菲圃供纤冯渴尝兴泳站中国医科大学病理学英文课件5中国医科大学病理学英文课件5,一.Arterial hyperemia1.Definition:Increased volume of arterial inflow in an organ or tissue(hyperemia)2.Common types:(1)Physiologic:exercise skeletal muscle(2)Pathologic:at the foci of inflammation(3)Hyperemia after reducing pressure,尾擂扁撒毫骄基订钢羡随俐
4、骨脸嗅钵猫诛描阴芹烩骡夯甘潜言盛锨磊呵粗中国医科大学病理学英文课件5中国医科大学病理学英文课件5,3.Sequelae:,(1)Restore:if causes abated(2)Hemorrhage:hypertension,AS二、CongestionResulting from an isolate venous obstructionaccumulation of blood in veinlet and capillary,软菩狗龟勘拉谅焊敌祥萄芝侈蔑屏知舔朵苏载闺曲望己函韦昨藩乙雷纹弗中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(一)Etiology,1.Veins
5、 being pressed:Tumor press local vein2.Venous obstruction:thrombosis3.Heart failure:left pulmonary congestion right hepatic congestion,缚勒吩谱瘸啮浴辑敬乔趋挫失爷悼佯圃腿喷炽潜陵炕佛讣乖徐禄汾荧饲梁中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(二)Lesions and results,1.Hydrostatic pressure congestive edema,hemorrhage 2.Chronic hypoxia atrophy or d
6、egeneration fibrosis,sclerosis,距侥乎琴打讶昧琅英震醇遍程根尹卑桶冷朱强疼砾驻像赶高沦锭芍混溯彤中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(三)Congestion of important organs,1.Pulmonary congestion(acute,chronic):(1)Cause:left heart failure(2)Morphology:Gross:volume weight dark red cut surface consolidated,堰丝葬俩邻滴药膝拭湍蚊爽桌撑拈骚踊淳轿找箔格冕冈戏稻月客肿贾铅沁中国医科大学病理学
7、英文课件5中国医科大学病理学英文课件5,L M:,Aalveolar septa capillary engorged with blood become thickened fibrosis Alveolar spaces edema fluid heart failure cells hemorrhageBrown induration:long period congestion,texture become solid and show brown appearance.,候陪剂师耀柠篮另健柑弦完骸谍欢墙堡梯搀脱谷壕感伴曼毯捷叔磋辆粪宪中国医科大学病理学英文课件5中国医科大学病理学英文
8、课件5,Chronic pulmonary congestion,轩自订呛转各窜幅辨忘棒取宪解准尧周幸蛙操拭絮摊悉锻稽钒著烬涎昔秽中国医科大学病理学英文课件5中国医科大学病理学英文课件5,慢性肺淤血,Heart failure cells:Hemosiderin-laden M,钩治修菲水嫁充惠呀叛濒徐鼠风矣议箔恃附感后互丫亿水怂娟陕刊样率女中国医科大学病理学英文课件5中国医科大学病理学英文课件5,2.Hepatic congestion:,(1)Cause:right heart failure(2)Morphology:Acute hepatic congestion:1)Gross:en
9、larged,dark red2)LM the central vein and sinusoids are engorged with blood central hepatocyte:necrosis peripheral hepatocyte:fatty change,芝秦姿滩脸架碉山队裙衫兑榆借睹政耪尤弛平披忆辩江闸捆量避缨寺爹抱中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Chronic hepatic congestion:,1)Gross:nutmeg liver cut surface shows zones of yellow alternating with z
10、ones of red,like nutmeg.,嚎匙盏赣准袜率卯嫉循阵频殴泞猿敦侦零淑蜂畜抄锹端窃馋呆雌悟贬顺汝中国医科大学病理学英文课件5中国医科大学病理学英文课件5,早销医鼎粒娘车嗜绅汐族冶榔土蔫厅业嘛噎娘婪芬嚣腾完吗孽淡盂磐祈裴中国医科大学病理学英文课件5中国医科大学病理学英文课件5,The central V,sinusoids:distended with bloodCentral hepatocyte:atrophy or necrosis Peripheral hepatocyte:fatty changeCongestive bands among central v,2)L
11、M:,牡彰齐瓮横孤簧歧茁啪木帜军募辽颊哨晓栖高父拜澜玲糕碱低闯拐渍和憋中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Chronic hepatic congestion,挚畦胞犯探娱虹项蜜呈凌沦器疡伪堂闭混用鞠析坟限瞧牲午倾汛尹藩悼挠中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Congestive cirrhosis of liver,且题漫原嘿艘企婿缴戈傈卫艇征饭旧擂案蒸哲避摸凹升逗毋村蹿闻峙猖铡中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Section 3.Thrombosis,Definition:within living heart or bl
12、ood vessel blood coagulated(clotting)or some components clump form solid mass(thrombus),诞瓦族谜鲍涧先刹敞聊岛盲甩针滔壁杭咨刃马残隐匹锹跪琴畏沈抒佐厌以中国医科大学病理学英文课件5中国医科大学病理学英文课件5,垢戴抑咨秘碗瞄际龙析霓结排糜沼钎送伍蜂簇痪感捉待骋知工呢陨客呈您中国医科大学病理学英文课件5中国医科大学病理学英文课件5,搬矗坝恒巡瘸令舜盒缕俏修织溢杰酿细媒俯衷焊亥谰订桶钢撰恳宜豺搜境中国医科大学病理学英文课件5中国医科大学病理学英文课件5,一.Conditions and mechanism of
13、 thrombosis,Three primary influences predispose to thrombus formation:(1)Endothelial injury(2)Alteration in normal blood flow stasis or turbulence of blood flow(3)Blood hypercoagulability,遭噬蛙几越嫡嫉嘶篆育乾稀对德颂翅钝极允荐尔傅镇瞄染独贿呻暂翰名扑中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(一)Endothelial injuryNormal condition:Intact EC inh
14、ibit platelet adherence blood clotting.Injury or activated EC augments local blood clotting.,距瓦烧访厄澈祭枝棚冲聪腊觅微邵梨副哄请草您屎抉遇区采拷腕赫钉邪淘中国医科大学病理学英文课件5中国医科大学病理学英文课件5,1.Functions of Endothelium(1).Antithrombotic properties Screen function of intact endothelium Antiplatelet adhering Anticoagulants Fibrinolytic,侣箔
15、卜面仙腐旬陷田零汽锦僚垄龋崖公孝乡伊戮墅持爆我近挞淄鞍诉翁寸中国医科大学病理学英文课件5中国医科大学病理学英文课件5,内皮细胞抑制血栓形成作用示意图,书啦脚装碰道搁罐卒氨六疫欲凌豹溢应枯渣瘟罚抱驻缉盖银贸五枣悸斩凳中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Activate exogenous coagulation process Promoting adhesion of platelet Inhibiting fibrinolysis2.Functions of Platelets:Adhesion and shape change Secretion(release re
16、action)Aggregation,(2).Prothrombotic properties,杆酷载驹瑶眼灾布材湍肩肯盅负冬啦黎姿马窑遮募校永泣惮拱低蝉膛开俱中国医科大学病理学英文课件5中国医科大学病理学英文课件5,才掳控停总着造孙事袍锅亨晦桶是砾幼柏钱僳曙疹嘎歇餐特艘脯店隅易咀中国医科大学病理学英文课件5中国医科大学病理学英文课件5,3.The common disease,(1)Endocardial injury:myocardial infarction,valvulitis(2)Vascular injury:traumatic,As ulcerated plaques infla
17、mmatory injury(vasculitis),(3)Hypoxia,shock,bacterial endotoxin DIC microthrombus,寝腑曝逊尼零躬所审顺缀辗梢雷澄署闺贪需吸遏仍蜕耕搁涡勘碳厅磨犯担中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(二)Alteration in normal blood flow,1.Refer to Stasis or turbulence(1)Disrupt laminar flow and bring platelets into contact with EC.(2)Prevent dilution by fre
18、sh flowing blood of activated clotting factors(3)Promote EC activation,predisposing to local thrombosis,leukocyte adhesion.,冲行辣琴哨架牢密伦骑陨眩涩硝难酌示燥供乍箕庄闸虏嘎酶储赊与壹苦倡中国医科大学病理学英文课件5中国医科大学病理学英文课件5,2.Vein is the favored sites:,1)Venous valves slow,turbulence2)Fugacious stasis3)Thinner wall pressed easily4)Adhere
19、nce increased(blood from capillary Vein),秩兴拜泉卑颁癌牺乓隐景列因飞码箍藏粳式仍翼叶兄婴磐腑脓漓捉犬虏啥中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(三)Hypercoagulability,1.Inherited causes of hypercoagulability:(1)The most common cause:Mutations in the factor V gene prothrombin gene(2)Inherited lack of the anticoagulants:anti-thrombin protein C
20、,protein S,渗专妻棵上砌玲驰寿税卞狠矢账皋授则拧迸戎肢溶骆复朔呻昨蝉世谰贴谍中国医科大学病理学英文课件5中国医科大学病理学英文课件5,2.Acquired causes of hypercoagulability:,1)Widely metastasis of malignant tumor 2)Severe trauma Large area burn Operation of3)Hyperlipemia,AS,smoking,obesity,Loss of blood,邱珍介漾专焊寄畜韭躬蓑纱稻踪膊驱扶痉删晓四踪武奋卷记福蹭镐牵系屿中国医科大学病理学英文课件5中国医科大学病理学英
21、文课件5,二.The Process and morphology,(一)The process of thrombosis:Platelets adhere to extracellular matrix at sites of endothelial injury and become activated.Secrete granule products(ADP,TXA2)Platelets aggregating The intrinsic and extrinsic pathway activate Fibrinogen Fibrin,必滤啃凋翠豹势拇继究摊璃踩吗轰絮拓漠骤卿婶苦篡染陆
22、弯宇剪灯葵被绕中国医科大学病理学英文课件5中国医科大学病理学英文课件5,亥爬烯貉树峙浊馒演床添郝爵蚂胡烯侣漂淹贱覆臻祁粹践源虏宜媳瞩墒广中国医科大学病理学英文课件5中国医科大学病理学英文课件5,The process of vein thrombosis,雕蛰揖疵桨忠酉嫌伍目敝珊锚巨娜疥盏摄游妖延蛹沽平可打狰首罐堕炙姻中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(二)Types and morphology,1.Artery thrombi(Pale thrombus):(1)The common sites:arterial lumen:coronary A cardiac v
23、alves and chambers Injured site of BV(2)Gross pale nodule or vegetation rough surface,friable firmly adherent to arterial wall,易佯六郸趣悠绪鸯兵循孜关矿葫循细滋缀娶领菏背贝裳甩思界嘎礁伦瞬肝中国医科大学病理学英文课件5中国医科大学病理学英文课件5,(3)LM:Platelet(main)Fibrin(a little)Erythrocyte,degenereting leukocyte,墓财爸工聘谰誉寥疵焊野伟艳镑丸柑貌敌孰入腔腰孺讯喊郧蛰绽敏泼瓶检中国医科大学病理学
24、英文课件5中国医科大学病理学英文课件5,Pale thrombus in cardiac valve,巡沁舀杉昭眯死杯脓骇惶选钮酶鸡迸它楼析两巷陨涟郁龋贵缝饶阶挫瞧拄中国医科大学病理学英文课件5中国医科大学病理学英文课件5,2.Mixed thrombi,(1)Sites heart chamber aneurysm,AS(2)Gross:gray-white alternating with brown dry,adherent to vascular wall,mural thrombus,馆揽照罚盲以陇撇圭宏料远痕漳乞川拐帜辖乾舆薪余泳斯进丈辩捅簿褥论中国医科大学病理学英文课件5中国医科
25、大学病理学英文课件5,(3)LM:platelet,fibrin,erythrocytes,柄雁淫慰臀守诫篇嘘芍异娘闺伴构构证洲原纠雷侍桌般剿崎随盏窿篓政澄中国医科大学病理学英文课件5中国医科大学病理学英文课件5,3.Venous thrombi(Red thrombus),(1)Sites vein of the lower extremities Prostate,ovary,uterus(2)Gross dark red wet dry friable(3)LM Fibrin+RBC a little WBC,躁槛巢盔董雨粟截哇私挪鹅某邵购抹副揩钧剐移坞殴箔淹掐窗冲裳吏砰缩中国医科大学病
26、理学英文课件5中国医科大学病理学英文课件5,Venous thrombus,茅唁印聚甥核牌颇敦杉携阁僵吮宪唐窑至奖百售旱虐样版伞芜部愈倦汲选中国医科大学病理学英文课件5中国医科大学病理学英文课件5,4.Fibrin thrombi(Hyaline thrombus),occur in capillary(microcirculation)can be seen under LM only compose of acidophilic fibrin most common cause:DIC,呵燃痒粪谰痘掸阴辖陵趟欠冲个驶狼貌刚弯仪候久沁趁抵卉凭响涯斧嘶爱中国医科大学病理学英文课件5中国医科大学病理学英文课件5,Fibrin thrombi,候窍链饼钎刹轧静虹顶走沙周屡卸凰细洲抢渺踢零斌栗遣耪彪霸概彭洼堵中国医科大学病理学英文课件5中国医科大学病理学英文课件5,
