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THROMBOSIS (VENOUS THROMBOSIS (THROMBUS FORMATION, OCCLUSION, VENOUS…
THROMBOSIS
VENOUS THROMBOSIS
THROMBUS FORMATION
OCCLUSION
VENOUS STASIS( STOP)= DUE TO IMMOBILE CALF MUSCLES
BLOCKAGE OF VENOUS RETURN
COMMON IN DEEP VEINS OF CALF
[+] PRESSURE
OEDEMA OF LEG
ARTERIAL THROMBOSIS
PLAQUES MAY RUPTURE=ENDOTHELIAL DAMAGE
FIBRIN DEPOSITION & PLATELETS CLUMP=THROMBUS=OCCLUDES VESSEL
PLAQUES FORM IN INTIMA= TURBULENCE
TISSUE UNDERGOES INFARCTION
OCCURS IN DISEASED ARTERIES E.G ATHEROSCLEROSIS
CARDIAC THROMBOSIS
STASIS DUE LOSS OF CONTRACTILITY OF WALL
ABNORMAL ENDOCARDIUM
INFARCT INVOLVING WALL & ENDOCARDIAL SURFACES
DEPOSITION OF THROMBUS
PRE-DISPOSING FACTORS ARE ABNORMALITIES IN:
BLOOD FLOW
ARTERIAL
ANEURYSMS
ATHEROSCLEROSIS PLAQUES
SPASMS
CARDIAC
CONDUCTION DEFECTS
CONTRACTION DEFECTS
VENOUS
POOR GEN. CIRCULATION(CARDIAC FAILURE)
LACK OF MUSCLE PUMP ( BEDREST)
DIRECT PRESSURE ( OCCLUSIVE BANDAGES/SPLINTS)
VESSEL WALL
ARTERIAL
MECH. DAMAGE ( SURGERY)
BACT. DAMAGE
ATHEROSCLEROSIS
CHEMICAL DAMAGE
CARDIAC
BACT. DAMAGE
MECH. DAMAGE
INFARCTION
VENOUS
MECHANICAL DAMAGE( FRACTURE LONG BONE)
BACTERIAL DAMAGE
DUE TO: INFLAMMATION
CHEMICAL DAMAGE( IV FLUIDS )
BLOOD CONSTITUENTS
[+] VISCOSITY
[+] PLASMA PROTEINS
POLYCYTHEMIA ( [+] HB )
DEHYDRATION=EXCESSIVE FLUID LOSS
CLOT
SOLID MASS FORMED FROM NON-CIRCULATING BLOOD(AFTER DEATH)
MACROSCOPIC
BASAL RED LAYER( CELLS SINK)
YELLOW SURFACE
FORMATION OF SEMI-SOLID MASS FROM CIRCULATING BLOOD CONSTITUENTS
THROMBUS
MICROSCOPIC
FIBRIN & TRAPPED CELLS
LINES OF ZAHN
PLATELETS
MACROSCOPIC
PALE & DRY
LINES OF ZAHN(@ EARLY STAGE)
ADHERENT TO WALL
FORMATION:
2.1. CORRALINE THROMBUS
: SUPERADDED FIBRIN FROM COAGULATION
2.2. FURTHER PLATELET DEPOSITION(removal)
1. PRIMARY PLATELET THROMBUS:
ADHERENCE OF PLATELETS ON VESSEL WALL
2.3. LAYERED APPEARANCE( ZAHN)
3. OCCLUSIVE THROMBUS
: MAY OCCLUDE VESSEL
4. PROPAGATION OF THROMBUS
: MAY GROW IN DIRECTION OF BLOOD FLOW NEXT TO BRANCH OF VESSEL
FATE
ORGANISED
PARTIAL BLOOD FLOW IS ESTABLISHED / THROMBUS CONVERTED TO FIBROUS PLAQUE
EMBOLISED
BREAKS OFF & FORMS EMBOLUS
RESOLUTION
LYSED
FIBRIN CAN CONTRACT WHICH WILL[-] VOLUME OF THROMBUS =RE-ESTABLISHING BLOOD FLOW IN A VESSEL
PROPAGATE/GROW
EFFECTS
ARTERIAL
COMPLETE OCCLUSION= ISCHAEMIA=INFARCTION
DISTANTLY, MAY DETACH & FORM EMBOLUS
VENOUS
OEDEMA
STAGNATION OF BLOOD FLOW
CONGESTION