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Vascular Disturbances, Thrombus: Formation of solid or semi solid mass…

- - - - Site of endothelial injury or turbulence
      - Grow in retrograde direction from site of attachment
      - Lines of Zahn - alternating pale layers of platelets & fibrin & dark layers of RBCs
    - - Sites of stasis
      - Extend in direction of blood flow
      - Resemble coagulated blood
      - Most common in veins and legs
    - - Thrombi may form on heart valves
      - Sterile vegetations - non-bacterial thrombotic endocarditis
  - - - Loss of distal pulses, cold, pale, painful
      - Tissue death & gangrene
    - - Area swollen, reddened and tender
  - - - Can cause thrombosis by itself
      - Particularly heart & arterial system
      - Caused by haemodynamic stresses e.g. hypertension, turbulent blood flow or bacterial toxins
      - Exposure of subendothelial collagen --> adherence of platelets, release of tissue factor
    - - Turbulence & stasis
      - Disrupt normal laminar flow, platelets in contact with endothelium
      - Dilution of activated clotting factors prevented by fresh flowing blood
      - Inflow of clotting factor inhibitors retarded
    - - Primary hypercoagulability e.g. factor V mutations
      - Secondary hypercoagulability e.g. oral contraceptives & prenancy, advancing age, disseminated cancer, smoking & obesity
- - - - Digestion
      - Organisation
  - - - Cough
      - Chest pain
      - Dyspnoea
- - - - Hypovolaemia (e.g. from blood loss or dehydration), poor cardiac output/low mean arterial pressure
    - - Obstruction to blood flow by intralumenal vascular obstruction, vascular constriction/intramural thickening or extramural vascular compression