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- Universidad Católica San Antonio
Dentistry notes UCAM
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Lesson 5: Hemodynamic Disorders- Arteries, veins, capillaries, & the blood carry nutrients and O2 to tissues and
collect wastes.
- volume of circulating blood= hyperaemia and congestion, haemorrhage and
shock
- obstructive nature= thrombosis, embolism, ischaemia and infarction
➢ Hyperemia
■ Arteriolar dilation(engorgement with oxygenated blood) increases
blood flow into a particular tissue(accumulation of Oxyg blood)
○ active process
○ arteriolar dilation & increased blood inflow
○ oxygenated blood
○ produces redness > erythema
○ E.g. happens when exposed to sun & exercising skeletal muscle
➢ Congestion
■ Impaired outflow(accumulation of deoxygenated blood)
○ passive process
○ impaired outflow of venous blood
○ deoxygenated blood
○ bluish > cyanosis
○ e.g., venous obstruction & liver with chronic passive congestion(nutmeg liver)
➢ Edema
○ accumulation of interstitial fluid within tissues / cavities: - pleura (hidrotorax) -
pericardial (hydropericardium) - peritoneal (ascites) - generalized (anasarca)
■ Causes:
1. Increased hydrostatic press.: impair venous return & arteriolar
dilation =
a. deep venous thrombosis
b. congestive heart failure(heart unable to contract)
- decreased cardiac output systemic congestion
renal hypoperfusion> sec. hyperaldosteronism
sodium/water retention ⇨ EDEMA
2. Decreased Osm. presse (Hypoproteinemia): less plasma
albumin occurs due to
a. nephrotic syndrome
b. liver disease
c. undernutrition
- > edema> renal hypoperfusion> sec.
hyperaldosteronism> sodium/water retention⇨
EDEMA
, 3. Lymph Obstruction: compromises resorption of fluid from
interstitial spaces= occurs due to
a. Parasites blocking the lymphatic nodes (elephantiasis)
b. cancer ("peau d'orange") tumor has to be resected
- lymph node resection ⇨ lymphedema
➢ Types of edema
1. subcutaneous edema= diffuse, far from the heart, pitting
edema
2. Pulmonary edema(lungs)= 2 to 3 times normal weight,
blood-tinged fluid. Blockage of circulation in the
alveoli(eosinophilic substances(edema) inside the alveoli.
Blood unable to move through the lungs due to lack of
pressure(as a result of decreased cardiac output)
3. Brain edema= localized or generalized, sulci are narrowed as
the gyri swell due to fluid accumulation, rain size increases and
become flattened against the skull> increasing pressure(not
good)
Blood
➢ Defective hemostasis (HEMORRHAGE)
○ extravasation of blood(RBC) from blood vessel (outside blood vessel)
○ APPEARANCES: can occur in tissues (hematome) - cavities (hemo-thorax,
-pericardium, ...) - mucous memb., serous surfaces. (petechiae) - larger
(purpura) - subcutaneous/skin (ecchymoses, colloquially bruises)
■ The normal degradation process of hemoglobin= hemoglobin>
bilirubin(green) >hemosiderin( the substance that stimulates the
accumulation of iron(golden-brown))
○ SEVERITY depends on site, intensity and velocity
○ CAUSES: - damage to endothelium of blood vessels(trauma/radiation/etc) &
defective clot formation(an area where hemostasis stops working or decrease
in platelets (ex. An area of hypocalcemia)
■ CONSEQUENCES (> 20% volume loss):
- hemorrhagic (hypovolemic) shock
- iron deficiency anemia ex.caused by internal bleeding (only
external)
- tissue alteration & pressure increase due to acute inflamm.
- hypovolemic stage; reduction of volume of blood in blood
vessels> decreased blood pressure>vasoconstriction+renin
angiotensin aldosterone system(increase sodium/water retention)
- increased blood pressure while suffering from a hemorrhage,
you lose more blood> shock
➢ Normal hemostasis= the process of coagulation of blood
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