Partial blood circulation disorders在线视频

Hello everyone

My name is Liu Yang I'm the teacher in this chapter of partial blood circulation disorders

Then in the this chapter

We will study few knowledge points

Firstly relative to local disturbance of blood circulation

There is systemic disturbance of blood circulation

They are closely related

The systemic disturbance of blood circulation

showed heart failure

It could cause organs or tissues

showed corresponding disturbance of blood circulation

The blood circulation disorders in coronary arteries

as a local disturbance of blood circulation

In turn it could cause heart failure

Which will affect systemic blood circulation disorders

So they are closely related

In this chapter we will focus on

some points

The first one is the change of blood

The second one is the change in blood flow

The third one is the change of blood quality

Finally we will introduce

some changes in the blood vessel wall

including the increased permeability

and the rupture of blood vessel walls

causing the ruptured bleeding

The first point is Hyperemia

Hyperemia is in the blood vessels of local tissues and organs

Increased blood content

It showed arterial hyperemia and venous hyperemia

Venous hyperemia is also called congestion

The common types of arterial hyperemia

included physiological hyperemia inflammatory hyperemia

and hyperemia after decompression

For example

the hyperemia in the stomach after we eat or exercise

and the muscle hyperemia

all of them are the physiological hyperemia

Then in terms of pathological changes of arterial congestion

It mainly comes down to three words

they are big red and hot

Large means

A slight increase in the volume of tissues and organs

Red means local oxygen and hemoglobin increase

and it showed red

Hot means that this local metabolic energy increases

which increased heat production

It will showed three outcomes

Firstly after removing the cause

it could be completely recovered

Secondly on the basis of hypertension or arteriosclerosis

it occurred arterial hyperemia

It is easy to cause a breaking bleeding

Thirdly the hyperemia after decompression

At this time the brain tissue obtained decreased blood

It is easy to cause collapse or syncope

Then the reasons of venous congestion

is the obstruction in venous reflux actually

So the blood accumulates in small arteries and veins

or in the capillaries

There are three main reasons

Three reasons are internal resistance external pressure and heart failure

As for the pathological manifestations

there are three main points

They are large purple and cold

Large means a slight increase in the volume of tissues and organs

Purple refers to the increase of reduced hemoglobin

and veins located below the body surface

so it is easy to cause heat dissipation increasing

Then they caused

purple and cold

Under the microscope

it showed dilation of small veins and capillaries

and contained lots of red blood cells

Hyperemia could also be caused by a permeability change of the blood vessel wall

accompanying with edema or hyperemia

The outcomes of venous hyperemia

has three main points

Firstly it could be recovered after the cause is removed

The second one is that it will cause congestive sclerosis after long-term congestion

The last one is when the permeability of the blood vessel wall increased

it will cause leaky haemorrhage

We have two examples

They are chronic liver congestion and chronic lung congestion

Let's look at chronic liver congestion first

The reasons caused chronic liver congestion

are similar to the reasons of chronic lung congestion

The main reason causing liver congestion is right heart failure

while the lung congestion due to the left heart failure

So let's study the pathological manifestations of the lung congestion

It showed as an increasing in lung volume

the section showed the dark red

and pink foamy liquid

There are four important features under the microscope

The first one is the thickening of the blood vessel wall

and the capillary vessel showed expansion

The second one is the change in alveolar cavity

They have large amounts of protein edema fluid red blood cells

Another one is a typical diagnostic heart failure cells

The heart failure cells arises in the left heart failure

In the process of chronic lung congestion

Macrophages phagocytosis with hemosiderin appeared in the alveolar cavity

We named it heart failure cells

Please see the image

It showed the general appearance of chronic lung congestion

It showed an increase in size

Mild congestion and red appearance

This is a normal lung tissue

The alveolar interval is relatively thin

Gas exchange in alveolar cavity

This is the microscopic histological image of chronic lung congestion

The alveolar interval in the image is wide

There are a lot of edema fluid in the alveolar cavity

In the alveolar cavity

as the arrow indicated in this image

There are a lot of hemosiderin in the heart failure cells

when we diagnosed chronic lung congestion

This image showed the same content

What about the outcome of chronic pulmonary congestion?

The patient always has a wheezing and difficulty breathing

or cough with pink foamy sputum

so the patient will get pulmonary sclerosis after long-term process of chronic pulmonary congestion

As for the chronic liver congestion

The right heart failure caused to blocked return of vena cava causes

then lead to the congestion of the liver

In terms of pathological changes

we use nutmeg liver to describe its general performance

It has the surface with red and yellow

There is a congestion around the central vein under the microscope

Hepatocytes atrophy

The hepatocyte around liver lobule showed fatty degeneration

Its clinical manifestations are mainly tenderness in the liver area

and decreasing in liver function

In B-ultrasound or other auxiliary examinations

You could see a slight increase in the liver

Its outcome is congestive cirrhosis arising from long-term chronic liver congestion

This is its typical rough image

We can see that its section is red and yellow

We call it nutmeg liver

This is the corresponding normal liver image

The hepatic cord and sinuses present the radial arrangement around the central vein

This is a normal histological structure

As for the change of blood volume

The last point is bleeding

Bleeding is caused by the escape of blood from the blood vessels or from the heart

It can be divided into physiological or pathological according to whether there is disease

it can be divided into ruptured and leaking according to the spillover mechanism

it can be divided into internal bleeding or external bleeding according to the location of bleeding

Ruptured bleeding is the most common type of bleeding

The main reason is mechanical damage

the heart or the walls of blood vessels

The most common feature is aneurysm rupture

The other reasons included tuberculosis malignant tumor ulcer

These are caused by erosion of blood vessels

Just like variceal bleeding

The varicose veins of the blood vessels appeared in the cirrhosis of the liver

For example in the varices at the lower part of esophagus

Then it showed variceal bleeding

It is more common that

Such as capillaries rupture in some soft tissue contusions

Then in this image

There is a bleeding spot on the surface of the intestinal mucosa

It's a encephalocoele hemorrhage

That's the end of this chapter

Thank you