General Concepts and Principles of

Disease and Therapeutics

(MED 7610)
Hemodynamic Disorders
 Discuss the etiopathogenesis and clinical

Learning manifestations of disorders of fluid and

hemodynamics.

Objectives Describe the morphologic changes accompanying

fluid and hemodynamic disorders
 Kumar, V. et al. (2018). Robbins Basic Pathology, Tenth Edition. Elsevier
Barone, J. et al. (2016). USMLE Step 1 Lecture Notes 2016 Pathology. Kaplan Medical

References
Schneider A.S. et al. (2014). Pathology 5th Edition. Lippincott Williams & Wilkins
https://www.youtube.com/watch?v=FBgwbD-b-n0
https://www.sciencedirect.com/topics/medicine-and-dentistry/hemodynamic-
monitoring
What are the • Interstitial injury may result from changes in plasma
composition or from local changes in the tissue (i.e.

results of injury to •
necrosis of parenchymal cells).
Fluid accumulation in the interstitial tissue may cause

the interstitium? structural abnormality without affecting the function

of parenchymal cells.
 • Accumulation of excess fluid.
• ANASARCA --- denotes massive edema of the

What is edema? •
whole body including the body cavities.
Classification:
1. Localized
2. Generalized
What are the • Inflammatory edema
forms of • Allergic edema

localized • Edema of venous obstruction

Edema of lymphatic obstruction
edema?
•
What are the Cardiac edema

generalized Edema of hypoproteinemia

forms of edema? Nephrogenic edema

What are the Pulmonary edema
Cerebral edema
clinical effects of Serosal cavity edema

edema? Subcutaneous edema

 Increase in the amount of blood within the vessels caused by dilatation of
the microcirculation.

What is Classification:
1. Active – active dilatation of the microcirculation in acute

hyperemia?
inflammation.
2. Passive (Congestion) – passive dilatation of blood vessels following
obstruction of venous outflow.
 • Define as the presence of blood in the
interstitial tissue outside of the blood
What is vessels.

hemorrhage? • Results from escape of erythrocytes across

intact vessels or from vascular rupture
 Clinical state characterized by a generalized
decrease in perfusion of tissues associated with
decrease in effective cardiac output.
What is shock? Stages: Compensation, Impaired Tissue
Perfusion, Decompensation
 • Hypovolemic

What are types •

•
Cardiogenic
Septic

of shock? • Neurogenic
• Anaphylactic
 • Often used synonymously with severe bacteremia to denote

What is
serious infection in which large and increasing numbers of
microorganisms have overwhelmed the body’s defense system and
are actively multiplying in the bloodstream.

septicemia? •
•
Associated with toxemia
Can be fatal
 Formation of a solid mass from the constituents of blood.

What is
Evolution:
1. Fibrinolysis

thrombosis?
2. Organization and recanalization
3. Thromboembolism
 • Hypercoagulative state
What is
• Endothelial damage
Virchow’s triad?
• Alteration in blood flow
 1. Pale thrombi- thrombi in fast-flowing arterial
What are the circulation.

types of
2. Red thrombi- composed of platelets, fibrin
and large numbers of erythrocytes trapped in

thrombosis? the fibrin mesh.

What are the • Platelets
Fibrin
components of a
•
• Red blood cells

thrombus? • White blood cells

What is
• Occlusion or obstruction of a vessel by an abnormal
mass transported from a different site by the circulation.
• Most emboli are detached fragments of thrombi that are

embolism? carried in the bloodstream to their sites of lodgment.

What are the
• Thromboembolism
• Air embolism
• Nitrogen gas embolism

types of
• Fat embolism
• Bone marrow embolism
• Atheromatous

embolism?
• Amniotic fluid embolism
• Tumor emboli
What is • Widespread development of

disseminated thrombi in the microcirculation

throughout the body.
intravascular • Often fatal.

coagulation?
END