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Presentation on theme: "HAEMODYNAMIC DISORDERS"— Presentation transcript:


What is haemodynamics? Dr. Afsar Saeed Shaikh M.B.B.S, M.Phil. Assistant Professor of Chemical Pathology Pathology Department, KEMU, Lahore.

3 INTRODUCTION Health of Cells & Organs:
Uninterrupted Circulation (O2 & Nutrients, Wastes) Normal Fluid & Electrolyte Balance

4 INTRODUCTION (contin……)
Normal Fluid Homeostasis Vessel Wall Integrity Intravascular Pressure Intravascular Osmolarity (CONTIN…….)

5 INTRODUCTION (contin……)
Normal Fluid Homeostasis Maintenance of blood as fluid Formation of clot in case of injury

6 INTRODUCTION (contin……)
Abnormalities of Haemodynamic System Primary (e.g. Pathology in discrete blood vessels like Hemorrhage, Thrombosis or Infarction) Secondary (e.g. Pulmonary Edema, Shock etc.)

7 EDEMA Definition: “Increased Fluid in the Interstitial Tissue Spaces”
Also Includes: Hydrothorax, Hydropericardium Hydroperitonium or Ascites and Anasarca.

8 Pathophysiological Classification
Inflammatory Edema Non-Inflammatory Edema Increased Hydrostatic Pressure Reduced Plasma Osmotic Pressure Lymphatic Obstruction Sodium Retention

9 Pathophysiological Classification (Continued….)
Increased Hydrostatic Pressure: Impaired Venous Return: (e.g. CCF, Constrictive Pericarditis, Liver Cirrhosis, Venous Obstruction) Arteriolar dilatation: (e.g. Exposure to Heat, Neurohormonal dysregulation)

10 Pathophysiological Classification (Continued….)
Reduced Plasma Osmotic Pressure Protein-Loosing Glomerulopathies (Nephrotic Syndrome) Liver Cirrhosis (Ascites) Malnutrition Protein-Loosing gastroenteropathies

11 Pathophysiological Classification (Continued….)
Lymphatic Obstruction Inflammatory Neoplastic Postsurgical Postirradiation

12 Factors Affecting Fluid Balance Across Capillary Wall

13 Pathophysiological Classification (Continued….)
Sodium Retention Excessive salt Intake with Renal Insufficiency Increased Tubular Reabsorption of Na+ Renal Hypoperfusion Incresed Renin-Angiotension-Aldosterone Secretion

Definitions: “Both indicates a local increased volume of blood in a particular tissue. ”

Differences: HYPEREMIA CONGESTION 1 An active process A passive process 2 Increased blood flow (vasodilatation) Impaired blood flow 3 During exercise & in inflammation Venous obstruction & cardiac failure 4 Oxygenated blood (Redder) Deoxygenated blood (Cyanosed)

16 Normal Vasculature Regarding Blood Volume

17 Hyperemia

18 Congestion

19 Congestion (CPC of Liver; gross)

20 Congestion (CPC of Liver)

21 Hemorrhage Definition: “Extravasation of blood due to vessel rupture”
Types: (depending on the site, extent and location) External Internal Hematoma: ‘Blood within the tissue’ (small; like a Bruise, or sufficiently large as to be fatal)

22 Hemorrhage Petechiae: Minute 1-2 mm
Into skin, mucous membrane, or serosal surfaces Causes: Locally increased intravascular pressure, low platelet count, defect in platelet function, and deficiency of clotting factors.

23 Petechial hemorrhages of colonic mucosa as a consequence of thrombocytopenia

24 Hemorrhage Purpura: Slightly larger ≥ 3mm
All causes of Petechiae, plus Secondary to trauma, vascular inflammation, and increased vascular fragility

25 Hemorrhage Ecchymoses: (Subcutaneous hematoma; Bruises)
Larger > 1-2 cm Characteristically seen after trauma Exacerbation of any of the aforementioned conditions

26 Hemorrhage Ecchymoses: (Colours changes in hematoma)
Hemoglobin (Red-blue) Bilirubin (Blue-green) Hemosiderin (Gold-brown)

27 Fatal intracerebral hemorrhage

28 Thank You !


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