Blood Flow

and
Circulation
Distubances
Lecture # 4
 Normal Fluid Homeostasis
• The health of cells and tissues depends not only on
an intact circulation to deliver oxygen and remove
wastes but also on normal fluid balance
• Normal fluid balance or homeostasis means maintaining
blood as a liquid until such time as injury necessitates
clot formation
• Clotting at inappropriate sites (thrombosis) or migration
of clots (embolism) obstructs blood flow to tissues &
leads to cell death (infarction)
• Conversely inability to clot after injury results in
hemorrhage Extensive hemorrhage can result in shock
 Disturbances of Circulation
• Circulation is the mechanism of distribution and return
of blood to and from tissues in a manner of circular
movement. The most important disturbances in this
mechanism generally are
• Hyperemia (active-passive)
• Oedema
• Shock
• Thrombosis
• Embolism
• Infarction
 Hyperemia

• Hyperemia is an increase in blood flow in an organ or

tissue due to dilation of arteries or arterioles i.e. active
hyperemia, while congestion is passive hyperemia due
to engorgement of veins and venules by blood

• Affected tissue is red (oxygenated blood) and warm, as

arterioles and capillaries are filled with blood
 Types of Hyperemia

Physiologic Hyperemia
• High blood flow to the stomach and intestines during
digestion
• High blood flow in the muscles during exercise
• High blood flow in skin to dissipate heat
• High neurovascular hyperemia (blushing)
 Types of Hyperemia

Pathologic Hyperemia
• Result of an underlying pathologic process
(usually inflammation)
• Arteriolar dilation is a response to
inflammatory stimuli / mediators
• Red coloration is a cardinal sign of inflammation =
"hyperemia of inflammation"
• Gross appearance: The arteries are distended with blood
and prominent - The affected part is swollen, enlarged and
heavier than normal - If the organ is incised, blood flows freely
from the cut surface

• Microscopical appearance: The capillaries are dilated and

filled with blood - The capillaries also appear to be more
numerous than before because in normal state some
capillaries are empty and collapsed much of the time
 Oedema
• Oedema = the abnormal (excess) accumulation of fluid
in interstitial tissue spaces or in body cavities
• Oedema fluid is outside both the vascular fluid and
cellular fluid compartments (ie. within interstitium)

• Gross appearance; Pale watery appearance,

• Microscopic appearance; Enlarged intracellular
spaces, faint pink staining fluid
 Thrombosis

Thrombosis is the formation of blood clot (thrombus) in an

uninjured vessels or thrombotic occlusion of a vessel after
minor injury. The thrombus is formed of blood elements
essentially platelets that develops inside the cardiovascular
system during life
Types of Thrombi
1.Pale Thrombus
•In a flowing blood as in cardiac chambers or in arteries
•Formed mainly of platelets

•Firm pale reddish grey

2. Red Thrombus
• In a stagnant blood adjacent to complete
vascular occlusion
• Formed of fibrin entrapping RBCs, leucocytes&
platelets
•Soft dark red and gelatinous
3.Mixed Thrombus
•In a slowly flowing blood usually in veins &
arteries
•Formed of alternating layers of platelets and fibrin
entrapping RBCs and leucocytes.
•Alternating red & pale layers
 Embolism
• An embolism, also called thromboembolism, is a
blockage in one of the arteries of the body due to a blood
clot that has broken off from another location in the body
(embolus) and traveled through the bloodstream to lodge
in a small blood vessel
• The blockage may limit or stop blood flow
• An embolism may be serious and life threatening
Causes
•Atherosclerosis (buildup of plaque on the walls of the
coronary arteries; atherosclerosis is a type of
arteriosclerosis
•Atrial fibrillation
•Endocarditis (inflammation of the lining and valves of the
heart)
•Mitral stenosis

Treatment

•Anticoagulants
•Angioplasty
•Embolectomy
 Shock

• Shock is a life-threatening condition that occurs when the

body is not getting enough blood flow
• Lack of blood flow means the cells and organs do not get
enough oxygen and nutrients to function properly
• Many organs can be damaged as a result
• Shock requires immediate treatment and can get worse
very rapidly
• As many 1 in 5 people who suffer shock will die from it
 Types of Shock

The main types of shock include:

•Cardiogenic shock (due to heart problems)

•Hypovolemic shock (caused by too little blood volume)
•Anaphylactic shock (caused by allergic reaction)
•Septic shock (due to infections)
•Neurogenic shock (caused by damage to the nervous
system)
 Infarction

Infarction, death of tissue resulting from a failure of blood

supply, commonly due to obstruction of a blood vessel by a
blood clot or narrowing of the blood-vessel channel
The dead tissue is called an infarct

Myocardial infarction (heart attack)—death of a section of

heart muscle—results from obstruction of a coronary artery

The condition often accompanies coronary thrombosis

Infarctions may also occur in the lungs (pulmonary

infarction) and the brain
Any
Question?