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Author(s): Gerald Abrams, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution-Non-commercial-Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/ We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact [email protected] with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
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Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

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Page 1: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Author(s): Gerald Abrams, M.D., 2009

License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution-Non-commercial-Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/

We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material.

Copyright holders of content included in this material should contact [email protected] with any questions, corrections, or clarification regarding the use of content.

For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use.

Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition.

Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.

Page 2: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicy

Use + Share + Adapt

Make Your Own Assessment

Creative Commons – Attribution License

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Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ

Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair.

To use this content you should do your own independent analysis to determine whether or not your use will be Fair.

{ Content the copyright holder, author, or law permits you to use, share and adapt. }

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Page 3: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Circulatory Derangements I

M1 – Cardiovascular/Respiratory Sequence

Gerald Abrams, MD

Fall 2008

Page 4: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Circulatory Derangements

•  I -Congestion, Edema •  II -Hemorrhage •  III-Thrombosis •  IV-Embolism, Ischemia, Infarction •  V –Atherosclerosis, Ischemic Ht. Disease

Page 5: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

CONGESTION Too much blood in an area

Within the cardiovascular system (unlike hemorrhage)

Vessels engorged with blood

Page 6: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

ACTIVE CONGESTION (hyperemia) Increased flow into the area -erythema-

PASSIVE CONGESTION Decreased outflow from area -cyanosis-

Page 7: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Source Undetermined

Page 8: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Normal Lung

Department of Pathology, University of Michigan

Page 9: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Congested Lung

Department of Pathology, University of Michigan

Page 10: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Normal Lung

G.D. Abrams, University of Michigan Medical School

Page 11: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Congested Lung

G.D. Abrams, University of Michigan Medical School

Page 12: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Congested Lung Hemorrhage by Diapedesis

G.D. Abrams, University of Michigan Medical School

Page 13: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Congestion erythrophagocytosis

G.D. Abrams, University of Michigan Medical School

Page 14: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Early CPC

G.D. Abrams, University of Michigan Medical School

Page 15: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Advanced CPC

G.D. Abrams, University of Michigan Medical School

Page 16: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Normal liver

G.D. Abrams, University of Michigan Medical School

Page 17: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver – Outflow Obstruction

G.D. Abrams, University of Michigan Medical School

Page 18: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver – Outflow Obstruction

G.D. Abrams, University of Michigan Medical School

Page 19: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver – Outflow Obstruction

G.D. Abrams, University of Michigan Medical School

Page 20: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver Central Hemorrhagic Necrosis

G.D. Abrams, University of Michigan Medical School

Page 21: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver Central Hemorrhagic Necrosis

G.D. Abrams, University of Michigan Medical School

Page 22: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver Cardiac Failure

Department of Pathology, University of Michigan

Page 23: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Nutmeg Liver

Department of Pathology, University of Michigan

Page 24: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Esophageal Varices

Samir (Wikimedia Commons)

Page 25: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Portal Circulation

Original image here: http://1.bp.blogspot.com/_DJHKI52rMWA/SfaTtEF0jqI/AAAAAAAAADw/6X0s8peMvOo/s320/shared_7303_HM-06.jpg

Gray’s Anatomy

Page 26: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Liver - Cirrhosis

Department of Pathology, University of Michigan

Page 27: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Esophageal Varices

Department of Pathology, University of Michigan

Page 28: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Esophageal Varices

Department of Pathology, University of Michigan

Page 29: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

EDEMA

Accumulation of excess fluid in the interstitial spaces / body cavities

Page 30: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Effusion

Fluid accumulation in a body cavity Pleural Effusion Pericardial Effusion Peritoneal Effusion = Ascites Anasarca – Generalized edema, a water-logged body

Page 31: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Source Undetermined

Page 32: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Fluid Collections

•  Inflammatory collection = Exudate

• Non-inflammatory collection = Transudate

Page 33: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Edematous Connective Tissue

G.D. Abrams, University of Michigan Medical School

Page 34: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Peripheral Edema

miss pupik, (flickr)

Page 35: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pitting Edema (1)

Department of Pathology, University of Michigan

Page 36: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pitting Edema (2)

Department of Pathology, University of Michigan

Page 37: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pitting Edema (3)

Department of Pathology, University of Michigan

Page 38: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Chronic Lymphedema

Source Undetermined

Page 39: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pulmonary Edema

G.D. Abrams, University of Michigan Medical School

Page 40: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pulmonary Edema

Department of Pathology, University of Michigan

Page 41: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Pulmonary Edema

Department of Pathology, University of Michigan

Page 42: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Laryngeal Edema

Department of Pathology, University of Michigan

Page 43: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Cerebral Edema

Department of Pathology, University of Michigan

Page 44: Author(s) - Open.Michigan · Hemorrhage by Diapedesis G.D. Abrams, University of Michigan Medical School . Congestion erythrophagocytosis G.D. Abrams, University of Michigan Medical

Slide 7: Source Undetermined Slide 8: Department of Pathology, University of Michigan Slide 9: Department of Pathology, University of Michigan Slide 10: G.D. Abrams, University of Michigan Medical School Slide 11: G.D. Abrams, University of Michigan Medical School Slide 12: G.D. Abrams, University of Michigan Medical School Slide 13: G.D. Abrams, University of Michigan Medical School Slide 14: G.D. Abrams, University of Michigan Medical School Slide 15: G.D. Abrams, University of Michigan Medical School Slide 16: G.D. Abrams, University of Michigan Medical School Slide 17: G.D. Abrams, University of Michigan Medical School Slide 18: G.D. Abrams, University of Michigan Medical School Slide 19: G.D. Abrams, University of Michigan Medical School Slide 20: G.D. Abrams, University of Michigan Medical School Slide 21: G.D. Abrams, University of Michigan Medical School Slide 22: Department of Pathology, University of Michigan Slide 23: Department of Pathology, University of Michigan Slide 24: Samir, Wikimedia Commons, http://en.wikipedia.org/wiki/File:Esophageal_varices_-_wale.jpg Slide 25: Gray’s Anatomy Slide 26: Department of Pathology, University of Michigan Slide 27: Department of Pathology, University of Michigan Slide 28: Department of Pathology, University of Michigan Slide 31: Source Undetermined Slide 33: G.D. Abrams, University of Michigan Medical School Slide 34: miss pupik, flickr, http://www.flickr.com/photos/miss_pupik/2418359498; CC:BY 2.0, http://creativecommons.org/licenses/by/2.0/deed.en Slide 35: Department of Pathology, University of Michigan Slide 36: Department of Pathology, University of Michigan Slide 37: Department of Pathology, University of Michigan Slide 38: G.D. Abrams, University of Michigan Medical School Slide 39: G.D. Abrams, University of Michigan Medical School Slide 40: Department of Pathology, University of Michigan Slide 41: Department of Pathology, University of Michigan Slide 42: Department of Pathology, University of Michigan Slide 43: Department of Pathology, University of Michigan

Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy