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4921389
Virchow'sTriad
Descripción
? Pathology Mapa Mental sobre Virchow'sTriad, creado por Lindie Metz el 21/03/2016.
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pathology
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Mapa Mental por
Lindie Metz
, actualizado hace más de 1 año
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Creado por
Lindie Metz
hace más de 8 años
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Resumen del Recurso
Virchow'sTriad
ENDOTHELIAL INJURY
Exposure of subEN ECM
Platelet adhesion
Release of Tissue factor
NB cause of arterial thrombus formarion
d/t MI, atherosclerosis leading to ulcerated plaques, vasculitis
Prothrombotic
Hypertension
Bacterial endotoxins
Hypercholesterolaemia
Radiation
Cigarette smoking
Mural thrombi – in chambers of heart d/t abnormal contraction
Rheumatic heart dx > mitral valve stenosis > LA dilation > atrial fibrilation
In aorta d/t anuerism, ruptured atherosclerotic plaque, often occludes
BLOOD HYPERCOAGULABILITY
Primary – inherited
Secondary – aquired
High risk
Prolonged immobilisation/bed rest
Atrial fibrilation
Tissue damage – surgery, fracture, burns
Disseminated cancer – release coagulation factors
Low risk
Cardiomyopathy
Nephrotic syndrome
Hyper-oestrogenic states – OCP,pregnancy, HRT
Sickle cell anaemia
Smoking (+ EN damage so double risk)
↑ age > ↑ platelet aggregation > ↓ prostacyclin
BLOOD STASIS/TURBULENCE
Turbulence
Atherosclerosis – counter currents and pockets of stasis
EN damage/dysfuntion
Stasis
NB cause of venous thrombus formation
Usually occlusive, mostly DVT > oedema + distal swelling
Superficial Saphenous system > visible swelling/pain > rarely embolises
Deep thrombi above knee (popliteal/femoral/illiac) >usually asymptomatic > can embolise
d/t CCF, ↑ age, immobilisation, obesity, post-surgery, migratory thrombophlebitis
Pockets of stasis behid obstruction, cause further enlargement
Laminar flow disrupted
Platelets come into contact with EN
↓ dilution of coagulation factors, ↓ inflow of clotting inhibitors
↑ EN activation > leukocyte edhesion > thrombus formation
PT
Extrinsic pathway, 11-13 sec
Add Ca+ to form quick fibrin clot
Sensitive to Coumadin
Prothrombin Time
PTT
Partial Thromboplastin Time
Add Ca+ and surface phospholipids
Intrinsic pathway, 28-35 sec
Sensitive to Heparin
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