3 Circulatory Disturbances

8/4/2019 3 Circulatory Disturbances

1/33

CirculatoryCirculatorydisturbancesdisturbancesCirculatoryCirculatorydisturbancesdisturbances

Venus Eisha L. BarteVenus Eisha L. Barte


2/33

Chronic passive

congestion of the lungs Dx: RHD with MS

RIP: CHF, LSHF

Gross: Lungs are swollen, boggy, brownish-red

Microscopic: (+) Hemosiderin (Yellow granular pigment)

within the alveolar macrophages


3/33


4/33

Pulmonary Edema Hx: Same with CPC Gross:

Lungs heavier than normal R lung 750 g, L lung 600 g Both dark red and subcrepitant (+) Frothy, serosanguinous fluid Bronchi and trachea, wet and congested


5/33

Pulmonary Edema Microscopic:

Expanded alveolar spaces

Filled with pink staining homogenousmaterial

Septal capillaries and veins, filled with:Plasma w/ or w/o RBCs and other bloodelements


6/33


7/33


8/33

Renal Vein Thrombosis Specimen: Kidney Small and large veins of the hilus partially

or completely occluded by the thrombi indifferent stages of organization Thrombi, attached to WALL Highly organized thrombi: With richly

vascularized connective tissue The young ones: Fibrin


9/33


10/33


11/33

Thrombi partialocclusion to the wall


12/33

Thrombi completewall occlusion


13/33

Coronary Atherosclerosis

with thrombosis Hx: developed sudden severe precordial chest

pain, DOA Autopsy:

Heart is enlarged, 400gm, due to LVH Epicardium: Smooth and glistening Myocardium: Reddish brown, flabby without focal

changes upon sectioning Coronary arteries: Segmental atherosclerosis with

narrowing of the lumen Anterior coronary artery: (+) occluding thrombus 2cmfrom origin.


14/33

Coronary Atherosclerosis

with thrombosis Microscopic: Epicardium with a

coronary artery

C. artery: Asymmetrical thickening ofwall due to atheromatous plaque in theintima.

Atheromatous plaque: Thick hyalinizedfibrous tissue punctuated by cholesterolclefts

A recent thrombus, partially attached

to the intima, almost occludes the lumen


15/33


16/33


17/33

Hemorrhoids with

thrombophlebitis Hx: Firm violaceous markedly tender,

polypoid mass in the anus, 6 oclock

position 2 years PTC

Operation: Hemorrhoidectomy


18/33

Hemorrhoids with

thrombophlebitis Microscopic: Skin and underlying sc

tissue

(+) central area of epidermalulceration (+) Large dilated veins

(+) Necrotic walls, w/ neutrophilic

infiltrates Around vessels with old thrombi arefilled with leukocyte infiltrates, mononuclear cells


19/33


20/33

Pulmonary infarction Hx: Post op complications

Developed sudden chest pain,

aggravated by deep inspiration Developed severe dyspnea and

orthopnea

RIP


21/33

Pulmonary infarction Autopsy: Lungs

Heavier than normal

Dark, red subcrepitant, edematous Wedge shaped on sectioning

Saddling, slightly adherent, friable,

greyish-red thrombus seen in pulmonaryartery


22/33

Pulmonary infarction Microscopic:

Acidophilia, compared to normal tissue

(+) Coagulation necrosis of the alveolarseptae, capillary and venous congestion,hemorrhage and edema into the alveolarspaces


23/33

Pulmonary infarct, wedgecut shaped on sectioning


24/33

Feeling ko lang


25/33

Hemorrhagic infarct of

the intestines Hx: Severe abdominal pain, 2 days

PTC

At first: Colicky, becoming peri-umbilical in location

Became more severe and generalized

(+) Episodes of vomiting


26/33


the intestines Admission

BP 90/60 mmHg, RR 30cpm, PR 115 bpm,

T 39C Abdomen distended and rigid, withtenderness and muscle guarding

Sparse bowel sounds

Explore lap was planned, but RIP


27/33


the intestines Autopsy:

Small intestinal loops markedly

distended and purplish red (+) Twisting of the loops at the

mesenteric attachment (volvulus)

Affected bowel loops filled withabundant bloody materials


28/33


the intestines Microscopic

(+) Eosinophilic tissue due to congestion

and extensive hemorrhage within themucosa and submucosa (+) Coagulation necrosis of muscular

layer

Intestinal villi shadowy outlines (--) intact mucosal glands


29/33

Shadowy outlines ofintestinal villi


30/33

Shadowy outlines ofintestinal villi


31/33

For side notes just refer to yourgeneral pathology lab sheets

Thanks


32/33

Matthew 6:33 Seek ye first the Kingdom of GOD, and

his righteousness, and all these thingsshall be added unto you.


33/33

THE ENDTHE ENDTHE ENDTHE END

God bless everyoneGod bless everyone

3 Circulatory Disturbances

Documents

Transcript of 3 Circulatory Disturbances