FSM template

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When we put love and enthusiasm into what we do,
it rebounds in the form of opportunities and
blessings, two of the most important ingredients
of a truly wealthy life
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Disorders of Circulation
A Commitment to Excellence
Dr. Venkatesh M. Shashidhar Associate Professor
of Pathology Fiji School of Medicine
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Circulatory disorders

• BV - Narrowing, rupture, aneurism.
• Thrombosis
• Embolism
• Venous congestion
• Edema
• Shock

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Thrombosis

• Intravascular coagulation
• Vessel damage - atheroma, toxins
• Blood changes - stasis, coagulation factors
• Types White, Red Mixed.
• Sites
• Arterial Brain, Heart, limbs, eys.
• Venous Leg
• Capillary DIC in septicemia

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Embolism

• Abnormal solid mass carried in blood.
• Source destination
• Types.
• Thromboembolism - atherosclerosis
• Fat - Fractures
• Tumor - cancers
• Gas Caisson disease
• Liquid Amniotic fluid in new born.
• Rapid onset of infarction vs. Thrombosis

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Sequels of Block

• Collateral circulation
• Ischemia,
• Infarction, Gangrene
• Haemorrhage

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Development of Coronary Atherosclerosis
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Common Sites of B.V block
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Coronary Atherosclerosis
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Coronary Atheorsclerosis
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Coronary Thrombosis With Infarction
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Atherosclerosis AortaRuptured aneurismNephroscle
rosisAG41
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Aorta Dissecting Aneurisms AG-9
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Coronary Narrowing in Atherosclerosis
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Atheroma Coronary Artery
Calcification
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Atheroma with Thrombosis
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Angiogram - Embolism Infarction
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Thrombo-embolism
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Renal Infarction
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Renal Infarction
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Subarachnoid Haemorrhage
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To keep yourself honest, Imagine a camcorder
recording all your decisions actions!
Lawrence MacGregor Serven
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Edema Shock.!
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Normal Microcirculation
Capillary Arterial
Venous Hydrostatic Pressure 36 16 Oncotic
Pressure - 26 - 26 Net filtration Pressure
10 mmHg - 9 mm Hg (leak-out) (Reabsorb)
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Edema

• Increased interstitial fluid volume
• Two major types
• Local - inflammation
• Generalised - anasarca - Systemic causes.

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Edema mechanism

• Leaky vessels inflammation.
• Increased capillary hydrostatic pressure
• Venous obstructions
• Cardiac failure
• Decreased Osmotic pressure
• Hypoproteinemia liver disease, anemia.
• Lymphatic obstruction
• Elephantiasis

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Shock

• Depressed vital functions due to decreased
  circulating blood volume
• Types
• Hypovolaemic - true/vasovagal
• Cardiogenic Heart failure, MI.
• Obstructive Pulm embolism.
• Anaphylactic vasodilation due to allergy.
• Septic capillary damage by infection.

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Shock Featurs

• Hypotension
• Tachycardia
• Cold clammy skin
• Rapid shallow respiration.
• Drowsiness, confusion, irritability
• Multi organ failure.

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Shock Mechanisms

• Compensatory mechanisms
• Adrenaline ? cold, clammy skin
• Complications Ischemic damage.

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Shock Management

• Position, clothing vital organs.!
• Airway
• Stimulants ammonia inhalation.
• Fluids, electrolytes, Blood pressure
• Treat the cause.

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It is never too late to become what you want to
be George Eliot